文章：

在前列腺癌的根治性立体定向放射治疗中，若无水凝胶间隔物，五分割45 Gy的剂量方案很可能无法耐受。

In Curative Stereotactic Body Radiation Therapy for Prostate Cancer, There Is a High Possibility That 45 Gy in Five Fractions Will Not Be Tolerated without a Hydrogel Spacer

原文发布日期：11 April 2024

DOI: 10.3390/cancers16081472

类型: Article

开放获取: 是

英文摘要：

The purpose of this study was to determine the maximum tolerated dose (MTD) for stereotactic body radiation therapy (SBRT) in the treatment of non-metastatic prostate cancer. This study was a phase 1 dose escalation trial conducted in Japan. Patients with histologically proven prostate cancer without lymph nodes or distant metastases were enrolled. The prescribed doses were 42.5, 45, or 47.5 Gy in five fractions. Dose-limiting toxicity (DLT) was defined as grade (G) 3+ gastrointestinal or genitourinary toxicity within 180 days after SBRT completion, and a 6 plus 6 design was used as the method of dose escalation. A total of 16 patients were enrolled, with 6 in the 42.5 Gy group and 10 in the 45 Gy group. No DLT was observed in the 42.5 Gy group. In the 45 Gy group, one patient experienced G3 rectal hemorrhage, and another had G4 rectal perforation, leading to the determination of 42.5 Gy as the MTD. None of the patients experienced biochemical recurrence or death during the follow-up period. We concluded that SBRT for non-metastatic prostate cancer at 42.5 Gy in five fractions could be safely performed, but a total dose of 45 Gy increased severe toxicity.

摘要翻译： 

本研究旨在确定立体定向体部放疗（SBRT）治疗非转移性前列腺癌的最大耐受剂量（MTD）。该研究是在日本开展的一项Ⅰ期剂量递增试验。入组患者为经组织学证实且无淋巴结或远处转移的前列腺癌患者。处方剂量设定为42.5 Gy、45 Gy或47.5 Gy，分5次照射。剂量限制性毒性（DLT）定义为SBRT结束后180天内发生的3级及以上胃肠道或泌尿生殖系统毒性，并采用6+6设计作为剂量递增方法。共纳入16例患者，其中42.5 Gy组6例，45 Gy组10例。42.5 Gy组未观察到DLT。在45 Gy组中，1例患者出现3级直肠出血，另1例发生4级直肠穿孔，由此确定42.5 Gy为MTD。随访期间所有患者均未出现生化复发或死亡。我们得出结论：以42.5 Gy分5次照射的SBRT方案可安全用于非转移性前列腺癌治疗，但45 Gy的总剂量会显著增加严重毒性风险。

原文链接：

In Curative Stereotactic Body Radiation Therapy for Prostate Cancer, There Is a High Possibility That 45 Gy in Five Fractions Will Not Be Tolerated without a Hydrogel Spacer