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癌症研究2020:肿瘤EHS的非转移性前列腺癌适形放疗毒性评估- taleb Lotfi- Oran大学1

摘要

简介:前列腺癌是工业化国家男性中最常见的癌症，其发病率稳步上升。近几十年来，由于其发生频率和严重性，它已成为一个真正的公共卫生问题。今天，构象放射治疗是治疗非转移性前列腺癌的标准技术，因为它在耐受性和疾病控制方面提供了好处。前列腺恶性生长是最著名的疾病，也是男性疾病死亡的第二大基本原因。放射治疗(RT)被广泛应用于前列腺恶性生长的治疗。部分加速术因其对改善肿瘤控制效果的有利地位而被广泛应用于前列腺恶性生长的放射治疗中。由于很大一部分被确定为非转移性前列腺恶性生长的患者可以持续10年以上，因此在限制RT相关危害的情况下决定RT方法对于改善生活性质具有重要意义。无论如何，较高的剂量与扩大的普通组织毒性有关，例如晚期胃肠道(GI)毒性和晚期泌尿生殖系统(GU)毒性。随着创新的推进，新的RT策略已经发展并已在临床实践中得到应用。三维适形放射治疗(3DCRT)传递符合肿瘤目标体积的放射部分。 Along these lines 3DCRT fundamentally builds the objective portion while reducing the presentation of solid tissue. RT strategies developed to a propelled type of 3DCRT, force regulated radiation treatment (IMRT), which creates non-uniform fields to expand the radiation portion conveyed to the proposed target volume while possibly limiting the light to the organs in danger. All things considered, the likelihood of a peripheral miss is a possible shortcoming of IMRT. Plus, the dose homogeneity, increment of light portions to bigger volumes of solid tissues and longer time required for arranging should be considered in the use of IMRT. The expanded absolute body introduction and screen units raise the danger of second malignancies of IMRT in examination with customary RT. The objective of our work was to evaluate the acute toxicity and the digestive and urinary sequel and secondary to conformal radiotherapy in patients with non-metastatic prostate cancer treated with EHS in oncology. Materials and methods: This is a prospective prognostic study of a cohort of 90 patients with non-metastatic prostate cancer treated with conformal radiotherapy from June 2010 to December 2014. The acute and late toxicities of radiotherapy were graded according to RTOG criteria (Radiation Therapeutic Oncology Group). Results: The average age of our patients is 66.3 ± 0.6 years (52-78 years). Locally advanced and / or localized high-risk stages (according to the AMICO classification) are found in 80% of cases. Irradiation was associated with hormone therapy in 94.4%. The target volume included the prostate or prostatic lodge alone in 30.1% of cases and the pelvis in 69.9%. The dose ranged from 64Gy to 74Gy. In terms of dosimetry, the dose constraints to organs at risk in this case the bladder, rectum and small intestine were respected. The majority of our patients tolerated radiation therapy well. There were only two cases of acute grade 3 urinary toxicity and 11 patients (12.2%) had grade 2 toxicity. On the gastrointestinal level, seven patients had acute grade 2 toxicity and no grade 3 complication was recorded. Regarding late-onset radiation complications, 16 patients (17.8%) presented with late grade 1 urinary toxicity and seven cases (7.8%) with grade 2. However, seven patients (7.8%) had late digestive toxicity grade 1, two (2.2%) grade 2 cases and one grade 3 patient. Conclusion: Conformational radiotherapy in prostate cancer makes it possible to respect the dose constraints to organs at risk (bladder, rectum and small intestine) and to reduce the occurrence of complications, which significantly improves patients' quality of life.

塔勒布Lotfi

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