- 期刊
Evaluation of Prostate Cancer Treated with Temporary High Dose Rate Interstitial Brachytherapy and Followed by EBRT
攝護腺癌接受暫時性高劑量率插種治療與外部放射治療療效之評估
摘要
目的：評估局部攝護腺癌在接受高劑量率組織插種近接治療與外部放射治療後之治療效果。 材料與方法：自2004年2月至2009年2月，有28位攝護腺癌病患其癌症期別為T1~3、N0、M0接受高劑量率組織插種近接治療與外部放射治療。病患於兩天內接受三次高劑量率組織插種治療，中位放射線劑量為18 Gy(15~21 Gy)。病患於接受高劑量率組織插種治療後2至4周開始接受外部放射治療與其劑量範圍從50 Gy至70.4 Gy。 結果：有三位病患於追蹤期間失聯，所以不列入本篇分析。病患之年齡分佈從48歲到82歲，其中位數為73歲。治療前攝護腺特異抗原指數(PSA)中位數為16.3 ng/ml，(6.2~85.3 ng/ml)；格里森分數(Gleason Score)之中位數為6與其分佈從2到9。20位病患(80%)在接受放射治療前有先接受抗雄激素荷爾蒙治療。病患之追蹤時間中位數為30個月（12~66個月）。依據Phoenix definition of biochemical failure，1年與5年的生化控制率分別為96%與84%。5年存活率為100%。有七位病患(28%)產生第二級放射線相關之急性副作用。兩位病患(8%)產生第二級慢性副作用。並沒有觀察到第三與第四級副作用的產生。 結論：局部攝護腺癌病患接受高劑量率組織插種治療與外部放射治療後其疾病控制是很明顯的，其產生的副作用也是在可接受的範圍內。儘管如此，為了得到更有意義的長期疾病控制率，存活率，與副作用之評估；更長期的追蹤與更多的病患數是必須的。
並列摘要
Purpose: To evaluate the treatment outcome of patients with localized prostate cancer treated with HDR interstitial brachytherapy followed by EBRT. Materials and Methods: From February 2004 to February 2009, 28 prostate cancer patients with cancer staging of T1~3, N0, M0 were treated with HDR interstitial brachytherapy followed by 3-D EBRT. Patient received 3 consecutive HDR-brachytherapy in 2 days with the brachytherapy median dose of 18 Gy (15~21 Gy). EBRT was given 2~4 weeks after the HDR interstitial brachytherapy with dose ranged from 50 Gy to 70.4 Gy. Results: Three patients were lost during the follow-up period and therefore were excluded from the analysis. The median age was 73 years old, with a range of 48~82 years old. The median pretreatment PSA value was 16.3 ng/ml, with a range of 6.2~85.3 ng/ml; and the median Gleason Score was 6, with a range of 2~9. Twenty patients (80%) received anti-androgenic hormone therapy prior to radiotherapy. The median follow-up period was 30 months (range 12~66 months). The 1 year and 5 years biochemical control rate was 96% and 84% respectively according to Phoenix definition of biochemical failure. The 5 years overall survival rate was 100%. Seven (28%) patients developed grade Ⅱ acute radiation associated side effects. Two (8%) patients had late grade Ⅱ toxicity. No Gr Ⅲ or Gr Ⅳ side effects were observed. Conclusion: Localized prostate cancer treated with HDR interstitial brachytherapy and EBRT has shown excellent result in disease control with well-acceptable complication rate. However, longer follow-up period and more patients are required for more meaningful long term disease control, survival, and side effect evaluation.
延伸閱讀
- Lan, K. H., Chen, Y. H., Wu, J. K., Hsu, F. M., Wang, C. W., & Cheng, C. H. (2010). 強度調控放射線治療於攝護腺癌之預後因子及治療結果. 放射治療與腫瘤學, 17(1), 9-18. https://doi.org/10.6316/TRO/201017(1)9
- Kuo, C. C., Yu, H. W., Huang, K. W., Chen, C. P., Chung, T. S., Chiou, J. F., & Tsai, J. T. (2008). 以劑量包覆順型度數學模型和腫瘤控制機率模式評估攝護腺癌在放射手術電腦刀治療計畫系統. 放射治療與腫瘤學, 15(4), 301-310. https://doi.org/10.6316/TRO/200815(4)301
- Liou, C. H., Liu, M. T., Chang, T. H., Pi, C. P., Wang, A. Y., Liu, W. S., Huang, C. Y., Wang, A. Y., Liu, W. S., & Huang2, C. Y. (2006). 攝護腺癌接受單獨放射線治療或合併荷爾蒙治療. 放射治療與腫瘤學, 13(3), 175-183. https://doi.org/10.6316/TRO/200613(3)175
- 張國楨、張慶雄、胡渝昌、陳建勳（2005）。早期攝護腺癌之手術治療與放射治療及其預後因子。放射治療與腫瘤學，12(1)，1-7。https://doi.org/10.6316/TRO/200512(1)1
- Chen, S. Y. H., Cheng, J. C. H., Tsai, S. Y., Cheng, S. H. G., Chang, D. S., Yang, A. L. Y., & Jian, J. J. M. (2003). 攝護腺癌病人接受全程放射治療的短期預後及預後因子分析. 放射治療與腫瘤學, 10(1), 1-9. https://doi.org/10.6316/TRO/200310(1)1