演題抄録

口演

開催概要
開催回
第58回・2020年・京都
 

前立腺癌のIMRTにおける骨構造照合と軟部組織照合の画像誘導による直腸出血頻度の比較

演題番号 : O5-1

[筆頭演者]
藤原 聖輝:1 
[共同演者]
金子 暁里:1、桝谷 隆:1、秋野 祐一:1,2、瀬島 亮汰:1、山﨑 泉:1、市來 美英子:1、小川 和彦:1,2

1:吹田徳洲会病院・放射線治療科、2:大阪大学・放射線治療科

 

[Objective] To compare the adverse effect of rectal bleeding in prostate cancer patients treated with intensity modulated radiotherapy (IMRT) using two forms of image guidance: bony structure-image guided radiotherapy (BSB-IGRT) or soft tissue-based image guided radiotherapy (STB-IGRT). [Material and method] This retrospective reviews consisted of 55 patients between the years 2014 and 2018. Median age was 73 (range 61-86) years old. T-stage was T1c : T2a : T2b : T2c : T3a : T3b : T4 = 15 : 20 : 3 : 12 : 4 : 0 : 1. Median pre-treatment PSA was 9.0 (range 4.0-452.0) ng / ml. Median gleason score was 7 (range 6-10). Risk classification (NCCN) was Low : Intermediate : High = 4:32:19. The dose evaluation point was PTV D50, and the median prescription dose was 78 (range 70-78) Gy in 39 (range 28-39) fractions. Adverse effect of rectal bleeding were evaluated based on CTCAE ver.5.0. [Results] BB-IGRT : STB-IGRT = 28 : 27. The median follow-up period for BB-IGRT group was 41 (range 10-63 ) months. And the median follow-up period for STB-IGRT group was 17 (range 10-32) months. Rectal bleeding observed within the follow-up periods was G1 : G2 : G3 = 5 (18%) : 6 (21%) : 1 (4%) by BSB-IGRT, G1 : G2 : G3 = 3 (11%) : 0 (0%) : 0 (0%) by STB-IGRT. The median period from the end of radiation therapy to the onset of rectal bleeding was 10 (range 2-17) months. The 2-year likelihood of rectum bleeding for the BSB-IGRT and STB-IGRT cohorts were 45% and 11%, respectively (p=0.02). [Conclusion] Compared with BSB-IGRT, STB-IGRT had significantly a lower incidence of rectal bleeding. STB-IGRT significantly contributed to the reduction of adverse events of rectal bleeding. In the future, we would like to extend the follow-up period and examine it again.

キーワード

臓器別:前立腺・男性生殖器

手法別:放射線治療

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