膀瘤集中适应性辐射疗法:I期剂量升级研究的临床结果
Shaista Hafeez1, Karole Warren-Oseni1, Kelly Jones1
1The Institute of Cancer Research, London, United Kingdom; The Royal Marsden NHS Foundation Trust, London, United Kingdom.
概括
图像导向的适应性辐射疗法允许在肌肉侵入性膀癌中最大耐受的瘤集中剂量为70 Gy. 这种方法证明了可行的激进治疗,具有可接受的毒性和有希望的长期结果.
科学领域:
- 辐射瘤学 辐射瘤学
- 泌尿器细胞癌的癌症.
- 临床试验设计 临床试验设计
背景情况:
- 肌肉侵入性膀癌 (MIBC) 需要有效的激进治疗策略.
- 图像引导适应性辐射疗法 (IGART) 提供精确的瘤向.
- 确定最佳辐射剂量对于最大限度地提高MIBC的疗效和最大限度地降低毒性至关重要.
研究的目的:
- 为了确定使用IGART的MIBC激进治疗的最大耐受瘤集中剂量 (MTD).
- 评估与这种剂量升级策略相关的长期临床结果.
主要方法:
- 一项前性研究招募了59名T2-T4aN0M0MIBC.患者.
- 患者接受了激进的放射治疗,剂量升级到膀瘤 (PTV_瘤) 高达74 Gy,无干涉的膀 (PTV_膀) 在52 Gy.
- 使用CTCAE v3.0和RTOG标准评估毒性,MTD通过特定的急性和晚期毒性值来定义.
主要成果:
- 最终使用日被确定为70 Gy.
- 发生19%的急性G3尿生殖毒性和7%的胃肠毒性;没有观察到急性G4毒性.
- 五年总生存率为58%,膀保存率为89%.
结论:
- 使用IGART的膀瘤剂量升级到70 Gy在MIBC中是可行的.
- 这种方法显示了可接受的毒性概况,并保证在随机试验中进一步调查.
- 这些发现支持IGART在强化膀癌放射治疗中的潜力.
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