剂量与特定的骨盆基结构之间的关联以及前列腺癌单剂量除性放射治疗后的泌尿和性功能障碍:从ABRUPT试验中进行的一次特异性分析
Stefano Arcangeli1,2, Valeria Faccenda1,3, Federica Ferrario2
1School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.
Clinical and translational radiation oncology
|February 24, 2026
概括
向膀三角管的辐射剂量预测前列腺癌放射治疗后的尿路副作用. 节省像膀三角形这样的骨盆基结构可能会改善功能结果并减少毒性.
科学领域:
- 辐射瘤学 辐射瘤学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 前列腺癌治疗方法 前列腺癌治疗方法
背景情况:
- 单剂量除性放射治疗 (SDRT) 是局部性前列腺癌的一个选择.
- 了解对骨盆功能基结构的剂量毒性关系对于最小化副作用至关重要.
研究的目的:
- 为了研究辐射剂量对骨盆功能基结构和局部前列腺癌SDRT后尿路和性副作用的发生率之间的关联.
主要方法:
- 从ABRUPT试验中对30名患者进行了后期分析.
- 盆腔功能基结构的轮,包括膀三角形,神经血管捆绑 (NVB),阴茎球 (PB),内动脉 (IPA) 和肌肉.
- 使用CTCAE和患者报告的结果 (PROs) 的剂量-体积组图,不良事件 (AE) 和使用后勤回归,Wilcoxon-Mann-Whitney和ROC分析的剂量-毒性关联的分析.
主要成果:
- 晚期泌尿功能障碍与膀触角D1cc ≥20.3 Gy (AUC = 0.80) 相相关.
- 膀体积较大 (>166.8 cc) 与尿路PRO恶化有关.
- 勃起功能障碍与NVB D0.035 cc ≥23.6 Gy (AUC = 0.98) 在恢复丸激素的患者中显示出具有暗示性的关联.
结论:
- 膀三角形是前列腺癌中SDRT尿道发病率的潜在预测因素.
- 在治疗规划期间节省骨盆基结构可能会增强功能性保存并减少晚期毒性.
- 需要在更大的试验中进行潜在的验证.
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