子宫癌质子束治疗与调强放疗的疗效比较。

Justin D Anderson, Molly M Voss, Brady S Laughlin, Allison E Garda, Khaled Aziz, Trey C Mullikin, Michael G Haddock, Ivy A Petersen, Todd A DeWees, Sujay A Vora
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引用次数: 0

摘要

目的:比较接受质子束辅助盆腔放射治疗(PT)和调强放射治疗(IMRT)的子宫内膜癌患者不良事件通用术语标准(PRO-CTCAE)的患者报告结局版本。材料与方法:选取2014 - 2020年间接受辅助PT或IMRT治疗的有治愈意图的子宫癌患者。使用PRO-CTCAE的妇科特异性子集将患者纳入前瞻性登记,以评估症状对日常生活的影响。问题包括腹泻、肠胃胀气、肠失禁和便秘等胃肠道症状,以及其他相关的妇科、泌尿和其他一般症状。基于症状的问题分为0到4分,3+级症状经常或几乎总是出现。在基线、治疗结束(EOT)以及治疗后3、6、9和12个月对患者报告的毒性进行分析。采用不等方差t检验来确定治疗类型是否是基线调整后PRO-CTCAE的重要因素。结果:67例患者符合纳入标准。22例接受PT治疗,45例接受IMRT治疗。73%的患者接受了近距离治疗。PT和IMRT的中位外束剂量均为45 Gy(范围45-58.8 Gy)。当比较PRO-CTCAE时,与IMRT相比,PT在EOT (P = 0.01)和12个月时(P = 0.24)腹泻较少。在接受IMRT的患者中,12个月时肠道失控更为常见(P = 0.15)。任何报告3+级胃肠道毒性的患者在IMRT中更常见(31%对9%,P = 0.09)。讨论:辅助PT是子宫癌患者的一种很有希望的治疗方法,与IMRT相比,可以减少患者报告的胃肠道毒性。
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Outcomes of Proton Beam Therapy Compared With Intensity-Modulated Radiation Therapy for Uterine Cancer.

Purpose: To compare Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in patients with endometrial cancer receiving adjuvant pelvic radiation therapy with proton beam therapy (PT) versus intensity-modulated radiation therapy (IMRT).

Materials and methods: Patients with uterine cancer treated with curative intent who received either adjuvant PT or IMRT between 2014 and 2020 were identified. Patients were enrolled into a prospective registry using a gynecologic-specific subset of PRO-CTCAE designed to assess symptom impact on daily living. Questions included gastrointestinal (GI) symptoms of diarrhea, flatulence, bowel incontinence, and constipation in addition to other pertinent gynecologic, urinary, and other general symptoms. Symptom-based questions were on a 0- to 4-point scale, with grade 3+ symptoms occurring frequently or almost always. Patient-reported toxicity was analyzed at baseline, end of treatment (EOT), and at 3, 6, 9, and 12 months after treatment. Unequal variance t tests were used to determine if treatment type was a significant factor in baseline-adjusted PRO-CTCAE.

Results: Sixty-seven patients met inclusion criteria. Twenty-two received PT and 45 patients received IMRT. Brachytherapy boost was delivered in 73% of patients. Median external beam dose was 45 Gy for both PT and IMRT (range, 45-58.8 Gy). When comparing PRO-CTCAE, PT was associated with less diarrhea at EOT (P = .01) and at 12 months (P = .24) than IMRT. Loss of bowel control at 12 months was more common in patients receiving IMRT (P = .15). Any patient reporting grade 3+ GI toxicity was noted more frequently with IMRT (31% versus 9%, P = .09).

Discussion: Adjuvant PT is a promising treatment for patients with uterine cancer and may reduce patient-reported GI toxicity as compared with IMRT.

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来源期刊
International Journal of Particle Therapy
International Journal of Particle Therapy Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
3.70
自引率
5.90%
发文量
23
审稿时长
20 weeks
期刊最新文献
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