- 作者：Jeff M. Michalski ; Kyounghwa Bae ; Mack Roach ; Arnold M. Markoe ; Howard M. S ; ler ; Janice Ryu ; Matthew B. Parliament ; William Straube ; Richard K. Valicenti ; James D. Cox
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2010
- 出版时间：January 2010
- 年：2010
- 卷：76
- 期：1
- 页码：14-22
- 全文大小：239 K
Purpose
To update the incidence of late toxicity of RTOG 9406, a three-dimensional conformal radiation therapy (3DCRT) dose escalation trial for prostate cancer.Methods and Materials
A total of 1,084 men were registered to this Phase I/II trial of 3DCRT (eligible patients, 1,055). The dose for level I was 68.4 Gy; 73.8 Gy for level II; 79.2 Gy for level III; 74 Gy for level IV; and 78 Gy for level V. Patients in levels I to III received 1.8 Gy/fraction, and those in levels IV to V received 2.0 Gy/fraction. Disease group I patients were treated at the prostate only, group 2 patients were treated at the prostate and at the seminal vesicles with a prostate boost, and group 3 patients were treated at the prostate and seminal vesicles. The median follow-up period for surviving patients was 6.1 y (level V) to 12.1 y (level I).
Results
The incidence rates of RTOG grade 3 or less gastrointestinal or genitourinary toxicity were 3 % , 4 % , 6 % , 7 % , and 9 % in group 1 and 6 % , 2 % , 6 % , 9 % , and 12 % in group 2 at dose levels of I, II, III, IV, and V, respectively. In group 1, level V patients had a higher probability of grade2 late or greater gastrointestinal or genitourinary toxicity than those in levels I, II, and III (hazard ratio [HR] = 1.93, p = 0.0101; HR = 2.29, p = 0.0007; HR = 2.52, p = 0.0002, respectively). In group 2, dose level V patients had a higher probability of grade 2 or greater late gastrointestinal or genitourinary toxicity than those in dose levels II, III, and IV (HR = 2.61, p = 0.0002; HR = 2.22, p = 0.0051; HR = 1.60, p = 0.0276, respectively).
Conclusions
Tolerance to high-dose 3DCRT remains excellent. There is significantly more grade 2 or greater toxicity with a dose of 78 Gy at 2 Gy/fraction than with 68.4 Gy to 79.2 Gy at 1.8 Gy/fraction and with 74 Gy at 2 Gy/fraction.