- 作者：Nancy P. Mendenhall ; Bradford S. Hoppe ; Romaine C. Nichols ; William M. Mendenhall ; Christopher G. Morris ; Zuofeng Li ; Zhong Su ; Christopher R. Williams ; Joseph Costa ; R ; al H. Henderson
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：1 March, 2014
- 年：2014
- 卷：88
- 期：3
- 页码：596-602
- 全文大小：352 K
Purpose
To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer.Methods and Materials
A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2聽years.
Results
Five-year rates of biochemical and clinical freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4聽years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4聽years for bowel, urinary irritative and/or obstructive, and urinary continence.
Conclusions
Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes.