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Objective:To investigate the efficacy and adverse reactions of moderately hypofractionated intensity modulated radiation therapy (IMRT) combined with androgen deprivation therapy (ADT) for locally advanced prostate cancer (LAPC).Methods:This study retrospectively analyzed the medical records of 40 LAPC patients who were admitted in The Second Hospital of Dalian Medical University during 2014-2020. The planning gross target volume (PGTV) dose for prostate gland and seminal vesicle gland was 64.8-70.0 Gy/25-28 f, 2.4-2.8 Gy/f and the dose of PGTVnd in 20 cases with positive pelvic lymph nodes was 60.0-64.4 Gy/25-28 f, 2.3-2.4 Gy/f. The dose of planning target volume (PTV) for the drainage area of pelvic lymph nodes was 45.0-50.4 Gy/25-28 f. The enrolled patients were treated with long-term ADT, including neoadjuvant, simultaneous, and adjuvant therapies. The efficacy and adverse reactions were evaluated. The prognostic factors affecting the biochemical failure-free survival (BFFS) were analyzed.Results:The median follow-up time was 31 months. The 2- and 3-year overall survival (OS) rates were 100% and 96.9%, respectively. The 1-, 2-, and 3-year BFFS rates were 90%, 76.8% and 72%, respectively. The 1-, 2-, and 3-year distant metastasis-free survival (DMFS) rates were 92.2%, 82.8% and 75.1%, respectively. Gleason (GS) score ( χ2=10.00, P < 0.05) and adjacent tissue invasion ( χ2=8.85, P<0.05) were prognostic factors related to BFFS for LAPC. Adjacent tissue invasion and GS 9-10 were independent poor prognostic factors. The incidence of acute urinary adverse reaction and rectal injury (grade≥2) was 7.5% and 20%, respectively. The incidence of late urinary adverse reaction and rectal injury (grade≥2) was 12.5% and 17.5%, respectively. Adverse reactions at grade 3-4 did not occur. Conclusions:The moderately hypofractionated IMRT combined with ADT is feasible for LAPC treatment, achieving satisfactory survival effects. 70 Gy/25-28 f, 2.5-2.8 Gy/f is a safe and effective moderate hypofraction scheme. Adjacent tissue invasion and GS score are prognostic factors related to BFFS for LAPC.
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Objective:To study the radiotherapy sensitization of recombinant human endostatin in patients with cervical cancer.Methods:Sixty patients with advanced cervical cancer (stage ⅡB to ⅣA) from July 2017 to November 2018 in the Second Affiliated Hospital of Dalian Medical University were selected. The patients were divided into experimental group and control group according to random number table with 30 cases each. The patients in experimental group were treated with recombinant human endostatin combined with concurrent chemoradiotherapy, while the patients in control group only received chemoradiotherapy. The serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were measured 1 week before treatment and 1 week after treatment, and short-term efficacy was evaluated 3 months after treatment.Results:The objective remission rate (ORR) and disease control rate (DCR) in experimental group were higher than those in control group: 93% (28/30) vs. 87% (26/30) and 97% (29/30) vs. 93% (28/30), but there were no statistical differences between 2 groups ( P>0.05). There was no statistically significant difference in the occurrence of adverse reactions between 2 groups ( P>0.05). Compared with that before treatment, the serum VEGF and bFGF after treatment were significantly lower, experimental group: (88.07 ± 37.53) ng/L vs. (227.27 ± 142.61) ng/L and (21.03 ± 5.75) ng/L vs. (38.34 ± 18.17) ng/L, control: (120.04 ± 81.22) ng/L vs. (197.34 ± 142.41) ng/L and (24.04 ± 7.29) ng/L vs. (39.78 ± 13.35) ng/L, and there were statistical differences ( P<0.01); after treatment, the serum VEGF and bFGF in experimental group were lower than those in control group, but there were no statistical difference between 2 groups ( P>0.05). Conclusions:For patients with advanced cervical cancer, recombinant human endostatin combined with concurrent chemoradiotherapy can further decrease the serum levels of VEGF and bFGF, improve the sensitivity of chemoradiotherapy, and enhance the short-term efficacy.