Journals / Marmara Medical Journal / 2004 / Volume: 17 Issue: 2

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KONVANSİYONEL EKSTERNAL RADYOTERAPİ VE KONFORMAL RADYOTERAPİ TEKNİKLERİNİN HORMONOTERAPİ DURUMUNA GÖRE AKUT YAN ETKİLER AÇISINDAN KARŞILAŞTIRILMASI

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Publication Date
2015-06-29
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Abstract

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Özet

Amaç : Prostat kanserinin primer tedavisinde konvansiyonel eksternal radyoterapi (EBRT) ile konformal radyoterapi teknik (CRT)uygulamaların hormonoterapi (HT) durumuna göre akut yan etkiler açısından karşılaştırılması amaçlanmıştır. Gereç ve Yöntem : Mart 1997- Temmuz 2002 tarihleri arasında lokalize prostat kanseri tanısı konmuş ve primer radyoterapi uygulanmış 75 hastanın EBRT uygulanan 47 ve CRT uygulanan 28 hasta idi. Tüm hastalar için medyan yaş 72 (55-85), medyan radyoterapi dozu 70 Gray (Gy) (63-76 Gy) olarak tespit edilmiştir. Hastaların 23’u (%31) hormonoterapi almamış , 22’si (%29) eş zamanlı hormonoterapi almış ve 30’u (%40) neoadjuvan hormonoterapi almıştı. Hastaların en az 3 aylık takibi mevcut olup, görülen akut yan etkiler EORTC/RTOG (European Organisation for Research and Treatment of Cancer / Radiation Therapy Oncology Group) skalası kullanılarak değerlendirilmiştir 1 . Bulgular: Grade I ve II akut üriner yan etkiler; konvansiyonel radyoterapi grubunda %30 ve %23 iken, konformal radyoterapi grubunda %61 ve %18 oranında gözlenmiştir (p=0.025). Grade II üriner yan etkiler; HT almayanda ve neoadjuvan hormonoterapi alanlarda %13 eş zamanlı hormonoterapi alan hastalarda %41 oranında saptanmıştır (p=0.02). Grade II rektal yan etkiler; konvansiyonel radyoterapi grubunda %30, konformal radyoterapi grubunda %7 oranında tespit edilmiştir (p=0.022). Sonuç : Konformal radyoterapi uygulaması ile grade II akut rektal ve üriner yan etkilerin azaldığı tespit edilmiştir. Eşzamanlı hormonoterapi kullanımı ile grade II akut üriner yan etki neoadjuvan kullanıma göre daha sık gözlenmiştir. Anahtar Kelimeler: Akut yan etkiler, Konvansiyonel, Konformal radyoterapi, Prostat kanseri

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Cite This Article

Çetin, İ., Abacıoğlu, U., Şengöz, M. (2015). -. Marmara Medical Journal, Volume: 17 Issue: 2. https://ajindex.com/articles/1287197

References (119)

  1. Cox JD, Stetz J, Pajak TF. Toxicity Criteria of the
  2. Radiation Therapy Oncology Group (RTOG) and
  3. the European Organization for Research and
  4. Treatment of Cancer (EORTC). Int J Radiat Oncol
  5. Biol Phys 1995; 31:1341-1346.
  6. Zelefsky MJ, Leibel SA, Fuks Z. Conventional
  7. external beam radiation therapy for prostate cancer:
  8. Where do we go from here? Int J Radiat Oncol Biol
  9. Phys 1993; 26:365-367.
  10. Gallagher MJ, Brereton HD, Rostock RA, et al. A
  11. prospective study of treatment techniques to
  12. minimize the volume of pelvic small bowel with
  13. reduction of acute and late effects associated with
  14. pelvic irradiation. Int J Radiat Oncol Biol Phys; 12:1565-1573.
  15. Leibel SA, Zelefsky MJ, Kutcher GJ, et al. The
  16. biological basis and clinical application of threedimensional
  17. conformal external beam radiation
  18. therapy in carcinoma of the prostate. Semin Oncol; 21:580.
  19. Sandler HM, Perez-Tamayo C, Ten Haken RK, et
  20. al. Dose escalation for stage C (T3) prostate cancer:
  21. Minimal rectal toxicity observed using conformal
  22. therapy. Radiother Oncol 1992; 23:53.
  23. Sandler HM, McLaughlin PW, Ten Haken RK,
  24. Addision H, Forman J, Lichter A. Three
  25. dimensional conformal radiotherapy for the
  26. treatment of prostate cancer: low risk of chronic
  27. rectal morbidity observed in a large series of
  28. patients. Int J Radiat Oncol Biol Phys 1995;:797-801.
  29. Dale E, Olsen DR, Foss SD. Normal tissue
  30. complication probabilities correlated with late
  31. effects in the rectum after prostate conformal
  32. radiotherapy. Int J Radiat Oncol Biol Phys 1999;:385-391.
  33. Hanks GE, Schultheiss TE, Hunt MA, Epstein BE.
  34. Factors influencing incidence of grade 2 morbidity
  35. in conformal and standard radiation treatment of
  36. prostate cancer. Int J Radiat Oncol Biol Phys 1995;:25-29.
  37. Soffen EM, Hanks GE, Hunt MA, Epsteın BE.
  38. Conformal static field radiation therapy of early
  39. prostate cancer versus non-conformal techniques: A
  40. reduction in acute morbidity. Int J Radiat Oncol
  41. Biol Phys 1992; 24:485-488.
  42. Koper PC, Stroom JC, Van Putten WL, et al. Acute
  43. morbidity reduction using 3DCRT for prostate
  44. carcinoma: A randomized study. Int J Radiat Oncol
  45. Biol Phys 1999; 43:727-734.
  46. Pollack A, Zagars GK, Smith LG, et al. Preliminary
  47. results of a randomized radiotherapy doseescalation
  48. study comparing 70 Gy with 78 Gy for
  49. prostate cancer. J Clin Oncol 2000; 18:3904-3911.
  50. Storey MR, Pollack A, Zagars G, Smith L, Antolak
  51. J, Rosen I. Complications from radiotherapy dose
  52. escalation in prostate cancer: Preliminary results of
  53. a randomized trial. Int J Radiat Oncol Biol Phys; 48:635-642.
  54. Zelefsky MJ, Leibel SA, Gaudin PB, et al. Dose
  55. escalation with three-dimensional conformal
  56. radiation therapy affects the outcome in prostate
  57. cancer. Int J Radiat Oncol Biol Phys 1998; 41:491-
  58. Fleming I, Cooper J, Henson D, et al. Prostate.In:
  59. AJCC cancer staging manual. Philadelphia, New
  60. York: Lippincott-Raven; 1997:219-224.
  61. Tait DM, Nahum AE, Meyer LC, et al. Acute
  62. toxicity in pelvic radiotherapy; a randomised trial
  63. of conformal versus conventional treatment.
  64. Radiother Oncol 1997; 42:121-36.
  65. Pollack A, Zagars GK, Starkschall G, et al.
  66. Conventional versus conformal radiotherapy for
  67. prostate cancer: prelimary results of dosimetry and
  68. acute toxicity. Int J Radiat Oncol Biol Phys 1996;:555-564.
  69. Vijayakumar S, Awan A, Karrison T, et al. Acute
  70. toxicity during external beam radiotherapy for
  71. localized prostate cancer: comparison of different
  72. techniques. Int J Radiat Oncol Biol Phys 1993;:359-371.
  73. Nuyttens JJ, Milito S, Rust PF, Turrisi AT. Dosevolume
  74. relationship for acute side effects during
  75. high dose conformal radiotherapy for prostate
  76. cancer. Radiother Oncol 2002; 64:209-214.
  77. Odrazka K, Vanasek J, Vaculikova M,, et al.
  78. Conformal radiotherapy for prostate cancer-longer
  79. duration of acute genitourinary toxicity in patients
  80. with prior history of invasive urological procedure.
  81. Acta Oncol 2001; 40:7810-7815.
  82. Herold DM, Hanlon AL, Hanks GE. Diabetes
  83. Mellitus: A predictor for late radiation morbidity.
  84. Int J Radiat Oncol Biol Phys 1999; 43:475-479.
  85. Lim Joon D, Hasegawa M,Wu CS, et al. Supraadditive
  86. apoptotic response in predominantly
  87. quiescent prostate tumors when treated with
  88. androjen-ablation and radiotherapy. Int J Radiat
  89. Oncol Biol Phys 1996; 36:191.
  90. Forman JD, Kumar R, Haas G, Montie J, Porter
  91. AT, Mesina CF. Neoadjuvant hormonal downsizing
  92. of localized carcinoma of prostate: effect on the
  93. volume of normal tissue irradiation. CA Invest; 13:132-133
  94. Marmara Medical Journal 2004;17(2);58-64
  95. İlknur Çetin, et.al.
  96. A comparison of Conventıonal External Radıotherapy Technique and Conformal Radiotherapy Technique in Terms of
  97. Acute Toxıcity With Regard to Hormonal Treatment
  98. Lawton CA, Winter K, Murray K, et al. Updated
  99. results of the phase III radiation therapy oncology
  100. group (RTOG) trial 85-31 evaluating the potential
  101. benefit of androgen suppression following standard
  102. radiation therapy for unfavorable prognosis
  103. carcinoma of the prostate. Int J Radiat Oncol Biol
  104. Phys 2001; 49;937-946.
  105. Pilepich MV, Winter K, John MJ, et al. Phase III
  106. radiation therapy oncology group (RTOG) trial 86-
  107. of androgen deprivation adjuvant to definitive
  108. radiotherapy in locally advanced carcinoma of the
  109. prostate. Int J Radiat Oncol Biol Phys 2001;:1243-1252.
  110. Zurlo A, Collete L, van Tienhoven G, Blank L, et
  111. al, EORTC Radiotherapy and Genito-Urinary Tract
  112. Cancer Group. Acute toxicity of conventional
  113. radiation therapy for high-risk prostate cancer in
  114. EORTC trial 22863. Eur Urol 2002; 42:125-132
  115. Sanguineti G, Franzone P, Marcenaro M, Paoli G,
  116. Orsatti M, Vitale V. Androgen deprivation impacts
  117. late rectal toxicity after conformal radiotherapy.
  118. Abstr 1328, 338a. ASCO Meeting 2000; 20-23.
  119. Fleming I, Cooper J, Henson D, et al. Prostate.In: