臨床泌尿器科75巻3号

2021年03月発行

綜説

局所前立腺癌に対する定位放射線療法

著者： 佐藤信¹

所属機関： ¹東北医科薬科大学医学部泌尿器科学分野

ページ範囲：P.177 - P.182

要旨

　近年，局所前立腺癌に対する定位放射線療法（SBRT）による治療報告が話題になっている．本稿では，SBRTの種類と臨床的効果，有害事象（AE）の発現などに関し，従来の放射線療法との比較において，中等度〜超寡分割照射を中心に最近の文献をレビューし解説する．

参考文献

1） Cooperberg MR, et al : Time Trends and Local Variation in Primary Treatment of Localized Prostate Cancer. J Clin Oncol 28 : 1117-1123, 2010

2） Widmark A, et al : Ultra-Hypofractionated versus Conventionally Fractionated Radiotherapy for Prostate Cancer : 5-Year Outcomes of the HYPO-RT-PC Randomised, Non-Inferiority, Phase 3 Trial. Lancet 394 : 385-395, 2019

3） Brenner DJ, et al : Direct Evidence that Prostate Tumors Show High Sensitivity to Fractionation（Low Alpha/Beta Ratio）, Similar to Late-Responding Normal Tissue. Int J Radiat Oncol Biol Phys 52 : 6-13, 2002

4） Dearnaley DP, et al : Escalated-Dose versus Control-Dose Conformal Radiotherapy for Prostate Cancer : Long-Term Results from the MRC RT01 Randomised Controlled Trial. Lancet Oncol 15 : 464-473, 2014

5） Kalbasi A, et al : Dose-Escalated Irradiation and Overall Survival in Men with Nonmetastatic Prostate Cancer. JAMA Oncol 1 : 897-906, 2015

6） Collins CD, et al : Radical External Beam Radiotherapy for Localised Carcinoma of the Prostate Using a Hypofractionation Technique. Clin Oncol （R Coll Radiol） 3 : 127-132, 1991

7） Livsey JE, et al : Hypofractionated Conformal Radiotherapy in Carcinoma of the Prostate : Five-Year Outcome Analysis. Int J Radiat Oncol Biol Phys 57 : 1254-1259, 2003

8） Miles EF, et al : Hypofractionation for Prostate Cancer : A Critical Review. Semin Radiat Oncol 18 : 41-47, 2008

9） Koontz BF, et al : A Systematic Review of Hypofractionation for Primary Management of Prostate Cancer. Eur Urol 68 : 683-691, 2015

10） Yan M, et al : Stereotactic Body Radiotherapy （SBRT） in Metachronous Oligometastatic Prostate Cancer : A Systematic Review and Meta-Analysis on the Current Prospective Evidence. Br J Radiol 93 : 20200496, 2020

11） Dearnaley D, et al : Conventional versus Hypofractionated High-Dose Intensity-Modulated Radiotherapy for Prostate Cancer : 5-Year Outcomes of the Randomised, Non-Inferiority, Phase 3 CHHiP Trial. Lancet Oncol 17 : 1047-1060, 2016

12） Incrocci L, et al : Hypofractionated versus Conventionally Fractionated Radiotherapy for Patients with Localised Prostate Cancer （HYPRO） : Final Efficacy Results from a Randomised, Multicentre, Open-Label, Phase 3 Trial. Lancet Oncol 17 : 1061-1069, 2016

13） Catton CN, et al : Randomized Trial of a Hypofractionated Radiation Regimen for the Treatment of Localized Prostate Cancer. J Clin Oncol 35 : 1884-1890, 2017

14） Lee WR, et al : Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients with Low-Risk Prostate Cancer. J Clin Oncol 34 : 2325-2332, 2016

15） King CR, et al : Stereotactic Body Radiotherapy for Localized Prostate Cancer : Pooled Analysis from a Multi-Institutional Consortium of Prospective Phase II Trials. Radiother Oncol 109 : 217-221, 2013

16） Mantz C : A Phase II Trial of Stereotactic Ablative Body Radiotherapy for Low-Risk Prostate Cancer Using a Non-Robotic Linear Accelerator and Real-Time Target Tracking : Report of Toxicity, Quality of Life, and Disease Control Outcomes with 5-Year Minimum Follow-Up. Front Oncol 4 : 279, 2014

17） Hannan R, et al : Stereotactic Body Radiation Therapy for Low and Intermediate Risk Prostate Cancer-Results from a Multi-Institutional Clinical Trial. Eur J Cancer 59 : 142-151, 2016

18） Musunuru HB, et al : Dose-Escalation of Five-Fraction SABR in Prostate Cancer : Toxicity Comparison of Two Prospective Trials. Radiother Oncol 118 : 112-117, 2016

19） Zimmermann M, et al : Prospective Phase II Trial of Once-weekly Hypofractionated Radiation Therapy for Low-Risk Adenocarcinoma of the Prostate : Late Toxicities and Outcomes. Clin Oncol （R Coll Radiol） 28 : 386-392, 2016

20） Meier RM, et al : Multicenter Trial of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer : Survival and Toxicity Endpoints. Int J Radiat Oncol Biol Phys 102 : 296-303, 2018

21） Brand DH, et al : Intensity-Modulated Fractionated Radiotherapy versus Stereotactic Body Radiotherapy for Prostate Cancer （PACE-B） : Acute Toxicity Findings from an International, Randomised, Open-Label, Phase 3, Non-Inferiority Trial. Lancet Oncol 20 : 1531-1543, 2019

22） Hamstra DA, et al : Continued Benefit to Rectal Separation for Prostate Radiation Therapy : Final Results of a Phase III Trial. Int J Radiat Oncol Biol Phys 97 : 976-985, 2017

23） Ashrafizadeh M, et al : Abscopal Effect in Radioimmunotherapy. Int Immunopharmacol 85 : 106663, 2020

24） Ugurluer G, et al : Magnetic Resonance Image-Guided Adaptive Stereotactic Body Radiotherapy for Prostate Cancer : Preliminary Results of Outcome and Toxicity. Br J Radiol 94 : 20200696, 2021