Aim. Study of the frequency of radiation therapy complications in patients with prostate cancer. Methods. The study included 142 patients who underwent radiation therapy combined with hormonal therapy in 2001-2015. Average age of patients was 68 years. All of them received 3D-conformal radiotherapy by linear accelerators with 6 to 15 MV photon beams. Single boost dose was 2 Gy, total boost dose was 75 Gy. We studied frequency and severity of acute hematological toxicity and early and late gastroenterological and urological complications of the treatment. Treatment-related toxicity was assessed by RTOG/ EORTC and CTCAE v. 4.0 scales. Results. Early radiation-induced proctitis of I, II and III degree were registered in 95 (66.9%), 32 (22.5%) and 8 (5.6%) patients, respectively. Acute cystitis of I, II and III degree were noted in 22 (15.5%), 87 (61.3%) and 16 (11.3%) patients, respectively. Signs of late radiation-induced proctitis of I degree was diagnosed in 21 (14.8%) cases. Late radiation-induced cystitis of I degree was diagnoswed in 37 (26.1%) patients. No late complications of higher severity occurred. Conclusion. The results of the conducted study showed that use of high-tech precision external-beam radiotherapy techniques in the treatment of prostate cancer along with high efficacy allows to reduce the number of early and late complications.
Aim. To study the role of postoperative parameters in predicting the probability of development of biochemical recurrence in patients with prostate cancer with low pre-operative risk of its progression. Methods. 95 patients who underwent radical prostatectomy, were included in the study, the average age being 59.5±0.7 (44-76) years. The average levels of total and free prostate-specific antigen were 5.8±0.2 (1.71-9.9) and 1.03±0.07 (0.2-3.6) ng/ml respectively. Biochemical recurrence was defined as the level of prostate-specific antigen higher than 0.2 ng/ml after radical prostatectomy. Results. 8 (8.4%) patients during the follow-up period were diagnosed with biochemical recurrence. The average period to biochemical recurrence development was 45.8±6.7 (24-84) months. Pathomorphological examination revealed presence of tumor cells at surgical margin in 18 (18.9%) cases. Biochemical recurrence was diagnosed in 5 out of 77 (6.5%) patients with negative surgical margins and in 3 out of 18 (1.7%) patients with positive surgical margins. In our study, no correlation between the state of surgical margin and biochemical recurrence development was revealed (χ2=1.958; р=0.162). In the study group postoperative Gleason score was not prognostically significant as well (р=0.294). The average tumor volume in resected material was 11.8±1.0% (1-55%) of prostate volume (мм3). Extraprostatic extension was diagnosed in 10 (10.5%) cases. Results of univariate dispersion analysis of postoperative parameters revealed prognostic significance of tumor volume in removed specimen (р=0.007) and extracapsular extension (р=0.027). Conclusion. In our study we determined that tumor volume and extracapsular extention are independent risk factors for biochemical recurrence in prostate cancer patients with low pre-operative risk of disease progression.
Обобщен о пыт оценки качества жизни (КЖ) пациентов, которым по поводу рака предстательной железы выполнена радикальная простатэктомия (РПЭ). Применяли опросники EORTCQLQ–C30 и EORTC QLQ–PR25. Независимыми факторами, обусловливающими ухудшение КЖ пациентов после РПЭ, признаны стадия опухоли, прогрессирование заболевания, нарушение функции удержания мочи, эректильная дисфункция, наличие биохимического рецидива. Раннее выявление факторов риска способствует улучшению КЖ пациентов после выполнения РПЭ.
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