在温和低剂量分数放射治疗 (MHRT) 用于前列腺癌 (PC) 牙普通使用强度调制放射治疗 (IMRT)，但在这种情况下，IMRT 与三维适形放射治疗 (3D-CRT) 尚未进行前瞻性比较。我们对 RTOG 0415 三期试验进行了次要分析，比较了 MHRT 与 IMRT 对低危 PC 患者的生存和毒性结果与 3D-CRT 相比。RTOG 0415 是一项非劣效试验，将低危 PC 患者随机分配为 MHRT 或传统分数放射治疗，根据放疗技术进行分层。进行了针对总体生存 (OS)，生化复发自由生存 (BRFS) 或 EPIC 评分和不良事件通用术语标准 (CTCAE) 毒性的二次分析。1079 名患者接受了分配的干预措施，并进行了中位数 5.8 年的随访。79.1% 的患者接受了 IMRT 治疗，放疗技术在各组之间平衡。对于所有患者，放疗技术与 BRFS、OS 和急性及迟发毒性的发生率无显著差异。对于完成 MHRT 的患者，3D-CRT 与 IMRT 之间存在晚期 GU 毒性分布的差异，但晚期 2 级或更高级别的 GU 或 GI 毒性没有差异。按放射治疗技术和分数对患者进行分层后，放射治疗后的 EPIC 尿液和肠道评分的最小临床重要差异 (MCID) 未显示出显著差异。RT 技术并未影响低危 PC 进行 MHRT 后的临床结果。尽管在接受 MHRT 的患者中，IMRT 或 3D-CRT 治疗技术导致晚期 GU 毒性分布存在差异，但其晚期 2 级及以上 GU 或 GI 毒性或患者报告的毒性并没有差异。与 RTOG 0415 的初始出版物所示的 MHRT 比 CFRT 有增加的晚期 GU 和 GI 毒性并不似乎与 3D-CRT 治疗技术有关。© 2023。作者(们) 独家许可 Springer Nature Limited。

While moderately hypofractionated radiotherapy (MHRT) for prostate cancer (PC) is commonly delivered by intensity modulated radiation therapy, IMRT has not been prospectively compared to three-dimensional conformal radiotherapy (3D-CRT) in this context. We conducted a secondary analysis of the phase III RTOG 0415 trial comparing survival and toxicity outcomes for low-risk PC following MHRT with IMRT versus 3D-CRT.RTOG 0415 was a phase III, non-inferiority trial randomizing low-risk PC patients to either MHRT or conventionally fractionated radiation with stratification by RT technique. A secondary analysis for differences in overall survival (OS), biochemical recurrence free survival (BRFS), or toxicity by EPIC scores and Common Terminology Criteria for Adverse Events (CTCAE) was performed.1079 patients received the allocated intervention with a median follow up of 5.8 years. 79.1% of patients were treated with IMRT and radiation technique was balanced between arms. Across all patients, RT technique was not associated with significant differences in BRFS, OS, or rates of acute and late toxicities. For patients completing MHRT, there was a difference in the late GU toxicity distribution between 3D-CRT and IMRT but no difference in late grade 2 or greater GU or GI toxicity. Stratifying patients by RT technique and fractionation, no significant differences were observed in the minimal clinically important difference (MCID) in EPIC urinary and bowel scores following RT.RT technique did not impact clinical outcomes following MHRT for low-risk PC. Despite different late GU toxicity distributions in patients treated with MHRT by IMRT or 3D-CRT, there was no difference in late Grade 2 or greater GU or GI toxicity or patient reported toxicity. Increases in late GU and GI toxicity following MHRT compared to CFRT, as demonstrated in the initial publication of RTOG 0415, do not appear related to a 3D-CRT treatment technique.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.