本研究对高危前列腺癌患者采用容积调制弧形放疗（VMAT）全盆放疗（WPRT）的治疗效果进行了调查。我们回顾性分析了2011年8月至2015年8月期间，在我院接受WPRT治疗的112例高危前列腺癌患者。处方剂量为前列腺78 Gy，持续39次分剂量，并对盆腔淋巴结（LN）区域进行46.8 Gy，持续26次分剂量。所有患者均接受长期雄激素剥夺治疗。我们使用CTCAE 4.0标准评估了晚期胃肠道（GI）和泌尿生殖系统（GU）的毒副作用。被审查案例的中位随访时间为97个月（四分位数范围[IQR] = 85-108个月）。患者的中位年龄为72岁（IQR = 67-75岁）。高危和非常高危组分别有41例（36.6%）和71例（63.4%）患者。根据Roach公式计算的LN侵袭风险中位数为36.9%（IQR = 26.6-56.3%）。8年总生存率、生化无进展生存率、无病存活率和远处转移无进展生存率分别为88.4%、91.9%、83.8%和98.0%。只有一位患者出现常见髂骨LN复发，该情况发生在盆腔放疗区域之外。所有复发病例均属于非常高危组。8年Grade 2或更高晚期GI和GU毒副作用的累计发生率分别为12.8%和11.8%。没有患者出现Grade 4或更高级别的毒副作用。对于高危前列腺癌，采用VMAT的WPRT耐受性好，疗效显著。© 2023年作者。由牛津大学出版社代表日本放射研究学会和日本放射肿瘤学会出版。

This study investigated the outcomes of whole-pelvis radiation therapy (WPRT) using volumetric modulated arc therapy (VMAT) for high-risk prostate cancer. We retrospectively analysed 112 patients with high-risk prostate cancer who started WPRT at our hospital between August 2011 and August 2015. The prescribed dose was 78 Gy in 39 fractions to the prostate and 46.8 Gy in 26 fractions to the pelvic lymph node (LN) area. All patients received long-term androgen deprivation therapy. We evaluated late gastrointestinal (GI) and genitourinary (GU) toxicities using the Common Terminology Criteria for Adverse Events version 4.0. The median follow-up period for censored cases was 97 (interquartile range [IQR] = 85-108) months. The median age was 72 (IQR = 67-75) years. The high-risk and very-high-risk groups included 41 (36.6%) and 71 patients (63.4%), respectively. The median risk of LN invasion calculated by the Roach formula was 36.9 (IQR = 26.6-56.3) %. The 8-year overall survival, biochemical failure-free survival, disease-free survival and distant metastasis-free survival rates were 88.4, 91.9, 83.8 and 98.0%, respectively. Only one patient experienced common iliac LN recurrence, which was outside the pelvic irradiation area. All patients with recurrent disease were categorized into the very-high-risk group. The 8-year cumulative rates of ≥Grade 2 late GI and GU toxicities were 12.8 and 11.8%, respectively. No patients experienced Grade 4 or higher toxicities. WPRT using VMAT for high-risk prostate cancer was well tolerated and effective.© The Author(s) 2023. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.