ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2025-8-3-109-114ojrdrt-471Research ArticleКОМБИНИРОВАННЫЕ МЕТОДЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯCOMBINED METHODS OF DIAGNOSTICS AND TREATMENTОпыт применения адъювантной и спасительной комбинированной гормонолучевой терапии в режиме умеренного гипофракционирования дозы при раке предстательной железыExperience with Postoperative Combined Hormone-Radiation Therapy Using Moderate Hypofractionation for Recurrent Prostate Cancerhttps://orcid.org/0009-0008-6497-6404КузнецовН. О.KuznetsovN. O.

Кузнецов Никита Олегович, +79006553733 

197022, г. Санкт-Петербург, ул. Льва Толстого, 6-8 

Kuznetsov Nikita Olegovich 

6/8, Lva Tolstogo str., St. Petersburg, 197022, +79006553733 

alkealol27@gmail.comhttps://orcid.org/0000-0002-7185-1967НовиковС. Н.NovikovS. N.

197758, Песочный пос., Санкт-Петербург, ул. Ленинградская, 68 

68, Leningradskaya str., Pesochny settlement, St. Petersburg, 97758 

https://orcid.org/0000-0003-1873-1293НовиковР. В.NovikovR. V.

197758, Песочный пос., Санкт-Петербург, ул. Ленинградская, 68 

194175, Санкт-Петербург, ул. Академика Лебедева, 6 

68, Leningradskaya str., Pesochny settlement, St. Petersburg, 97758 

6, Akademika Lebedeva str., St. Petersburg, 194175 

https://orcid.org/0009-0008-8585-0982СамарцеваЕ. Е.SamartsevaE. E.

197758, Песочный пос., Санкт-Петербург, ул. Ленинградская, 68 

68, Leningradskaya str., Pesochny settlement, St. Petersburg, 97758 

https://orcid.org/0000-0003-1491-2644МережкоЮ. О.MerezhkoYu. O.

197758, Песочный пос., Санкт-Петербург, ул. Ленинградская, 68 

68, Leningradskaya str., Pesochny settlement, St. Petersburg, 97758 

https://orcid.org/0000-0002-1753-7926КанаевС. В.KanaevS. V.

197758, Песочный пос., Санкт-Петербург, ул. Ленинградская, 68 

68, Leningradskaya str., Pesochny settlement, St. Petersburg, 97758 

Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова Минздрава РоссииРоссияFirst Pavlov State Medical University of St. PetersburgRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Петрова Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Петрова Минздрава России ; Военно-медицинская академии имени С. М. Кирова МО РФРоссияN.N. Petrov National Medical Research Center of Oncology ; S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian FederationRussian Federation20252309202583109114Copyright © Кузнецов Н.О., Новиков С.Н., Новиков Р.В., Самарцева Е.Е., Мережко Ю.О., Канаев С.В., 20252025Кузнецов Н.О., Новиков С.Н., Новиков Р.В., Самарцева Е.Е., Мережко Ю.О., Канаев С.В.Kuznetsov N.O., Novikov S.N., Novikov R.V., Samartseva E.E., Merezhko Y.O., Kanaev S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/471

Введение: Послеоперационная лучевая терапия (ЛТ), включая адъювантную (АЛТ) и спасительную (СЛТ), широко используется для лечения рака предстательной железы (РПЖ) после радикальной простатэктомии (РПЭ). Низкое значение α/β РПЖ создает предпосылки для гипофракционирования дозы, однако данные о его эффективности и безопасности в послеоперационном режиме ограничены.Цель: Оценить показатели эффективности и безопасности комбинированной гормонолучевой терапии в режиме умеренного гипофракционирования дозы на область ложа удаленной предстательной железы (ЛУПЖ) и регионарные тазовые лимфатические узлы (РЛУ) с последовательным бустом на ЛУПЖ у пациентов с РПЖ. Материалы и методы: Проведен ретроспективный анализ 64 пациентов, получивших послеоперационную ЛТ в комбинации с антиандрогенной терапией (АДТ) в период с 2020 по 2023 гг. ЛТ проводилась в два этапа: облучение ЛУПЖ и РЛУ (РОД 3 Гр, СОД 39 Гр, 13 фракций) с последующим бустом на ЛУПЖ (РОД 3 Гр, СОД 18 Гр, 6 фракций). Оценивались биохимический контроль, степень лучевой токсичности (по критериям RTOG), а также динамика уровня качества жизни.Результаты: Медиана наблюдения составила 36,5 месяцев. Биохимический рецидив зарегистрирован у 17,2 % пациентов. Острая токсичность мочевыводящих путей (МВП) III степени отмечена у 4,7 % пациентов, желудочно-кишечного тракта (ЖКТ) отсутствовала. Поздняя токсичность со стороны МВП III степени (стриктуры уретры, макрогематурия) — у 4,7 %, ЖКТ III степени — не зарегистрирована. Несмотря на исходное недержание мочи у 57,8 % пациентов, уровень качества жизни оставался стабильным на протяжении всего периода наблюдения.Выводы: Послеоперационная комбинированная гормонолучевая терапия РПЖ в режиме умеренного гипофракционирования дозы демонстрирует высокую эффективность и благоприятный профиль безопасности при сохранении качества жизни.

Introduction: Postoperative radiotherapy (RT), including adjuvant (ART) and salvage (SRT), widely used for treatment for prostate cancer (PCa) after radical prostatectomy (RP). The low α/β ratio of PCa provides a rationale for dose hypofractionation; however, data on its efficacy and safety in the postoperative setting are limited.Purpose: To evaluate the efficacy and safety of combined hormone-radiotherapy using a moderately hypofractionated dose regimen to the prostate bed (PB) and pelvic lymph nodes (PLN) with a sequential boost to the PB in PCa patients.Materials and methods: A retrospective analysis of 64 patients who received postoperative RT combined with androgen deprivation therapy (ADT) between 2020 and 2023 was performed. RT was delivered in two phases: irradiation of the PB and PLN (fraction dose 3 Gy, total dose 39 Gy, 13 fractions) followed by a boost to the PB (fraction dose 3 Gy, total dose 18 Gy, 6 fractions). Biochemical control, radiation toxicity, and quality of life dynamics were assessed.Results: The median follow-up was 36.5 months. Biochemical recurrence was observed in 17.2 % of patients. Acute grade III genitourinary (GU) toxicity occurred in 4.7 % of patients, while gastrointestinal (GI) toxicity of this grade was absent. Late grade III GU toxicity(urethral strictures, macrohematuria) was recorded in 4.7 % of patients; grade III GI toxicity was not registered. Despite baseline urinary incontinence in 57.8 % of patients, the level of quality of life remained stable throughout the observation period.Conclusion: Postoperative combined hormone-radiotherapy for PCa using a moderately hypofractionated dose regimen demonstrates high efficacy and a favorable safety profile while preserving quality of life.

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The authors declare that there are no conflicts of interest present.