目的：發表單一醫學中心使用導航螺旋刀治療非轉移性攝護腺癌之結果。 材料與方法：自 2006 年 12 月至 2013 年 6 月，共 85 位攝護腺癌病人接受影像導引導航螺旋刀 治療。每日使用 MVCT 影像導引以減少對位誤差。生化控制失敗採用 Pheonix 定義，副作用的 分級根據 CTCAE 4.0 版本。 結果：中位追蹤期為 41 個月，中位放射劑量至攝護腺為 76 Gy。所有病人中有 54% 為高風險 群。四年生化控制率為 93.3%，所有中低風險群的病人皆控制良好，高風險的病人有 6 位生化 失敗，其中2位併發骨頭轉移。治療期間，僅分別有 4.7% 及 9.4% 的病人出現第二級的腸胃道 和泌尿道急性副作用。大於第二級的慢性副作用累積發生率，包含出血性直腸癌、出血性膀胱 炎和尿道狹窄則分別為 8.2%、4.7% 及 4.7%。 結論：對於攝護腺癌之病人，使用導航螺旋刀之影像導引放射治療，在我們的短期追蹤下有良 好的生化控制。治療相關的副作用是可接受的。

Purpose : We report the results of non-metastatic prostate cancer patients treated by helical tomotherapy (HT) in a single institution. Materials and Methods : From December 2006 to June 2013, eighty-five prostate cancer patients receiving image-guided radiation therapy (IGRT) with HT were enrolled in this study. Mega-voltage computed tomography was performed to minimize geographic miss and setup error. The Phoenix definition was used to define biochemical failure. Toxicities were recorded based on Common Terminology Criteria for Adverse Events, version 4.0. Results : The median follow-up interval was 41 months (range, 8-96 months). The median radiation dose delivered was 76 Gy to the whole prostate. Fifty-four percent of patients were in the high-risk category. The 4-year biochemical control rate was 93.3%. All of the patients attributed to the low- and intermediate-risk groups had good biochemical control (n= 39). For high-risk group, only 13% (6/46) patients had biochemical failure, and 2 of them also developed bony metastases. During treatment, only 4.7% and 9.4% of the patients experienced grade 2 acute gastrointestinal and genitourinary toxicities, respectively. No grade 3 or 4 acute toxicity was observed. The cumulative incidence of late toxicities of grade 2 or above hemorrhagic proctitis, hemorrhagic cystitis and urethral stricture were 8.2%, 4.7% and 4.7%, respectively. Conclusion : For prostate cancer patients, IGRT with HT results an excellent biochemical control in our limited follow-up period. The treatment-related toxicities were acceptable.