Potters Louis, Klein Eric A, Kattan Michael W, Reddy Chandana A, Ciezki Jay P, Reuther Alwyn M, Kupelian Patrick A
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center at Mercy Medical Center, Rockville Centre, NY, USA.
Radiother Oncol. 2004 Apr;71(1):29-33. doi: 10.1016/j.radonc.2003.12.011.
To review the freedom from biochemical recurrence (FBR) rates after permanent prostate brachytherapy (PPB), external beam radiotherapy (RT) to a minimum 70Gy, or radical prostatectomy (RP) for clinically localized stage T1-T2 adenocarcinoma of the prostate.
The study cohort consisted of 1819 consecutively treated clinical stage T1-T2 (AJCC 1997) localized prostate cancer patients between 1992 and 1998. All patients received monotherapy treatment without additional adjuvant therapy. The distribution by treatment modality was as follows: RT for 340, RP for 746, and PPB for 733 cases. The median follow-up time was 58 months for all cases (51 months for PPB cases, 56 months for RT cases, and 64 months for RP cases). Biochemical relapse was defined as to be detectable PSA levels in RP cases, and the ASTRO consensus panel definition for the RT and PPB cases.
The 7-year FBR rates for PPB vs EBRT vs RP were 74, 77, and 79%, respectively. Multivariate analysis identified iPSA (P < 0.001) and bGS (P < 0.001) as independent predictors of relapse. Treatment modality, age, clinical T-stage, and race were not independent predictors of failure.
Pretreatment PSA levels, and biopsy Gleason score determined outcome in this study cohort. Biochemical failure rates in this study cohort are similar between PPB, RT, and RP as monotherapy for clinically localized prostate cancer.
回顾永久性前列腺近距离放疗（PPB）、外照射放疗（RT）至至少70Gy或根治性前列腺切除术（RP）治疗临床局限性T1-T2期前列腺腺癌后的无生化复发（FBR）率。
研究队列包括1992年至1998年间连续接受治疗的1819例临床分期为T1-T2（美国癌症联合委员会1997年版）的局限性前列腺癌患者。所有患者均接受单一疗法治疗，未接受额外的辅助治疗。治疗方式分布如下：RT治疗340例，RP治疗746例，PPB治疗733例。所有病例的中位随访时间为58个月（PPB病例为51个月，RT病例为56个月，RP病例为64个月）。生化复发在RP病例中定义为可检测到的PSA水平，在RT和PPB病例中按照美国放射肿瘤学会共识小组的定义。
PPB、EBRT和RP的7年FBR率分别为74%、77%和79%。多变量分析确定初始PSA（iPSA，P<0.001）和活检Gleason评分（bGS，P<0.001）为复发的独立预测因素。治疗方式、年龄、临床T分期和种族不是失败的独立预测因素。
在本研究队列中，治疗前PSA水平和活检Gleason评分决定预后。作为临床局限性前列腺癌的单一疗法，本研究队列中PPB、RT和RP的生化失败率相似。
