Weight Christopher J, Ciezki Jay P, Reddy Chandana A, Zhou Ming, Klein Eric A
Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Int J Radiat Oncol Biol Phys. 2006 Jun 1;65(2):347-50. doi: 10.1016/j.ijrobp.2005.12.054. Epub 2006 Mar 20.
To determine if the presence of perineural invasion (PNI) predicts biochemical recurrence in patients who underwent low-dose-rate brachytherapy for the treatment of localized prostate cancer.
A retrospective case control matching study was performed. The records of 651 patients treated with brachytherapy between 1996 and 2003 were reviewed. Sixty-three of these patients developed biochemical failure. These sixty-three patients were then matched in a one-to-one ratio to patients without biochemical failure, controlling for biopsy Gleason score, clinical stage, initial prostate-specific antigen, age, and the use of androgen deprivation. The pathology of the entire cohort was then reviewed for evidence of perineural invasion on initial prostate biopsy specimens. The biochemical relapse free survival rates for these two groups were compared.
Cases and controls were well matched, and there were no significant differences between the two groups in age, Gleason grade, clinical stage, initial prostate-specific antigen, and the use of androgen deprivation. PNI was found in 19 (17%) patients. There was no significant difference in the rates of PNI between cases and controls, 19.6% and 14.3% respectively (p = 0.45). PNI did not correlate with biochemical relapse free survival (p = 0.40).
Perineural invasion is not a significant predictor of biochemical recurrence in patients undergoing brachytherapy for prostate cancer.
确定在接受低剂量率近距离放射治疗局限性前列腺癌的患者中，神经周围侵犯（PNI）的存在是否可预测生化复发。
进行了一项回顾性病例对照匹配研究。回顾了1996年至2003年间接受近距离放射治疗的651例患者的记录。其中63例患者出现生化失败。然后将这63例患者与未发生生化失败的患者以1:1的比例进行匹配，同时控制活检Gleason评分、临床分期、初始前列腺特异性抗原、年龄和雄激素剥夺的使用情况。然后复查整个队列的初始前列腺活检标本的病理，以寻找神经周围侵犯的证据。比较这两组的生化无复发生存率。
病例组和对照组匹配良好，两组在年龄、Gleason分级、临床分期、初始前列腺特异性抗原和雄激素剥夺的使用方面无显著差异。19例（17%）患者发现有神经周围侵犯。病例组和对照组的神经周围侵犯率分别为19.6%和14.3%，无显著差异（p = 0.45）。神经周围侵犯与生化无复发生存无关（p = 0.40）。
对于接受前列腺癌近距离放射治疗的患者，神经周围侵犯不是生化复发的显著预测因素。
