Sylvester John E, Grimm Peter D, Blasko John C, Millar Jeremy, Orio Peter F, Skoglund Scott, Galbreath Robert W, Merrick Gregory
Seattle Prostate Institute, Seattle, WA 98104, USA.
Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):57-64. doi: 10.1016/j.ijrobp.2006.07.1382. Epub 2006 Nov 2.
Long-term biochemical relapse-free survival (BRFS) rates in patients with clinical Stages T1-T3 prostate cancer continue to be scrutinized after treatment with external beam radiation therapy and brachytherapy.
We report 15-year BRFS rates on 223 patients with clinically localized prostate cancer that were consecutively treated with I(125) or Pd (103) brachytherapy after 45-Gy neoadjuvant EBRT. Multivariate regression analysis was used to create a pretreatment clinical prognostic risk model using a modified American Society for Therapeutic Radiology and Oncology consensus definition (two consecutive serum prostate-specific antigen rises) as the outcome. Gleason scoring was performed by the pathologists at a community hospital. Time to biochemical failure was calculated and compared by using Kaplan-Meier plots.
Fifteen-year BRFS for the entire treatment group was 74%. BRFS using the Memorial Sloan-Kettering risk cohort analysis (95% confidence interval): low risk, 88%, intermediate risk 80%, and high risk 53%. Grouping by the risk classification described by D'Amico, the BRFS was: low risk 85.8%, intermediate risk 80.3%, and high risk 67.8% (p = 0.002).
I(125) or Pd(103) brachytherapy combined with supplemental EBRT results in excellent 15-year biochemical control. Different risk group classification schemes lead to different BRFS results in the high-risk group cohorts.
对于临床分期为T1 - T3期的前列腺癌患者，在接受外照射放疗和近距离放射治疗后，其长期无生化复发生存率（BRFS）仍在持续受到审视。
我们报告了223例临床局限性前列腺癌患者的15年BRFS率，这些患者在接受45 Gy新辅助外照射放疗（EBRT）后连续接受了碘-125（I¹²⁵）或钯-103（Pd¹⁰³）近距离放射治疗。采用多变量回归分析，以改良的美国放射肿瘤学会共识定义（连续两次血清前列腺特异性抗原升高）为结果创建一个治疗前临床预后风险模型。由社区医院的病理学家进行 Gleason评分。通过Kaplan - Meier曲线计算并比较生化失败时间。
整个治疗组的15年BRFS为74%。使用纪念斯隆凯特琳癌症中心风险队列分析的BRFS（95%置信区间）：低风险，88%；中风险，80%；高风险，53%。按照达米科描述的风险分类进行分组，BRFS为：低风险85.8%，中风险80.3%，高风险67.8%（p = 0.002）。
碘-125（I¹²⁵）或钯-103（Pd¹⁰³）近距离放射治疗联合补充性EBRT可带来出色的15年生化控制效果。不同的风险组分类方案在高风险组队列中导致不同的BRFS结果。
