Zelefsky Michael J, Kattan Michael W, Fearn Paul, Fearon Bertha L, Stasi Jason P, Shippy Alison M, Scardino Peter T
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Urology. 2007 Aug;70(2):283-7. doi: 10.1016/j.urology.2007.03.060.
To update our previously published nomogram predicting for biochemical outcome with 10-year data from a larger cohort of patients treated with three-dimensional conformal radiotherapy (RT) or intensity-modulated RT for localized prostate cancer.
From 1988 to 2004, 2253 patients were treated with three-dimensional conformal RT or intensity-modulated RT for clinical Stage T1-T3 prostate cancer. Prescription doses ranged from 64.8 to 86.4 Gy. The median follow-up time was 7 years. The nomogram was developed using a proportional hazards regression model predicting for the probability of biochemical relapse after RT according to the nadir plus 2 ng/mL definition of prostate-specific antigen (PSA) relapse.
The 10-year PSA relapse-free survival rate was 62%. The nomogram incorporated the following variables to predict likelihood of PSA failure after RT: pretreatment PSA level, Gleason score, radiation dose, use of neoadjuvant androgen deprivation, and clinical stage. The concordance index of this long-term nomogram was 0.72.
A nomogram predicting the 10-year probability of biochemical control after three-dimensional conformal RT or intensity-modulated RT for prostate cancer was reasonably accurate and discriminating. The nomogram also provided evidence that long-term biochemical control can be achieved after conformal RT for the treatment of localized prostate cancer.
利用更大队列接受三维适形放疗（RT）或调强放疗治疗局限性前列腺癌患者的10年数据，更新我们之前发表的预测生化结局的列线图。
1988年至2004年，2253例临床分期为T1 - T3期前列腺癌患者接受了三维适形放疗或调强放疗。处方剂量范围为64.8至86.4 Gy。中位随访时间为7年。列线图采用比例风险回归模型构建，根据前列腺特异性抗原（PSA）复发的最低点加2 ng/mL定义预测放疗后生化复发的概率。
10年无PSA复发生存率为62%。列线图纳入以下变量预测放疗后PSA失败的可能性：治疗前PSA水平、 Gleason评分、放射剂量、新辅助雄激素剥夺的使用情况和临床分期。该长期列线图的一致性指数为0.72。
预测前列腺癌三维适形放疗或调强放疗后10年生化控制概率的列线图具有合理的准确性和区分度。该列线图还提供了证据，表明适形放疗治疗局限性前列腺癌后可实现长期生化控制。
