前列腺癌根治术后PSA复发患者的挽救性放疗：单机构经验
Salvage radiotherapy for patients with PSA relapse after radical prostatectomy: a single institution experience.
作者信息
Quero Laurent, Mongiat-Artus Pierre, Ravery Vincent, Maylin Claude, Desgrandchamps François, Hennequin Christophe
机构信息
Department of Radiation Oncology, Saint Louis Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France.
出版信息
BMC Cancer. 2008 Jan 29;8:26. doi: 10.1186/1471-2407-8-26.
BACKGROUND
To assess the efficacy of salvage radiotherapy (RT) for persistent or rising PSA after radical prostatectomy and to determine prognostic factors identifying patients who may benefit from salvage RT.
METHODS
Between 1990 and 2003, 59 patients underwent RT for PSA recurrence after radical prostatectomy. Patients received a median of 66 Gy to the prostate bed with 3D or 2D RT. The main end point was biochemical failure after salvage RT, defined as an increase of the serum PSA value >0.2 ng/ml confirmed by a second elevation.
RESULTS
Median follow-up was 38 months. The 3-year and 5-year bDFS rates were 56.1% and 41.2% respectively. According to multivariate analysis, only preRT PSA > or =1 ng/ml was associated with biochemical relapse.
CONCLUSION
When delivered early, RT is an effective treatment after radical prostatectomy. Only preRT PSA > or =1 ng/ml predicted relapse.
背景
评估挽救性放疗（RT）对前列腺癌根治术后前列腺特异抗原（PSA）持续升高或上升患者的疗效，并确定可从挽救性放疗中获益患者的预后因素。
方法
1990年至2003年间，59例患者在前列腺癌根治术后因PSA复发接受放疗。患者接受三维（3D）或二维（2D）放疗，前列腺床中位剂量为66 Gy。主要终点为挽救性放疗后的生化失败，定义为血清PSA值升高>0.2 ng/ml，且经第二次升高确认。
结果
中位随访时间为38个月。3年和5年生化无复发生存率（bDFS）分别为56.1%和41.2%。多因素分析显示，仅放疗前PSA≥1 ng/ml与生化复发相关。
结论
早期进行放疗是前列腺癌根治术后的有效治疗方法。仅放疗前PSA≥1 ng/ml可预测复发。
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