Cosset Jean-Marc, Flam Thierry, Thiounn Nicolas, Gomme Stephanie, Rosenwald Jean-Claude, Asselain Bernard, Pontvert Dominique, Henni Mehdi, Debre Bernard, Chauveinc Laurent
Radiology Department, Institut Curie, Paris, France.
Int J Radiat Oncol Biol Phys. 2008 Jul 15;71(4):1042-8. doi: 10.1016/j.ijrobp.2007.11.056. Epub 2008 Mar 12.
The aim of this study was to analyze overall and relapse-free survival in a cohort of 809 patients, 34% of whom corresponded to a higher-risk group than American Brachytherapy Society (ABS) criteria.
Between January 1999 and September 2004, 809 patients were treated with permanent loose 125 iodine seed implantation (IsoSeed Bebig, Eckert and Ziegler) by the Paris Institut Curie, Cochin Hospital, and Necker Hospital group. Of these 809 patients, 533 (65.9%) corresponded exactly to ABS criteria. Two hundred and seventy-six patients (34.1%) had a prostate-specific antigen (PSA) level between 10 and 15, or a Gleason score of 7, or both (non-ABS group).
Overall 5-year survival was 98%, with no difference between the ABS group and the non-ABS patient subgroups (p = 0.62).Five-year relapse-free survival was 97% in the ABS group; it was significantly lower (p = 0.001) in the non-ABS group but remained satisfactory at 94%. On subgroup analysis, the results appeared to be better for the subgroup of patients with PSA 10-15 than for the subgroup with a Gleason score of 7.
Our results suggest that selected patients in the intermediate-risk group of localized prostate cancers can be safely proposed as recipients of permanent implant brachytherapy as monotherapy.
本研究旨在分析809例患者的总生存率和无复发生存率，其中34%的患者属于比美国近距离放射治疗协会（ABS）标准风险更高的组。
1999年1月至2004年9月期间，巴黎居里研究所、科钦医院和内克尔医院集团对809例患者进行了永久性松散125碘籽源植入治疗（IsoSeed Bebig，Eckert和Ziegler）。在这809例患者中，533例（65.9%）完全符合ABS标准。276例患者（34.1%）前列腺特异性抗原（PSA）水平在10至15之间，或Gleason评分为7，或两者兼有（非ABS组）。
总5年生存率为98%，ABS组和非ABS患者亚组之间无差异（p = 0.62）。ABS组的5年无复发生存率为97%；非ABS组显著较低（p = 0.001），但仍令人满意，为94%。亚组分析显示，PSA为10 - 15的患者亚组结果似乎优于Gleason评分为7的患者亚组。
我们的结果表明，局部前列腺癌中风险组的选定患者可以安全地被推荐接受永久性植入近距离放射治疗作为单一疗法。
