Quero L, Mongiat-Artus P, Ravery V, Hennequin V, Maylin C, Desgrandchamps F, Hennequin C
Service de cancérologie-radiothérapie, hôpital Saint-Louis, AP-HP, 1 avenue Claude-Vellefaux, Paris, France.
Cancer Radiother. 2009 Jul;13(4):267-75. doi: 10.1016/j.canrad.2009.02.007. Epub 2009 May 14.
Study about the efficacy of salvage radiotherapy (RT), in terms of biochemical disease free survival (bDFS), according to ASTRO and Phoenix (nadir+2) definitions, for persistent or rising PSA after radical prostatectomy.
Retrospective analysis of 59 patients who underwent RT between 1990 and 2003 for PSA recurrence after radical prostatectomy. Patients received a median of 66Gy to the prostate bed with 3D or 2D RT. The main end point was bDFS according to ASTRO and Phoenix (nadir+2) definitions. Different criterion sets were analysed to calculate bDFS and pretreatment factors that might predict biochemical relapse were sought for each.
After a 38-month median follow-up, the 3-year bDFS rates were: 60 and 72% for ASTRO and Phoenix (nadir+2 ng/ml) definitions respectively. According to univariate analysis, pre-RT PSA> or =1 ng/ml and seminal vesicle involvement were associated with biochemical relapse. Multivariate analysis retained only pre-RT PSA> or =1 ng/ml as an independent predictor of biochemical relapse for the two definitions.
Salvage RT is an effective treatment after radical prostatectomy according to ASTRO or Phoenix definitions. Only pre-RT PSA> or =1 ng/ml predicted relapse.
根据美国放射肿瘤学会（ASTRO）和菲尼克斯（最低点+2）的定义，研究挽救性放疗（RT）对根治性前列腺切除术后前列腺特异性抗原（PSA）持续升高或上升患者的无生化复发生存率（bDFS）的疗效。
对1990年至2003年间因根治性前列腺切除术后PSA复发而接受放疗的59例患者进行回顾性分析。患者接受三维（3D）或二维（2D）放疗，前列腺床中位剂量为66Gy。主要终点是根据ASTRO和菲尼克斯（最低点+2）定义的bDFS。分析不同的标准集以计算bDFS，并寻找可能预测每种情况下生化复发的预处理因素。
中位随访38个月后，根据ASTRO和菲尼克斯（最低点+2 ng/ml）定义，3年bDFS率分别为60%和72%。单因素分析显示，放疗前PSA≥1 ng/ml和精囊受累与生化复发相关。多因素分析仅将放疗前PSA≥1 ng/ml作为两种定义下生化复发的独立预测因素。
根据ASTRO或菲尼克斯定义，挽救性放疗是根治性前列腺切除术后的一种有效治疗方法。只有放疗前PSA≥1 ng/ml可预测复发。
