Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, The Netherlands.
Radiother Oncol. 2009 Nov;93(2):168-73. doi: 10.1016/j.radonc.2009.08.033. Epub 2009 Sep 11.
For the radiation treatment of prostate cancer high dose should be delivered for optimal biochemical control. Treatment can be given by dose-escalated external beam radiotherapy (EBRT) or external beam radiotherapy combined with a radioactive seed implantation (EBSeeds) or high-dose rate (HDR) brachytherapy (EBTI). Differences in outcome between the modalities were assessed by a systematic review.
A systematic search was performed resulting in 40 articles to be used. Data were extracted on biochemical control and overall survival at 3, 5, and 8 years and other time points mentioned in the articles. Also known prognostic parameters were noted. Comparison of the modalities was done by a Weibull survival analysis and estimation of Hazard Ratio's (HR) was done with 95% confidence intervals (95% CIs).
The HR for biochemical recurrence was 1.40 (95% CI 1.31-1.51) for EBRT relative to EBTI, and was 1.37 (95% CI 1.26-1.49) for EBSeeds relative to EBTI. The HR for overall survival was 1.50 (95% CI 1.29-1.73) for EBRT relative to EBTI, and was 2.33 (95% CI 2.04-2.66) for EBSeeds relative to EBTI.
The combination of external beam radiotherapy and HDR brachytherapy results in a superior biochemical control and overall survival found in a systematic review on radiotherapy for prostate cancer.
为了获得最佳的生化控制效果，前列腺癌的放射治疗应采用高剂量。治疗可以通过剂量递增的外束放射治疗（EBRT）或外束放射治疗联合放射性种子植入（EBSeeds）或高剂量率（HDR）近距离放射治疗（EBTI）来进行。通过系统评价评估了这些方法之间的结果差异。
进行了系统搜索，共检索到 40 篇文章用于分析。提取了生化控制和 3、5、8 年及文章中提到的其他时间点的总生存率数据，同时还记录了已知的预后参数。通过威布尔生存分析对这些方法进行了比较，并使用 95%置信区间（95%CI）计算了危险比（HR）。
与 EBTI 相比，EBRT 的生化复发 HR 为 1.40（95%CI 1.31-1.51），EBSeeds 的 HR 为 1.37（95%CI 1.26-1.49）。与 EBTI 相比，EBRT 的总生存 HR 为 1.50（95%CI 1.29-1.73），EBSeeds 的 HR 为 2.33（95%CI 2.04-2.66）。
在前列腺癌放射治疗的系统评价中，外束放射治疗联合 HDR 近距离放射治疗可获得更好的生化控制和总生存效果。
