Hoag Cancer Center, Department of Medical Oncology, Hoag Memorial Hospital Presbyterian, Newport Beach, CA 92658, USA.
Int J Radiat Oncol Biol Phys. 2011 Mar 1;79(3):719-23. doi: 10.1016/j.ijrobp.2009.11.041. Epub 2010 May 14.
Radical prostatectomy for invasive prostate cancer is associated with positive margin rates in 10% to 50% of resected specimens. Postoperative radiation therapy may benefit patients who have organ-confined prostate cancer with positive margins.
We performed a retrospective analysis to examine whether adjunctive radiation therapy enhanced long-term survival for prostate cancer patients who underwent prostatectomy for localized prostate cancer but with positive margins. We used the Hoag Cancer Center database to identify patients diagnosed with invasive prostate cancer. Relative and overall survival rates were calculated.
Among 1,474 patients diagnosed with localized invasive prostate cancer during the years 1990 to 2006 and undergoing prostatectomy, 113 (7.7%) were identified who had positive margins and did not have local extension of disease, positive lymph nodes, or distant metastases. A total of 17 patients received adjunctive radiation therapy (Group A), whereas 96 did not (Group B; 3 received hormonal therapy). Both groups had a median age of 64 years and median follow-up of 7.5 years. In Group A, no patients have died as of last follow-up, but in Group B, 18 have died. Estimated 10-year and 15-year overall survival rates were both 100% for Group A compared with 85% and 57% respectively for Group B (p2=0.050, log rank). Relative 10- and 15 year survival rates were both 100% for Group A compared with 100% and 79% respectively for Group B.
This retrospective analysis suggests that prostate cancer patients with localized disease but positive margins do derive a survival benefit from adjuvant radiation therapy.
根治性前列腺切除术治疗浸润性前列腺癌，术后标本中 10%~50%有阳性切缘。术后放疗可能有益于有阳性切缘的局限性前列腺癌患者。
我们进行了一项回顾性分析，以研究对于局限性前列腺癌但有阳性切缘的前列腺癌患者，辅助放疗是否能提高长期生存。我们使用 Hoag 癌症中心的数据库来识别诊断为浸润性前列腺癌并于 1990 年至 2006 年期间接受前列腺切除术的患者。计算相对生存率和总生存率。
在诊断为 1990 年至 2006 年局限性侵袭性前列腺癌并接受前列腺切除术的 1474 例患者中，有 113 例（7.7%）患者有阳性切缘，但没有疾病局部扩展、阳性淋巴结或远处转移。共有 17 例患者接受了辅助放疗（A 组），而 96 例患者未接受（B 组；3 例接受了激素治疗）。两组患者的中位年龄均为 64 岁，中位随访时间为 7.5 年。在 A 组，截至最后一次随访时，没有患者死亡，但在 B 组，有 18 例患者死亡。A 组的 10 年和 15 年总生存率估计均为 100%，而 B 组分别为 85%和 57%（p2=0.050，对数秩检验）。A 组的 10 年和 15 年相对生存率估计均为 100%，而 B 组分别为 100%和 79%。
这项回顾性分析表明，局限性疾病但有阳性切缘的前列腺癌患者确实能从辅助放疗中获益。
