Department of Radiation Oncology, St. Luke's Hospital, Dublin, Ireland.
Int J Radiat Oncol Biol Phys. 2011 Sep 1;81(1):35-45. doi: 10.1016/j.ijrobp.2010.04.065. Epub 2010 Aug 25.
To examine the long-term outcomes of a randomized trial comparing short (4 months; Arm 1) and long (8 months; Arm 2) neoadjuvant hormonal therapy before radiotherapy for localized prostate cancer.
Between 1997 and 2001, 276 patients were enrolled and the data from 261 were analyzed. The stratification risk factors were prostate-specific antigen level >20 ng/mL, Gleason score≥7, and Stage T3 or more. The intermediate-risk stratum had one factor and the high-risk stratum had two or more. Staging was done from the bone scan and computed tomography findings. The primary endpoint was biochemical failure-free survival.
The median follow-up was 102 months. The overall survival, biochemical failure-free survival. and prostate cancer-specific survival did not differ significantly between the two treatment arms, overall or at 5 years. The cumulative probability of overall survival at 5 years was 90% (range, 87-92%) in Arm 1 and 83% (range, 80-86%) in Arm 2. The biochemical failure-free survival rate at 5 years was 66% (range, 62-71%) in Arm 1 and 63% (range, 58-67%) in Arm 2.
No statistically significant difference was found in biochemical failure-free survival between 4 months and 8 months of neoadjuvant hormonal therapy before radiotherapy for localized prostate cancer.
研究比较局部前列腺癌放疗前 4 个月(第 1 臂)和 8 个月(第 2 臂)短程与长程新辅助激素治疗的随机试验的长期结果。
1997 年至 2001 年间,共纳入 276 例患者,其中 261 例的数据进行了分析。分层风险因素为前列腺特异性抗原水平>20ng/ml、Gleason 评分≥7 分和 T3 期或更高级别。中危分层有一个因素,高危分层有两个或更多因素。分期依据骨扫描和计算机断层扫描结果进行。主要终点是生化无失败生存。
中位随访时间为 102 个月。两组之间的总生存、生化无失败生存和前列腺癌特异性生存无显著差异,总体或 5 年时均无显著差异。5 年时总生存的累积概率在第 1 臂为 90%(范围,87-92%),在第 2 臂为 83%(范围,80-86%)。5 年时生化无失败生存率在第 1 臂为 66%(范围,62-71%),在第 2 臂为 63%(范围,58-67%)。
局部前列腺癌放疗前 4 个月和 8 个月新辅助激素治疗的生化无失败生存率无统计学显著差异。