College of Human Medicine, Michigan State University, East Lansing, MI, USA.
Radiat Oncol. 2010 Sep 16;5:80. doi: 10.1186/1748-717X-5-80.
The purpose of this study was to determine the expected time to prostate specific antigen (PSA) normalization with or without neoadjuvant androgen deprivation (NAAD) therapy after treatment with intensity modulated radiotherapy (IMRT) for patients with clinically localized prostate cancer.
A retrospective cohort research design was used. A total of 133 patients with clinical stage T1c to T3b prostate cancer (2002 AJCC staging) treated in a community setting between January 2002 and July 2005 were reviewed for time to PSA normalization using 1 ng/mL and 2 ng/mL as criteria. All patients received IMRT as part of their management. Times to PSA normalization were calculated using the Kaplan-Meier method. Significance was assessed at p < 0.05.
Fifty-six of the 133 patients received NAAD (42.1%). Thirty-one patients (23.8%) received radiation to a limited pelvic field followed by an IMRT boost, while 99 patients received IMRT alone (76.2%). The times to serum PSA normalization < 2 ng/mL when treated with or without NAAD were 298 ± 24 and 302 ± 33 days (mean ± SEM), respectively (p > 0.05), and 303 ± 24 and 405 ± 46 days, respectively, for PSA < 1 ng/mL (p < 0.05). Stage T1 and T2 tumors had significantly increased time to PSA normalization < 1 ng/mL in comparison to Stage T3 tumors. Also, higher Gleason scores were significantly correlated with a faster time to PSA normalization < 1 ng/mL.
Use of NAAD in conjunction with IMRT leads to a significantly shortened time to normalization of serum PSA < 1 ng/mL in patients with clinically localized prostate cancer.
本研究旨在确定接受调强放射治疗（IMRT）治疗后，伴有或不伴有新辅助雄激素剥夺（NAAD）治疗的局限性前列腺癌患者前列腺特异性抗原（PSA）正常化的预期时间。
采用回顾性队列研究设计。共回顾分析了 2002 年 AJCC 分期 T1c 至 T3b 期局限性前列腺癌患者 133 例，这些患者均于 2002 年 1 月至 2005 年 7 月在社区环境下接受治疗。以 1ng/ml 和 2ng/ml 为标准，采用 Kaplan-Meier 法计算 PSA 正常化时间。以 p<0.05 为差异有统计学意义。
133 例患者中，56 例（42.1%）接受了 NAAD。31 例（23.8%）患者接受了局限性骨盆放疗，随后接受了 IMRT 加量放疗，99 例（76.2%）患者仅接受了 IMRT 治疗。接受或不接受 NAAD 治疗时，PSA<2ng/ml 的血清 PSA 正常化时间分别为 298±24 和 302±33 天（均数±SEM）（p>0.05），PSA<1ng/ml 的血清 PSA 正常化时间分别为 303±24 和 405±46 天（p<0.05）。与 T3 期肿瘤相比，T1 和 T2 期肿瘤 PSA<1ng/ml 的正常化时间显著延长。此外，较高的 Gleason 评分与 PSA<1ng/ml 的正常化时间较快显著相关。
在接受 IMRT 的同时使用 NAAD 治疗可显著缩短局限性前列腺癌患者 PSA<1ng/ml 正常化的时间。
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