Fonteyne Valérie, Lumen Nicolaas, Villeirs Geert, Ost Piet, De Meerleer Gert
Department of Radiotherapy, Ghent University Hospital, 9000 Ghent, Belgium.
Adv Urol. 2012;2012:368528. doi: 10.1155/2012/368528. Epub 2011 Nov 30.
Purpose. Patients with high-risk prostate cancer (PC) can be treated with high-dose intensity-modulated radiotherapy (IMRT) and long-term androgen deprivation (AD). In this paper we report on (i) late toxicity and (ii) biochemical (bRFS) and clinical relapse-free survival (cRFS) of this combined treatment. Methods. 126 patients with high-risk PC (T3-4 or PSA >20 ng/mL or Gleason 8-10) and ≥24 months of followup were treated with high-dose IMRT and AD. Late toxicity was recorded. Biochemical relapse was defined as PSA nadir +2 ng/mL. Clinical relapse was defined as local failure or metastases. Results. The incidence of late grade 3 gastrointestinal and genitourinary toxicity was 2 and 6%, respectively. Five-year bRFS and cRFS were 73% and 86% respectively. AD was a significant predictor of bRFS (P = 0.001) and cRFS (P = 0.01). Conclusion. High-dose IMRT and AD for high-risk PC offers excellent biochemical and clinical control with low toxicity.
目的。高危前列腺癌（PC）患者可接受高剂量调强放疗（IMRT）及长期雄激素剥夺治疗（AD）。本文报告该联合治疗的（i）晚期毒性以及（ii）生化无复发生存期（bRFS）和临床无复发生存期（cRFS）。方法。126例高危PC患者（T3 - 4或PSA>20 ng/mL或 Gleason 8 - 10）且随访时间≥24个月，接受了高剂量IMRT及AD治疗。记录晚期毒性。生化复发定义为PSA最低点 +2 ng/mL。临床复发定义为局部失败或转移。结果。晚期3级胃肠道和泌尿生殖系统毒性的发生率分别为2%和6%。5年bRFS和cRFS分别为73%和86%。AD是bRFS（P = 0.001）和cRFS（P = 0.01）的显著预测因素。结论。高危PC的高剂量IMRT及AD治疗可实现良好的生化和临床控制，且毒性较低。
