Department of Radiation Oncology, Washington University Medical School, St. Louis, MO 63110, USA.
Int J Radiat Oncol Biol Phys. 2012 Jul 1;83(3):e363-70. doi: 10.1016/j.ijrobp.2011.12.070.
Report of clinical cancer control outcomes on Radiation Therapy Oncology Group (RTOG) 9406, a three-dimensional conformal radiation therapy (3D-CRT) dose escalation trial for localized adenocarcinoma of the prostate.
RTOG 9406 is a Phase I/II multi-institutional dose escalation study of 3D-CRT for men with localized prostate cancer. Patients were registered on five sequential dose levels: 68.4 Gy, 73.8 Gy, 79.2 Gy, 74 Gy, and 78 Gy with 1.8 Gy/day (levels I-III) or 2.0 Gy/day (levels IV and V). Neoadjuvant hormone therapy (NHT) from 2 to 6 months was allowed. Protocol-specific, American Society for Therapeutic Radiation Oncology (ASTRO), and Phoenix biochemical failure definitions are reported.
Thirty-four institutions enrolled 1,084 patients and 1,051 patients are analyzable. Median follow-up for levels I, II, III, IV, and V was 11.7, 10.4, 11.8, 10.4, and 9.2 years, respectively. Thirty-six percent of patients received NHT. The 5-year overall survival was 90%, 87%, 88%, 89%, and 88% for dose levels I-V, respectively. The 5-year clinical disease-free survival (excluding protocol prostate-specific antigen definition) for levels I-V is 84%, 78%, 81%, 82%, and 82%, respectively. By ASTRO definition, the 5-year disease-free survivals were 57%, 59%, 52%, 64% and 75% (low risk); 46%, 52%, 54%, 56%, and 63% (intermediate risk); and 50%, 34%, 46%, 34%, and 61% (high risk) for levels I-V, respectively. By the Phoenix definition, the 5-year disease-free survivals were 68%, 73%, 67%, 84%, and 80% (low risk); 70%, 62%, 70%, 74%, and 69% (intermediate risk); and 42%, 62%, 68%, 54%, and 67% (high risk) for levels I-V, respectively.
Dose-escalated 3D-CRT yields favorable outcomes for localized prostate cancer. This multi-institutional experience allows comparison to other experiences with modern radiation therapy.
报告放射治疗肿瘤学组（RTOG）9406 的临床癌症控制结果，这是一项针对局限性前列腺腺癌的三维适形放疗（3D-CRT）剂量递增试验。
RTOG 9406 是一项多机构的 3D-CRT 剂量递增研究，入组了局限性前列腺癌男性患者。患者被登记在五个连续剂量水平上：68.4 Gy、73.8 Gy、79.2 Gy、74 Gy 和 78 Gy，每天 1.8 Gy（水平 I-III）或 2.0 Gy（水平 IV 和 V）。允许使用 2 至 6 个月的新辅助激素治疗（NHT）。报告了协议特异性、美国放射治疗肿瘤学学会（ASTRO）和凤凰城生化失败定义。
34 家机构共入组了 1084 名患者，其中 1051 名患者可进行分析。水平 I、II、III、IV 和 V 的中位随访时间分别为 11.7、10.4、11.8、10.4 和 9.2 年。36%的患者接受了 NHT。剂量水平 I-V 的 5 年总生存率分别为 90%、87%、88%、89%和 88%。根据 ASTRO 定义，水平 I-V 的 5 年临床无病生存率（不包括协议前列腺特异性抗原定义）分别为 84%、78%、81%、82%和 82%。根据凤凰城定义，5 年无病生存率分别为低危组（57%、59%、52%、64%和 75%）、中危组（46%、52%、54%、56%和 63%）和高危组（50%、34%、46%、34%和 61%）（水平 I-V）。
递增剂量 3D-CRT 为局限性前列腺癌带来了良好的结果。这项多机构的经验使我们能够与其他现代放射治疗经验进行比较。
