Department of Radiation Oncology, I.R.C.C.S. - C.R.O.B., Via Padre Pio 1, 85028, Rionero in Vulture (PZ), Italy,
Radiol Med. 2013 Dec;118(8):1412-21. doi: 10.1007/s11547-012-0872-0. Epub 2012 Sep 17.
This study evaluated the biochemical diseasefree survival (bDFS) rate, overall survival rate (OS) and toxicity after low-dose rate I(125) permanent-implant prostate brachytherapy (LDR-BRT) in elderly patients affected by prostate cancer.
Patients aged ≥65 years with a diagnosis of prostate cancer and treated at our institution were retrospectively evaluated. All patients received LDR-BRT as monotherapy; the prescribed dose was 145 Gy to the prostate. Patients were stratified according to the National Comprehensive Cancer Network (NCCN) recurrence risk groups. Biochemical failure was defined according to the American Society of Therapeutic Radiology and Oncology (ASTRO) criteria. The Radiation Therapy Oncology Group (RTOG) scale was used for toxicity. The bDFS was calculated from implant date to biochemical recurrence.
Between June 2003 and December 2008, 80 elderly patients with a median age of 75 (range, 65-86) years were treated with LDR-BRT: 51 low risk (64%), and 29 intermediate risk (36%). Over a median follow-up period of 53 (range, 28-94) months, the global actuarial 5-year bDFS rate was 91.3% and the 5-year OS was 95%. Toxicity was mild: late grade-3 genitourinary toxicity was observed in only four patients (5%).
Our data suggest that LDR-BRT is effective and safe as monotherapy in elderly patients.
本研究评估了低剂量率碘（125）永久性植入前列腺近距离放射治疗（LDR-BRT）在老年前列腺癌患者中的生化无病生存率（bDFS）、总生存率（OS）和毒性。
回顾性评估了在我院就诊的年龄≥65 岁、诊断为前列腺癌并接受治疗的患者。所有患者均接受 LDR-BRT 作为单一疗法；前列腺的处方剂量为 145Gy。根据美国国家综合癌症网络（NCCN）复发风险组对患者进行分层。生化失败根据美国放射治疗肿瘤学协会（ASTRO）标准定义。毒性采用放射治疗肿瘤学组（RTOG）量表进行评估。bDFS 从植入日期到生化复发进行计算。
2003 年 6 月至 2008 年 12 月，80 名中位年龄为 75 岁（范围 65-86 岁）的老年患者接受了 LDR-BRT 治疗：51 例低危（64%），29 例中危（36%）。在中位随访 53 个月（范围 28-94 个月）期间，总体 5 年 bDFS 率为 91.3%，5 年 OS 为 95%。毒性较轻：仅 4 名患者（5%）出现晚期 3 级泌尿生殖毒性。
我们的数据表明，LDR-BRT 作为单一疗法在老年患者中是有效且安全的。
