联合放疗与激素治疗对高危前列腺癌的治疗——结果及影响预后因素的识别

Treatment of high risk prostate cancer with combined radiotherapy and hormonal treatment- results and identification of factors influencing outcome.

作者信息

Kubes J, Dedeckova K, Cvek J, Vondrácek V, Dvorak J, Argalacsová S, Navrátil M, Buril J

机构信息

Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1st Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

J BUON. 2013 Jul-Sep;18(3):669-74.

PMID:24065481

Abstract

PURPOSE

The aim of this work was to prospectively analyze the outcome of combined hormonal treatment and radical radiotherapy in high risk non metastatic prostate cancer patients (T1=4, N0-1, M0).

METHODS

Between April 2003 and December 2007 196 patients with high risk prostate cancer were treated with curative intent. The treatment consisted of 2-month neoadjuvant hormonal treatment (LHRH analog), radical radiotherapy (68-78 Gy, conformal technique) and an optional 2-year adjuvant hormonal treatment.

RESULTS

The median follow up time was 59 months. Fiveyear overall survival was 86% and 5-year biochemical disease free survival (DFS) 70%. Factors found to be statistically significant relative to outcomes were Gleason score (p=0.017), initial PSA value (p=0.039) and adjuvant hormonal treatment (p=0.035). There was no significant association between radiotherapy dose or volume and biochemical DFS (bDFS). Late genitourinary and gastrointestinal toxicity was acceptable.

CONCLUSION

Treatment combining hormonal therapy and radical radiotherapy can be recommended for this subgroup of prostate cancer patients. Adjuvant hormonal treatment should also be used.

摘要

目的

本研究旨在前瞻性分析高危非转移性前列腺癌患者（T1 = 4，N0 - 1，M0）接受联合激素治疗和根治性放疗的疗效。

方法

2003年4月至2007年12月期间，196例高危前列腺癌患者接受了根治性治疗。治疗包括2个月的新辅助激素治疗（促黄体激素释放激素类似物）、根治性放疗（68 - 78 Gy，适形技术）以及可选的2年辅助激素治疗。

结果

中位随访时间为59个月。5年总生存率为86%，5年无生化疾病生存率（DFS）为70%。发现与预后具有统计学显著相关性的因素为 Gleason 评分（p = 0.017）、初始前列腺特异抗原（PSA）值（p = 0.039）和辅助激素治疗（p = 0.035）。放疗剂量或体积与生化无病生存率（bDFS）之间无显著相关性。晚期泌尿生殖系统和胃肠道毒性可接受。