Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah.
Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah.
Pract Radiat Oncol. 2013 Jul-Sep;3(3):234-240. doi: 10.1016/j.prro.2012.11.011. Epub 2013 Jan 28.
To evaluate the effect of radiation therapy on prostate cancer-specific and overall survival with node-positive cancer in a retrospective Surveillance, Epidemiology and End RESULTS (SEER) population based study.
The survival of subjects with cT1-T4,cN1,M0 prostate adenocarcinoma diagnosed between 1988 and 2006 were compared with univariate and multivariate Cox regression analysis.
A total of 1100 subjects, with a median age of 69 years and median follow-up time of 90 months, were identified. The 10-year cancer-specific survival for men who had no definitive therapy was 50.3% and for those who had radiation therapy 62.7%. This was significantly different favoring radiation therapy (hazard ratio [HR] = 0.66, 95% confidence interval [CI] = 0.54 to 0.82, P ≤ .01). On multivariate analysis evaluating age, histologic grade, T stage, year of diagnosis, marital status, SEER registry and radiation therapy, radiation therapy (HR = 0.67, 95% CI = 0.54 to 0.84, P ≤ .01), year of diagnosis (HR = 0.96, 95% CI = 0.93 to 0.99, P = .01), and low and intermediate grade disease were correlated with improved CSS. The number needed to treat to prevent 1 prostate cancer-specific death at 10 years was 8 persons. A cause of death analysis revealed non-prostate cancer deaths were not statistically different in the comparison groups.
Radiation therapy is correlated with a clinically significant reduction in all cause and prostate cancer-specific death.
在一项回顾性监测、流行病学和结果（SEER）人群基础研究中，评估放射治疗对淋巴结阳性癌症患者前列腺癌特异性和总体生存率的影响。
对 1988 年至 2006 年间诊断为 cT1-T4、cN1、M0 前列腺腺癌的患者进行单变量和多变量 Cox 回归分析，比较其生存情况。
共纳入 1100 例患者，中位年龄为 69 岁，中位随访时间为 90 个月。未接受确定性治疗的患者 10 年癌症特异性生存率为 50.3%，接受放射治疗的患者为 62.7%。这具有显著差异，放射治疗有优势（风险比[HR] = 0.66，95%置信区间[CI] = 0.54 至 0.82，P ≤ 0.01）。多变量分析评估年龄、组织学分级、T 分期、诊断年份、婚姻状况、SEER 登记处和放射治疗，放射治疗（HR = 0.67，95%CI = 0.54 至 0.84，P ≤ 0.01）、诊断年份（HR = 0.96，95%CI = 0.93 至 0.99，P = 0.01）和低级别和中级别疾病与 CSS 改善相关。为预防 10 年内 1 例前列腺癌特异性死亡而需要治疗的人数为 8 人。死因分析显示，两组之间非前列腺癌死亡无统计学差异。
放射治疗与全因和前列腺癌特异性死亡的临床显著降低相关。
