Pegurri Ludovica, Buglione Michela, Girelli Giovanni, Guarnieri Alessia, Meattini Icro, Ricardi Umberto, Mangoni Monica, Gabriele Pietro, Bellavita Rita, Krengli Marco, Bonetta Alberto, Cagna Emanuela, Bunkheila Feisal, Borghesi Simona, Signor Marco, Di Marco Adriano, Bertoni Filippo, Stefanacci Marco, Gatta Roberto, De Bari Berardino, Magrini Stefano Maria
Tumori. 2014 Jan-Feb;100(1):31-7. doi: 10.1700/1430.15812.
In 2002, a survey including 1759 patients treated from 1980 to 1998 established a "benchmark" Italian data source for prostate cancer radiotherapy. This report updates the previous one.
Data on clinical management and outcomes of 3001 patients treated in 15 centers from 1999 through 2003 were analyzed and compared with those of the previous survey.
Significant differences in clinical management (-10% had abdominal magnetic resonance imaging; +26% received ≥70 Gy, +48% conformal radiotherapy, -20% pelvic radiotherapy) and in G3-4 toxicity rates (-3.8%) were recorded. Actuarial 5-year overall, disease-specific, clinical relapse-free, and biochemical relapse-free survival rates were 88%, 96%, 96% and 88%, respectively. At multivariate analysis, D'Amico risk categories significantly impacted on all the outcomes; higher radiotherapy doses were significantly related with better overall survival rates, and a similar trend was evident for disease-specific and biochemical relapse-free survival; cumulative probability of 5-year late G1-4 toxicity was 24.8% and was significantly related to higher radiotherapy doses (P <0.001).
The changing patterns of practice described seem related to an improvement in efficacy and safety of radiotherapy for prostate cancer. However, the impact of the new radiotherapy techniques should be prospectively evaluated.
2002年，一项针对1980年至1998年期间接受治疗的1759例患者的调查建立了意大利前列腺癌放疗的“基准”数据源。本报告对之前的报告进行了更新。
分析了1999年至2003年期间在15个中心接受治疗的3001例患者的临床管理和结局数据，并与之前的调查数据进行了比较。
记录到临床管理方面存在显著差异（腹部磁共振成像检查的患者减少10%；接受≥70 Gy放疗的患者增加26%，接受适形放疗的患者增加48%，接受盆腔放疗的患者减少20%）以及G3 - 4毒性发生率存在显著差异（降低3.8%）。5年精算总生存率、疾病特异性生存率、临床无复发生存率和生化无复发生存率分别为88%、96%、96%和88%。多因素分析显示，达米科风险分类对所有结局均有显著影响；较高的放疗剂量与较好的总生存率显著相关，疾病特异性生存率和生化无复发生存率也呈现类似趋势；5年晚期G1 - 4毒性累积概率为24.8%，且与较高的放疗剂量显著相关（P <0.001）。
所描述的实践模式变化似乎与前列腺癌放疗的疗效和安全性改善有关。然而，新放疗技术的影响应进行前瞻性评估。
