Lee Sea-Won, Hwang Tae-Kon, Hong Sung-Hoo, Lee Ji-Youl, Chung Mi Joo, Jeong Song Mi, Kim Sung Hwan, Lee Jong Hoon, Jang Hong Seok, Yoon Sei Chul
Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Radiat Oncol J. 2014 Sep;32(3):138-46. doi: 10.3857/roj.2014.32.3.138. Epub 2014 Sep 30.
This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy.
A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL.
After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed.
The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.
本单机构研究旨在观察根治性前列腺切除术后接受术后放疗患者的结局。
纳入2005年8月至2011年7月在韩国天主教大学首尔圣玛丽医院接受根治性前列腺切除术后接受放疗的59例经组织学确诊为前列腺腺癌的男性患者。他们接受盆腔45 - 50 Gy照射，并对前列腺床进行追加照射，常规分割照射总剂量达63 - 72 Gy（中位剂量，64.8 Gy）。分析接受激素治疗患者的比例及其给药方式。主要终点是放疗结束后的生化无复发生存期（bRFS）。次要终点是总生存期（OS）。生化复发定义为前列腺特异性抗原水平高于0.2 ng/mL。
中位随访53个月（范围，0至104个月）后，所有患者的5年bRFS估计为80.4%。5年OS估计为96.6%。接受雄激素剥夺治疗的患者5年bRFS为95.1%，而未接受任何治疗的患者为40.0%（p < 0.01）。然而，多因素分析中生存差异的统计学意义未持续存在。3年精算3级慢性毒性为1.7%，未观察到3级急性毒性。
本机构根治性前列腺切除术后放疗的生化和毒性结局良好，与其他研究相当。
