Boladeras Anna, Martinez Evelyn, Ferrer Ferran, Gutierrez Cristina, Villa Salvador, Pera Joan, Guedea Ferran
Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, l'Hospitalet de Llobregat, Barcelona, Spain.
Department of Radiation Oncology, Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona, Barcelona, Spain.
Rep Pract Oncol Radiother. 2016 May-Jun;21(3):181-7. doi: 10.1016/j.rpor.2015.12.002. Epub 2016 Feb 20.
To present survival and toxicity outcomes in patients with clinically localized, non-metastatic prostate cancer (PCa) treated with external beam radiotherapy (EBRT) combined with androgen deprivation therapy (ADT).
Retrospective study of 849 PCa patients (pts) treated from 1996 to 2005. Until August 2000, all patients (281) were treated with conventional dose EBRT (<76 Gy); subsequent pts received ≥76 Gy (565 pts). Median age was 70 years (range, 39-82). Most pts were intermediate (353; 42.8%) or high-risk (344; 41.7%). Mean PSA was 10.1 ng/ml. Median dose to the prostate was 75 Gy. Complete ADT was administered to 525 pts (61.8%).
Median follow-up was 109.6 months (range, 68.3-193.4). Overall survival (OS) was 92.5% and 81.1% at 5 and 10 years; by risk group (low, intermediate, high), 5- and 10-year OS rates were 94.3% and 85.9%, 92.3% and 79.2%, and 91.9% and 80.2% (p = 0.728). Five- and 10-year BRFS was 94.1% and 80.6% (low risk), 86.4% and 70.9% (intermediate), and 85.2% and 71.4% (high) (p = 0.0666). Toxicity included rectitis: grade 1 (G1) (277 pts; 32.6%), G2 (108; 12.7%), and G3 (20; 2.6%) and urethritis: G1 (294; 34.6%); G2 (223; 26.2%), and G3 (11; 1.3%). By dose rate (<76 Gy vs. ≥76 Gy), 5 and 10-year BRFS rates were 83.1% and 68.3% vs. 88.4% and 74.8% (p = 0.038).
Our results are comparable to other published series in terms of disease control and toxicity. These findings confirm the need for dose escalation to achieve better biochemical control and the benefits of ADT in high-risk PCa patients.
呈现接受外照射放疗（EBRT）联合雄激素剥夺治疗（ADT）的临床局限性、非转移性前列腺癌（PCa）患者的生存及毒性结果。
对1996年至2005年期间接受治疗的849例PCa患者进行回顾性研究。至2000年8月，所有患者（281例）接受常规剂量EBRT（<76 Gy）治疗；随后的患者接受≥76 Gy（565例）治疗。中位年龄为70岁（范围39 - 82岁）。大多数患者为中危（353例；42.8%）或高危（344例；41.7%）。平均前列腺特异抗原（PSA）为10.1 ng/ml。前列腺的中位剂量为75 Gy。525例患者（61.8%）接受了完整的ADT治疗。
中位随访时间为109.6个月（范围68.3 - 193.4个月）。5年和10年的总生存率（OS）分别为92.5%和81.1%；按风险组（低、中、高）划分，5年和10年的OS率分别为94.3%和85.9%、92.3%和79.2%、91.9%和80.2%（p = 0.728）。5年和10年的生化无复发生存率（BRFS）分别为94.1%和80.6%（低危）、86.4%和70.9%（中危）、85.2%和71.4%（高危）（p = 0.0666）。毒性反应包括直肠炎：1级（G1）（277例患者；32.6%）、2级（G2）（108例；12.7%）、3级（G3）（20例；2.6%）以及尿道炎：G1（294例；34.6%）；G2（223例；26.2%）、G3（11例；1.3%）。按剂量率（<76 Gy与≥76 Gy）划分，5年和10年的BRFS率分别为83.1%和68.3%与88.4%和74.8%（p = 0.038）。
在疾病控制和毒性方面，我们的结果与其他已发表系列相当。这些发现证实了提高剂量以实现更好生化控制的必要性以及ADT在高危PCa患者中的益处。
