Jones Glenn Wayne, Kellini Osama, Roberts Robin, Girgis Nevein, Brown Chelsea, Nottage Krista, McGowan Thomas, Quee-Brown Corrine Sin, Brown Conville
The Partners Clinical Research Centre, 72 Collins Avenue, Nassau, Bahamas.
School of Clinical Medicine and Research, University of West Indies, Nassau, Bahamas.
Cancer Causes Control. 2017 Nov;28(11):1285-1293. doi: 10.1007/s10552-017-0940-9. Epub 2017 Sep 1.
This is a first report from The Bahamas of management and long-term outcomes in men with non-metastatic prostate cancer treated with radiotherapy, with or without androgen deprivation therapy, from 2004 to 2016.
Patients were characterized by baseline factors, stratified by risk groups using tumor stage (clinical T-stage), prostate-specific antigen (PSA) test result and Gleason grade, and sorted by treatment combinations (by radiation volume and use of androgen deprivation).
Overall, 205/216 men were Afro-Caribbean. Median age was 66. There were 18 low-, 77 intermediate-, and 121 high-risk patients, treated with prostate-only versus pelvis plus prostate radiotherapy, many receiving 2 years of androgen suppression. Time to commence radiation was about 6 months from initial diagnosis. In those not relapsing, global PSA nadir was reached in 4 years and was under 1.0, reduced from a mean at baseline of 31. At 10 years, disease-free experience (32 relapses) was 68% and overall survival was 87%, although only 2/12 deaths were related to prostate cancer. This experience compares favorably with recently published outcomes from other countries using very similar treatments.
This study establishes benchmark statistics from diagnosis to long-term follow-up. Outcomes in Bahamian men are consistent with expectations from risk-stratified guidelines followed in developed countries.
这是巴哈马群岛关于2004年至2016年接受放疗（无论是否联合雄激素剥夺治疗）的非转移性前列腺癌男性患者的管理及长期预后的首份报告。
患者以基线因素为特征，根据肿瘤分期（临床T分期）、前列腺特异性抗原（PSA）检测结果和 Gleason分级分为不同风险组，并按治疗组合（放疗范围和雄激素剥夺的使用情况）进行分类。
总体而言，205/216名男性为非洲裔加勒比人。中位年龄为66岁。有18名低风险、77名中风险和121名高风险患者，接受了仅前列腺放疗与盆腔加前列腺放疗，许多患者接受了2年的雄激素抑制治疗。从初始诊断到开始放疗的时间约为6个月。在未复发的患者中，4年内达到了总体PSA最低点，低于1.0，较基线时的平均31有所降低。10年时，无病生存率（32例复发）为68%，总生存率为87%，尽管只有2/12例死亡与前列腺癌有关。该结果与其他国家近期发表的使用非常相似治疗方法的结果相比具有优势。
本研究建立了从诊断到长期随访的基准统计数据。巴哈马男性患者的预后与发达国家遵循的风险分层指南的预期一致。
