Jacobsen Mikael G, Thomsen Frederik B, Fode Mikkel, Bisbjerg Rasmus, Østergren Peter B
a Department of Urology , Gentofte and Herlev University Hospital , Herlev , Denmark.
b Department of Urology , Zealand University Hospital , Roskilde , Denmark.
Scand J Urol. 2018 Apr;52(2):164-168. doi: 10.1080/21681805.2018.1438510. Epub 2018 Feb 20.
Brachytherapy is one of several curative treatments for localized prostate cancer (PCa). The objective of this study was to report biochemical recurrence-free survival (BRFS), metastatic-free survival (MFS) and PCa-specific mortality after low-dose brachytherapy, stratified according to the D'Amico risk classification in a large Danish cohort.
The study population comprised 502 men treated with brachytherapy in 1998-2012. BRFS was defined by the Phoenix criteria. Kaplan-Meier survival analysis was used to estimate BRFS and MFS. The cumulative PCa mortality was analysed using competing risk analyses. Multivariable Cox regression analysis was used to estimate risk of biochemical recurrence.
In total, 206 men were classified with low-risk PCa, 265 men with intermediate-risk PCa and 33 men with high-risk PCa. Median follow-up was 6.6 years [95% confidence interval (CI) 6.2-7.0]. The 10 year BRFS was 90% (95% CI 83-97), 75% (95% CI 65-87) and 75% (95% CI 59-92) in men with low-, intermediate- and high-risk PCa, respectively. The 10 year MFS was 95% (95% CI 89-100), 93% (95% CI 88-98) and 78% (95% CI 57-99) in men with low-, intermediate- and high-risk PCa, respectively. The 10 year cumulative incidence of PCa mortality was 1% (95% CI 0-3), 5% (95% CI 0-12) and 11% (95% CI 0-25) for men with low-, intermediate- and high-risk PCa, respectively.
Low-dose brachytherapy offers good short- to intermediate-term cancer control in selected men with localized PCa. Further studies are needed for safety analyses and for comparison with other treatment modalities.
近距离放射治疗是局限性前列腺癌（PCa）的几种根治性治疗方法之一。本研究的目的是报告在一个大型丹麦队列中，根据达米科风险分类分层的低剂量近距离放射治疗后的无生化复发生存期（BRFS）、无转移生存期（MFS）和PCa特异性死亡率。
研究人群包括1998年至2012年接受近距离放射治疗的502名男性。BRFS根据凤凰城标准定义。采用Kaplan-Meier生存分析来估计BRFS和MFS。使用竞争风险分析来分析累积PCa死亡率。采用多变量Cox回归分析来估计生化复发风险。
总共206名男性被归类为低风险PCa，265名男性为中风险PCa，33名男性为高风险PCa。中位随访时间为6.6年[95%置信区间（CI）6.2 - 7.0]。低风险、中风险和高风险PCa男性的10年BRFS分别为90%（95%CI 83 - 97）、75%（95%CI 65 - 87）和75%（95%CI 59 - 92）。低风险、中风险和高风险PCa男性的10年MFS分别为95%（95%CI 89 - 100）、93%（95%CI 88 - 98）和78%（95%CI 57 - 99）。低风险、中风险和高风险PCa男性的10年PCa死亡率累积发生率分别为1%（95%CI 0 - 3）、5%（95%CI 0 - 12）和11%（95%CI 0 - 25）。
低剂量近距离放射治疗为选定的局限性PCa男性提供了良好的短期至中期癌症控制。需要进一步研究进行安全性分析以及与其他治疗方式进行比较。
