Morgan Tiffany M, Rossi Peter J, Cutrell Patrick K, Zhang Chao, Press Robert H, Rahnema Sara, Sanda Martin, Pattaras John, Cimmino Cara, Hershatter Bruce, Jani Ashesh B, Patel Pretesh R
Department of Radiation Oncology, Emory University, Atlanta, GA; Winship Cancer Institute, Emory University, Atlanta, GA.
Winship Cancer Institute, Emory University, Atlanta, GA; Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA.
Brachytherapy. 2019 Nov-Dec;18(6):793-799. doi: 10.1016/j.brachy.2019.06.001. Epub 2019 Jul 20.
The purpose of the study was to report our institutional quality of life data for those undergoing high-dose-rate brachytherapy with an International Prostate Symptom Score (IPSS) ≥15 compared with those with an IPSS <15.
The charts of 95 patients with localized adenocarcinoma of the prostate treated with high-dose-rate as monotherapy or as a boost after external beam radiation therapy at a single institution between 2012 and 2015 were reviewed. All patients completed the IPSS and Expanded Prostate Index for Prostate Cancer-Clinical Practice quality of life assessments before treatment and at least one followup survey. Linear mixed models were performed to test for significant changes and differences in each outcome over time.
Median followup in the IPSS <15 group was 23 months and 16 months in the IPSS ≥15 group. Median prostate volume was 46.3 cc and 45.4 cc, respectively (p = 0.901). IPSS, incontinence, and urinary irritation/obstruction scores were significantly higher in the IPSS ≥15 group compared with the IPSS <15 group at baseline (all p ≤ 0.05). By the >24 months time point, these scores had decreased below baseline and were not significantly different from those with a baseline IPSS <15 (all p > 0.1). 12.5% in the IPSS ≥15 group developed a new Grade 2 genitourinary toxicity requiring an alpha blocker compared with 26.5% in the IPSS <15 group (p = 0.34). No patients required emergency placement of a foley catheter within 30 days of treatment.
Given the low rates of genitourinary toxicity, this technique appears appropriate even for those with high baseline urinary symptoms.
本研究旨在报告国际前列腺症状评分（IPSS）≥15的接受高剂量率近距离放射治疗患者与IPSS<15的患者相比，我们机构的生活质量数据。
回顾了2012年至2015年期间在单一机构接受高剂量率作为单一疗法或作为外照射放疗后增敏治疗的95例局限性前列腺腺癌患者的病历。所有患者在治疗前和至少一次随访调查时完成了IPSS和前列腺癌扩展前列腺指数临床实践生活质量评估。采用线性混合模型来检验每个结果随时间的显著变化和差异。
IPSS<15组的中位随访时间为23个月，IPSS≥15组为16个月。前列腺中位体积分别为46.3立方厘米和45.4立方厘米（p = 0.901）。基线时，IPSS≥15组的IPSS、尿失禁和尿路刺激/梗阻评分显著高于IPSS<15组（所有p≤0.05）。到>24个月时间点时，这些评分已降至基线以下，且与基线IPSS<15的患者无显著差异（所有p>0.1）。IPSS≥15组中有12.5%的患者出现新的2级泌尿生殖系统毒性，需要使用α受体阻滞剂，而IPSS<15组为26.5%（p = 0.34）。治疗后30天内无患者需要紧急放置导尿管。
鉴于泌尿生殖系统毒性发生率较低，即使对于基线尿路症状严重的患者，该技术似乎也是合适的。
