Temesfői Viktória, Herczeg Róbert, Lőcsei Zoltán, Sebestyén Klára, Sebestyén Zsolt, Mangel László, Damásdi Miklós
Lab-on-a-Chip Research Group, János Szentágothai Research Center, University of Pécs, Ifjúság útja 20, H-7624 Pécs, Hungary.
Department of Laboratory Medicine, Medical School, University of Pécs, Ifjúság útja 13, H-7624 Pécs, Hungary.
J Clin Med. 2020 Dec 30;10(1):110. doi: 10.3390/jcm10010110.
Radiation therapy has undergone significant technical development in the past decade. However, the complex therapy of intermediate-risk patients with organ-confined prostate carcinoma still poses many questions. Our retrospective study investigated the impact of selected components of the treatment process including radiotherapy, hormone deprivation, risk classification, and patients' response to therapy.
The impact of delivered dose, planning accuracy, duration of hormone deprivation, risk classification, and the time to reach prostate-specific antigen (PSA) nadir state were analyzed among ninety-nine individuals afflicted with organ-confined disease. Progression was defined as a radiological or biochemical relapse within five years from radiotherapy treatment.
We found that 58.3% of the progressive population consisted of intermediate-risk patients. The progression rate in the intermediate group was higher (21.9%) than in the high-risk population (12.1%). Dividing the intermediate group, according to the International Society of Urological Pathology (ISUP) recommendations, resulted in the non-favorable subgroup having the highest rate of progression (33.3%) and depicting the lowest percentage of progression-free survival (66.7%).
Extended pelvic irradiation on the regional lymph nodes may be necessary for the ISUP Grade 3 subgroup, similarly to the high-risk treatment. Therapy optimization regarding the intermediate-risk population based on the ISUP subgrouping suggestions is highly recommended in the treatment of organ-confined prostate cancer.
在过去十年中，放射治疗技术取得了重大进展。然而，对器官局限性前列腺癌中危患者的复杂治疗仍存在许多问题。我们的回顾性研究调查了治疗过程中选定组成部分的影响，包括放射治疗、激素剥夺、风险分类以及患者对治疗的反应。
分析了99例患有器官局限性疾病患者的放疗剂量、计划准确性、激素剥夺持续时间、风险分类以及达到前列腺特异性抗原（PSA）最低点状态的时间的影响。进展定义为放疗后五年内出现放射学或生化复发。
我们发现，58.3%的进展性患者为中危患者。中间组的进展率（21.9%）高于高危人群（12.1%）。根据国际泌尿病理学会（ISUP）的建议对中间组进行划分，结果显示预后不良亚组的进展率最高（33.3%），无进展生存率最低（66.7%）。
与高危治疗类似，对于ISUP 3级亚组可能需要对区域淋巴结进行扩大盆腔照射。在器官局限性前列腺癌的治疗中，强烈建议根据ISUP亚组分类建议对中危人群进行治疗优化。
