Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA.
Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA.
Acta Oncol. 2022 Apr;61(4):468-477. doi: 10.1080/0284186X.2021.2016948. Epub 2021 Dec 30.
To report 5- and 7-year outcomes after image-guided moderately accelerated hypofractionated proton therapy (AHPT) for prostate cancer.
We reviewed the first 582 prostate cancer patients enrolled on prospective outcomes tracking trial and treated with double-scattered moderately AHPT between 2008 and 2015. 269 patients had low-risk (LR) and 313 had intermediate-risk (IR) disease, including 149 with favorable intermediate-risk (FIR) and 164 with unfavorable intermediate-risk (UIR) disease. LR patients received a median 70.0GyRBE (2.5GyRBE/fraction) and IR patients received a median of 72.5 GyRBE. Seventeen patients (UIR, = 12) received androgen deprivation therapy (ADT) for a median of 6 months. Toxicities were graded per the CTCAE, v4.0, and patient-reported quality-of-life data were reviewed.
Median follow-up was 8.0 years (0.9-12.2). The 5- and 7-year rates of freedom from biochemical progression (FFBP) overall and in the LR and IR subsets, respectively, were 96.8/95.2%, 98.8/98.8%, and 95.0/91.9%. For the FIR and UIR subsets, they were 97.2/95.2% and 93.1/88.8%. Actuarial 5- and 7-year rates of late CTCAE, v4.0, grade 2 gastrointestinal (GI), grade 3 GI, and grade 3 genitourinary (GU) toxicities were 9.9%/11.2%, 1.4/1.4% and 1.3/2.1%, respectively. No grade ≥4 GI or GU toxicities occurred. The mean (standard deviation, SD) IPSS and EPIC Composite bowel function and bother scores were 7 (SD = 5), 97 (SD = 7), and 94 (SD = 6), respectively at baseline, 7 (SD = 5), 92 (SD = 13), and 92 (SD = 9) at the 5-year follow-up, and 7 (SD = 5), 93 (SD = 12), and 92 (SD = 10) at the 7-year follow-up.
Image-guided AHPT 5- and 7-year outcomes show high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes in this cohort.
报告经图像引导适度加速质子治疗（AHPT）治疗前列腺癌的 5 年和 7 年结果。
我们回顾了 2008 年至 2015 年间前瞻性结果跟踪试验中首批 582 名接受双散射适度 AHPT 治疗的前列腺癌患者的资料。269 名患者为低危（LR），313 名患者为中危（IR），包括 149 名预后良好的中危（FIR）和 164 名预后不良的中危（UIR）。LR 患者接受中位 70.0GyRBE（2.5GyRBE/分次），IR 患者接受中位 72.5GyRBE。17 名患者（UIR，n=12）接受中位 6 个月的雄激素剥夺治疗（ADT）。毒性分级采用 CTCAE，v4.0，同时回顾患者报告的生活质量数据。
中位随访时间为 8.0 年（0.9-12.2）。总体和 LR 及 IR 亚组的 5 年和 7 年生化无进展生存率（FFBP）分别为 96.8/95.2%、98.8/98.8%和 95.0/91.9%。FIR 和 UIR 亚组分别为 97.2/95.2%和 93.1/88.8%。5 年和 7 年的迟发性 CTCAE，v4.0，胃肠道（GI）2 级，GI3 级和 GU3 级毒性的累积发生率分别为 9.9%/11.2%、1.4%/1.4%和 1.3/2.1%。没有发生任何≥4 级 GI 或 GU 毒性。基线时的平均（标准差，SD）国际前列腺症状评分（IPSS）和 EPIC 综合肠道功能和困扰评分分别为 7（SD=5）、97（SD=7）和 94（SD=6），5 年随访时分别为 7（SD=5）、92（SD=13）和 92（SD=9），7 年随访时分别为 7（SD=5）、93（SD=12）和 92（SD=10）。
在该队列中，图像引导的 AHPT 5 年和 7 年结果显示出较高的疗效、极小的医生评估毒性和良好的患者报告结果。
