Department of Radiation Oncology, University Hospital of Udine, Udine, Italy.
Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy;
In Vivo. 2022 Jan-Feb;36(1):306-313. doi: 10.21873/invivo.12703.
BACKGROUND/AIM: Stereotactic radiotherapy (SRT) is an effective treatment for localized prostate cancer. However, is it not clear whether the addition of androgen deprivation therapy (ADT) to SRT is beneficial. The aim of this study was to analyze the outcomes of a series of patients treated with SRT plus ADT for localized prostate cancer.
Patients were treated with SRT with 42 Gy in 7 fractions with volumetric-modulated arc therapy plus Image Guided Radiotherapy (V-MAT IGRT) technique. ADT was administered to patients with intermediate unfavorable- and high-risk disease. Study endpoints were biochemical disease-free survival (bDFS), overall survival (OS), acute and late toxicity and patient-reported outcomes (PROs) using international prostate cancer symptoms scale (IPSS) and international index of erectile function (IIEF).
A total of 170 consecutive patients were identified, of which 49 (28.8%) with low-risk, 15 (8.8%) with favorable intermediate-risk 76 (44.7%) with unfavorable intermediate-risk and 30 (17.6%) with high-risk class. All patients of unfavorable intermediate- and high-risk groups were administered LHRH analogue concurrently to SRT and for at least 6 months. Patients with unfavorable intermediate- and high-risk presented a 5-year bDFS of 81.7% and 76.9%, respectively.
SRT consisting of 42 Gy in seven fractions with short-term ADT represents a safe and effective treatment for unfavorable intermediate and high risk prostate cancer. Our results support the need of high quality studies to test the efficacy of ADT combined with SRT for unfavorable intermediate- and high-risk localized prostate cancer.
背景/目的：立体定向放疗（SRT）是治疗局限性前列腺癌的有效方法。然而，目前尚不清楚在 SRT 中加入雄激素剥夺疗法（ADT）是否有益。本研究旨在分析一组接受 SRT 联合 ADT 治疗局限性前列腺癌患者的结果。
患者采用 42Gy 分 7 次的容积调强弧形治疗联合图像引导放疗（V-MAT IGRT）技术进行 SRT。中危和高危疾病患者给予 ADT。研究终点为生化无病生存率（bDFS）、总生存率（OS）、急性和晚期毒性以及国际前列腺癌症状评分（IPSS）和国际勃起功能指数（IIEF）的患者报告结局（PROs）。
共确定了 170 例连续患者，其中低危 49 例（28.8%）、中危有利 15 例（8.8%）、中危不利 76 例（44.7%）和高危 30 例（17.6%）。所有中危和高危患者在 SRT 时同步给予促黄体激素释放激素类似物，并至少持续 6 个月。中危和高危组患者的 5 年 bDFS 分别为 81.7%和 76.9%。
7 个疗程共 42Gy 的 SRT 联合短期 ADT 是治疗中危和高危前列腺癌的一种安全有效的方法。我们的结果支持需要高质量的研究来检验 ADT 联合 SRT 治疗中危和高危局限性前列腺癌的疗效。
