Bao Alicia, Barsky Andrew R, Maxwell Russell, Bekelman Justin E, Both Stefan, Christodouleas John P, Deville Curtiland, Fang Penny, Tochner Zelig A, Vapiwala Neha
Ohio State College of Medicine, The Ohio State University, Columbus, OH, USA.
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA.
Int J Part Ther. 2021 Oct 20;8(4):14-24. doi: 10.14338/IJPT-21-00016. eCollection 2022 Spring.
Long-term data regarding the disease control outcomes of proton beam therapy (PBT) for patients with favorable risk intact prostate cancer (PC) are limited. Herein, we report our institution's long-term disease control outcomes in PC patients with clinically localized disease who received PBT as primary treatment.
One hundred sixty-six favorable risk PC patients who received definitive PBT to the prostate gland at our institution from 2010 to 2012 were retrospectively assessed. The outcomes studied were biochemical failure-free survival (BFFS), biochemical failure, local failure, regional failure, distant failure, PC-specific survival, and overall survival. Patterns of failure were also analyzed. Multivariate Cox proportional hazards modeling was used to estimate independent predictors of BFFS.
The median length of follow-up was 8.3 years (range, 1.2-10.5 years). The majority of patients had low-risk disease (58%, n = 96), with a median age of 64 years at the onset of treatment. Of 166 treated men, 13 (7.8%), 8 (4.8%), 2 (1.2%) patient(s) experienced biochemical failure, local failure, regional failure, respectively. Regional failure was seen in an obturator lymph node in 1 patient and the external iliac lymph nodes in the other. None of the patients experienced distant failure. There were 5 (3.0%) deaths, none of which were due to PC. The 5- and 8-year BFFS rate were 97% and 92%, respectively. None of the clinical disease characteristics or treatment-related factors assessed were associated with BFFS on multivariate Cox proportional hazards modeling (all .05).
Disease control rates reported in our assessment of PBT were similar to those reported in previous clinically localized intact PC analyses, which used intensity-modulated radiotherapy, three-dimensional conformal radiotherapy, or radical prostatectomy as definitive therapy. In addition, BFFS rates were similar, if not improved, to previous PBT studies.
关于质子束治疗（PBT）对低危局限性前列腺癌（PC）患者疾病控制效果的长期数据有限。在此，我们报告本机构对临床局限性疾病的PC患者进行PBT作为主要治疗的长期疾病控制效果。
回顾性评估了2010年至2012年在本机构接受前列腺确定性PBT的166例低危PC患者。研究的结局包括无生化失败生存（BFFS）、生化失败、局部失败、区域失败、远处失败、前列腺癌特异性生存和总生存。还分析了失败模式。采用多变量Cox比例风险模型估计BFFS的独立预测因素。
中位随访时间为8.3年（范围1.2 - 10.5年）。大多数患者为低危疾病（58%，n = 96），治疗开始时的中位年龄为64岁。在166例接受治疗的男性中，分别有13例（7.8%）、8例（4.8%）、2例（1.2%）患者发生生化失败、局部失败、区域失败。1例患者的闭孔淋巴结出现区域失败，另1例患者的髂外淋巴结出现区域失败。所有患者均未发生远处失败。有5例（3.0%）死亡，均非由前列腺癌所致。5年和8年的BFFS率分别为97%和92%。在多变量Cox比例风险模型中，所评估的临床疾病特征或治疗相关因素均与BFFS无关（所有P>.05）。
我们对PBT评估中报告的疾病控制率与先前对临床局限性局限性PC的分析结果相似，先前的分析使用调强放疗、三维适形放疗或根治性前列腺切除术作为确定性治疗。此外，BFFS率与先前的PBT研究相似，即便没有提高。
