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挽救性高剂量率近距离放射治疗前列腺癌:一家大型中心对100例连续患者的经验。

Salvage HDR brachytherapy for prostate cancer: a high-volume center experience on 100 consecutive patients.

作者信息

Mäkelä Lauri, Bergroth Robin, Taipale Lauri, Tornberg Sara, Visapää Harri

机构信息

Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

出版信息

Scand J Urol. 2023 Feb-Dec;57(1-6):36-40. doi: 10.1080/21681805.2023.2168048. Epub 2023 Feb 1.

Abstract

AIM

This study aims to evaluate the safety and efficacy of salvage HDR brachytherapy in patients who have undergone a thorough diagnostic process.

MATERIALS AND METHODS

100 prostate cancer patients - locally relapsed after previous radiotherapy - were treated with salvage HDR brachytherapy to a total dose of 24 Gy. Before treatment, the patients underwent PET imaging, prostate MRI, and prostate biopsies to confirm local relapse and exclude systemic disease. Concomitant ADT was applied in 69 patients. Toxicity and efficacy data were collected as a patient chart review. Toxicity was graded using Common Terminology Criteria for Adverse Events (CTCAE 5.0).

RESULTS

The 3-year bDFS and OS were 74% (confidence interval [CI] 95%: 60-87%) and 93% (CI 95%: 84-100%), respectively. Acute Grade 1-2 genitourinary toxicity was observed in 70 patients, 58 patients with Grade 1 and 12 patients with Grade 2, respectively. Acute Grade 1 gastrointestinal toxicity was observed in 8 patients.

CONCLUSIONS

This retrospective study shows that salvage HDR brachytherapy is a well-tolerated and effective treatment for histologically proven, local radio-recurrent disease.

摘要

目的

本研究旨在评估在经过全面诊断流程的患者中挽救性高剂量率近距离放射治疗的安全性和有效性。

材料与方法

100例先前放疗后局部复发的前列腺癌患者接受了总剂量为24 Gy的挽救性高剂量率近距离放射治疗。治疗前,患者接受了PET成像、前列腺MRI和前列腺活检,以确认局部复发并排除全身性疾病。69例患者同时接受了雄激素剥夺治疗(ADT)。通过查阅患者病历收集毒性和疗效数据。使用不良事件通用术语标准(CTCAE 5.0)对毒性进行分级。

结果

3年生化无复发生存率(bDFS)和总生存率(OS)分别为74%(95%置信区间[CI]:60 - 87%)和93%(CI 95%:84 - 100%)。70例患者观察到急性1 - 2级泌尿生殖系统毒性,其中58例为1级,12例为2级。8例患者观察到急性1级胃肠道毒性。

结论

这项回顾性研究表明,挽救性高剂量率近距离放射治疗对于经组织学证实的局部放疗复发性疾病是一种耐受性良好且有效的治疗方法。

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