Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba, 272-8513, Japan.
Ir J Med Sci. 2023 Dec;192(6):2663-2671. doi: 10.1007/s11845-023-03356-z. Epub 2023 Apr 25.
Radiotherapy (RT) after radical prostatectomy (RP) includes adjuvant radiotherapy (ART) and salvage radiotherapy (SRT), which can prevent or cure biochemical recurrence.
To evaluate long-term outcomes of RT after RP and to examine factors affecting biochemical recurrence-free survival (bRFS).
Sixty-six received ART and 73 received SRT between 2005 and 2012 were included. The clinical outcomes and late toxicities were evaluated. Univariate and multivariate analyses were performed to examine factors affecting bRFS.
Median follow-up from RP was 111 months. Five-year bRFS and 10-year distant metastasis-free survival from RP were 82.8% and 84.5% in ART, and 74.6% and 92.4% in SRT, respectively. The most frequent late toxicity was hematuria, which was higher in ART (p = .01). No recurrence within RT field was occurred. On univariate analysis, pelvic RT was associated with favorable bRFS in ART (p = .048). In SRT, post-RP prostate-specific antigen (PSA) level (< 0.05 ng/mL), PSA nadir after RT (≤ 0.01 ng/mL), and time to PSA nadir (≥ 10 months) were associated with favorable bRFS (p = .03, p < .001, and p = .002, respectively). On multivariate analysis, post-RP PSA level and time to PSA nadir were independent predictive factors for bRFS in SRT (p = .04 and p = .005).
ART and SRT had favorable outcomes with no recurrence within RT field. In SRT, the time to PSA nadir after RT (≥ 10 months) was found to be a new predictor for favorable bRFS and useful in assessing treatment efficacy.
根治性前列腺切除术（RP）后的放疗包括辅助放疗（ART）和挽救性放疗（SRT），可以预防或治愈生化复发。
评估 RP 后放疗的长期结果，并研究影响生化无复发生存（bRFS）的因素。
纳入 2005 年至 2012 年间接受 ART 的 66 例和接受 SRT 的 73 例患者。评估临床结局和晚期毒性。进行单因素和多因素分析，以研究影响 bRFS 的因素。
RP 后中位随访时间为 111 个月。ART 的 5 年 bRFS 和 10 年 RP 远处无转移生存率分别为 82.8%和 84.5%，SRT 分别为 74.6%和 92.4%。最常见的晚期毒性是血尿，ART 组更高（p = .01）。RT 野内无复发。单因素分析显示，盆腔放疗与 ART 的良好 bRFS 相关（p = .048）。在 SRT 中，RP 后 PSA 水平（< 0.05 ng/mL）、RT 后 PSA 最低值（≤ 0.01 ng/mL）和 PSA 最低值时间（≥ 10 个月）与良好的 bRFS 相关（p = .03，p < .001 和 p = .002）。多因素分析显示，RP 后 PSA 水平和 PSA 最低值时间是 SRT 中 bRFS 的独立预测因素（p = .04 和 p = .005）。
ART 和 SRT 具有良好的结果，RT 野内无复发。在 SRT 中，RT 后 PSA 最低值时间（≥ 10 个月）是预测 bRFS 的新因素，有助于评估治疗效果。
