LDR 近距离放疗优于单次 HDR 前列腺近距离放疗：一项前瞻性研究。

LDR brachytherapy offers superior tumor control to single-fraction HDR prostate brachytherapy: A prospective study.

机构信息

Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain.

Department of Radiation Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.

出版信息

Prostate. 2023 Aug;83(11):1068-1075. doi: 10.1002/pros.24548. Epub 2023 May 7.

DOI:10.1002/pros.24548

PMID:37150842

Abstract

PURPOSE

To compare the clinical outcomes of single-fraction high-dose-rate (HDR) brachytherapy and single-fraction low-dose-rate (LDR) brachytherapy as the sole treatment for primary prostate cancer.

MATERIAL AND METHODS

A quasi-randomized study that allocated, from March 2008 to February 2012, 129 low and intermediate risk prostate cancer patients to one single-fraction HDR of 19 Gy (61 patients) or to a 145 Gy I LDR permanent implant (68 patients. Biochemical relapse-free survival (bRFS) and overall survival (OS) were compared using the Kaplan-Meier method and Cox regression analysis.

RESULTS

After a median follow-up of 72 months in the HDR group, 26 patients relapsed, and after a median follow-up of 84 months in the LDR group, 7 patients relapsed (p < 0.0001). The 5-year bRFS was significantly better for the LDR group than for the HDR group (93.7% and 61.1%, respectively) (p < 0.0001). The 5-year OS also was significantly better in the LDR group (95.5% vs. 89.9%) (p = 0.0436).

CONCLUSIONS

Permanent LDR prostate implant brachytherapy offers better clinical outcomes than single-fraction HDR for prostate cancer.

摘要

目的

比较单次高剂量率（HDR）近距离放疗和单次低剂量率（LDR）近距离放疗作为原发性前列腺癌单一治疗方法的临床结果。

材料和方法

这是一项准随机研究，于 2008 年 3 月至 2012 年 2 月，将 129 例低危和中危前列腺癌患者分配至单次 HDR 19Gy 组（61 例）或单次 LDR 145Gy 永久植入组（68 例）。使用 Kaplan-Meier 方法和 Cox 回归分析比较生化无复发生存（bRFS）和总生存（OS）。

结果

在 HDR 组的中位随访 72 个月后，有 26 例患者复发，在 LDR 组的中位随访 84 个月后，有 7 例患者复发（p<0.0001）。LDR 组的 5 年 bRFS 明显优于 HDR 组（93.7%和 61.1%）（p<0.0001）。LDR 组的 5 年 OS 也明显优于 HDR 组（95.5%比 89.9%）（p=0.0436）。