低剂量率近距离放射治疗局限性前列腺癌患者的适当局部照射剂量对肿瘤学结局的影响。

Effect of Adequate Local Radiation Dose on Oncological Outcomes in Localized Prostate Cancer Patients Treated With Low-dose-rate Brachytherapy.

机构信息

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan;

出版信息

Anticancer Res. 2023 Jul;43(7):3159-3166. doi: 10.21873/anticanres.16489.

DOI:10.21873/anticanres.16489

PMID:37351978

Abstract

BACKGROUND/AIM: We retrospectively investigated the effect of a biologically effective dose (BED) of Low-dose rate brachytherapy (LDR-BT) and its possible interaction with androgen deprivation therapy (ADT) during LDR-BT treatment for intermediate-risk prostate cancer (PCa).

PATIENTS AND METHODS

A total of 693 patients with localized, intermediate-risk PCa, who underwent LDR-BT with or without supplemental external beam radiotherapy, were included in this study. We stratified patients into two groups according to BED (<180 Gy2, lower BED group; ≥180 Gy2, higher BED group) and evaluated the effect of ADT duration on the oncological outcomes of each group.

RESULTS

In total, 431 patients received BED ≥180 Gy2. Significant differences in biochemical recurrence-free survival (BCRFS) and clinical progression-free survival (CPFS) were observed among the non-ADT, ADT ≤3 months, and ADT >3 months subgroups of the lower BED group (p=0.005 and 0.049, respectively). However, no significant differences in BCRFS or CPFS were detected in the higher BED group (p=0.63 and 0.76, respectively). Multivariate analysis of BCR and CP in the lower BED group revealed a significant decreasing trend in the BCRFS (p for trend=0.001) and CPFS rates (p for trend=0.015) as ADT duration increased, which was associated with favorable outcomes. However, no significant trend was observed in the BCRFS or CPFS rate in the higher BED group.

CONCLUSION

An adequate local radiation dose provides favorable oncological outcomes and could potentially reduce the need for long-term ADT.

摘要

背景/目的：我们回顾性研究了低剂量率近距离放射治疗（LDR-BT）的生物有效剂量（BED）及其在 LDR-BT 治疗中与雄激素剥夺治疗（ADT）的相互作用对中危前列腺癌（PCa）的影响。

患者和方法

本研究共纳入 693 例接受 LDR-BT 联合或不联合补充外照射放疗的局限性、中危 PCa 患者。我们根据 BED（<180 Gy2，低 BED 组；≥180 Gy2，高 BED 组）将患者分为两组，并评估 ADT 持续时间对每组患者肿瘤学结果的影响。

结果

共有 431 例患者接受了 BED≥180 Gy2。低 BED 组中非 ADT、ADT≤3 个月和 ADT>3 个月亚组之间在生化无复发生存率（BCRFS）和临床无进展生存率（CPFS）方面有显著差异（p=0.005 和 0.049）。然而，高 BED 组中在 BCRFS 或 CPFS 方面未观察到显著差异（p=0.63 和 0.76）。低 BED 组中 BCR 和 CP 的多变量分析显示，随着 ADT 持续时间的增加，BCRFS（p 趋势=0.001）和 CPFS 率（p 趋势=0.015）呈显著下降趋势，与良好的结果相关。然而，高 BED 组中在 BCRFS 或 CPFS 率方面未观察到显著趋势。