Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Department of Radiation Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Strahlenther Onkol. 2024 Aug;200(8):698-705. doi: 10.1007/s00066-024-02222-w. Epub 2024 Mar 15.
Comparing oncological outcomes and toxicity after primary treatment of localized prostate cancer using HDR- or LDR-mono-brachytherapy (BT), or conventionally (CF) or moderately hypofractionated (HF) external beam radiotherapy.
Retrospectively, patients with low- (LR) or favorable intermediate-risk (IR) prostate cancer treated between 03/2000 and 09/2022 in two centers were included. Treatment was performed using either CF with total doses between 74 and 78 Gy, HF with 2.4-2.6 Gy per fraction in 30 fractions, or LDR- or HDR-BT. Biochemical control (BC) according to the Phoenix criteria, and late gastrointestinal (GI), and genitourinary (GU) toxicity according to RTOG/EORTC criteria were assessed.
We identified 1293 patients, 697 with LR and 596 with IR prostate cancer. Of these, 470, 182, 480, and 161 were treated with CF, HF, LDR-BT, and HDR-BT, respectively. For BC, we did not find a significant difference between treatments in LR and IR (p = 0.31 and 0.72). The 5‑year BC for LR was between 93 and 95% for all treatment types. For IR, BC was between 88% in the CF and 94% in the HF group. For CF and HF, maximum GI and GU toxicity grade ≥ 2 was between 22 and 27%. For LDR-BT, we observed 67% grade ≥ 2 GU toxicity. Maximum GI grade ≥ 2 toxicity was 9%. For HDR-BT, we observed 1% GI grade ≥ 2 toxicity and 19% GU grade ≥ 2 toxicity.
All types of therapy were effective and well received. HDR-BT caused the least late toxicities, especially GI.
比较使用 HDR 或 LDR 单式近距离放疗（BT）、常规（CF）或中度超分割放疗（HF）对局限性前列腺癌进行初始治疗后的肿瘤学结果和毒性。
回顾性纳入 2000 年 3 月至 2022 年 9 月在两个中心治疗的低危（LR）或中危（IR）局限性前列腺癌患者。治疗方法包括 CF，总剂量为 74-78 Gy；HF，30 次分割，每次 2.4-2.6 Gy；LDR 或 HDR-BT。根据凤凰标准评估生化控制（BC），根据 RTOG/EORTC 标准评估晚期胃肠道（GI）和泌尿生殖系统（GU）毒性。
共纳入 1293 例患者，LR 前列腺癌 697 例，IR 前列腺癌 596 例。其中 CF、HF、LDR-BT 和 HDR-BT 治疗分别为 470、182、480 和 161 例。LR 和 IR 患者的 BC 治疗之间无显著差异（p=0.31 和 0.72）。LR 患者的 5 年 BC 为所有治疗类型的 93%-95%。IR 患者中，CF 组和 HF 组的 BC 分别为 88%和 94%。CF 和 HF 的最大 GI 和 GU 毒性≥2 级为 22%-27%。LDR-BT 组观察到 67%的 GU 毒性≥2 级。最大 GI 毒性≥2 级的发生率为 9%。HDR-BT 组观察到 1%的 GI 毒性≥2 级和 19%的 GU 毒性≥2 级。
所有类型的治疗均有效且患者接受度良好。HDR-BT 引起的晚期毒性最小，尤其是 GI 毒性。
