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根治性前列腺切除术后生化失败后短期与长期雄激素剥夺加挽救性放疗的随机试验:URONCOR 06-24。

A randomised trial of short- vs long-term androgen deprivation with salvage radiotherapy for biochemical failure following radical prostatectomy: URONCOR 06-24.

机构信息

Department of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain.

出版信息

BJU Int. 2024 Oct;134(4):568-577. doi: 10.1111/bju.16484. Epub 2024 Jul 23.

DOI:10.1111/bju.16484
PMID:39041411
Abstract

BACKGROUND

Salvage radiotherapy (SRT) and androgen-deprivation therapy (ADT) are widely used in routine clinical practice to treat patients with prostate cancer who develop biochemical recurrence (BCR) after radical prostatectomy (RP). However, there is no standard-of-care consensus on optimal duration ADT. Investigators propose three distinct risk groups in patients with prostate cancer treated with SRT in order to better define the indications and duration of ADT combined with SRT.

STUDY DESIGN

The URONCOR 06-24 trial (ClinicalTrials.gov identifier NCT05781217) is a prospective, multicentre, randomised, open-label, phase III, clinical trial. The aim of the trial is to determine the impact of short-term (6 months) vs long-term (24 months) ADT in combination with SRT on distant metastasis-free survival (MFS) in patients with prostate cancer with BCR after RP (intermediate and high risk).

ENDPOINTS

The primary endpoint is 5-year MFS rates in patients with prostate cancer treated with long- vs short-term ADT in combination with SRT. Secondary objectives are biochemical-relapse free interval, pelvic progression-free survival, time to start of systemic treatment, time to castration resistance, cancer-specific survival, overall survival, acute and late toxicity, and quality of life.

METHODS AND ANALYSIS

Total of 534 patients will be randomised 1:1 to ADT 6 months or ADT 24 months with a luteinizing hormone-releasing hormone analogue in combination with SRT, stratified by risk group and pathological lymph node status.

ETHICS AND DISSEMINATION

The study is conducted under the guiding principles of the World Medical Association Declaration of Helsinki. The results will be disseminated at research conferences and in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

EudraCT number 2021-006975-41.

摘要

背景

挽救性放疗(SRT)和雄激素剥夺治疗(ADT)广泛应用于常规临床实践中,用于治疗根治性前列腺切除术(RP)后发生生化复发(BCR)的前列腺癌患者。然而,对于联合 SRT 治疗的前列腺癌患者,ADT 的最佳持续时间尚无标准治疗共识。研究人员在接受 SRT 治疗的前列腺癌患者中提出了三个不同的风险组,以便更好地定义联合 SRT 的 ADT 的适应证和持续时间。

研究设计

URONCOR 06-24 试验(ClinicalTrials.gov 标识符 NCT05781217)是一项前瞻性、多中心、随机、开放标签、III 期临床试验。该试验的目的是确定 SRT 联合短期(6 个月)与长期(24 个月)ADT 对 RP 后 BCR 前列腺癌患者远处无转移生存(MFS)的影响(中高危)。

终点

接受 SRT 联合长 vs 短期 ADT 治疗的前列腺癌患者的 5 年 MFS 率为主要终点。次要终点包括生化无复发生存期、盆腔无进展生存期、开始系统治疗时间、去势抵抗时间、癌症特异性生存率、总生存率、急性和晚期毒性、生活质量。

方法和分析

总共将有 534 例患者按照风险组和病理淋巴结状态分层,1:1 随机分为 ADT 6 个月或 ADT 24 个月联合促黄体激素释放激素类似物的 SRT。

伦理与传播

该研究遵循世界医学协会赫尔辛基宣言的指导原则进行。研究结果将在研究会议和同行评议期刊上发表。

试验注册号

EudraCT 编号 2021-006975-41。

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