Tao Yinjie, Cheng Weishi, Zhen Hongnan, Shen Jing, Guan Hui, Hou Xiaorong, Hu Ke, Zhang Fuquan, Liu Zhikai
Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Cancer Control. 2025 Jan-Dec;32:10732748251330058. doi: 10.1177/10732748251330058. Epub 2025 Apr 12.
IntroductionThis study evaluates the clinical outcomes, survival benefits, and toxicities of two moderate-hypofractionated radiotherapy (MHRT) patterns, 60 Gy in 20 fractions (60 Gy/20f) and 70 Gy in 28 fractions (70 Gy/28f), in early-stage prostate cancer patients.MethodsThis retrospective study analyzed data from 187 patients diagnosed between 2014 and 2023, using propensity score matching to ensure efficacy assessment accuracy. The primary endpoints reported were overall survival (OS) and disease-free survival (DFS), calculated using Kaplan-Meier analysis. Toxicity and side effects were evaluated using Criteria for Adverse Events v5.0, focusing on the urinary and gastrointestinal (GI) systems.ResultsAfter matching, each of the 60 Gy and 70 Gy groups included 73 patients. The median follow-up duration for all patients was 36.0 months. The OS rates for the 60 Gy and 70 Gy groups were 86.3% and 89.0%, respectively, with 3-year OS rates of 92.4% and 89.0% ( = 0.375). The 3-year DFS rates were 91.0% in the 60 Gy group and 81.0% in the 70 Gy group ( = 0.096), indicating no significant differences between the groups. The incidence of acute Grade 2 or higher urinary toxicities was comparable between the two groups (60 Gy group vs 70 Gy group: 9.6% vs 9.6%, = 1.0), while the 70 Gy group demonstrated an advantage for late Grade 2 or higher toxicities (60 Gy group vs 70 Gy group: 12.3% vs 2.8%, = .028). For the GI system, the incidence of acute toxicities was higher in the 60 Gy group, albeit not statistically significant (60 Gy group vs 70 Gy group: 11.0% vs 6.8%, = .383), while late toxicities were equivalent between the groups (60 Gy group vs 70 Gy group: 1.4% vs 1.4%, = 1.0).ConclusionBoth MHRT fractionation patterns demonstrate comparable survival outcomes and toxicities in early-stage prostate cancer, suggesting MHRT's viability as a primary treatment. The 60 Gy/20f pattern marginally favored survival, albeit not with statistical significance.
引言
本研究评估了两种中等分割放疗（MHRT）模式，即20次分割给予60 Gy（60 Gy/20f）和28次分割给予70 Gy（70 Gy/28f），对早期前列腺癌患者的临床结局、生存获益和毒性反应。
方法
本回顾性研究分析了2014年至2023年期间诊断的187例患者的数据，采用倾向评分匹配以确保疗效评估的准确性。报告的主要终点为总生存期（OS）和无病生存期（DFS），采用Kaplan-Meier分析进行计算。使用不良事件标准v5.0评估毒性和副作用，重点关注泌尿系统和胃肠道（GI）系统。
结果
匹配后，60 Gy组和70 Gy组各有73例患者。所有患者的中位随访时间为36.0个月。60 Gy组和70 Gy组的OS率分别为86.3%和89.0%，3年OS率分别为92.4%和89.0%（P = 0.375）。60 Gy组的3年DFS率为91.0%，70 Gy组为81.0%（P = 0.096），表明两组之间无显著差异。两组急性2级或更高等级泌尿系统毒性的发生率相当（60 Gy组 vs 70 Gy组：9.6% vs 9.6%，P = 1.0），而70 Gy组在晚期2级或更高等级毒性方面具有优势（60 Gy组 vs 70 Gy组：12.3% vs 2.8%，P = 0.028）。对于胃肠道系统，60 Gy组急性毒性的发生率较高，尽管无统计学意义（60 Gy组 vs 70 Gy组：11.0% vs 6.8%，P = 0.383），而两组晚期毒性相当（60 Gy组 vs 70 Gy组：1.4% vs 1.4%，P = 1.0）。
结论
两种MHRT分割模式在早期前列腺癌中均显示出相当的生存结局和毒性反应，表明MHRT作为主要治疗方法的可行性。60 Gy/20f模式在生存方面略有优势，尽管无统计学意义。
