Murthy Vedang, Samanta Asesh, Maitre Priyamvada, Nayak Prashant, Singh Pallavi, Agrawal Archi, Joshi Amit, Prakash Gagan
Department of Radiation Oncology, Tata Memorial Hospital & Advanced Centre for Treatment Research and Education in Cancer, Homi Bhabha National Institute, Mumbai, India.
Department of Nuclear Medicine & Molecular Imaging, Tata Memorial Hospital & Advanced Centre for Treatment Research and Education in Cancer, Homi Bhabha National Institute, Mumbai, India.
Prostate Cancer Prostatic Dis. 2025 May 22. doi: 10.1038/s41391-025-00983-8.
To assess long-term survival in a "STAMPEDE-like" cohort of high-risk locally advanced prostate cancer, staged with PSMA PET-CT, treated with hypofractionated radiotherapy (RT) and long-term androgen deprivation therapy (LT-ADT) without abiraterone.
MATERIALS & METHODS: Patients with non-metastatic prostate cancer fulfilling "STAMPEDE high-risk" criteria, staged with PSMA PET-CT, treated with external beam RT from 2016 to 2021 were included. RT dose was >74 Gy equivalent to prostate with LT-ADT ≥ 2 years. We analysed metastatic-free survival (MFS), prostate cancer specific survival (PCSS) and overall survival (OS) using Kaplan-Meier method.
170 patients were eligible, treated with hypofractionated RT with median prostate 2Gy-equivalent dose of 82 Gy. About one-third were node-positive and treated with whole pelvic RT. Over median follow up of 65 months, 6-years MFS, PCSS and OS were 80.7%, 95.8% and 94.4% respectively. On multivariate analysis, Gleason score and nodal stage showed significant association with MFS.
For PSMA-PETCT staged high risk prostate cancer, appropriately intensified local treatment could be complementary or an alternative to systemic intensification in selected patients.
评估一组采用PSMA PET-CT分期、接受大分割放疗（RT）和长期雄激素剥夺治疗（LT-ADT）且未使用阿比特龙的“类STAMPEDE”高危局部晚期前列腺癌患者的长期生存率。
纳入2016年至2021年期间符合“STAMPEDE高危”标准、采用PSMA PET-CT分期并接受外照射放疗的非转移性前列腺癌患者。放疗剂量相当于前列腺的剂量>74 Gy，LT-ADT治疗≥2年。我们使用Kaplan-Meier方法分析无转移生存期（MFS）、前列腺癌特异性生存期（PCSS）和总生存期（OS）。
170例患者符合条件，接受了大分割放疗，前列腺中位2 Gy等效剂量为82 Gy。约三分之一的患者为淋巴结阳性，并接受了全盆腔放疗。在中位随访65个月时，6年MFS、PCSS和OS分别为80.7%、95.8%和94.4%。多因素分析显示，Gleason评分和淋巴结分期与MFS显著相关。
对于PSMA-PETCT分期的高危前列腺癌患者，适当强化局部治疗可能是某些患者全身强化治疗的补充或替代方案。
