Salvage high-dose-rate brachytherapy for locally recurrent prostate cancer after primary radiotherapy failure
Salvage high-dose-rate brachytherapy for locally recurrent prostate cancer after primary radiotherapy failure
复制标题
DOI：
10.1016/j.radonc.2016.04.032
复制
发表时间：
2016-06-01
影响因子：
5.7
通讯作者：
Fijalkowski, Marek
中科院分区：
文献类型：
--
作者：
Wojcieszek, Piotr;Szlag, Marta;Fijalkowski, Marek
背景与目的：评价高剂量率近距离放射治疗（HDR BT）作为原发性放疗失败后局部复发前列腺癌的抢救方式。材料与方法：对83例局部放疗后复发的前列腺癌患者进行补救性HDR BT治疗，治疗方案为3次植入，每2周一次，每次植入10 Gy，总剂量为30 Gy。评估急性和晚期毒性率。采用Kaplan-Meier法计算总生存期（OS）和生化对照。结果：补救性HDR术后中位随访41个月。3年OS为93%，5年OS为86%。3年和5年生化无病生存率（bDFS）分别为76%和67%。与生化控制相关的单一因素是达到挽救性PSA最低点的时间（p- 0.006）。OS与原发性最低点水平显著相关（p- 0.001），而原发性生化复发间隔具有临界意义（p- 0.07）。结论：对于既往放疗的前列腺癌局部复发患者，挽救性HDR BT是一种很有前景的治疗选择。原发性放疗后较低的PSA最低点和较长的原发性无病间隔影响预后。2016爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: To evaluate high-dose-rate brachytherapy (HDR BT) as a salvage modality for locally recurrent prostate cancer after primary radiotherapy failure.Materials and methods: Eighty-three prostate cancer patients, who locally relapsed after radiotherapy, were treated with salvage HDR BT. The schedule was three implantations, every two weeks, with 10 Gy per implant, to a total dose of 30 Gy. Acute and late toxicity rates were evaluated. Overall survival (OS) and biochemical control were calculated using Kaplan-Meier method.Results: Median follow-up after salvage HDR was 41 months. The 3-year and 5-year OS were 93% and 86%, respectively. The 3-year and 5-year biochemical disease-free survival (bDFS) were 76% and 67%, respectively. The single factor associated with biochemical control was time to achieve salvage PSA nadir (p-.006). OS was linked significantly with primary nadir level (p-.001) while primary biochemical relapse interval was of borderline significance (p-.07).Conclusions: Salvage HDR BT is a promising treatment option for patients with localized relapse of previously irradiated prostate cancer. Lower PSA nadir after primary radiotherapy and longer primary disease-free interval influence the outcome. (C) 2016 Elsevier Ireland Ltd. All rights reserved.