Impact of Time to Castration Resistance on Cytoreductive Radiotherapy in Metastatic Castration-Resistant Prostate Cancer.
Impact of Time to Castration Resistance on Cytoreductive Radiotherapy in Metastatic Castration-Resistant Prostate Cancer.
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去势抵抗时间对转移性去势抵抗性前列腺癌减瘤放疗的影响
DOI：
10.3389/fonc.2020.606133
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发表时间：
2020
影响因子：
4.7
通讯作者：
He L
中科院分区：
文献类型：
--
作者：
Mai L;Zhang Z;Li Y;Liu R;Li J;Huang S;Lin M;Liu B;Cao W;Wu J;Liu M;Zhou F;Liu Y;He L
局部放疗在转移性去势抵抗性前列腺癌（mCRPC）中的作用尚不明确。本研究旨在确定局部放疗的价值和mCRPC的潜在候选者。方法回顾性分析2011年6月至2019年2月215例接受或未接受细胞减灭放疗（CRT）的mCRPC患者的临床资料。从mCRPC发作开始计算总生存期（OS）。受试者工作特征（ROC）曲线用于确定去势抵抗时间（TCR）的截止点。结果155例（72.1%）患者在mCRPC后接受阿比特龙治疗，54例（25.1%）患者接受CRT治疗。中位TCR为14.9个月。中位随访31.7个月后，中位OS为33.3个月。东部肿瘤协作组（ECOG）体能评分0-1、寡转移、mCRPC后阿比特龙、CRT和TCR ≥9个月是更好OS的独立预后因素。分层分析显示，当CRT应用于阿比特龙治疗的患者时，生存率提高（HR 0.44; 95% CI 0.23-0.83; P = 0.012）和TCR ≥9个月（HR 0.39; 95% CI 0.21-0.74; P = 0.004）。TCR ≥9个月的患者放疗后PSA缓解率高于TCR <9个月的患者。放疗后未报告3级或更严重的不良事件。结论ECOG体能状态评分、寡转移、阿比特龙应用、TCR和CRT是影响mCRPC患者OS的独立预后因素。对原发性雄激素剥夺治疗反应持续时间短的患者不太可能从CRT中获益。
Background The role of local radiotherapy in metastatic castration-resistant prostate cancer (mCRPC) remains undefined. This study aimed to identify the value of local radiotherapy and potential candidates for mCRPC. Methods A total of 215 patients with mCRPC treated with or without cytoreductive radiotherapy (CRT) between June 2011 and February 2019 were analyzed. Overall survival (OS) was calculated from the onset of mCRPC. The receiver-operating characteristic (ROC) curve was used to find the cutoff point for time to castration resistance (TCR). Results One-hundred and fifty-five (72.1%) patients received abiraterone after mCRPC, and 54 (25.1%) patients received CRT. The median TCR was 14.9 months. After a median follow-up of 31.7 months, the median OS was 33.3 months. The Eastern Cooperative Oncology Group (ECOG) performance scores 0–1, oligometastases, abiraterone after mCRPC, CRT, and TCR ≥9 months were independent prognostic factors for better OS. Stratified analyses showed improved survival when CRT was applied to patients treated with abiraterone (HR 0.44; 95% CI 0.23–0.83; P = 0.012) and TCR ≥9 months (HR 0.39; 95% CI 0.21–0.74; P = 0.004). The percentage of PSA response after radiotherapy was higher in patients with TCR ≥9 months compared to those with TCR <9 months. No grade 3 or worse adverse events after radiotherapy were reported. Conclusions ECOG performance score, oligometastases, abiraterone application, TCR and CRT were independent prognostic factors for OS in patients with mCRPC. Patients with a short duration of response to primary androgen deprivation therapy were less likely to benefit from CRT.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
3.2
作者：
George, Daniel J.;Sartor, Oliver;Higano, Celestia S.
通讯作者：
Higano, Celestia S.
影响因子：
2.1
作者：
Lan, Tian;Chen, Ye;Ye, JianJun
通讯作者：
Ye, JianJun
影响因子：
8.4
作者：
Loriot, Yohann;Eymard, Jean-Christophe;Fizazi, Karim
通讯作者：
Fizazi, Karim
影响因子：
168.9
作者：
Mickisch, GHJ;Garin, A;Sylvester, R
通讯作者：
Sylvester, R