Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial.
Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial.
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DOI：
10.1016/j.juro.2008.11.032
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Crawford ED
中科院分区：
文献类型：
--
作者：
Thompson IM;Tangen CM;Paradelo J;Lucia MS;Miller G;Troyer D;Messing E;Forman J;Chin J;Swanson G;Canby-Hagino E;Crawford ED
三分之一的男性在根治性前列腺切除术后会出现前列腺外疾病。我们目前的长期随访的随机临床试验的放射治疗，以减少随后的转移性疾病和死亡的风险。431例pT 3 N 0 M0前列腺癌患者随机接受60-64戈伊辅助放疗或观察。主要研究终点是无转移生存期。在425名符合条件的男性中，211名随机接受观察，214名接受辅助放疗。在接受观察的人中，70人最终接受了放射治疗。放疗组的无转移生存率显著较低（RT组214例事件中有93例事件，观察组211例事件中有114例事件，风险比[HR] 0.71，95%置信区间[CI] 0.54，0.94; p=0.016）。辅助放疗显著提高了生存率（RT组214例中有88例死亡，观察组211例中有110例死亡，HR 0.72，95%CI 0.55，0.96; p=0.023）。pT 3 N 0 M0前列腺癌患者根治性前列腺切除术后的辅助放疗显著降低了转移风险并增加了生存率。
Extraprostatic disease will be manifest in one third of men after radical prostatectomy. We present long-term followup of a randomized clinical trial of radiotherapy to reduce risk of subsequent metastatic disease and death. 431 men with pT3N0M0 prostate cancer were randomized to 60–64 Gy adjuvant radiotherapy or observation. The primary study endpoint was metastasis-free survival. Of 425 eligible men, 211 were randomized to observation and 214 to adjuvant radiation. Of those receiving observation, 70 ultimately received radiotherapy. Metastatic-free survival was significantly less with radiotherapy (93 events out of 214 on the RT arm, 114 events out of 211 on observation, Hazard Ratio [HR] 0.71, 95% confidence interval [CI] 0.54, 0.94; p=0.016). Survival was improved significantly with adjuvant radiation (88 deaths out of 214 on the RT arm, 110 deaths out of 211 on observation HR 0.72, 95% CI 0.55,0.96; p=0.023). Adjuvant radiotherapy after radical prostatectomy for a man with pT3N0M0 prostate cancer significantly reduces the risk of metastasis and increases survival.
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