Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate - A randomized controlled trial
Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate - A randomized controlled trial
复制标题
DOI：
10.1001/jama.294.10.1233
复制
发表时间：
2005-09-14
影响因子：
120.7
通讯作者：
Shipley, WU
中科院分区：
文献类型：
--
作者：
Zietman, AL;DeSilvio, ML;Shipley, WU
背景临床局限性前列腺癌在美国男性中非常普遍，但常规放射治疗后复发是常见的。目的评估增加临床局限性前列腺癌患者的放射剂量可改善疾病结局的假设。设计，设置，393例T1 b至T2 b期前列腺癌患者的随机对照试验，前列腺特异性抗原（PSA）水平低于15 ng/mL在1996年1月至1999年12月期间随机分组，并在2家美国学术机构接受治疗。中位年龄为67岁，中位PSA水平为6.3 ng/mL。中位随访时间为5.5年（范围：1.2-8.2年）。干预患者随机接受外照射，总剂量为70.2戈伊（常规剂量）或79.2戈伊（高剂量）。这是使用适形光子和质子束的组合提供的。主要结果测量PSA水平升高结果5年时无生化衰竭的男性比例为61.4%，常规剂量治疗组有效率为80.4%（95%可信区间为54.6%~ 68.3%），高剂量治疗组有效率为80.4%（95%可信区间为74.7%~ 86.1%）（P
Context Clinically localized prostate cancer is very prevalent among US men, but recurrence after treatment with conventional radiation therapy is common.Objective To evaluate the hypothesis that increasing the radiation dose delivered to men with clinically localized prostate cancer improves disease outcome.Design, Setting, and Patients Randomized controlled trial of 393 patients with stage T1b through T2b prostate cancer and prostate-specific antigen (PSA) levels less than 15 ng/mL randomized between January 1996 and December 1999 and treated at 2 US academic institutions. Median age was 67 years and median PSA level was 6.3 ng/mL. Median follow-up was 5.5 (range, 1.2-8.2) years.Intervention Patients were randomized to receive external beam radiation to a total dose of either 70.2 Gy (conventional dose) or 79.2 Gy (high dose). This was delivered using a combination of conformal photon and proton beams.Main Outcome Measure Increasing PSA level (ie, biochemical failure) 5 years after treatment.Results The proportions of men free from biochemical failure at 5 years were 61.4% (95% confidence interval, 54.6%-68.3%) for conventional-dose and 80.4% (95% confidence interval, 74.7%-86.1%) for high-dose therapy (P