Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: Recommendations of the RTOG-ASTRO Phoenix Consensus Conference
Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: Recommendations of the RTOG-ASTRO Phoenix Consensus Conference
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DOI：
10.1016/j.ijrobp.2006.04.029
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发表时间：
2006-07-15
影响因子：
7
通讯作者：
Sandler, Howard
中科院分区：
文献类型：
--
作者：
Roach, Mack, III;Hanks, Gerald;Sandler, Howard
1996年，美国治疗放射学和肿瘤学学会（ASTRO）发起了一次共识会议，以建立外部放射治疗（EBRT）后生化失败的定义。ASTRO的定义将前列腺特异性抗原（PSA）失效定义为PSA在最低点后连续三次上升，失效日期为最低点和第一次上升或任何足以引起开始治疗的上升之间的中间点。该定义与临床进展或生存无关；它在接受激素治疗（HT）的患者中表现不佳，并且回溯对Kaplan-Meier无事件生存率的估计存在偏差。2005年1月21日，ASTRO和放射治疗肿瘤小组在亚利桑那州凤凰城召开了第二次共识会议，以修订ASTRO的定义。专家组建议：(1)PSA高于最低水平2 ng/mL或更高，可视为有或无HT的EBRT后生化失败的标准定义；(2)失效日期应“在召唤时”确定（而不是回溯日期）。他们建议允许研究人员在单独EBRT（无激素治疗）后使用ASTRO共识定义，并严格遵守“充分随访”的指导方针。为避免因随访时间短而产生的伪影，报告的对照日期应列示为比中位随访时间短2年。例如，如果中位随访为5年，则应引用3年的控制率。保留ASTRO定义的严格版本将允许与大量现有文献进行比较。(c) 2006爱思唯尔公司
In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined "at call" (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to "adequate follow-up." To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature. (c) 2006 Elsevier Inc.