Four prognostic groups predict long-term survival from prostate cancer following radiotherapy alone on radiation therapy oncology group clinical trials
Four prognostic groups predict long-term survival from prostate cancer following radiotherapy alone on radiation therapy oncology group clinical trials
复制标题
DOI：
10.1016/s0360-3016(00)00578-2
复制
发表时间：
2000-06-01
影响因子：
7
通讯作者：
Grignon, D
中科院分区：
文献类型：
--
作者：
Roach, M;Lu, JD;Grignon, D
目的：Gleason评分（GS）、T分期和病理淋巴结状态已被描述为接受外照射放疗（XRT）的男性前列腺癌死亡的主要独立预测因素。在这项分析中，我们结合联合收割机这三个因素来定义预后亚组，与疾病特异性生存（DSS）死亡从前列腺癌。方法和材料：男性进入四个放射治疗肿瘤组（RTOG）第三期随机试验之一，1975年和1992年之间，临床局限性前列腺癌（CAP）（n = 1557），被选中进行这项分析。如果符合以下条件，则纳入患者：1）他们是可评估的，有资格参加试验; 2）他们在最初的治疗中没有接受激素治疗; 3）可以进行随访。对于本研究，如果：1）死亡被证实是由于CAP; 2）死亡是由于治疗并发症;或3）死亡是由于未知原因伴活动性恶性肿瘤。在早期和晚期RTOG研究中接受治疗的患者的中位随访时间分别超过11年和6年。亚组根据其预处理GS，T-阶段，和淋巴结，使患者有类似的风险死于前列腺癌combined.Results：通过结合患者类似的DSS，四个亚组被确定。风险组1患者的GS = 2-6，T1-2Nx;组2：GS = 2-6，T3 Nx;或GS = 2-6，N+，或GS = 7，T1-2Nx;组3：T3 Nx，GS = 7;或NS，GS = 7，或T1-2Nx，GS = 8-10;组4患者为T3 Nx，GS = 8-10，或N+，GS = 8-10。第1组至第4组的5年、10年和15年DSS分别为96%、86%和72%; 94%、75%和61%; 83%、62%和39%;以及64%、34%和27%。这四个风险组的识别提供了一个基础，估计长期的DSS与XRT单独治疗的男性，并应促进未来的前瞻性随机试验的设计。(C)2000 Elsevier Science Inc.
Purpose: Gleason score (GS), T stage, and pathologic lymph node status have been described as major independent predictors of death due to prostate cancer in men treated with external beam radiotherapy (XRT). In this analysis we combine these three factors to define prognostic subgroups that correlate with disease-specific survival (DSS) death from prostate cancer.Methods and Materials: Men entered on one of four Radiation Therapy Oncology Group (RTOG) Phase III randomized trials between 1975 and 1992, for clinically localized prostate cancer (CAP) (n = 1557), were selected For this analysis. Patients were included if: 1) they were evaluable, and eligible for the trial; 2) they received no hormonal therapy with their initial treatment; and 3) follow-up was available. For this study a DSS event was declared if: 1) death was certified as due to CAP; 2) death was due to complications of treatment; or 3) death was from unknown causes with active malignancy. The median follow-up for patients treated on early and late RTOG studies exceeded 11 and 6 years respectively. Subgroups were identified based on their pretreatment GS, T-stage, and lymph node such that patients with similar risk of dying from prostate cancer were combined.Results: By combining patients with similar DSS, four subgroups were identified. Risk Group 1 patients had a GS = 2-6, and T1-2Nx; Group 2: GS = 2-6, T3Nx; or GS = 2-6, N+, or GS = 7, T1-2Nx; Group 3: T3Nx, GS = 7; or NS, GS = 7, or T1-2Nx, GS = 8-10; and Group 4 patients were T3Nx, GS = 8-10, or N+, GS = 8-10. The 5-, 10-, and 15-year DSS was 96%, 86%, and 72%; 94%, 75%, and 61%; 83%, 62%, and 39%; and 64%, 34%, and 27% for Groups 1 through 4, respectively.Conclusions: Recognition of these four risk groups provides a basis for estimating the long-term DSS for men treated with XRT alone and should facilitate the design of future prospective randomized trials. (C) 2000 Elsevier Science Inc.