Effect of Adequate Local Radiation Dose on Oncological Outcomes in Localized Prostate Cancer Patients Treated With Low-dose-rate Brachytherapy
Effect of Adequate Local Radiation Dose on Oncological Outcomes in Localized Prostate Cancer Patients Treated With Low-dose-rate Brachytherapy
复制标题
足够的局部放射剂量对接受低剂量率近距离放射治疗的局限性前列腺癌患者肿瘤结果的影响
DOI：
10.21873/anticanres.16489
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发表时间：
2023
影响因子：
2
通讯作者：
T. Kimura
中科院分区：
文献类型：
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作者：
Yuki Enei;Fumihiko Urabe;K. Miki;Hirotaka Suzuki;K. Iwatani;K. Tashiro;Shunsuke Tsuzuki;A. Furuta;Takaya Sasaki;S. Sato;Hiroyuki Takahashi;M. Aoki;T. Kimura
背景/目的：我们回顾性研究了低剂量率近距离放射治疗（LDR-BT）的生物有效剂量（BED）的作用及其在LDR-BT治疗中危前列腺癌（PCa）期间与雄激素剥夺治疗（ADT）的可能相互作用。患者和方法：本研究共纳入了693例接受LDR-BT伴或不伴补充外照射放疗的局部中度风险PCa患者。我们根据BED将患者分为两组（<180 Gy 2，低BED组; ≥180 Gy 2，高BED组），并评价ADT持续时间对各组肿瘤结局的影响。结果：共有431例患者接受了BED ≥180 Gy 2。在较低BED组的非ADT、ADT ≤3个月和ADT >3个月亚组中观察到生化无复发生存期（BCRFS）和临床无进展生存期（CPFS）的显著差异（分别为p=0.005和0.049）。然而，在较高BED组中未检测到BCRFS或CPFS的显著差异（分别为p=0.63和0.76）。BCR和CP的多变量分析显示，随着ADT持续时间的增加，BCRFS（趋势p =0.001）和CPFS率（趋势p =0.015）呈显著下降趋势，这与有利结局相关。然而，在较高BED组中未观察到BCRFS或CPFS率的显著趋势。结论：适当的局部辐射剂量可提供良好的肿瘤学结局，并可能减少长期ADT的需求。
Background/Aim: We retrospectively investigated the effect of a biologically effective dose (BED) of Low-dose rate brachytherapy (LDR-BT) and its possible interaction with androgen deprivation therapy (ADT) during LDR-BT treatment for intermediate-risk prostate cancer (PCa). Patients and Methods: A total of 693 patients with localized, intermediate-risk PCa, who underwent LDR-BT with or without supplemental external beam radiotherapy, were included in this study. We stratified patients into two groups according to BED (<180 Gy2, lower BED group; ≥180 Gy2, higher BED group) and evaluated the effect of ADT duration on the oncological outcomes of each group. Results: In total, 431 patients received BED ≥180 Gy2. Significant differences in biochemical recurrence-free survival (BCRFS) and clinical progression-free survival (CPFS) were observed among the non-ADT, ADT ≤3 months, and ADT >3 months subgroups of the lower BED group (p=0.005 and 0.049, respectively). However, no significant differences in BCRFS or CPFS were detected in the higher BED group (p=0.63 and 0.76, respectively). Multivariate analysis of BCR and CP in the lower BED group revealed a significant decreasing trend in the BCRFS (p for trend=0.001) and CPFS rates (p for trend=0.015) as ADT duration increased, which was associated with favorable outcomes. However, no significant trend was observed in the BCRFS or CPFS rate in the higher BED group. Conclusion: An adequate local radiation dose provides favorable oncological outcomes and could potentially reduce the need for long-term ADT.