Optimal Duration of Androgen Deprivation in Combination with Radiation Therapy for Japanese Men with High-Risk Prostate Cancer
Optimal Duration of Androgen Deprivation in Combination with Radiation Therapy for Japanese Men with High-Risk Prostate Cancer
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日本高危前列腺癌男性雄激素剥夺联合放射治疗的最佳持续时间
DOI：
10.1159/000324478
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发表时间：
2011
影响因子：
1.6
通讯作者：
T. Miki
中科院分区：
文献类型：
--
作者：
N. Takaha;K. Okihara;K. Kamoi;Y. Kimura;Takeshi Yamada;A. Kawauchi;Kana Kobayashi;H. Yamazaki;T. Nishimura;T. Miki
目的：评价体外放射治疗(EBRT)联合去雄激素治疗(ADT)在同一机构治疗日本高危前列腺癌(PCa)的疗效和毒性。方法：75例高危PCa患者接受70Gy三维适形放射治疗，联合新辅助、同期、辅助ADT治疗。结果：中位年龄72岁(59-82岁)。中位初始血清前列腺特异性抗原(PSA)为19.0(4.7~200)ng/ml，整个ADT中位数为27(8~63)个月。启动ADT和完成EBRT后的中位随访期分别为66(41-105)个月和59(36-94)个月。5年总体无临床进展和生化进展生存率分别为98.3、97.2和87.4%；2例(2.7%)癌症死亡，3例(4.0%)临床进展，11例(14.7%)生化进展。多因素分析显示ADT总持续时间小于24个月是生化进展的独立危险因素(p=0.01)。观察到与EBRT相关的3级毒性反应：1例直肠炎和直肠出血，1例直肠出血。结论：70GyEBRT联合ADT可为日本高危PCa患者提供无病生存益处和可耐受的不良事件。建议使用24个月或更长时间的ADT，以尽量减少生化进展。
Objectives: To evaluate the efficacy and toxicity of external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) for Japanese high-risk prostate cancer (PCa) patients in a single institution. Methods: Seventy-five high-risk PCa patients were treated by three-dimensional conformal radiotherapy of 70 Gy combined with neoadjuvant, concurrent and adjuvant ADT. Results: Median age was 72 (59–82) years. Median initial serum prostate-specific antigen (PSA) was 19.0 (4.7–200) ng/ml. Median duration of the entire ADT was 27 (8–63) months. Median follow-up after initiating ADT and after completing EBRT was 66 (41–105) and 59 (36–94) months, respectively. Five-year overall, clinical progression-free, and biochemical progression-free survival rates were 98.3, 97.2, and 87.4%; 2 (2.7%) cancer deaths, 3 (4.0%) clinical progressions, and 11 (14.7%) biochemical progressions. Multivariate analysis suggested a total duration of ADT shorter than 24 months as an independent risk factor of biochemical progression (p = 0.01). Grade 3 toxicities related to EBRT were observed: 1 patient with proctitis and rectal bleeding and 1 patient with rectal bleeding. Conclusions: It is suggested that 70 Gy EBRT combined with ADT confers disease-free survival benefit with tolerable adverse events for Japanese high-risk PCa patients. ADT of 24 months or longer might be recommended to minimize biochemical progression.
影响因子：
45.3
作者：
Horwitz, Eric M.;Bae, Kyounghwa;Shipley, William U.
通讯作者：
Shipley, William U.