Influence of body mass index on prostate-specific antigen failure after androgen suppression and radiation therapy for localized prostate cancer
Influence of body mass index on prostate-specific antigen failure after androgen suppression and radiation therapy for localized prostate cancer
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DOI：
10.1002/cncr.22564
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发表时间：
2007-04-15
期刊：
影响因子：
6.2
通讯作者：
D'Amico, Anthony V.
中科院分区：
文献类型：
--
作者：
Efstathiou, Jason A.;Chen, Ming-Hui;D'Amico, Anthony V.
背景。体重指数（BMI）的增加与根治性前列腺切除术后前列腺特异性抗原（PSA）失效的时间缩短有关。在接受雄激素抑制治疗（AST）和放射治疗（RT）的临床局限性前列腺癌患者中，研究BMI是否与PSA失效时间相关。这项观察性前瞻性队列研究包括102名临床局限性前列腺癌患者，在1995年12月至2001年4月期间接受70 Gy放射治疗和6个月AST的单组随机试验。99名（97%）男性的基线身高和体重数据可用，并据此计算BMI。调整年龄（连续）和已知预后因素，包括PSA水平（连续）、Gleason评分和t类别，进行Cox回归分析，以分析BMI（连续）是否与PSA失效时间相关（连续两次就诊时，PSA >1.0 ng/mL, >增加0.2 ng/mL）。基线时的中位年龄和中位BMI（四分位间距[IQR]）分别为72（69.1-74.7）岁和27.4 (24.8-30.7)kg/m(2)。除了PSA水平升高（P = 0.006）和Gleason 8-10癌（P = 0.024）外，中位随访（IQR）为6.9（5.6-8.5）年，BMI升高也与RT和ast后PSA失效时间缩短显著相关（校正风险比[HR]: 1.10； 95%可信区间[Cl]: 1.01-1.19; P = 0.026）。在调整已知预后因素后，基线BMI与临床局限性前列腺癌患者接受RT和AST治疗后PSA失效的时间显著相关。进一步的研究需要评估AST给药后BMI增加对PSA失败、前列腺癌特异性和全因死亡率的影响。
BACKGROUND. Increasing body mass index (BMI) is associated with shorter time to prostate-specific antigen (PSA) failure after radical prostatectomy. whether BMI is associated with time to PSA failure was investigated in men treated with androgen suppression therapy (AST) and radiation therapy (RT) for clinically localized prostate cancer.METHODS. The observational prospective cohort study consisted of 102 men with clinically localized prostate cancer who received 70 Gy RT with 6 months of AST on a single arm of a randomized trial between December 1995 and April 2001. Height and weight data were available at baseline for 99 (97%) of the men, from which BMI was calculated. Adjusting for age (continuous) and known prognostic factors including PSA level (continuous), Gleason score, and T-category, Cox regression analyses were performed to analyze whether BMI (continuous) was associated with time to PSA failure (PSA >1.0 ng/mL and increasing >0.2 ng/mL on 2 consecutive visits).RESULTS. Median age and median BMI (interquartile range [IQR]) at baseline was 72 (69.1-74.7) years and 27.4 (24.8-30.7) kg/m,(2) respectively. In addition to an increasing PSA level (P = .006) and Gleason 8-10 cancer (P = .024), after a median follow-up (IQR) of 6.9 (5.6-8.5) years, an increasing BMI was also significantly associated with a shorter time to PSA failure (adjusted hazard ratio [HR]: 1.10; 95% confidence interval [Cl]: 1.01-1.19; P = .026) after RT and AST.CONCLUSIONS. After adjusting for known prognostic factors, baseline BMI is significantly associated with time to PSA failure after RT and AST for men with clinically localized prostate cancer. Further study is warranted to assess the impact of an increasing BMI after AST administration on PSA failure, prostate cancer-specific, and all-cause mortality.