Early hypofractionated salvage radiotherapy for postprostatectomy biochemical recurrence.
Early hypofractionated salvage radiotherapy for postprostatectomy biochemical recurrence.
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DOI：
10.1002/cncr.25824
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发表时间：
2011-06-15
期刊：
影响因子：
6.2
通讯作者：
Ritter, Mark A.
中科院分区：
文献类型：
--
作者：
Kruser, Tim J.;Jarrard, David F.;Graf, Andrew K.;Hedican, Sean P.;Paolone, David R.;Wegenke, John D.;Liu, Glenn;Geye, Heather M.;Ritter, Mark A.
前列腺切除术后辅助放疗或补救性放疗，当使用标准分割时，需要6.5-8周的治疗。我们报告的安全性和有效性加快放疗过程的抢救前列腺放疗。共有108例患者连续接受了65 Gy的补救性放射治疗，分为2.5 Gy的26个部分。中位随访时间为32.4个月。抢救前PSA中位数为0.44（0.05-9.50）。18例患者（17%）在手术后或放疗同时接受雄激素剥夺。整个组4年的生化失败精算自由度为67% +/ - 5.3%。前50名入组患者的5年控制率为67%，中位随访时间为43个月。发生1例急性3级GU毒性，未观察到急性3级GI和晚期3级毒性。单因素分析显示，较高的Gleason评分（p=0.006）、PSA翻倍时间≤12个月（p=0.03）、神经周围侵犯（p=0.06）和阴性切缘（p=0.06）与抢救失败有关。在多变量分析中，较高的Gleason评分（p=0.057）和负边缘（p=0.088）与生化失败保持关联。低分割放疗（65 Gy, 2.5 Gy，约5周）与其他常用的治疗方案相比，治疗时间缩短了1-1/2至3周，毒副率低，并在4 - 5年显示出令人鼓舞的疗效。对于美国每年约有20 - 35000名前列腺切除术后生化复发的男性来说，低分割术可能是一种方便、高效且耐受性良好的挽救方法。
Post-prostatectomy adjuvant or salvage radiotherapy, when using standard fractionation, requires 6.5–8 weeks of treatment. We report on the safety and efficacy of an expedited radiotherapy course for salvage prostate radiotherapy. A total of 108 consecutive patients were treated with salvage radiation therapy to 65 Gy in 26 fractions of 2.5 Gy. Median follow-up was 32.4 months. Median pre-salvage PSA was 0.44 (0.05–9.50). Eighteen patients (17%) received androgen deprivation following surgery or concurrently with radiation. The actuarial freedom from biochemical failure for the entire group at 4 years was 67% +/− 5.3%. An identical 67% control rate was seen at 5 years for the first 50 enrolled patients whose median followup was longer at 43 months. One acute grade 3 GU toxicity occurred, with no acute grade 3 GI and no late grade 3 toxicities observed. On univariate analysis, higher Gleason score (p=0.006), PSA doubling time ≤ 12 months (p=0.03), perineural invasion (p=0.06), and negative margins (p=0.06) showed association with unsuccessful salvage. On multivariate analysis, higher Gleason score (p=0.057) and negative margins (p=0.088) retained an association with biochemical failure. Hypofractionated radiotherapy (65 Gy in 2.5 Gy fractions in about 5 weeks) reduces the length of treatment by from 1–1/2 to 3 weeks relative to other treatment schedules commonly employed, produces low rates of loxicity, and demonstrates encouraging efficacy at 4 – 5 years. Hypofractionation may provide a convenient, resource efficient and well-tolerated salvage approach for the estimated 20–35,000 US men per year experiencing biochemical recurrence after prostatectomy.
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影响因子：
254.7
作者：
Jemal, Ahmedin;Siegel, Rebecca;Thun, Michael J.
通讯作者：
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影响因子：
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DOI：
10.1016/j.ijrobp.2007.01.067
发表时间：
2007-08-01
影响因子：
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作者：
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