Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer
Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer
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DOI：
10.1016/j.radonc.2012.01.007
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发表时间：
2012-05-01
影响因子：
5.7
通讯作者：
Bryant, Linda
中科院分区：
文献类型：
--
作者：
Hoskin, Peter J.;Rojas, Ana M.;Bryant, Linda
背景资料：一项随机III期试验比较了外照射放疗（EBRT）单独与EBRT结合高剂量率近距离放射治疗增强（HDR-BTb）在局部prostate adenocarcinosis.Methods：从1997年12月至2005年8月，218例患者被分配到EBRT单独（n = 108）或EBRT其次是一个临时的高剂量率植入（n = 110）。根据肿瘤分期、PSA、Gleason评分和雄激素剥夺治疗（ADT）对患者进行分层。生化/临床无复发生存期（RFS）是主要终点。次要终点是总生存期（OS），泌尿和肠toxicity.Results：RFS是显着较高的EBRT + HDR-BTb治疗的患者（对数秩p = 0.04）。在多变量分析治疗组中，风险类别和ADT是复发风险的显著协变量。OS差异不显著。严重的晚期泌尿和肠道发病率是similar.Conclusions：EBRT + HDR-BTb导致RFS显着改善相比，EBRT单独与复发的风险降低31%（p = 0.01）和严重的晚期泌尿和直肠发病率相似。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学103（2012）217-222
Background: A randomised phase-III trial compared external beam radiotherapy (EBRT) alone with EBRT combined with high-dose-rate brachytherapy boost (HDR-BTb) in localised prostate adenocarcinoma.Methods: From December 1997 to August 2005, 218 patients were assigned to EBRT alone (n = 108) or EBRT followed by a temporary high-dose-rate implant (n = 110). Patients were stratified according to tumour stage, PSA, Gleason score and androgen deprivation therapy (ADT). Biochemical/clinical relapse-free survival (RFS) was the primary endpoint. Secondary endpoints were overall survival (OS), urinary and bowel toxicity.Results: RFS was significantly higher in patients treated with EBRT + HDR-BTb (log rank p = 0.04). In multivariate analysis treatment arm, risk category and ADT were significant covariates for risk of relapse. Differences in OS were not significant. Incidence of severe late urinary and bowel morbidity was similar.Conclusions: EBRT + HDR-BTb resulted in a significant improvement in RFS compared to EBRT alone with a 31% reduction in the risk of recurrence (p = 0.01) and similar incidence of severe late urinary and rectal morbidity. (C) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 103 (2012) 217-222