Salvage radiation therapy for prostate cancer patients after prostatectomy
Salvage radiation therapy for prostate cancer patients after prostatectomy
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DOI：
10.1093/jjco/hyy195
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发表时间：
2019-03-01
影响因子：
2.4
通讯作者：
Ohno, Yoshio
中科院分区：
文献类型：
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作者：
Mima, Takashi;Ohori, Makoto;Ohno, Yoshio
目的本研究的目的是确定危险因素，以预测生化复发（BCR）的患者接受补救放射治疗（SRT）后根治性直肠癌切除术（RP. Methods），我们回顾性分析了122例日本患者接受SRT的BCR后RP。使用单因素和多因素考克斯比例风险模型，我们确定了预测因素的BCR后SRT.Results的中位随访时间为61.3个月，45.9%的患者显示BCR后SRT，61.5和41.8%的非BCR率在第二和第五年。单因素比例风险分析显示，前列腺外疾病（P = 0.029）、精囊浸润（P = 0.005）、微血管浸润（P = 0.001）、术后Gleason评分（P = 0.008）和SRT前前列腺特异性抗原（PSA）（P = 0.005）与SRT后BCR显著相关。然而，在多变量分析中，只有微血管浸润和较高的SRT前PSA是显著的预测因素。15例微血管浸润和SRT前PSA > 1.2 ng/ml的患者SRT后第二年的非BCR率仅为21%，而72例微血管浸润阴性和SRT前PSA > 1.2 ng/ml的患者SRT后第二年的非BCR率为72.5%。
Objectives The aim of this study was to identify risk factors to predict a biochemical recurrence (BCR) in patients treated with salvage radiation therapy (SRT) after radical prostatectomy (RP).Methods We retrospectively reviewed 122 Japanese patients who received SRT for BCR after RP. Using uni- and multivariate Cox proportional hazard models, we identified the predictive factors of BCR after SRT.Results With a median follow-up of 61.3 months, 45.9% of the patients showed BCR after SRT, with 61.5 and 41.8% of non-BCR rates at the second and fifth years. Univariate proportional hazards analysis demonstrated that extraprostatic disease (P = 0.029), seminal vesicle invasion (P = 0.005), microvascular invasion (P = 0.001), postoperative Gleason score (P = 0.008) and pre-SRT prostate-specific antigen (PSA) (P = 0.005) were significantly associated with BCR after SRT. However, only the presence of microvascular invasion and a higher pre-SRT PSA were significant predictors in the multivariate analysis. The non-BCR rate in the second year after SRT for 15 patients with microvascular invasion and pre-SRT PSA > 1.2 ng/ml was only 21% compared to 72.5% of 72 patients with negative microvascular invasion and a pre-SRT PSA of