A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer.
A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer.
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DOI：
10.1016/j.urology.2008.05.057
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发表时间：
2008-12
期刊：
影响因子：
2.1
通讯作者：
Pollack, Alan
中科院分区：
文献类型：
--
作者：
Trabulsi, Edouard J.;Valicenti, Richard K.;Hanlon, Alexandra L.;Pisansky, Thomas M.;Sandler, Howard M.;Kuban, Deborah A.;Catton, Charles N.;Michalski, Jeff M.;Zelefsky, Michael J.;Kupelian, Patrick A.;Lin, Daniel W.;Anscher, Mitchell S.;Slawin, Kevin M.;Roehrborn, Claus G.;Forman, Jeffrey D.;Liauw, Stanley L.;Kestin, Larry L.;DeWeese, Theodore L.;Scardino, Peter T.;Stephenson, Andrew J.;Pollack, Alan
目前尚不清楚根治性前列腺切除术后的术后补救性放射治疗（SRT）和早期辅助放疗（ART）是否能达到同等的长期肿瘤控制。我们研究了一组接受抗逆转录病毒治疗的患者，将他们与生化失败后接受SRT的匹配对照组进行比较。在一个包含2299例患者的多机构数据库中，449例pT3-4N0疾病患者符合纳入条件，其中211例接受ART治疗，238例接受SRT治疗。根据术前前列腺特异性抗原Gleason评分、精囊浸润情况、手术切缘状况及术后随访，按1:1比例进行配对。共匹配192例患者（96:96）。手术后的中位随访时间为94个月，RT完成后的中位随访时间为73个月。与SRT相比，抗逆转录病毒治疗的生化失败显著减少。ART后手术5年无生化失败（FFBF）为75%，SRT为66%（风险比[HR] [H11005] 1.6, P [H11005] .049）。ART治疗结束后5年FFBF为73%，SRT治疗结束后为50% （HR [H11005] 2.3, log rank [LR] P [H11005] .0007）。从RT结束开始，SRT和Gleason评分≥8是FFBF减少的独立预测因子。从手术之日起，Gleason评分≥8是FFBF的显著预测因子。与SRT相比，早期ART治疗p3 - 4n0前列腺癌可显著降低根治性前列腺切除术后长期生化进展的风险。Gleason评分≥8是多变量分析中与转移进展相关的唯一因素。
It is unclear whether postoperative salvage radiation therapy (SRT) and early adjuvant radiotherapy (ART) after radical prostatectomy lead to equivalent long-term tumor control. We studied a group of patients undergoing ART by comparing them with a matched control group undergoing SRT after biochemical failure. Using a multi-institutional database of 2299 patients, 449 patients with pT3-4N0 disease were eligible for inclusion, including 211 patients receiving ART and 238 patients receiving SRT. Patients were matched in a 1:1 ratio according to preoperative prostate-specific antigen Gleason score, seminal vesicle invasion, surgical margin status, and follow-up from date of surgery. A total of 192 patients were matched (96:96). The median follow-up was 94 months from surgery and 73 months from RT completion. There was a significant reduction in biochemical failure with ART compared with SRT. The 5-year freedom from biochemical failure (FFBF) from surgery was 75% after ART, compared with 66% for SRT (hazard ratio [HR] [H11005] 1.6, P [H11005] .049). The 5-year FFBF from the end of RT was 73% after ART, compared with 50% after SRT (HR [H11005] 2.3, log rank [LR] P [H11005] .0007). From the end of RT, SRT and Gleason score ≥8 were independent predictors of diminished FFBF. From the date of surgery, Gleason score ≥8 was a significant predictor of FFBF. Early ART for pT3-4N0 prostate cancer significantly reduces the risk of long-term biochemical progression after radical prostatectomy compared with SRT. Gleason score ≥8 was the only factor on multivariate analysis associated with metastasic progression.
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影响因子：
45.3
作者：
Swanson, Gregory P.;Hussey, Michael A.;Crawford, E. David
通讯作者：
Crawford, E. David
影响因子：
6.6
作者：
GIBBONS, RP;COLE, BS;HAFERMANN, MD
通讯作者：
HAFERMANN, MD
影响因子：
168.9
作者：
Bolla, M;van Poppel, H;Piérart, M
通讯作者：
Piérart, M
DOI：
10.1016/j.ijrobp.2007.01.049
发表时间：
2007-08-01
影响因子：
7
作者：
Feng, Mary;Hanlon, Alexandra L.;Sandler, Howard M.
通讯作者：
Sandler, Howard M.
DOI：
10.1016/s0360-3016(97)00080-1
发表时间：
1997-07-01
影响因子：
7
作者：
Morris, MM;Dallow, KC;Shipley, WU
通讯作者：
Shipley, WU