Moderate dose escalation with single-fraction high-dose-rate brachytherapy boost for clinically localized intermediate- and high-risk prostate cancer: 5-year outcome of the first 100 consecutively treated patients
Moderate dose escalation with single-fraction high-dose-rate brachytherapy boost for clinically localized intermediate- and high-risk prostate cancer: 5-year outcome of the first 100 consecutively treated patients
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DOI：
10.1016/j.brachy.2011.01.003
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发表时间：
2011-09-01
期刊：
影响因子：
1.9
通讯作者：
Polgar, Csaba
中科院分区：
文献类型：
--
作者：
Agoston, Peter;Major, Tibor;Polgar, Csaba
目的：分析连续100例连续接受单次高剂量率近距离放疗和外照射的患者的临床结果和毒性资料。方法与材料：280例局限性中高危前列腺癌患者接受单次高剂量率近距离放疗。其中，对头100名接受单一HDR-BT部分治疗的患者的结果和毒性进行了评估。前列腺和小泡接受60GyEBRT的中位剂量。结果：中位随访时间为61.5个月。整个队列的总生存率、病因特异性生存率、无病生存率和生化无疾病证据(BNED)的5年精算率分别为93.3%、99.0%、89.3%和85.5%。BNED的7年精算率在中等风险组为84.2%，在高风险组为81.6%(p=0.8464)。BNED对1、2、3级肿瘤的7年精确率分别为97.5%、80.0%和67.1%。发生晚期3级胃肠道和泌尿生殖系统(GU)毒性的5年概率分别为2.1%和14.4%。有放疗前电切病史的患者发生3级GU并发症的频率明显更高(29.1%vs.8.8%；p=0.0047)。结论：60GyEBRT加10GyHDR-BT单次强化治疗的5年结果令人鼓舞。放射治疗前经尿道电切显著增加晚期严重GU并发症的风险。(C)2011年美国近距离放射治疗学会。爱思唯尔公司出版，版权所有。
PURPOSE: To analyze the clinical outcome and toxicity data of the first 100 consecutive patients treated with a single-fraction high-dose-rate brachytherapy (HDR-BT) and external beam radiotherapy (EBRT).METHODS AND MATERIALS: Two-hundred eighty patients have been treated with HDR-BT boost for localized intermediate- to high-risk prostate cancer. Among these, the outcome and toxicity of the first 100 patients treated with a single HDR-BT fraction were assessed. A median dose of 60 Gy EBRT was given to the prostate and vesicles. Interstitial HDR-BT of 10 Gy was performed during the course of EBRT.RESULTS: Median followup time was 61.5 months. The 5-year actuarial rates of overall survival, cause-specific survival, disease-free survival, and biochemical no evidence of disease (bNED) for the entire cohort were 93.3%, 99.0%, 89.3%, and 85.5%, respectively. The 7-year actuarial rate of bNED was 84.2% for the intermediate-risk group and 81.6% for the high-risk group (p = 0.8464). The 7-year actuarial rates of bNED for Grade 1, 2, and 3 tumors were 97.5%, 80.0%, and 67.1%, respectively. The 5-year probability for developing late Grade 3 gastrointestinal and genitourinary (GU) toxicity was 2.1% and 14.4%, respectively. Grade 3 GU complications occurred significantly more frequently in patients with a history of preirradiation transurethral resection (29.1% vs. 8.8%; p = 0.0047).CONCLUSIONS: Five-year outcome after 60 Gy EBRT plus a single fraction of 10 Gy HDR-BT boost is encouraging. Preradiation transurethral resection significantly increases the risk of late severe GU complications. (C) 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.