Does Local Recurrence of Prostate Cancer After Radiation Therapy Occur at the Site of Primary Tumor? Results of a Longitudinal MRI and MRSI Study
Does Local Recurrence of Prostate Cancer After Radiation Therapy Occur at the Site of Primary Tumor? Results of a Longitudinal MRI and MRSI Study
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DOI：
10.1016/j.ijrobp.2011.11.030
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发表时间：
2012-04-01
影响因子：
7
通讯作者：
Coakley, Fergus V.
中科院分区：
文献类型：
--
作者：
Arrayeh, Elnasif;Westphalen, Antonio C.;Coakley, Fergus V.
目的：探讨前列腺癌放射治疗后局部复发是否发生在治疗前原发灶的同一部位，应用纵向磁共振成像(MR)和磁共振波谱成像评估优势肿瘤部位。方法和材料：本研究符合HIPAA标准，并经我们的人类研究委员会批准。我们确定了我们机构前列腺癌数据库(1996年起)中所有在放射治疗前接受直肠内磁共振成像和磁共振波谱成像的患者(n=124)，这些患者在接受放射治疗前接受了活检证实的前列腺癌，并在放射治疗后至少两年再次接受了磁共振成像。两位放射科医生记录了放射治疗前后明确的显性肿瘤的存在、位置和大小。如果至少50%的肿瘤位置重叠，则认为复发肿瘤位于与基线肿瘤相同的位置。结果：9例患者放疗前和放疗后均有明确的优势肿瘤，放疗前后肿瘤平均直径分别为1.8 cm(1~2.2)和1.9 cm(1.4~2.6)。中位随访时间为7.3年(2.7~10.8)。9例患者中，8例(89%)肿瘤复发部位与原发灶相同。结论：前列腺癌放疗后局部复发多发生在原发灶与原发灶相同部位，以加强局部肿瘤控制为目的的辅助局部治疗是治疗的合理补充。(C)2012年爱思唯尔公司。
Purpose: To determine if local recurrence of prostate cancer after radiation therapy occurs at the same site as the primary tumor before treatment, using longitudinal magnetic resonance (MR) imaging and MR spectroscopic imaging to assess dominant tumor location.Methods and Materials: This retrospective study was HIPAA compliant and approved by our Committee on Human Research. We identified all patients in our institutional prostate cancer database (1996 onward) who underwent endorectal MR imaging and MR spectroscopic imaging before radiotherapy for biopsy-proven prostate cancer and again at least 2 years after radiotherapy (n = 124). Two radiologists recorded the presence, location, and size of unequivocal dominant tumor on pre-and postradiotherapy scans. Recurrent tumor was considered to be at the same location as the baseline tumor if at least 50% of the tumor location overlapped. Clinical and biopsy data were collected from all patients.Results: Nine patients had unequivocal dominant tumor on both pre-and postradiotherapy imaging, with mean pre-and postradiotherapy dominant tumor diameters of 1.8 cm (range, 1-2.2) and 1.9 cm (range, 1.4-2.6), respectively. The median follow-up interval was 7.3 years (range, 2.7-10.8). Dominant recurrent tumor was at the same location as dominant baseline tumor in 8 of 9 patients (89%).Conclusions: Local recurrence of prostate cancer after radiation usually occurs at the same site as the dominant primary tumor at baseline, suggesting supplementary focal therapy aimed at enhancing local tumor control would be a rational addition to management. (C) 2012 Elsevier Inc.