High dose rate brachytherapy as a boost for the treatment of localized prostate cancer
High dose rate brachytherapy as a boost for the treatment of localized prostate cancer
复制标题
DOI：
10.1016/j.juro.2006.08.109
复制
发表时间：
2007-01-01
影响因子：
6.6
通讯作者：
Khan, Farhan
中科院分区：
文献类型：
--
作者：
Phan, Thinh P.;Syed, A. M. Nisar;Khan, Farhan
目的：报告高剂量率近距离放射治疗局限性前列腺癌的疗效和毒副反应。材料和方法：1996年至2003年，309例前列腺癌患者接受外照射和高剂量率近距离放射治疗。此外，36%的患者接受了新辅助/同时或辅助雄激素剥夺治疗。将患者分为3组。治疗前Gleason评分<6分，前列腺特异性抗原<10 ng/ml，临床分期<T2a<T2a者67例。第2组患者Gleason评分7分以上，治疗前前列腺特异性抗原>10 ng/ml，临床分期T2b以上。结果：中位随访59个月，美国放射治疗与肿瘤学学会定义的5年生化控制率为86%，病因特异性生存率为98%，总生存率为91%。分层1~3组的生化控制率分别为98%、90%和78%。在单因素分析危险组中，治疗前前列腺特异性抗原和Gleason评分是生化控制的显著预测因素。然而，在多变量分析中，只有危险组和治疗前前列腺特异性抗原有显著意义。按一般毒性标准评分，急性尿路中毒3级2例。在副作用方面，4%的患者出现3级泌尿生殖系统毒性，1例出现4级直肠并发症。结论：外照射加高剂量率近距离照射治疗前列腺癌具有良好的生化控制效果，可提高患者的特异性生存率和总生存率，且严重急性或晚期并发症较少。
Purpose: We report the outcome and toxicities of high dose rate brachytherapy as a boost for localized prostate cancer.Materials and Methods: Between 1996 and 2003, 309 patients with prostate carcinoma were treated with external beam radiation therapy and high dose rate brachytherapy. Furthermore, 36% of the patients received neoadjuvant/concurrent or adjuvant androgen deprivation therapy. Patients were stratified into 3 groups. Group 1 of 67 patients had Gleason score 6 or less, pretreatment prostate specific antigen 10 ng/ml or less and clinical stage T2a or less. Group 2 of 109 patients had Gleason score 7 or greater, pretreatment prostate specific antigen greater than 10 ng/ml and clinical stage T2b or greater. Group 3 of 133 patients had 2 or more of these higher risk factors.Results: At a median followup of 59 months the 5-year biochemical control rate, as defined by the American Society for Therapeutic Radiation and Oncology, was 86%, cause specific survival was 98% and overall survival was 91%. Biochemical control in stratified groups 1 to 3 was 98%, 90% and 78%, respectively. On univariate analysis risk group, pretreatment prostate specific antigen and Gleason score were significant predictors of biochemical control. However, on multivariate analysis only risk group and pretreatment prostate specific antigen were significant. Using the Common Toxicity Criteria scale there were 2 cases of grade 3 acute urinary toxicity. Regarding late side effects 4% of patients had grade 3 genitourinary toxicity and 1 had a grade 4 rectal complication.Conclusions: External beam radiation therapy and high dose rate brachytherapy for prostate cancer resulted in excellent biochemical control, cause specific survival and overall survival with minimal severe acute or late complications.