Comparison of three moderate fractionated schedules employed in high-dose-rate brachytherapy monotherapy for clinically localized prostate cancer
Comparison of three moderate fractionated schedules employed in high-dose-rate brachytherapy monotherapy for clinically localized prostate cancer
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DOI：
10.1016/j.radonc.2018.07.026
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发表时间：
2018-11-01
影响因子：
5.7
通讯作者：
Ogawa, Kazuhiko
中科院分区：
文献类型：
--
作者：
Yamazaki, Hideya;Masui, Koji;Ogawa, Kazuhiko
背景：在此，我们报告了 3 个方案的高剂量率间质近距离放射治疗 (HDR-BT) 单药治疗局限性前列腺癌的结果。 患者和方法：总共 347 名患者接受了 45.5 Gy/7 分次治疗（n = 86；45.5 Gy 组，中位随访时间 131 个月）、49 Gy/7 分次治疗（n = 149；49） Gy 组，75.9 个月）和 54 Gy/9 分次（n = 112；54 Gy 组，68 个月）。结果：45.5 Gy、49 Gy 和 54 Gy 组的精算 5 年生化无失败生存率为 86.8%、94.1% 和 88.5% (p = 0.2023)属于高危人群；中等风险组为 90.4%、100% 和 97.4% (p = 0.0818)；低风险组中分别为 100% 和 100% 不可用。 45.5 Gy、49 Gy 和 54 Gy 组的 5 年无远处转移（和总体）生存率分别为 94.4%、98.2% 和 96.3%（100%、92.8% 和 99.1%）（p = 0.5454 和 p = 0.0028）。 5 年时，45.5 Gy、49 Gy 和 54 Gy 组的 2 级胃肠道毒性累积发生率分别为 1.2%、2.7% 和 3.4%（p = 0.5605）。对于泌尿生殖毒性，49 Gy 组显示出比 45.5 Gy (2.4%) 和 54 Gy 组 (10.1%) 观察到的更高的 >2 级毒性，为 20.5%。未检测到任何类型的 4 级或 5 级毒性。结论：3 个方案在每个风险组中显示出模棱两可的结果，具有不同的毒性特征。采用这些方案的 HDR-BT 单一疗法是局部前列腺癌可接受的治疗选择。 (C) 2018 Elsevier B.V. 保留所有权利。
Background: Herein, we report the outcomes of 3 schedules of high-dose-rate interstitial brachytherapy (HDR-BT) monotherapy for localized prostate cancer.Patients and methods: A total of 347 patients were treated with 45.5 Gy/7 fractions (n = 86; 45.5 Gy arm, median follow-up time 131 months), 49 Gy/7 fractions (n = 149; 49 Gy arm, 75.9 months), and 54 Gy/9 fractions (n = 112; 54 Gy arm, 68 months).Results: The actuarial 5-year biochemical failure-free survival rates were 86.8%, 94.1%, and 88.5% (p = 0.2023) for the 45.5 Gy, 49 Gy, and 54 Gy arms in the high-risk group; 90.4%, 100%, and 97.4% (p = 0.0818) in the intermediate-risk group; and not available, 100%, and 100% in the low-risk group, respectively. The 5-year distant metastasis-free (and overall) survival rates were 94.4%, 98.2%, and 96.3% (100%, 92.8%, and 99.1%) for the 45.5 Gy, 49 Gy, and 54 Gy arms (p = 0.5454 and p = 0.0028), respectively. At 5 years, accumulated incidence of grade >= 2 gastrointestinal toxicity was 1.2%, 2.7%, and 3.4% for the 45.5 Gy, 49 Gy, and 54 Gy arms (p = 0.5605), respectively. For genitourinary toxicity, the 49 Gy arm showed a higher grade >2 toxicity of 20.5% than those observed in the 45.5 Gy (2.4%) and 54 Gy arms (10.1%). No grade 4 or 5 of either type of toxicity was detected.Conclusions: The 3 schedules showed equivocal outcomes in each risk group, with different toxicity profiles. HDR-BT monotherapy with these schedules is an acceptable treatment option for localized prostate cancer. (C) 2018 Elsevier B.V. All rights reserved.