Stereotactic body radiotherapy for localized prostate cancer: Pooled analysis from a multi-institutional consortium of prospective phase II trials
Stereotactic body radiotherapy for localized prostate cancer: Pooled analysis from a multi-institutional consortium of prospective phase II trials
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DOI：
10.1016/j.radonc.2013.08.030
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发表时间：
2013-11-01
影响因子：
5.7
通讯作者：
Katz, Alan
中科院分区：
文献类型：
--
作者：
King, Christopher R.;Freeman, Debra;Katz, Alan
目的：探讨立体定向全身放射治疗(SBRT)治疗局限性前列腺癌的疗效。方法与材料：收集2003-11年间8家机构的1100例前列腺癌患者参加SBRT前瞻性2期临床试验，并进行汇总分析。使用CyberKnife的SBRT分4-5次进行，中位剂量为36.25Gy.患者为低危(58%)、中危(30%)和高危(11%)。14%患者接受短期雄激素剥夺治疗(ADT)。结果：中位随访36个月，49例PSA失败(4.5%)，其中9例为良性PSA反弹。全组5年生化无复发生存率(BRFs)分别为95%、83%和78%。GS=8(p=0.001)，低、中、高危患者分别为95%、84%和81%(p<；0.001)。ADT(p=0.71)或作为总剂量的函数(p=0.17)没有观察到差异。在16%的患者中，PSA反弹为0.2 ng/ml。在135例至少随访5年的患者中，低风险患者和中风险患者的5年BRF率分别为99%和93%。结论：对于低风险和中风险患者，SBRT后PSA无复发生存率优于其他确定的治疗方法。目前的证据支持在这些患者的治疗选择中考虑采用SBRT。(C)2013年提交人。爱思唯尔爱尔兰有限公司出版。版权所有。
Purpose: The effectiveness of stereotactic body radiotherapy (SBRT) for localized prostate cancer is tested.Methods and materials: A total of 1100 patients with clinically localized prostate cancer were enrolled in separate prospective phase 2 clinical trials of SBRT from 8 institutions during 2003-11 and pooled for analysis. SBRT using the CyberKnife delivered a median dose of 36.25 Gy in 4-5 fractions. Patients were low-risk (58%), intermediate-risk (30%) and high-risk (11%). A short-course of androgen deprivation therapy (ADT) was given to 14%. PSA relapse defined as a rise >2 ng/ml above nadir was analyzed with the Kaplan Meier method.Results: With a median follow-up of 36 months there were 49 patients with PSA failure (4.5%), 9 of whom were subsequently determined to be benign PSA bounces. The 5-year biochemical relapse free survival (bRFS) rate was 93% for all patients; 95%, 83% and 78% for. GS = 8, respectively (p = 0.001), and 95%, 84% and 81% for low-, intermediate- and high-risk patients, respectively (p < 0.001). No differences were observed with ADT (p = 0.71) or as a function of total dose (p = 0.17). A PSA bounce of >0.2 ng/ml was noted among 16% of patients. For 135 patients possessing a minimum of 5 years follow-up, the 5-year bRFS rate for low- and intermediate-risk patients was 99% and 93%, respectively.Conclusion: PSA relapse-free survival rates after SBRT Compare favorably with other definitive treatments for low and intermediate risk patients. The current evidence supports consideration of SBRT among the therapeutic options for these patients. (C) 2013 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.