Predictive factors for late genitourinary and gastrointestinal toxicity in patients with prostate cancer treated with adjuvant or salvage radiotherapy
Predictive factors for late genitourinary and gastrointestinal toxicity in patients with prostate cancer treated with adjuvant or salvage radiotherapy
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DOI：
10.1016/j.ijrobp.2007.01.049
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发表时间：
2007-08-01
影响因子：
7
通讯作者：
Sandler, Howard M.
中科院分区：
文献类型：
--
作者：
Feng, Mary;Hanlon, Alexandra L.;Sandler, Howard M.
目的：确定前列腺癌挽救或辅助放疗 (RT) 后晚期泌尿生殖 (GU) 和胃肠道 (GI) 毒性的发生率和严重程度，并确定这些毒性的预测因素。方法和材料：分析了一个大型多机构数据库，其中包括 959 名在根治性前列腺切除术 (RP) 后接受术后 RT 的男性：19% 接受辅助 RT，81% 接受挽救 RT，78 % 仅接受前列腺床治疗，22% 接受骨盆放疗。结果：中位随访时间为 55 个月。 5 年时，10% 的患者出现 2 级晚期 GU 毒性，1% 出现 3 级晚期 GU 毒性，4% 的患者出现 2 级晚期胃肠道毒性，0.4% 出现 3 级晚期胃肠道毒性。多变量分析表明，辅助放疗 (p = 0.03)、雄激素剥夺 (p < 0.0001) 和前列腺卧床放疗 (p = 0.007) 可预测 2 级或更高级别的晚期 GU 毒性。对于胃肠道毒性，虽然辅助放疗在单变量分析中显着，但在多变量分析中未发现显着因素。结论：总体而言，术后放疗的高级别毒性数量较低。因此，在适当的环境下可以安全地使用辅助放疗和挽救性放疗。 (C) 2007 爱思唯尔
Purpose: To determine the rate and magnitude of late genitourinary (GU) and gastrointestinal (GI) toxicities after salvage or adjuvant radiotherapy (RT) for prostate cancer, and to determine predictive factors for these toxicities.Methods and Materials: A large multi-institutional database that included 959 men who received postoperative RT after radical prost-atectomy (RP) was analyzed: 19 % received adjuvant RT, 81 % received salvage RT, 78 % were treated to the prostate bed only, and 22% received radiation to the pelvis.Results: The median follow-up time was 55 months. At 5 years, 10% of patients had Grade 2 late GU toxicity and 1 % had Grade 3 late GU toxicity, while 4% of patients had Grade 2 late GI toxicity and 0.4% had Grade 3 late GI toxicity. Multivariate analysis demonstrated that adjuvant RT (p = 0.03), androgen deprivation (p < 0.0001), and prostate bed-only RT (p = 0.007) predicted for Grade 2 or higher late GU toxicity. For GI toxicity, although adjuvant RT was significant in the uni,variate analysis, no significant factors were found in the multivariate analysis.Conclusions: Overall, the number of high-grade toxicities for postoperative RT was low. Therefore, adjuvant and salvage RT can safely be used in the appropriate settings. (C) 2007 Elsevier