Biologically effective dose values for prostate brachytherapy: Effects on PSA failure and posttreatment biopsy results
Biologically effective dose values for prostate brachytherapy: Effects on PSA failure and posttreatment biopsy results
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DOI：
10.1016/j.ijrobp.2005.07.981
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发表时间：
2006-02-01
影响因子：
7
通讯作者：
Rosenstein, BS
中科院分区：
文献类型：
--
作者：
Stock, RG;Stone, NN;Rosenstein, BS
目的：为了分析生物有效剂量（BED）值对前列腺特异性抗原（PSA）失败和治疗后活检的影响，方法和材料：从1990年到2003年，1,377例患者接受了单独的前列腺近距离放射治疗（I-125或Pd-103）（571），激素和近距离放射治疗（371），以及三联疗法（激素，植入物和外部束）（435）。剂量被定义为D90（剂量-体积直方图中90%腺体的剂量）。结果：10年时无PSA失败（FFPF）率为87%。BED 100-120、>120-140、>140-160、180-200和>200的10年FFPF分别为46%、68%、81%、85.5%、90%、90%和92%（p < 0.0001）。BED和Gleason评分的影响最大，在多变量分析中p值< 0.0001。治疗后活检阳性率为7%（31/446）。BED 100-120、>120-140、>140-160、>160-180、>180-200、>200的阳性率分别为24%（8/33）、15%（3/20）、6%（2/33）、6%（3/52）、7%（6/82）、1%（1/72）、3%（4/131）。P < 0.0001。在多变量分析中，BED是活检结果最显著的预测因子（p = 0.006）。结论：生物有效剂量方程提供了一种比较前列腺癌近距离放射治疗管理中不同同位素和联合治疗的方法。BED对FFPF和治疗后活检的影响表现出强烈的剂量反应关系。(C)2006爱思唯尔公司
Purpose: To analyze the effect of biologically effective dose (BED) values on prostate-specific antigen (PSA) failure and posttreatment biopsy.Methods and Materials: From 1990 to 2003, 1,377 patients had prostate brachytherapy alone (I-125 or Pd-103) (571), hormonal and brachytherapy (371), and trimodality therapy (hormonal, implant, and external beam) (435). Dose was defined as the D90 (dose delivered to 90% of the gland from the dose-volume histogram).Results: Freedom from PSA failure (FFPF) at 10 years was 87%. The 10-year FFPF for BED 100-120, >120-140, >140-160, 180-200, and >200 were 46%, 68%, 81%, 85.5%, 90%, 90%, and 92%, respectively (p < 0.0001). BED and Gleason score had the greatest effect, with p values of p < 0.0001 in multivariate analysis. Posttreatment positive biopsy rate was 7% (31/446). The positive biopsy rates for BED 100-120, >120-140, >140-160, >160-180, >180-200, and >200 were 24% (8/33), 15% (3/20), 6% (2/33), 6% (3/52), 7% (6/82),1% (1/72), and 3% (4/131), respectively (p < 0.0001). BED was the most significant predictor of biopsy outcome in multivariate analysis (p = 0.006).Conclusions: Biologically effective dose equations provide a method of comparing different isotopes and combined therapies in the brachytherapy management of prostate cancer. The effects of BED on FFPF and posttreatment biopsy demonstrate a strong dose-response relationship. (C) 2006 Elsevier Inc.