An attempt to optimize treatment strategy using a novel risk categorization of prostate cancer

前列腺癌的放射治疗有许多选择，包括外照射(EBRT)、低剂量率(LDR)或高剂量率(HDR)近距离放射治疗。然而，目前还不清楚哪组患者适合哪种方案或其最佳辐射剂量。我们开发了一种独创的风险分组方法，名为PRIX(前列腺癌风险指数)。在EBRT中，Prix 0组不需要放射剂量递增，而Prix 1-6组需要它。在近距离放射治疗中，LDR和HDR在Prix 0中都显示出良好的效果。HDR在Prix1-6中也表现出令人满意的结果，这表明通过降低分馏来增加生物有效剂量与更好的结果相关。我们正在计划下一步的临床试验，包括针对Prix 1的LDR近距离放射治疗，使用CyberKnife的立体定向放射治疗，以及基于本研究获得的这些发现的低分割调强放射治疗。

There are many options in radiotherapy for prostate cancer, including external beam radiotherapy (EBRT), low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy. However, it is still unclear which patient-group is suitable for which option or its optimal radiation dose. We developed an original risk-grouping method named PRIX (Prostate Cancer Risk Index). In EBRT, PRIX 0 group did not required radiation dose-escalation, while PRIX 1-6 needed it. In brachytherapy, both LDR and HDR showed good results in PRIX 0. HDR also showed satisfactory results in PRIX 1-6, which implied thatescalating the biological effective dose by hypofractionation was associated with better results. We are planning next clinical trials, including LDR brachytherapy for PRIX 1, stereotactic radiotherapy using CyberKnife, and hypofractionated intensity-modulated radiotherapy, based on these findings obtained by this study.