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在急性前列腺切除术后,复发前列腺癌的救援放射治疗

Andrew J Stephenson¹, Shahrokh F Shariat, Michael J Zelefsky

¹Department of Urology, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

|March 18, 2004

概括

救援放射治疗可以治愈复发的前列腺癌. 像格里森评分和PSA水平这样的关键因素可以预测持续的反应,确定从这种治疗中受益最多的患者.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

救援放射治疗为前列腺癌复发后的前列腺切除术提供了潜在的治疗方法.
之前的研究表明,在易转移性进展的高风险患者中,疗效有限.

研究的目的:

确定预测救援放射治疗持续反应的变量.
划分可能从复发前列腺癌的这种治疗中受益的患者子组.

主要方法:

对501名因前列腺切除术后PSA升高而接受救援放射治疗的患者进行了回顾性审查.
对疾病进展的预测因子的分析,以PSA水平或雄激素剥夺疗法启动来定义.

主要成果:

50%的患者经历了疾病的进展,10%的患者发展了远程转移.
进展的预测因素包括高的格里森得分 (8-10),PSA>2.0 ng/mL,负边际,短的PSA翻倍时间 (PSADT ≤10个月) 和精液囊泡入侵.
没有不良特征的患者4年无进展概率 (PFP) 为77%.

结论:

格里森得分,治疗前PSA,手术边缘,PSADT和精液囊泡入侵是挽救放射治疗反应的关键预后因素.
选择的高度或快速PSADT患者,以前被认为是糟糕的候选人,可以实现持久的反应.

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