欧洲泌尿病学协会生物化学复发风险分类作为救援放射治疗的决策工具-多中心研究
Felix Preisser1, Raisa S Abrams-Pompe2, Piter Jan Stelwagen3
1Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.
European urology
|June 24, 2023
概括
早期救援放射治疗 (SRT) 显著改善了前列腺切除术后高风险生化复发 (BCR) 的存活率. 低风险BCR患者可能会从监测中受益,因为早期的SRT在这个群体中显示出最小的生存率增长.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
背景情况:
- 欧洲泌尿病学协会 (EAU) 开发了一种生物化学复发 (BCR) 后根性前列腺切除术 (RP) 的风险分层.
- 评估这种EAU风险分层在指导救援放射治疗 (SRT) 治疗决策中的有用性至关重要.
研究的目的:
- 确定EAU风险分层是否有效地识别了在RP后从SRT中受益的患者.
- 根据BCR风险分类,比较早期或晚期接受SRT和没有SRT的患者的结果.
主要方法:
- 来自10个欧洲中心 (1989-2020年) 的2379名RP后BCR患者的分析.
- 患者被分为EAU低风险和高风险BCR组.
- 多变量考克斯模型和西蒙-马库奇方法评估了基于SRT时间和风险组的生存差异.
主要成果:
- 与没有SRT相比,接受早期SRT的高风险BCR患者显示12年整体存活率 (81%对66%,p<0.001) 和癌症特异性存活率 (98%对82%,p<0.001) 显著改善.
- 早期的SRT显著降低了死亡风险 (HR:0.55) 和癌症特异性死亡 (HR:0.08).
- 低风险BCR患者从早期SRT中没有显著的生存益处 (p > 0.2).
结论:
- 早期的SRT建议用于高风险BCR患者,以改善生存结果.
- 对低风险BCR患者来说,监测可能是一个合适的选择,因为在这个群体中观察到SRT的益处有限.
- 在RP之后,EAU风险分层对于个性化SRT决策非常有价值.
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