在低风险和中等风险的局部性前列腺癌中,冷治疗与放射治疗后的生存率相比较低
Han Li1, Zhihu Xu2, Zhengtong Lv3
1Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Peking University Fifth School of Clinical Medicine, Beijing, China.
Clinical genitourinary cancer
|July 8, 2023
概括
结冷疗法和放射疗法在低风险和中等风险前列腺癌 (PCa) 中显示出类似的生存结果. 这项研究表明,冷疗法是PCa患者放射治疗 (RT) 的可行替代方案,提供可比的整体存活率 (OS) 和癌症特异性存活率 (CSS).
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 焦点疗法,包括冷疗法,在低风险和中等风险前列腺癌 (PCa) 中越来越受欢迎,特别是在患有并发症的患者中.
- 低温疗法提供了一个不那么侵入性的替代方案,比如放射治疗 (RT) 等全腺治疗.
- 在中期结果上缺乏共识,比较PCa的冷疗法和RT.
研究的目的:
- 为了比较低风险和中等风险PCa患者的冷藏疗法和RT之间的中期整体存活率 (OS) 和癌症特异性死亡率 (CSM).
- 评估冷手术作为放射治疗的替代品的疗效.
主要方法:
- 使用了监测,流行病学和最终结果 (SEER) 数据库 (2004-2015) 对47787名PCa患者.
- 采用了卡普兰-梅尔方法,多变量考克斯回归和竞争风险回归 (细灰).
- 应用倾向性得分匹配 (PSM) 和治疗权重的逆概率 (IPTW) 进行可靠的比较分析.
主要成果:
- 在PSM (N=4670) 后,5年后的生存率为冷治疗的89%和RT的91.8%;累计的CSM为0.65%和0.57%.
- 多变量分析表明,冷疗法与较差的生存状况有关 (HR 1.29,P < .01),但在CSS方面没有显著差异.
- 除了心血管死亡之外的敏感性分析显示,治疗方法之间没有显著的OS或CSS差异.
结论:
- 对于低风险和中等风险的PCa,在冷治疗和RT之间没有观察到显著的生存差异.
- 低温疗法已成为传统辐射疗法的可行和潜在可行的替代方案,适用于部分PCa患者.
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