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单独治疗的LDR-Brachytherapy似乎不适合NCCN不利的中期风险前列腺癌患者

Andreas Boehle¹, Dorothea Zywietz², Irina Robrahn-Nitschke³

¹Department of Urology, University of Luebeck, Luebeck, Germany; Department of Urology, HELIOS Agnes-Karll Hospital Bad Schwartau, Bad Schwartau, Germany.

Urologic oncology

|September 15, 2023

概括

将中等风险前列腺癌 (PCa) 分为有利的 (FIR) 和不利的 (UIR) 是至关重要的. 结合方式的放射治疗 (CRT) 显示了UIRPCa的优异结果,而不是单独治疗的基疗法 (BT).

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:

中等风险 (IR) 前列腺癌 (PCa) 是一个异质的群体.
将中等风险的PCa分为有利的 (FIR) 和不利的 (UIR) 可以完善风险分层.
比较放射治疗方案对于优化治疗策略至关重要.

研究的目的:

为了验证IR PCa的细分为FIR和UIR类别.
为了比较I-LDR-brachytherapy (BT) 单疗法与联合方式放射治疗 (CRT) 在历史队列中的结果.

主要方法:

对490名IR PCa患者的回顾性分析,这些患者接受了BT或CRT治疗.
患者被分为FIR和UIR组.
卡普兰-梅尔分析和考克斯回归被用来评估生化无复发生存率 (BRFS),无转移生存率 (MFS) 和前列腺癌特异性生存率 (CSS).

主要成果:

与BT相比,CRT的10年BRFS (94%为FIR,89%为UIR) 优于BT (81%为FIR,37%为UIR).
与BT (87%的FIR,78%的UIR) 相比,CRT还显示出优越的10年MFS (94%的FIR,95%的UIR).
在UIR患者中,CRT与BT相比显著降低了生化复发和转移 (BRFS的P<0.001,MFS的P=0.011).

结论:

将IR PCa分为FIR和UIR的分类在临床上是相关的.
在UIR PCa患者中,BT单疗与临床失败的增加有关.
对于UIR PCa患者来说,CRT提供了很好的结果.

关键词:

生物化学复发的发生.在LDR-brachytherapy治疗中使用LDR.结果结果的结果.前列腺癌是什么意思前列腺癌是什么意思放射疗法是一种放射治疗.不良的中间风险不良的风险.

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