选择性盆腔淋巴结放射治疗和不良风险前列腺癌患者的死亡风险:随机后分析分析
Mutlay Sayan1, Ming-Hui Chen2, Marian Loffredo1
1Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA.
概括
全盆腔放射治疗 (WPRT) 可能会降低患有不利风险前列腺癌 (PC) 的年轻男性的死亡率. 长期数据显示,WPRT显著降低了65岁以下男性的全因和前列腺癌特异性死亡风险.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 临床试验 临床试验
背景情况:
- 当代随机试验支持针对局部,不利风险前列腺癌 (PC) 的全骨盆放射治疗 (WPRT).
- 关于WPRT对死亡率的影响的长期数据有限.
- 评估WPRT与死亡率的关联对于治疗指南至关重要.
研究的目的:
- 评估辐射治疗量与全因死亡率 (ACM) 和PC特定死亡率 (PCSM) 之间的长期关联.
- 调查WPRT对不良风险PC男性死亡率的影响.
- 为了确定年龄是否会改变WPRT对死亡率结果的影响.
主要方法:
- 一个随机临床试验,涉及350名男性,从2005年至2015年具有局部,不利风险的PC.
- 患者接受了雄激素剥夺疗法 (ADT) 和RT加多西或ADT和RT.
- 多变量回归分析评估了辐射治疗量与死亡率之间的关联,调整了共变量,并包括了年龄相互作用术语.
主要成果:
- 随访时间中位数为10.2年后,死亡人数为89人 (25.43%),其中42人死于PC.
- 在350名患者中,88名 (25.14%) 接受了WPRT.
- 在65岁以下的男性中,WPRT与明显降低ACM风险 (AHR,0.33;P = .04) 和降低PCSM风险 (AHR,0.17;P = .09) 的趋势有关.
结论:
- 全盆腔辐射疗法 (WPRT) 表明,在被诊断患有不利风险前列腺癌的年轻男性中,有可能降低死亡率.
- 观察到的WPRT对死亡的好处是特定于65岁以下的患者.
- 这些发现表明,WPRT可能是选择晚期前列腺癌的年轻患者群体的有价值的治疗策略.
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