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高风险和区域性前列腺癌风险分层的完善:随机试验的综合分析

Praful Ravi¹, Wanling Xie¹, Marc Buyse²

¹Dana-Farber Cancer Institute, Boston, MA, USA.

European urology

|May 22, 2024

概括

患有高风险局部前列腺癌的患者接受放射治疗和长期雄激素缺乏治疗,如果他们有多种风险因素或淋巴结参与,结果会更差. 这些发现有助于识别可能受益于强化治疗策略的患者.

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:

放射治疗 (RT) 加上长期雄激素剥夺疗法 (ltADT) 是高风险局部/局部区域前列腺癌 (HRLPC) 的标准.
鉴定标准治疗预后较差的患者对于治疗优化至关重要.

研究的目的:

评估使用RT + ltADT治疗的HRLPC患者的结局.
确定与该患者组预后较差相关的特定风险因素.

主要方法:

分析了来自十项随机对照试验的个人患者数据.
预后因素包括格里森得分≥8,cT3-4,前列腺特异抗原 (PSA) >20 ng/ml,cN1疾病.
使用多变量回归评估了无转移生存 (MFS),总生存 (OS) 和其他结果.

主要成果:

格里森评分≥8,cN1疾病,cT3-4,和PSA>20 ng/ml都与较差的MFS和OS有关.
患有两到三个风险因素 (RF) 的患者的10年MFS (53%) 和OS (60%) 与患有1个RF的患者相比显著降低.
患有cN1疾病的患者的结果特别糟糕,10年MFS为36%,OS为47%.

结论:

具有两到三个风险因素 (cN0) 或cN1疾病的HRLPC患者经历了标准RT和ltADT的最差结果.
这些发现有助于患者咨询,并可以指导HRLPC辅助临床试验的设计.
患有多种危险因素或淋巴结参与的患者可能是治疗强化候选人.

关键词:

安卓素剥夺疗法是一种安卓素缺乏疗法.高风险的前列腺癌是前列腺癌.没有转移的生存率.总体生存率总体生存率辐射疗法辐射疗法风险分层是指风险的分层.

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