前列腺癌幸存者的治疗后监测强度和整体生存时间 (AFT-30)
Ronald C Chen1, Ramsankar Basak2, Stacie Dusetzina3
1Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS, USA.
JNCI cancer spectrum
|October 9, 2024
概括
治疗后加强前列腺癌监测测试并没有改善整体存活率. 更高的前列腺特异性抗原 (PSA) 测试频率与更多的手术和救援治疗有关,而不是更好的生存结果.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 治疗后的监测对数百万癌症幸存者至关重要.
- 引导前列腺癌监测临床实践的经验数据有限.
- 这项研究调查了局部性前列腺癌患者的监测强度和生存结果之间的关联.
研究的目的:
- 评估局部性前列腺癌患者的监测测试强度和整体存活率之间的关联.
- 评估监测强度对无复发生存时间 (RFS) 的影响.
- 检查监测强度与使用诊断程序和救援治疗之间的关系.
主要方法:
- 分析了10147名被诊断患有局部前列腺癌 (2005-2010) 的男性,他们接受了激进前列腺切除术或放射治疗.
- 监测强度根据治疗后第一年进行的前列腺特异性抗原 (PSA) 测试数量进行分类:低 (0-1),中等 (2) 或高 (≥3).
- 统计分析检查了PSA监测强度与整体存活率,RFS和次要结果之间的关联.
主要成果:
- 对于放射治疗或急性前列腺切除术患者,监测强度组的整体存活率没有显著差异.
- 无复发生存期 (RFS) 在放射治疗患者中没有显著差异,但在急性前列腺切除术患者的高强度监测组中更差 (P=.01).
- 对于这两种治疗方式,更高的监测强度与更多地使用诊断程序和救援治疗相关.
结论:
- 在急性前列腺切除术或局部前列腺癌放射治疗后增加PSA监测的频率与改善整体存活率无关.
- 更密集的监测与接受额外程序和救援处理的可能性更高有关.
- 目前的监测强度实践可能需要重新评估,以优化患者的治疗结果和资源利用.
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