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在放射性复发前列腺癌的救援低剂量与高剂量支臂疗法之间
Shaoqin Xie1, Jianjiang Liu2, Bin Shen1
1Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
BJU international
|February 10, 2025
概括
拯救性低剂量率支臂疗法 (LDR-BT) 在精选患者中提供了比高剂量率支臂疗法 (HDR-BT) 更好的无复发生存率 (RFS). 然而,LDR-BT与严重的胃肠道和泌尿器毒性增加有关.
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:
- 救援放射治疗是初级治疗后复发前列腺癌的治疗选择.
- 低剂量率支臂治疗 (LDR-BT) 和高剂量率支臂治疗 (HDR-BT) 是前列腺癌治疗的既定技术.
- 对救援LDR-BT与HDR-BT的疗效和毒性进行比较对于治疗选择至关重要.
研究的目的:
- 评估救援低剂量率支臂治疗 (LDR-BT) 的疗效和毒性.
- 将救援LDR-BT的结果与救援高剂量率支架疗法 (HDR-BT) 的已发表数据进行比较.
主要方法:
- 在2024年5月之前,对PubMed和EMBASE数据库进行了系统审查.
- 对救援LDR-BT的无复发生存 (RFS) 数据在各子组中进行了分析.
- 使用WebPlotDigitizer和R集成的闪亮应用程序重建了生存曲线,以与HDR-BT数据进行比较.
主要成果:
- 包括891名患者在内的31项研究符合挽救LDR-BT的标准.
- 救援LDR-BT的RFS中位数为131.6个月,5年RFS为63.5%.
- 与HDR-BT (HR 0.67) 相比,救援LDR-BT显示RFS得到改善,特别是在年轻的患者和那些 PSA水平较高或从初级治疗时间较长的患者中. 然而,LDR-BT的严重胃肠道 (3.5%对0.3%) 和尿生殖系统 (12.7%对5.8%) 毒性的比率更高.
结论:
- 与HDR-BT相比,Salvage LDR-BT在特定患者队列中显示出更高的无复发生存率.
- 改善LDR-BT的疗效与较高的严重胃肠道和生殖尿道毒性的发病率有关.
- 患者选择至关重要,以平衡LDR-BT的好处与其潜在的毒性风险.
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