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大量的活检核心参与与中等风险前列腺癌SBRT单疗后的失败无关

Joshua C Hurwitz¹, Jonathan A Haas², Vianca F Santos³

¹Department of Radiation Oncology, New York University Grossman Long Island School of Medicine, Mineola, NY 11501, United States; Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

|July 6, 2025

概括

高容量 (≥50%) 活检核心参与 (HVCI) 不能预测SBRT治疗中期风险前列腺癌的复发. 这表明,在SBRT时代,对于风险分层的有利风险患者来说,HVCI可能不必要.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
辐射瘤学辐射瘤学
病理学病理学病理学

背景情况:

高容量 (≥50%) 活检核心参与 (HVCI) 是不良的中期风险前列腺癌的已知风险因素.
在现代SBRT (立体体辐射疗法) 和剂量升级技术之前,曾经进行过将HVCI与复发联系起来的研究.

研究的目的:

评估SBRT治疗中期风险前列腺癌患者HVCI的预后价值.
确定HVCI是否仍然是SBRT时代结果的重要预测因素,特别是格里森2级和3级疾病.

主要方法:

对888名局部中期风险前列腺癌患者的回顾性审查,这些患者接受了五分量SBRT单疗法治疗.
使用传统权重和权重方法 (线性和指数) 对更高格莱森等级核心的HVCI分析.
使用回归模型分析了瘤结果,包括生化无病生存期 (BDFS) 和PSA极点 (TTN) 的时间.

主要成果:

在22%的患者中存在HVCI,与前列腺体积和直接与T阶段相反相关.
在整体队列,GG2或GG3亚组中,没有发现HVCI和BDFS之间的显著关联.
虽然PSA nadir与HVCI无关,但在GG3亚组中观察到TTN和HVCI之间存在负相关性 (p=0.04).

结论:

在SBRT单疗后,HVCI与BDFS无关,特别是在有利的中等风险 (GG2) 前列腺癌中.
根据TTN分析,HVCI可能在不利的中等风险 (GG3) 前列腺癌中保持预后价值.
需要进行前性研究来确认HVCI是否对SBRT时代的风险分层GG2前列腺癌至关重要.

关键词:

活检核心参与度生物检查核心的生物检查核心良好的中等风险前列腺癌.尿生殖系统癌症是什么中级风险的前列腺癌.阳性核心的百分比是正核.前列腺活检前列腺活检前列腺癌是什么意思前列腺癌是什么意思 SABR SABR是一款 SABR 系列的车型.在SBRT和SBRT之间.不利的中等风险前列腺癌前列腺核磁共振 (MRI) 的前列腺.

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