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经尿道切除前列腺是否会在同时进行综合增强放射治疗后增加毒性风险? 一个匹配的队列研究与长期随访

Aysenur Elmali¹, Birhan Demirhan², Ozan Cem Guler³

¹Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana Dr. Turgut Noyan Research and Treatment Center, 01120, Adana, Turkey.

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]

|November 4, 2025

概括

前通过尿道切除前列腺 (TURP) 增加了前列腺癌放射治疗 (RT) 后更早和更严重的生殖尿道 (GU) 毒性的风险. 这一发现凸显了在个性化RT规划中需要考虑TURP历史的必要性.

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:

前列腺癌的治疗通常涉及放射治疗 (RT).
同时综合增强 (SIB) 技术为前列腺内病变 (IPL) 提供升级剂量.
通过尿道切除前列腺 (TURP) 是良性前列腺增生的一个常见程序,可能会影响RT结果.

研究的目的:

在接受SIB RT的前列腺癌患者中评估生殖尿路 (GU) 毒性.
具体评估前前尿道切除前列腺 (TURP) 对GU毒性的影响.
在这个患者群体中确定晚期GU毒性的预测因素.

主要方法:

对606名局部性前列腺癌患者进行了回顾性分析,这些患者接受了图像引导RT (2012-2023) 治疗.
倾向分数匹配 (PSM) 创建了一个158名患者的队列 (79名先前有 TURP,79名没有).
SIB RT向IPL输送高达86 Gy;毒性按CTCAE v4.03.03进行分级.

主要成果:

平均78个月的随访后,晚期等级≥2GU毒性发生在TURP患者中的21.5%,而非TURP患者中的7.6% (p=0.02).
在TURP患者中,毒性发生的中位时间明显较短 (16 vs. 47个月,p=0.007).
之前的TURP和糖尿病是晚期GU毒性增加的独立预测因素.

结论:

之前的TURP独立地与SIB RT接受的前列腺癌患者的较高和较早发作的晚期GU毒性有关.
这些发现表明,TURP状态应该是个性化RT规划的一个因素.
考虑TURP病史可能有助于减轻前列腺癌RT中的GU毒性风险.

关键词:

性尿毒性性尿毒性图像指导放射疗法是指导图像的放射疗法.前列腺癌是什么意思前列腺癌是什么意思同时的集成提升.翻过身来翻过身来,就是这样.

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