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基于图像的复发模式在长期随访后在前列腺癌中重新照射后

Una Ryg^1,2, Wolfgang Lilleby³, Line Brennhaug Nilsen⁴

¹Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.

Advances in radiation oncology

|November 11, 2025

概括

前列腺癌再辐射往往导致前列腺内复发,无论是在高剂量区域内还是外. 大约三分之一的患者在治疗后发展区域性或远程转移性疾病.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
尿道瘤学尿道瘤学

背景情况:

前列腺癌放射后疗法的局部失败表明预后不佳.
之前的再辐射研究集中在毒性和瘤结果上,对复发模式的数据有限.

研究的目的:

为了调查前列腺癌在重新照射后的复发模式.
通过了解在重新照射后发生复发的情况,为未来的治疗决策提供信息.

主要方法:

在确定的放射治疗 (2012-2018) 后,对33名患有局部前列腺癌复发的男性进行了回顾性分析.
再照射方式包括焦点高剂量率支臂疗法 (23名患者) 或立体体辐射疗法 (10名患者).
用多参数MRI评估复发部位,并与辐射剂量分布图进行比较.

主要成果:

在99个月的中位数随访期间,25名患者经历了生物化学复发.
在有充分成像的20名患者中,5名患者仅在高剂量区域内复发,7名患者在该区域内外复发.
四名患者出现了前列腺内复发和区域性淋巴结转移;一个患有前列腺复发和骨转移.

结论:

前列腺癌在再照射后经常在前列腺中复发,影响高剂量辐射区域内外的区域.
很大一部分患者 (大约三分之一) 与前列腺内复发同时或之后发展区域性或远程转移性疾病.

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