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国家布拉基疗法模式促进中等和高风险前列腺癌的使用:弥合证据和实践之间的差距

Alicia C Smart¹, Yetkin Tuac², Zhiyu Qian³

¹Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA.

|December 5, 2025

概括

外部辐射疗法与胸膜疗法增强 (EBRT-BT) 改善了前列腺癌患者的治疗结果,但仍然未得到充分利用. 这项研究分析了国家趋势,发现EBRT-BT使用的适度增加,特别是在高风险的情况下.

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:

外部光束辐射疗法与胸膜疗法增强 (EBRT-BT) 已被证明可以提高中期和高风险前列腺癌中无生物化学进展的存活率.
尽管有强有力的证据,但EBRT-BT在常规实践中的临床采用尚未得到充分理解.
ASCENDE-RT试验提供了支持EBRT-BT的高级证据,促使对其试验后利用趋势进行评估.

研究的目的:

评估前列腺癌中使用支臂疗法增强与外部束辐射疗法 (EBRT-BT) 的国家趋势.
确定影响EBRT-BT在患者治疗中的采用临床和人口因素.
评估ASCENDE-RT试验出版物对EBRT-BT使用模式的影响.

主要方法:

使用监测,流行病学和最终结果 (SEER) 数据库 (2015-2020) 的回顾性队列研究.
纳入标准:患有中等或高风险局部前列腺癌的男性接受EBRT,或不接受支臂治疗作为主要治疗.
使用多变量后勤回归分析来确定与EBRT-BT接收相关的因素,并分析时间趋势.

主要成果:

在48777名符合条件的患者中,13.9%接受了EBRT-BT,在不良的中期风险疾病中,从12.4% (2015) 增加到14.6% (2020).
在研究期间,EBRT-BT在高风险疾病患者中的使用率从12.5%上升到15.2%.
年龄较小,格里森等级较高的群体和高级T阶段与较高的EBRT-BT使用量显著相关 (p < 0.001);与2015年相比,2018-2020年使用量增加.

结论:

在前列腺癌治疗中,尽管有强有力的证据和指导方针建议,但胸膜疗法提升仍然未得到充分利用.
关于EBRT-BT,既有证据和当前的临床实践之间存在重大差异.
需要制定战略来改善EBRT-BT在临床环境中的获取和适当使用.

关键词:

支臂治疗可以增强支臂治疗的效果.外部光束辐射疗法外部光束辐射疗法练习模式实践模式前列腺癌是什么意思前列腺癌是什么意思

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