Eur Urol:前列腺切除术后生化复发前列腺癌的强化剂量与常规剂量挽救性放疗比较

2021-07-04 AlexYang MedSci原创

根治性前列腺切除术(RP)后的前列腺癌的生化进展一般采用挽救性放射治疗(SRT)。

根治性前列腺切除术(RP)后的前列腺癌的生化进展一般采用挽救性放射治疗(SRT)。

近期,有研究人员报告了SAKK 09/10试验的结果,比较常规剂量和强化剂量的SRT结果

SAKK 09/10是一项随机、多中心、3期试验,招募了RP术后生化进展的男性。研究人员将患者随机分配到常规剂量(64Gy)组或强化剂量(70Gy)组,不进行激素治疗。主要终点是无生化进展(FFBP)。次要终点包括临床无进展生存期(PFS)、接受激素治疗的时间、总生存期(OS)、急性和晚期毒性(不良事件通用术语标准V4.0)和生活质量(QoL)。

2011年2月至2014年4月期间,350名患者随机分配到64Gy(n=175)组或70Gy(n=175)组。随机分配时的前列腺特异性抗原中位数为0.3纳克/毫升。在中位随访6.2年后,64Gy组的FFBP中位数为8.2年,70Gy组为7.6年(对数秩p=0.4),风险比 1.14(95%置信区间为0.82-1.60)。6年的FFBP率分别为62%和61%。在临床PFS、激素治疗时间或OS方面没有观察到两组间存在明显差异。在64Gy治疗组中,分别有35名(21%)和13名(7.9%)患者观察到晚期2级和3级泌尿生殖系统毒性;在70Gy治疗组中,分别有46名(26%)和7名(4%)患者观察到上述晚期泌尿生殖系统毒性(p=0.8)。在64Gy治疗组中,分别有12名(7.3%)和7名(4.2%)患者观察到晚期2级和3级胃肠道毒性;在70Gy治疗组中,分别有35名(20%)和4名(2.3%)患者观察到上述毒性(P=0.009)。另外,QoL方面没有显著差异。

与基线相比的(A)泌尿症状,(B) 肠道症状,(C) 性活动和(D) 情绪功能变化

对于前列腺癌手术后肿瘤标志物增加的患者,最佳放疗剂量尚不清楚。研究人员发现,实施更高的剂量只会增加胃肠道的副作用,而不会给患者带来任何好处。综上所述,常规剂量的前列腺SRT对于RP后前列腺癌早期生化进展的患者是足够的,不用进行剂量增强

原始出处:

Pirus Ghadjar , Stefanie Hayoz , Jürg Bernhard et al. Dose-intensified Versus Conventional-dose Salvage Radiotherapy for Biochemically Recurrent Prostate Cancer After Prostatectomy: The SAKK 09/10 Randomized Phase 3 Trial. Eur Urol. Jun 2021

 

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    2021-07-04 ms4000001408306525

    学习了

    0

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    2021-07-04 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0

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