J Clin Oncol:雄激素阻断治疗和外束放射治疗在局部前列腺癌中的治疗序列研究

2020-03-18 AlexYang MedSci原创

剂量升级的放射治疗(RT)与雄激素阻断治疗(ADT)是局部前列腺癌(LPCa)的一种根治性标准方案。这些疗法的最优顺序不清楚。最近,有研究人员在III期试验中比较了新辅助疗法与同步使用ADT联合剂量升

剂量升级的放射治疗(RT)与雄激素阻断治疗(ADT)是局部前列腺癌(LPCa)的一种根治性标准方案。这些疗法的最优顺序不清楚。最近,有研究人员在III期试验中比较了新辅助疗法与同步使用ADT联合剂量升级前列腺RT(PRT)疗法的治疗情况。

研究的参与者为新诊断的LPCa患者,他们格林森得分≤7,临床阶段为T1b到T3a且前列腺特异性抗原<30ng/mL。他们被随机的分配到新辅助治疗组和同步治疗组。研究总共有432名患者随机的分配到Lee新辅助(n=215)或者同步治疗组(n=217)。在第10年,无生化复发生存(bRFS)比例在两个组中分别为80.5%和87.4%。10年总生存(OS)率分别为76.4%和73.7%。两个组之间的bRFS或者OS没有显著的差异(P值分别为0.10和0.70)。相对于新辅助组,同步使用组的bRFS风险比为0.66(95% CI, 0.41到1.07),OS为0.94(95% CI, 0.68到1.30)。研究人员在晚期RT相关等级不小于3的GI(2.5% vs. 3.9%)或者泌尿生殖系毒性(2.9% vs. 2.9%)中没有发现两组之间的显著差异。

最后,研究人员指出,两组之间的bRFS没有统计学显著差异。相似的,OS或者晚期RT相关毒性也没有差异。基于这些结果,短期ADT和剂量升级PRT的新辅助和同步启始均为LPCa合理的标准疗法。

原始出处:

Shawn Malone , Soumyajit Roy , Libni Eapen et al. Sequencing of Androgen-Deprivation Therapy With External-Beam Radiotherapy in Localized Prostate Cancer: A Phase III Randomized Controlled Trial. J Clin Oncol. 20 Feb 2020

 

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    2020-03-20 chg122
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    2020-03-18 libra2778

    研究思路最重要

    0

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    2020-03-18 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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    2020-03-18 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0