Biochemical control in intermediate- and high-risk prostate cancer after EBRT with and without brachytherapy boost.

IF 2.7 3区医学 Q3 ONCOLOGY

Strahlentherapie und Onkologie Pub Date : 2025-01-01 Epub Date: 2024-06-03 DOI:10.1007/s00066-024-02245-3

Matthias Moll, Łukasz Magrowski, Martina Mittlböck, Harald Heinzl, Christian Kirisits, Jakub Ciepał, Oliwia Masri, Gerd Heilemann, Rafał Stando, Tomasz Krzysztofiak, Gabriela Depowska, Andrea d'Amico, Tomasz Techmański, Anna Kozub, Wojciech Majewski, Rafał Suwiński, Piotr Wojcieszek, Jacek Sadowski, Joachim Widder, Gregor Goldner, Marcin Miszczyk

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引用次数: 0

Abstract

Purpose: External beam radiotherapy (EBRT) with or without brachytherapy boost (BTB) has not been compared in prospective studies using guideline-recommended radiation dose and recommended androgen-deprivation therapy (ADT). In this multicenter retrospective analysis, we compared modern-day EBRT with BTB in terms of biochemical control (BC) for intermediate-risk (IR) and high-risk (HR) prostate cancer.

Methods: Patients were treated for primary IR or HR prostate cancer during 1999-2019 at three high-volume centers. Inclusion criteria were prescribed ≥ 76 Gy EQD2 (α/β = 1.5 Gy) for IR and ≥ 78 Gy EQD2 (α/β = 1.5 Gy) for HR as EBRT alone or with BTB. All HR patients received ADT and pelvic irradiation, which were optional in IR cases. BC between therapies was compared in survival analyses.

Results: Of 2769 initial patients, 1176 met inclusion criteria: 468 HR (260 EBRT, 208 BTB) and 708 IR (539 EBRT, 169 BTB). Median follow-up was 49 and 51 months for HR and IR, respectively. BTB patients with ≥ 113 Gy EQD_2Gy experienced a stable, good BC outcome compared with BTB at lower doses. Patients treated with ≥ 113 Gy EQD_2Gy also experienced significantly improved BC compared with EBRT (10-year BC failure rates after ≥ 113 Gy BTB and EBRT: respectively 20.4 and 41.8% for HR and 7.5 and 20.8% for IR).

Conclusions: In patients with IR and HR prostate cancer, BTB with ≥ 113 Gy EQD_2Gy offered a BC advantage compared with dose-escalated EBRT and lower BTB doses.

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采用或不采用近距离放射治疗的 EBRT 后，中高危前列腺癌的生化控制情况。

目的：在采用指南推荐的放射剂量和推荐的雄激素剥夺疗法（ADT）的前瞻性研究中，尚未对有无近距离放射治疗（BTB）的体外射束放疗（EBRT）进行比较。在这项多中心回顾性分析中，我们对中危（IR）和高危（HR）前列腺癌的生化控制（BC）情况进行了现代 EBRT 与 BTB 的比较：1999年至2019年期间，在三家高容量中心接受治疗的原发性IR或HR前列腺癌患者。纳入标准为：IR患者的EQD2≥76 Gy（α/β = 1.5 Gy），HR患者的EQD2≥78 Gy（α/β = 1.5 Gy），作为EBRT单独或与BTB一起使用。所有HR患者都接受了ADT和盆腔照射，IR病例可选择接受ADT和盆腔照射。在生存分析中对不同疗法的 BC 进行了比较：在 2769 例初始患者中，有 1176 例符合纳入标准：468例HR（260例EBRT，208例BTB）和708例IR（539例EBRT，169例BTB）。HR和IR患者的中位随访时间分别为49个月和51个月。与较低剂量的 BTB 相比，EQD2Gy ≥ 113 Gy 的 BTB 患者的 BC 结果稳定、良好。与EBRT相比，接受EQD2Gy≥113 Gy治疗的患者的BC也明显改善（接受≥113 Gy BTB和EBRT治疗后的10年BC失败率：HR分别为20.4%和41.8%，IR分别为7.5%和20.8%）：结论：对于IR和HR前列腺癌患者，与剂量递增的EBRT和较低剂量的BTB相比，EQD2Gy≥113 Gy的BTB具有BC优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Strahlentherapie und Onkologie 医学-核医学

CiteScore

5.70

自引率

12.90%

发文量

141

审稿时长

3-8 weeks

期刊介绍： Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.