Abiraterone for "STAMPEDE-Like" cohort of high-risk prostate cancer in the PSMA-PET era: too much, too early?

IF 5.8 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2025-05-22 DOI:10.1038/s41391-025-00983-8

Vedang Murthy, Asesh Samanta, Priyamvada Maitre, Prashant Nayak, Pallavi Singh, Archi Agrawal, Amit Joshi, Gagan Prakash

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引用次数: 0

Abstract

Purpose: To assess long-term survival in a "STAMPEDE-like" cohort of high-risk locally advanced prostate cancer, staged with PSMA PET-CT, treated with hypofractionated radiotherapy (RT) and long-term androgen deprivation therapy (LT-ADT) without abiraterone.

Materials & methods: Patients with non-metastatic prostate cancer fulfilling "STAMPEDE high-risk" criteria, staged with PSMA PET-CT, treated with external beam RT from 2016 to 2021 were included. RT dose was >74 Gy equivalent to prostate with LT-ADT ≥ 2 years. We analysed metastatic-free survival (MFS), prostate cancer specific survival (PCSS) and overall survival (OS) using Kaplan-Meier method.

Results: 170 patients were eligible, treated with hypofractionated RT with median prostate 2Gy-equivalent dose of 82 Gy. About one-third were node-positive and treated with whole pelvic RT. Over median follow up of 65 months, 6-years MFS, PCSS and OS were 80.7%, 95.8% and 94.4% respectively. On multivariate analysis, Gleason score and nodal stage showed significant association with MFS.

Conclusion: For PSMA-PETCT staged high risk prostate cancer, appropriately intensified local treatment could be complementary or an alternative to systemic intensification in selected patients.

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阿比特龙用于PSMA-PET时代的“踩踏样”高危前列腺癌队列：太多，太早？

目的：评估“踩踏样”高风险局部晚期前列腺癌患者的长期生存率，这些患者采用PSMA PET-CT分期，接受低分割放疗（RT）和不使用阿比特龙的长期雄激素剥夺治疗（LT-ADT）。材料与方法：纳入2016 - 2021年符合STAMPEDE高风险标准、PSMA PET-CT分期、外束放疗的非转移性前列腺癌患者。LT-ADT≥2年，放疗剂量为474 Gy，相当于前列腺。我们采用Kaplan-Meier法分析无转移生存期（MFS）、前列腺癌特异性生存期（PCSS）和总生存期（OS）。结果：170例患者接受低分割放疗，中位前列腺2gy当量剂量为82 Gy。约三分之一淋巴结阳性并接受全盆腔rt治疗。中位随访65个月，6年MFS， PCSS和OS分别为80.7%，95.8%和94.4%。多因素分析显示Gleason评分和淋巴结分期与MFS有显著相关性。结论：对于PSMA-PETCT分期的高危前列腺癌患者，适当强化局部治疗可作为全身强化的补充或替代。

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

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.