PO73

Brachytherapy Pub Date : 2023-09-01 DOI:10.1016/j.brachy.2023.06.174

Wiwatchai Sittiwong, Pittaya Dankulchai

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Baseline patient characteristics and tumor characteristics were reported. Univariate and multivariate analysis were performed to identify factors associated local recurrence by using Cox's regression analysis. Results 32 patients with the median follow up time of 59.2 months were included. The median age of patients was 70 years. Most patients were categorized as unfavorable to very high risk (19 patients, 59.4%); however, most common grade group was grade group 2 (14 patients, 43.7%). Most patients received androgen deprivation therapy (ADT) either by medication or surgical castration (25 patients, 78.1%). The proportion of patients underwent HDR brachytherapy as monotherapy (18 patients, 56.2%) was similar to as a boost (14 patients, 43.8%). For tumor characteristics, most of DILs were located at peripheral zone (28 patients, 87.5%). Median DIL volume and prostate volume were 1.13 ml (95%CI 0.78 to 1.48), and 39.4 ml (95%CI 31.38 to 47.42), respectively. Median PSA density and DILcPSA were 0.30 (95%CI 0.12 to 0.48) and 0.33 (95%CI 0.15 to 0.51), respectively. There were 9 patients developed local recurrence. The rate of 5-year local recurrence-free survival was 68.5%. Among factors selected to predict local recurrence, DILcPSA was found to be significantly associated with local recurrence for both univariate and multivariate Cox's regression analysis with HR of 2.10 (95%CI 1.12 to 27.67) p=0.035 and 2.06 (95%CI 1.09 to 27.41) p 0.039, respectively. Prostate volume, DIL volume and PSA density were found no significant correlation with local recurrence. Conclusions DILcPSA could be a potential predictive factor to predict local recurrence in prostate cancer patients receiving HDR brachytherapy. To identify a predictive factor associated with local recurrence in prostate cancer patients receiving HDR brachytherapy. Localized, non-metastatic prostate cancer patients who were treated with brachytherapy with or without external beam radiation (EBRT) between January 2015 to December 2021 were retrospectively reviewed. HDR monotherapy was prescribed at 19 Gy to prostate while HDR brachytherapy was prescribed at 15 Gy to prostate after EBRT of 45-50 Gy to whole pelvis. Factors to identify a predictor of local recurrence included prostate volume, dominant intraprostatic lesion (DIL) volume, PSA density and DIL-concentrated PSA (DILcPSA). DILcPSA is defined as the PSA density within the area of DIL volume which can be calculated by PSA density multiplied by DIL volume. Baseline patient characteristics and tumor characteristics were reported. Univariate and multivariate analysis were performed to identify factors associated local recurrence by using Cox's regression analysis. 32 patients with the median follow up time of 59.2 months were included. The median age of patients was 70 years. Most patients were categorized as unfavorable to very high risk (19 patients, 59.4%); however, most common grade group was grade group 2 (14 patients, 43.7%). Most patients received androgen deprivation therapy (ADT) either by medication or surgical castration (25 patients, 78.1%). The proportion of patients underwent HDR brachytherapy as monotherapy (18 patients, 56.2%) was similar to as a boost (14 patients, 43.8%). For tumor characteristics, most of DILs were located at peripheral zone (28 patients, 87.5%). Median DIL volume and prostate volume were 1.13 ml (95%CI 0.78 to 1.48), and 39.4 ml (95%CI 31.38 to 47.42), respectively. Median PSA density and DILcPSA were 0.30 (95%CI 0.12 to 0.48) and 0.33 (95%CI 0.15 to 0.51), respectively. There were 9 patients developed local recurrence. The rate of 5-year local recurrence-free survival was 68.5%. Among factors selected to predict local recurrence, DILcPSA was found to be significantly associated with local recurrence for both univariate and multivariate Cox's regression analysis with HR of 2.10 (95%CI 1.12 to 27.67) p=0.035 and 2.06 (95%CI 1.09 to 27.41) p 0.039, respectively. Prostate volume, DIL volume and PSA density were found no significant correlation with local recurrence. 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HDR monotherapy was prescribed at 19 Gy to prostate while HDR brachytherapy was prescribed at 15 Gy to prostate after EBRT of 45-50 Gy to whole pelvis. Factors to identify a predictor of local recurrence included prostate volume, dominant intraprostatic lesion (DIL) volume, PSA density and DIL-concentrated PSA (DILcPSA). DILcPSA is defined as the PSA density within the area of DIL volume which can be calculated by PSA density multiplied by DIL volume. Baseline patient characteristics and tumor characteristics were reported. Univariate and multivariate analysis were performed to identify factors associated local recurrence by using Cox's regression analysis. Results 32 patients with the median follow up time of 59.2 months were included. The median age of patients was 70 years. Most patients were categorized as unfavorable to very high risk (19 patients, 59.4%); however, most common grade group was grade group 2 (14 patients, 43.7%). Most patients received androgen deprivation therapy (ADT) either by medication or surgical castration (25 patients, 78.1%). The proportion of patients underwent HDR brachytherapy as monotherapy (18 patients, 56.2%) was similar to as a boost (14 patients, 43.8%). For tumor characteristics, most of DILs were located at peripheral zone (28 patients, 87.5%). Median DIL volume and prostate volume were 1.13 ml (95%CI 0.78 to 1.48), and 39.4 ml (95%CI 31.38 to 47.42), respectively. Median PSA density and DILcPSA were 0.30 (95%CI 0.12 to 0.48) and 0.33 (95%CI 0.15 to 0.51), respectively. There were 9 patients developed local recurrence. The rate of 5-year local recurrence-free survival was 68.5%. Among factors selected to predict local recurrence, DILcPSA was found to be significantly associated with local recurrence for both univariate and multivariate Cox's regression analysis with HR of 2.10 (95%CI 1.12 to 27.67) p=0.035 and 2.06 (95%CI 1.09 to 27.41) p 0.039, respectively. Prostate volume, DIL volume and PSA density were found no significant correlation with local recurrence. Conclusions DILcPSA could be a potential predictive factor to predict local recurrence in prostate cancer patients receiving HDR brachytherapy. To identify a predictive factor associated with local recurrence in prostate cancer patients receiving HDR brachytherapy. Localized, non-metastatic prostate cancer patients who were treated with brachytherapy with or without external beam radiation (EBRT) between January 2015 to December 2021 were retrospectively reviewed. HDR monotherapy was prescribed at 19 Gy to prostate while HDR brachytherapy was prescribed at 15 Gy to prostate after EBRT of 45-50 Gy to whole pelvis. Factors to identify a predictor of local recurrence included prostate volume, dominant intraprostatic lesion (DIL) volume, PSA density and DIL-concentrated PSA (DILcPSA). 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Median DIL volume and prostate volume were 1.13 ml (95%CI 0.78 to 1.48), and 39.4 ml (95%CI 31.38 to 47.42), respectively. Median PSA density and DILcPSA were 0.30 (95%CI 0.12 to 0.48) and 0.33 (95%CI 0.15 to 0.51), respectively. There were 9 patients developed local recurrence. The rate of 5-year local recurrence-free survival was 68.5%. Among factors selected to predict local recurrence, DILcPSA was found to be significantly associated with local recurrence for both univariate and multivariate Cox's regression analysis with HR of 2.10 (95%CI 1.12 to 27.67) p=0.035 and 2.06 (95%CI 1.09 to 27.41) p 0.039, respectively. Prostate volume, DIL volume and PSA density were found no significant correlation with local recurrence. 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引用次数: 0

摘要

目的探讨前列腺癌患者接受HDR近距离放疗后局部复发的预测因素。材料与方法回顾性分析2015年1月至2021年12月期间接受近距离或不加外束放疗(EBRT)治疗的局限性非转移性前列腺癌患者。全骨盆EBRT 45 ~ 50 Gy后，HDR单药治疗19 Gy, HDR近距离治疗15 Gy。预测局部复发的因素包括前列腺体积、显性前列腺内病变(DIL)体积、PSA密度和DIL浓缩PSA (DILcPSA)。DILcPSA定义为DIL体积范围内的PSA密度，由PSA密度乘以DIL体积计算得到。报告基线患者特征和肿瘤特征。采用Cox回归分析进行单因素和多因素分析，以确定局部复发相关因素。结果32例患者，中位随访时间59.2个月。患者中位年龄为70岁。大多数患者为不良至高危(19例，59.4%);然而，最常见的分级组是2级组(14例，43.7%)。大多数患者接受药物或手术阉割的雄激素剥夺治疗(ADT)(25例，78.1%)。接受HDR近距离放疗作为单药治疗的患者比例(18例，56.2%)与强化治疗(14例，43.8%)相似。从肿瘤特征来看，大部分DILs位于外周带(28例，87.5%)。中位DIL容积和前列腺容积分别为1.13 ml (95%CI 0.78 ~ 1.48)和39.4 ml (95%CI 31.38 ~ 47.42)。中位PSA密度和DILcPSA分别为0.30 (95%CI 0.12 ~ 0.48)和0.33 (95%CI 0.15 ~ 0.51)。局部复发9例。5年局部无复发生存率为68.5%。在预测局部复发的因素中，单因素和多因素Cox回归分析均发现DILcPSA与局部复发有显著相关性，HR分别为2.10 (95%CI 1.12 ~ 27.67) p=0.035和2.06 (95%CI 1.09 ~ 27.41) p= 0.039。前列腺体积、DIL体积和PSA密度与局部复发无显著相关性。结论DILcPSA可作为预测前列腺癌HDR近距离放疗患者局部复发的潜在预测因素。目的:探讨接受HDR近距离放疗的前列腺癌患者局部复发的预测因素。本研究回顾性回顾了2015年1月至2021年12月期间接受近距离放射治疗或不接受外束放疗(EBRT)的局部非转移性前列腺癌患者。全骨盆EBRT 45 ~ 50 Gy后，HDR单药治疗19 Gy, HDR近距离治疗15 Gy。预测局部复发的因素包括前列腺体积、显性前列腺内病变(DIL)体积、PSA密度和DIL浓缩PSA (DILcPSA)。DILcPSA定义为DIL体积范围内的PSA密度，由PSA密度乘以DIL体积计算得到。报告基线患者特征和肿瘤特征。采用Cox回归分析进行单因素和多因素分析，以确定局部复发相关因素。32例患者中位随访时间为59.2个月。患者中位年龄为70岁。大多数患者为不良至高危(19例，59.4%);然而，最常见的分级组是2级组(14例，43.7%)。大多数患者接受药物或手术阉割的雄激素剥夺治疗(ADT)(25例，78.1%)。接受HDR近距离放疗作为单药治疗的患者比例(18例，56.2%)与强化治疗(14例，43.8%)相似。从肿瘤特征来看，大部分DILs位于外周带(28例，87.5%)。中位DIL容积和前列腺容积分别为1.13 ml (95%CI 0.78 ~ 1.48)和39.4 ml (95%CI 31.38 ~ 47.42)。中位PSA密度和DILcPSA分别为0.30 (95%CI 0.12 ~ 0.48)和0.33 (95%CI 0.15 ~ 0.51)。局部复发9例。5年局部无复发生存率为68.5%。在预测局部复发的因素中，单因素和多因素Cox回归分析均发现DILcPSA与局部复发有显著相关性，HR分别为2.10 (95%CI 1.12 ~ 27.67) p=0.035和2.06 (95%CI 1.09 ~ 27.41) p= 0.039。前列腺体积、DIL体积和PSA密度与局部复发无显著相关性。目的探讨前列腺癌患者接受HDR近距离放疗后局部复发的预测因素。材料与方法回顾性分析2015年1月至2021年12月期间接受近距离或不加外束放疗(EBRT)治疗的局限性非转移性前列腺癌患者。全骨盆EBRT 45 ~ 50 Gy后，HDR单药治疗19 Gy, HDR近距离治疗15 Gy。预测局部复发的因素包括前列腺体积、显性前列腺内病变(DIL)体积、PSA密度和DIL浓缩PSA (DILcPSA)。DILcPSA定义为DIL体积范围内的PSA密度，由PSA密度乘以DIL体积计算得到。报告基线患者特征和肿瘤特征。采用Cox回归分析进行单因素和多因素分析，以确定局部复发相关因素。结果32例患者，中位随访时间59.2个月。患者中位年龄为70岁。大多数患者为不良至高危(19例，59.4%);然而，最常见的分级组是2级组(14例，43.7%)。大多数患者接受药物或手术阉割的雄激素剥夺治疗(ADT)(25例，78.1%)。接受HDR近距离放疗作为单药治疗的患者比例(18例，56.2%)与强化治疗(14例，43.8%)相似。从肿瘤特征来看，大部分DILs位于外周带(28例，87.5%)。中位DIL容积和前列腺容积分别为1.13 ml (95%CI 0.78 ~ 1.48)和39.4 ml (95%CI 31.38 ~ 47.42)。中位PSA密度和DILcPSA分别为0.30 (95%CI 0.12 ~ 0.48)和0.33 (95%CI 0.15 ~ 0.51)。局部复发9例。5年局部无复发生存率为68.5%。在预测局部复发的因素中，单因素和多因素Cox回归分析均发现DILcPSA与局部复发有显著相关性，HR分别为2.10 (95%CI 1.12 ~ 27.67) p=0.035和2.06 (95%CI 1.09 ~ 27.41) p= 0.039。前列腺体积、DIL体积和PSA密度与局部复发无显著相关性。结论DILcPSA可作为预测前列腺癌HDR近距离放疗患者局部复发的潜在预测因素。目的:探讨接受HDR近距离放疗的前列腺癌患者局部复发的预测因素。本研究回顾性回顾了2015年1月至2021年12月期间接受近距离放射治疗或不接受外束放疗(EBRT)的局部非转移性前列腺癌患者。全骨盆EBRT 45 ~ 50 Gy后，HDR单药治疗19 Gy, HDR近距离治疗15 Gy。预测局部复发的因素包括前列腺体积、显性前列腺内病变(DIL)体积、PSA密度和DIL浓缩PSA (DILcPSA)。DILcPSA定义为DIL体积范围内的PSA密度，由PSA密度乘以DIL体积计算得到。报告基线患者特征和肿瘤特征。采用Cox回归分析进行单因素和多因素分析，以确定局部复发相关因素。32例患者中位随访时间为59.2个月。患者中位年龄为70岁。大多数患者为不良至高危(19例，59.4%);然而，最常见的分级组是2级组(14例，43.7%)。大多数患者接受药物或手术阉割的雄激素剥夺治疗(ADT)(25例，78.1%)。接受HDR近距离放疗作为单药治疗的患者比例(18例，56.2%)与强化治疗(14例，43.8%)相似。从肿瘤特征来看，大部分DILs位于外周带(28例，87.5%)。中位DIL容积和前列腺容积分别为1.13 ml (95%CI 0.78 ~ 1.48)和39.4 ml (95%CI 31.38 ~ 47.42)。中位PSA密度和DILcPSA分别为0.30 (95%CI 0.12 ~ 0.48)和0.33 (95%CI 0.15 ~ 0.51)。局部复发9例。5年局部无复发生存率为68.5%。在预测局部复发的因素中，单因素和多因素Cox回归分析均发现DILcPSA与局部复发有显著相关性，HR分别为2.10 (95%CI 1.12 ~ 27.67) p=0.035和2.06 (95%CI 1.09 ~ 27.41) p= 0.039。前列腺体积、DIL体积和PSA密度与局部复发无显著相关性。 DILcPSA可能是预测HDR近距离放疗前列腺癌患者局部复发的潜在预测因素。 DILcPSA可能是预测HDR近距离放疗前列腺癌患者局部复发的潜在预测因素。

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PO73

Purpose To identify a predictive factor associated with local recurrence in prostate cancer patients receiving HDR brachytherapy. Materials and Methods Localized, non-metastatic prostate cancer patients who were treated with brachytherapy with or without external beam radiation (EBRT) between January 2015 to December 2021 were retrospectively reviewed. HDR monotherapy was prescribed at 19 Gy to prostate while HDR brachytherapy was prescribed at 15 Gy to prostate after EBRT of 45-50 Gy to whole pelvis. Factors to identify a predictor of local recurrence included prostate volume, dominant intraprostatic lesion (DIL) volume, PSA density and DIL-concentrated PSA (DILcPSA). DILcPSA is defined as the PSA density within the area of DIL volume which can be calculated by PSA density multiplied by DIL volume. Baseline patient characteristics and tumor characteristics were reported. Univariate and multivariate analysis were performed to identify factors associated local recurrence by using Cox's regression analysis. Results 32 patients with the median follow up time of 59.2 months were included. The median age of patients was 70 years. Most patients were categorized as unfavorable to very high risk (19 patients, 59.4%); however, most common grade group was grade group 2 (14 patients, 43.7%). Most patients received androgen deprivation therapy (ADT) either by medication or surgical castration (25 patients, 78.1%). The proportion of patients underwent HDR brachytherapy as monotherapy (18 patients, 56.2%) was similar to as a boost (14 patients, 43.8%). For tumor characteristics, most of DILs were located at peripheral zone (28 patients, 87.5%). Median DIL volume and prostate volume were 1.13 ml (95%CI 0.78 to 1.48), and 39.4 ml (95%CI 31.38 to 47.42), respectively. Median PSA density and DILcPSA were 0.30 (95%CI 0.12 to 0.48) and 0.33 (95%CI 0.15 to 0.51), respectively. There were 9 patients developed local recurrence. The rate of 5-year local recurrence-free survival was 68.5%. Among factors selected to predict local recurrence, DILcPSA was found to be significantly associated with local recurrence for both univariate and multivariate Cox's regression analysis with HR of 2.10 (95%CI 1.12 to 27.67) p=0.035 and 2.06 (95%CI 1.09 to 27.41) p 0.039, respectively. Prostate volume, DIL volume and PSA density were found no significant correlation with local recurrence. Conclusions DILcPSA could be a potential predictive factor to predict local recurrence in prostate cancer patients receiving HDR brachytherapy. To identify a predictive factor associated with local recurrence in prostate cancer patients receiving HDR brachytherapy. Localized, non-metastatic prostate cancer patients who were treated with brachytherapy with or without external beam radiation (EBRT) between January 2015 to December 2021 were retrospectively reviewed. HDR monotherapy was prescribed at 19 Gy to prostate while HDR brachytherapy was prescribed at 15 Gy to prostate after EBRT of 45-50 Gy to whole pelvis. Factors to identify a predictor of local recurrence included prostate volume, dominant intraprostatic lesion (DIL) volume, PSA density and DIL-concentrated PSA (DILcPSA). DILcPSA is defined as the PSA density within the area of DIL volume which can be calculated by PSA density multiplied by DIL volume. Baseline patient characteristics and tumor characteristics were reported. Univariate and multivariate analysis were performed to identify factors associated local recurrence by using Cox's regression analysis. 32 patients with the median follow up time of 59.2 months were included. The median age of patients was 70 years. Most patients were categorized as unfavorable to very high risk (19 patients, 59.4%); however, most common grade group was grade group 2 (14 patients, 43.7%). Most patients received androgen deprivation therapy (ADT) either by medication or surgical castration (25 patients, 78.1%). The proportion of patients underwent HDR brachytherapy as monotherapy (18 patients, 56.2%) was similar to as a boost (14 patients, 43.8%). For tumor characteristics, most of DILs were located at peripheral zone (28 patients, 87.5%). Median DIL volume and prostate volume were 1.13 ml (95%CI 0.78 to 1.48), and 39.4 ml (95%CI 31.38 to 47.42), respectively. Median PSA density and DILcPSA were 0.30 (95%CI 0.12 to 0.48) and 0.33 (95%CI 0.15 to 0.51), respectively. There were 9 patients developed local recurrence. The rate of 5-year local recurrence-free survival was 68.5%. Among factors selected to predict local recurrence, DILcPSA was found to be significantly associated with local recurrence for both univariate and multivariate Cox's regression analysis with HR of 2.10 (95%CI 1.12 to 27.67) p=0.035 and 2.06 (95%CI 1.09 to 27.41) p 0.039, respectively. Prostate volume, DIL volume and PSA density were found no significant correlation with local recurrence. DILcPSA could be a potential predictive factor to predict local recurrence in prostate cancer patients receiving HDR brachytherapy.

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Brachytherapy

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