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
{"title":"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。","authors":"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","doi":"10.1007/s00066-024-02245-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sub>2Gy</sub> experienced a stable, good BC outcome compared with BTB at lower doses. Patients treated with ≥ 113 Gy EQD<sub>2Gy</sub> 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).</p><p><strong>Conclusions: </strong>In patients with IR and HR prostate cancer, BTB with ≥ 113 Gy EQD<sub>2Gy</sub> offered a BC advantage compared with dose-escalated EBRT and lower BTB doses.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"11-19"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739258/pdf/","citationCount":"0","resultStr":"{\"title\":\"Biochemical control in intermediate- and high-risk prostate cancer after EBRT with and without brachytherapy boost.\",\"authors\":\"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\",\"doi\":\"10.1007/s00066-024-02245-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sub>2Gy</sub> experienced a stable, good BC outcome compared with BTB at lower doses. Patients treated with ≥ 113 Gy EQD<sub>2Gy</sub> 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).</p><p><strong>Conclusions: </strong>In patients with IR and HR prostate cancer, BTB with ≥ 113 Gy EQD<sub>2Gy</sub> offered a BC advantage compared with dose-escalated EBRT and lower BTB doses.</p>\",\"PeriodicalId\":21998,\"journal\":{\"name\":\"Strahlentherapie und Onkologie\",\"volume\":\" \",\"pages\":\"11-19\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739258/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Strahlentherapie und Onkologie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00066-024-02245-3\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Strahlentherapie und Onkologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00066-024-02245-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/3 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Biochemical control in intermediate- and high-risk prostate cancer after EBRT with and without brachytherapy boost.
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 EQD2Gy experienced a stable, good BC outcome compared with BTB at lower doses. Patients treated with ≥ 113 Gy EQD2Gy 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 EQD2Gy offered a BC advantage compared with dose-escalated EBRT and lower BTB doses.
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.
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