PPP02 演讲时间：上午 10:39

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-10-25 DOI:10.1016/j.brachy.2024.08.010

Vitaly A. Biryukov MD, PhD , Elizaveta O. Shchukina MD , Natalia B. Ermakova PhD , Dmitry B. Sanin PhD , Olga G. Lepilina PhD , Oleg B. Karyakin (Prof.) , Sergey A. Ivanov (Prof.) , Andrey D. Kaprin (Prof.)

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引用次数: 0

摘要

过去10年间（2012-2022年），俄罗斯联邦I-II期前列腺癌患者人数从48.4%增至63.0%。在 2021 年的俄罗斯，前列腺癌是仅次于肺癌的第二大男性癌症。近距离放射治疗是治疗局部前列腺癌最常用的方法之一。自 2016 年起，A.F.Tsyb MRRC 的前列腺癌近距离放射治疗组在泌尿外科放射治疗和外科治疗部门使用 Ir-192 进行 HDR-BT 单药治疗。材料与方法本研究回顾了2016年4月至2019年12月期间在A.F.Tsyb MRRC接受治疗的低危和中危进展组局部前列腺癌患者的治疗结果。276名患者被随机分配接受单次分次19 Gy或两次分次15 Gy的HDR-BT治疗，每次间隔两周。2 × 15 Gy组患者人数为146人，1 × 19组患者人数为130人。患者特征见表 1。近距离放射治疗是在脊髓麻醉下使用 Ir-192 进行的。随访包括前列腺 TRUS、毒性记录和血清 PSA 测量。对生化治疗失败（纳达 + 2 ng/ml）或临床怀疑复发的患者进行前列腺多参数 MRI 和 PSMA-PET 检查。任何疑似局部复发的影像学检查均需经活检证实：结果32例患者均有生化复发的记录：15 Gy х 2组5例，19 Gy组27例。根据 Mantel-Cox 对数秩标准估算，复发风险与 HDR-BT 模式的相关性具有统计学意义（p<0.001）。采用 Kaplan-Meyer 法进行的分析表明，接受 2 次 HDR-BT 治疗的患者平均复发时间为 88.25±1.77 个月（95% CI：84.78 - 91.72），接受 1 次 HDR-BT 治疗的患者平均复发时间为 67.45±1.98 个月（95% CI：63.58 - 71.32）。两组患者均未达到中位数。结论：总之，两部分 15 Gy 的 HDR 单药治疗比一部分 19 Gy 的单药治疗具有更高的癌症控制率。单次分次治疗的效果较差，本中心目前不采用单次分次治疗。

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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PPP02 Presentation Time: 10:39 AM

In the Russian Federation the number of patients with prostate cancer in stage I-II has increased from 48.4% to 63.0% over the past 10 years (2012 - 2022). It is the second most common cancer in men after lung cancerin 2021 in Russia. One of the most common methods of treating localized prostate cancer is brachytherapy. In the Department of radiation and surgical treatment of urological diseases with the prostate cancer brachytherapy group of the A.F.Tsyb MRRC, HDR-BT as monotherapy has been performed since 2016 with the use of Ir-192.

Purpose

Compare the efficiency of modes of HDR-BT with the use of Ir-192 in the treatment of localized prostate cancer.

Materials and Methods

In the study the review is given to the results of treatment of patients with localized prostate cancer of low and intermediate risk progression groups who were treated at the A.F.Tsyb MRRC from April 2016 to December 2019. 276 patients were randomized to receive HDR-BT as either a single fraction of 19 Gy or as two fractions of 15 Gy two week apart. The number of patients in the 2 × 15 Gy group was 146, in the 1 × 19 group - 130. The characteristics of the patients are presented in Table 1. Brachytherapy was performed with the use of Ir-192 under spinal anesthesia. Follow-up included a TRUS of prostate, recording of toxicity, and measurement of serum PSA. Patients with biochemical failure (nadir + 2 ng/ml) or clinical suspicion of recurrence were investigated with multiparametric MRI of prostate, and PSMA-PET. Any radiographic suspicion of local recurrence was confirmed on biopsy.

Results

Biochemical relapse was documentedin32 patients: 5 patients in group 15 Gy х 2 and 27 patients in group 19 Gy. The dependence of the risk of relapse on the HDR-BT mode, estimated using the Mantel-Cox log-rank criterion, was statistically significant (p<0.001). The analysis performed using the Kaplan-Meyer method showed that the average time of recurrence among patients who received 2 fractions of HDR-BT was 88.25±1.77 months (95% CI: 84.78 - 91.72), among patients who received one fraction of HDR-BT - 67.45±1.98 (95% CI: 63.58 - 71.32). The median was not reached in both groups of patients.

Conclusions

In conclusion, HDR monotherapy delivered as two fraction of15 Gy have a high cancer control rate than as one fraction of 19 Gy. Single fraction monotherapy provides inferior results and is not used in our center now.

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.