PPP03 演讲时间：上午 10:48

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-10-25 DOI:10.1016/j.brachy.2024.08.011

Vitaly A. Biryukov MD, PhD , Kseniia S. Makarova MD , Alexey V. Troyanov MD , Yulia V. Gumenetskaya MD, PhD , Tatyana A. Rodina MD , Elizaveta O. Shchukina MD , Oleg B. Karyakin (Prof) , Sergey A. Ivanov (Prof) , Andrey D. Kaprin (Prof)

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引用次数: 0

摘要

极高风险前列腺癌（PC）是一种具有远处疾病进展高风险的侵袭性癌症。多项研究表明，使用多西他赛进行系统强化治疗可降低接受体外放射治疗（EBRT）和雄激素剥夺治疗（ADT）的男性患者的 PC 特异性死亡率。在联合放疗模式（EBRT + 近距离放疗 [BT] 增效）与 ADT 的基础上增加化疗是否能改善该群体的预后尚不清楚。目的比较分析 VHR PC 患者接受或不接受新辅助多西他赛化疗的 EBRT、BT 增效和 ADT 的疗效：EBRT加BT增强和ADT（n = 66）或EBRT加BT增强、ADT和新辅助多西他赛化疗（n = 20）。前列腺和精囊的敷形 EBRT 采用常规分次给药，总剂量为 44-46 Gy，Ir-192 高剂量率 BT 采用单次分次给药，剂量为 15 Gy。新辅助多西他赛剂量为75 mg/m2，每3周一次，共4个周期。ADT（包括促性腺激素释放激素激动剂）的中位持续时间为24个月。中位年龄为66岁（范围：46-81岁）。随访时间中位数为 65 个月（21.5 - 108.7 个月）。结果化疗组的六年无进展生存期[PFS]为 80.1%，而非化疗组为 77.2%（P = 0.499）。Gleason评分9-10分与PC复发风险的增加有统计学意义（P = 0.013）。接受化疗组和未接受化疗组的六年总生存率[OS]分别为100%和82.8%（p = 0,075）。结论接受或不接受 EBRT+BT+ADT 化疗的 VHR 前列腺癌患者的 PFS、OS 和 PCSS 在统计学上没有显著差异。

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PPP03 Presentation Time: 10:48 AM

Very-high risk [VHR] prostate cancer [PC] is an aggressive subgroup with high risk of distant disease progression. According to a number of studies systemic treatment intensification with docetaxel reduces PC-specific mortality in men receiving external beam radiation therapy [EBRT] with androgen deprivation therapy [ADT]. Whether the addition of chemotherapy to combined modality of radiotherapy (EBRT + brachytherapy [BT] boost) with ADT improves outcomes in this group is unclear.

Purpose

A comparative analysis of the efficacy of EBRT, BT boost and ADT with or without neoadjuvant docetaxel chemotherapy in VHR PC patients.

Materials and Methods

A total of 86 men diagnosed between 2016 and 2020 with VHR prostate cancer were stratified into 2 groups: EBRT plus BT boost and ADT (n = 66) or EBRT plus BT boost, ADT and neoadjuvant docetaxel chemotherapy (n = 20). Conformal EBRT was delivered with conventional fractionation to a total dose of 44-46 Gy to the prostate gland and seminal vesicles and the Ir-192 high-dose rate BT was delivered with one single fraction of 15 Gy. Neoadjuvant docetaxel was administered at 75 mg/m2 every 3 weeks for 4 cycles. A median duration of ADT, consisting of a gonadotropin-releasing hormone agonist, was 24 months. Median age was 66 years (range: 46-81 years). Median follow-up was 65 months (range: 21,5 - 108,7 months). The characteristics of the patient groups are presented in table 1.

Results

Six-years progression free survival [PFS] was 80,1% for the group with chemotherapy vs. 77,2% for no-chemotherapy group (p = 0,499). The presence of Gleason score 9-10 was associated with a statistically significant increase in the risk of PC recurrence (p = 0.013). Six-years overall survival [OS] was 100% and 82,8% for groups with and without chemotherapy respectively (p = 0,075). Six-years PC-specific survival [PCSS] was 100% and 93,4% for groups with and without chemotherapy respectively (p = 0,306).

Conclusion

There was no statistically-significant difference in PFS, OS and PCSS in VHR prostate cancer patients received EBRT+BT+ADT with or without chemotherapy.

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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.