Lucas Mose, Laura Isabel Loebelenz, Alexander Althaus, Maiwand Ahmadsei, Etienne Mathier, Isabelle Broemel, Daniel M Aebersold, Verena Carola Obmann, Mohamed Shelan
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Among other clinicopathological data, T stage, Prostate Imaging-Reporting and Data System (PI-RADS) score, and multiparametric magnetic resonance imaging-based extra-prostatic extension (mEPE) score were collected and analyzed using the log-rank test.</p><p><strong>Results: </strong>A total of 74 patients were eligible for analysis. Median age at treatment was 68.8 years and median prostate volume was 47.8 cm<sup>3</sup>. Fifty-four and 14 patients were diagnosed with Gleason scores 7a and 7b, respectively. In total, 40 patients were classified as having unfavorable intermediate-risk prostate cancer according to American Urological Association/American Society for Radiation Oncology/ Society of Urologic Oncology (AUA/ASTRO/SUO) guidelines. The median follow-up was 30 months (range: 4-91.2 months; interquartile range (IQR): 18.5-48 months). The 3‑year BFS was 92%. A total of 12 (16.2%) biochemical failures were reported. In univariate analysis, an mEPE score of 5, the delivered total radiation dose (35 Gy vs. 36.25 Gy), and a prostate-specific antigen (PSA) nadir >1 ng/ml were associated with lower BFS (mEPE-BFS: p < 0.001, total radiation dose-BFS: p = 0.04, PSA nadir-BFS: p =< 0.001).</p><p><strong>Conclusion: </strong>Patients diagnosed with intermediate-risk prostate cancer with a high mEPE score are more likely to experience biochemical failure after SBRT. Treatment intensification measures, such as administration of concomitant ADT, should be considered.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic significance of the mEPE score in intermediate-risk prostate cancer patients undergoing ultrahypofractionated robotic SBRT.\",\"authors\":\"Lucas Mose, Laura Isabel Loebelenz, Alexander Althaus, Maiwand Ahmadsei, Etienne Mathier, Isabelle Broemel, Daniel M Aebersold, Verena Carola Obmann, Mohamed Shelan\",\"doi\":\"10.1007/s00066-024-02355-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to evaluate the prognostic significance of magnetic resonance imaging (MRI) parameters on biochemical failure-free survival (BFS) in patients diagnosed with intermediate-risk prostate cancer and treated with robotic ultrahypofractionated stereotactic body radiotherapy (SBRT) without androgen deprivation therapy (ADT).</p><p><strong>Methods: </strong>A retrospective analysis was conducted in patients with intermediate-risk prostate cancer undergoing robotic SBRT delivered in five fractions with a total radiation dose of 35-36.25 Gy. The primary endpoint was biochemical failure as defined by the Phoenix criteria. Among other clinicopathological data, T stage, Prostate Imaging-Reporting and Data System (PI-RADS) score, and multiparametric magnetic resonance imaging-based extra-prostatic extension (mEPE) score were collected and analyzed using the log-rank test.</p><p><strong>Results: </strong>A total of 74 patients were eligible for analysis. Median age at treatment was 68.8 years and median prostate volume was 47.8 cm<sup>3</sup>. Fifty-four and 14 patients were diagnosed with Gleason scores 7a and 7b, respectively. In total, 40 patients were classified as having unfavorable intermediate-risk prostate cancer according to American Urological Association/American Society for Radiation Oncology/ Society of Urologic Oncology (AUA/ASTRO/SUO) guidelines. The median follow-up was 30 months (range: 4-91.2 months; interquartile range (IQR): 18.5-48 months). The 3‑year BFS was 92%. 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引用次数: 0
摘要
目的：本研究旨在评估磁共振成像（MRI）参数对诊断为中危前列腺癌并接受机器人超低分割立体定向放射治疗（SBRT）而不采用雄激素剥夺治疗（ADT）的患者生化无衰竭生存（BFS）的预后意义。方法：对接受机器人SBRT治疗的中危前列腺癌患者进行回顾性分析，机器人SBRT分五段进行，总辐射剂量为35-36.25 Gy。主要终点是根据Phoenix标准定义的生化失败。其他临床病理数据包括T分期、前列腺影像学报告和数据系统（PI-RADS）评分、基于多参数磁共振成像的前列腺外展（mEPE）评分，并采用log-rank检验进行分析。结果：共有74例患者符合分析条件。治疗时的中位年龄为68.8岁，中位前列腺体积为47.8 cm3。Gleason评分为7a和7b的患者分别为54例和14例。根据美国泌尿外科协会/美国放射肿瘤学会/泌尿外科肿瘤学会（AUA/ASTRO/SUO）指南，总共有40例患者被归类为不良中危前列腺癌。中位随访时间为30个月(范围：4-91.2个月；四分位间距（IQR）： 18.5-48个月)。3年BFS为92%。共报告生化不合格12例（16.2%）。在单因素分析中，mEPE评分为5分、放射总剂量（35 Gy vs. 36.25 Gy）和前列腺特异性抗原（PSA）最低值>1 ng/ml与较低的BFS （mEPE-BFS: p ）相关。结论：mEPE评分高的中危险前列腺癌患者更容易在SBRT后出现生化失败。应考虑加强治疗措施，如同时给予ADT。
Prognostic significance of the mEPE score in intermediate-risk prostate cancer patients undergoing ultrahypofractionated robotic SBRT.
Purpose: This study aimed to evaluate the prognostic significance of magnetic resonance imaging (MRI) parameters on biochemical failure-free survival (BFS) in patients diagnosed with intermediate-risk prostate cancer and treated with robotic ultrahypofractionated stereotactic body radiotherapy (SBRT) without androgen deprivation therapy (ADT).
Methods: A retrospective analysis was conducted in patients with intermediate-risk prostate cancer undergoing robotic SBRT delivered in five fractions with a total radiation dose of 35-36.25 Gy. The primary endpoint was biochemical failure as defined by the Phoenix criteria. Among other clinicopathological data, T stage, Prostate Imaging-Reporting and Data System (PI-RADS) score, and multiparametric magnetic resonance imaging-based extra-prostatic extension (mEPE) score were collected and analyzed using the log-rank test.
Results: A total of 74 patients were eligible for analysis. Median age at treatment was 68.8 years and median prostate volume was 47.8 cm3. Fifty-four and 14 patients were diagnosed with Gleason scores 7a and 7b, respectively. In total, 40 patients were classified as having unfavorable intermediate-risk prostate cancer according to American Urological Association/American Society for Radiation Oncology/ Society of Urologic Oncology (AUA/ASTRO/SUO) guidelines. The median follow-up was 30 months (range: 4-91.2 months; interquartile range (IQR): 18.5-48 months). The 3‑year BFS was 92%. A total of 12 (16.2%) biochemical failures were reported. In univariate analysis, an mEPE score of 5, the delivered total radiation dose (35 Gy vs. 36.25 Gy), and a prostate-specific antigen (PSA) nadir >1 ng/ml were associated with lower BFS (mEPE-BFS: p < 0.001, total radiation dose-BFS: p = 0.04, PSA nadir-BFS: p =< 0.001).
Conclusion: Patients diagnosed with intermediate-risk prostate cancer with a high mEPE score are more likely to experience biochemical failure after SBRT. Treatment intensification measures, such as administration of concomitant ADT, should be considered.
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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