HDR近距离放疗联合外束放疗治疗不利的局限性前列腺癌：从开始到标准治疗的单中心经验。

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2025-03-01 DOI:10.1016/j.brachy.2024.12.005

Ka-Kit David Yeung , Juanita Crook , Gregory Arbour , Cynthia Araujo , Deidre Batchelar , David Kim , David Petrik , Tracey Rose , Francois Bachand

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引用次数: 0

摘要

目的：高剂量率（HDR）近距离放疗越来越多地被用于前列腺癌的剂量递增治疗。我们报告了HDR前列腺近距离治疗联合外束放疗（EBRT）的临床疗效和毒性，并评估了4年PSA≤0.2 ng/mL对无失败生存（FFS）治愈的生化定义的可预测性。方法：采用单中心回顾性研究，纳入2011 - 2019年接受HDR近距离放疗联合EBRT治疗的所有高、中、高危前列腺癌患者。收集患者和前列腺癌的特征、治疗、临床终点和随访情况。结果：共分析319例患者。中位年龄为68岁，中位随访77.1个月。其中高、中级142例，高危177例。近距离放疗剂量最初为20 Gy/2，随后为15 Gy/1。所有患者均接受46 Gy/23次EBRT治疗。5年和9年的总生存率分别为92.2%和77.0%。5年无失败生存率为86.0%，9年为76.1%。79.3%的患者在4年时PSA≤0.2 ng/mL， 94.1%的患者在9年时与FFS相关。3级尿道狭窄、血尿和直肠炎发生率分别为2.8%、0%和0%。结论：除EBRT外，HDR近距离放疗是治疗不利的局限性前列腺癌的有效方法，其毒性非常可接受。4年PSA < 0.2 ng/mL的生化定义可预测9年的FFS。

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HDR brachytherapy combined with external beam radiotherapy for unfavorable localized prostate cancer: A single center experience from inception to standard of care

PURPOSE

High dose rate (HDR) brachytherapy is increasingly adopted for dose escalation in prostate cancer treatment. We report the clinical efficacy and toxicity of HDR prostate brachytherapy combined with external beam radiotherapy (EBRT) and evaluate the predictability of the biochemical definition of cure of 4-year PSA ≤0.2 ng/mL for failure free survival (FFS).

METHODS

A single centre retrospective study was conducted, including all patients with high-tier intermediate risk and high-risk prostate cancer treated with HDR brachytherapy combined with EBRT from 2011 to 2019. Patient and prostate cancer characteristics, treatment, clinical endpoints, and follow up were collected.

RESULTS

Total 319 patients were analyzed. The median age was 68 with median follow up of 77.1 months. Total 142 had high-tier intermediate and 177 had high-risk disease. Brachytherapy doses were initially 20 Gy/2 fractions, and subsequently 15 Gy/1 fraction. All patients received 46 Gy/23 fractions of EBRT. Overall survival at 5 and 9 years was 92.2% and 77.0%, respectively. Failure-free survival (FFS) was 86.0% at 5 years and 76.1% at 9 years. PSA ≤ 0.2 ng/mL at 4 years was seen in 79.3% of patients and was associated with FFS of 94.1% at 9 years. Grade 3 urethral stricture, hematuria, or proctitis occurred in 2.8%, 0%, and 0%, respectively.

CONCLUSION

HDR brachytherapy in addition to EBRT is effective treatment for unfavourable localized prostate cancer with a very acceptable toxicity profile. The biochemical definition of cure of PSA < 0.2 ng/mL at 4 years was predictive for FFS at 9 years.

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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.