Comparison of the Survivals and Adverse Events for Localized High-Risk Prostate Cancer Treated with Intensity-Modulated Radiotherapy Plus Androgen Deprivation and Trimodality Therapy, Including Low-Dose Iodine-125 Brachytherapy and External Beam Radiotherapy Plus Androgen Deprivation

被引：0

作者：

Kitagawa, Yutaka ^{[1
]}

Yoshida, Kenji ^{[1
]}

Takeuchi, Yuuki ^{[1
]}

Tanino, Tomohiko ^{[2
]}

Sakaguchi, Hiromi ^{[1
]}

Shimizu, Ryutaro ^{[3
]}

Yamaguchi, Noriya ^{[3
]}

Morizane, Shuichi ^{[3
]}

Takenaka, Atsushi ^{[3
]}

机构：

[1] Tottori Univ Hosp, Clin Dept Radiat Oncol, Yonago 6838504, Japan

[2] Tottori Prefectural Cent Hosp, Dept Radiol, Tottori 6800901, Japan

[3] Tottori Univ, Fac Med, Sch Med, Div Urol,Dept Surg, Yonago 6838503, Japan

来源：

YONAGO ACTA MEDICA | 2025年 / 68卷 / 01期

关键词：

Key words adverse events; I-125; brachytherapy; intensity-modulated radiotherapy; localized prostate cancer; trimodality; RADIATION-THERAPY; DEFINITIVE RADIOTHERAPY; FOLLOW-UP; SUPPRESSION; CARCINOMA; TOXICITY; ADJUVANT; DURATION; OUTCOMES; TRIAL;

D O I：

10.33160/yam.2025.02.002

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Background To evaluate and compare the survivals and radiotherapy-induced adverse events (AEs) of intensity-modulated radiotherapy (IMRT) with androgen deprivation therapy (ADT) and trimodality therapy, including low-dose iodine-125 brachytherapy, external beam radiotherapy, and ADT, for high-risk localized prostate cancer (LPC). Methods High-risk patients with LPC at T stage >= 3a, Gleason score >= 8, and initial prostate-specific antigen >= 20.0 ng/mL treated between 2010 and 2021 were retrospectively evaluated. All the patients were treated with IMRT plus ADT or trimodality therapy. In both groups, ADT was initiated 6 months before and continued for 2 years after radiotherapy. Survival and acute and late radiation-induced AEs were evaluated and compared. Results Two hundred and thirty-eight patients were treated with IMRT, and 91 underwent trimodality. Five- and 7-year biochemical-clinical failure-free survival (BCFFS) rates in the IMRT/trimodality group were 94.9/96.2, and 91.8/91.5%, respectively (P = 0.511). Stratified by 1-2/3 factors, 5- and 7-year BCFFS rates in the IMRT groups were 95.8/91.8, and 95.8/75.6%, respectively (P = 0.009). Five and 7-year BCFFS rates in the trimodality group were 96.8/94.1, and 91.4/94.1%, respectively (P = 0.995). The cumulative 3-/5-year incidence of late genitourinary AEs in the IMRT/trimodality group was 7.3/8.4, and 15.5/16.9%, respectively (P = 0.037), and the cumulative 3-/5-year incidence of late gastrointestinal AEs was 2.2/3.4, and 11.0/12.2%, respectively (P = 0.001). Thirty patients (9.1%) could not complete long-term ADT. Conclusion Treatment results of both IMRT and trimodality were considered to be good, and our results also indicated that the long-term survival of unfavorable high-risk patients with LPC who had three risk factors was poor in the IMRT group. Further treatment experience of both modalities must be accumulated with more appropriate patient allocations.

引用

页码：12 / 21

页数：10

共 32 条

[1] Bolla M, Gonzalez D, Warde P, Dubois JB, Mirimanoff RO, Storme G, Et al., Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin, N Engl J Med, 337, pp. 295-300, (1997)
[2] D'Amico AV, Manola J, Loffredo M, Renshaw AA, DellaCroce A, Kantoff PW., 6-month androgen suppression plus radiation therapy vs radiation therapy alone for patients with clinically localized prostate cancer: a randomized controlled trial, JAMA, 292, pp. 821-827, (2004)
[3] Pilepich MV, Winter K, John MJ, Mesic JB, Sause W, Rubin P, Et al., Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate, Int J Radiat Oncol Biol Phys, 50, pp. 1243-1252, (2001)
[4] Pilepich MV, Winter K, Lawton CA, Krisch RE, Wolkov HB, Movsas B, Et al., Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma—long-term results of phase III RTOG 85-31, Int J Radiat Oncol Biol Phys, 61, pp. 1285-1290, (2005)
[5] Wortel RC, Incrocci L, Pos FJ, van der Heide UA, Lebesque JV, Aluwini S, Et al., Late side effects after image guided intensity modulated radiation therapy compared to 3D- conformal radiation therapy for prostate cancer: results from 2 prospective cohorts, Int J Radiat Oncol Biol Phys, 95, pp. 680-689, (2016)
[6] Wortel RC, Incrocci L, Pos FJ, Lebesque JV, Witte MG, van der Heide UA, Et al., Acute toxicity after image-guided intensity modulated radiation therapy compared to 3D conformal radiation therapy in prostate cancer patients, Int J Radiat Oncol Biol Phys, 91, pp. 737-744, (2015)
[7] Sharma NK, Li T, Chen DY, Pollack A, Horwitz EM, Buyyounouski MK., Intensity-modulated radiotherapy reduc¬es gastrointestinal toxicity in patients treated with androgen deprivation therapy for prostate cancer, Int J Radiat Oncol Biol Phys, 80, pp. 437-444, (2011)
[8] Abu-Gheida I, Reddy CA, Kotecha R, Weller MA, Shah C, Kupelian PA, Et al., Ten-year outcomes of moderately hypo- fractionated (70 Gy in 28 fractions) intensity modulated radia¬tion therapy for localized prostate cancer, Int J Radiat Oncol Biol Phys, 104, pp. 325-333, (2019)
[9] Hoffman KE, Voong KR, Levy LB, Allen PK, Choi S, Schlembach PJ, Et al., Randomized trial of hypofractionated, dose-Escalated, intensity-modulated radiation therapy (IMRT) versus conventionally fractionated IMRT for localized prostate cancer, J Clin Oncol, 36, pp. 2943-2949, (2018)
[10] Spratt DE, Zumsteg ZS, Ghadjar P, Kollmeier MA, Pei X, Cohen G, Et al., Comparison of high-dose (86.4 G y) IMRT vs combined brachytherapy plus IMRT for intermediate¬risk prostate cancer, BJU Int, 114, pp. 360-367, (2014)

← 1 2 3 4 →