PDF(Pubmed)
Abstract：
UNASSIGNED: Extreme hypofractionated stereotactic body radiotherapy (SBRT) is a therapeutic alternative for localized low- or intermediate-risk prostate cancer. Despite the availability of several studies, the toxicity profile of SBRT has not been comprehensively described. This real-world evidence study assessed the efficacy and toxicities associated with this regimen, and potential prognosis factors for genitourinary toxicities.
UNASSIGNED: This retrospective study included 141 consecutive patients with localized prostatic adenocarcinoma treated with CyberKnife™ SBRT, as primary irradiation, at the Oscar Lambret Center between 2010 and 2020. The prescribed dose was 36.25 Gy in 5 fractions. Acute and late toxicities were graded according to the CTCAE (version 5.0). Biochemical recurrence-free survival (bRFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The cumulative incidence of biochemical recurrence (cBR) was estimated using the Kalbfleisch-Prentice method.
UNASSIGNED: Among the included patients, 13.5 % had a history of transurethral resection of the prostate (TURP). The median follow-up was 48 months. At 5 years, bRFS, cBR, and OS were 72 % (95 %CI: 61-81), 7 % (95 %CI: 3-14), and 82 % (95 %CI: 73-89), respectively. Twenty-nine patients experienced at least one late toxicity of grade ≥ 2; genitourinary (N = 29), including 3 cases of chronic hematuria, and/or gastrointestinal (N = 1). The cumulative incidence of late urinary toxicity of grade ≥ 2 was 20.6 % at 5 years (95 %CI: 13.9-28.1). Multivariate analysis revealed that a history of TURP was significantly associated with late urinary toxicity of grade ≥ 2, after adjusting for clinical target volume (Odds Ratio = 3.06; 95%CI: 1.05-8.86; P = 0.04).
UNASSIGNED: Extreme hypofractionated SBRT is effective for localized prostate cancer with a low risk of late toxicity. A history of TURP is associated with a higher risk of late urinary toxicity. These findings may contribute to the optimal management of patients treated with this regimen, particularly those with a history of TURP.
UNASSIGNED: This retrospective study included 141 consecutive patients with localized prostatic adenocarcinoma treated with CyberKnife™ SBRT, as primary irradiation, at the Oscar Lambret Center between 2010 and 2020. The prescribed dose was 36.25 Gy in 5 fractions. Acute and late toxicities were graded according to the CTCAE (version 5.0). Biochemical recurrence-free survival (bRFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The cumulative incidence of biochemical recurrence (cBR) was estimated using the Kalbfleisch-Prentice method.
UNASSIGNED: Among the included patients, 13.5 % had a history of transurethral resection of the prostate (TURP). The median follow-up was 48 months. At 5 years, bRFS, cBR, and OS were 72 % (95 %CI: 61-81), 7 % (95 %CI: 3-14), and 82 % (95 %CI: 73-89), respectively. Twenty-nine patients experienced at least one late toxicity of grade ≥ 2; genitourinary (N = 29), including 3 cases of chronic hematuria, and/or gastrointestinal (N = 1). The cumulative incidence of late urinary toxicity of grade ≥ 2 was 20.6 % at 5 years (95 %CI: 13.9-28.1). Multivariate analysis revealed that a history of TURP was significantly associated with late urinary toxicity of grade ≥ 2, after adjusting for clinical target volume (Odds Ratio = 3.06; 95%CI: 1.05-8.86; P = 0.04).
UNASSIGNED: Extreme hypofractionated SBRT is effective for localized prostate cancer with a low risk of late toxicity. A history of TURP is associated with a higher risk of late urinary toxicity. These findings may contribute to the optimal management of patients treated with this regimen, particularly those with a history of TURP.
摘要：
■极端小分割立体定向身体放疗（SBRT）是局部低或中危前列腺癌的治疗替代方案。尽管有几项研究，SBRT的毒性特征尚未得到全面描述.这项真实世界的证据研究评估了与该方案相关的疗效和毒性，和泌尿生殖系统毒性的潜在预后因素。
■这项回顾性研究包括141例接受Cyberknife™SBRT治疗的局限性前列腺腺癌患者，作为初级照射，2010年至2020年在奥斯卡·兰布雷特中心。处方剂量为5分36.25Gy。根据CTCAE（5.0版）对急性和晚期毒性进行分级。使用Kaplan-Meier方法估计生化无复发生存期(bRFS)和总生存期(OS)。使用Kalbfleisch-Prentice方法估计生化复发（cBR）的累积发生率。
■在纳入的患者中，13.5％的人有经尿道前列腺电切术（TURP）的病史。中位随访时间为48个月。在5年,bRFS,cBR,OS为72%（95CI：61-81），7%（95CI：3-14），和82%（95CI：73-89），分别。29例患者经历了至少一种≥2级的晚期毒性；泌尿生殖系统（N=29），包括3例慢性血尿，和/或胃肠(N=1)。≥2级的晚期尿毒性的累积发生率在5年为20.6％（95CI：13.9-28.1）。多变量分析显示，在调整临床目标体积后，TURP病史与≥2级的晚期尿毒性显着相关（赔率比=3.06；95CI：1.05-8.86；P=0.04）。
■极端超分割SBRT对局部前列腺癌有效，晚期毒性风险低。TURP病史与晚期尿毒性的高风险相关。这些发现可能有助于该方案治疗的患者的最佳管理，特别是那些有TURP历史的人。
■这项回顾性研究包括141例接受Cyberknife™SBRT治疗的局限性前列腺腺癌患者，作为初级照射，2010年至2020年在奥斯卡·兰布雷特中心。处方剂量为5分36.25Gy。根据CTCAE（5.0版）对急性和晚期毒性进行分级。使用Kaplan-Meier方法估计生化无复发生存期(bRFS)和总生存期(OS)。使用Kalbfleisch-Prentice方法估计生化复发（cBR）的累积发生率。
■在纳入的患者中，13.5％的人有经尿道前列腺电切术（TURP）的病史。中位随访时间为48个月。在5年,bRFS,cBR,OS为72%（95CI：61-81），7%（95CI：3-14），和82%（95CI：73-89），分别。29例患者经历了至少一种≥2级的晚期毒性；泌尿生殖系统（N=29），包括3例慢性血尿，和/或胃肠(N=1)。≥2级的晚期尿毒性的累积发生率在5年为20.6％（95CI：13.9-28.1）。多变量分析显示，在调整临床目标体积后，TURP病史与≥2级的晚期尿毒性显着相关（赔率比=3.06；95CI：1.05-8.86；P=0.04）。
■极端超分割SBRT对局部前列腺癌有效，晚期毒性风险低。TURP病史与晚期尿毒性的高风险相关。这些发现可能有助于该方案治疗的患者的最佳管理，特别是那些有TURP历史的人。
