Abstract：
OBJECTIVE: Until March 2018, patients with high-risk localized prostate cancer had been administered high-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) without additional hormone therapy (HT) at our institution. In this study, we aimed to evaluate long-term outcomes of this treatment.
METHODS: Patients with prostate cancer who received HDR-BT and EBRT between April 1997 and March 2021 and who were followed up for at least 6 months were included in the study. High-risk groups were classified into five levels according to the National Comprehensive Cancer Network guidelines. The EBRT and HDR-BT doses were 39-45 Gy/13-25 fractions. and 16.5-22 Gy/2-4 fractions, respectively. None of the patients received HT during initial treatment. The Kaplan-Meier method was used to estimate biochemical freedom from failure (bFFF), cause-specific survival (CSS), and overall survival (OS) rates. Biochemical failure was also determined.
RESULTS: Seventy-two patients were enrolled in the study, with a median follow-up of 91.9 months. The median age and initial prostate-specific antigen (iPSA) level were 71 years and 10.95 ng/mL, respectively. The median biologically effective dose for HDR-BT plus EBRT was 270.3 Gy. The 5- and 7-year bFFF, CSS, and OS rates were 85.2 and 74.2%, 100 and 100%, and 95.7 and 91.9%, respectively. Only the iPSA ≤ 20 group was associated with the higher bFFF rate. The 7-year bFFF rates in the groups with iPSA ≤ 20 and iPSA > 20 were 86.6 and 48.6%, respectively.
CONCLUSIONS: HDR-BT plus EBRT without HT might be an alternative treatment option for patients with high-risk localized prostate cancer and iPSA levels ≤ 20. Further studies are required to validate the efficacy of this treatment strategy.
METHODS: Patients with prostate cancer who received HDR-BT and EBRT between April 1997 and March 2021 and who were followed up for at least 6 months were included in the study. High-risk groups were classified into five levels according to the National Comprehensive Cancer Network guidelines. The EBRT and HDR-BT doses were 39-45 Gy/13-25 fractions. and 16.5-22 Gy/2-4 fractions, respectively. None of the patients received HT during initial treatment. The Kaplan-Meier method was used to estimate biochemical freedom from failure (bFFF), cause-specific survival (CSS), and overall survival (OS) rates. Biochemical failure was also determined.
RESULTS: Seventy-two patients were enrolled in the study, with a median follow-up of 91.9 months. The median age and initial prostate-specific antigen (iPSA) level were 71 years and 10.95 ng/mL, respectively. The median biologically effective dose for HDR-BT plus EBRT was 270.3 Gy. The 5- and 7-year bFFF, CSS, and OS rates were 85.2 and 74.2%, 100 and 100%, and 95.7 and 91.9%, respectively. Only the iPSA ≤ 20 group was associated with the higher bFFF rate. The 7-year bFFF rates in the groups with iPSA ≤ 20 and iPSA > 20 were 86.6 and 48.6%, respectively.
CONCLUSIONS: HDR-BT plus EBRT without HT might be an alternative treatment option for patients with high-risk localized prostate cancer and iPSA levels ≤ 20. Further studies are required to validate the efficacy of this treatment strategy.
摘要：
目的：直到2018年3月，在我们机构，高危局限性前列腺癌患者接受了高剂量率近距离放射治疗（HDR-BT）联合外照射放射治疗（EBRT），而没有额外的激素治疗（HT）。在这项研究中,我们旨在评估该治疗的长期结局.
方法：在1997年4月至2021年3月期间接受HDR-BT和EBRT并随访至少6个月的前列腺癌患者被纳入研究。根据国家综合癌症网络指南将高危人群分为五个级别。EBRT和HDR-BT剂量为39-45Gy/13-25分。和16.5-22Gy/2-4分数，分别。在初始治疗期间没有患者接受HT。Kaplan-Meier方法用于估计生化免于失败(bFFF)，特定原因生存(CSS)，和总生存率（OS）。还确定了生化失败。
结果：72名患者被纳入研究，中位随访时间为91.9个月。中位年龄和初始前列腺特异性抗原（iPSA）水平为71岁和10.95ng/mL，分别。HDR-BT加EBRT的中位生物学有效剂量为270.3Gy。5年和7年的bFFF，CSS,OS率分别为85.2％和74.2％，100和100％，95.7％和91.9％，分别。只有iPSA≤20组与较高的bFFF率相关。iPSA≤20和iPSA>20的7年bFFF率为86.6％和48.6％，分别。
结论：HDR-BT加不含HT的EBRT可能是高危局限性前列腺癌且iPSA水平≤20的患者的替代治疗选择。需要进一步的研究来验证这种治疗策略的有效性。
方法：在1997年4月至2021年3月期间接受HDR-BT和EBRT并随访至少6个月的前列腺癌患者被纳入研究。根据国家综合癌症网络指南将高危人群分为五个级别。EBRT和HDR-BT剂量为39-45Gy/13-25分。和16.5-22Gy/2-4分数，分别。在初始治疗期间没有患者接受HT。Kaplan-Meier方法用于估计生化免于失败(bFFF)，特定原因生存(CSS)，和总生存率（OS）。还确定了生化失败。
结果：72名患者被纳入研究，中位随访时间为91.9个月。中位年龄和初始前列腺特异性抗原（iPSA）水平为71岁和10.95ng/mL，分别。HDR-BT加EBRT的中位生物学有效剂量为270.3Gy。5年和7年的bFFF，CSS,OS率分别为85.2％和74.2％，100和100％，95.7％和91.9％，分别。只有iPSA≤20组与较高的bFFF率相关。iPSA≤20和iPSA>20的7年bFFF率为86.6％和48.6％，分别。
结论：HDR-BT加不含HT的EBRT可能是高危局限性前列腺癌且iPSA水平≤20的患者的替代治疗选择。需要进一步的研究来验证这种治疗策略的有效性。
