■我们报告了高危前列腺癌(PCa)患者的结局,最初根据3层NCCN分类系统进行分类,外束放射治疗(EBRT)和高剂量率近距离放射治疗(HDR-BT)。根据使用CAPRA评分和较新的5层NCCN分类的风险分组的重新分层对患者进行分析。
■471例接受EBRT治疗的高危PCa患者,HDR-BT,纳入1999年至2018年的雄激素剥夺治疗(ADT)。竞争风险生存分析比较CAPRA得分<6的个体与生化复发(BCR)和转移发生率≥6。此外,采用Kaplan-Meier分析评估两组的总生存期(OS).使用5层NCCN分层重复进行相同的分析,比较分类为高风险与高危患者。
■中位年龄为71岁,中位随访期为72个月.整个队列接受了74Gy或更高的EQD2,EQD2中位数为106.89Gy。CAPRA评分≥6且属于NCCN高危人群均与BCR相关,子分布危险比(sHR)为3.04(p=0.015)和2.53(p=0.013),分别。对于转移发生率,CAPRA组和NCCN组的sHR相似,分别为2.60(p=0.094)和2.71(p=0.037),分别。对于10年操作系统,CAPRA评分≥6且属于NCCN极高风险组的患者的HR相似,分别为2.11(p=0.005)和2.10(p=0.002).
■我们表明,根据3层NCCN系统分类的高危PCa患者受益于使用CAPRA评分或5层NCCN分层方法的进一步分层。CAPRA评分≥6或被分类为极高风险的患者表现出更高的BCR风险。转移,和死亡。这些患者可能会从进一步加强调查和治疗中受益,基于正在进行的研究。
UNASSIGNED: We report outcomes of high-risk prostate cancer (PCa) patients, initially classified according to a 3-tier NCCN classification system, treated with external beam radiation therapy (EBRT) and high-dose-rate brachytherapy boost (HDR-BT). Patients were analyzed based on a re-stratification of their risk grouping using CAPRA score and a newer 5-tier NCCN classification.
UNASSIGNED: 471 high-risk PCa patients treated with EBRT, HDR-BT, and androgen deprivation therapy (ADT) between 1999 and 2018 were included. Competing risk survival analyses to compare individuals with CAPRA scores < 6 vs. ≥ 6 for biochemical relapse (BCR) and metastasis incidence were conducted. Also, overall survival (OS) for both groups using Kaplan-Meier analysis was assessed. The same analyses were repeated using a 5-tier NCCN stratification comparing those classified as high-risk vs. very high-risk patients.
UNASSIGNED: The median age was 71 years, and the median follow-up period was 72 months. The whole cohort received an EQD2 of 74 Gy or greater, with a median EQD2 of 106.89 Gy. Both a CAPRA score ≥ 6 and belonging to the NCCN very high-risk group were associated with BCR, with subdistribution hazard ratios (sHRs) of 3.04 (p = 0.015) and 2.53 (p = 0.013), respectively. For metastasis incidence, both the CAPRA and NCCN groups had similar sHRs of 2.60 (p = 0.094) and 2.71 (p = 0.037), respectively. For 10-year OS, patients with CAPRA score ≥ 6 and belonging to the NCCN very high-risk group presented similar HRs of 2.11 (p = 0.005) and 2.10 (p = 0.002).
UNASSIGNED: We showed that high-risk PCa patients classified according to the 3-tier NCCN system benefit from further stratification using the CAPRA score or the 5-tier NCCN stratification method. Patients with a CAPRA score ≥ 6 or classified as very high-risk demonstrate a higher hazard of BCR, metastasis, and death. These patients might benefit from further intensification of their investigations and treatment, based on ongoing research.