■第二恶性肿瘤是前列腺近距离放射治疗后的罕见但可能致命的事件,但其长期风险数据仍然匮乏。这项研究的目的是评估近距离放射治疗后与前列腺切除术(RP)相比的盆腔第二恶性肿瘤的数量。
■1999年至2010年在不列颠哥伦比亚省接受低剂量125I近距离放射治疗和前列腺切除术的患者的回顾性回顾。骨盆(膀胱和直肠)的KaplanMeier(KM)估计,侵入性骨盆,评估任何第二恶性肿瘤和第二恶性肿瘤的死亡.进行Cox多变量分析,调整初始治疗类型,年龄,RP后佐剂/救助EBRT状态,和吸烟史。
■纳入了两千三千名78例近距离放射治疗和9089例前列腺切除术患者。中位年龄为66岁(IQR61-71)和63岁(IQR58-67),分别。事件或受到谴责的中位随访时间为14年(IQR11.5-17.3)。近距离放射治疗后15年和20年盆腔第二恶性肿瘤的KM估计值分别为6.4%和9.8%,前列腺切除术后的3.2%和4.2%。到任何第二恶性肿瘤的时间和从任何第二恶性肿瘤到死亡的时间没有显着差异(P>.05)。关于Cox多变量分析,近距离放射治疗,与手术相比,是骨盆的独立因素(HR1.81[95%CI1.45-2.26],P<.001)和浸润性盆腔第二恶性肿瘤(HR2.13[95%CI1.61-2.83],P<.001)。年龄增加和吸烟也与更高的事件估计相关(P<.001)。
■调整年龄后,RP后辅助/救助EBRT状态和吸烟状态,与根治性前列腺切除术相比,接受近距离放射治疗的患者的盆腔和浸润性盆腔第二恶性肿瘤的长期HR数值更高.
UNASSIGNED: Second malignancy is a rare but potentially lethal event after prostate brachytherapy, but data remain scarce on its long-term risk. The objective of this study is to estimate the number of pelvic second malignancies following brachytherapy compared to radical prostatectomy (RP).
UNASSIGNED: We retrospectively reviewed patients treated with low-dose 125I brachytherapy and RP in British Columbia from 1999 to 2010. Kaplan-Meier estimates for pelvic (bladder and rectum), invasive pelvic, any second malignancy, and death from any second malignancy were assessed. Cox multivariable analyses were performed adjusting for initial treatment type, age, post-RP adjuvant/salvage external beam radiation therapy status, and smoking history.
UNASSIGNED: Two thousand three hundred seventy-eight brachytherapy and 9089 RP patients were included. Median age was 66 years (interquartile range [IQR] 61-71) and 63 years (IQR 58-67), respectively. Median follow-up time to event or censured was 14 years (IQR 11.5-17.3). The Kaplan-Meier estimates for pelvic second malignancy at 15 and 20 years were 6.4% and 9.8%, respectively, after brachytherapy, and 3.2% and 4.2% after RP. Time to any second malignancy and time to death from any second malignancy were not significantly different (P > .05). On Cox multivariable analysis, brachytherapy, compared to surgery, was an independent factor for pelvic (hazard ratio [HR] 1.81 [95% CI 1.45-2.26], P < .001) and invasive pelvic second malignancy (HR 2.13 [95% CI 1.61-2.83], P < .001). Increased age and smoking were also associated with higher estimates of events (P < .001).
UNASSIGNED: After adjustment for age, post-RP adjuvant/salvage external beam radiation therapy status, and smoking status, numerically higher long-term HRs of pelvic and invasive pelvic second malignancy in patients treated with brachytherapy compared to RP were noted.