論文

国際誌
2020年9月

High-dose-rate brachytherapy and hypofractionated external beam radiotherapy combined with long-term androgen deprivation therapy for very high-risk prostate cancer.

International journal of urology : official journal of the Japanese Urological Association
  • Takashi Kasahara
  • ,
  • Fumio Ishizaki
  • ,
  • Akira Kazama
  • ,
  • Eri Yuki
  • ,
  • Kazutoshi Yamana
  • ,
  • Ryo Maruyama
  • ,
  • Tomoya Oshikane
  • ,
  • Motoki Kaidu
  • ,
  • Hidefumi Aoyama
  • ,
  • Vladimir Bilim
  • ,
  • Tsutomu Nishiyama
  • ,
  • Yoshihiko Tomita

27
9
開始ページ
800
終了ページ
806
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/iju.14305

OBJECTIVE: To estimate the outcomes of high-dose-rate brachytherapy combined with hypofractionated external beam radiotherapy in prostate cancer patients classified as very high risk by the National Comprehensive Cancer Network. METHODS: Between June 2009 and September 2015, 66 patients meeting the criteria for very high-risk disease received high-dose-rate brachytherapy (2 fractions of 9 Gy) as a boost of external beam radiotherapy (13 fractions of 3 Gy). Androgen deprivation therapy was administered for approximately 3 years. Biochemical failure was assessed using the Phoenix definition. RESULTS: The median follow-up period was 53 months from the completion of radiotherapy. The 5-year biochemical failure-free, distant metastasis-free, prostate cancer-specific and overall survival rates were 88.7, 89.2, 98.5 and 97.0%, respectively. The independent contribution of each component of the very high-risk criteria was assessed in multivariable models. Primary Gleason pattern 5 was associated with increased risks of biochemical failure (P = 0.017) and distant metastasis (P = 0.049), whereas clinical stage ≥T3b or >4 biopsy cores with Gleason score 8-10 had no significant impact on the two outcomes. Grade 3 genitourinary toxicities were observed in two (3.0%) patients, whereas no grade ≥3 gastrointestinal toxicities occurred. CONCLUSIONS: The present study shows that this multimodal approach provides potentially excellent cancer control and acceptable associated morbidity for very high-risk disease. Patients with primary Gleason pattern 5 are at a higher risk of poor outcomes, indicating the need for more aggressive approaches in these cases.

リンク情報
DOI
https://doi.org/10.1111/iju.14305
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32633027
ID情報
  • DOI : 10.1111/iju.14305
  • PubMed ID : 32633027

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