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首页> 美国卫生研究院文献>Journal of Radiation Research >The effects of PSA kinetics on the outcome of hypofractionated salvage radiotherapy for biochemical recurrence of prostate cancer after prostatectomy
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The effects of PSA kinetics on the outcome of hypofractionated salvage radiotherapy for biochemical recurrence of prostate cancer after prostatectomy

机译：PSA动力学对前列腺切除后前列腺癌生物化学复发的次规救出放射治疗的影响

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摘要

The feasibility and efficacy of hypofractionated salvage radiotherapy (HS-RT) for prostate cancer (PC) with biochemical recurrence (BR) after prostatectomy, and the usefulness of prostate-specific antigen (PSA) kinetics as a predictor of BR, were evaluated in 38 patients who received HS-RT without androgen deprivation therapy between May 2009 and January 2017. Their median age, PSA level and PSA doubling time (PSA-DT) at the start of HS-RT were 68 (53–74) years, 0.28 (0.20–0.79) ng/ml and 7.7 (2.3–38.5) months, respectively. A total dose of 60 Gy in 20 fractions (three times a week) was three-dimensionally delivered to the prostate bed. After a median follow-up of 62 (30–100) months, 19 (50%) patients developed a second BR after HS-RT, but only 1 patient died before the last follow-up. The 5-year overall survival and BR-free survival rates were 97.1 and 47.4%, respectively. Late grade 2 gastrointestinal and genitourinary morbidities were observed in 0 and 5 (13%) patients, respectively. The PSA level as well as pathological T-stage and surgical margin status were regarded as significant predictive factors for a second BR by multivariate analysis. BR developed within 6 months after HS-RT in 11 (85%) of 13 patients with a PSA-DT < 10 months compared with 1 (17%) of 6 with a PSA-DT ≥ 10 months (median time to BR: 3 vs 14 months, P < 0.05). Despite the small number of patients, our HS-RT protocol seems feasible, and PSA kinetics may be useful for predicting the risk of BR and determining the appropriate follow-up schedule.
机译：前列腺切除术后前列腺癌（PC）具有生物化学复发（BR）的次级抗癌患者（PC）的可行性和有效性，以及前列腺特异性抗原（PSA）动力学作为BR预测的抗原（PSA）动力学的有用性，在38中被评估在2009年5月至2017年5月期间收到HS-RT的患者，在2009年5月至2017年1月期间，HS-RT开始时的中位数，PSA水平和PSA倍增时间（PSA-DT）为68（53-74）岁，0.28（ 0.20-0.79）Ng / ml和7.7（2.3-38.5）个月。在20分级分（每周三次）的总剂量为60μm，三维递送至前列腺床。在62（30-100）个月的中位随访后，19名（50％）患者在HS-RT后开发了第二个BR，但在最后一次随访之前只有1例死亡。 5年的总体存活率和无BR-FRES存活率分别为97.1和47.4％。在0和5（13％）患者中观察到晚期2级胃肠道和泌尿生长病。 PSA水平以及病理T-阶段和手术边缘地位被多元分析视为第二种BR的显着预测因素。在11名（85％）的13名患者的13名患者中，在PSA-DT <10个月的13名患者中发生在6个月内开发，与1（17％）6例，PSA-DT≥10个月（中位数到BR：3 vs 14个月，p <0.05）。尽管较少的患者，但我们的HS-RT协议似乎是可行的，并且PSA动力学可能有助于预测BR的风险并确定适当的后续时间表。

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