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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Subgroup analysis of patients with localized prostate cancer treated within the Dutch-randomized dose escalation trial.
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Subgroup analysis of patients with localized prostate cancer treated within the Dutch-randomized dose escalation trial.

机译：在荷兰随机剂量递增试验中治疗的局部前列腺癌患者的亚组分析。

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PURPOSE: To investigate the effect of dose escalation within prognostic risk groups in prostate cancer. PATIENTS AND METHODS: Between 1997 and 2003, 664 patients with localized prostate cancer were randomly assigned to receive 68- or 78-Gy of radiotherapy. Two prognostic models were examined: a risk group model (low-, intermediate-, and high-risk) and PSA-level groupings. High-risk patients with hormonal therapy (HT) were analyzed separately. Outcome variable was freedom from failure (FFF) (clinical failure or PSA nadir+2 microg/L). RESULTS: In relation to the advantage of high-dose radiotherapy, intermediate-risk patients benefited most from dose escalation. However no significant heterogeneity could be demonstrated between the risk groups. For two types of PSA-level groupings: PSA<10 and > or = 10 microg/L, and <8, 8-18 and >8 microg/L, the test for heterogeneity was significant (p=0.03 and 0.05, respectively). Patients with PSA 8-18 microg/L (n=297, HR=0.59) derived the greatest benefit from dose escalation. No heterogeneity could be demonstrated for high-risk patients with and without HT. CONCLUSION: Intermediate-risk group derived the greatest benefit for dose escalation. However, from this trial no indication was found to exclude low-risk or high-risk patients from high-dose radiotherapy. Patients could be selected for high-dose radiotherapy based on PSA-level groupings: for patients with a PSA<8 microg/L high-dose radiotherapy is probably not indicated, but should be confirmed in other randomized studies.
机译：目的：研究剂量升高对前列腺癌预后风险人群的影响。患者与方法：在1997年至2003年之间，随机分配了664位局限性前列腺癌患者接受68-或78-Gy放射治疗。检查了两种预后模型：风险组模型（低，中和高风险）和PSA级分组。激素治疗（HT）的高危患者被单独分析。结果变量为无故障（FFF）（临床故障或PSA最低点+2 microg / L）。结果：关于高剂量放疗的优势，中度风险患者受益于剂量递增。但是，风险组之间没有明显的异质性。对于两种类型的PSA级别分组：PSA <10和>或= 10 microg / L，以及<8、8-18和> 8 microg / L，异质性检验非常显着（分别为p = 0.03和0.05） 。 PSA 8-18 microg / L（n = 297，HR = 0.59）的患者从剂量增加中获得最大收益。有和没有HT的高危患者均未显示异质性。结论：中危组在剂量增加方面获益最大。但是，从该试验中未发现将高危放疗排除低危或高危患者的适应症。可以根据PSA水平分组选择患者进行大剂量放射治疗：对于PSA <8 microg / L的患者，可能不建议进行大剂量放射治疗，但应在其他随机研究中予以证实。

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