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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate.
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Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate.

机译：根治性前列腺切除术后前列腺癌的辅助和挽救性放射治疗。

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PURPOSE: To evaluate the outcome of adjuvant and salvage radiotherapy (RT) after radical prostatectomy (RP) for clinically localized prostate cancer using conventional clinical end-points, and the biochemical relapse-free rate (bRFR). METHODS: Between 1987 and 1994, 113 node negative, hormonally naive men received RT 1 month to 12 years after RP. Adjuvant RT was given for positive resection margins and/or pT3 disease. Salvage RT was given for a persistently elevated prostatic specific antigen (PSA), a rising PSA, or palpable recurrence post RP. Clinical and biochemical endpoints determined outcome. Log-rank testing and the Cox proportional hazards model identified factors predictive for biochemical relapse free rate. RESULTS: Median follow-up after RT was 3.7 years (range 0.2-9 years). Five-year clinical local control was 95% for patients with no palpable evidence of disease and 59% for those with palpable recurrence (P < 0.0001). 5-year bRFR was 81% for adjuvant RT, 19% for salvage of biochemical recurrence, 0% for patients with palpable disease (P < 0.0001). Improved bRFR for adjuvant and salvage RT was predicted by a Gleason score < 7 vs. 7 vs. > 7 (hazard ratio 1.53; 95% CI 0.99-2.35) and an undetectable pre-RT PSA vs. PSA < 2.0 ng/ml vs. PSA > 2.0 ng/ml (hazard ratio 3.81; 95% CI 2.47-5.87). Seminal vesicle involvement was not a statistically significant independent predictor of bRFR. CONCLUSIONS: The most favourable bRFR was observed for adjuvant therapy. Salvage was most successful with a pre-RT PSA < 2.0 ng/ml, or Gleason score < 7. Few patients with a pre-RT PSA > 2.0 ng/ml were salvaged, and none with palpable recurrence. These patients require investigation of alternative salvage strategies.
机译：目的：使用传统的临床终点，评估根治性前列腺切除术（RP）对临床局限性前列腺癌的辅助和挽救性放疗（RT）的结果以及生化无复发率（bRFR）。方法：在1987年至1994年之间，有113个淋巴结阴性，激素天真的男性接受了RP治疗后1个月至12年的RT。辅助RT用于阳性切缘和/或pT3疾病。对于持续升高的前列腺特异性抗原（PSA），升高的PSA或RP后明显复发，给予挽救性RT。临床和生化终点确定了结局。对数秩检验和Cox比例风险模型确定了可预测生化无复发率的因素。结果：放疗后的中位随访时间为3.7年（范围0.2-9年）。没有明显疾病迹象的患者的五年临床局部控制为95％，而具有明显复发的患者为59％（P <0.0001）。辅助放疗的5年bRFR为81％，挽救生化复发的为19％，有明显疾病的患者为0％（P <0.0001）。通过Gleason评分<7 vs. 7 vs.> 7（危险比1.53; 95％CI 0.99-2.35）和不可检测的RT前PSA vs. PSA <2.0 ng / ml vs PSA> 2.0 ng / ml（危险比3.81; 95％CI 2.47-5.87）。精囊受累不是bRFR的统计学显着独立预测因子。结论：在辅助治疗中观察到最有利的bRFR。 RT-pre PSA <2.0 ng / ml或Gleason评分<7时，挽救最成功。很少有RT- PSA> 2.0 ng / ml的患者得到挽救，且无明显复发。这些患者需要研究其他挽救策略。

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