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首页> 外文期刊>Strahlentherapie und Onkologie >Dose Escalation for Patients with Decreasing PSA during Radiotherapy for Elevated PSA after Radical Prostatectomy Improves Biochemical Progression-Free Survival : Results of a Retrospective Study.
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Dose Escalation for Patients with Decreasing PSA during Radiotherapy for Elevated PSA after Radical Prostatectomy Improves Biochemical Progression-Free Survival : Results of a Retrospective Study.

机译：前列腺癌根治术后PSA升高的放疗过程中PSA降低的患者剂量增加可提高无生化进展的生存率：一项回顾性研究的结果。

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PURPOSE: : The optimal dose for salvage radiotherapy (SRT) after radical prostatectomy (RP) is still not defined. It should be at least 66 Gy. In the present study, the suitability of PSA regression as a selection criterion for an SRT dose escalation to 70.2 Gy was examined. PATIENTS AND METHODS: : Between 1997 and 2007, 301 prostate cancer patients received SRT after RP at the Charite - University Medicine Berlin, Campus Benjamin Franklin. None of the patients had antihormone therapy prior to SRT. A total of 234 patients received 66.6 Gy. From 2002 on, 67 patients with a PSA decrease during SRT were irradiated with 70.2 Gy. The influence of this selection and dose escalation on freedom from biochemical progression (bNED) was analyzed. RESULTS: : The median follow-up of the whole group was 30 months, the median pre-SRT PSA was 0.28 ng/ml. Of the patients, 27% (82/301) developed biochemical progression, 31% from the 66.6 Gy cohort (73/292) and 13% from the 70.2 Gy cohort (9/67) (p = 0.01). The calculated 2-years bNED was 74% for the whole group, 88% vs. 71% after 70.2 Gy and 66.6 Gy, respectively (p = 0.01). In a multivariate analysis, the total dose (p = 0.017), the re-achievement of an undetectable PSA after SRT (p = 0.005), and the infiltration of the seminal vesicles (p = 0.049) were independent parameters of bNED. CONCLUSION: : Our analysis suggests that patient selection during SRT for a dose escalation to 70.2 Gy can improve the freedom from biochemical progression in patients with SRT after RP.
机译：目的：：尚无根治性前列腺切除术（RP）后抢救放疗（SRT）的最佳剂量。至少应为66 Gy。在本研究中，检查了PSA回归作为SRT剂量升至70.2 Gy的选择标准的适用性。患者与方法：1997年至2007年间，在Charite-University Medicine Berlin，本杰明·富兰克林校区进行RP后，有301名前列腺癌患者接受了RP后的SRT。 SRT之前没有患者接受抗激素治疗。总共234例患者接受了66.6 Gy。从2002年开始，对67例SRT期间PSA降低的患者进行了70.2 Gy的照射。分析了这种选择和剂量递增对不受生化进展影响（bNED）的影响。结果：整个组的中位随访时间为30个月，SRT前PSA的中位值为0.28 ng / ml。在这些患者中，有27％（82/301）发生了生化进展，来自66.6 Gy队列（73/292）的31％和来自70.2 Gy队列（9/67）的13％（p = 0.01）。整个组计算的2年bNED为74％，分别为70.2 Gy和66.6 Gy后的71％（p = 0.01）。在多变量分析中，总剂量（p = 0.017），SRT后无法检出PSA的重新获得（p = 0.005）和精囊囊浸润（p = 0.049）是bNED的独立参数。结论：我们的分析表明，在SRT期间选择剂量增加到70.2 Gy的患者可以改善RP后SRT患者的生化进展自由度。

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