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J Clin Oncol:强化局部放疗可改善局限性前列腺癌患者的疾病控制

2021-01-29 MedSci原创 MedSci原创

体外放射疗法(EBRT)治疗局限性前列腺癌的剂量反应关系已有概述。全前列腺剂量最高增加至80 Gy被认为是安全有效的。本研究旨在研究EBRT对肉眼可见肿瘤的病灶强化是否能提高局限性前列腺癌患者的生化无

体外放射疗法(EBRT)治疗局限性前列腺癌的剂量反应关系已有概述。全前列腺剂量最高增加至80 Gy被认为是安全有效的。本研究旨在研究EBRT对肉眼可见肿瘤的病灶强化是否能提高局限性前列腺癌患者的生化无病生存期(bDFS)。

这是一项III期、多中心、随机对照的前列腺癌局部病灶消融性MicroBoost试验,在2009-2015年间招募了571名中高危前列腺癌患者,随机分组后,标准治疗组的患者整个前列腺接受了77 Gy(2.2 Gy/次)的放疗。病灶强化组同时接受了高达95 Gy(最高2.7 Gy/次)病灶强化放疗。主要终点是5年bDFS。次要终点是无病生存率(DFS)、无远处转移生存率、前列腺癌特异性生存率、总体生存率、毒性和与健康相关的生活质量。

中位随访了72个月。病灶强化组的生化DFS显著高于标准治疗组(危险比0.45,95% CI 0.28~0.71,p<0.001)。随访5年时,强化组和标准组的bDFS分别为92%和85%。前列腺癌特异性存活率和总存活率无显著差异(p分别为0.49和0.50)。标准组2级及以上晚期泌尿生殖系和胃肠道毒性的累积发生率分别为23%和12%,而强化组的分别为28%和13%。两组健康相关的生活质量的差异同样很小,没有统计学意义

综上,对于前列腺内肿瘤病灶进行强化放疗,可在全前列腺标准体外放疗基础上进一步改善局部中高危前列腺癌患者的bDFS,且不会影响毒性和生活质量。该研究表明,病灶聚焦放疗增强策略可在不违背高危器官剂量限制性的同时改善肿瘤控制的方法有效且安全。

原始出处:

Kerkmeijer Linda G W,Groen Veerle H,Pos Floris J et al. Focal Boost to the Intraprostatic Tumor in External Beam Radiotherapy for Patients With Localized Prostate Cancer: Results From the FLAME Randomized Phase III Trial. J Clin Oncol, 2021, undefined: JCO2002873.

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    2021-09-21 minlingfeng
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    2021-04-30 MedSciZeng

    #J Clin Oncol#点击查看更多该期刊内容

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createdBy=7eeb2500172, createdName=haouestc, createdTime=Sat Mar 20 20:57:07 CST 2021, time=2021-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961847, encodeId=f29796184ed9, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:16:51 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406017, encodeId=674e140601e69, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1d85457124, createdName=ms2000001436803178, createdTime=Fri Jan 29 17:30:49 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921088, encodeId=86c39210883e, content=副作用大不大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Fri Jan 29 16:24:05 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921090, encodeId=2daa9210904c, content=全前列腺剂量最高增加至80 Gy被认为是安全有效的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
    2021-01-31 chg122
  5. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
  6. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
    2021-01-29 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1865998, encodeId=63571865998d1, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Sep 21 13:57:07 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924050, encodeId=9f6419240500d, content=<a href='/topic/show?id=61d24e655df' target=_blank style='color:#2F92EE;'>#局限性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47655, encryptionId=61d24e655df, topicName=局限性)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encodeId=b17c1038200e6, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040941, encodeId=6fce104094123, content=前列腺癌相关研究,学习了,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921144, encodeId=6f0892114424, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1d85457124, createdName=ms2000001436803178, createdTime=Fri Jan 29 17:30:49 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921088, encodeId=86c39210883e, content=副作用大不大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Fri Jan 29 16:24:05 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921090, encodeId=2daa9210904c, content=全前列腺剂量最高增加至80 Gy被认为是安全有效的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
    2021-01-29 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1865998, encodeId=63571865998d1, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Sep 21 13:57:07 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924050, encodeId=9f6419240500d, content=<a href='/topic/show?id=61d24e655df' target=_blank style='color:#2F92EE;'>#局限性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47655, encryptionId=61d24e655df, topicName=局限性)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encodeId=b17c1038200e6, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040941, encodeId=6fce104094123, content=前列腺癌相关研究,学习了,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921144, encodeId=6f0892114424, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1d85457124, createdName=ms2000001436803178, createdTime=Fri Jan 29 17:30:49 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921088, encodeId=86c39210883e, content=副作用大不大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Fri Jan 29 16:24:05 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921090, encodeId=2daa9210904c, content=全前列腺剂量最高增加至80 Gy被认为是安全有效的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
    2021-01-29 ms2000001436803178

    学到了

    0

  9. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sun Jan 31 06:57:07 CST 2021, time=2021-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1460475, encodeId=b03314604e5da, content=<a href='/topic/show?id=ebf74e65779' target=_blank style='color:#2F92EE;'>#局限性前列腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47657, encryptionId=ebf74e65779, topicName=局限性前列腺癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8256335432, createdName=yang0212, createdTime=Sun Jan 31 06:57:07 CST 2021, time=2021-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038200, encodeId=b17c1038200e6, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040941, encodeId=6fce104094123, content=前列腺癌相关研究,学习了,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921144, encodeId=6f0892114424, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1d85457124, createdName=ms2000001436803178, createdTime=Fri Jan 29 17:30:49 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921088, encodeId=86c39210883e, content=副作用大不大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Fri Jan 29 16:24:05 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921090, encodeId=2daa9210904c, content=全前列腺剂量最高增加至80 Gy被认为是安全有效的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
    2021-01-29 liyu7822

    副作用大不大

    1

    展开1条回复
  10. [GetPortalCommentsPageByObjectIdResponse(id=1865998, encodeId=63571865998d1, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Sep 21 13:57:07 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924050, encodeId=9f6419240500d, content=<a href='/topic/show?id=61d24e655df' target=_blank style='color:#2F92EE;'>#局限性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47655, encryptionId=61d24e655df, topicName=局限性)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encodeId=b17c1038200e6, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040941, encodeId=6fce104094123, content=前列腺癌相关研究,学习了,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Jan 29 18:57:07 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921144, encodeId=6f0892114424, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1d85457124, createdName=ms2000001436803178, createdTime=Fri Jan 29 17:30:49 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921088, encodeId=86c39210883e, content=副作用大不大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Fri Jan 29 16:24:05 CST 2021, time=2021-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921090, encodeId=2daa9210904c, content=全前列腺剂量最高增加至80 Gy被认为是安全有效的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Fri Jan 29 16:27:20 CST 2021, time=2021-01-29, status=1, ipAttribution=)]
    2021-01-29 言西早

    全前列腺剂量最高增加至80 Gy被认为是安全有效的。

    0

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