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首页> 外文期刊>International Journal of Radiation Oncology, Biology, Physics >Does hormone therapy reduce disease recurrence in prostate cancer patients receiving dose-escalated radiation therapy? An analysis of Radiation Therapy Oncology Group 94-06.
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Does hormone therapy reduce disease recurrence in prostate cancer patients receiving dose-escalated radiation therapy? An analysis of Radiation Therapy Oncology Group 94-06.

机译:激素治疗是否能降低接受剂量递增放射治疗的前列腺癌患者的疾病复发?放射治疗肿瘤学分析94-06。

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摘要

PURPOSE: The purpose of this study was to evaluate the effect on freedom from biochemical failure (bNED) or disease-free survival (DFS) by adding hormone therapy (HT) to dose-escalated radiation therapy (HDRT). METHODS AND MATERIALS: We used 883 analyzable prostate cancer patients who enrolled on Radiation Therapy Oncology Group (RTOG) 94-06, a Phase I/II dose escalation trial, and whose mean planning target volume dose exceeded 73.8 Gy (mean, 78.5 Gy; maximum, 84.3 Gy). We defined biochemical failure according to the Phoenix definition. RESULTS: A total of 259 men started HT 2 to 3 months before HDRT, but not longer than 6 months, and 66 men with high-risk prostate cancer received HT for a longer duration. At 5 years, the biochemical failure rates after HDRT alone were 12%, 18%, and 29% for low-, intermediate-, and high-risk patients, respectively (p < 0.0001). Cox proportional hazards regression analysis adjusted for covariates revealed that pretreatment PSA level was a significant factor, whereas risk group, Gleason score, T-stage, and age were not. When the patients were stratified by risk groups, the Cox proportion hazards regression model (after adjusting for pretreatment PSA, biopsy Gleason score, and T stage) did not reveal a significant effect on bNED or DFS by adding HT to HDRT CONCLUSION: The addition of HT did not significantly improve bNED survival or DFS in all prostate cancer patients receiving HDRT, but did approach significance in high-risk patient subgroup. The result of this study is hypothesis generating and requires testing in a prospective randomized trial.
机译:目的:本研究的目的是通过在剂量递增放射治疗(HDRT)中添加激素治疗(HT)来评估对免受生化衰竭(bNED)或无病生存(DFS)的影响。方法和材料:我们使用了883位可分析的前列腺癌患者,他们参加了I / II期剂量递增试验的放射治疗肿瘤学组(RTOG)94-06,其平均计划目标体积剂量超过73.8 Gy(平均78.5 Gy;最大84.3 Gy)。我们根据Phoenix的定义定义了生化失败。结果:共有259名男性在HDRT前2至3个月开始HT,但不超过6个月,而66名高危前列腺癌男性接受HT的时间更长。在5年时,低,中,高风险患者仅接受HDRT后的生化失败率分别为12%,18%和29%(p <0.0001)。对协变量进行校正后的Cox比例风险回归分析显示,治疗前PSA水平是一个重要因素,而风险组,Gleason评分,T期和年龄则不是。当按危险人群对患者进行分层时,Cox比例风险回归模型(在对治疗前PSA,活检Gleason评分和T分期进行调整后)没有通过在HDRT中添加HT对bNED或DFS产生显着影响。结论:在所有接受HDRT的前列腺癌患者中,HT均不能显着改善bNED生存或DFS,但在高危患者亚组中却具有显着意义。这项研究的结果是产生假设的结果,需要在前瞻性随机试验中进行测试。

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