Impact of age on the Quadrella index assessing oncological and functional results after prostate brachytherapy: A 6-year analysis.

IF 1.1 4区 医学 Q4 ONCOLOGY Journal of Contemporary Brachytherapy Pub Date : 2023-04-01 DOI:10.5114/jcb.2023.127049
Guillaume Tremblay, Truong An Nguyen, Julien Marolleau, Jean-Pierre Malhaire, Alexandre Fourcade, Nicolas Boussion, Gaelle Goasduff, Emmanuelle Martin, Gurvan Dissaux, Olivier Pradier, G Fournier, U Schick, Antoine Valeri
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Abstract

Purpose: As the oncological results of prostate brachytherapy (BT) are excellent for low-risk (LR) or favorable intermediate-risk (FIR) prostate cancer (PCa), evaluating the side effects has become a major issue, especially for young men. The objective of the study was to compare the oncologic and functional results of BT using Quadrella index for patients aged 60 or less compared with older patients.

Material and methods: From June, 2007 to June, 2017, 222 patients, including 70 ≤ 60 years old and 152 > 60 years old, underwent BT for LR-FIR PCa, with good erectile function at baseline according to International Index of Erectile Function-5 (IIEF-5) > 16. Quadrella index was achieved under the following circumstances: 1) Absence of biological recurrence (Phoenix criteria); 2) Absence of erectile dysfunction (ED) (IIEF-5 > 16); 3) No urinary toxicity (international prostate score symptom) IPSS < 15 or IPSS > 15, and ΔIPSS < 5; 4) No rectal toxicity (RT) (Radiation Therapy Oncology Group, RTOG = 0). Patients were treated on demand with phosphodiesterase inhibitors (PDE5i) post-operatively.

Results: The Quadrella index was satisfied for about 40-80% of patients ≤ 60 years vs. 33-46% for older patients during 6-year follow-up (significant difference from the second year). At year 5, 100% of evaluable patients aged ≤ 60 and 91.8% > 60 (p = 0.29) reached Phoenix criteria. The criterion of ED (IIEF-5 < 16) largely explained the validity rate of Quadrella alone. There was no ED for 67.2-81.4% of patients ≤ 60 years compared with 40.0-56.1% for patients > 60 (significant difference since year 4 in favor of young men). After two years of follow-up, more than 90% of patients in both the groups showed neither urinary nor rectal toxicities.

Conclusions: For young men displaying LR-FIR PCa, BT appears to be a first-class therapeutic option, as the oncological results were at least equivalent to those of older patients with good long-term tolerance.

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年龄对评估前列腺近距离放疗后肿瘤和功能结果的Quadrella指数的影响:一项6年分析。
目的:由于前列腺近距离放射治疗(BT)对于低危(LR)或有利的中危(FIR)前列腺癌(PCa)的肿瘤学结果非常好,因此评估其副作用已成为一个主要问题,特别是对于年轻男性。该研究的目的是使用Quadrella指数比较60岁或以下患者与老年患者的BT肿瘤和功能结果。材料与方法:2007年6月至2017年6月,222例患者(其中年龄≤60岁的70例,年龄> 60岁的152例)根据国际勃起功能指数-5 (IIEF-5) > 16,基线勃起功能良好,接受了LR-FIR PCa的BT治疗。在以下情况下获得Quadrella指数:1)无生物复发(Phoenix标准);2)无勃起功能障碍(ED) (ief -5 > 16);3)无尿毒性(国际前列腺评分症状)IPSS < 15或IPSS > 15, ΔIPSS < 5;4)无直肠毒性(RT)(放射治疗肿瘤组,RTOG = 0),术后按需给予磷酸二酯酶抑制剂(PDE5i)治疗。结果:在6年的随访中,≤60岁患者的Quadrella指数满意度约为40-80%,而老年患者的Quadrella指数满意度为33-46%(与第二年相比有显著差异)。在第5年,100%≤60岁的可评估患者和91.8% > 60岁的可评估患者(p = 0.29)达到凤凰标准。ED的判据(ief -5 < 16)在很大程度上解释了Quadrella单独的效度。≤60岁的患者中,67.2-81.4%没有ED,而> 60岁的患者中,40.0-56.1%没有ED(从第4年开始,年轻男性有显著差异)。经过两年的随访,两组中超过90%的患者均未出现泌尿和直肠毒性。结论:对于患有LR-FIR PCa的年轻男性,BT似乎是一种一流的治疗选择,因为肿瘤学结果至少与长期耐受性良好的老年患者相当。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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