局部前列腺癌症质子束和强度调制放射治疗的病例匹配结果。

IF 2.1 Q3 ONCOLOGY International Journal of Particle Therapy Pub Date : 2023-05-18 eCollection Date: 2023-01-01 DOI:10.14338/IJPT-23-00002.1
Alicia Bao, Andrew R Barsky, Stefan Both, John P Christodouleas, Curtiland Deville, Zelig A Tochner, Neha Vapiwala, Russell Maxwell
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引用次数: 0

摘要

目的:尽管强度调制放射治疗(IMRT)和质子束治疗(PBT)都能有效地长期控制局部前列腺癌症(PCa)的疾病,但直接比较这两种治疗方式的数据有限。方法:回顾性分析334例接受常规分级(79.2 GyRBE,44个分级)PBT或IMRT治疗的患者的数据。倾向性评分匹配用于平衡与生化无故障生存率(BFFS)相关的因素。匹配后,年龄、种族和合并症(与BFFS无关)仍然不平衡。使用单变量和协变量调整的多变量(MVA)Cox回归模型来确定模式是否影响BFFS。结果:在334名患者中,176名(52.7%)患者被纳入与国家综合癌症网络(NCCN)风险组完全匹配的匹配队列。中位随访时间为9.0年(四分位间距[IQR]:7.8-10.2年),IMRT和PBT匹配组的长期BFFS相似,8年估计值分别为85%(95%CI:76%-91%)和91%(95%CI:82%-96%,P = .39)。在MVA方面,在两种不匹配(危险比[HR] = 0.75,95%CI:0.35-1.63,P = .47)和匹配(HR = 0.87,95%置信区间0.33-2.33,P = .78)队列。前列腺癌特异性生存率(PCSS)和总生存率(OS)也相似(P > .05)。然而,在一项不匹配的分析中,PBT臂在照射区域内的继发性癌症发生率显著降低(0.6%,95%CI:0.0%-3.1%与4.5%,95%CI:1.8%-9.0%,P = .028)。结论:PBT和IMRT都为前列腺癌提供了良好的长期疾病控制,在匹配患者中,两种模式在BFFS、PCSS和OS方面没有显著差异。在不匹配的队列中,PBT组的继发性恶性肿瘤发生率较低;然而,由于癌症的继发发病率总体较低,并且两组患者的特征不平衡,这些数据是严格的假设生成,需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Case-Matched Outcomes of Proton Beam and Intensity-Modulated Radiation Therapy for Localized Prostate Cancer.

Purpose: Although both intensity-modulated radiation therapy (IMRT) and proton beam therapy (PBT) offer effective long-term disease control for localized prostate cancer (PCa), there are limited data directly comparing the 2 modalities.

Methods: The data from 334 patients treated with conventionally fractionated (79.2 GyRBE in 44 fractions) PBT or IMRT were retrospectively analyzed. Propensity score matching was used to balance factors associated with biochemical failure-free survival (BFFS). Age, race, and comorbidities (not BFFS associates) remained imbalanced after matching. Univariable and covariate-adjusted multivariable (MVA) Cox regression models were used to determine if modality affected BFFS.

Results: Of 334 patients, 176 (52.7%) were included in the matched cohort with exact matching to National Comprehensive Cancer Network (NCCN) risk group. With a median follow-up time of 9.0 years (interquartile range [IQR]: 7.8-10.2 years), long-term BFFS was similar between the IMRT and PBT matched arms with 8-year estimates of 85% (95% CI: 76%-91%) and 91% (95% CI: 82%-96%, P = .39), respectively. On MVA, modality was not significantly associated with BFFS in both the unmatched (hazard ratio [HR] = 0.75, 95% CI: 0.35-1.63, P = .47) and matched (HR = 0.87, 95% CI: 0.33-2.33, P = .78) cohorts. Prostate cancer-specific survival (PCSS) and overall survival (OS) were also similar (P > .05). However, in an unmatched analysis, the PBT arm had significantly fewer incidences of secondary cancers within the irradiated field (0.6%, 95% CI: 0.0%-3.1% versus 4.5%, 95% CI: 1.8%-9.0%, P = .028).

Conclusions: Both PBT and IMRT offer excellent long-term disease control for PCa, with no significant differences between the 2 modalities in BFFS, PCSS, and OS in matched patients. In the unmatched cohort, fewer incidences of secondary malignancy were noted in the PBT group; however, owing to overall low incidence of secondary cancer and imbalanced patient characteristics between the 2 groups, these data are strictly hypothesis generating and require further investigation.

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来源期刊
International Journal of Particle Therapy
International Journal of Particle Therapy Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
3.70
自引率
5.90%
发文量
23
审稿时长
20 weeks
期刊最新文献
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