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Fractionated stereotactic body radiotherapy for up to five prostate cancer oligometastases: Interim outcomes of a prospective clinical trial.
分割立体定向体放射治疗多达五个前列腺癌寡核苷酸: 一项前瞻性临床试验的中期结果。
androgen deprivation therapy oligometastases prostate cancer stereotactic body radiotherapy
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摘要

Stereotactic body radiotherapy (SBRT) can delay escalation to systemic treatment in men with oligometastatic prostate cancer (PCa). However, large, prospective studies are still required to evaluate the efficacy of this approach in different patient groups. This is the interim analysis of a prospective, single institution study of men relapsing with up to five synchronous lesions following definitive local treatment for primary PCa. Our aim was to determine the proportion of patients not requiring treatment escalation following SBRT. In total, 199 patients were enrolled to receive fractionated SBRT (50 Gray in 10 fractions) to each visible lesion. Fourteen patients were castration resistant at enrolment. The proportion of patients not requiring treatment escalation 2 years following SBRT was 51.7% (95% CI: 44.1-59.3%). The median length of treatment escalation-free survival over the entire follow-up period was 27.1 months (95% CI; 21.8-29.4 months). Prior androgen deprivation therapy (ADT) predicted a significantly lower rate of freedom from treatment escalation at 2 years compared to no prior ADT (odds ratio = 0.21, 95% CI: 0.08-0.54, p = 0.001). There was no difference in the efficacy of SBRT when treating 4-5 vs. 1-3 initial lesions. A prostate-specific antigen (PSA) decline was induced in 75% of patients, with PSA readings falling to an undetectable level in six patients. No late grade three toxicities were observed. These interim results suggest that SBRT can be used to treat up to five synchronous PCa oligometastases to delay treatment escalation.

译文

立体定向全身放疗 (SBRT) 可延缓男性寡转移前列腺癌 (PCa) 的升级至全身治疗。然而,仍需要大量的前瞻性研究来评估这种方法在不同患者群体中的疗效。这是一项前瞻性、单一机构研究的中期分析,研究对象是原发性 PCa 最终局部治疗后复发的男性,最多可出现五个同步病变。我们的目的是确定 SBRT 后不需要治疗升级的患者比例。总共有 199 名患者被纳入每个可见病变的分级 SBRT (10 个部分中的 50 个灰色)。14 名患者在登记时出现去势抵抗。SBRT 后不需要治疗升级 2 年的患者比例为 51.7% (95% 置信区间: 44.1-59.3%)。在整个随访期内,治疗无升级生存期的中位数为 27.1 个月 (95% CI; 21.8-29.4 个月)。先前的雄激素剥夺疗法 (ADT) 预测,与之前的 ADT 相比,在 2 年半的时间里,免于治疗升级的比率显著降低 (比值比 = 0.21,95% CI: 0.08-0.54, p = 0.001)。SBRT 在治疗 4-5 和 1-3 初始病变时的疗效没有差异。75% 的患者前列腺特异性抗原 (PSA) 下降,六名患者的 PSA 读数降至不可检测的水平。未观察到晚期三级毒性。这些中期结果表明,SBRT 可用于治疗多达五个同步 PCa 寡核苷酸,以延迟治疗升级。

Stereotactic Body Radiotherapy

肿瘤 放疗 治疗方法
概述  :  

随着立体定向放射外科概念的出现,围绕立体定向放射外科的不同医疗设备的发明和新技术相继出现。上世纪八十年代,Colombo和Betti等学者对医用直线加速器加以改进,增加了立体定向系统和准直器,采用非共面多弧度小野三维集束照射病灶,取得了与伽马刀类似的治疗效果。将这种经过改进的直线加速器成为X刀。一般采用分次治疗,在学术界称为立体定向放射治疗。立体定向放射治疗技术简称SBRT,是利用高度精准的放疗技术,将根治性的放射剂量通过外照射方式聚焦到肿瘤部位,达到根治肿瘤的目的。其具有影像引导技术,通过

Stereotactic   /,stɪərɪo'tæktɪk/

       adj. 定向性测定的;趋实体性的

       Therapy of 206 patients with pancreatic carcinoma(PC) with Stereotactic Gamma Ray Whole Body Therapeutic System. 采用立体定向伽玛射线全身治疗系统治疗206例胰腺癌(PC)患者。

 

Body   英 /'bɒdɪ/   美 /'bɑdi/

       n. 身体;主体;大量;团体;主要部分;vt. 赋以形体;

同根词   bodily adj. 身体的;肉体的;bod adj. 很好的;bodied adj. 有形的;有躯体的;

       You only have one body and mind. 你只有一个身体和头脑。


Radiotherapy   英 /,reɪdɪə(ʊ)'θerəpɪ/   美 /'redɪo'θɛrəpi/

       n. [特医] 放射疗法

       A radioactive isotope of cobalt with mass number '0 and exceptionally intense gamma-ray activity, used in radiotherapy, metallurgy, and materials testing. 钴的一种放射性同位素,质子数'0,具有异常强烈的伽马射线作用,用于放射疗法、冶金和材料测试。

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