演題抄録

口演

開催概要
開催回
第58回・2020年・京都
 

局所進行前立腺癌への全骨盤強度変調放射線治療の10年成績:傾向スコアマッチ解析

演題番号 : O5-2

[筆頭演者]
相澤 理人:1 
[共同演者]
中村 清直:1、則久 佳毅:3、井上 貴博:2,4、山﨑 俊成:2,5、小林 恭:2、赤松 秀輔:2、小川 修:2、溝脇 尚志:1

1:京都大学・放射線腫瘍学・画像応用治療学、2:京都大学・泌尿器科、3:ベルランド総合病院・放射線治療科、4:三重大学・腎泌尿器外科、5:神戸市立医療センター中央市民病院・泌尿器科

 

Backgrounds: The role of prophylactic whole pelvic radiation therapy for locally advanced prostate cancer (LAPCa) remains controversial. The aim of this study was to evaluate long-term efficacy and safety of whole pelvic intensity-modulated radiation therapy with simultaneous-integrated boost (WP-SIB-IMRT) for LAPCa.
Methods: All patients with T3-4 prostate cancer treated with WP-SIB-IMRT between February 2006 and September 2009 at our institution were analyzed retrospectively. The prescribed dose was 78 Gy/39 fractions to the prostate with 58.5 Gy/39 fractions to the prophylactic pelvic nodal area delivered using simultaneous integrated boost technique. All patients received short-term neoadjuvant androgen-deprivation therapy alone (median: 8.3 months). Propensity-score matching analysis was also performed to compare its efficacy with that of the cohort receiving prostate-only intensity-modulated radiation therapy (PO-IMRT) with comparable backgrounds.
Results: In total, 47 consecutive patients were analyzed. The distribution of T stage was as follows: T3a in 23 and T3b-4 in 24 cases, respectively. The distribution of Gleason score sum was as follows: 7 in 12, 8 in 17, 9 in 18 cases, respectively. The median pre-treatment prostate-specific antigen was 57.9 ng/mL. The median follow-up period was 10.5 years. The 10-year cancer-specific survival and biochemical failure (BF) rates were 92.2 and 55.7%, respectively. The 10-year cumulative incidence rates of ≥ grade 2 late genitourinary and gastrointestinal toxicities were 32.7 and 10.9%, respectively. No significant difference of BF rates was observed between the WP-SIB-IMRT and PO-IMRT cohorts (p = 0.34).
Conclusions: The WP-SIB-IMRT for LAPCa with an increased risk of pelvic node involvement resulted in excellent survival outcomes with acceptable morbidities, although no significant improvement regarding disease control was observed compared with PO-IMRT in this small cohort study. Further investigations are needed.

キーワード

臓器別:前立腺・男性生殖器

手法別:放射線治療

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