高危前列腺癌 放射治疗.ppt

Results—Responses were obtained from 3,937/6,003 cases (66%) and 459/1,000 (46%) controls. Twelve years post diagnosis, at a median age of 75 years, the proportion of cases with adverse symptoms was 87% for erectile dysfunction or sexually inactive, 20% for urinary incontinence and 14% for bowel disturbances. The corresponding proportions for controls were 62%, 6% and 7%, respectively. Men with prostate cancer, except those on surveillance, had an increased risk of erectile dysfunction, compared to control men. Radical prostatectomy was associated with an increased risk of urinary incontinence (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.36– 2.62) and radiotherapy increased the risk of bowel dysfunction (OR 2.46, 95% CI 1.73–3.49) compared with men in the control group. Multi-modal treatment, in particular including androgen deprivation therapy (ADT), was associated with the highest risk of adverse effects; for instance radical prostatectomy followed by radiotherapy and ADT was associated with an OR of 3.74 [95 CI 1.76-7.95] for erectile dysfunction and OR 3.22 [95% CI 1.93-5.37] for urinary incontinence. Conclusion—The proportion of men who suffer long-term impact on functional outcomes after prostate cancer treatment was substantial. 这项研究是外照射联合或不联合长期抗雄治疗转移风险高的前列腺癌的EORTC随机研究的10年随访结果，可以看出，与单独治疗相比，诺雷得辅助治疗显著提高患者10年的总生存与无进展生存率 原文标题：外照射联合或不联合长期抗雄治疗转移风险高的前列腺癌：EORTC随机研究10年结果 第一作者：Bolla M (美国) 发表期刊：Lancet Oncology (柳叶刀) 发表时间：2010年 文献性质：临床研究 (EORTC 22863) 研究参与：法国、荷兰、加拿大、瑞士、比利时、以色列、意大利、西班牙、马耳他 该研究为26个中心、前瞻性、随机、开放、对照III期研究；入组年龄80岁，WHO PS 0-2，新诊断组织学确诊为T1-2(WHO组织学分级3)或T3-4(任何组织学分级)前列腺癌的患者415例，随机分为放疗和放疗+即刻抗雄治疗组，主要终点为DFS，次要终点为OS、无远处转移生存、疾病特异性死亡、局部区域失败，中位随访9.1年 Prostate cancer patients with T2c-T4 prostate cancer with no extra pelvic lymph node involvement and prostate-specific antigen (PSA) less than 150 ng/mL were included All patients in this study received flutamide (250 mg three times a day) with goserelin (3.6 mg subcutaneously monthly) until the RT was completed.