Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients with Positive Margins or Extracapsular Extension

医学 前列腺切除术 危险系数 前列腺癌 临床终点 耐受性 泌尿科 不利影响 放射治疗 比例危险模型 内科学 佐剂 随机对照试验 置信区间 癌症 外科
作者
Greetta Hackman,Kimmo Taari,Teuvo L.J. Tammela,Mika Matikainen,Mauri Kouri,Timo Joensuu,Tiina Luukkaala,Arto J. Salonen,Taina Isotalo,Anssi Pétas,Niilo Hendolin,Peter J. Boström,S. Aaltomaa,Kari Lehtoranta,Per M. Hellström,Jarno Riikonen,Merja Korpela,Heikki Minn,Pirkko‐Liisa Kellokumpu‐Lehtinen,­Eero Pukkala
出处
期刊:European Urology [Elsevier BV]
卷期号:76 (5): 586-595 被引量:88
标识
DOI:10.1016/j.eururo.2019.07.001
摘要

It remains unclear whether patients with positive surgical margins or extracapsular extension benefit from adjuvant radiotherapy following radical prostatectomy. To compare the effectiveness and tolerability of adjuvant radiotherapy following radical prostatectomy. This was a randomised, open-label, parallel-group trial. A total of 250 patients were enrolled between April 2004 and October 2012 in eight Finnish hospitals, with pT2 with positive margins or pT3a, pN0, M0 cancer without seminal vesicle invasion. A total of 126 patients received adjuvant radiotherapy at 66.6 Gy. The primary endpoint was biochemical recurrence-free survival, which we analysed using the Kaplan-Meier method and Cox proportional hazard regression. Overall survival, cancer-specific survival, local recurrence, and adverse events were secondary endpoints. The median follow-up time for patients who were alive when the follow-up ended was 9.3 yr in the adjuvant group and 8.6 yr in the observation group. The 10-yr survival for biochemical recurrence was 82% in the adjuvant group and 61% in the observation group (hazard ratio [HR] 0.26 [95% confidence interval {CI} 0.14–0.48], p < 0.001), and for overall survival 92% and 87%, respectively (HR 0.69 [95% CI 0.29–1.60], p = 0.4). Two and four metastatic cancers occurred, respectively. Out of the 43 patients with biochemical recurrence in the observation group, 37 patients received salvage radiotherapy. In the adjuvant group, 56% experienced grade 3 adverse events, versus 40% in the observation group (p = 0.016). Only one grade 4 adverse event occurred (adjuvant group). A limitation of this study was the number of patients. Adjuvant radiotherapy following radical prostatectomy is generally well tolerated and prolongs biochemical recurrence-free survival compared with radical prostatectomy alone in patients with positive margins or extracapsular extension. Radiotherapy given immediately after prostate cancer surgery prolongs prostate-specific antigen progression-free survival, but causes more adverse events, when compared with surgery alone.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
周娅敏发布了新的文献求助10
刚刚
1秒前
1秒前
Ming发布了新的文献求助10
1秒前
1秒前
1秒前
2秒前
aaaa完成签到 ,获得积分10
2秒前
搜集达人应助小灰灰采纳,获得10
2秒前
脑洞疼应助零零落落采纳,获得10
2秒前
Cheney发布了新的文献求助50
2秒前
科研通AI2S应助tochege采纳,获得10
2秒前
彼得兔完成签到,获得积分10
3秒前
3秒前
3秒前
第十二夜关注了科研通微信公众号
3秒前
3秒前
3秒前
桐桐应助要吃烧饼么采纳,获得10
4秒前
镜花水月发布了新的文献求助10
5秒前
tender发布了新的文献求助10
5秒前
5秒前
6秒前
无私追命发布了新的文献求助10
6秒前
即将拥有腹肌的小王完成签到,获得积分10
6秒前
6秒前
Ava应助一团采纳,获得10
6秒前
smottom应助科研通管家采纳,获得10
7秒前
斯文败类应助科研通管家采纳,获得10
7秒前
曲奇饼干完成签到,获得积分10
7秒前
7秒前
7秒前
科研通AI2S应助科研通管家采纳,获得10
7秒前
7秒前
田様应助guard采纳,获得10
7秒前
领导范儿应助科研通管家采纳,获得10
7秒前
8秒前
大个应助科研通管家采纳,获得10
8秒前
彭于晏应助科研通管家采纳,获得10
8秒前
8秒前
高分求助中
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Effective Learning and Mental Wellbeing 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3974463
求助须知:如何正确求助?哪些是违规求助? 3518823
关于积分的说明 11196212
捐赠科研通 3255008
什么是DOI,文献DOI怎么找? 1797655
邀请新用户注册赠送积分活动 877052
科研通“疑难数据库(出版商)”最低求助积分说明 806130