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1
題名:早期攝護腺癌之手術治療與放射治療及其預後因子     (14點)
THE IMPACT OF RADICAL PROSTATECTOMY AND RADIOTHERAPY IN BIOCHEMICAL RELAPSE FOR STAGE T1-T2 PROSTATE CANCER
著者:張國楨(Kuo-Chen Chang) ;張慶雄(Ching-Hsiung Chang) ;胡渝昌(Yu-Chang Hu) ;陳建勳(Chien-Hsun Chen)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:局部攝護腺癌 ; 放射線治療 ; 攝護腺根除性摘除手術 ; 攝護腺特異抗原 ; Local prostate cancer ; Radiotherapy ; Radical prostatecomy ; PSA
刊名:放射治療與腫瘤學
頁碼:1-7
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

且且:以領護據特異抗原( prostate specific antigen , PSA ) ,因溯分析( retrospective analysis) ,比較臨床分期為T 1 一T2 的局部攝讓腺痞,接受放射線治療( radiation therapy ) 與攝護腺根除性摘除手術( radical prostatectomy ) 的治療結果。 姐姐盟主法:從1991 年7 月至2003 年7 月,共有235 位臨床分期為T1 - 'T2 的早期攝證腺癌 病人,在本院接受放射線治療或攝護腺根除性摘除( radical prostatectomy ) 治療。所有的病人都 有治療前的血中PSA 濃度、切片的格里森分數( Gleason score ) 、治療前的貨商蔓治療不超過六 個月,局部治療後沒看再給予其他的輔助治療。共有119 位( 50.6% ) 接受徹底根除手術,手術 後邊緣有殘餘病社者不列入本研究的對象;接受體外放射線治療劑量小於70 Gy 者共有52 位 (22.1%) 大於等於70 Gy 者共有38 位(16.2% )體外放射線治療合併近接治療者共有19 位 (8.1%) 另外有7 位( 3%) 接受經展道攝E蓋臉切除手術後加體外放射線治療。放射線治療劑量 小於70 Gy 與大於70 Gy 的中值劑量分別是65.6 Gy 及70.2 Gy 。所有病人的中值追蹤時間為 41.9 個月。PSA{直可作為對治療反應的指標,治療後PSA 值多會下降,如果不正常的升高,有 可能局部復發或疾病惡化(disease progression) 。臨床上都以PSA 值判斷攝護腺瘖預後之好縷 或治療後追蹤檢查疾病有無持續存在( persistent disease )或復發(relapse) 。 本研究是以臨床T 分期、治療前的血中PSA 濃度、Gleason 分敏、治療模式等變數對生化性無復發存活率( biochemical relapse free survival, bRFS ) ,作多項變數分析。 益是:手術與放射線治療的5 年bRFS (5周year biochemical relapse free survival )分別是53 . 5%與59.0% ' 7 年bRFS 分別是21.3%與45.0% '多變數分析顯示手術前的血中PSA 濃度( p =0.029 )與Gleason 分數(p = 0.006) 是獨立的復發預後因子,治療模式(p = 0.25) 與隘床T分期(p = 0.53) 不是PSA 復發的獨立預後因子。 益益T 1 - T2 的局部攝護腺瘡,與根除性摘除手f相比較,放射線治療也有相當的治療結果, 對於PSA 復發的影響沒有統計上的意義。
Purpose: This retrospective analysis reviewed the biochemical relapse free survival rates after treatment with radiotherapy or radical prostatectomy (RP) for clinical stage T1-T2 localized prostate cancer. Methods and Materials: The study population comprised 235 patients treated at either Urology section or Radiation Oncology section in our institution. All patients had pretreatment prostate-specific antigen (iPSA) levels and biopsy Gleason scores (bGSs) Neoadjuvant androgen block treatment was given for less than 6 months. No adjuvant therapy was given after local therapy. 119 patients (50.6%) had undergone radical prostacteomy (RP). 52 patients (22.1%) received EBRT < 70 Gy, 38 patients (16.2%) received EBRT ~ 70 Gy, 7 patients (3%) were treated with post TURP radiotherapy and combined interstitial and radiotherapy was delivered for 19 patients (8.1 %). Only patients with free surgical margin were enrolled in the group of RP. The median radiation doses in EBRT < 70 Gy and EBRT ~ 70 Gy was 65.6 Gy and 70.2 Gy, respectively. The median follow-up time for all patients was 41.9 months. Biochemical relapse was defined as two consecutive PSA > 0.2 ng/ml for RP and three consecutive rising PSA levels (American Society for Therapeutic Radiology Oncology consensus definition) for all other cases. Cox regression multivariate analysis was performed using clinical T stage, bGS, iPSA and treatment modality. Results: The 5-year bRFS (biological relapse free survival) for RP and radiotherapy was 53.5% and 59% respectively. The 7-year bRFS for RP and radiotherapy was 21.3% and 45% respectively. Multivariate analysis showed iPSA (p =0.029) and bGS (p =0.006) to be independent predictors of relapse. Treatment modality and clinical T stage were not independent predictors of relapse. Conclusion: There was no significant difference between RP and radiotherapy in the view of biochemical relapse for stage T1-T2 prostate cancer


    

本卷期目次
放射治療與腫瘤學
強度調控放射治療(IMRT)的簡化蒙地卡羅模擬/ 許任玓陳俊丞葉健一李宗其徐椿壽張栢菁
早期攝護腺癌之手術治療與放射治療及其預後因子/ 張國楨張慶雄胡渝昌陳建勳
Treatment Outcomes for Epidermoid Carcinoma of the Anal Canal in a Single Institution/ Yen-Chao ChenNagn-Ming TsangFu-Ti ChangJi-Hong Hong
Treatment Results of Chemotherapy and Radiotherapy in Limited-Stage Small Cell Lung Cancer/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao ChangAi-Yih WangChao-Yuan Huang
Radiotherapy for Squamous Cell Carcinoma of the Maxillary Sinus/ Y. C. Jeffrey ChaoJian-Sheng JanJin-Ching Lin
Radiotherapy for the Treatment of Giant Cell Tumor of the Spine: A Report of 3 Cases and Review of the Literature/ Jenny QueChen-Hsing KaoTsung-Chia TsaiLi-Ching LinKuei-Li LinForn-Chia Lin
放射治療之惡性腦瘤患者接受另類療法與食物觀念的調查分析/ 陳玉萍曾振淦陳美伶洪志宏曾雁明李弘暉
Surgery Followed by Concurrent Chemoradiation with Weekly Cisplatin and Adjuvant Systemic Chemotherapy for Locally Advanced Esophageal Cancer-A Pilot Study/ Kuo-Hwa ChangShih-Kai HungHung-Chang LiuCharng-Jer HuangYuen-Liang LaiYu-Jen Chen
早期攝護腺癌之手術治療與放射治療及其預後因子/ 張國楨張慶雄胡渝昌陳建勳
TREATMENT OUTCOMES FOR EPIDERMOID CARCINOMA OF THE ANAL CANAL IN A SINGLE INSTITUTION/ Yen-Chao ChenNagn-Ming TsangFu-Ti ChangJi-Hong Hong
TREATMENT RESULTS OF CHEMOTHERAPY AND RADIOTHERAPY IN LIMITED-STAGE SMALL CELL LUNG CANCER/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao ChangAi-Yih WangChao-Yuan Huang
RADIOTHERAPY FOR SQUAMOUS CELL CARCINOMA OF THE MAXILLARY SINUS/ Y. C. Jeffrey ChaoJian-Sheng JanJin-Ching Lin
強度調控放射治療(IMRT)的簡化蒙地卡羅模擬/ 許任玓陳俊丞葉健一李宗其徐椿壽張?菁
放射治療之惡性腦瘤患者接受另類療法與食物觀念的調查分析/ 陳玉萍曾振淦陳美伶洪志宏曾雁明李弘暉
RADIOTHERAPY FOR THE TREATMENT OF GIANT CELL TUMOR OF THE SPINE: A REPORT OF 3 CASES AND REVIEW OF THE LITERATURE/ Jenny QueCheng-Hsing KaoTsung-Chia TsaiLi-Ching LinKuei-Li LinForn-Chia Lin
SURGERY FOLLOWED BY CONCURRENT CHEMORADIATION WITH WEEKLY CISPLATIN AND ADJUVANT SYSTEMIC CHEMOTHERAPY FOR LOCALLY ADVANCED ESOPHAGEAL CANCER-A PILOT STUDY/ Kuo-Hwa ChangShih-Kai HungHung-Chang LiuCharng-Jer HuangYuen-Liang LaiYu-Jen Chen
 
   
 
   

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