خبرگزاری آیصد (جدیدترین و جذاب ترین اخبار ایران و جهان)

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Clinical Investigation   19  Feb.2014

Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

Nancy P. Mendenhall, MD^∗, Bradford S. Hoppe, MD^∗, Romaine C. Nichols, MD^∗, William M. Mendenhall, MD^∗, Christopher G. Morris, MS^∗, Zuofeng Li, DSc^∗, Zhong Su, PhD^∗, http://dx.doi.org/10.1016/j.ijrobp.2013.11.007

To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer.

Methods and Materials--A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2 years.

Results--Five-year rates of biochemical and clinical freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4 years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4 years for bowel, urinary irritative and/or obstructive, and urinary continence.

Conclusions--Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes.

Summary--Proton therapy (PT) for low-, intermediate-, and high-risk prostate cancer patients is highly effective, minimally toxic, and associated with excellent patient-reported outcomes. PT compares favorably with other contemporary radiation modalities used in treating prostate cancer.

International Journal of Radiation Oncology*Biology*Physics Volume 88, Issue 3, 1 March 2014, Pages 596–602