Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose

Detalhes bibliográficos
Autor(a) principal: Castro, Douglas Guedes De
Data de Publicação: 2004
Outros Autores: Pellizzon, Antônio Cássio Assis, Chen, Michael Jenwei, Nishimoto, Inês Nobuko, Maia, Maria Aparecida Conte, Novaes, Paulo Eduardo Ribeiro Dos Santos, Fogaroli, Ricardo César, Ferrigno, Robson, Salvajoli, João Victor [UNIFESP]
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0100-39842004000400009
http://repositorio.unifesp.br/handle/11600/2163
Resumo: OBJECTIVE: To compare the biochemical response in patients with locally advanced prostate cancer treated with external beam radiation therapy alone or in combination with conformal brachytherapy boost. MATERIALS AND METHODS: From November 1997 to January 2000, 74 patients received 45 Gy of pelvic external irradiation and four were treated with high dose rate iridium-192 conformal boost implants of 4 Gy each (BT). These were compared with 29 other patients treated with 45 Gy of pelvic external irradiation followed by a 24 Gy of bilateral ARC boost (RT) from October 1996 to February 2000. Some patients received neoadjuvant androgen deprivation therapy. Three-year actuarial biochemical control rates (BC3) and pretreatment biochemical response predictors such as prostate-specific antigen pretreatment (PSAi), Gleason score (GS) and clinical stage (CS), were evaluated. RESULTS: Median follow-up was of 25 months for the RT group and 37 months for the BT group. BC3 was 51% versus 73% (p = 0.032) for RT and BT, respectively. Comparisons of biochemical control by treatment group stratified by PSAi showed that BC3 for RT versus BT was 85.7% versus 79.1% (p = 0.76) for PSAi < 10 ng/mL and 38% versus 68% (p = 0.023) for PSAi > 10 ng/mL, respectively. For patients with GS < 6, BC3 was 37% versus 80% (p = 0.001) for RT versus BT and, for patients with GS > 6, BC3 was 78% versus 55% (p = 0.58) for RT versus BT, respectively. For patients with CS < T2a, BC3 was 36% versus 74% (p = 0.018) for RT versus BT and, for patients with CS > T2a, BC3 was 73% versus 69% (p = 0.692) for RT versus BT, respectively. The relative risk of biochemical relapse was 2.3 (95% IC: 1.0-5.1) for patients in RT group compared to the BT group. When adjusted for PSAi and GS, the relative risk of biochemical relapse was 2.4 (95% IC: 1.0-5.7). CONCLUSION: The treatment modality was an independent prognostic factor for biochemical relapse, with a significant improvement in the biochemical control with BT. These early results suggest that this treatment was most beneficial in patients with PSAi > 10 ng/mL, CS < T2a and GS < 6.
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spelling Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de doseEvaluation of biochemical response on early prostate cancer: comparison between treatment with external beam radiation alone and in combination with high-dose rate conformal brachytherapy boostProstate cancerRadiotherapyHigh dose rate brachytherapyCâncer de próstataRadioterapiaBraquiterapia de alta taxa de doseOBJECTIVE: To compare the biochemical response in patients with locally advanced prostate cancer treated with external beam radiation therapy alone or in combination with conformal brachytherapy boost. MATERIALS AND METHODS: From November 1997 to January 2000, 74 patients received 45 Gy of pelvic external irradiation and four were treated with high dose rate iridium-192 conformal boost implants of 4 Gy each (BT). These were compared with 29 other patients treated with 45 Gy of pelvic external irradiation followed by a 24 Gy of bilateral ARC boost (RT) from October 1996 to February 2000. Some patients received neoadjuvant androgen deprivation therapy. Three-year actuarial biochemical control rates (BC3) and pretreatment biochemical response predictors such as prostate-specific antigen pretreatment (PSAi), Gleason score (GS) and clinical stage (CS), were evaluated. RESULTS: Median follow-up was of 25 months for the RT group and 37 months for the BT group. BC3 was 51% versus 73% (p = 0.032) for RT and BT, respectively. Comparisons of biochemical control by treatment group stratified by PSAi showed that BC3 for RT versus BT was 85.7% versus 79.1% (p = 0.76) for PSAi < 10 ng/mL and 38% versus 68% (p = 0.023) for PSAi > 10 ng/mL, respectively. For patients with GS < 6, BC3 was 37% versus 80% (p = 0.001) for RT versus BT and, for patients with GS > 6, BC3 was 78% versus 55% (p = 0.58) for RT versus BT, respectively. For patients with CS < T2a, BC3 was 36% versus 74% (p = 0.018) for RT versus BT and, for patients with CS > T2a, BC3 was 73% versus 69% (p = 0.692) for RT versus BT, respectively. The relative risk of biochemical relapse was 2.3 (95% IC: 1.0-5.1) for patients in RT group compared to the BT group. When adjusted for PSAi and GS, the relative risk of biochemical relapse was 2.4 (95% IC: 1.0-5.7). CONCLUSION: The treatment modality was an independent prognostic factor for biochemical relapse, with a significant improvement in the biochemical control with BT. These early results suggest that this treatment was most beneficial in patients with PSAi > 10 ng/mL, CS < T2a and GS < 6.OBJETIVO: Análise comparativa da resposta bioquímica em pacientes submetidos à teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose para tumores localizados da próstata. MATERIAIS E MÉTODOS: De novembro de 1997 a janeiro de 2000, 74 pacientes foram submetidos à teleterapia com 45 Gy e reforço com braquiterapia de alta taxa de dose com irídio-192 e dose de 16 Gy em quatro inserções (BT). Estes foram comparados a 29 pacientes submetidos à teleterapia com 45 Gy e reforço com arcoterapia e dose mediana de 24 Gy (RT) entre outubro de 1996 e fevereiro de 2000. Nos dois grupos houve associação ocasional de hormonioterapia neoadjuvante. Sobrevida atuarial livre de doença em três anos (SB3) e fatores prognósticos pré-tratamento da resposta bioquímica, como o antígeno prostático-específico inicial (PSAi), escore de Gleason da biópsia de próstata (EG) e estádio clínico (EC), foram analisados. RESULTADOS: O seguimento mediano foi de 25 meses para o grupo RT e 37 meses para o BT. Na análise atuarial, a SB3 foi de 51% e 73% (p = 0,032) para RT e BT, respectivamente. Na análise estratificada pelo PSAi, a SB3 para RT e BT foi de 85,7% e 79,1% (p = 0,76) para PSAi < 10 ng/mL e de 38% e 68% (p = 0,023) para PSAi > 10 ng/mL, respectivamente. Quando estratificado pelo EG, a SB3 para RT e BT foi de 37% e 80% (p = 0,001) para EG < 6 e 78% e 55% para EG > 6 (p = 0,58); estratificando-se pelo EC, a SB3 para RT e BT foi de 36% e 74% (p = 0,018) para EC < T2a e 73% e 69% para EC > T2a (p = 0,692), respectivamente. O risco relativo bruto de recidiva bioquímica foi de 2,3 (95% IC: 1,0-5,1) para os pacientes tratados com RT, em relação à BT; quando ajustado pelo PSAi e EG, o risco relativo de recidiva bioquímica foi de 2,4 (95% IC: 1,0-5,7). CONCLUSÃO: A modalidade de tratamento foi fator prognóstico independente de recidiva bioquímica, com maior controle bioquímico associado à BT. Nossos resultados preliminares sugerem que o maior benefício com BT foi obtido nos pacientes com PSAi > 10 ng/mL, EC < T2a e EG < 6.Hospital do Câncer A.C. Camargo Departamento de RadioterapiaUniversidade de São PauloHospital do Câncer A.C. Camargo Centro de EstudosUniversidade Metodista de Santos Faculdade de MedicinaHospital do Câncer A.C. CamargoUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaFaculdade de Medicina de MaríliaUNIFESP, EPMSciELOColégio Brasileiro de Radiologia e Diagnóstico por ImagemHospital do Câncer A.C. Camargo Departamento de RadioterapiaUniversidade de São Paulo (USP)Hospital do Câncer A.C. Camargo Centro de EstudosUniversidade Metodista de Santos Faculdade de MedicinaHospital do Câncer A.C. CamargoUniversidade Federal de São Paulo (UNIFESP)Faculdade de Medicina de MaríliaCastro, Douglas Guedes DePellizzon, Antônio Cássio AssisChen, Michael JenweiNishimoto, Inês NobukoMaia, Maria Aparecida ConteNovaes, Paulo Eduardo Ribeiro Dos SantosFogaroli, Ricardo CésarFerrigno, RobsonSalvajoli, João Victor [UNIFESP]2015-06-14T13:31:12Z2015-06-14T13:31:12Z2004-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion265-269application/pdfhttp://dx.doi.org/10.1590/S0100-39842004000400009Radiologia Brasileira. Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, v. 37, n. 4, p. 265-269, 2004.10.1590/S0100-39842004000400009S0100-39842004000400009.pdf0100-3984S0100-39842004000400009http://repositorio.unifesp.br/handle/11600/2163porRadiologia Brasileirainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T07:18:00Zoai:repositorio.unifesp.br/:11600/2163Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-28T07:18Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
Evaluation of biochemical response on early prostate cancer: comparison between treatment with external beam radiation alone and in combination with high-dose rate conformal brachytherapy boost
title Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
spellingShingle Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
Castro, Douglas Guedes De
Prostate cancer
Radiotherapy
High dose rate brachytherapy
Câncer de próstata
Radioterapia
Braquiterapia de alta taxa de dose
title_short Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
title_full Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
title_fullStr Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
title_full_unstemmed Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
title_sort Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
author Castro, Douglas Guedes De
author_facet Castro, Douglas Guedes De
Pellizzon, Antônio Cássio Assis
Chen, Michael Jenwei
Nishimoto, Inês Nobuko
Maia, Maria Aparecida Conte
Novaes, Paulo Eduardo Ribeiro Dos Santos
Fogaroli, Ricardo César
Ferrigno, Robson
Salvajoli, João Victor [UNIFESP]
author_role author
author2 Pellizzon, Antônio Cássio Assis
Chen, Michael Jenwei
Nishimoto, Inês Nobuko
Maia, Maria Aparecida Conte
Novaes, Paulo Eduardo Ribeiro Dos Santos
Fogaroli, Ricardo César
Ferrigno, Robson
Salvajoli, João Victor [UNIFESP]
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Hospital do Câncer A.C. Camargo Departamento de Radioterapia
Universidade de São Paulo (USP)
Hospital do Câncer A.C. Camargo Centro de Estudos
Universidade Metodista de Santos Faculdade de Medicina
Hospital do Câncer A.C. Camargo
Universidade Federal de São Paulo (UNIFESP)
Faculdade de Medicina de Marília
dc.contributor.author.fl_str_mv Castro, Douglas Guedes De
Pellizzon, Antônio Cássio Assis
Chen, Michael Jenwei
Nishimoto, Inês Nobuko
Maia, Maria Aparecida Conte
Novaes, Paulo Eduardo Ribeiro Dos Santos
Fogaroli, Ricardo César
Ferrigno, Robson
Salvajoli, João Victor [UNIFESP]
dc.subject.por.fl_str_mv Prostate cancer
Radiotherapy
High dose rate brachytherapy
Câncer de próstata
Radioterapia
Braquiterapia de alta taxa de dose
topic Prostate cancer
Radiotherapy
High dose rate brachytherapy
Câncer de próstata
Radioterapia
Braquiterapia de alta taxa de dose
description OBJECTIVE: To compare the biochemical response in patients with locally advanced prostate cancer treated with external beam radiation therapy alone or in combination with conformal brachytherapy boost. MATERIALS AND METHODS: From November 1997 to January 2000, 74 patients received 45 Gy of pelvic external irradiation and four were treated with high dose rate iridium-192 conformal boost implants of 4 Gy each (BT). These were compared with 29 other patients treated with 45 Gy of pelvic external irradiation followed by a 24 Gy of bilateral ARC boost (RT) from October 1996 to February 2000. Some patients received neoadjuvant androgen deprivation therapy. Three-year actuarial biochemical control rates (BC3) and pretreatment biochemical response predictors such as prostate-specific antigen pretreatment (PSAi), Gleason score (GS) and clinical stage (CS), were evaluated. RESULTS: Median follow-up was of 25 months for the RT group and 37 months for the BT group. BC3 was 51% versus 73% (p = 0.032) for RT and BT, respectively. Comparisons of biochemical control by treatment group stratified by PSAi showed that BC3 for RT versus BT was 85.7% versus 79.1% (p = 0.76) for PSAi < 10 ng/mL and 38% versus 68% (p = 0.023) for PSAi > 10 ng/mL, respectively. For patients with GS < 6, BC3 was 37% versus 80% (p = 0.001) for RT versus BT and, for patients with GS > 6, BC3 was 78% versus 55% (p = 0.58) for RT versus BT, respectively. For patients with CS < T2a, BC3 was 36% versus 74% (p = 0.018) for RT versus BT and, for patients with CS > T2a, BC3 was 73% versus 69% (p = 0.692) for RT versus BT, respectively. The relative risk of biochemical relapse was 2.3 (95% IC: 1.0-5.1) for patients in RT group compared to the BT group. When adjusted for PSAi and GS, the relative risk of biochemical relapse was 2.4 (95% IC: 1.0-5.7). CONCLUSION: The treatment modality was an independent prognostic factor for biochemical relapse, with a significant improvement in the biochemical control with BT. These early results suggest that this treatment was most beneficial in patients with PSAi > 10 ng/mL, CS < T2a and GS < 6.
publishDate 2004
dc.date.none.fl_str_mv 2004-08-01
2015-06-14T13:31:12Z
2015-06-14T13:31:12Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0100-39842004000400009
Radiologia Brasileira. Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, v. 37, n. 4, p. 265-269, 2004.
10.1590/S0100-39842004000400009
S0100-39842004000400009.pdf
0100-3984
S0100-39842004000400009
http://repositorio.unifesp.br/handle/11600/2163
url http://dx.doi.org/10.1590/S0100-39842004000400009
http://repositorio.unifesp.br/handle/11600/2163
identifier_str_mv Radiologia Brasileira. Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, v. 37, n. 4, p. 265-269, 2004.
10.1590/S0100-39842004000400009
S0100-39842004000400009.pdf
0100-3984
S0100-39842004000400009
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv Radiologia Brasileira
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 265-269
application/pdf
dc.publisher.none.fl_str_mv Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
publisher.none.fl_str_mv Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
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collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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