Scholarlink

Purpose <p>This study aimed to evaluate the prognostic significance of magnetic resonance imaging (MRI) parameters on biochemical failure-free survival (BFS) in patients diagnosed with intermediate-risk prostate cancer and treated with robotic ultrahypofractionated stereotactic body radiotherapy (SBRT) without androgen deprivation therapy (ADT).</p> Methods <p>A&#xa0;retrospective analysis was conducted in patients with intermediate-risk prostate cancer undergoing robotic SBRT delivered in five fractions with a&#xa0;total radiation dose of 35–36.25 Gy. The primary endpoint was biochemical failure as defined by the Phoenix criteria. Among other clinicopathological data, T&#xa0;stage, Prostate Imaging-Reporting and Data System (PI-RADS) score, and multiparametric magnetic resonance imaging-based extra-prostatic extension (mEPE) score were collected and analyzed using the log-rank test.</p> Results <p>A&#xa0;total of 74&#xa0;patients were eligible for analysis. Median age at treatment was 68.8 years and median prostate volume was 47.8&#xa0;cm<sup>3</sup>. Fifty-four and 14&#xa0;patients were diagnosed with Gleason scores 7a and 7b, respectively. In total, 40&#xa0;patients were classified as having unfavorable intermediate-risk prostate cancer according to American Urological Association/American Society for Radiation Oncology/ Society of Urologic Oncology (AUA/ASTRO/SUO) guidelines. The median follow-up was 30&#xa0;months (range: 4–91.2 months; interquartile range (IQR): 18.5–48&#xa0;months). The 3‑year BFS was 92%. A&#xa0;total of 12&#xa0;(16.2%) biochemical failures were reported. In univariate analysis, an mEPE score of 5, the delivered total radiation dose (35 Gy vs. 36.25 Gy), and a&#xa0;prostate-specific antigen (PSA) nadir &gt;1 ng/ml were associated with lower BFS (mEPE–BFS: <i>p</i> &lt; 0.001, total radiation dose–BFS: <i>p</i> = 0.04, PSA&#xa0;nadir–BFS: <i>p</i> =&lt; 0.001).</p> Conclusion <p>Patients diagnosed with intermediate-risk prostate cancer with a&#xa0;high mEPE score are more likely to experience biochemical failure after SBRT. Treatment intensification measures, such as administration of concomitant ADT, should be considered.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prognostic significance of the mEPE score in intermediate-risk prostate cancer patients undergoing ultrahypofractionated robotic SBRT

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年1月14日

查看全文
  • Lucas Mose,
  • Laura Isabel Loebelenz,
  • Alexander Althaus,
  • Maiwand Ahmadsei,
  • Etienne Mathier,
  • Isabelle Broemel,
  • Daniel M. Aebersold,
  • Verena Carola Obmann,
  • Mohamed Shelan

摘要

Purpose

This study aimed to evaluate the prognostic significance of magnetic resonance imaging (MRI) parameters on biochemical failure-free survival (BFS) in patients diagnosed with intermediate-risk prostate cancer and treated with robotic ultrahypofractionated stereotactic body radiotherapy (SBRT) without androgen deprivation therapy (ADT).

Methods

A retrospective analysis was conducted in patients with intermediate-risk prostate cancer undergoing robotic SBRT delivered in five fractions with a total radiation dose of 35–36.25 Gy. The primary endpoint was biochemical failure as defined by the Phoenix criteria. Among other clinicopathological data, T stage, Prostate Imaging-Reporting and Data System (PI-RADS) score, and multiparametric magnetic resonance imaging-based extra-prostatic extension (mEPE) score were collected and analyzed using the log-rank test.

Results

A total of 74 patients were eligible for analysis. Median age at treatment was 68.8 years and median prostate volume was 47.8 cm3. Fifty-four and 14 patients were diagnosed with Gleason scores 7a and 7b, respectively. In total, 40 patients were classified as having unfavorable intermediate-risk prostate cancer according to American Urological Association/American Society for Radiation Oncology/ Society of Urologic Oncology (AUA/ASTRO/SUO) guidelines. The median follow-up was 30 months (range: 4–91.2 months; interquartile range (IQR): 18.5–48 months). The 3‑year BFS was 92%. A total of 12 (16.2%) biochemical failures were reported. In univariate analysis, an mEPE score of 5, the delivered total radiation dose (35 Gy vs. 36.25 Gy), and a prostate-specific antigen (PSA) nadir >1 ng/ml were associated with lower BFS (mEPE–BFS: p < 0.001, total radiation dose–BFS: p = 0.04, PSA nadir–BFS: p =< 0.001).

Conclusion

Patients diagnosed with intermediate-risk prostate cancer with a high mEPE score are more likely to experience biochemical failure after SBRT. Treatment intensification measures, such as administration of concomitant ADT, should be considered.