期刊
JOURNAL OF UROLOGY
卷 181, 期 3, 页码 956-962出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.juro.2008.11.032
关键词
prostatic neoplasms; radiotherapy; prostate-specific antigen; neoplasm metastasis
资金
- Public Health Service Cooperative Agreement grants
- National Cancer Institute, Department of Health and Human Services [CA38926, CA32102, CA14028, CA58416, CA58658, CA42777, CA27057, CA46136, CA35431, CA58882, CA12644, CA58861, CA35090, CA37981, CA76429, CA04919, CA76132, CA35119, CA35178, CA35176, CA46282, CA67575, CA45377, CA46113, CA74647, CA35261, CA049020, CA20319, CA76447, CA58723, CA12213, CA22433, CA46441]
- National Cancer Institute of Canada [PFI-2]
Purpose: Extraprostatic disease will be manifest in a third of men after radical prostatectomy. We present the long-term followup of a randomized clinical trial of radiotherapy to reduce the risk of subsequent metastatic disease and death. Materials and Methods: A total of 431 men with pT3N0M0 prostate cancer were randomized to 60 to 64 Gy adjuvant radiotherapy or observation. The primary study end point was metastasis-free survival. Results: Of 425 eligible men 211 were randomized to observation and 214 to adjuvant radiation. Of those men under observation 70 ultimately received radiotherapy. Metastasis-free survival was significantly greater with radiotherapy (93 of 214 events on the radiotherapy arm vs 114 of 211 events on observation; HR 0.71; 95% CI 0.54, 0.94; p = 0.016). Survival improved significantly with adjuvant radiation (88 deaths of 214 on the radiotherapy arm vs 110 deaths of 211 on observation; HR 0.72; 95% CI 0.55, 0.96; p = 0.023). Conclusions: Adjuvant radiotherapy after radical prostatectomy for a man with pT3NOMO prostate cancer significantly reduces the risk of metastasis and increases survival.
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