The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy
| Autor: | Rui-Yi Wu, Zhao-Chong Zeng, Bo-Heng Zhang, Lei Xu, Bing Chen, Guomin Wang, Ye-Qing Xu |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Ultrasonic Therapy Urology medicine.medical_treatment Prostate cancer Prostate Humans Medicine Combined Modality Therapy External beam radiotherapy Lymph node Aged business.industry Prostatic Neoplasms General Medicine Prostate-Specific Antigen medicine.disease High-intensity focused ultrasound Surgery Prostate-specific antigen medicine.anatomical_structure Hormonal therapy Original Article Radiology Radiotherapy Conformal business |
| Zdroj: | Asian Journal of Andrology. 13:499-504 |
| ISSN: | 1745-7262 1008-682X |
| DOI: | 10.1038/aja.2010.153 |
| Popis: | The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU+LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU+LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P = 0.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU+LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU+LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU+LRT and CRT were independently associated with DSS (P = 0.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU+LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade ≥ II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU+LRT showed good efficacy and better safety. |
| Databáze: | OpenAIRE |
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