Randomized trial comparing cryoablation and external beam radiotherapy for T2C-T3B prostate cancer

被引:34
作者
Chin, J. L. [1 ]
Ng, C-K [1 ]
Touma, N. J. [1 ]
Pus, N. J. [1 ]
Hardie, R. [1 ]
Abdelhady, M. [1 ]
Rodrigues, G. [2 ]
Radwan, J. [2 ]
Venkatesan, V. [2 ]
Moussa, M. [3 ]
Downey, D. B. [4 ]
Bauman, G. [3 ]
机构
[1] Univ Western Ontario, London Hlth Sci Ctr, Div Urol, Dept Surg, London, ON N6A 4G5, Canada
[2] Univ Western Ontario, London Hlth Sci Ctr, Div Radiat, Dept Oncol, London, ON N6A 4G5, Canada
[3] Univ Western Ontario, London Hlth Sci Ctr, Dept Pathol, London, ON N6A 4G5, Canada
[4] Univ Western Ontario, London Hlth Sci Ctr, Dept Diagnost Radiol, London, ON N6A 4G5, Canada
关键词
cryoablation; T3 prostate cancer; external beam radiotherapy; randomized clinical trial;
D O I
10.1038/sj.pcan.4500988
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
The objective was to evaluate the relative efficacy of cryoablation ( CRYO) versus external beam radiation ( EBRT) for clinically locally advanced prostate cancer in a randomized clinical trial. Patients with histologically proven, clinically staged as T2C, T3A or T3B disease were randomized with 6 months of perioperative hormone therapy to one of the two procedures. Owing largely to a shift in practice to longer term adjuvant hormonal therapy and higher doses of radiation for T3 disease, only 64 out of the planned 150 patients were accrued. Twenty-one of 33 ( 64%) in the CRYO group and 14 of 31 ( 45%) in the EBRT-treated group who had met the ASTRO definition of failure were also classified as treatment failure. The mean biochemical disease-free survival ( bDFS) was 41 months for the EBRT group compared to 28 months for the CRYO group. The 4-year bDFS for EBRT and CRYO groups were 47 and 13%, respectively. Disease-specific survival ( DSS) and overall survival ( OS) for both groups were very similar. Serious complications were uncommon in either group. EBRT patients exhibited gastrointestinal ( GI) adverse effects more frequently. Taking into account the relative deficiency in numbers and the original trial design, this prospective randomized trial indicated that the results of CRYO were less favorable compared to those of EBRT, and was suboptimal primary therapy in locally advanced prostate cancer.
引用
收藏
页码:40 / 45
页数:6
相关论文
共 22 条
[1]
Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer [J].
Bahn, DK ;
Lee, F ;
Badalament, R ;
Kumar, A ;
Greski, J ;
Chernick, M .
UROLOGY, 2002, 60 (2A) :3-11
[2]
Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial [J].
Bolla, M ;
Collette, L ;
Blank, L ;
Warde, P ;
Dubois, JB ;
Mirimanoff, RO ;
Storme, G ;
Bernier, J ;
Kuten, A ;
Sternberg, C ;
Mattelaer, J ;
Torecilla, JL ;
Pfeffer, JR ;
Cutajar, CL ;
Zurlo, A ;
Pierart, M .
LANCET, 2002, 360 (9327) :103-108
[3]
Chin J L, 1996, Tech Urol, V2, P187
[4]
Results of salvage cryoablation of the prostate after radiation: Identifying predictors of treatment failure and complications [J].
Chin, JL ;
Pautler, SE ;
Mouraviev, V ;
Touma, N ;
Moore, K ;
Downey, DB .
JOURNAL OF UROLOGY, 2001, 165 (06) :1937-1941
[5]
Three-dimensional transrectal ultrasound guided cryoablation for localized prostate cancer in nonsurgical candidates: A feasibility study and report of early results [J].
Chin, JL ;
Downey, DB ;
Mulligan, M ;
Fenster, A .
JOURNAL OF UROLOGY, 1998, 159 (03) :910-914
[6]
Cox JD, 1997, INT J RADIAT ONCOL, V37, P1035
[7]
Prospective trial of cryosurgical ablation of the prostate: Five-year results [J].
Donnelly, BJ ;
Saliken, JC ;
Ernst, DS ;
Ali-Ridha, N ;
Brasher, PMA ;
Robinson, JW ;
Rewcastle, JC .
UROLOGY, 2002, 60 (04) :645-649
[8]
Cryosurgery as primary treatment for localized prostate cancer: A community hospital experience [J].
Ellis, DS .
UROLOGY, 2002, 60 (2A) :34-39
[9]
PERINEAL CRYOSURGERY FOR PROSTATIC CARCINOMA [J].
FLOCKS, RH ;
BOATMAN, DL ;
NELSON, CMK .
JOURNAL OF UROLOGY, 1972, 108 (06) :933-&
[10]
Treatment of organ confined prostate cancer with third generation cryosurgery: Preliminary multicenter experience [J].
Han, KR ;
Cohen, JK ;
Miller, RJ ;
Pantuck, AJ ;
Freitas, DG ;
Cuevas, CA ;
Kim, HL ;
Lugg, J ;
Childs, SJ ;
Shuman, B ;
Jayson, MA ;
Shore, ND ;
Moore, Y ;
Zisman, A ;
Lee, JY ;
Ugarte, R ;
Mynderse, LA ;
Wilson, TM ;
Sweat, SD ;
Zincke, H ;
Belldegrun, AS .
JOURNAL OF UROLOGY, 2003, 170 (04) :1126-1130