글로벌 연구동향
방사선종양학
- 2018년 12월호
[Anticancer Res.] Patterns of Recurrence After Salvage Radiotherapy Encompassing Pelvic Lymphatics in Men with High-risk Prostate Cancer.울산의대 / 고민지, 김영석*
- 출처
- Anticancer Res.
- 등재일
- 2018 Nov
- 저널이슈번호
- 38(11):6579-6584. doi: 10.21873/anticanres.13025.
- 내용
Abstract
BACKGROUND/AIM:
The efficacy of adjuvant or salvage radiation to the regional lymph node area has not been fully investigated in high-risk prostate cancer patients; instead, radiotherapy is limited to the prostate fossa. The present study aimed to assess patterns of recurrence in prostate cancer patients with biochemical failure (BCF) who were treated with whole-pelvic salvage radiotherapy (SRT) following radical prostatectomy.PATIENTS AND METHODS:
The clinical data from 196 high-risk prostate cancer patients who received SRT for BCF after radical prostatectomy were reviewed. BCF after SRT was detected in 80 patients, and 59 patients underwent imaging studies.RESULTS:
Twenty four recurrences in 16 patients were identified, including 13 bone metastases, 6 vesicourethral anastomosis site recurrences, and 5 lymph node recurrences (one simultaneous with vesicourethral anastomosis). Regarding the treatment field, no in-field nodal recurrence was observed, whereas 4 out-of-field and 1 edge-of-field recurrences were detected.CONCLUSION:
Locoregional recurrence was most common at the anastomosis site. Most nodal recurrences were located outside the pelvis, suggesting that elective pelvic nodal irradiation should be recommended in a selected patient population.
Author informationKoh M1, Kim YS2, Ahn H3, Kim CS3.
1
Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
2
Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea ysk@amc.seoul.kr.
3
Department of Urology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
- 키워드
- Prostate cancer; pattern of failure; pelvic nodal irradiation; salvage radiotherapy
- 연구소개
- 전립선암으로 수술을 받는 환자들 중 1/4 이상에서 PSA가 상승하는 생화학적 재발을 보임. 이들에게 유일한 근치적 치료인 구제 방사선치료를 시행하고 있으며, 현재 표준은 전립선 수술부위에만 방사선치료를 하는 것임. 연구자들은 고위험군 전립선암환자들에게서 구제 방사선치료 시 전립선 수술부위 뿐만 아니라 골반 림프절을 포함하였음. 이에 따라 치료 부위 내 림프절 전이는 관찰되지 않았으며, 치료 부위 주변 또는 밖에서 림프절 전이가 관찰됨. 골전이를 제외하고는 요도 문합부에서 재발이 많았는데, 이는 방사선조사 선량을 증가해야 함을 시사함. 본 연구 결과는 향후 방사선치료 범위를 결정할 때 고려해야할 사항이며, 전향적 연구를 통해 결과를 확인할 필요가 있음.
- 덧글달기
- 이전글 [Radiat Oncol.] Long-term results and PSA kinetics after robotic SBRT for prostate cancer: multicenter retrospective study in Korea (Korean radiation oncology group study 15-01).
- 다음글 [PLoS One.] Combined therapy of transarterial chemoembolization and stereotactic body radiation therapy versus transarterial chemoembolization for ≤5cm hepatocellular carcinoma: Propensity score matching analysis.