Irradiación posprostatectomía del cáncer de próstata
Un análisis preliminar
Palabras clave:
NEOPLASMAS DE PRÓSTATA, PROSTATECTOMÍA
Resumen
Se estudiaron los resultados de la irradiación posprostatectomía radical por cáncer de próstata. Se analizaron 62 pacientes consecutivos tratados entre 1994 y 2002. Veinte pacientes fueron irradiados en forma adyuvante por presentar factores de riesgo elevado de recidiva local posoperatoria, y 42 por recaídas bioquímicas luego de la cirugía (17 de ellos presentaban una recidiva palpable en la pelvis). La sobrevida actuarial libre de recaída bioquímica, la sobrevida causa específica y la sobrevida global a los cinco años luego de la irradiación fueron 90%, 100% y 100% para pacientes tratados con radioterapia adyuvante, y 45%, 97% y 95% para los pacientes tratados con radioterapia de rescate, respectivamente. En estos últimos, cuando no se empleó hormonoterapia asociada, la comprobación de descenso del nivel de antígeno protático específico (PSA) a los 50 Gy orienta hacia un mejor control bioquímico. Las complicaciones tardías urinarias fueron más frecuentes que cuando se emplea solamente la radioterapia como tratamiento radical de inicio.
Citas
1) Leborgne F, Leborgne JH, Zubizarreta E, Ortega B, Leborgne-Deus J, Leborgne F, et al. Cáncer localizado de próstata: experiencia de diez años con radioterapia conformal tridimensional. Rev Med Uruguay 2004; 20(3): 193-201.
2) International Commission on Radiation Units and Measurements (ICRU). ICRU Report 50. Prescribing, recording, and reporting photon beam therapy. Washington: ICRU, 1993.
3) American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37(5): 1035-41.
4) Thames H, Kuban D, Levy L, Horwitz EM, Kupelian P, Martínez A, et al. Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 2003; 57(4): 929-43.
5) Kaplan EL, Meier P. Non parametric estimation from incomplete observations. J Am Statist Assoc 1958; 53: 457-81.
6) Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 1966; 50(3): 163-70.
7) Storey MR, Pollack A, Zagars G, Smith L, Antolak J, Rosen I. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48(3): 635-42.
8) Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999; 281(17): 1591-7.
9) Eisenberger CF, Walsh PC, Eisenberger MA, Chow NH, Partin AW, Mostwin JL, et al. Incidental non-Hodgkin’s lynphoma in patients with localized prostate cancer. Urology 1999; 53: 175-9.
10) Stephenson AJ, Shariat SF, Zelefsky MJ, Kattan MW, Butler EB, The BS, et al. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 2004; 291(11): 1325-32.
11) Catton C, Gospodarowicz M, Warde P, Panzarella T, Catton P, McLean M, et al. Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate. Radiother Oncol 2001; 59(1): 51-60.
12) Bolla M, van-Poppel H, Collette L, Van-Cangh P, Vekemans K, Da-Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 2005; 366(9485): 572-8.
13) Choo R, Hruby G, Hong J, Hong E, DeBoer G, Danjoux C, et al. Positive resection margin and/or pathologic T3 adenocarcinoma of prostate with undetectable postoperative prostate-specific antigen after radical prostatectomy: to irradiate or not?. Int J Radiat Oncol Biol Phys 2002; 52(3): 674-80.
14) Cozzarini C, Bolognesi A, Ceresoli GL, Fiorino C, Rossa A, Bertini R, et al. Role of postoperative radiotherapy after pelvic lymphadenectomy and radical retropubic prostatectomy: a single institute experience of 415 patients. Int J Radiat Oncol Biol Phys 2004; 59(3): 674-83.
15) Taylor N, Kelly JF, Kuban DA, Babaian RJ, Pisters LL, Pollack A. Adjuvant and salvage radiotherapy after radical prostatectomy for prostate cancer. Int J Radiat Oncol Biol Phys 2003; 56(3): 755-63.
16) MacDonald OK, Schild SE, Vora SA, Andrews PE, Ferrigni RG, Novicki DE, et al. Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys 2004; 58(5):1 530-5.
17) Buskirk SJ, Pisansky S, Schild K, Prussak T, Igel T, Wehle R, et al. Results of salvage radiation therapy for a rising serum prostate specific antigen level following radical prostatectomy for prostate cancer. Abstract Nº161. Prostate Cancer Symposium, 2005.
18) Kirkpatrick JP, Calingaert B, Clough RW, Oleson JR, Quaranta BP, Hahn CA et al. Adjuvant and salvage radiotherapy following radical prostatectomy. Abstract Nº 2190. Int J Rad Oncol Biol Phys 2004; 60(Supl): S450-1.
19) Katz MS, Zelefsky MJ, Venkatraman ES, Fuks Z, Hummer A et al. Predictors of biochemical outcome with salvage conformal radiotherapy after radical prostatectomy for prostate cancer. JCO 2003; 21: 483-9.
20) Do T, Giatri Dave G, Parker R, Kagan R. Serum PSA Evaluations during salvage radiotherapy for post-prostatectomy biochemical failures as prognosticators for treatment outcomes. Int J Rad Oncol Biol Phys 2001; 50: 1220-5.
21) Collie AC, Buskirk SJ, Wehle MJ, Young PR, Petrou SP, Broderick GA et al. Evaluation of chronic toxicity following radiation therapy for patients with a rising PSA status post prostatectomy. Int J Rad Oncol Biol Phys 2004; 60(Supl): S478.
2) International Commission on Radiation Units and Measurements (ICRU). ICRU Report 50. Prescribing, recording, and reporting photon beam therapy. Washington: ICRU, 1993.
3) American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37(5): 1035-41.
4) Thames H, Kuban D, Levy L, Horwitz EM, Kupelian P, Martínez A, et al. Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 2003; 57(4): 929-43.
5) Kaplan EL, Meier P. Non parametric estimation from incomplete observations. J Am Statist Assoc 1958; 53: 457-81.
6) Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 1966; 50(3): 163-70.
7) Storey MR, Pollack A, Zagars G, Smith L, Antolak J, Rosen I. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48(3): 635-42.
8) Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999; 281(17): 1591-7.
9) Eisenberger CF, Walsh PC, Eisenberger MA, Chow NH, Partin AW, Mostwin JL, et al. Incidental non-Hodgkin’s lynphoma in patients with localized prostate cancer. Urology 1999; 53: 175-9.
10) Stephenson AJ, Shariat SF, Zelefsky MJ, Kattan MW, Butler EB, The BS, et al. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 2004; 291(11): 1325-32.
11) Catton C, Gospodarowicz M, Warde P, Panzarella T, Catton P, McLean M, et al. Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate. Radiother Oncol 2001; 59(1): 51-60.
12) Bolla M, van-Poppel H, Collette L, Van-Cangh P, Vekemans K, Da-Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 2005; 366(9485): 572-8.
13) Choo R, Hruby G, Hong J, Hong E, DeBoer G, Danjoux C, et al. Positive resection margin and/or pathologic T3 adenocarcinoma of prostate with undetectable postoperative prostate-specific antigen after radical prostatectomy: to irradiate or not?. Int J Radiat Oncol Biol Phys 2002; 52(3): 674-80.
14) Cozzarini C, Bolognesi A, Ceresoli GL, Fiorino C, Rossa A, Bertini R, et al. Role of postoperative radiotherapy after pelvic lymphadenectomy and radical retropubic prostatectomy: a single institute experience of 415 patients. Int J Radiat Oncol Biol Phys 2004; 59(3): 674-83.
15) Taylor N, Kelly JF, Kuban DA, Babaian RJ, Pisters LL, Pollack A. Adjuvant and salvage radiotherapy after radical prostatectomy for prostate cancer. Int J Radiat Oncol Biol Phys 2003; 56(3): 755-63.
16) MacDonald OK, Schild SE, Vora SA, Andrews PE, Ferrigni RG, Novicki DE, et al. Salvage radiotherapy for palpable, locally recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys 2004; 58(5):1 530-5.
17) Buskirk SJ, Pisansky S, Schild K, Prussak T, Igel T, Wehle R, et al. Results of salvage radiation therapy for a rising serum prostate specific antigen level following radical prostatectomy for prostate cancer. Abstract Nº161. Prostate Cancer Symposium, 2005.
18) Kirkpatrick JP, Calingaert B, Clough RW, Oleson JR, Quaranta BP, Hahn CA et al. Adjuvant and salvage radiotherapy following radical prostatectomy. Abstract Nº 2190. Int J Rad Oncol Biol Phys 2004; 60(Supl): S450-1.
19) Katz MS, Zelefsky MJ, Venkatraman ES, Fuks Z, Hummer A et al. Predictors of biochemical outcome with salvage conformal radiotherapy after radical prostatectomy for prostate cancer. JCO 2003; 21: 483-9.
20) Do T, Giatri Dave G, Parker R, Kagan R. Serum PSA Evaluations during salvage radiotherapy for post-prostatectomy biochemical failures as prognosticators for treatment outcomes. Int J Rad Oncol Biol Phys 2001; 50: 1220-5.
21) Collie AC, Buskirk SJ, Wehle MJ, Young PR, Petrou SP, Broderick GA et al. Evaluation of chronic toxicity following radiation therapy for patients with a rising PSA status post prostatectomy. Int J Rad Oncol Biol Phys 2004; 60(Supl): S478.
Publicado
2005-10-31
Cómo citar
1.
Leborgne F, Mezzera J, Leborgne Deus J, Aguiar S. Irradiación posprostatectomía del cáncer de próstata. Rev. Méd. Urug. [Internet]. 31 de octubre de 2005 [citado 17 de noviembre de 2024];21(3):194-9. Disponible en: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/803
Sección
Artículos originales
