Biochemical failure and toxicity in treatment with brachytherapy and external beam radiotherapy compared with radical prostatectomy in localized prostate cancer
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Advisors
Alvarado Cutipa-Flores, Germán F.Del Castillo Pacora, Ruben Francisco
Issue Date
2022-06-29Keywords
Neoplasia de próstataRadioterapia
Braquiterapia
Prostatectomía
Falla bioquímico
Toxicidad
Prostate neoplasm
Radiotherapy
Brachytherapy
Prostatectomy
Biochemical failure
Toxicity
Metadata
Show full item recordAbstract
Antecedentes: El cáncer de próstata localizado (T1-3N0M0) tiene opciones terapéuticas como la prostatectomía radical (PR), la radioterapia de haz externo (EBRT) y la braquiterapia (BT). Sin embargo, la evidencia de los resultados de estos tratamientos es limitada y no se han realizado estudios que comparen el Falla Bioquímica (FB) y la toxicidad asociada al tratamiento quirúrgico y a la EBRT + Braquiterapia de alta dosis (HDBT) en la región. Material y Métodos: Estudio de cohorte retrospectivo, se revisaron las historias clínicas de los pacientes diagnosticados con cáncer de próstata localizado entre 2014 y 2018 en uno de los principales centros privados de neoplasias de Lima, Perú; se utilizó la regresión de Cox tanto para el resultado de BF como para el resultado de toxicidad grado 2, calculando el HR con IC 95%. Resultados: De 549 pacientes, el 76,3% (419) recibió RP como tratamiento primario, y el 72% tenía entre 50 y 70 años en el momento del diagnóstico. Los pacientes tratados con EBRT + HDBT presentaron peores características. El grupo de EBRT + HDBT tuvo un 40% menos de riesgo de presentar FB (HR 0,6; IC 95% 0,4 - 0,9), y también un 50% más de riesgo de presentar toxicidad mayor o igual a grado 2 (HR 1,5; IC 95% 1,0 - 2,0) que el grupo tratado con RP. Conclusión: Nuestros resultados muestran que al comparar los pacientes tratados con EBRT + HDBT y RP, el BF fue mayor en RP, y la toxicidad post-tratamiento fue mayor en EBRT + HDBT. Sin embargo, ambos grupos de comparacion no son homogéneos por lo que la comparacion no puede ser objetiva.Background: Localized prostate cancer (T1-3N0M0) has therapeutic options such as Radical Prostatectomy (RP), external beam radiation therapy (EBRT) and Brachytherapy (BT). However, the evidence of the outcome of these treatments is limited and no studies have been conducted comparing Biochemical Failure (BF) and toxicity associated with surgical treatment and EBRT + High-Dose Brachytherapy (HDBT) in the region. Methods and Materials: Retrospective cohort study, clinical records of patients diagnosed with localized prostate cancer between 2014 and 2018 were reviewed at one of the main private neoplasm centers in Lima, Peru; Cox regression was used for both the BF outcome and the grade 2 toxicity outcome, calculating the HR with 95% CI. Results: Of 549 patients, 76.3% (419) received RP as primary treatment, and 72% were between 50 and 70 years old at the time of diagnosis. The patients treated with EBRT + HDBT presented worse characteristics. The EBRT + HDBT group had a 40% lower risk of presenting BF (HR 0.6; 95% CI 0.4 - 0.9), and also a 50% greater risk of presenting toxicity greater than or equal to grade 2 (HR 1.5; CI 95% 1.0 - 2.0) than the group treated with RP. Conclusion: Our results show that when comparing patients treated with EBRT + HDBT and RP, BF was greater in RP, and post-treatment toxicity was greater in EBRT + HDBT. However, both comparison groups are not homogeneous, so the comparison cannot be objective.
Type
info:eu-repo/semantics/bachelorThesisRights
info:eu-repo/semantics/openAccessAttribution-NonCommercial-ShareAlike 4.0 International
Language
spaCollections
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