Didelės rizikos prostatos vėžio gydymas taikant radikalią prostatektomiją arba spindulinę terapiją: dviejų centrų patirtis

Background/objectiveThere are no randomized trials on the comparative effectiveness of radical prostatectomy (RP) and radiotherapy (RT) for high-risk prostate cancer. Our aim was to compare treatment outcomes of high-risk prostate cancer after RP and RT, including overall survival (OS), biochemical-progression-free survival (bPFS) and disease-progression-free survival (dPFS), using two cancer treatments centers’ patient data.MethodsData on high-risk prostate cancer patients between 2005 and 2009 were retrospectively reviewed in two cancer centers: National Cancer Institute, Vilnius, Lithuania and N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; 210 patients were included in the study group treated with RP (n = 174) or RT (n = 36). The mean follow-up time was 5.6 and 6.6 years, respectively.ResultsLower T stage was an independent predictor of better OS (p = 0.01) and bPFS (p = 0.03). Only the highest Gleason score ≥8 was significantly predictive of a worse OS (p = 0.05), bPFS (p = 0.02) and dPFS (p = 0.001). A high PSA level was predictive of a worse bPFS (p = 0.007 for PSA ≥20) and dPFS (p = 0.008 for ≥20). The treatment modality in this study was insignificant after T stage, Gleason score and PSA level adjustment for OS, bPFS survival and dPFS survival (p = 0.17, p = 0.39, p = 0.20).ConclusionsThe T stage, Gleason score and pretreatment PSA level are significant factors for OS, bPFS survival, and dPFS survival of highrisk prostate cancer patients. Treatment option (RP or RT) was not an independent predictor of survival in this study.Įvadas / tikslasIki šiol nėra atlikta atsitiktinės atrankos klinikinių tyrimų siekiant palyginti radikalios prostatektomijos (RP) ir spindulinės terapijos (ST) efektyvumą gydant didelės rizikos prostatos vėžį. Šio tyrimo tikslas – naudojant dviejų gydymo centrų duomenis įvertinti didelės rizikos prostatos vėžiu sergančių ir RP arba ST gydytų pacientų bendrąjį išgyvenamumą, išgyvenamumą ikibiocheminio progresavimo ir iki ligos progresavimo.Pacientai ir metodai2005–2009 metų duomenys apie didelės rizikos prostatos vėžio ligonius buvo retrospektyviai surinkti dviejuose gydymo centruose: Nacionaliniame vėžio institute (Vilnius, Lietuva) ir N. N. Aleksandrovo nacionaliniame vėžio centre (Minskas, Baltarusija). Tyrimo grupę sudarė 210 pacientų, iš kurių 174 taikyta RP, 36 – ST. Vidutinis stebėjimo laikas buvo atitinkamai 5,6 ir 6,6 metų.RezultataiPirminis naviko išplitimas (T) buvo susijęs su geresniu bendruoju išgyvenamumu (p = 0,01) ir geresniu išgyvenamumu iki biocheminio progresavimo (p = 0,03). Esant didžiausiam naviko diferenciacijos laipsniui (pagal Gleason ≥8) nustatytas reikšmingai blogesnis bendrasis išgyvenamumas (p = 0,05), išgyvenamumas iki biocheminio progresavimo (p = 0,02) ir išgyvenamumas iki ligos progresavimo (p = 0,001). Blogesnis išgyvenamumas iki biocheminio progresavimo (p = 0,007) ir iki ligosprogresavimo (p = 0,008) taip pat buvo susijęs su aukštu PSA lygiu (≥ 20 ng/mL). Šioje tyrimo grupėje taikytas gydymas neturėjo reikšmingos įtakos bendrajam išgyvenamumui, išgyvenamumui iki biocheminio progresavimo ir iki ligos progresavimo (atitinkamai p = 0,17, p = 0,39, p = 0,20) atsižvelgus į pirminį naviko išplitimą, naviko diferenciaciją ir PSA lygį.IšvadosPirminis naviko išplitimas (T), naviko diferenciacijos laipsnis (pagal Gleason) ir PSA lygis iki gydymo turėjo reikšmingos įtakos bendrajam išgyvenamumui, išgyvenamumui iki biocheminio progresavimo ir iki ligos progresavimo didelės rizikos prostatos vėžiu sergančių pacientų grupėje. Šiame tyrime taikytas gydymas (RP arba ST) nebuvo nepriklausomas išgyvenamumui įtakądarantis veiksnys

Radical prostatectomy vs radiotherapy in high-risk prostate cancer patients: two centre experience

Background/objective There are no randomized trials on the comparative effectiveness of radical prostatectomy (RP) and radiotherapy (RT) for high-risk prostate cancer. Our aim was to compare treatment outcomes of high-risk prostate cancer after RP and RT, including overall survival (OS), biochemical-progression-free survival (bPFS) and disease-progression-free survival (dPFS), using two cancer treatments centers’ patient data. Methods Data on high-risk prostate cancer patients between 2005 and 2009 were retrospectively reviewed in two cancer centers: National Cancer Institute, Vilnius, Lithuania and N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; 210 patients were included in the study group treated with RP (n = 174) or RT (n = 36). The mean follow-up time was 5.6 and 6.6 years, respectively. Results Lower T stage was an independent predictor of better OS (p = 0.01) and bPFS (p = 0.03). Only the highest Gleason score ≥8 was significantly predictive of a worse OS (p = 0.05), bPFS (p = 0.02) and dPFS (p = 0.001). A high PSA level was predictive of a worse bPFS (p = 0.007 for PSA ≥20) and dPFS (p = 0.008 for ≥20). The treatment modality in this study was insignificant after T stage, Gleason score and PSA level adjustment for OS, bPFS survival and dPFS survival (p = 0.17, p = 0.39, p = 0.20). Conclusions The T stage, Gleason score and pretreatment PSA level are significant factors for OS, bPFS survival, and dPFS survival of highrisk prostate cancer patients. Treatment option (RP or RT) was not an independent predictor of survival in this study

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements