Posttreatment Complications of Early-Stage Prostate Cancer Patients
Notice bibliographique
Résumé
PURPOSE: The purpose of this study was to compare treatment complications for early-stage prostate cancer managed by either brachytherapy or three-dimensional conformal radiotherapy (3D-CRT). MATERIALS AND METHODS: [corrected] Records were reviewed for 86 men treated with transperineal interstitial permanent prostate brachytherapy and for 76 men treated with dose-escalated (75.6-Gy) six-field 3DCRT between 1998 and 2000. Median ages were 65 and 66 years, respectively; median Gleason scores were 6 and 7; baseline prostate-specific antigen levels were 6.1 and 9.0 ng/mL; and the follow-up period was 42 months. In the urinary domain, patients who underwent brachytherapy recorded an International Prostate Symptom Score prospectively at baseline, as well as 3 months and every 6 months following, whereas patients who underwent 3D-CRT were assigned a Radiation Therapy Oncology Group (RTOG) late toxicity score at similar time intervals. In the bowel domain, RTOG late toxicity score was used for both groups, and physician-dictated notes were used to assess sexual function. All patients who underwent brachytherapy were prescribed tamsulosin (Flomax) to manage urinary symptoms for a minimum of 3 months after treatment. RESULTS: With respect to urinary symptoms, a direct comparison cannot be made between the International Prostate Symptom Score and the RTOG late toxicity score. Nonetheless, it was evident that patients who underwent brachytherapy had more severe urinary sequelae in the months after implantation. Tamsulosin was still being used by 78% of patients at 6 months, decreasing to 55% at 1 year and 27% at 2 years. Intermittent self-catheterization was required at 6 months after treatment by 5% of patients who underwent brachytherapy, and a transurethral resection of the prostate was performed in one of these patients at 12 months. In patients who underwent 3D-CRT, 14% used tamsulosin at some point in the follow-up period and none required catheterization or transurethral resection of the prostate. In the bowel domain, 20% of patients who underwent brachytherapy experienced grade 1 gastrointestinal toxicity, most within the first 12 months of follow-up, compared with 30% grade 1 or 2 gastrointestinal scores in the 3D-CRT group (peaking in the second year after treatment). In the sexual domain, 9% of patients who underwent brachytherapy who were previously potent reported a loss of potency by 18 months, compared with 53% of patients who underwent 3D-CRT. Without the help of sildenafil (Viagra), these figures rose to 24% and 58%. CONCLUSIONS: 3D-CRT is associated with fewer urinary symptoms, whereas brachytherapy has a more favorable toxicity profile for bowel and sexual function. In the absence of a randomized clinical trial, such a comparison can be helpful both in counseling patients as to what to expect from either treatment and in facilitating their treatment decision process.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».