https://scholars.lib.ntu.edu.tw/handle/123456789/485649
標題: | Differences in toxicity and outcome associated with circadian variations between patients undergoing daytime and evening radiotherapy for prostate adenocarcinoma | 作者: | Feng-Ming Hsu Hou W.-H. CHAO-YUAN HUANG CHIA-CHUN WANG CHIAO-LING TSAI YU-CHIEH TSAI HONG-JENG YU YEONG-SHIAU PU CHIA-HSIEN CHENG |
公開日期: | 2016 | 出版社: | Taylor and Francis Ltd | 卷: | 33 | 期: | 2 | 起(迄)頁: | 210-219 | 來源出版物: | Chronobiology International | 摘要: | This retrospective study tested the hypothesis that disease control and treatment-related toxicity in patients undergoing high-dose radiotherapy (HDRT) for prostate cancer varies in a circadian manner. Patients with localized prostate adenocarcinoma receiving HDRT (median 78 Gy) to the prostate and involved seminal vesicle(s) without elective pelvic irradiation were divided into a daytime treatment (before 5 PM) group (n = 267) and evening treatment (after 5 PM) group (n = 142). Biochemical failure (Phoenix definition), acute and late gastrointestinal (GI) and genitourinary toxicities (Common Terminology Criteria for Adverse Events version 4), biochemical failure-free survival (BFFS) and freedom from late toxicity were assessed. Analyses were performed by binary logistic regression and Cox proportional hazard regression. The median follow-up was 68 months, and 75% of patients were ?70 years old. Evening HDRT was significantly associated with worse freedom from ?grade 2 late GI complications (hazard ratio = 2.96; p < 0.001). The detrimental effect of evening HDRT was significant in patients older than 70 years old (p < 0.001) but not in younger patients (p = 0.63). In a subgroup of propensity score-matched cohort with T2b-T3 disease (n = 154), the 5-year BFFS was worse in the evening group than the daytime group (72% vs. 85%, hazard ratio = 1.95, p = 0.05). Our study indicates that evening HDRT may lead to more GI complications, especially in older patients, and worse BFFS in patients with T2b-T3 disease. ? 2016 Taylor & Francis. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84961211381&doi=10.3109%2f07420528.2015.1130049&partnerID=40&md5=e594538d008a9530c2f73251a04345aa https://scholars.lib.ntu.edu.tw/handle/123456789/485649 |
ISSN: | 0742-0528 | DOI: | 10.3109/07420528.2015.1130049 | SDG/關鍵字: | adenocarcinoma; aged; circadian rhythm; disease free survival; female; human; male; metabolism; middle aged; physiology; prostate; Prostatic Neoplasms; retrospective study; treatment outcome; very elderly; Adenocarcinoma; Aged; Aged, 80 and over; Circadian Rhythm; Disease-Free Survival; Female; Humans; Male; Middle Aged; Prostate; Prostatic Neoplasms; Retrospective Studies; Treatment Outcome |
顯示於: | 腫瘤醫學研究所 |
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