Abstract:
QUESTIONS UNDER STUDY/PRINCIPLES:A retrospective assessment of long-term results on a single centre, single author experience in treating prostate cancer with high dose curative radiotherapy (RT) with or without androgen deprivation (AD). METHODS:Between 1991 and 2004, 408 patients with clinically localised prostate cancer were treated with RT (+/-AD) at the University Hospital of Geneva. RT alone was delivered to 229 patients whereas AD associated to RT was given to 179 patients. The latter was most frequently delivered to those patients with worse prognostic factors at diagnosis (high PSA values, high Gleason scores, stage T3-T4; p <0.001). Patient's biochemical failure was established at the time of PSA progression above the post-treatment nadir value +2 ng/ml. Late urinary, rectal, and sexual side effects were assessed and scored according to the Radiotherapy Oncology Group grading system. RESULTS:Ten-year overall survival (OS) and cancer specific survival were 93% and 62% (p = 0.10), and 94% and 71% (p = 0.19) for patients treated with RT with and without AD respectively (p = 0.10). Ten-year biochemical disease-free survival (bDFS) was 61% and 50% for patients treated with RT with and without AD, respectively (p = 0.14). On Cox regression analysis, PSA at diagnosis and treatment modality correlated significantly with OS, whereas PSA at diagnosis, Gleason score, and treatment modality correlated significantly with bDFS. Mostly high-risk patients (PSA >20 ng/ml and/or Gleason 8-10) benefited from neo-adjuvant AD+RT compared to patients treated with RT alone (67% versus 32%, 5-year bDFS; p <0.001). The 5-year probability of moderate to severe late urinary and low-GI toxicities was 15% and 7% respectively. Regarding sexual toxicity, the 5-year risk of complete failure of erections after treatment was 57%. CONCLUSIONS:AD+RT significantly improved both 10-year OS and bDFS, especially in patients with high-risk disease at diagnosis. Patients treated with RT alone presented with continuous failures during the 10-year interval of observation, thus questioning the wisdom of proposing RT alone at doses below 74 Gy, especially for patients with long life expectancies.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Miralbell R,Pampallona S,Rouzaud M,Pugliesi A,Weber D,Ares Cdoi
smw-12604subject
Has Abstractpub_date
2009-09-05 00:00:00pages
511-7issue
35-36eissn
1424-7860issn
1424-3997pii
smw-12604journal_volume
139pub_type
杂志文章abstract::Pulmonary embolism (PE) is traditionally treated in hospital. Growing evidence from non randomized prospective studies suggests that a substantial proportion of patients with non-massive PE might be safely treated in the outpatient setting using low molecular weight heparins. Based on this evidence, professional socie...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:smw-12661
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journal_title:Swiss medical weekly
pub_type: 临床试验,杂志文章
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abstract::Apart from the degree of stenosis, plaque morphology has emerged in recent years as an important contributory factor in stroke risk. Ultrasound studies have shown that hypo- or anechogenic plaques carry a higher risk of cerebrovascular events than echogenic ones. Similarly, heterogeneous plaques presenting a complex p...
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12581
更新日期:2009-10-17 00:00:00
abstract:OBJECTIVE:To assess the clinical implementation and report preliminary results of a novel technique called the Ozaki procedure for stentless aortic valve replacement through reconstruction of the valve leaflets from autologous pericardium. METHOD:Between September 2015 and May 2017 30 patients (20 males, mean ± standa...
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abstract:PURPOSE:To study the association between maternal smoking during pregnancy and low birth weight (LBW), small-for-gestational-age birth weight (SGA) and preterm birth, and to quantify the population-attributable fractions for these outcomes in Switzerland. METHODS:Data were gathered for all births in the Canton of Vaud...
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doi:2005/35/smw-11122
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pub_type: 杂志文章,多中心研究
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doi:2001/35/smw-09768
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2004/19/smw-10584
更新日期:2004-05-15 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2007/07/smw-11606
更新日期:2007-02-24 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2012.13638
更新日期:2012-07-17 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/17/smw-11274
更新日期:2006-04-29 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/09/smw-11265
更新日期:2006-03-04 00:00:00