Background/Objectives: Carbon-ion radiotherapy (CIRT) offers precise dose distribution and enhanced biological effectiveness in localized prostate cancer. However, the safety of CIRT in patients with a history of surgery for benign prostatic hyperplasia (BPH), such as transurethral resection of the prostate (TURP), remains unclear. This study aimed to evaluate the long-term safety and oncological outcomes of CIRT in this population.Methods:A retrospective analysis was conducted in 74 of 3848 patients with prostate cancer and a history of surgery for BPH who underwent CIRT combined with risk-adapted androgen deprivation therapy between 2007 and 2023. Adverse events were assessed using CTCAE v5.0. Biochemical recurrence-free survival was estimated using the Kaplan–Meier method and risk factors for hematuria with multivariate logistic regression and receiver operation characteristic (ROC) analysis.Results:CIRT was generally well-tolerated. Early Grade 2 genitourinary (GU) adverse events occurred in 5.4% of patients, and late-Grade 2 or higher GU events occurred in 8.1%. The cumulative incidence of Grade 2 ≥ GU events remained 10% at 36 months. Compared to holmium laser enucleation of the prostate, a shorter interval between BPH surgery and CIRT initiation and a history of TURP were independently associated with an increased risk of hematuria. Notably, 5-year bRFS was 100% in low- and intermediate-risk groups and 88.6% in the high-risk group.Conclusions:CIRT demonstrates acceptable oncological outcomes and urinary complication rates in patients with prostate cancer and a history of BPH surgery. These findings suggest that CIRT can be a feasible treatment option in this surgically altered population, but careful patient selection, individualized treatment planning, and long-term follow-up are essential. Given the absence of a non-BPH control group, oncological efficacy should be interpreted with caution.
背景/目的：碳离子放射治疗（CIRT）在局限性前列腺癌中具有精确的剂量分布和增强的生物学效应。然而，对于有良性前列腺增生（BPH）手术史（如经尿道前列腺切除术[TURP]）的患者，CIRT的安全性尚不明确。本研究旨在评估CIRT在该人群中的长期安全性和肿瘤学结果。 方法：对2007年至2023年间接受CIRT联合风险适应性雄激素剥夺治疗的3848例前列腺癌患者中，有BPH手术史的74例患者进行回顾性分析。使用CTCAE v5.0评估不良事件。采用Kaplan-Meier法估算无生化复发生存率，并使用多变量逻辑回归和受试者工作特征（ROC）分析血尿的危险因素。 结果：CIRT总体耐受性良好。早期2级泌尿生殖系统（GU）不良事件发生率为5.4%，晚期2级或以上GU事件发生率为8.1%。36个月时，≥2级GU事件的累积发生率保持在10%。与钬激光前列腺剜除术相比，BPH手术与CIRT开始间隔时间较短以及有TURP病史与血尿风险增加独立相关。值得注意的是，低危和中危组的5年无生化复发生存率为100%，高危组为88.6%。 结论：对于有BPH手术史的前列腺癌患者，CIRT显示出可接受的肿瘤学结果和泌尿系统并发症发生率。这些发现表明，CIRT可作为该手术改变人群的可行治疗选择，但仔细的患者选择、个体化治疗计划和长期随访至关重要。鉴于缺乏非BPH对照组，对肿瘤学疗效的解释应保持谨慎。
肿瘤(癌症)患者之家