质子治疗（PT）已成为我们综合癌症中心治疗局限性前列腺癌的标准护理选择。然而，目前对长期临床结果的大规模分析还很少。因此，本文旨在评估PT对局限性前列腺癌患者的长期疗效和毒性。回顾了2006年5月至2020年1月间治疗的2772名患者。根据美国国家综合癌症网络指南，将疾病风险分为低风险组（LR，n=640）、有利－中度风险组（F-IR，n=850）、不利－中度风险组（U-IR，n=851）、高风险组（HR，n=315）或非常高风险组（VHR，n=116）。使用Kaplan-Meier曲线和多元模型分析生化复发和毒性。患者的中位年龄为66岁，中位随访时间为7.0年。盆腔淋巴结照射被指示给28名患者（1%）（2名（0.2%）U-IR，11名（3.5%）HR和15名（12.9%）VHR）。剂量中位数为78Gy，分1.8-2.0Gy（RBE）。LR组自由生化复发率在5年和10年时分别为98.2%和96.8%；F-IR组分别为98.3%和93.6%；U-IR组分别为94.2%和90.2%；HR组分别为94.3%和85.2%；VHR组分别为86.1%和68.5%。两名患者死于前列腺癌。晚期≥3级泌尿生殖道和胃肠道毒性的总体发生率分别为0.87%和1.01%。这一大规模队列研究表明，对于局限性前列腺癌，质子治疗取得了卓越的临床效果，即使是在风险较高且在过去接受过侵袭性治疗效果较差的患者群体中也是如此。© 2023 Elsevier B.V.。保留所有权利。

Proton therapy (PT) has emerged as a standard-of-care treatment option for localized prostate cancer at our comprehensive cancer center. However, there are few large-scale analyses examining the long-term clinical outcomes. Therefore, this article aims to evaluate the long-term effectiveness and toxicity of PT in patients with localized prostate cancer.Review of 2772 patients treated from May 2006 through January 2020. Disease risk was stratified according to National Comprehensive Cancer Network guidelines as low [LR, n=640]; favorable-intermediate [F-IR, n=850]; unfavorable-intermediate [U-IR, n=851]; high [HR, n=315]; or very high [VHR, n=116]. Biochemical failure and toxicity were analyzed using Kaplan-Meier estimates and multivariate models.The median patient age was 66 years; the median follow-up time was 7.0 years. Pelvic lymph node irradiation was prescribed to 28 patients (1%) (2 [0.2%] U-IR, 11 [3.5%] HR, and 15 [12.9%] VHR). The median dose was 78 Gy in 1.8-2.0 Gy(RBE) fractions. Freedom from biochemical relapse (FFBR) rates at 5 years and 10 years were 98.2% and 96.8% for the LR group; 98.3% and 93.6%, F-IR; 94.2% and 90.2%, U-IR; 94.3% and 85.2%, HR; and 86.1% and 68.5%, VHR. Two patients died of prostate cancer. Overall rates of late grade ≥ 3 GU and GI toxicity were 0.87% and 1.01%.Proton therapy for localized prostate cancer demonstrated excellent clinical outcomes in this large cohort, even among higher-risk groups with historically poor outcomes despite aggressive therapy.Copyright © 2023 Elsevier B.V. All rights reserved.