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关于前列腺癌焦点治疗的最新情况
Hector Ayerra Perez1, Javier Fermín Barba Abad1, Javier Extramiana Cameno1
1Department of Urology, Araba University Hospital. OSI Araba, Osakidetza, Vitoria-Gasteiz, Spain.
Clinical genitourinary cancer
|May 31, 2023
概括
与激进治疗相比,焦点疗法可以降低低风险前列腺癌的发病率. 虽然短期有效性被证明,但长期数据和比较仍然有限,阻止它们成为黄金标准.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 最少侵入性的治疗方法
背景情况:
- 激进前列腺切除术 (RP) 和放射疗法是低风险前列腺癌的既定治疗方法,但与显著的发病率相关.
- 焦点疗法旨在尽量减少与治疗相关的副作用,同时保持瘤控制.
研究的目的:
- 审查前列腺癌主要焦点疗法的现状,包括原则,疗效和副作用.
- 为了评估冷疗法,高强度焦点超声波 (HIFU),光动力疗法 (PDT) 和不可逆转的电穿孔 (IRE).
主要方法:
- 从2000年到2022年,对MEDLINE发表的文章进行系统审查.
- 专注于详细介绍焦点疗法的原理,瘤疗效,发病率和副作用的研究.
主要成果:
- 在结果测量中存在显著的异质性,这使得直接比较变得困难.
- 结晶外科和HIFU比PDT和IRE有更多的临床经验.
- 生物化学复发率从4.5%到23%不等,其中高达20%需要救援治疗. 勃起功能障碍和尿失禁的发病率差异很大 (分别为3-50%和0-34%).
结论:
- 焦点疗法在选择低风险前列腺癌患者中显示出短期瘤疗效.
- 更广泛的采用需要标准化的MRI引导的融合活检和更多的长期数据.
- 目前,没有焦点治疗被认为是黄金标准,特别是对于中等/高风险患者.
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