老年患者局部性前列腺癌:激进的前列腺切除术或放射治疗与观察对比
Fausto Petrelli1, Lorenzo Dottorini1, Agostina De Stefani2
1Medical Oncology Unit, ASST Bergamo Orest, Treviglio, BG, Italy.
Journal of geriatric oncology
|May 27, 2024
概括
激进前列腺切除术 (RP) 和放射治疗 (RT) 与观察相比,改善了局部前列腺癌 (PC) 的老年男性的生存率. 在观察性研究中,手术显示了比RT更大的生存益处.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 手术瘤学手术瘤学
背景情况:
- 局部性前列腺癌 (PC) 在老年男性中很常见.
- 对于老年人PC的治疗决定需要仔细考虑生存结果.
- 激进前列腺切除术 (RP) 和放射治疗 (RT) 是主要的治疗选择.
研究的目的:
- 评估RP和RT对65岁及以上患者的整体存活率 (OS) 和PC特定死亡率 (PCSM) 的影响.
- 为了比较手术和RT的有效性与老年男性局部PC的观察.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆进行了全面的文献审查,截至2023年12月.
- 包括的研究比较了RP或RT与65岁以上男性局部PC的观察.
- 对于OS和PCSM的危险比率 (HRs) 使用随机效应模型进行了聚合.
主要成果:
- 分析了13项研究 (284,066名患者),包括3项RCT和10项回顾性研究.
- 在观察性研究 (HR=0.52) 和RCT (HR=0.84) 中,RP显示了显著的OS益处.
- 与观察相比,RP和RT都显示出显著的PCSM益处,并注意到高异质性.
结论:
- 对于局部PC的老年男性来说,RP和RT比观察提供了生存优势.
- 患者应根据个人病史,预期寿命和偏好考虑RP或RT.
- 进一步的研究可能会澄清鉴于观察到的异质性,治疗的益处.
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