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局部治疗有利于前列腺癌患者:系统性审查和元分析

Qihao Sun¹, Kun Du², Shulei Sun³

¹Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.

International journal of urology : official journal of the Japanese Urological Association

|July 16, 2024

概括

局部治疗 (LT) 显著改善了瘤前列腺癌 (OmPCa) 患者的整体生存率和无进展生存率. 需要进一步的随机对照试验来证实这些发现.

科学领域:

在瘤学瘤学.
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

低甲基前列腺癌 (OmPCa) 是局部疾病和广泛转移的前列腺癌之间的中间阶段.
对OmPCa的最佳治疗策略仍在研究中,需要评估局部疗法的作用.

研究的目的:

评估局部治疗 (LT) 的有效性,包括放射治疗 (RT) 和细胞减小前列腺切除术 (CRP),以改善OmPCa.患者的治疗结果.
综合现有研究的证据,以指导OmPCa管理的临床决策.

主要方法:

2010年至2023年11月期间发表的研究的系统审查和元分析.
包括11篇文章:3个随机对照试验 (RCT) 和8个回顾性分析.
评估整体存活率 (OS),无放射性进展生存率 (rPFS),前列腺特异性抗原无进展生存率 (PSA-PFS),癌症特异性存活率 (CSS) 和并发症率 (CR).

主要成果:

在OmPCa患者中,局部治疗 (LT) 显著改善了整体存活率 (OS) (HR=0.64,p<0.0001).
在RCT和非RCT (HR=0.44,p=0.0001) 两种类型的PSA无进展生存期 (PSA-PFS) 中都观察到显著的改善.
虽然非RCT显示了无放射性进展生存率 (rPFS) 的显著改善 (HR=0.42,p=0.002),但RCT没有达到统计学意义 (p=0.09).

结论:

局部治疗 (LT) 在诊断为OmPCa.患者的OS和PFS改善方面显示出显著的益处.
虽然结果很有希望,但需要进一步进行高质量的随机对照试验 (RCT),以最终证实LT在OmPCa.的疗效.

关键词:

癌症特异性生存率癌症特异性生存率当地治疗当地治疗精细成形的前列腺癌.总体存活率总体存活率没有进展的生存率.

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