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确定焦点治疗的最佳候选人:全面审查
Alireza Ghoreifi1, Leonard Gomella2, Jim C Hu3
1Department of Urology, University of Southern California, Los Angeles, CA, USA.
Prostate cancer and prostatic diseases
|October 24, 2024
概括
针对局部性前列腺癌 (PCa) 的焦点治疗 (FT) 在选定的患者中是有效的. 目前的指导方针建议进行MRI向活检,并考虑FT的中等风险单焦性疾病.
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.
- 医疗成像医学成像
背景情况:
- 焦点治疗 (FT) 对局部性前列腺癌 (PCa) 显示出前景.
- 在不同研究中,FT的患者选择标准存在显著的变化.
- 在PCa中对FT进行最佳的患者选择需要进一步澄清.
研究的目的:
- 审查最近关于前列腺癌中FT最佳患者选择的证据.
- 综合目前的建议,以确定适合FT的候选人.
主要方法:
- 在PubMed数据库进行系统的文献搜索,截至2023年12月31日.
- 从相关研究中提取的数据进行定性分析.
- 排除不相关的文章和包括的研究的质量评估.
主要成果:
- 在PCa中对FT患者的选择没有I级证据.
- 多学科共识建议多参数MRI (mpMRI) 和向活检.
- FT候选人应该有局部,中等风险 (Gleason 3+4,4+3),最好是单焦点疾病,预期寿命可接受.
- 前列腺体积>50毫升和勃起功能障碍不排除患者;建议PSA<20 ng/mL (理想情况下<10 ng/mL).
- 对于FT选择的基因组生物标志物的实用性目前尚不清楚.
结论:
- 对精心挑选的局部性前列腺癌 (PCa) 患者来说,焦点治疗 (FT) 是一种可行的选择.
- 本综述提供了对FT最佳患者选择策略的见解.
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