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目前的焦点治疗在前列腺癌中的作用
Sara Tamburini1, Lorenzo Bianchi1,2, Pietro Piazza1,2
1Division of Urology, IRCCS Azienza Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Urologia
|November 14, 2024
概括
前列腺癌 (PCa) 的焦点治疗 (FT) 显示出有希望的功能结果,但与标准治疗相比,缺乏明确的瘤学证据. 在FT在日常实践中得到广泛采用之前,需要更多的研究.
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:
- 多参数磁共振成像 (mpMRI) 改善了前列腺癌 (PCa) 指数病变的检测和定位.
- 这导致了对PCa微侵袭性焦点治疗 (FT) 的兴趣增加.
- 然而,与标准治疗相比,FT的最终瘤疗效仍未得到充分报道.
研究的目的:
- 探索前列腺癌 (PCa) 不同焦点治疗 (FT) 模式的疗效,安全性,瘤和功能结果.
主要方法:
- 进行了非系统的文献综述.
- 在PubMed中搜索了关于"前列腺癌"和"焦点治疗"或特定模式 (HIFU,IRE,冷,FLA) 的文章.
- 包括在2018年至2023年间发表的22篇文章.
主要成果:
- 焦点疗法包括半离析,焦点离析或向疗法,使用热 (HIFU,冷疗法,RFA,FLA) 或非热 (胸膜疗法,IRE,VTP) 能量.
- 高强度聚焦超声波 (HIFU) 和冷疗法是最受研究的,比激进治疗显示出潜在的功能益处,但复发/再治疗率更高.
- 仅有有限的数据可以将FT与标准化激进治疗进行比较.
结论:
- 目前关于FT结果的证据主要来自回顾性,非比较性,单中心研究.
- 目前没有焦点治疗被认为是常规实践中标准化治疗的安全替代方案.
- FT应保留给经过精心挑选的PCa患者,患有低风险或有利的中期风险疾病,不适合激进选择.
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