前列腺癌:一个回顾
Ruben Raychaudhuri1,2, Daniel W Lin3,2, R Bruce Montgomery1,2,4
1Department of Medicine, University of Washington, Seattle.
JAMA
|March 10, 2025
概括
前列腺癌是男性常见的癌症,局部疾病的生存率很高. 先进的前列腺癌治疗,包括雄激素受体通路抑制剂,改善了转移病例的生存结果.
科学领域:
- 癌症学
- 尿道病学
- 癌症研究
背景情况:
- 前列腺癌是美国男性最常见的非皮肤癌,
- 风险因素包括遗传,年龄和黑人种族,鼓励共享决策进行查.
- 局部性前列腺癌的5年生存率接近100%,而转移性癌症的5年生存率为37%.
研究的目的:
- 概述目前对前列腺癌流行病学,风险因素和治疗策略的理解.
- 突出治疗局部和转移性前列腺癌的进展.
- 提供有关查,积极监测和治疗选择的临床决策信息.
主要方法:
- 对前列腺癌发病率和死亡率的流行病学数据的审查.
- 风险因素的分析,包括遗传倾向和人口变量.
- 评估局部化和转移性前列腺癌的治疗方法,包括积极监测,手术,辐射,抗雄激素治疗和新药.
主要成果:
- 预计在2024年和2022年分别有超过299,000例新的美国病例和140万例的全球病例.
- 大约75%的患者患有局部性疾病,10%患有转移性疾病.
- 新型雄激素受体通路抑制剂,如阿比拉,可显著改善转移性前列腺癌患者的整体存活率.
结论:
- 根据疾病阶段和风险分层,前列腺癌的治疗有所不同.
- 积极监测适用于局部病例的三分之一,而辐射或前列腺切除是高风险疾病的选择.
- 与雄激素受体通路抑制剂或化疗相结合的雌激素剥夺疗法代表了转移性前列腺癌的治疗标准.
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