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转移导向的治疗在小转移性前列腺癌:生物学理由和发表的数据的系统审查

Francesco Fiorica^1,2, Teodoro Sava², Jacopo Giuliani²

¹Department of Clinical Oncology, Section of Radiation Oncology and Nuclear Medicine, AULSS 9 Scaligera, 37122 Verona, Italy.

|April 26, 2025

概括

转移导向疗法 (MDT) 单独显示了对寡头转移性前列腺癌 (OMPC) 的承诺. 将MDT与雄激素剥夺疗法 (ADT) 结合起来可以改善无疾病进展的存活率,但其对整体存活率的影响尚不确定.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
尿瘤学尿瘤学

背景情况:

以转移为导向的疗法 (MDT) 可以预防疾病的进展,并改善寡头转移性前列腺癌 (OMPC) 的存活率.
将MDT纳入OMPC治疗策略的生物学理由需要进一步研究.
目前关于MDT在OMPC中的作用的证据需要系统评估.

研究的目的:

系统地审查OMPCMDT的文献.
分析将MDT整合到OMPC治疗中的生物学理由.
调查目前关于MDT在OMPC中的作用的证据.

主要方法:

在MEDLINE/PUBMED和EMBASE数据库中进行系统的文献搜索,直到2024年1月.
分析了主要瘤和泌尿病学会年会的会议记录.
包括2014年至2024年间发表的18项研究,涉及1058名接受转移导向放射治疗的患者.

主要成果:

单单MDT在OMPC患者中显示出有前途的结果.
结合MDT和抗雄激素剥夺疗法 (ADT) 显著改善了2年和4年无病进展生存率 (DPFS) (p < 0.00001和p = 0.006).
在未经激素治疗的患者中,单独使用MDT和MDT加上激素操纵之间没有观察到治疗升级的无生存时间的显著差异. 单独使用MDT的整体存活率 (OS) 与割敏感疾病的组合治疗相比较高.

结论:

单独的MDT对于OMPC来说是一个有价值的,经常更好的策略.
结合MDT和ADT显著增强DPFS,但其对OS的影响仍然不确定.
未来的研究应该专注于基于生物标志物的方法,以优化MDT的使用和患者选择多式疗法.

关键词:

转移导向疗法 (MDT) 是一种转移导向疗法.低基质性前列腺癌 (OMPC) 是一种前列腺癌.多式联络方式前列腺癌

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