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救援焦点疗法与激进前列腺切除术用于局部化放射性前列腺癌
Alexander Light1,2, Max Peters3, Manit Arya1,2
1Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, England, United Kingdom.
JAMA oncology
|February 12, 2026
概括
救援焦点治疗 (sFT) 和救援激进前列腺切除术 (sRP) 有效地治疗放射治疗后复发的前列腺癌. sFT显示的并发症较少,为局部疾病患者提供了有利的治疗比率.
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.
- 辐射瘤学 辐射瘤学
背景情况:
- 放射治疗后复发的前列腺癌通常具有较差的生存结果.
- 救援焦点治疗 (sFT) 和救援激进前列腺切除术 (sRP) 是局部复发的潜在治疗选择.
- 关于长期结果和sFT与sRP的比较有效性的数据有限.
研究的目的:
- 在放射治疗后复发前列腺癌患者中,比较sFT和sRP之间的癌症控制和术后并发症.
- 评估两种治疗方式的10年癌症特异性和整体生存率.
- 评估与sFT和sRP相关的术后并发症的发生率.
主要方法:
- 国际,多中心队列研究利用匹配的比较数据.
- 从前性注册表 (HIFU,冷疗法,焦点循环评估和救生治疗) 获得的sFT患者.
- 从国际回顾性注册表中获得的sRP患者.
- 根据关键的临床和治疗变量进行1:1的枢纽性匹配.
- 主要结局:10年癌症特异性存活率;次要结局:整体存活率,术后并发症 (Clavien-Dindo等级1-5和3-5).
主要成果:
- 在癌症特异性10年生存率 (92%的sFT与99%的sRP) 或sFT和sRP之间的整体生存率之间没有统计学上显著的差异.
- 与sFT相比,sRP与任何外科手术后并发症 (aOR 24.20) 和重大并发症 (aOR 9.31) 的几率明显更高.
- 共有923名患者有资格进行匹配 (419名sFT,504名sRP).
结论:
- 无论是sFT和sRP都是治疗局部复发性前列腺癌放射治疗后的有效治疗方法.
- 与sRP相比,sFT显示的术后并发症率明显较低.
- sFT可能为局部放射性复发前列腺癌的特定患者提供更有利的治疗比率.
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