立体定向体放射治疗转移性耐阉割前列腺癌的现状。

IF 5.1 2区 医学 Q1 ONCOLOGY
Jennifer Le Guevelou, Francesco Cuccia, Ronan Flippot, Giuseppe Ferrera, Mario Terlizzi, Thomas Zilli, Renaud De Crevoisier, Jean-Michel Hannoun-Levi, Stephane Supiot, Paul Sargos, David Pasquier
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引用次数: 0

摘要

背景:阉割抗药性的出现与前列腺癌(PCa)患者的预后不佳有关。转移导向疗法已在多种疾病环境中进行了研究,可改善特定患者的预后。我们的系统性综述旨在总结立体定向体放射治疗(SBRT)治疗阉割抵抗性前列腺癌(CRPC)的证据:方法:我们于 2024 年 3 月在 Pubmed 上使用关键词 "SBRT "和 "CRPC "以及 "立体定向消融放疗 (SABR)" 和 "CRPC "进行了文献检索。该检索共检索到 108 篇文章,其中 19 篇被收录:结果:文献主要以回顾性系列研究为主。在一项随机II期试验中,对于患有远期寡进展的男性患者,使用雄激素受体通路抑制剂的SBRT可显著延长无进展生存期(PFS),包括无生化进展生存期(危险比为0.35,P 结论:SBRT可显著延长无进展生存期(PFS),包括无生化进展生存期(危险比为0.35,P 结论:SBRT可显著延长无进展生存期(PFS):在少转移性 CRPC 患者中,SBRT 可实现长期生化反应和 PFS。在少转移情况下,SBRT 可用于延长全身治疗的持续时间和疗效。尽管如此,目前的证据水平仍然很低,纳入前瞻性试验仍是这类患者的首选方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The current landscape of stereotactic body radiation therapy for metastatic castration-resistant prostate cancer.

The current landscape of stereotactic body radiation therapy for metastatic castration-resistant prostate cancer.

Background: The onset of castration-resistance is associated with dismal outcomes in patients with prostate cancer (PCa). Metastasis directed therapy has been investigated in multiple disease settings and may improve outcomes in selected patients. Our systematic review aims to summarize evidence with stereotactic body radiotherapy (SBRT) in castration-resistant prostate cancer (CRPC).

Methods: The literature search was performed on March 2024, on Pubmed, using the keywords "SBRT" AND "CRPC", and "stereotactic ablative radiotherapy (SABR)" AND "CRPC". This search retrieved a total of 108 articles, 19 were included.

Results: The literature is largely dominated by retrospective series. In men with metachronous oligoprogression, SBRT with androgen receptor pathway inhibitor significantly increased progression-free survival (PFS) including biochemical progression-free survival in a randomized phase II trial (hazard ratio of 0.35, p < 0.001). In patients continuing ADT, the bPFS ranged between 9.5 months to 17.9 months, and next systemic treatment-free survival (NEST-FS) reached up to 2 years. In men with induced oligoprogression, SBRT enabled NEST-FS up to 3 years. SBRT was well tolerated, with less than 5% grade 3 toxicity reported across studies.

Conclusion: In the population of patients with oligometastatic CRPC, SBRT enables long-term biochemical response and PFS. In the oligoprogressive setting, SBRT could be integrated to prolong the duration and efficacy of systemic therapies. Nevertheless, the level of evidence remains very low and inclusion within prospective trials remain the preferred option for this population of patients.

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来源期刊
Prostate Cancer and Prostatic Diseases
Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学
CiteScore
10.00
自引率
6.20%
发文量
142
审稿时长
6-12 weeks
期刊介绍: Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.
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