少转移性前列腺癌的现代治疗方法

J. Stanić, M. Nikitović, N. Miletić, V. Stankovic
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引用次数: 0

摘要

少转移性疾病被定义为介于局部和广泛转移性疾病之间的一种中间状态。少转移性前列腺癌通常定义为影像学上出现5个或更少的转移灶。在精确和个性化癌症治疗的时代,更敏感的成像技术的引入以及安全有效的局部非或微创治疗选择的可用性,导致了少转移性前列腺癌的发病率和临床兴趣的增加。此外,低转移性前列腺癌的治疗模式正朝着更积极的方向发展。回顾性研究表明,在转移性前列腺癌中,根治性前列腺切除术和局部或转移性放射治疗的毒性风险最小,可以提高临床疗效。由于没有足够的数据得出其对生存率影响的可靠结论,因此只有在前瞻性临床试验的背景下才应考虑在患者被告知有限证据的情况下治疗少转移性前列腺癌。目前不一致的检测和治疗少转移性前列腺癌患者的方法需要标准化,以便未来的临床研究能够正确进行,更重要的是,进行比较。这些关键条件将揭示是否应将少转移诊断和治疗纳入前列腺癌患者的标准临床实践。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modern approach in oligometastatic prostate cancer therapy
Oligometastatic disease is defined as an intermediate state between localized and widespread metastatic disease. Oligometastatic prostate cancer is generally defined by the presence of five or fewer metastatic sites on imaging. In the era of precision and personalized cancer care, the introduction of more sensitive imaging technologies and the availability of safe and effective localized non-or minimally invasive treatment options, have led to an increase in the incidence and clinical interest in oligometastatic prostate cancer. In addition, the therapeutic paradigm for oligometastatic prostate cancer is evolving toward a more aggressive approach. Retrospective studies have shown that in the metastatic setting, treatments such as radical prostatectomy and local or metastasis-directed radiation therapy can be performed with minimal risk of toxicity and may enhance clinical outcomes. As there is insufficient data to draw reliable conclusions about their impact on survival, aggressive approaches in the treatment of oligometastatic prostate cancer should be considered only in the context of prospective clinical trials, with the patient informed of the limited evidence of benefit. The current inconsistent approach of detecting and treating oligometastatic prostate cancer patients will need to be standardized in order for future clinical studies to be properly performed and, more importantly, compared. These crucial conditions will reveal if oligometastasis diagnosis and therapy should be included in the standard clinical practice of prostate cancer patients.
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