Eng Tony Y, Thomas Charles R, Herman Terrence S
Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX 78284, USA.
Urol Oncol. 2002 Nov-Dec;7(6):239-57. doi: 10.1016/s1078-1439(02)00198-9.
Prostate cancer in men is similar to breast cancer in women; both cancers rank first, respectively, in incidence and are normally responsive to radiation therapy. In addition, advances in mammography help detect earlier breast cancers, and the development and refinement of prostatic specific antigen (PSA) has resulted in early detection of low-stage localized prostate cancers. This has generated debate over the proper management of localized prostate cancer. While there have not been any controlled, prospective, randomized trials of sufficient power to compare the various local therapies, based on the current available data, the three commonly used local modalities, surgery, and external beam radiation therapy and brachytherapy (radioactive seed implant), have similar efficacy controlling the disease up to 10 years in many patients. Technological advances in treatment delivery and planning have improved the treatment of prostate cancer with external-beam radiotherapy using three-dimensional conformal radiotherapy (3DCRT), ultrasound-guided transperineal implant, or intensity-modulated radiotherapy (IMRT), as well as proton or neutron beam based therapies.
男性前列腺癌与女性乳腺癌相似；这两种癌症的发病率分别位居第一，并且通常对放射治疗有反应。此外，乳房X光检查技术的进步有助于更早地发现乳腺癌，前列腺特异性抗原（PSA）的发展和完善使得早期低阶段局限性前列腺癌得以被发现。这引发了关于局限性前列腺癌恰当治疗方法的争论。虽然尚无足够有力的对照、前瞻性、随机试验来比较各种局部治疗方法，但根据目前可得的数据，三种常用的局部治疗方式，即手术、外照射放疗和近距离放射治疗（放射性粒子植入），在许多患者中控制疾病长达10年的疗效相似。治疗实施和规划方面的技术进步改善了前列腺癌的治疗，采用了三维适形放疗（3DCRT）、超声引导经会阴植入、调强放疗（IMRT）等外照射放疗技术，以及基于质子或中子束的治疗方法。
