Lin Amy M, Small Eric J
UCSF Comprehensive Cancer Center, University of California, San Francisco, California 94115, USA.
Curr Opin Oncol. 2007 May;19(3):229-33. doi: 10.1097/CCO.0b013e3280ad43bd.
This review highlights the most important developments in the diagnosis, prevention, and treatment of prostate cancer published in the medical literature over the past year.
Recent research has revealed a relatively high rate of prostate specific antigen screening in elderly men regardless of comorbidity status. Other findings include data that finasteride may increase the sensitivity of prostate specific antigen to detect prostate cancer. In terms of use of androgen deprivation therapy as part of primary therapy, a randomized trial has demonstrated that immediate therapy for locally advanced prostate cancer improves overall survival. There is growing literature, however, confirming the risks associated with this treatment, including an increased incidence of cardiovascular events and diabetes. New randomized trial data of adjuvant radiotherapy for high-risk disease have not demonstrated a survival benefit over observation. For patients who experience disease relapse following local therapy, definitions of biochemical failure following prostatectomy and radiation therapy are proposed. In more advanced disease, immunotherapy has preliminarily demonstrated survival benefit in a randomized trial.
Data reported over the last year have significant implications for those involved in the management of prostate cancer, ranging from primary care physicians to medical oncologists, urologists, and radiation oncologists.
本综述重点介绍过去一年医学文献中发表的前列腺癌诊断、预防和治疗方面最重要的进展。
近期研究显示,无论合并症状况如何,老年男性前列腺特异性抗原筛查率相对较高。其他发现包括非那雄胺可能会提高前列腺特异性抗原检测前列腺癌的敏感性。就雄激素剥夺疗法作为主要治疗的一部分而言,一项随机试验表明,局部晚期前列腺癌立即治疗可改善总体生存率。然而,越来越多的文献证实了这种治疗相关的风险,包括心血管事件和糖尿病发病率增加。高危疾病辅助放疗的新随机试验数据未显示出比观察有生存获益。对于局部治疗后疾病复发的患者,提出了前列腺切除术后和放疗后生化失败的定义。在更晚期疾病中,免疫疗法在一项随机试验中初步显示出生存获益。
过去一年报告的数据对参与前列腺癌管理的人员具有重要意义,从初级保健医生到医学肿瘤学家、泌尿科医生和放射肿瘤学家。