Huang William C, Lee Courtney L, Eastham James A
Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Curr Urol Rep. 2007 May;8(3):217-23. doi: 10.1007/s11934-007-0009-5.
A significant number of men with prostate cancer will experience biochemical failure following treatment with primary radiation therapy. For patients with biopsy-proven recurrent cancer confined to the prostate, local salvage therapy may be a potentially curative treatment option. Most men, however, do not undergo local salvage therapy owing to difficulties in diagnosis as well as concerns over treatment-related complications in the salvage setting. Recently, improvements in technique and technology have substantially reduced the morbidity associated with locally ablative therapies, resulting in an increased interest in the use of minimally invasive therapies such as brachytherapy, cryotherapy, and high-intensity focused ultrasound in the salvage setting. Although these treatments are well tolerated, concerns remain over incomplete and inadequate treatment with locally ablative therapies. Future studies are required to appropriately select candidates for salvage ablative therapies and to determine the long-term oncologic efficacy of these treatments.
相当数量的前列腺癌男性患者在接受原发性放射治疗后会出现生化失败。对于经活检证实为局限于前列腺的复发性癌症患者，局部挽救性治疗可能是一种潜在的治愈性治疗选择。然而，由于诊断困难以及对挽救性治疗环境中与治疗相关并发症的担忧，大多数男性并未接受局部挽救性治疗。最近，技术和工艺的改进已大幅降低了与局部消融治疗相关的发病率，这使得人们对在挽救性治疗环境中使用近距离放射治疗、冷冻治疗和高强度聚焦超声等微创治疗的兴趣增加。尽管这些治疗耐受性良好，但对于局部消融治疗的不彻底和不充分仍存在担忧。未来需要开展研究，以适当选择挽救性消融治疗的候选者，并确定这些治疗的长期肿瘤学疗效。
