Allen Gregory W, Howard Andrew R, Jarrard David F, Ritter Mark A
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
Cancer. 2007 Oct 1;110(7):1405-16. doi: 10.1002/cncr.22940.
Depending on initial prognostic factors, an estimated 10%-60% of men who undergo definitive radiation therapy for prostate cancer may experience a biochemical recurrence. Even though hormonal therapy is standard for metastatic recurrences, no consensus exists on optimal salvage therapy for those recurrences thought confined to the prostate. Salvage treatment options for these local recurrences have historically been limited to salvage prostatectomy, hormonal therapy, or cryotherapy. Salvage prostate brachytherapy, however, uses a widely available technique and may provide another option for attaining disease control in patients with localized failures, although only about 110 cases have been reported in the literature. In this report, the authors have described their own series of salvage brachytherapy cases as well as presented a review of other such series reported in the literature. In addition, the authors included a comprehensive review of published experiences with surgery and cryotherapy as salvage options. It appears that salvage brachytherapy, when combined with careful patient selection, is at least as effective as other salvage options with comparable or potentially fewer treatment-related side effects.
根据初始预后因素，接受前列腺癌根治性放射治疗的男性中，估计有10%-60%可能会出现生化复发。尽管激素疗法是转移性复发的标准治疗方法，但对于那些被认为局限于前列腺的复发，最佳挽救治疗方案尚无共识。对于这些局部复发，以往的挽救治疗选择仅限于挽救性前列腺切除术、激素疗法或冷冻疗法。然而，挽救性前列腺近距离放射治疗采用一种广泛可用的技术，对于局部复发的患者，可能为实现疾病控制提供另一种选择，尽管文献中仅报道了约110例病例。在本报告中，作者描述了他们自己的挽救性近距离放射治疗病例系列，并对文献中报道的其他此类系列进行了综述。此外，作者还对作为挽救选择的手术和冷冻疗法的已发表经验进行了全面综述。看来，挽救性近距离放射治疗结合仔细的患者选择，至少与其他挽救选择一样有效，且治疗相关副作用相当或可能更少。
