Michaelson M Dror, Cotter Shane E, Gargollo Patricio C, Zietman Anthony L, Dahl Douglas M, Smith Matthew R
Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, USA.
CA Cancer J Clin. 2008 Jul-Aug;58(4):196-213. doi: 10.3322/CA.2008.0002. Epub 2008 May 23.
Prostate cancer is the most commonly diagnosed noncutaneous cancer in men in the United States. Treatment of men with prostate cancer commonly involves surgical, radiation, or hormone therapy. Most men with prostate cancer live for many years after diagnosis and may never suffer morbidity or mortality attributable to prostate cancer. The short-term and long-term adverse consequences of therapy are, therefore, of great importance. Adverse effects of radical prostatectomy include immediate postoperative complications and long-term urinary and sexual complications. External beam or interstitial radiation therapy in men with localized prostate cancer may lead to urinary, gastrointestinal, and sexual complications. Improvements in surgical and radiation techniques have reduced the incidence of many of these complications. Hormone treatment typically consists of androgen deprivation therapy, and consequences of such therapy may include vasomotor flushing, anemia, and bone density loss. Numerous clinical trials have studied the role of bone antiresorptive therapy for prevention of bone density loss and fractures. Other long-term consequences of androgen deprivation therapy may include adverse body composition changes and increased risk of insulin resistance, diabetes, and cardiovascular disease. Ongoing and planned clinical trials will continue to address strategies to prevent treatment-related side effects and improve quality of life for men with prostate cancer.
前列腺癌是美国男性中最常被诊断出的非皮肤癌。前列腺癌男性患者的治疗通常包括手术、放疗或激素治疗。大多数前列腺癌男性患者在确诊后能存活多年，可能永远不会出现因前列腺癌导致的发病或死亡。因此，治疗的短期和长期不良后果非常重要。根治性前列腺切除术的不良反应包括术后即刻并发症以及长期的泌尿和性功能并发症。局部前列腺癌男性患者接受外照射或近距离放射治疗可能会导致泌尿、胃肠和性功能并发症。手术和放疗技术的改进降低了许多此类并发症的发生率。激素治疗通常包括雄激素剥夺疗法，这种疗法的后果可能包括血管舒缩性潮红、贫血和骨密度降低。众多临床试验研究了骨吸收抑制疗法在预防骨密度降低和骨折方面的作用。雄激素剥夺疗法的其他长期后果可能包括不良的身体成分变化以及胰岛素抵抗、糖尿病和心血管疾病风险增加。正在进行和计划中的临床试验将继续探讨预防治疗相关副作用并改善前列腺癌男性患者生活质量的策略。
