Mitra A, Khoo V
Clinical Research Fellow, Institute of Cancer Research, Sutton, Surrey, UK.
Surg Oncol. 2009 Sep;18(3):247-54. doi: 10.1016/j.suronc.2009.02.005. Epub 2009 Mar 12.
There are no standardised guidelines for the role of adjuvant radiotherapy post-prostatectomy. Evidence that may shed light into its appropriate usage is marred by the difficulty in defining adjuvant radiotherapy and failure of some studies to adequately distinguish it from salvage radiotherapy. The ability to identify which prostate cancers are likely to benefit from immediate post-operative radiotherapy would enable the judicious use of this modality and minimise the unnecessary exposure to its side-effects. This review outlines the pre- and post-surgical clinical considerations that form the discussion around the requirement for adjuvant therapy; radiotherapy, androgen deprivation therapy and chemotherapy. Principles for the use of local and systemic therapies are discussed.
前列腺切除术后辅助放疗的作用尚无标准化指南。由于难以定义辅助放疗以及一些研究未能充分将其与挽救性放疗区分开来,可能有助于明确其合理应用的证据受到了影响。确定哪些前列腺癌可能从术后即刻放疗中获益的能力,将有助于明智地使用这种治疗方式,并最大限度地减少不必要的副作用暴露。本综述概述了术前和术后的临床考虑因素,这些因素构成了围绕辅助治疗(放疗、雄激素剥夺治疗和化疗)需求的讨论。文中讨论了局部和全身治疗的使用原则。