Drouin S J, Rouprêt M
Service d'Urologie Hôpital Pitié-Salpêtrière, Faculté de médecine Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalo-Universitaire Est, Université Paris VI, Paris, France.
Prog Urol. 2010 Jun;20 Suppl 3:S198-202. doi: 10.1016/S1166-7087(10)70039-7. Epub 2010 Jun 29.
Incidence of prostate cancer is constantly growing no matter of the stage of the disease. Locally advanced tumours and metastatic stages of the disease are not exception. Nevertheless, management of advanced prostate cancer is still uncertain. Thus, non invasive molecular or imaging techniques have been proposed to optimize the diagnosis of advanced prostate cancer. The debate is still ongoing regarding therapeutic options to offer to the patient to obtain the optimal oncologic control. Radical prostatectomy can now be considered as an option in certain cases of high-risk prostate cancer, on the basis of a multimodal treatment. The field of hormonotherapy is also evolving. New molecules (GnRH Antagonists, anti androgen) or new modalities of prescription (six-month GnRH agonist) appear. The prescription modalities evolve as well (e.g.; intermittent treatment). Lastly, chemotherapy is now proposed for metastatic symptomatic prostate cancer but also for locally advanced disease. Basic research and genetic investigations are still ongoing to explore pathways and factors of progression to the metastatic status and to find the most appropriate treatment for each patient.
无论疾病处于何种阶段，前列腺癌的发病率都在持续上升。局部晚期肿瘤和疾病的转移阶段也不例外。然而，晚期前列腺癌的治疗仍不明确。因此，已提出采用非侵入性分子或成像技术来优化晚期前列腺癌的诊断。关于为患者提供何种治疗方案以实现最佳肿瘤控制的争论仍在继续。基于多模式治疗，根治性前列腺切除术现在可被视为某些高危前列腺癌病例的一种选择。激素治疗领域也在不断发展。出现了新的分子（GnRH拮抗剂、抗雄激素）或新的处方方式（六个月GnRH激动剂）。处方方式也在演变（例如间歇性治疗）。最后，现在化疗不仅适用于转移性有症状的前列腺癌，也适用于局部晚期疾病。基础研究和基因研究仍在进行，以探索向转移状态进展的途径和因素，并为每位患者找到最合适的治疗方法。
