Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
BJU Int. 2011 Feb;107(4):576-84. doi: 10.1111/j.1464-410X.2010.09514.x. Epub 2010 Aug 24.
To conduct an analysis of localized prostate cancer treatment in the USA between 1998 and 2002.
Results from the National Cancer Institute's Patterns of Care study from 10 regional cancer registries in 1998 and 14 registries in 2002 were compared using univariate and multivariate statistical methods.
Patients with localized prostate cancer in 2002 were younger, had lower prostate-specific antigen values, and higher Gleason scores compared with those diagnosed in 1998. Little change occurred in age-adjusted percentages of men who were treated with a radical prostatectomy (45-46%) or by external beam radiation (EBRT) alone (19-20%). The proportion receiving brachytherapy (BT), alone or with EBRT, increased from 14.9 to 17.7%, while the proportion receiving watchful waiting declined from 12.6 to 9.0%. Younger African-American men with intermediate/high-risk disease were less likely to receive any type of aggressive therapy in comparison with Non-Hispanic White men. Over 70% of men who were ≥ 75 years of age, with low-risk disease, were treated with EBRT or BT.
Older men with low-risk disease might be overtreated with aggressive therapy, while younger intermediate/high-risk African-American men appear less likely to receive indicated aggressive therapy.
分析 1998 年至 2002 年间美国局限性前列腺癌的治疗情况。
比较了来自 1998 年 10 个地区癌症登记处和 2002 年 14 个登记处的美国国家癌症研究所模式护理研究的结果，使用单变量和多变量统计方法。
2002 年诊断为局限性前列腺癌的患者比 1998 年诊断的患者年龄更小，前列腺特异性抗原值更低，Gleason 评分更高。接受根治性前列腺切除术（45-46%）或单纯外照射放疗（EBRT）治疗的男性比例在年龄调整后几乎没有变化（19-20%）。接受单纯或联合 EBRT 的近距离放射治疗（BT）的比例从 14.9%增加到 17.7%，而观察等待的比例从 12.6%下降到 9.0%。与非西班牙裔白人男性相比，患有中高危疾病的年轻非洲裔美国男性接受任何类型积极治疗的可能性较小。超过 70%年龄≥75 岁、低危疾病的男性接受 EBRT 或 BT 治疗。
患有低危疾病的老年男性可能过度接受积极治疗，而年轻的中高危非洲裔美国男性似乎不太可能接受有指征的积极治疗。
