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前列腺切除术后的辅助放疗。我们目前的情况如何?

Adjuvant radiation treatment after prostatectomy. Where do we stand?

作者信息

Elshaikh Mohamed A, Ibrahim Dina R, Stricker Hans, Peabody James O

机构信息

Department of Radiation Oncology, Henry Ford Health System, Detroit, MI 48202, USA.

出版信息

Can J Urol. 2011 Apr;18(2):5592-600.

Abstract

INTRODUCTION

Prostate cancer is the second most common cause of cancer death in American men. For patients with adverse pathologic features, postoperative radiotherapy to prostate bed after radical prostatectomy has been shown in randomized studies to improve many important clinical endpoints including overall survival. In this review article, we distinguish adjuvant radiation treatment (ART) from salvage radiation treatment (SRT), discuss the evidences for ART and its potential side effects focusing on the debate concerning the optimal timing of post prostatectomy radiation treatment (RT).

MATERIAL AND METHODS

A comprehensive literature search was conducted in MEDLINE including pre-MEDLINE.

CONCLUSION

for patients with adverse pathologic factors, adjuvant radiation treatment after prostatectomy reduces the rate of PSA failure with the potential for significantly improving metastases-free and overall survival. Whether an equivalent survival benefit can be attained with early salvage radiation treatment after biochemical recurrence, is still an area of debate.

摘要

引言

前列腺癌是美国男性癌症死亡的第二大常见原因。对于具有不良病理特征的患者,随机研究表明,根治性前列腺切除术后对前列腺床进行术后放疗可改善许多重要的临床终点,包括总生存期。在这篇综述文章中,我们区分了辅助性放射治疗(ART)和挽救性放射治疗(SRT),讨论了ART的证据及其潜在副作用,重点关注前列腺切除术后放射治疗(RT)最佳时机的争论。

材料与方法

在包括预医学在线数据库在内的MEDLINE中进行了全面的文献检索。

结论

对于具有不良病理因素的患者,前列腺切除术后的辅助性放射治疗可降低PSA失败率,有可能显著提高无转移生存期和总生存期。生化复发后早期挽救性放射治疗是否能获得同等的生存益处,仍是一个有争议的领域。

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