Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Lancet Oncol. 2012 Jun;13(6):e259-69. doi: 10.1016/S1470-2045(12)70084-0.
What is the best way to manage patients with intermediate-risk prostate cancer? One of the most controversial aspects of treatment is the role of short-term androgen deprivation therapy in combination with definitive radiotherapy. In two randomised trials of patients with mostly intermediate-risk prostate cancer, increased overall survival was reported when short-term androgen deprivation therapy was added to radiotherapy. However, radiation doses in these studies were far below the current standard of care. This limitation, in combination with the heterogeneous nature of the cancers classified as intermediate risk, has complicated the application of these trial results to modern clinical practice. In this Review, we discuss clinical evidence for and against use of short-term androgen deprivation therapy with dose-escalated radiotherapy for patients with intermediate-risk prostate cancer.
对于中危前列腺癌患者，最佳的管理方式是什么？治疗中最具争议的方面之一是短期雄激素剥夺疗法联合根治性放疗的作用。在两项针对大多数中危前列腺癌患者的随机试验中，短期雄激素剥夺疗法联合放疗可提高总生存率。然而，这些研究中的放射剂量远低于当前的治疗标准。这一局限性，加上被归类为中危的癌症的异质性，使得这些试验结果在现代临床实践中的应用变得复杂。在这篇综述中，我们讨论了短期雄激素剥夺疗法联合剂量递增放疗对中危前列腺癌患者的临床应用的证据。
