Autran-Gomez Ana Maria, Scarpa Roberto Mario, Chin Joseph
Department of Urology and Surgical Oncology, University of Western Ontario, London, ON, Canada.
Urol Int. 2012;89(4):373-9. doi: 10.1159/000339616. Epub 2012 Jul 10.
Salvage high-intensity focused ultrasound (HIFU) and cryotherapy (CRYO) have emerged as interesting alternatives in the treatment of local radio-recurrent prostate cancer. Currently, recommendations concerning the use of CRYO and HIFU in the salvage setting are still evolving.
The objective of this review was to analyze the results from studies on CRYO and HIFU as salvage treatment in local radio-recurrent prostate cancer.
A National Center for Biotechnology Information PubMed search (www.pubmed.gov) was conducted from 1993 to 2011 using medical subject headings 'High-Intensity Focused Ultrasound', 'Cryotherapy', 'Local Radio-Recurrent' and 'Prostate Cancer'.
In the past years, there have been several published series demonstrating promising acceptable morbidity and oncological outcomes in the short term for HIFU and in the intermediate term for CRYO. The introduction of newer-generation devices and technical modifications has facilitated reduction of complications associated with the procedures. As with any salvage treatment, careful patient selection and subsequent follow-up are principal points.
HIFU and CRYO are promising salvage treatments in patients with local radio-recurrent prostate cancer. The risk of significant complications in the salvage setting is higher compared with primary therapy; therefore, the patients must be informed about the risk of complications and the modality of treatment. However, only further evaluation in formal prospective clinical trials will hopefully confirm their role in clinical practice.
挽救性高强度聚焦超声(HIFU)和冷冻疗法(CRYO)已成为局部放射性复发前列腺癌治疗中有趣的替代方法。目前,关于在挽救性治疗中使用CRYO和HIFU的建议仍在不断发展。
本综述的目的是分析有关CRYO和HIFU作为局部放射性复发前列腺癌挽救性治疗的研究结果。
利用医学主题词“高强度聚焦超声”、“冷冻疗法”、“局部放射性复发”和“前列腺癌”,于1993年至2011年在美国国立生物技术信息中心的PubMed数据库(www.pubmed.gov)中进行检索。
在过去几年中,有几个已发表的系列研究表明,HIFU在短期内以及CRYO在中期均显示出有前景且可接受的发病率和肿瘤学结果。新一代设备的引入和技术改进有助于减少与这些手术相关的并发症。与任何挽救性治疗一样,仔细的患者选择和后续随访是关键要点。
HIFU和CRYO对于局部放射性复发前列腺癌患者是有前景的挽救性治疗方法。与初始治疗相比,挽救性治疗中出现严重并发症的风险更高;因此,必须告知患者并发症风险和治疗方式。然而,只有通过正式的前瞻性临床试验进行进一步评估,才有望证实它们在临床实践中的作用。