Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA 02115, USA.
Semin Radiat Oncol. 2013 Jul;23(3):222-34. doi: 10.1016/j.semradonc.2013.01.006.
The National Comprehensive Cancer Network guidelines currently endorse salvage local therapy as a reasonable alternative to observation or androgen-deprivation therapy for select men with a biopsy-proven local recurrence after definitive radiation for prostate cancer. Patients being considered for salvage therapy should have had localized disease at presentation, a prostate-specific antigen < 10 at recurrence, a life expectancy >10 years at recurrence, and a negative metastatic workup. In this systematic review, we synthesize the current literature describing the oncologic efficacy and toxicity profile of salvage brachytherapy, prostatectomy, cryotherapy, and high-intensity focused ultrasound. We found 5-year biochemical control rates to be similar across treatments, in the range of 52%-56%, although patient selection and definition of failure was variable. Toxicity profiles were also distinct between local salvage modalities.
美国国家综合癌症网络指南目前认可挽救性局部治疗，作为一种合理的替代方法，适用于在根治性放疗后经活检证实前列腺癌局部复发的特定患者，这些患者可选择观察或雄激素剥夺治疗。考虑接受挽救性治疗的患者在初诊时应具有局限性疾病，复发时前列腺特异性抗原（PSA）<10，复发时预期寿命>10 年，且转移情况检查为阴性。在本系统评价中，我们综合了目前描述挽救性近距离放疗、前列腺切除术、冷冻治疗和高强度聚焦超声治疗的肿瘤学疗效和毒性特征的文献。我们发现，尽管患者选择和失败定义存在差异，但各种治疗方法的 5 年生化控制率相似，在 52%-56%的范围内。局部挽救性治疗方法的毒性特征也存在差异。
