Prostate Brachytherapy Program, BC Cancer Agency, 600 W 10th Ave, Vancouver, BC V5Z 4E6.
Can Fam Physician. 2013 Dec;59(12):1269-74.
To describe treatment options for clinically localized prostate cancer: radical prostatectomy, prostate brachytherapy, external beam radiation, and active surveillance.
Prostate-specific antigen (PSA) outcomes presented are from non-randomized, cohort, and other comparisons trials (level II evidence). We describe PSA outcomes from Canadian centres when they are available. One small randomized controlled trial (level I evidence) in localized prostate cancer is available to compare radical prostatectomy with brachytherapy.
Treatment choice in prostate cancer is based on initial PSA level, clinical stage of disease, and Gleason score, together with baseline urinary function, comorbidities, and patient age. In this article, we describe patients' eligibility for and the common side effects of all treatment options. Prostate brachytherapy and active surveillance have evolved as new standard treatments of localized prostate cancer. We give a brief overview of the brachytherapy procedure, side effects, and PSA outcomes across Canada, as well as active surveillance guidelines.
Prostate cancer treatment requires a multidisciplinary approach, with input from both urology and radiation oncology. Input from family physicians is often as important in helping guide patients through the treatment decision process.
描述局限性前列腺癌的治疗选择：根治性前列腺切除术、前列腺近距离放疗、外照射放疗和主动监测。
呈现的前列腺特异性抗原（PSA）结果来自非随机、队列和其他比较试验（证据等级 II）。我们描述了加拿大中心的 PSA 结果，只要有可用的结果。在局限性前列腺癌中，有一项小型随机对照试验（证据等级 I）可用于比较根治性前列腺切除术和近距离放疗。
前列腺癌的治疗选择基于初始 PSA 水平、疾病临床分期和 Gleason 评分，以及基线尿功能、合并症和患者年龄。在本文中，我们描述了所有治疗选择的患者入选标准和常见副作用。前列腺近距离放疗和主动监测已成为局限性前列腺癌的新标准治疗方法。我们简要概述了加拿大各地的近距离放疗程序、副作用和 PSA 结果，以及主动监测指南。
前列腺癌的治疗需要多学科方法，泌尿科和放射肿瘤学都需要参与。家庭医生的意见在帮助患者进行治疗决策过程中往往同样重要。
