Gómez-Millán Jaime, Lara María Fernanda, Correa Generoso Raquel, Perez-Rozos Alberto, Lupiáñez-Pérez Yolanda, Medina Carmona Jose Antonio
Department of Radiation Oncology, University Hospital Virgen de la Victoria, Malaga, Spain.
Department of Urology, University Hospital Virgen de la Victoria, Malaga, Spain.
Crit Rev Oncol Hematol. 2015 Aug;95(2):144-53. doi: 10.1016/j.critrevonc.2015.02.008. Epub 2015 Feb 25.
Prognosis of prostate cancer has improved as a result of the combination with androgen deprivation therapy and the increase of radiation dose. However, a high number of prostate cancer patients will develop biochemical recurrence; therefore a research effort to increase the control of the tumour in these patients is necessary.
To increase the therapeutic ratio (the index between cytotoxic effects and normal tissue complications with a certain dose of radiation), different new strategies described in the literature have been reviewed.
There are several strategies that may increase the efficacy of radiotherapy to treat prostate cancer. First is based on physics and technology, and second based on biology.
Technical advances in radiotherapy allow intensification of radiation through escalation of the dose or in combination with chemotherapy. Furthermore, targeting specific molecular dysregulated pathways in the tumour will increase the effects of radiation specifically in tumour cells. Hopefully, these strategies will result in increased rates of tumour control in all prognostic groups, especially in high risk tumours and a subgroup of patients with intermediate risk tumours, minimizing treatment morbidity and increasing the therapeutic ratio of radiotherapy.
由于雄激素剥夺疗法与放射剂量的增加相结合，前列腺癌的预后得到了改善。然而，大量前列腺癌患者会出现生化复发；因此，有必要开展研究以加强对这些患者肿瘤的控制。
为了提高治疗比（一定剂量放射治疗下细胞毒性效应与正常组织并发症之间的指标），对文献中描述的不同新策略进行了综述。
有几种策略可能会提高放射治疗前列腺癌的疗效。第一种基于物理和技术，第二种基于生物学。
放射治疗的技术进步使得通过提高剂量或与化疗联合来加强放射治疗。此外，针对肿瘤中特定的分子失调途径将增加放射治疗对肿瘤细胞的特异性作用。有望这些策略能提高所有预后组的肿瘤控制率，尤其是高危肿瘤和部分中危肿瘤患者亚组，同时将治疗发病率降至最低并提高放射治疗的治疗比。
