Saluja Ronak, Cheung Patrick, Zukotynski Katherine, Emmenegger Urban
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Urol Oncol. 2016 May;34(5):225-32. doi: 10.1016/j.urolonc.2016.02.016. Epub 2016 Mar 19.
The prognosis of men with metastatic, castration-sensitive prostate cancer (CSPC) depends on both the distribution and extent of metastases, among other things. Patients with low-volume or oligometastatic disease have improved survival compared with those with high-volume metastases. While chemohormonal therapy is the new standard of care for men with high-volume metastatic CSPC, stereotactic ablative radiotherapy (SABR) is emerging as a promising treatment option with low toxicity for the management of oligometastatic CSPC. Our review summarizes the current evidence on the role of SABR in oligometastatic prostate cancer. SABR shows control rates of metastases ranging from 88% to 100% at 6 months to 3 years, and progression-free survival commonly reported as >50% for the first 12 months. In addition, SABR may allow androgen-deprivation therapy to be delayed by more than 2 years in selected patients, minimizing the chronic side effects associated with such therapy. However, much still needs to be learned before SABR can be implemented as standard treatment for oligometastatic prostate cancer.
转移性去势敏感性前列腺癌（CSPC）男性患者的预后取决于多种因素，其中包括转移灶的分布和范围。与高负荷转移患者相比，低负荷或寡转移疾病患者的生存期有所改善。虽然化学激素疗法是高负荷转移性CSPC男性患者的新治疗标准，但立体定向消融放疗（SABR）正成为一种有前景的治疗选择，对寡转移CSPC的治疗毒性较低。我们的综述总结了目前关于SABR在寡转移前列腺癌中作用的证据。SABR显示，在6个月至3年时转移灶的控制率为88%至100%，通常报道前12个月的无进展生存率>50%。此外，在部分患者中，SABR可能使雄激素剥夺治疗延迟超过2年，从而将与此类治疗相关的慢性副作用降至最低。然而，在SABR能够作为寡转移前列腺癌的标准治疗方法实施之前，仍有许多需要了解的地方。
