Dorff Tanya B, Ballas Leslie K, Schuckman Anne K
Division of Medical Oncology, Norris Comprehensive Cancer Center, USC Keck School of Medicine, 1441 Eastlake Ave. #3440, Los Angeles, CA, 90033, USA.
Department of Radiation Oncology, Norris Comprehensive Cancer Center, USC Keck School of Medicine, 1441 Eastlake Ave., Los Angeles, CA, 90033, USA.
Curr Oncol Rep. 2017 Aug;19(8):54. doi: 10.1007/s11912-017-0615-4.
The aim of this review is to evaluate the trends in multidisciplinary management of localized penile cancer and systemic therapy for advanced disease in the evolving era of targeted and immune checkpoint therapy.
Organ preservation (surgical or incorporating radiation) and reconstructive techniques are important considerations for quality of life in penile cancer survivors. Although local recurrence may be higher with organ preservation, salvage therapy appears successful. Inguinal and pelvic node management requires multidisciplinary care, including chemotherapy; optimal use of radiation has not been fully defined. Advanced in understanding the biology of penile cancer, particularly with regard to epidermal growth factor receptor (EGFR) and HPV status, have led to clinical trials of targeted and immune therapy for patients with refractory disease. Refinements in the management of penile cancer are occurring, though level 1 evidence remains scarce. Referral to specialized centers will facilitate successful completion of clinical trials to advance standard care in this disease.
本综述旨在评估在靶向治疗和免疫检查点治疗不断发展的时代，局部阴茎癌多学科管理及晚期疾病全身治疗的趋势。
器官保留（手术或联合放疗）及重建技术是阴茎癌幸存者生活质量的重要考量因素。尽管器官保留可能导致局部复发率较高，但挽救性治疗似乎是成功的。腹股沟和盆腔淋巴结管理需要多学科护理，包括化疗；放疗的最佳应用尚未完全明确。对阴茎癌生物学的深入理解，特别是关于表皮生长因子受体（EGFR）和人乳头瘤病毒（HPV）状态，已促使针对难治性疾病患者开展靶向治疗和免疫治疗的临床试验。阴茎癌管理正在不断完善，不过一级证据仍然稀缺。转诊至专业中心将有助于成功完成临床试验，以推进该病的标准治疗。
