Golbari Nicole M, Katz Aaron E
Stony Brook University, Stony Brook, NY, USA.
Winthrop University Hospital, Mineola, NY, USA.
Curr Urol Rep. 2017 Aug;18(8):63. doi: 10.1007/s11934-017-0709-4.
While recurrence after primary treatment of prostate cancer (PCa) is not uncommon, there is currently no consensus on the most appropriate management after radiation treatment failure. This article seeks to explore the currently utilized modalities for salvage treatment for radiorecurrent PCa. We focused our review on the oncologic outcomes and reported toxicity rates in the latest studies examining salvage radical prostatectomy (SRP), salvage cryotherapy (SCT), salvage high-intensity focused ultrasound (HIFU) and re-irradiation.
There does not appear to be any significant difference in overall survival for more invasive salvage radical prostatectomy compared to the minimally invasive salvage approaches. Additionally, there seems to be a trend towards lower morbidity rates associated with minimally invasive and focal salvage treatment. We are encouraged by the results presented in this review and find that there is clearly a role for emerging minimally invasive and focal therapies as durable options for salvage treatment in patients with radiorecurrent PCa.
虽然前列腺癌(PCa)初次治疗后复发并不罕见,但目前对于放射治疗失败后最合适的管理尚无共识。本文旨在探讨目前用于放射性复发PCa挽救治疗的方法。我们的综述重点关注了最新研究中挽救性根治性前列腺切除术(SRP)、挽救性冷冻治疗(SCT)、挽救性高强度聚焦超声(HIFU)和再次放疗的肿瘤学结局及报告的毒性发生率。
与微创挽救方法相比,更具侵入性的挽救性根治性前列腺切除术在总生存期方面似乎没有显著差异。此外,微创和局部挽救治疗的发病率似乎有降低的趋势。我们对本综述中呈现的结果感到鼓舞,并发现对于放射性复发PCa患者,新兴的微创和局部治疗作为挽救治疗的持久选择显然有其作用。