Navrátil J, Poprach A, Lakomý R, Kocák I, Vašina J, Krupa P, Vyzula R
Klin Onkol. 2019 Spring;32(2):97-100. doi: 10.14735/amko201997.
With advancements in diagnostic techniques, oligometastatic prostate cancer is diagnosed in patients who were, in the past, considered to have localized disease. Moreover, evidence of the effectiveness of treatment intensification for this disease is increasing, focusing on primary tumors as well as metastatic lesions. Thus, we can delay the start of systemic palliative treatment and improve overall survival. Many questions remain unclear, such as the definition of oligometastasis disease, or which patients should be offered aggressive treatment. Data are limited and come from small retrospective studies but show conclusively the benefits of survival in targeted primary prostate and metastatic prostate cancer therapy with surgery or radiotherapy. Often, stereotactic radiotherapy is used in this indication, with minimal side effects. In retrospective studies, 3-5 metastatic lesions were generally accepted for definition of oligometastatic disease, but patient subgroups were heterogeneous. A recent study attempts to better define oligometastatic disease and find out the right degree of intensification of treatment. When and in which patient to use metastasis-targeted therapy and when the standard systemic treatment is already meaningful. It is already clear that selected patients benefit from targeted personalized treatment.
The purpose of this review is to offer an update of the problem of oligometastatic prostate cancer. The article presents an overview of data from contemporary literature, modern possibilities of diagnostic imaging methods and treatment options of oligometastatic prostate cancer including surgery and radiotherapy. authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 8. 2. 2019 Accepted: 5. 3. 2019.
随着诊断技术的进步，寡转移前列腺癌在过去被认为患有局限性疾病的患者中被诊断出来。此外，针对这种疾病强化治疗有效性的证据越来越多，重点是原发性肿瘤和转移性病变。因此，我们可以推迟全身姑息治疗的开始并提高总生存率。许多问题仍不明确，例如寡转移疾病的定义，或者哪些患者应接受积极治疗。数据有限且来自小型回顾性研究，但确凿地显示了手术或放疗对原发性前列腺癌和转移性前列腺癌进行靶向治疗的生存益处。通常，立体定向放射疗法用于此适应症，副作用最小。在回顾性研究中，3 - 5个转移性病变通常被接受用于寡转移疾病的定义，但患者亚组是异质性的。最近的一项研究试图更好地定义寡转移疾病并找出合适的治疗强化程度。何时以及在哪些患者中使用转移灶靶向治疗，以及何时标准全身治疗已经有意义。已经很清楚，选定的患者从靶向个性化治疗中获益。
本综述的目的是提供寡转移前列腺癌问题的最新情况。本文概述了当代文献中的数据、诊断成像方法的现代可能性以及寡转移前列腺癌的治疗选择，包括手术和放疗。作者声明他们在研究中使用的药物、产品或服务方面没有潜在的利益冲突。编辑委员会声明该手稿符合生物医学论文的ICMJE建议。提交日期：2019年2月8日 接受日期：2019年3月5日。
