Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street-Cox 3, Boston, MA 02114, USA.
Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 75 Francis Street, ASB1 L2, Boston, MA 02215, USA.
Hematol Oncol Clin North Am. 2020 Feb;34(1):45-69. doi: 10.1016/j.hoc.2019.08.017. Epub 2019 Oct 28.
Randomized controlled trials provide evidence-driven clinical decision making in the management of newly diagnosed nonmetastatic and oligometastatic prostate cancer. Advances in technology (eg, multiparametric MRI, MR/transrectal ultrasound fusion biopsy, image-guided radiation therapy, stereotactic body radiation therapy) have transformed diagnosis and treatment of prostate cancer while improving cancer control and quality-of-life outcomes. Exciting breakthroughs are revealing possible new indications for radiotherapy, particularly with respect to oligometastatic prostate cancer. Ongoing studies using next-generation androgen receptor-targeted agents hold promise to continue to improve important clinical outcomes, including metastasis-free prostate cancer-specific and overall survival in addition to health-related quality of life.
随机对照试验为新诊断的非转移性和寡转移性前列腺癌的管理提供了循证临床决策依据。技术的进步（例如，多参数 MRI、MR/经直肠超声融合活检、图像引导放疗、立体定向体部放疗）改变了前列腺癌的诊断和治疗方式，同时提高了癌症控制和生活质量。激动人心的突破揭示了放疗的可能新适应症，特别是在寡转移性前列腺癌方面。正在进行的使用下一代雄激素受体靶向药物的研究有望继续改善重要的临床结局，包括无转移前列腺癌特异性和总体生存率，以及健康相关的生活质量。
