Makino Tomoyuki, Izumi Kouji, Iwamoto Hiroaki, Mizokami Atsushi
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8640, Ishikawa, Japan.
Department of Urology, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Ishikawa, Japan.
Cancers (Basel). 2021 Sep 5;13(17):4470. doi: 10.3390/cancers13174470.
Despite the significant advances in the treatment of high-risk prostate cancer, patients with very high-risk features such as being locally advanced (clinical stage T3-4 or minimal nodal involvement), having a high Gleason pattern, or with oligometastasis may still have a poor prognosis despite aggressive treatment. Multidisciplinary treatment with both local and systemic therapies is thought to be effective, however, unfortunately, there is still no standard treatment. However, in recent years, local definitive therapy using a combination of radiotherapy and androgen deprivation is being supported by several randomized clinical trials. This study reviews the current literature with a focus on the definition of very high-risk prostate cancer, the role of modern imaging, and its treatment options.
尽管在高危前列腺癌的治疗方面取得了显著进展，但具有极高风险特征的患者，如局部晚期（临床分期T3 - 4或微小淋巴结受累）、高格里森分级模式或寡转移，即便接受积极治疗，预后可能仍较差。局部和全身治疗相结合的多学科治疗被认为是有效的，然而，不幸的是，目前仍没有标准治疗方案。不过，近年来，放疗和雄激素剥夺联合的局部确定性治疗得到了多项随机临床试验的支持。本研究回顾了当前文献，重点关注极高危前列腺癌的定义、现代影像学的作用及其治疗选择。
