Cao Jian-Zhou, Su Rui, Pan Jin-Feng, Yan Ze-Jun, Ma Qi
Medical School, Ningbo University, Ningbo, China.
Comprehensive Urogenital Cancer Center, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, China.
Front Oncol. 2021 Nov 18;11:705025. doi: 10.3389/fonc.2021.705025. eCollection 2021.
Patients with localized prostate cancer (PCa) are often treated with radical prostatectomy (RP). However, more than 30% of such patients have high risk of recurrence. Salvage radiotherapy (SRT), androgen deprivation therapy (ADT) and combination of radiotherapy and ADT are the standard care for recurrent PCa. Recently, high intensity focused ultrasound (HIFU) has gradually applied in the treatment of recurrent PCa. Here, we proposed a hypothesis that combined HIFU and bicalutamide 150mg as first line salvage therapy to treat patients with local recurrent PCa with visible lesions due to the following advantages: (1) HIFU is effective in reducing local tumor load, and bicalutamide 150mg is a feasible and safety option to combine with HIFU. (2) Compared with radiotherapy, HIFU plus 150mg bicalutamide is minimal invasiveness with fewer adverse effects and better quality of life(QOL); (3) Radiotherapy can be preserved as the second-line salvage method in the cases who are failure to HIFU and 150mg bicalutamide combination. More clinical trials are warranted to confirm this hypothesis in treatment with recurrent PCa.
局限性前列腺癌（PCa）患者通常接受根治性前列腺切除术（RP）治疗。然而，超过30%的此类患者有较高的复发风险。挽救性放疗（SRT）、雄激素剥夺疗法（ADT）以及放疗与ADT联合是复发性PCa的标准治疗方法。近来，高强度聚焦超声（HIFU）已逐渐应用于复发性PCa的治疗。在此，我们提出一个假说，即联合HIFU与150mg比卡鲁胺作为一线挽救性治疗方法，用于治疗因以下优势而出现可见病灶的局部复发性PCa患者：（1）HIFU在降低局部肿瘤负荷方面有效，且150mg比卡鲁胺是与HIFU联合使用的可行且安全的选择。（2）与放疗相比，HIFU加150mg比卡鲁胺具有微创性，不良反应较少，生活质量（QOL）更好；（3）在HIFU与150mg比卡鲁胺联合治疗失败的病例中，放疗可作为二线挽救方法保留。需要更多的临床试验来证实这一假说在复发性PCa治疗中的有效性。
