Bišof Vesna
Department of Oncology, Clinical Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
Acta Clin Croat. 2019 Nov;58(Suppl 2):36-41. doi: 10.20471/acc.2019.58.s2.06.
The standard of treatment of metastatic hormone-sensitive prostate cancer (mHSPC) is androgen deprivation therapy (ADT) with docetaxel or abiraterone. However, numerous retrospective studies suggested outcome benefit of prostate radiotherapy. Small randomized trial (HORRAD) showed no overall survival (OS) benefit of the addition of prostate radiotherapy to ADT but there was a trend toward survival benefit in a low volume disease. Although the results of large randomized study (STAMPEDE) have also not proved improvement of OS in unselected patients, robust improvement of failure-free survival was found. In addition, OS was significantly improved in patients with a low volume disease. In the absence of reliable molecular markers, the extent of metastatic disease has emerged as an important factor for treatment decision making. In this review, we summarize data from non-randomized as well as from randomized studies concerning prostate radiotherapy to contribute to the improvement of treatment tailoring for each individual patient with mHSPC in order to achieve the best possible treatment outcomes.
转移性激素敏感性前列腺癌（mHSPC）的标准治疗方法是采用多西他赛或阿比特龙进行雄激素剥夺治疗（ADT）。然而，大量回顾性研究表明前列腺放疗对治疗结果有益。小型随机试验（HORRAD）显示，在ADT基础上加用前列腺放疗对总生存期（OS）并无益处，但对于低负荷疾病患者有生存获益的趋势。尽管大型随机研究（STAMPEDE）的结果也未证实未选择患者的OS有所改善，但无进展生存期有显著改善。此外，低负荷疾病患者的OS显著改善。在缺乏可靠分子标志物的情况下，转移疾病的范围已成为治疗决策的重要因素。在本综述中，我们总结了来自非随机以及随机研究中有关前列腺放疗的数据，以促进针对每位mHSPC患者的个体化治疗方案的改进，从而实现最佳治疗效果。
