EJ Whitten Foundation Prostate Cancer Research Centre, Epworth HealthCare, Melbourne, Vic., Australia.
Department of Surgery, University of Melbourne, Melbourne, Vic., Australia.
BJU Int. 2023 Jan;131(1):20-31. doi: 10.1111/bju.15883. Epub 2022 Sep 27.
To provide a summary and discussion of international guidelines, position statements and consensus statements in relation to focal therapy (FT) for prostate cancer (PCa).
The European Association of Urology-European Association of Nuclear Medicine-European Society for Radiotherapy and Oncology-European Society of Urogential Radiology-International Society of Urological Pathology-International Society of Geriatric Oncology and American Urological Association-American Society for Radiation Oncology-Society of Urologic Oncology guidelines were interrogated for recommendations for FT. PubMed and Ovid Medline were searched for consensus statements. Only studies in English since 2015 were included. Reference lists of the included articles were also interrogated and a manual search for studies was also performed.
Our results showed a lack of long-term randomised data for FT. International Urological guidelines emphasised the need for more high-quality clinical trials with robust oncological and toxicity outcomes. Consensus and positions statements were heterogenous.
A globally accepted guideline for FT planning, technique and follow-up are still yet to be determined. Well-designed studies with long-term follow-up and robust clinical and toxicity endpoints are needed to improve our understanding of FT and create uniform guidelines to streamline management and follow-up.
总结和讨论与前列腺癌（PCa）局部治疗（FT）相关的国际指南、立场声明和共识声明。
对欧洲泌尿外科学会-欧洲核医学学会-欧洲放射肿瘤学会-欧洲泌尿生殖放射学会-国际泌尿病理学会-国际老年肿瘤学会和美国泌尿外科学会-美国放射肿瘤学会-泌尿肿瘤学会的指南进行了检索，以获取有关 FT 的建议。在 PubMed 和 Ovid Medline 上搜索了共识声明。仅纳入自 2015 年以来发表的英文研究。还查阅了纳入文章的参考文献列表，并进行了手动搜索。
我们的结果表明，FT 缺乏长期随机数据。国际泌尿学指南强调需要更多高质量的临床试验，以获得可靠的肿瘤学和毒性结果。共识和立场声明存在差异。
FT 规划、技术和随访的全球接受指南仍有待确定。需要进行设计良好的长期随访研究，并采用可靠的临床和毒性终点，以提高我们对 FT 的理解，并制定统一的指南来简化管理和随访。
