Xue Qin, Zhang Jingliang, Jiao Jianhua, Qin Weijun, Yang Xiaojian
Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Front Oncol. 2022 Sep 23;12:980239. doi: 10.3389/fonc.2022.980239. eCollection 2022.
Over the past two decades, there has been a tendency toward early diagnosis of prostate cancer due to raised awareness among the general public and professionals, as well as the promotion of prostate-specific antigen (PSA) screening. As a result, patients with prostate cancer are detected at an earlier stage. Due to the risks of urine incontinence, erectile dysfunction, etc., surgery is not advised because the tumor is so small at this early stage. Doctors typically only advise active surveillance. However, it will bring negative psychological effects on patients, such as anxiety. And there is a higher chance of cancer progression. Focal therapy has received increasing attention as an alternative option between active monitoring and radical therapy. Due to its minimally invasive, oncological safety, low toxicity, minimal effects on functional outcomes and support by level 1 evidence from the only RCT within the focal therapy literature, photodynamic treatment (PDT) holds significant promise as the focal therapy of choice over other modalities for men with localized prostate cancer. However, there are still numerous obstacles that prevent further advancement. The review that follows provides an overview of the preclinical and clinical published research on PDT for prostate cancer from 1999 to the present. It focuses on clinical applications of PDT and innovative techniques and technologies that address current problems, especially the use of nanoparticle photosensitizers in PDT of prostate cancer.
在过去二十年中，由于公众和专业人士的意识提高以及前列腺特异性抗原（PSA）筛查的推广，前列腺癌有早期诊断的趋势。因此，前列腺癌患者在更早阶段被检测出来。由于存在尿失禁、勃起功能障碍等风险，鉴于肿瘤在这个早期阶段非常小，不建议进行手术。医生通常只建议进行主动监测。然而，这会给患者带来负面心理影响，如焦虑。而且癌症进展的几率更高。聚焦治疗作为主动监测和根治性治疗之间的一种替代选择，受到了越来越多的关注。由于其微创、肿瘤学安全性、低毒性、对功能结果影响最小以及在聚焦治疗文献中唯一的随机对照试验（RCT）提供的一级证据支持，光动力治疗（PDT）作为局部前列腺癌男性患者优于其他方式的聚焦治疗选择具有重大前景。然而，仍有许多障碍阻碍其进一步发展。以下综述概述了1999年至今关于前列腺癌光动力治疗的临床前和临床已发表研究。它侧重于光动力治疗的临床应用以及解决当前问题的创新技术，特别是纳米颗粒光敏剂在前列腺癌光动力治疗中的应用。
