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现代放射治疗在转移性前列腺癌治疗中的作用与潜力

The Role and Potential of Modern Radiotherapy in the Treatment of Metastatic Prostate Cancer.

作者信息

Kwiatkowski Robert, Kłeczek Anna M, Gabor Jadwiga, Brzezińska Natalia, Swinarew Andrzej S

机构信息

Radiotherapy Department, Katowice Oncological Center, 40-074 Katowice, Poland.

Faculty of Science and Technology, University of Silesia, 41-500 Chorzów, Poland.

出版信息

Cancers (Basel). 2025 Mar 20;17(6):1045. doi: 10.3390/cancers17061045.

Abstract

: Prostate cancer is one of the most prevalent cancers among men, with a significant proportion progressing to metastatic disease. Traditional treatments for metastatic prostate cancer have primarily been palliative, focusing on symptom relief. However, recent advances in radiotherapy have shown promise in improving outcomes for these patients. : This study presents a modern treatment plan for extensive metastatic prostate cancer. Pre-treatment imaging revealed extensive lymph node metastases and high metabolic activity in the prostate. The treatment regimen included bicalutamide, androgen deprivation therapy with leuprorelin, and six cycles of docetaxel chemotherapy, followed by a targeted radiotherapy regimen aimed at both the primary tumor and metastatic lymph nodes. : Following the comprehensive radiotherapy regimen, the patient's PSA level dropped below the edge of detection, indicating complete biochemical remission. Follow-up imaging and clinical assessments confirmed the absence of active metastatic sites. : The findings support the integration of radiotherapy into comprehensive treatment plans for metastatic prostate cancer, demonstrating that radiotherapy can achieve complete remission even in patients with extensive metastatic disease. This suggests a need for re-evaluating traditional approaches and exploring more personalized, multimodal treatment strategies. Enhanced imaging techniques, such as PET/PSMA scans, play a crucial role in accurately targeting metastatic sites, enabling more effective and individualized treatment.

摘要

前列腺癌是男性中最常见的癌症之一,其中很大一部分会发展为转移性疾病。转移性前列腺癌的传统治疗主要是姑息性的,侧重于缓解症状。然而,放射治疗的最新进展显示出改善这些患者预后的前景。

本研究提出了一种针对广泛性转移性前列腺癌的现代治疗方案。治疗前成像显示前列腺存在广泛的淋巴结转移和高代谢活性。治疗方案包括比卡鲁胺、用亮丙瑞林进行雄激素剥夺治疗以及六个周期的多西他赛化疗,随后是针对原发性肿瘤和转移性淋巴结的靶向放射治疗方案。

在综合放射治疗方案之后,患者的前列腺特异性抗原(PSA)水平降至检测下限以下,表明完全生化缓解。后续的成像和临床评估证实没有活跃的转移部位。

这些发现支持将放射治疗纳入转移性前列腺癌的综合治疗方案,表明放射治疗即使在患有广泛性转移性疾病的患者中也能实现完全缓解。这表明需要重新评估传统方法并探索更个性化的多模式治疗策略。增强成像技术,如PET/PSMA扫描,在准确靶向转移部位方面发挥着关键作用,从而实现更有效和个性化的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a79c/11941568/157937376533/cancers-17-01045-g001.jpg

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