Armstrong J
St. Luke's Hospital, Dublin, Ireland.
Ir J Med Sci. 1998 Jul-Sep;167(3):138-44. doi: 10.1007/BF02937924.
Analysis of the results of treatment of localised prostate cancer with radiation and surgery has identified patients who are at high risk of developing metastatic dissemination. High histologic grade, serum prostate specific antigen above 20 ng/ml, extension beyond the capsule of the prostate, and involvement of lymph nodes are highly predictive of metastatic risk. Antiandrogen therapy has high rates of activity in the treatment of overt metastatic disease prompting its assessment as an adjuvant treatment added to radiation therapy. There are now major prospective randomized trials which have been completed. The current evidence indicates that a large survival benefit ensues when antiandrogen therapy is added to radiation for appropriately selected patients. This adjuvant approach is likely to become the standard of care. Strategies for further enhancement of adjuvant therapy are discussed.
对局部前列腺癌放疗和手术治疗结果的分析已确定了发生转移扩散高风险的患者。高组织学分级、血清前列腺特异性抗原高于20 ng/ml、超出前列腺包膜范围以及淋巴结受累高度预示转移风险。抗雄激素疗法在明显转移性疾病的治疗中具有较高的活性，促使其作为放疗辅助治疗进行评估。目前已经完成了一些大型前瞻性随机试验。现有证据表明，对于适当选择的患者，放疗联合抗雄激素治疗可带来显著的生存获益。这种辅助治疗方法可能会成为标准治疗方案。文中还讨论了进一步增强辅助治疗的策略。
