前列腺癌局灶治疗研究进展

Focal therapy for prostate cancer

局部治疗(focal therapy,FT)是治疗局限性前列腺癌(prostate cancer,PCa)的一种治疗方式,主要针对低中危局限性前列腺癌,以减少全腺体治疗,如根治性前列腺切除术(radical prostatectomy,RP)或根治性外放疗的不良反应,FT优点是在控制肿瘤的同时,更多地保留性功能和膀胱功能。FT的治疗靶点统称为主要病灶(index lesion,IL),多通过影像学确定,目前最常用的是多参数磁共振成像(multiparametric magnetic resonance imaging,mpMRI)。大量回顾性研究指出FT可降低再活检的阳性率、获得良好的短期肿瘤控制效果,但仍然缺乏大样本的前瞻性随机对照数据。本文将对应用于PCa治疗的FT进行简要综述,包括FT的治疗基础、靶病灶的确定和相关临床研究数据等。

Focal therapy(FT)is an option for treatment of localized prostate cancer(PCa),mainly focusing on low and intermediate risk patients,with the aim of reducing side effects of primary whole-gland treatments such as radical prostatectomy or radiotherapy.FT can preserve both sexual and bladder function while simultaneously providing sufficient oncological control.Index lesion(IL)is the target of FT and is detected by imaging examinations,among which,multiparametric magnetic resonance imaging(mpMRI)is the most used imaging method.Many retrospective published studies point out that FT can lower the positive rate of rebiopsy and short-term oncological outcome is good.However,data from prospective controlled trials are still lacking.This article will briefly review FT for PCa treatment,including the treatment basis of FT,determination of target lesions,and relevant clinical research data.