前列腺癌局灶治疗的新进展

Research advances of focal therapy for prostate cancer

前列腺癌目前是全球男性中第2常见的恶性肿瘤,在中国的发病率也日益增高。大多前列腺癌患者被诊断后接受了全腺治疗,但局限性前列腺癌的患者因为全腺治疗的副作用可能无法从治疗中获益。随着影像技术的进展和“主要病灶”理论的提出,局灶治疗技术得到了长足的发展。临床上目前使用的局灶治疗技术主要包括高强度聚集超声、局灶激光消融、冷冻疗法、不可逆电穿孔和光动力疗法。本研究对局灶治疗近年来的临床试验进行回顾,发现高强度聚集超声和局灶激光消融的治疗方法具有更好的无失败生存率和术后功能控制。

Prostate cancer is now the second most common malignancy in men worldwide,with an increasing incidence in China.Most prostate cancer patients receive whole-gland therapy after diagnosis,but patients with localized prostate cancer may not benefit from the treatment due to side effects.With the development of imaging technology and the theory of“index lesion,”focal therapy has been greatly developed,which includs high intensity focused ultrasound,focal laser ablation,cryotherapy,irreversible electroporation and photodynamic therapy.This study reviews the clinical trials in recent years and reveals that high intensity focused ultrasound and focal laser ablation have better failure-free survival and postoperative functional control compared with other focal therapy techniques.