医学
前列腺癌
放射治疗
肿瘤科
雄激素剥夺疗法
内科学
不利影响
回顾性队列研究
转移
癌症
作者
Elise De Bleser,Phuoc T. Tran,Piet Ost
出处
期刊:Current Opinion in Urology
[Ovid Technologies (Wolters Kluwer)]
日期:2017-11-01
卷期号:27 (6): 587-595
被引量:37
标识
DOI:10.1097/mou.0000000000000441
摘要
Purpose of review To summarize the available literature regarding radiotherapy as a metastasis-directed therapy (MDT) in the treatment of oligometastatic prostate cancer (PCa). Recent findings Three different clinical scenarios of oligometastatic PCa exist in which MDT can be applied: de novo oligometastatic PCa, oligorecurrent PCa, and oligoprogressive PCa. A cut off of three to five metastatic lesions is most often used in these settings. Data from retrospective studies, treating over 1000 patients in total, have been reported. The median progression-free survival ranges between 1 and 3 years, but is influenced by a heterogeneous use of androgen deprivation therapy. For lymph node metastases, a propensity scored matched analysis suggests that cancer specific and overall survival is improved with MDT over standard of care. MDT treatment regimens vary with different radiotherapy techniques, doses, and volumes. Adverse events are limited to grade 1–2 and only rarely grade 3 events are reported. Summary Based on data from retrospective studies, progression-free survival following MDT for oligometastatic PCa is promising with few adverse events. Comparative prospective studies are under way and will shed light on the future of MDT.
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