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The role of metastasis-directed therapy and local therapy of the primary tumor in the management of oligometastatic prostate cancer

机译:转移导向治疗和原发肿瘤局部治疗在少转移性前列腺癌管理中的作用

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摘要

Oligometastasis has been proposed as an intermediate stage of cancer spread between localized disease and widespread metastasis. Oligometastatic malignancy is now being diagnosed more frequently as the result of improvements in diagnostic modalities such as functional imaging. The importance of oligometastasis in managing metastatic prostate cancer is that it is possible to treat with a curative aim by metastasis-directed or local therapy in selected patients. Many studies have shown that these aggressive treatments lead to improved survival in other oligometastatic malignancies. However, few studies have shown definitive benefits of metastasis-directed or local therapy in oligometastatic prostate cancer. Review of the available studies suggests that stereotactic radiotherapy (RT) of metastatic lesions in oligorecurrent disease is a feasible and safe modality for managing oligometastatic prostate cancer. Also, stereotactic RT can delay the start of androgen deprivation therapy. Many retrospective studies of metastatic prostate cancer have shown that patients undergoing local therapy seem to have superior overall and cancer-specific survival compared with patients not receiving local therapy. Ongoing prospective randomized trials would be helpful to evaluate the role of local therapy in oligometastatic prostate cancer.
机译:寡转移已被提出为癌症在局部疾病和广泛转移之间扩散的中间阶段。由于功能性影像学等诊断方式的改进,现在越来越多地诊断出低位恶性肿瘤。在转移性前列腺癌的处理中,低转移的重要性在于可以通过针对特定患者的转移导向或局部疗法达到治愈目的。许多研究表明,这些积极的治疗方法可改善其他低转移性恶性肿瘤的生存率。然而,很少有研究显示转移导向或局部疗法在少转移性前列腺癌中具有明确的益处。对现有研究的回顾表明,少复发性疾病转移灶的立体定向放疗(RT)是治疗少转移性前列腺癌的可行且安全的方法。同样,立体定向RT可延迟雄激素剥夺治疗的开始。转移性前列腺癌的许多回顾性研究表明,与未接受局部治疗的患者相比,接受局部治疗的患者似乎具有更好的总体生存和癌症特异性生存率。正在进行的前瞻性随机试验将有助于评估局部治疗在少转移性前列腺癌中的作用。

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