Gastrointestinal toxicity following radiotherapy for prostate cancer: a ring of fire.

摘要

Prostate cancer (PCa) is the most common male malignancy. Early disease detection has produced a stage migration so that the majority of new cases are now locally confined at diagnosis [1]. These tumours have a long latency between diagnosis and death. Contemporary literature can only estimate the natural history of today's early PCa. Consequently, we must balance the risks of overtreatment for indolent disease with undertreatment for a tumour that will affect the patient within his lifetime. As randomised treatment and screening trials mature, we gain evidence to inform our practice. We know that between 1 in 10 and 1 in 48 men need radical treatment to save 1 man from dying of PCa [1]. These figures are likely to change as follow-up matures. To date, published treatment randomised controlled trials (RCTs) have compared radical prostatectomy (RP) with observation or watchful waiting. This choice reflects that in most countries, the urologist is first to see patients with PCa and that prostate-specific antigen was a urologic issue for many years. However, data show that radical radiotherapy (RT) works well for PCa.