Prostatic cancer: are we closer to rational treatment selection?
Prostatic cancer: are we closer to rational treatment selection?
复制标题
前列腺癌：我们是否更接近合理的治疗选择？
作者：
H. Scher
尽管前列腺癌各阶段的治疗存在争议，但不断出现的指南可以为个体患者更好地选择治疗方法。对于早期疾病，前列腺特异性抗原测定与其他分期程序相结合，提高了我们定义真正的器官局限性疾病的能力。腹腔镜淋巴结清扫术的广泛使用使许多患者避免了不必要的剖腹手术。对于患有转移性疾病的患者，需要研究保留效力的抗雄激素作为单一疗法的总体效果。最令人鼓舞的是，越来越多的团体正在使用前列腺特异性抗原的变化来评估疾病活动性，并将最近的实验室研究迅速转化为临床。随着我们预测个体患者肿瘤生物学潜力的能力得到提高，更多个体化的治疗建议将成为可能。
Despite the controversies in management for all stages of prostatic cancer, guidelines are emerging that allow for better selection of treatments for individual patients. For early stage disease, prostate-specific antigen determinations in conjunction with other staging procedures have refined our ability to define truly organ-confined disease. The more widespread use of laparoscopic lymph node dissections has spared many patients needless laparotomies. For patients with metastatic disease, the overall effect of potency-sparing antiandrogens as monotherapy needs to be investigated. Most encouraging is that more groups are using prostate-specific antigen changes to assess disease activity and the rapid translation of recent laboratory investigations into the clinic. As our ability to predict the biologic potential of an individual patient's tumor is improved, more individualized treatment recommendations will be possible.