Focal therapy in prostate cancer: modalities, findings and future considerations

被引:84
作者
Lindner, Uri [1 ]
Trachtenberg, John [1 ]
Lawrentschuk, Nathan [1 ]
机构
[1] Univ Toronto, Dept Urol & Surg Oncol, Princess Margaret Hosp, Univ Hlth Network, Toronto, ON M5G 2M9, Canada
关键词
INTENSITY-FOCUSED ULTRASOUND; TARGETED PHOTODYNAMIC THERAPY; INDUCED INTERSTITIAL THERMOTHERAPY; GUIDED PERCUTANEOUS CRYOTHERAPY; DIFFUSION-WEIGHTED MRI; CONTRAST-ENHANCED MRI; QUALITY-OF-LIFE; RADICAL PROSTATECTOMY; LASER-ABLATION; INITIAL-EXPERIENCE;
D O I
10.1038/nrurol.2010.142
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Focal therapy is emerging as an alternative to active surveillance for the management of low-risk prostate cancer in carefully selected patients. The aim of focal therapy is long-term cancer control without the associated morbidity that plagues all radical therapies. Different energy modalities have been used to focally ablate cancer tissue, and available techniques include cryotherapy, laser ablation, high-intensity focused ultrasound and photodynamic therapy. The majority of evidence for focal therapy has come from case series and small phase I trials, and larger cohort studies with longer follow-up are only now being commenced. More data from large trials on the safety and efficacy of focal therapy are therefore required before this approach can be recommended in men with prostate cancer; in particular, studies must confirm that no viable cells remain in the region of ablation. Focal therapy might eventually prove to be a 'middle ground' between active surveillance and radical treatment, combining minimal morbidity with cancer control and the potential for re-treatment.
引用
收藏
页码:562 / 571
页数:10
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