Concurrent chemoradiation for high-risk prostate cancer
Concurrent chemoradiation for high-risk prostate cancer作者机构：Department of Radiation Oncology New York University School of Medicine
出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)
年 卷 期：2015年第6卷第4期
页 面：35-42页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Prostate cancer Chemoradiation Highrisk prostate cancer Concurrent chemotherapy Chemotherapy Intensity modulated radiation therapy
摘 要：There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients thatare likely to recur after locoregional treatment that is thought of as a high-risk population. This more aggressive subset includes patients with clinical stage greater than T2 b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/d L. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.
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