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Aktuelle Urol 2024; 55(02): 134-138
DOI: 10.1055/a-2175-3159
Übersicht

Gibt es eine Indikation zur Lokaltherapie des mHSPC?

Is there an indication for local treatment in metastasised hormone-sensitive prostate cancer?
Constantin Rieger 
1   Urologie, Universitätsklinikum Köln, Köln, Germany
,
David Pfister
1   Urologie, Universitätsklinikum Köln, Köln, Germany
,
Jonathan Hollmann
2   Strahlentherapie, Universität Basel, Basel, Switzerland (Ringgold ID: RIN27209)
,
Alexandros Papachristofilou
2   Strahlentherapie, Universität Basel, Basel, Switzerland (Ringgold ID: RIN27209)
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Zusammenfassung

Beim metastasierten hormonsensitiven Prostatakarzinom (mHSPC) bestehen prinzipiell 2 mögliche Indikationen für eine Lokaltherapie des Primärtumors oder von Metastasen: Die Linderung oder Vermeidung von Symptomen und Komplikationen sowie eine Verbesserung des Krankheitsverlaufs, idealerweise mit einer Anhebung des Gesamtüberlebens und der Lebensqualität der Patienten.

Eine Lokaltherapie des mHSPC kann die systemische Therapie nicht ersetzen, sondern lediglich ergänzen. In diesem Beitrag werden die urologische und die radioonkologische Sicht zur Lokaltherapie des mHSPC dargelegt.

Abstract

In case of newly diagnosed metastasised hormone-sensitive prostate cancer, there are two indications for local treatment: to reduce or avoid local symptoms thus improving quality of life and prolonging survival in a subset of patients. Local treatment must be seen in a multimodal treatment approach and is not a replacement of systemic treatment. In the following review, we highlight the current literature for the different local treatment options, radiotherapy and radical prostatectomy, and try to give indications for which option should be offered to which patient.

Schlüsselwörter

hormonsensitives Prostatakarzinom - Metastasen - Radiotherapie - Prostatektomie

Keywords

prostate cancer - radiotherapy - prostatectomy - hormone-sensitive


Publication History

Received: 31 July 2023

Accepted after revision: 07 September 2023

Article published online:
27 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 NATIONAL CANCER INSTITUTE. Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Prostate Cancer. https://seer.cancer.gov/statfacts/html/prost.html
    PubMed
  • 2 Elmehrath AO, Afifi AM, Al-Husseini MJ. et al. Causes of Death Among Patients With Metastatic Prostate Cancer in the US From 2000 to 2016. JAMA Netw Open 2021; 4: e2119568
    CrossrefPubMedSearch in Google Scholar
  • 3 Weiner AB, Matulewicz RS, Eggener SE. et al. Increasing incidence of metastatic prostate cancer in the United States (2004–2013). Prostate Cancer Prostatic Dis 2016; 19: 395-397
    CrossrefPubMedSearch in Google Scholar
  • 4 Fizazi K, Tran N, Fein L. et al. Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial. Lancet Oncol 2019; 20: 686-700
    CrossrefPubMedSearch in Google Scholar
  • 5 Kyriakopoulos CE, Chen Y-H, Carducci MA. et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial. J Clin Oncol 2018; 36: 1080-1087
    CrossrefPubMedSearch in Google Scholar
  • 6 European Association of Urology. Prostate Cancer Guidelines Panel. https://uroweb.org/guidelines/prostate-cancer/chapter/treatment
    PubMed
  • 7 Parker CC, James ND, Brawley CD. et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet 2018; 392: 2353-2366
    CrossrefPubMedSearch in Google Scholar
  • 8 Won ACM, Gurney H, Marx G. et al. Primary treatment of the prostate improves local palliation in men who ultimately develop castrate-resistant prostate cancer. BJU Int 2013; 112: E250-E255
    CrossrefPubMedSearch in Google Scholar
  • 9 Heidenreich A, Paffenholz P, Pfister D. et al. Cytoreductive radical prostatectomy: who benefits from the surgical approach?. Curr Opin Urol 2023; 33: 168-171
    CrossrefPubMedSearch in Google Scholar
  • 10 Tzelepi V, Efstathiou E, Wen S. et al. Persistent, biologically meaningful prostate cancer after 1 year of androgen ablation and docetaxel treatment. J Clin Oncol 2011; 29: 2574-2581
    CrossrefPubMedSearch in Google Scholar
  • 11 Zelefsky MJ, Reuter VE, Fuks Z. et al. Influence of local tumor control on distant metastases and cancer related mortality after external beam radiotherapy for prostate cancer. J Urol 2008; 179: 1368-1373
    CrossrefPubMedSearch in Google Scholar
  • 12 Heidenreich A, Fossati N, Pfister D. et al. Cytoreductive Radical Prostatectomy in Men with Prostate Cancer and Skeletal Metastases. Eur Urol Oncol 2018; 1: 46-53
    CrossrefPubMedSearch in Google Scholar
  • 13 Chaloupka M, Stoermer L, Apfelbeck M. et al. Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer. Cancers (Basel) 2021; 13: 5636
    CrossrefPubMedSearch in Google Scholar
  • 14 Mao Y, Hu M, Yang G. et al. Cytoreductive prostatectomy improves survival outcomes in patients with oligometastases: a systematic meta-analysis. World J Surg Oncol 2022; 20: 255
    CrossrefPubMedSearch in Google Scholar
  • 15 Xue P, Wu Z, Wang K. et al. Oncological Outcome of Combining Cytoreductive Prostatectomy and Metastasis-Directed Radiotherapy in Patients with Prostate Cancer and Bone Oligometastases: A Retrospective Cohort Study. Cancer Manag Res 2020; 12: 8867-8873
    CrossrefPubMedSearch in Google Scholar
  • 16 Mazzone E, Preisser F, Nazzani S. et al. The Effect of Lymph Node Dissection in Metastatic Prostate Cancer Patients Treated with Radical Prostatectomy: A Contemporary Analysis of Survival and Early Postoperative Outcomes. Eur Urol Oncol 2019; 2: 541-548
    CrossrefPubMedSearch in Google Scholar
  • 17 Guo Y, Shi D, Zhang J. et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score is a Novel Significant Prognostic Factor for Patients with Metastatic Prostate Cancer Undergoing Cytoreductive Radical Prostatectomy. J Cancer 2019; 10: 81-91
    CrossrefPubMedSearch in Google Scholar
  • 18 Mandel PC, Huland H, Tiebel A. et al. Enumeration and Changes in Circulating Tumor Cells and Their Prognostic Value in Patients Undergoing Cytoreductive Radical Prostatectomy for Oligometastatic Prostate Cancer-Translational Research Results from the Prospective ProMPT trial. Eur Urol Focus 2021; 7: 55-62
    CrossrefPubMedSearch in Google Scholar
  • 19 Yang G, Xie J, Zhang S. et al. Clinical Significance of Mesenchymal Circulating Tumor Cells in Patients With Oligometastatic Hormone-Sensitive Prostate Cancer Who Underwent Cytoreductive Radical Prostatectomy. Front Oncol 2021; 11: 812549
    CrossrefPubMedSearch in Google Scholar
  • 20 Guo Y, Wang R, Wu P. et al. Preoperative Nutritional Risk Index Predicts Recurrence of Oligometastatic Prostate Cancer in Patients Undergoing Cytoreductive Radical Prostatectomy. Nutr Cancer 2021; 73: 1440-1447
    CrossrefPubMedSearch in Google Scholar
  • 21 Dai B, Zhang S, Wan F-N. et al. Combination of Androgen Deprivation Therapy with Radical Local Therapy Versus Androgen Deprivation Therapy Alone for Newly Diagnosed Oligometastatic Prostate Cancer: A Phase II Randomized Controlled Trial. Eur Urol Oncol 2022; 5: 519-525
    CrossrefPubMedSearch in Google Scholar
  • 22 Boevé LMS, Hulshof MCCM, Vis AN. et al. Effect on Survival of Androgen Deprivation Therapy Alone Compared to Androgen Deprivation Therapy Combined with Concurrent Radiation Therapy to the Prostate in Patients with Primary Bone Metastatic Prostate Cancer in a Prospective Randomised Clinical Trial: Data from the HORRAD Trial. Eur Urol 2019; 75: 410-418
    CrossrefPubMedSearch in Google Scholar
  • 23 Ali A, Hoyle A, Haran ÁM. et al. Association of Bone Metastatic Burden With Survival Benefit From Prostate Radiotherapy in Patients With Newly Diagnosed Metastatic Prostate Cancer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Oncol 2021; 7: 555-563
    CrossrefPubMedSearch in Google Scholar
  • 24 Bossi A, Foulon S, Maldonado X. et al. Prostate irradiation in men with de novo, low-volume, metastatic, castration-sensitive prostate cancer (mCSPC): Results of PEACE-1, a phase 3 randomized trial with a 2×2 design. JCO 2023; 41: LBA5000-LBA5000
    CrossrefPubMedSearch in Google Scholar
  • 25 Attard G, Murphy L, Clarke NW. et al. Abiraterone acetate and prednisolone with or without enzalutamide for high-risk non-metastatic prostate cancer: a meta-analysis of primary results from two randomised controlled phase 3 trials of the STAMPEDE platform protocol. Lancet 2022; 399: 447-460
    CrossrefPubMedSearch in Google Scholar
  • 26 Simforoosh N, Dadpour M, Mofid B. Cytoreductive and Palliative Radical Prostatectomy, Extended Lymphadenectomy and Bilateral Orchiectomy in Advanced Prostate Cancer with Oligo and Widespread Bone Metastases: Result of a Feasibility, Our Initial Experience. Urol J 2019; 16: 162-167
    CrossrefPubMedSearch in Google Scholar
  • 27 Lan T, Chen Y, Su Q. et al. Oncological Outcome of Cytoreductive Radical Prostatectomy in Prostate Cancer Patients With Bone Oligometastases. Urology 2019; 131: 166-175
    CrossrefPubMedSearch in Google Scholar
  • 28 Moschini M, Morlacco A, Kwon E. et al. Treatment of M1a/M1b prostate cancer with or without radical prostatectomy at diagnosis. Prostate Cancer Prostatic Dis 2017; 20: 117-121
    CrossrefPubMedSearch in Google Scholar