臨床泌尿器科68巻4号

2014年04月発行

増刊号特集 前立腺癌の診療ナビゲーション―わかりやすく丁寧に！ Ⅶ　前立腺癌が再発・再燃した場合の対処法

3．臨床的再発―放射線治療後の再発

著者： 福森知治¹

所属機関： ¹徳島大学医学部泌尿器科

ページ範囲：P.272 - P.276

051


Q　放射線治療後の再発の定義，および放射線治療後の再発の対処法と注意点について教えてください。


Point

●放射線治療後の再発の定義は放射線治療後PSA最低値から2.0ng/ml以上の上昇である。

●再発の評価の際にはPSA bounceに注意が必要である。

●再発後の治療は早期のホルモン療法が中心である。

参考文献

1）Roach M 3rd, Hanks G, Thames H Jr, et al：Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer：recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 65：965-974, 2006

2）Stock RG, Stone NN and Cesaretti JA：Prostate-specific antigen bounce after prostate seed implantation for localized prostate cancer：descriptions and implications. Int J Radiat Oncol Biol Phys 56：448-453, 2003

3）Toledano A, Chauveinc L, Flam T, et al：PSA bounce after permanent implant prostate brachytherapy may mimic a biochemical failure：a study of 295 patients with a minimum 3-year followup. Brachytherapy 5：122-126, 2006

4）Satoh T, Ishiyama H, Matsumoto K, et al：Prostate-specific antigen“bounce”after permanent 125I-implant brachytherapy in Japanese men：a multi-institutional pooled analysis. BJU Int 103：1064-1068, 2009

5）Kotzerke J, Volkmer BG, Neumaier B, et al：Carbon-11 acetate positron emission tomography can detect local recurrence of prostate cancer. Eur J Nucl Med Mol Imaging 29：1380-1384, 2002

6）Agarwal PK, Sadetsky N, Konety BR, et al：Treatment failure after primary and salvage therapy for prostate cancer：likelihood, patterns of care, and outcomes. Cancer 112：307-314, 2008

7）Shipley WU, Desilvio M, Pilepich MV, et al：Early initiation of salvage hormone therapy influences survival in patients who failed initial radiation for locally advanced prostate cancer：a secondary analysis of RTOG protocol 86-10. Int J Radiat Oncol Biol Phys 64：1162-1167, 2006

8）Pinover WH, Horwitz EM, Hanlon AL, et al：Validation of a treatment policy for patients with prostate specific antigen failure after three-dimensional conformal prostate radiation therapy. Cancer 97：1127-1133, 2003

9）Alongi F, De Bari B, Campostrini F, et al：Salvage therapy of intraprostatic failure after radical external-beam radiotherapy for prostate cancer：a review. Crit Rev Oncol Hematol. 2013 Aug

10）Murat FJ, Poissonnier L, Rabilloud M, et al：Mid-term results demonstrate salvage high-intensity focused ultrasound（HIFU）as an effective and acceptably morbid salvage treatment option for locally radiorecurrent prostate cancer. Eur Urol 55：640-647, 2009