Инновации в лучевой терапии при лечении рака предстательной железы: улучшение результатов и минимизация побочных эффектов

Abstract

Prostate cancer is one of the most common oncological diseases affecting men and causing an increase in the mortality rate among men worldwide. Russia has also seen a significant increase in morbidity and mortality in recent years. Currently, there is no absolutely effective method of treating prostate cancer. It is necessary to search for new economically justified methods with minor side effects or without them. The purpose of this article is to compare the methods of radiation therapy, to determine the advantages of innovative methods improving results and minimizing side effects in the treatment of patients with prostate cancer. We reviewed the current state of remote radiotherapy (EBRT/DLT) in high-risk cases, including the use of androgen deprivation therapy (ADT/ADT), the role of hypofractionation and stereotactic radiotherapy (SBRT/STLT), new data on combination therapy. An analysis of publications has shown the feasibility of combining long-term ADT and remote radiotherapy in patients with high-risk prostate cancer for maximum disease control and increased overall survival compared with treatment without this combination. Randomized data suggest that increasing the dose with LDR brachytherapy may be more effective than increasing the dose with EBRT alone. Over the past decade, advances in technology, imaging capabilities, and improved radiobiological understanding have profoundly changed radiation therapy for prostate cancer, allowing for increased dose and widespread introduction of hypofractionation. In addition, the integration of magnetic resonance imaging (MRI) and improved physical accuracy of dose delivery gave impetus to additional targeting of intra-static tumor lesions previously independent of the traditional concept of determining the target of radiation therapy.