Recurrent prostate cancer after primary treatment with radiation therapy is a common problem. Patients with localized recurrence may benefit from salvage therapy, but careful patient selection is crucial because not all patients will benefit from local salvage therapy, and salvage therapy has increased morbidity compared to primary treatments for prostate cancer. This review aims to provide an overview of the evaluation of patients with recurrent disease after radiation therapy and how it is continuing to evolve with increasing data on outcomes, as well as improving technologies and techniques. Our enhanced understanding of treatment outcomes and risk stratification has influenced the identification of patients who may benefit from local salvage treatment. Advances in imaging and biopsy techniques have enhanced the accuracy of locating the recurrence, which affects treatment decisions. Additionally, the growing interest in image-targeted ablative therapies that have less morbidity and complications than whole-gland therapies for suitable patients influences the evaluation process for those considering focal salvage therapy. Although significant changes have been made in the diagnostic evaluation of patients with recurrent disease after radiation therapy, it remains unclear whether these changes will ultimately improve patient outcomes.
放射治疗后前列腺癌复发是临床常见问题。局限性复发患者可能从挽救性治疗中获益，但并非所有患者都能从局部挽救治疗中获益，且相比前列腺癌初始治疗，挽救性治疗具有更高的并发症风险，因此精细的患者筛选至关重要。本综述旨在系统阐述放疗后复发患者的评估体系，并探讨该体系如何随着疗效数据的积累、技术手段的进步而持续演进。对治疗结果和风险分层认知的深化，促进了潜在获益患者的精准识别。影像学与活检技术的革新显著提升了复发灶定位精度，直接影响治疗决策。此外，相较于全腺体治疗，针对适宜患者的图像引导消融治疗因其更低的并发症发生率而备受关注，这正在改变局部挽救治疗的评估流程。尽管放疗后复发患者的诊断评估已取得显著进展，但这些变革能否最终改善患者预后仍有待明确。
肿瘤(癌症)患者之家