最近，耶魯大學(xué)醫(yī)學(xué)院研究人員在Archives of Internal Medicine雜志上發(fā)表文章稱：前列腺癌治療對(duì)于預(yù)期壽命較短的老年前列腺癌患者而言并非總是必要的。
論文主要作者——耶魯大學(xué)醫(yī)學(xué)院內(nèi)科副教授Cary-Gross認(rèn)為對(duì)于那些侵襲性不強(qiáng)的前列腺癌老年患者來說,，前列腺癌不太可能會(huì)繼續(xù)惡化或是對(duì)機(jī)體造成危害。因此,，在某些情況下,，前列腺的治療是得不償失的，是弊大于利的,。
Cary-Gross所帶領(lǐng)的科研團(tuán)隊(duì)通過分析9年的醫(yī)療數(shù)據(jù)（這些數(shù)據(jù)也即該項(xiàng)研究一共納入了39,270名67歲或是67歲以上的前列腺癌老年患者）后發(fā)現(xiàn)：過去十年里,，那些預(yù)期壽命較短的前列腺癌老年患者接受藥物越來越普遍。從1998至2007年,，接受治療的前列腺癌男性患者的人數(shù)比例從61.2%上升到了67.6%,。其中增幅最大的是那些預(yù)期壽命最短并且腫瘤分級(jí)只是中等風(fēng)險(xiǎn)的前列腺癌男性患者。但預(yù)期壽命較長腫瘤屬低風(fēng)險(xiǎn)的前列腺癌患者接受治療的比例較低,。
這一結(jié)果表明,，那些在臨床獲益可能是最低的前列腺癌病人過多地接受了治療。盡管對(duì)致命性的癌癥不做出相應(yīng)的治療會(huì)反映出醫(yī)療水平較低這一事實(shí),，但對(duì)病情基本不會(huì)惡化的前列腺癌老年患者進(jìn)行過多積極治療在增加并發(fā)癥危險(xiǎn)以及浪費(fèi)治療費(fèi)用生物同時(shí),，反而不會(huì)讓患者受益。
研究人員呼吁癌癥患者的治療手段應(yīng)遵循臨床證據(jù)以及患者的意愿,，對(duì)那些侵襲性不強(qiáng)且且壽命預(yù)期較短的前列腺癌老年患者應(yīng)以積極的監(jiān)測(cè)代替積極的治療,。（生物谷Bioon.com）
doi:10.1001/archinternmed.2011.1494
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The Relationship Between Clinical Benefit and Receipt of Curative Therapy for Prostate Cancer
Ann C. Raldow, MD; Carolyn J. Presley, MD; James B. Yu, MD; Richa Sharma, MPH; Laura D. Cramer, PhD; Pamela R. Soulos, MPH; Jessica B. Long, MPH; Danil V. Makarov, MD, MHS; Cary P. Gross, MD
Life expectancy (LE) and tumor characteristics are clinical factors that affect the likelihood of benefit from curative therapy (CTx) for prostate cancer. Treatment of patients with a shorter LE may contribute to additional costs or complications, without a commensurate improvement in quality of life or survival.1-3 The National Comprehensive Cancer Network practice guidelines in oncology4 recommend active surveillance as an alternative to CTx (radical prostatectomy or radiation therapy) for patients with low-risk tumor characteristics who have an LE of less than 10 years. For patients with intermediate-risk cancers and an LE of 10 years or more, CTx is recommended.4 Although therapeutic options for patients with prostate cancer have expanded considerably in recent years, little . . .
