Updates in the use of radiotherapy in the management of primary and locally-advanced penile cancer  

作　　者：Akshar Patel Arash O.Naghavi Peter A.Johnstone Philippe E.Spiess G.Daniel Grass 

机构地区：[1]University of South Florida Morsani College of Medicine,Tampa,FL,USA [2]Department of Radiation Oncology,H.Lee Moffitt Cancer Center and Research Institute,Tampa,FL,USA [3]Department of Genitourinary Oncology,H.Lee Moffitt Cancer Center and Research Institute,Tampa,FL,USA

出　　处：《Asian Journal of Urology》2022年第4期389-406,共18页亚洲泌尿外科杂志（英文）

摘　　要：Objective:Penile cancer is a rare malignancy in most developed countries,but may represent a significant oncologic challenge in certain African,Asian,and South American regions.Various treatment approaches have been described in penile cancer,including radio-therapy.This review aimed to provide a synopsis of radiotherapy use in penile cancer management and the associated toxicities.In addition,we aimed to discuss palliative radiation for metastases to the penis and provide a brief overview of how tumor biology may assist with treatment decision-making.Methods:Peer-reviewed manuscripts related to the treatment of penile cancer with radio-therapy were evaluated by a PubMed search(1960-2021)in order to assess its role in the definitive and adjuvant settings.Selected manuscripts were also evaluated for descriptions of radiation-related toxicity.Results:Though surgical resection of the primary is an excellent option for tumor control,select patients may be treated with organ-sparing radiotherapy by either external beam radiation or brachytherapy.Data from randomized controlled trials comparing radiotherapy and surgery are lacking,and thus management is frequently determined by institutional practice patterns and available expertise.Similarly,this lack of clinical trial data leads to divergence in opinion regarding lymph node management.This is further complicated in that many cited studies evaluating lymph node radiotherapy used non-modern radiotherapy delivery techniques.Groin toxicity from either surgery or radiotherapy remains a challenging problem and further risk assessment is needed to guide intensification with multi-modal therapy.Intrinsic differences in tumor biology,based on human papillomavirus infection,may help aid future prognostic and predictive models in patient risk stratification or treatment approach.Conclusion:Penile cancer is a rare disease with limited clinical trial data driving the majority of treatment decisions.As a result,the goal of management is to effectively treat the disease while balan

关 键 词：BRACHYTHERAPY CHEMORADIATION Radiation RADIOTHERAPY Penile cancer Squamous cell carcinoma of the penis Penile-sparing Penile metastase Human papillomavirus 

分 类 号：R737.27[医药卫生—肿瘤]