Resumo
Objetivo: Analisar as características do câncer de próstata e os avanços no diagnóstico e tratamento. Revisão bibliográfica: O câncer de próstata é o segundo tipo mais comum em homens, representando 29% dos diagnósticos de câncer masculino no Brasil. Localiza-se na glândula prostática, responsável pela produção do líquido seminal. Fatores de risco incluem idade avançada, histórico familiar e mutações nos genes BRCA1 e BRCA2. O diagnóstico é realizado por exame de toque retal, dosagem de PSA e escore de Gleason, que avalia a agressividade tumoral. No tratamento, destacam-se a radioterapia de intensidade modulada (IMRT), com maior precisão e menor toxicidade, e a radioterapia guiada por imagem, que aumenta a eficácia terapêutica. Além disso, a cirurgia robótica na prostatectomia radical oferece menor morbidade e melhor recuperação funcional. Considerações finais: O câncer de próstata apresenta alta incidência e impacto significativo na saúde masculina. Os avanços diagnósticos e terapêuticos, como a radioterapia hipofracionada e as técnicas cirúrgicas minimamente invasivas, têm contribuído para melhores desfechos clínicos, o que destaca a importância de uma abordagem personalizada e multidisciplinar para garantir qualidade de vida aos pacientes.
Referências
ACHARD V e ZILLI T. Prostate cancer intensity-modulated radiotherapy and long-term genitourinary toxicity: an evolving therapeutic landscape. Prostate Cancer and Prostatic Diseases, 2023; 26(1): 1-2.
BAUMAN G, et al. Intensity-modulated radiotherapy in the treatment of prostate cancer. Clinical Oncology, 2012; 24(7): 461-473.
BORGES-OSÓRIO MR e ROBINSON WM. Genética humana. 3rd ed. Porto Alegre: Artmed, 2013; 425.
BRASIL. Ministério da Saúde. Instituto Nacional de Câncer. Estadiamento. Rio de Janeiro: INCA, 2022.
Disponível em: https ://www.gov.br/inca/pt-br/assuntos/cancer/como-surge-o-cancer/estadiamento. Ace ssado em 10 de setembro de 2023.
BRASIL. Ministério da Saúde. Saúde do Homem. INCA - Instituto Nacional de Câncer. 2020. Disponível em: https ://www.inca.gov.br/campanhas/cancer-de-prostata/2020/saude-dohomem. Acessado em: 22 de novembro de 2023.
BRAVO BS, et al. Câncer de próstata: revisão de literatura / Prostate cancer: literature review. Brazilian Journal of Health Review, 2022; 5(1): 567-577.
CAO L, et al. Robot-assisted and laparoscopic vs open radical prostatectomy in clinically localized prostate cancer: perioperative, functional, and oncological outcomes: a systematic review and meta-analysis. Medicine (Baltimore), 2019; 98(22): 15770.
CARVALHO LM. Metástase óssea no câncer de próstata; 53 f. Trabalho de Conclusão de Curso (Graduação em Medicina) - Faculdade de Medicina; Universidade Federal Fluminense; Rio de Janeiro, 2022.
CHANG JY. Intensity-modulated radiotherapy, not 3-dimensional conformal, is the preferred technique for treating locally advanced lung cancer. Seminars in Radiation Oncology, 2015; 25(2): 110-116.
FICARRA V, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. European Urology, 2012; 62(3): 418-430.
GAO L, et al. Autophagy and tumour radiotherapy. Advances in Experimental Medicine and Biology, 2020; 1207: 375-387.
HATANO K, et al. Current status of intensity-modulated radiation therapy for prostate cancer: history, clinical results and future directions. International Journal of Urology, 2019; 26(8): 775-784.
HUMMEL S, et al. Intensity-modulated radiotherapy for the treatment of prostate cancer: a systematic review and economic evaluation. Health Technology Assessment, 2010; 14(47): 1-108.
KING MT, et al. Low dose rate brachytherapy for primary treatment of localized prostate cancer: a systemic review and executive summary of an evidence-based consensus statement. Brachytherapy, 2021; 20(6): 1114-1129.
LANTZ A, et al. Functional and oncological outcomes after open versus robot-assisted laparoscopic radical prostatectomy for localised prostate cancer: 8-year follow-up. European Urology, 2021; 80(5): 650-660.
LAVERY HJ, et al. The advanced learning curve in robotic prostatectomy: a multi-institutional survey. Journal of Robotic Surgery, 2009; 3(3): 165.
LEE WR, et al. Randomized phase III noninferiority study comparing two radiotherapy fractionation schedules in patients with low-risk prostate cancer. Journal of Clinical Oncology, 2016; 34(20): 2325-2332.
MCCLELLAND S, et al. Is moderate hypofractionation accepted as a new standard of care in North America for prostate cancer patients treated with external beam radiotherapy? Survey of genitourinary expert radiation oncologists. International Brazilian Journal of Urology, 2019; 45(2): 273-287.
MCCORMICK BZ, et al. Contemporary outcomes following robotic prostatectomy for locally advanced and metastatic prostate cancer. Translational Andrology and Urology, 2021; 10(5).
MCLAUGHLIN PW e NARAYANA V. Progress in low dose rate brachytherapy for prostate cancer. Seminars in Radiation Oncology, 2020; 30(1): 39-48.
PICARDI C, et al. Hypofractionated radiotherapy for prostate cancer in the postoperative setting: what is the evidence so far? Cancer Treatment Reviews, 2018; 62: 91-96.
PODDER TK, et al. Advances in radiotherapy for prostate cancer treatment. Advances in Experimental Medicine and Biology, 2018; 1096: 31-47.
RABOY A, et al. Early experience with extraperitoneal endoscopic radical retropubic prostatectomy. Surgical Endoscopy, 1998; 12(10): 1264-1267.
RAJWA P, et al. Prostate cancer risk, screening and management in patients with germline BRCA1/2 mutations. Nature Reviews Urology, 2023; 20(4): 205-216.
SEKHOACHA M, et al. Prostate cancer review: genetics, diagnosis, treatment options, and alternative approaches. Molecules, 2022; 27(17): 5730.
SHEETS NC, et al. Intensity-modulated radiation therapy, proton therapy, or conformal radiation therapy and morbidity and disease control in localized prostate cancer. JAMA, 2012; 307(15): 1611-1620.
SIVKOV AV, et al. Brachytherapy for prostate cancer and immune response. Experimental and Clinical Urology, 2022; 15(3): 36-43.
SLEVIN F, et al. A comparison of outcomes for patients with intermediate and high-risk prostate cancer treated with low dose rate and high dose rate brachytherapy in combination with external beam radiotherapy. Clinical and Translational Radiation Oncology, 2020; 20: 1-8.
WANG G, et al. Genetics and biology of prostate cancer. Genes & Development, 2018; 32(17-18): 1105-1140.
YU T, et al. The effectiveness of intensity modulated radiation therapy versus three-dimensional radiation therapy in prostate cancer: a meta-analysis of the literature. PLoS ONE, 2016; 11(5): 154499.
