Braquiterapia para el cáncer de próstata. Una revisión actualizada de su historia, sus indicaciones, la evidencia que la sustenta y sus controversias.
Palabras clave:
próstata, cáncer, braquiterapia.Resumen
Introducción: en Chile el cáncer de próstata es el cáncer más frecuente en hombres. Se estima que aproximadamente 5700 hombres son diagnosticados cada año. Esta enfermedad aun en sus estadios iniciales tiene un comportamiento y tratamiento específico dependiendo de características clínicas y patológicas. Las alternativas terapéuticas incluyen desde el seguimiento activo hasta la cirugía. La radioterapia en forma de braquiterapia tiene un rol fundamental desde el cáncer de próstata de bajo hasta el alto riesgo.
Objetivos: el objetivo de esta revisión pretende resumir las publicaciones más recientes sobre la evolución histórica de esta modalidad de tratamiento, sus indicaciones de tratamiento así como la evidencia que la sustenta. Metodología: se realizó una revisión exhaustiva libre de la literatura publicada en Pubmed utilizando los términos MESH. Resultados: la Braquiterapia en su forma de baja y alta tasa tiene amplia evidencia que la sustenta tanto como escalamiento de dosis asociado cuando se asocia a radioterapia externa como tratamiento exclusivo. Estudios randomizados muestran resultados superiores en términos de control bioquímico sin diferencias en sobrevida global. Conclusiones: la braquiterapia de cáncer de próstata ha presentado grandes avances tecnológicos que la posicionan como una alternativa terapéutica para la gran mayoría de los pacientes con cáncer de próstata localizado y debiera discutirse con ellos previo al inicio del tratamiento.
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