在阴茎鳞状细胞癌 (PeCa) 中，原发性肿瘤的治疗方案因疾病阶段而异，可能包括手术、放射、局部化疗或激光切除。本综述旨在强调放射治疗作为原发性 PeCa 器官保留策略的价值的当前证据。通过 Scopus、PubMed/MEDLINE 和 Web of ScienceTM 评估了采用外照射放射治疗 (EBRT) 和近距离放射治疗的原发性 PeCa 治疗手稿（2013-2023）评估其功效和安全性。动物研究、少于 5 名患者的研究和病例报告被排除在外。放疗提供了器官保存的潜力，其肿瘤控制率与根治性手术相当，而 EBRT 的疾病特异性生存率高达 70%。近距离放射治疗 (BT) 是治疗仅限于龟头的肿瘤的首选照射方法，而对于 >4 厘米的肿瘤，预计复发风险较高。 BT 显示 8-10 年无截肢生存率为 73%，5-10 年无进展生存率为 81%。与BT相比，全截肢显着提高了5年无病生存率。与 EBRT 相比，BT 具有卓越的 5 年局部控制率和阴茎保存率。近距离放射治疗常见的急性毒性包括放射性皮炎、无菌性尿道炎和尿道粘连。 BT 的主要晚期不良事件是软组织坏死 (0-31%) 和外道狭窄 (0-43%)。BT 是一种有利的放射方式，提供了一种有效且保守的方法。 HDR BT 因其增强的剂量分布和辐射防护而受到青睐。放射肿瘤科医生和泌尿科医生之间的合作对于提供最佳患者选择和管理毒性从而优化患者治疗结果至关重要。版权所有 © 2024。由 Elsevier Ltd 出版。

In squamous cell carcinoma of the penis (PeCa), treatment options for primary tumors vary by disease stage and may include surgery, radiation, topical chemotherapy, or laser excision. This review aims to highlight the current evidence on the value of radiotherapy as an organ-preserving strategy in primary PeCa.Manuscripts on primary PeCa treatment with external beam radiotherapy (EBRT) and brachytherapy were evaluated via Scopus, PubMed/MEDLINE, and Web of ScienceTM (2013-2023) to assess their efficacy and safety. Animal studies, studies with <5 patients, and case reports were excluded.Radiotherapy offers the potential for organ preservation with tumor control rates comparable to radical surgery, while disease-specific survival rates up to 70 % were experienced with EBRT. Brachytherapy (BT) is the preferred method of irradiation for glans-limited tumors, whereas a higher relapse risk is expected for tumors >4 cm. BT shows 73 % amputation-free survival at 8-10 years and 81 % progression-free survival at 5-10 years. Compared with BT, total amputation significantly improves 5-year disease-free survival rate. BT offers a superior 5-year local control and penile preservation rates compared to EBRT. Common acute toxicities of brachytherapy include radiodermatitis, sterile urethritis, and urethral adhesions. The primary late adverse events of BT are soft tissue necrosis (0-31 %) and meatal stenosis (0-43 %).BT is a favorable radiation modality, offering an efficient and conservative approach. HDR BT is favored for its enhanced dose distribution and radiation protection. Collaboration between radiation oncologists and urologists is essential in order to provide an optimal patient selection and manage toxicities thus optimizing patient outcomes.Copyright © 2024. Published by Elsevier Ltd.