EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part II: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer
EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part II: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer
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DOI：
10.1016/j.eururo.2016.08.002
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发表时间：
2017-04-01
期刊：
影响因子：
23.4
通讯作者：
Mottet, Nicolas
中科院分区：
文献类型：
--
作者：
Cornford, Philip;Bellmunt, Joaquim;Mottet, Nicolas
目的：总结2016年版欧洲泌尿外科协会(EAU) -欧洲放射与肿瘤学会(ESTRO) -国际老年肿瘤学会（SIOG）治疗复发，转移和去雄抵抗性前列腺癌（CRPC）的指南。证据获取：工作小组对新数据（2013-2015）进行了文献综述。指南进行了更新，并在对文献进行系统回顾的基础上增加了证据水平和/或推荐等级。证据综合：局部治疗后复发的定义是前列腺特异性抗原（PSA）水平在根治性前列腺切除术（RP）后升高>0.2 ng/ml，放射治疗（RT）后升高>2 ng/ml。如果PSA < 1.0 ng/ml， c -11-胆碱正电子发射断层扫描/计算机断层扫描的重要性有限；骨扫描和计算机断层扫描可以省略，除非PSA在10 ~ 10 ng/ml。多参数磁共振成像和活检对于评估RP后的生化失败很重要。RP后PSA复发的治疗包括PSA水平的补救性RT
Objective: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC).Evidence acquisition: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature.Evidence synthesis: Relapse after local therapy is defined by a rising prostate-specific antigen (PSA) level >0.2 ng/ml following radical prostatectomy (RP) and >2 ng/ml above the nadir after radiation therapy (RT). C-11-choline positron emission tomography/ computed tomography is of limited importance if PSA is < 1.0 ng/ml; bone scans and computed tomography can be omitted unless PSA is > 10 ng/ml. Multiparametric magnetic resonance imaging and biopsy are important to assess biochemical failure following RT. Therapy for PSA relapse after RP includes salvage RT at PSA levels