Bristol Oncology Centre, Bristol, UK.
Clin Oncol (R Coll Radiol). 2010 Feb;22(1):46-55. doi: 10.1016/j.clon.2009.10.015. Epub 2009 Nov 30.
A substantial proportion of patients who have undergone a radical prostatectomy for localised prostate cancer will have either persistently detectable prostate-specific antigen (PSA) levels or a delayed rise in PSA. The optimum treatment for these situations is not known. The key question is whether the PSA is reflective of local or distant progression. For salvage radiotherapy to be most effective, treatment should be considered before the PSA level is allowed to rise too high, when disease is more likely to be confined to the prostate bed. However, at low PSA levels, current imaging techniques are poor at detecting disease, making it difficult to differentiate local and distant recurrences and to target the radiotherapy appropriately. We review current and investigational imaging techniques, including bone scan, computed tomography, magnetic resonance imaging, positron emission tomography and Prostascint, assessing their utility in the situation of biochemical recurrence after radical prostatectomy.
相当一部分接受根治性前列腺切除术治疗局限性前列腺癌的患者，其前列腺特异性抗原（PSA）水平持续升高或延迟升高。目前尚不清楚这些情况下的最佳治疗方法。关键问题是 PSA 是反映局部还是远处进展。为了使挽救性放疗最有效，应在 PSA 水平升高之前考虑治疗，因为此时疾病更可能局限于前列腺床。然而，在 PSA 水平较低的情况下，目前的成像技术在检测疾病方面效果不佳，这使得区分局部和远处复发以及进行适当的放疗变得困难。我们回顾了目前和正在研究的成像技术，包括骨扫描、计算机断层扫描、磁共振成像、正电子发射断层扫描和 Prostascint，评估了它们在根治性前列腺切除术后生化复发情况下的应用价值。
