Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Clin Transl Oncol. 2012 Jul;14(7):520-7. doi: 10.1007/s12094-012-0835-x.
Prostate cancer (PC) is the most common cancer in men. Many patients have prolonged survival and die of other diseases, so treatment decisions are often influenced by age and coexisting comorbidities. The main procedure to diagnose PC is an ultrasound-guided core needle biopsy, which is indicated when a digital rectal examination (DRE) finds nodularity or when PSA is >10 ng/ml, but is also recommended with PSA between 4.0 and 10 ng/ml. Depending on age, PSA, Gleason score and characteristics of the tumour, treatment options for localised PC are active surveillance, radical prostatectomy and radiation therapy. Androgen deprivation treatment (ADT) should be added to radiotherapy for men with intermediate- or high-risk PC. ADT is the current standard first-line treatment for metastatic PC. Castration-resistant PC is a heterogeneous entity. Several treatments such as sipuleucel-T, docetaxel-based chemotherapy, radium 223, cabazitaxel or abiraterone plus prednisone, zoledronic and denosumab, are useful for this situation.
前列腺癌（PC）是男性最常见的癌症。许多患者生存期延长，死于其他疾病，因此治疗决策往往受到年龄和并存合并症的影响。诊断 PC 的主要方法是超声引导下的核心针活检，当直肠指检（DRE）发现结节或 PSA>10ng/ml 时，需要进行活检，但当 PSA 在 4.0 至 10ng/ml 之间时，也建议进行活检。根据年龄、PSA、Gleason 评分和肿瘤特征，局限性 PC 的治疗选择包括主动监测、根治性前列腺切除术和放疗。对于中高危 PC 患者，放疗应加用雄激素剥夺治疗（ADT）。ADT 是转移性 PC 的当前标准一线治疗。去势抵抗性 PC 是一种异质性实体。对于这种情况，一些治疗方法如 sipuleucel-T、多西他赛为基础的化疗、镭 223、卡巴他赛或阿比特龙加泼尼松、唑来膦酸和地舒单抗等是有用的。
