Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
Semin Oncol. 2013 Jun;40(3):322-36. doi: 10.1053/j.seminoncol.2013.04.011.
Prostate cancer is the most common solid tumor diagnosed in men in the United States and Western Europe. Primary treatment with radiation or surgery is largely successful at controlling localized disease. However, a significant number (up to one third of men) may develop biochemical recurrence (BR), defined as a rise in serum prostate-specific antigen (PSA) level. A general presumption is that BR will lead to overt progression in patients over subsequent years. There are a number of factors that a physician must consider when counseling and recommending treatment to a patient with a rising PSA. These include the following (1) various PSA-based definitions of BR; (2) source of PSA (ie, local or distant disease, residual benign prostate); (3) available modalities to treat the disease with the least morbidity; and (4) timing of therapy. In this article we review the current and future factors that clinicians should consider in the diagnosis and treatment of recurrent prostate cancer.
前列腺癌是美国和西欧男性最常见的实体肿瘤。采用放射治疗或手术进行的主要治疗在控制局部疾病方面效果显著。然而，相当数量（多达三分之一的男性）可能会出现生化复发（BR），其定义为血清前列腺特异性抗原（PSA）水平升高。一般认为 BR 会导致患者在随后几年内出现明显进展。当为 PSA 升高的患者提供咨询和推荐治疗方案时，医生必须考虑以下多个因素：（1）各种基于 PSA 的 BR 定义；（2）PSA 的来源（即局部或远处疾病、残留良性前列腺）；（3）用最低发病率治疗疾病的可用方式；以及（4）治疗时机。本文综述了当前和未来临床医生在诊断和治疗复发性前列腺癌时应考虑的因素。
