McLaughlin Patrick W, Liss Adam L, Nguyen Paul L, Assimos Dean G, D'Amico Anthony V, Gottschalk Alexander R, Gustafson Gary S, Keole Sameer R, Liauw Stanley L, Lloyd Shane, Movsas Benjamin, Prestidge Bradley R, Showalter Timothy N, Taira Al V, Vapiwala Neha, Davis Brian J
*University of Michigan, Novi ∥William Beaumont Hospital, Troy ††Henry Ford Health System, Detroit, MI †Dana-Farber Cancer Institute/Brigham and Women's Hospital, American Society of Clinical Oncology, Boston, MA ‡University of Alabama School of Medicine, Birmingham, AL, American Urological Association §University of California San Francisco, San Francisco ∥∥Mills Peninsula Hospital, San Mateo, CA ¶Mayo Clinic, Scottsdale, AZ #The University of Chicago Medical Center, Chicago, IL **Huntsman Cancer Hospital, Salt Lake City, UT ‡‡Bon Secours Cancer Institute, Norfolk §§University of Virginia, Charlottesville, VA ¶¶University of Pennsylvania, Philadelphia, PA ##Mayo Clinic, Rochester, MN.
Am J Clin Oncol. 2017 Feb;40(1):1-10. doi: 10.1097/COC.0000000000000354.
To present the most updated American College of Radiology consensus guidelines formed from an expert panel on treatment of locally advanced, high-risk prostate cancer METHODS:: The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
The panel summarized the most recent and relevant literature on the topic and voted on 4 clinical variants illustrating the appropriate management of locally advanced, high-risk cancer. Numerical rating and commentary reflecting the panel consensus was given for each treatment approach in each variant.
Aggressive local approaches including surgery followed by adjuvant XRT, beam combined with androgen deprivation therapy, and beam combined with brachytherapy have resulted in unpresented success in locally advanced, high-risk prostate cancer. By combining most recent medical literature and expert opinion, this guideline can aid clinicians in the appropriate integration of available therapeutic modalities.
介绍由专家小组制定的关于局部晚期高危前列腺癌治疗的最新美国放射学会共识指南。
美国放射学会适宜性标准是针对特定临床情况的循证指南，每年由多学科专家小组进行审查。指南的制定和修订包括对同行评审期刊上的当前医学文献进行广泛分析，并应用成熟的方法（兰德/加州大学洛杉矶分校适宜性方法以及推荐分级评估、制定和评价或GRADE）来评估特定临床场景下成像和治疗程序的适宜性。在证据不足或不明确的情况下，专家意见可能会补充现有证据以推荐成像或治疗。
该小组总结了关于该主题的最新相关文献，并对4种临床变体进行了投票，这些变体说明了局部晚期高危癌症的适当管理。针对每个变体中的每种治疗方法给出了反映小组共识的数值评分和评论。
积极的局部治疗方法，包括手术加辅助放疗、外照射联合雄激素剥夺治疗以及外照射联合近距离放疗，在局部晚期高危前列腺癌的治疗中取得了前所未有的成功。通过结合最新的医学文献和专家意见，本指南可帮助临床医生合理整合可用的治疗方式。
