MBBS, PhD, Urology Trainee, Austin Hospital, Vic.
MB, BCh, BAO, PhD, FRACS (Urol), Urological Surgeon, Royal Melbourne Hospital, Frankston Hospital, Vic; Principal Research Fellow, Department of Surgery, University of Melbourne, Vic; Research and Education Lead, GU-oncology, Victorian Comprehensive Cancer Centre, Vic.
Aust J Gen Pract. 2020 Apr;49(4):200-205. doi: 10.31128/AJGP-09-19-5055.
Prostate cancer is a common tumour type in Australian men.
The aim of this article is to review important changes in prostate cancer diagnosis and management over the past five years, particularly as they pertain to general practice.
The management of prostate cancer has changed significantly in recent years, particularly the use of imaging, with the introduction of prostate magnetic resonance imaging as routine in the diagnostic pathway, and the increasing use of prostate-specific membrane antigen positron emission tomography for early stratification in the salvage setting for failure of primary treatment in localised disease. In addition, upfront combinations of androgen deprivation therapy with other systemic treatments have yielded significant gains in overall survival for patients with metastatic disease. There has also been an increasing recognition of the association between germline DNA repair defects and progressive disease, and interest in the potential to identify patients for therapies that target these defects. There have been significant changes in how prostate cancer is diagnosed and managed in the past five years, with the introduction of new clinical pathways that were unprecedented just a decade previously.
前列腺癌是澳大利亚男性中常见的肿瘤类型。
本文旨在回顾过去五年中前列腺癌诊断和治疗的重要变化,特别是与全科医学相关的变化。
近年来,前列腺癌的治疗发生了重大变化,特别是影像学的应用,前列腺磁共振成像已常规用于诊断途径,前列腺特异性膜抗原正电子发射断层扫描(PSMA-PET)在局部疾病原发治疗失败后的挽救性治疗中用于早期分层的应用也越来越多。此外,雄激素剥夺治疗与其他全身治疗的联合应用使转移性疾病患者的总生存率显著提高。人们也越来越认识到种系 DNA 修复缺陷与进行性疾病之间的关联,并对确定有针对性治疗这些缺陷的患者的潜力产生了兴趣。在过去的五年中,前列腺癌的诊断和治疗发生了重大变化,引入了新的临床途径,这在十年前是前所未有的。