Hospital Israelita Albert Einstein, São Paulo, Brazil.
Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
JCO Glob Oncol. 2021 Apr;7:559-571. doi: 10.1200/GO.20.00511.
To present a summary of the recommendations for the treatment and follow-up for metastatic castration-resistant prostate cancer (mCRPC) as acquired through a questionnaire administered to 99 physicians working in the field of prostate cancer in developing countries who attended the Prostate Cancer Consensus Conference for Developing Countries.
A total of 106 questions out of more than 300 questions addressed the use of imaging in staging mCRPC, treatment recommendations across availability and response to prior drug treatments, appropriate drug treatments, and follow-up, and those same scenarios when limited resources needed to be considered. Responses were compiled and the percentages were presented by clinicians to support each response. Most questions had five to seven relevant options for response including abstain and/or unqualified to answer, or in the case of yes or no questions, the option to abstain was offered.
Most of the recommendations from this panel were in line with prior consensus, including the preference of a new antiandrogen for first-line therapy of mCRPC. Important aspects highlighted in the scenario of limited resources included the option of docetaxel as treatment preference as first-line treatment in several scenarios, docetaxel retreatment, consideration for reduced doses of abiraterone, and alternative schedules of an osteoclast-targeted therapy.
There was wide-ranging consensus in the treatment for men with mCRPC in both optimal and limited resource settings.
总结转移性去势抵抗性前列腺癌(mCRPC)治疗和随访建议,这些建议是通过对参加发展中国家前列腺癌共识会议的 99 名从事前列腺癌领域工作的发展中国家医生进行问卷调查获得的。
共有 106 个问题,涉及 mCRPC 分期中影像学的使用、在可及性和对先前药物治疗反应的基础上的治疗建议、适当的药物治疗和随访,以及在需要考虑有限资源的情况下的相同情况。收集了这些回复,并由临床医生以百分比形式呈现,以支持每种回复。大多数问题有 5 到 7 个相关选项可供选择,包括弃权和/或无资格回答,或者在是与否的问题中,提供了弃权选项。
该小组的大多数建议与之前的共识一致,包括在 mCRPC 的一线治疗中首选新的抗雄激素。在资源有限的情况下,强调了一些重要方面,包括在几种情况下选择多西他赛作为一线治疗的首选,多西他赛的再次治疗,考虑减少阿比特龙的剂量,以及破骨细胞靶向治疗的替代方案。
在最佳和有限资源环境下,对 mCRPC 男性的治疗存在广泛的共识。