Pereira Felipe Moraes Toledo, Silva Adriano Gonçalves E, Dettino Aldo Lourenço Abbade, Cardoso Ana Paula Garcia, Sasse Andre Deeke, Kann Ariel Galapo, Dzik Carlos, Herchenhorn Daniel, Jardim Denis Leonardo Fontes, Lopera Diego, Ayadi Mouna, Salman Pamela, Kopp Ray Antonio Manneh, De Carvalho Ricardo Saraiva, Cavallero Sandro Roberto De Araujo, Aguiar Sergio, Souza Vinicius Carrera, Uson Junior Pedro Luiz Serrano, Soares Andrey
Hospital São Camilo, Pompeia, São Paulo, Brazil.
Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil.
JCO Glob Oncol. 2021 Apr;7:545-549. doi: 10.1200/GO.20.00507.
To present a summary of the recommendations for the treatment and follow-up for the biochemical recurrence of castration-resistant prostate cancer (PCa) as acquired through a questionnaire administered at the Prostate Cancer Consensus Conference for Developing Countries.
A total of 27 questions were identified as relating to this topic. Responses from the clinician were tallied and are presented in percentage format. Topics included the use of imaging in staging, treatment recommendations across different patient scenarios of life expectancy and prostate-specific antigen (PSA) doubling time, and follow-up for nonmetastatic castration-resistant PCa.
A consensus agreed that in optimal conditions, positron emission tomography-computed tomography with prostate-specific membrane antigen would be used although in limited resource situations the combined use of CT of the abdomen and pelvic (or pelvic MRI), a bone scan, and a CT of the thorax or chest x-ray was recommended. In cases when PSA levels double in < 10 months, more than 90% of clinicians agreed on the use of apalutamide or enzalutamide, regardless of life expectancy. With a doubling time of more than 10 months, > 54% of experts recommended no treatment independent of life expectancy. More than half of the experts, regardless of resources, recommended follow-up with a physical examination and PSA levels every 3-6 months and imaging only in the case of symptoms.
The voting results and recommendations presented in this document can be used by physicians to support management for biochemical recurrence of castration-resistant PCa in areas of limited resources. Individual clinical decision making should be supported by available data.
总结在发展中国家前列腺癌共识会议上通过问卷调查获得的去势抵抗性前列腺癌（PCa）生化复发的治疗及随访建议。
共确定了27个与该主题相关的问题。统计临床医生的回答，并以百分比形式呈现。主题包括分期中影像学的使用、不同预期寿命和前列腺特异性抗原（PSA）倍增时间的患者情况下的治疗建议，以及非转移性去势抵抗性PCa的随访。
达成的共识是，在最佳条件下，将使用前列腺特异性膜抗原正电子发射断层扫描计算机断层扫描，尽管在资源有限的情况下，建议联合使用腹部和盆腔CT（或盆腔MRI）、骨扫描以及胸部CT或胸部X光。在PSA水平在<10个月内翻倍的情况下，超过90%的临床医生同意使用阿帕鲁胺或恩杂鲁胺，无论预期寿命如何。倍增时间超过10个月时，>54%的专家建议无论预期寿命如何均不进行治疗。超过一半的专家，无论资源情况如何，建议每3 - 6个月进行一次体格检查和PSA水平随访，仅在出现症状时进行影像学检查。
本文档中的投票结果和建议可供医生用于支持资源有限地区去势抵抗性PCa生化复发的管理。个体临床决策应得到现有数据的支持。
