Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.
Hospital Santa Lucia, Brasilia, Brazil.
JCO Glob Oncol. 2021 Apr;7:538-544. doi: 10.1200/GO.20.00508.
To present a summary of the treatment and follow-up recommendations for the biochemical recurrence in castration-sensitive prostate cancer (PCa) acquired through a questionnaire administered to 99 PCa experts from developing countries during the Prostate Cancer Consensus Conference for Developing Countries.
A total of 27 questions were identified as related to this topic from more than 300 questions. The clinician's responses were tallied and presented in a percentage format. Topics included the use of imaging for staging biochemical recurrence, treatment recommendations for three different clinical scenarios, the field of radiation recommended, and follow-up. Each question had 5-7 relevant response options, including "abstain" and/or "unqualified to answer," and investigated not only recommendations but also if a limitation in resources would change the recommendation.
For most questions, a clear majority (> 50%) of clinicians agreed on a recommended treatment for imaging, treatment scenarios, and follow-up, although only a few topics reached a consensus > 75%. Limited resources did affect several areas of treatment, although in many cases, they reinforced more stringent criteria for treatment such as prostate-specific antigen values > 0.2 ng/mL and STAMPEDE inclusion criteria as a basis for recommending treatment.
A majority of clinicians working in developing countries with limited resources use similar cutoff points and selection criteria to manage patients treated for biochemically recurrent castration-sensitive PCa.
通过对发展中国家前列腺癌共识会议上 99 名来自发展中国家的前列腺癌专家进行问卷调查，总结治疗和随访建议，以应对去势敏感型前列腺癌（PCa）的生化复发。
从 300 多个问题中确定了 27 个与该主题相关的问题。对临床医生的回答进行了统计，并以百分比的形式呈现。主题包括生化复发的影像学分期、三种不同临床情况的治疗建议、推荐的放疗领域以及随访。每个问题有 5-7 个相关的答案选择，包括“弃权”和/或“不合格回答”，不仅调查了建议，还调查了资源限制是否会改变建议。
对于大多数问题，大多数（>50%）临床医生对影像学、治疗方案和随访的推荐治疗方法表示一致，但只有少数几个主题达成了>75%的共识。有限的资源确实影响了治疗的几个领域，但在许多情况下，它们强化了治疗的更严格标准，如前列腺特异性抗原值>0.2ng/ml 和 STAMPEDE 纳入标准作为推荐治疗的依据。
在资源有限的发展中国家工作的大多数临床医生使用相似的临界值和选择标准来管理接受去势敏感型 PCa 生化复发治疗的患者。
