Krausewitz Philipp, Ritter Manuel, Essler Markus
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Deutschland.
Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Deutschland.
Urologie. 2023 Apr;62(4):347-353. doi: 10.1007/s00120-023-02028-1. Epub 2023 Feb 3.
Risk stratification of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has undergone significant changes in recent years in light of new therapies and innovative imaging.
Established and innovative methods for detection of metastasis, risk group stratification, and treatment of mHSPC are outlined and compared.
Background knowledge and treatment-relevant guideline recommendations on mHSPC are presented and complemented by recent study results.
Integration of modern imaging techniques, especially prostate-specific membrane antigen (PSMA) PET/CT, into the diagnostic algorithm has the potential to significantly improve risk stratification and treatment of mHSPC. By using PSMA PET/CT, metastases are detected early and sensitively. This leads to the definition of new subgroups amenable to modern therapeutic strategies. The prognostic value of using PSMA PET/CT with regard to established risk categories in mHSPC is currently being evaluated.
Modern imaging, especially PSMA PET/CT, has significant added value for the diagnosis and treatment of mHSPC in almost all subgroups. In particular, it helps to select patients who will benefit from intensification or de-escalation of systemic therapy.
鉴于新疗法和创新成像技术，近年来转移性激素敏感性前列腺癌（mHSPC）患者的风险分层发生了显著变化。
概述并比较用于检测转移、风险组分层和治疗mHSPC的既定方法和创新方法。
介绍了关于mHSPC的背景知识和与治疗相关的指南建议，并辅以近期研究结果。
将现代成像技术，尤其是前列腺特异性膜抗原（PSMA）PET/CT纳入诊断算法，有可能显著改善mHSPC的风险分层和治疗。通过使用PSMA PET/CT，可以早期且灵敏地检测到转移灶。这导致了适用于现代治疗策略的新亚组的定义。目前正在评估在mHSPC既定风险类别方面使用PSMA PET/CT的预后价值。
现代成像技术，尤其是PSMA PET/CT，在几乎所有亚组的mHSPC诊断和治疗中都具有显著的附加价值。特别是，它有助于选择将从全身治疗强化或降级中获益的患者。
