De Felice Francesca, Vitti Elisa, Cattaneo Carlo Guglielmo, Tomaciello Miriam, Marampon Francesco, Musio Daniela, Gaudino Chiara, Minniti Giuseppe
Radiation Oncology, AOU Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Radiation Oncology, AOU Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Urol Oncol. 2025 Jun;43(6):399.e9-399.e13. doi: 10.1016/j.urolonc.2024.10.025. Epub 2024 Nov 13.
Treatment monitoring in metastatic castrate-resistant prostate cancer has become a hot topic in the androgen receptor pathway inhibitors (ARPIs) era. Patients without increase in their PSA level at the time of imaging progression are not a rare phenomenon. What is the best monitoring strategy in asymptomatic cases represents a salient question. Here we presented 2 case reports involving men with metastatic castration-resistant prostate cancer who experienced disease progression without the anticipated increase in PSA levels. Our 2 cases show that imaging beyond standard PSA determination should be incorporate to monitor disease progression in patients with metastatic castrate-resistant prostate cancer even in the context of an undetectable PSA.
在雄激素受体通路抑制剂（ARPI）时代，转移性去势抵抗性前列腺癌的治疗监测已成为一个热门话题。在影像学进展时前列腺特异性抗原（PSA）水平未升高的患者并非罕见现象。对于无症状病例，最佳监测策略是什么是一个突出问题。在此，我们报告了2例转移性去势抵抗性前列腺癌男性患者的病例，他们在疾病进展时未出现预期的PSA水平升高。我们的2例病例表明，即使在PSA检测不到的情况下，也应采用标准PSA测定以外的影像学检查来监测转移性去势抵抗性前列腺癌患者的疾病进展。
