Borkowetz Angelika, Wullich Bernd, Saar Matthias, Schmidt-Hegemann Nina, Linxweiler Johannes
Department of Urology, University of Rostock, Rostock, Germany.
German Prostate Cancer Consortium (DPKK), Düsseldorf, Germany.
Urol Int. 2025 Apr 14:1-10. doi: 10.1159/000545630.
Metastasis-directed therapy (MDT) is a promising approach for recurrent or de novo oligo-metastatic castration-sensitive prostate cancer (omCSPC). The aim of this study was to evaluate the treatment approaches in omCSPC among German physicians.
An anonymous online questionnaire was sent via
Participants (n = 166; 33% urologists, 66% radiooncologists) define omCSPC as ≤3 (31%) or ≤4 (58%) metastases. Multimodal therapy consisting of local therapy of the primary tumor, MDT, and androgen deprivation therapy (ADT) was favored. For local therapy, radiotherapy was the preferred approach (radiotherapy: 84%, prostatectomy: 16%). Overall, 77% and 76% considered MDT as (very) highly important in synchronous and metachronous omCSPC, respectively. In total, 80% would complement MDT with time-limited ADT. Compared to urologists, radiooncologists more often include cases with ≥3 metastases (p = 0.006) and see a higher importance of radiotherapy (p = 0.023), a lower importance of prostatectomy (p < 0.001) as well as a higher importance of MDT (in de novo p = 0.038, in metachronous p = 0.010).
MDT with time-limited ADT is a common treatment strategy in omCSPC. Especially in synchronous omCSPC, radiotherapy as local treatment for the primary is the preferred option rather than radical prostatectomy.
转移灶导向治疗（MDT）是复发性或初发性寡转移去势敏感性前列腺癌（omCSPC）的一种有前景的治疗方法。本研究的目的是评估德国医生对omCSPC的治疗方法。
通过
参与者（n = 166；33%为泌尿外科医生，66%为放射肿瘤学家）将omCSPC定义为转移灶≤3个（31%）或≤4个（58%）。由原发肿瘤局部治疗、MDT和雄激素剥夺治疗（ADT）组成的多模式治疗受到青睐。对于局部治疗，放疗是首选方法（放疗：84%，前列腺切除术：16%）。总体而言，77%和76%的人分别认为MDT在同步和异时性omCSPC中（非常）极为重要。总计80%的人会用限时ADT补充MDT。与泌尿外科医生相比，放射肿瘤学家更常将转移灶≥3个的病例纳入（p = 0.006），且认为放疗的重要性更高（p = 0.023），前列腺切除术的重要性更低（p < 0.001），以及MDT的重要性更高（初发性中p = 0.038，异时性中p = 0.010）。
MDT联合限时ADT是omCSPC的一种常见治疗策略。特别是在同步omCSPC中，放疗作为原发肿瘤的局部治疗是首选方案，而非根治性前列腺切除术。
