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ManagementofLocalizedProstateCancer课件
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RESULT
50%Noadjuvanttherapy
0%Adjuvantradiationtherapytotheprostatebed
25%Adjuvantradiationtherapytotheprostatebedandwholepelvis
25%Immediateandrogendeprivationtherapy
0%Clinicaltrialofchemotherapy
CaseHistory(continued)
。
但是,。
病人感觉良好,无任何不适症状。
***如常,服用万艾可能正常勃起。
Whatdoyourecommend?
ANotreatment 
BSalvageradiationtherapytotheprostatebed 
CImmediateADT 
DCryosurgery 
EChemotherapy
FClinicaltrial
RESULT
50%Notreatment
50%Salvageradiationtherapytotheprostatebed
0%ImmediateADT
0%Cryosurgery
0%Chemotherapy
0%Clinicaltrial
Salvagetherapy
PatientswhohavePSA(biochemical)failurefollowingradicalprostatectomyandhavenoevidenceofmetastaticdiseasehavetheoptionsofwatchfulwaiting,radiotherapy,orhormonalablationassalvagetherapy.
Thechoiceoftherapydependsonthetimingoftherecurrence(ie,soonaftersurgery)andtherateofPSAlevelelevation.
Salvagetherapy
•Expectantmanagementisanoptionforpatientswithpresumedlocalrecurrenceunfitfor,orunwillingtoundergo,radiationtherapy
PSArecurrenceindicativeofsystemicrelapseisbesttreatedbyearlyADTresultingindecreasedfrequencyofclinicalmetastases
LHRHanalogues/orchiectomyorbicalutamideat150mg/daycanbothbeusedwhenthereisindicationforhormonaltherapy
CaseHistory(continued)
他选择行补救性放疗
但是,PSA持续升高(3年内),
PSA的倍增时间约为8个月
Whichimagingtestsdoyouorder?
ABonescan 
BCTscanoftheabdomenandpelvis 
CProstaScintscan 
DPETscan 
EEndorectalprostateMRI 
FChestx-ray
RESULT
100%Bonescan
0%CTscanoftheabdomenandpelvis
0%ProstaScintscan
0%PETscan
0%EndorectalprostateMRI
0%Chestx-ray