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手术或放射治疗:西班牙局部性前列腺癌治疗决策的决定因素
J Perez-Ardavin1, C D Vera-Donoso1, J M Alapont1
1Servicio de Urología, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
Actas urologicas espanolas
|February 14, 2026
概括
局部性前列腺癌 (PCa) 的治疗选择取决于患者的年龄和并发症. 泌尿科医生和放射瘤学家根据临床因素对激进前列腺切除术和放射治疗的偏好有所不同.
科学领域:
- 泌尿病学和放射瘤学 泌尿病学和放射瘤学
- 在瘤学瘤学.
- 医疗决策的制定 医疗决策的制定
背景情况:
- 局部性前列腺癌 (PCa) 治疗包括在激进前列腺切除术 (RP) 和放射治疗 (RT) 之间进行选择.
- 治疗决策受到各种患者特定因素的影响.
- 最佳的治疗选择需要了解医生的观点.
研究的目的:
- 调查西班牙的泌尿科医生和放射瘤学家如何评估影响局部PCa初级治疗建议的因素.
- 为PCa治疗开发临床决策支持算法.
主要方法:
- 在西班牙泌尿科医生和放射瘤学家之间进行了一项在线横截面调查.
- 一个带有假设临床情景的问卷评估了使用利克尔特尺度的治疗偏好.
- 临床共识被定义为≥75%的同意.
主要成果:
- 年轻的患者 (<50岁) 具有高的国际前列腺症状评分 (IPSS),静脉前列腺突起,低Qmax和高空后残留 (PVR) 显示了>75%的选择手术 (RP).
- 高龄患者 (>70岁) 患有多种并发症和高体重指数 (BMI) >35的老年患者显示,超过75%的人更喜欢放射治疗 (RT).
- 在泌尿科医生和放射瘤学家之间观察到治疗偏好的显著差异 (p < 0.001).
结论:
- 患者的年龄,并发症和尿路症状是局部PCa治疗选择的主要决定因素.
- 在治疗偏好方面存在特殊差异.
- 分享决策工具和临床决策支持算法对于优化PCa治疗策略至关重要.
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