Castration-resistant prostate cancer: AUA Guideline.
J Urol
; 190(2): 429-38, 2013 Aug.
Article
em En
| MEDLINE
| ID: mdl-23665272
ABSTRACT
PURPOSE:
This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data. MATERIALS ANDMETHODS:
A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data.RESULTS:
Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice.CONCLUSIONS:
As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies.Palavras-chave
ADT; CRPC; FDA; Food and Drug Administration; H&P; OS; PFS; PSA; QOL; SRE; androgen antagonists; androgen deprivation therapy; castration-resistant prostate cancer; drug therapy; history and physical; immunotherapy; mCRPC; metastatic castration-resistant prostate cancer; overall survival; progression-free survival; prostate specific antigen; prostatic neoplasms; quality of life; skeletal-related event
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Protocolos de Quimioterapia Combinada Antineoplásica
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Imunoterapia
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Antagonistas de Androgênios
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Antineoplásicos
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
/
Male
Idioma:
En
Revista:
J Urol
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos