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中华腔镜泌尿外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 373 -382. doi: 10.3877/cma.j.issn.1674-3253.2026.04.002

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转移性激素敏感性前列腺癌治疗决策及展望
郭任博, 邹本奎, 边家盛()   
  1. 250117 济南,山东第一医科大学附属肿瘤医院泌尿外科
  • 收稿日期:2025-03-07 出版日期:2026-08-01
  • 通信作者: 边家盛
  • 基金资助:
    国家自然科学基金(82203815); 吴阶平医学基金(2020HZ06); 山东省自然科学基金(ZR2020LZL011)

Treatment decisions and future perspectives of metastatic hormone-sensitive prostate cancer

Renbo Guo, Benkui Zou, Jiasheng Bian()   

  1. Department of Urology, Cancer Hospital Affiliated to Shandong First Medical University, Jinan 250117, China
  • Received:2025-03-07 Published:2026-08-01
  • Corresponding author: Jiasheng Bian
引用本文:

郭任博, 邹本奎, 边家盛. 转移性激素敏感性前列腺癌治疗决策及展望[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(04): 373-382.

Renbo Guo, Benkui Zou, Jiasheng Bian. Treatment decisions and future perspectives of metastatic hormone-sensitive prostate cancer[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(04): 373-382.

转移性激素敏感性前列腺癌(mHSPC)的治疗在近年来取得了显著进展。单纯的雄激素剥夺治疗(ADT)已不再作为一线标准治疗,取而代之的是ADT联合新型雄激素受体通路抑制剂(ARPIs)或/和多西他赛的二联或三联强化治疗方案。此外,对于低瘤负荷或寡转移患者,前列腺原发灶的局部放疗或减瘤手术展现出改善生存的潜力。随着治疗手段的不断丰富,基于肿瘤负荷和转移时间的风险分层对制定个体化治疗决策至关重要。未来,针对DNA损伤修复缺陷和PI3K/AKT通路的精准靶向治疗,以及放射配体治疗(如Lu-PSMA),有望进一步改善mHSPC患者的预后。本文就mHSPC的最新药物治疗、局部治疗、风险分层治疗策略及未来展望进行论述,以期为临床实践提供参考。

The treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has made significant progress in recent years. Androgen deprivation therapy (ADT) alone is gradually being phased out and replaced by doublet or triplet intensified therapies combining ADT with novel androgen receptor pathway inhibitors (ARPIs) and/or docetaxel. In addition, for patients with low-volume or oligometastatic disease, local radiotherapy or cytoreductive surgery of the primary prostate tumor has shown the potential to improve survival. With the continuous enrichment of treatment modalities, risk stratification based on tumor volume and timing of metastasis is crucial for making individualized treatment decisions. In the future, precision targeted therapies for DNA damage repair defects and the PI3K/AKT pathway, as well as radioligand therapies (such as Lu-PSMA), are expected to further improve the prognosis of mHSPC patients. This article reviews the latest drug therapies, local therapies, risk-stratified treatment strategies, and future perspectives for mHSPC, aiming to provide a reference for clinical practice.

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