The diagnosis and treatment of localized high-risk prostate cancer: a case report and regimen prescription strategy / 中华泌尿外科杂志

ABSTRACT

Objective To exploie the choices and timing of different treatment regimens of prostate cancer.Methods The complete clinical data of one case of localized high-risk prostate cancer was reported.The patient,aged 69 years old,was admitted to hospital with urinary frequency and dysuria for 2 years.Serum total PSA was 36.8ng/ml and prostate biopsy dignosed as prostate cancer.The Gleason score was 4 + 3,and the clinical stage was T2b N0M0.Results The patient underwent radical prostatectomy,salvage radiotherapy + androgen deprivation therapy,abiraterone,enzalutamide,Radium-223,docetaxel + prednisone chemotherapy and mitoxantrone + prednisone chemotherapy,which included almost all of the current domestic treatment regimens.The patient lived for 57 months from the initiation of treatment.Conclusions For the patients with high-risk prostate cancer,especially for elderly patients,they should firstly be recommended the treatment of radical radiotherapy + 2-3 years of androgen deprivation therapy.For young patients,radical prostatectomy + extended pelvic lymph node dissection as part of multi-modal therapies is considered to be a positive choice.However,for the patients with risk factors or recurrence after radical prostatectomy,the postoperative radiotherapy should be performed in order to reduce biochemical recurrence and improve local control.Currently,the order of choice of abiraterone,enzalutamide or docetaxel + prednisone chemotherapy,is based on the patient's situation,past history of treatment,symptoms,side effects as well as other related clinical features.