Despite curative-intent local therapy, approximately 27% to 53% of prostate cancer (PCa) patients experience prostate-specific antigen (PSA) recurrence, known as biochemical recurrence (BCR). BCR significantly raises the risk of PCa-related morbidity and mortality, yet there is no consensus on optimal management. Prostate-specific membrane antigen-positron emission tomography (PSMA PET) has emerged as highly sensitive imaging, distinguishing local recurrences from distant metastases, crucially influencing treatment decisions. Genomic biomarkers such as Decipher, Prolaris, and Oncotype DX contribute to refining recurrence risk profiles, guiding decisions on intensifying adjuvant therapies, like radiotherapy and androgen deprivation therapy (ADT). This review assesses PSMA PET and biomarker utility in post-radical prostatectomy BCR scenarios, highlighting their impact on clinical decision-making. Despite their promising roles, the routine integration of biomarkers is limited by availability and cost, requiring further evidence. PSMA PET remains indispensable for restaging and treatment evaluation in these patients. Integrating biomarkers and PSMA PET promises to optimize personalized management strategies for BCR, though more comprehensive consensus-building studies are needed to define their standardized utility in clinical practice.
尽管进行了以治愈为目的的局部治疗，仍有约27%至53%的前列腺癌患者会出现前列腺特异性抗原复发，即生化复发。生化复发显著增加了前列腺癌相关发病率和死亡率的风险，但目前对于其最佳管理方案尚未达成共识。前列腺特异性膜抗原-正电子发射断层扫描作为一种高灵敏度影像技术，能够有效区分局部复发与远处转移，对治疗决策具有关键影响。同时，Decipher、Prolaris和Oncotype DX等基因组生物标志物有助于细化复发风险分层，指导强化辅助治疗（如放疗和雄激素剥夺疗法）的决策。本综述评估了根治性前列腺切除术后生化复发场景中PSMA PET与生物标志物的应用价值，重点探讨了它们对临床决策的影响。尽管这些工具展现出良好前景，但生物标志物的常规应用仍受限于可及性与成本，需要更多证据支持。对于这类患者，PSMA PET在再分期和治疗评估中仍不可或缺。整合生物标志物与PSMA PET有望优化生化复发的个体化管理策略，但尚需更全面的共识研究来明确其在临床实践中的标准化应用。
肿瘤(癌症)患者之家