在韩国建立转移性激素敏感性前列腺癌的共识建议:一项修改的德尔菲研究。

IF 2.1 3区 医学 Q2 UROLOGY & NEPHROLOGY
Jae Young Joung, In Gab Jeong, Sung Gu Kang, Young Hwii Ko, Kyo Chul Koo, Kwang Hyun Kim, Myung Ki Kim, Soodong Kim, Jeong Hyun Kim, Sung-Woo Park, Jae Young Park, Wan Song, Seung Hwan Lee, Seung Il Jung, Jae Hoon Chung, Chang Wook Jeong, Kwan Joong Joo, Seock Hwan Choi, Se Young Choi, Seol Ho Choo, Hong Koo Ha, Sung Kyu Hong, Sung-Hoo Hong, Jeong Hee Hong, Jun Hyuk Hong, Sun Il Kim, Cheol Kwak, Seong Soo Jeon
{"title":"在韩国建立转移性激素敏感性前列腺癌的共识建议:一项修改的德尔菲研究。","authors":"Jae Young Joung, In Gab Jeong, Sung Gu Kang, Young Hwii Ko, Kyo Chul Koo, Kwang Hyun Kim, Myung Ki Kim, Soodong Kim, Jeong Hyun Kim, Sung-Woo Park, Jae Young Park, Wan Song, Seung Hwan Lee, Seung Il Jung, Jae Hoon Chung, Chang Wook Jeong, Kwan Joong Joo, Seock Hwan Choi, Se Young Choi, Seol Ho Choo, Hong Koo Ha, Sung Kyu Hong, Sung-Hoo Hong, Jeong Hee Hong, Jun Hyuk Hong, Sun Il Kim, Cheol Kwak, Seong Soo Jeon","doi":"10.4111/icu.20250147","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Consensus is lacking among South Korean urologists on the appropriate treatment of metastatic hormone-sensitive prostate cancer (mHSPC). A modified, Delphi-based consensus on managing mHSPC patients was developed to support clinical decision-making.</p><p><strong>Materials and methods: </strong>Thirty-six questions on mHSPC treatment were developed by an expert committee (five urologists). Nine questions required achievement of consensus (key questions). Twenty-three urologists participated in two rounds of a Delphi survey. Consensus was defined as ≥75% agreement among panelists, with ≥90% agreement representing strong consensus.</p><p><strong>Results: </strong>Eighteen questions (50.0%) reached strong consensus, 15 (41.7%) reached consensus, and three (8.3%) reached no consensus. Eight key questions (88.9%) reached strong consensus and one (11.1%) reached consensus. Consensus was reached on recommending androgen-deprivation therapy (ADT) intensification, irrespective of disease volume or type, with an androgen receptor pathway inhibitor (ARPI) as the preferred option. Not using docetaxel alone with ADT when an ARPI is available for treatment intensification was recommended (strong consensus). For high-volume mHSPC patients with a pathogenic, speckle-type poxvirus and zinc finger protein mutation, ADT+ARPI was recommended over triplet therapy (strong consensus). Panelists recommended regular imaging every 6-12 months if no ARPI reimbursement restrictions exist, but a 3-month interval (per current reimbursement guidelines) otherwise. ADT+ARPI was the most recommended systemic treatment (strong consensus).</p><p><strong>Conclusions: </strong>This Delphi consensus established local consensus on controversial areas of mHSPC management. The findings offer meaningful perspectives that may help shape future treatment strategies and encourage thoughtful reconsideration of reimbursement criteria to align evidence and clinical practice in South Korea.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"416-430"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437568/pdf/","citationCount":"0","resultStr":"{\"title\":\"Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.\",\"authors\":\"Jae Young Joung, In Gab Jeong, Sung Gu Kang, Young Hwii Ko, Kyo Chul Koo, Kwang Hyun Kim, Myung Ki Kim, Soodong Kim, Jeong Hyun Kim, Sung-Woo Park, Jae Young Park, Wan Song, Seung Hwan Lee, Seung Il Jung, Jae Hoon Chung, Chang Wook Jeong, Kwan Joong Joo, Seock Hwan Choi, Se Young Choi, Seol Ho Choo, Hong Koo Ha, Sung Kyu Hong, Sung-Hoo Hong, Jeong Hee Hong, Jun Hyuk Hong, Sun Il Kim, Cheol Kwak, Seong Soo Jeon\",\"doi\":\"10.4111/icu.20250147\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Consensus is lacking among South Korean urologists on the appropriate treatment of metastatic hormone-sensitive prostate cancer (mHSPC). A modified, Delphi-based consensus on managing mHSPC patients was developed to support clinical decision-making.</p><p><strong>Materials and methods: </strong>Thirty-six questions on mHSPC treatment were developed by an expert committee (five urologists). Nine questions required achievement of consensus (key questions). Twenty-three urologists participated in two rounds of a Delphi survey. Consensus was defined as ≥75% agreement among panelists, with ≥90% agreement representing strong consensus.</p><p><strong>Results: </strong>Eighteen questions (50.0%) reached strong consensus, 15 (41.7%) reached consensus, and three (8.3%) reached no consensus. Eight key questions (88.9%) reached strong consensus and one (11.1%) reached consensus. Consensus was reached on recommending androgen-deprivation therapy (ADT) intensification, irrespective of disease volume or type, with an androgen receptor pathway inhibitor (ARPI) as the preferred option. Not using docetaxel alone with ADT when an ARPI is available for treatment intensification was recommended (strong consensus). For high-volume mHSPC patients with a pathogenic, speckle-type poxvirus and zinc finger protein mutation, ADT+ARPI was recommended over triplet therapy (strong consensus). Panelists recommended regular imaging every 6-12 months if no ARPI reimbursement restrictions exist, but a 3-month interval (per current reimbursement guidelines) otherwise. ADT+ARPI was the most recommended systemic treatment (strong consensus).</p><p><strong>Conclusions: </strong>This Delphi consensus established local consensus on controversial areas of mHSPC management. The findings offer meaningful perspectives that may help shape future treatment strategies and encourage thoughtful reconsideration of reimbursement criteria to align evidence and clinical practice in South Korea.</p>\",\"PeriodicalId\":14522,\"journal\":{\"name\":\"Investigative and Clinical Urology\",\"volume\":\"66 5\",\"pages\":\"416-430\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437568/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Investigative and Clinical Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4111/icu.20250147\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Investigative and Clinical Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4111/icu.20250147","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:韩国泌尿科医生对转移性激素敏感性前列腺癌(mHSPC)的适当治疗缺乏共识。一种改进的、基于delphi的mHSPC患者管理共识被开发出来,以支持临床决策。材料和方法:由专家委员会(5名泌尿科医师)制定了关于mHSPC治疗的36个问题。9个问题需要达成共识(关键问题)。23名泌尿科医生参加了两轮德尔菲调查。共识被定义为小组成员之间≥75%的共识,≥90%的共识代表强烈的共识。结果:18个问题(50.0%)一致,15个问题(41.7%)一致,3个问题(8.3%)不一致。8个关键问题(88.9%)达成强烈共识,1个(11.1%)达成共识。在推荐雄激素剥夺治疗(ADT)强化方面达成了共识,无论疾病的体积或类型如何,雄激素受体途径抑制剂(ARPI)是首选。当ARPI可用于治疗强化时,建议不要单独使用多西他赛和ADT(强烈共识)。对于具有致病性斑点型痘病毒和锌指蛋白突变的高容量mHSPC患者,推荐使用ADT+ARPI而不是三联疗法(强烈共识)。小组成员建议,如果没有ARPI报销限制,每6-12个月定期成像一次,否则每3个月一次(根据当前报销指南)。ADT+ARPI是最推荐的全身治疗(强烈共识)。结论:德尔菲共识建立了mHSPC管理争议领域的局部共识。这些发现提供了有意义的观点,可能有助于制定未来的治疗策略,并鼓励对韩国的报销标准进行深思熟虑的重新考虑,以使证据和临床实践保持一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.

Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.

Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.

Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.

Purpose: Consensus is lacking among South Korean urologists on the appropriate treatment of metastatic hormone-sensitive prostate cancer (mHSPC). A modified, Delphi-based consensus on managing mHSPC patients was developed to support clinical decision-making.

Materials and methods: Thirty-six questions on mHSPC treatment were developed by an expert committee (five urologists). Nine questions required achievement of consensus (key questions). Twenty-three urologists participated in two rounds of a Delphi survey. Consensus was defined as ≥75% agreement among panelists, with ≥90% agreement representing strong consensus.

Results: Eighteen questions (50.0%) reached strong consensus, 15 (41.7%) reached consensus, and three (8.3%) reached no consensus. Eight key questions (88.9%) reached strong consensus and one (11.1%) reached consensus. Consensus was reached on recommending androgen-deprivation therapy (ADT) intensification, irrespective of disease volume or type, with an androgen receptor pathway inhibitor (ARPI) as the preferred option. Not using docetaxel alone with ADT when an ARPI is available for treatment intensification was recommended (strong consensus). For high-volume mHSPC patients with a pathogenic, speckle-type poxvirus and zinc finger protein mutation, ADT+ARPI was recommended over triplet therapy (strong consensus). Panelists recommended regular imaging every 6-12 months if no ARPI reimbursement restrictions exist, but a 3-month interval (per current reimbursement guidelines) otherwise. ADT+ARPI was the most recommended systemic treatment (strong consensus).

Conclusions: This Delphi consensus established local consensus on controversial areas of mHSPC management. The findings offer meaningful perspectives that may help shape future treatment strategies and encourage thoughtful reconsideration of reimbursement criteria to align evidence and clinical practice in South Korea.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.10
自引率
4.30%
发文量
82
审稿时长
4 weeks
期刊介绍: Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise: • Precision Medicine in Urology • Urological Oncology • Robotics/Laparoscopy • Endourology/Urolithiasis • Lower Urinary Tract Dysfunction • Female Urology • Sexual Dysfunction/Infertility • Infection/Inflammation • Reconstruction/Transplantation • Geriatric Urology • Pediatric Urology • Basic/Translational Research One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信