Abstract：
OBJECTIVE: 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.
METHODS: 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.
METHODS: 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.
摘要：
目的：本指南旨在基于现有的已发表数据，为去势抵抗性前列腺癌患者的治疗提供合理的依据。
方法：使用对照词汇对已发表的文献进行系统综述和荟萃分析，并补充与前列腺癌和去势抵抗相关概念相关的关键词。搜索策略由参考图书馆员和方法学家制定和执行，以创建仅限于英语的证据报告，发表同行评议的文献。这篇综述产生了从1996年到2013年发表的303篇文章，这些文章被用来构成大多数指南声明。临床原则和专家意见用于缺乏足够的循证数据的指南陈述。
结果：创建了指南声明，以告知临床医生适当使用观察，雄激素剥夺和抗雄激素治疗，雄激素合成抑制剂，免疫疗法，放射性核素治疗，全身化疗,姑息治疗和骨骼健康。这些是基于六个指标患者开发的，以代表临床实践中遇到的最常见情况。
结论：由于FDA批准的用于转移性CRPC患者的治疗药物的显著增加，临床医生面临着多种治疗选择和这些药物的潜在排序的挑战，因此,使临床决策更加复杂。鉴于这一领域的快速发展性质，本指南应与近期的系统文献综述以及对个体患者治疗目标的理解结合使用.在所有情况下,在选择管理策略时，应考虑患者的偏好和个人目标。
方法：使用对照词汇对已发表的文献进行系统综述和荟萃分析，并补充与前列腺癌和去势抵抗相关概念相关的关键词。搜索策略由参考图书馆员和方法学家制定和执行，以创建仅限于英语的证据报告，发表同行评议的文献。这篇综述产生了从1996年到2013年发表的303篇文章，这些文章被用来构成大多数指南声明。临床原则和专家意见用于缺乏足够的循证数据的指南陈述。
结果：创建了指南声明，以告知临床医生适当使用观察，雄激素剥夺和抗雄激素治疗，雄激素合成抑制剂，免疫疗法，放射性核素治疗，全身化疗,姑息治疗和骨骼健康。这些是基于六个指标患者开发的，以代表临床实践中遇到的最常见情况。
结论：由于FDA批准的用于转移性CRPC患者的治疗药物的显著增加，临床医生面临着多种治疗选择和这些药物的潜在排序的挑战，因此,使临床决策更加复杂。鉴于这一领域的快速发展性质，本指南应与近期的系统文献综述以及对个体患者治疗目标的理解结合使用.在所有情况下,在选择管理策略时，应考虑患者的偏好和个人目标。
