摘要前列腺癌是我国男性常见恶性肿瘤，骨骼为其最常见远处转移部位。骨转移显著增加疾病进展、骨相关事件（SRE）及死亡风险，严重影响患者生存和生活质量。为系统评估我国前列腺癌骨转移的诊疗现状并识别临床实践中的关键问题，本蓝皮书基于全国多学科临床医师开展问卷调研，并结合循证医学证据与专家共识进行综合分析。结果显示，在前列腺癌骨转移的筛查、诊断、治疗及多学科协作（MDT）方面仍存在不足，包括随访阶段骨转移监测重视不足、高危人群识别不充分、骨扫描及骨代谢标志物应用率偏低、骨保护药物启用延迟及使用不规范，以及部分地区MDT覆盖不足等问题。循证证据表明，骨转移一经确诊即应尽早、规范并长期应用骨保护药物，以有效预防或延缓SRE发生并改善患者预后。专家组据此提出倡议，强调加强随访监测、规范诊疗流程、提高骨保护治疗依从性，并推动以骨转移为核心的MDT模式规范化开展，以全面提升我国前列腺癌骨转移的诊疗质量和患者获益。

abstractsProstate cancer is one of the most common malignancies among men in China，and bone is its most frequent site of distant metastasis. Bone metastases markedly increase the risks of disease progression，skeletal-related events（SREs），and mortality，thereby substantially impairing patient survival and quality of life. To systematically evaluate the current status of diagnosis and management of prostate cancer bone metastases in China and to identify key gaps in clinical practice，this blue book was developed based on a nationwide questionnaire survey of multidisciplinary clinicians，integrated with evidence-based data and expert consensus. The results indicate persistent deficiencies in screening，diagnosis，treatment，and multidisciplinary team（MDT）collaboration，including insufficient attention to bone metastasis surveillance during follow-up，inadequate identification of high-risk populations，low utilization of bone scintigraphy and bone turnover markers，delayed initiation and nonstandard use of bone-protective agents，and limited MDT coverage in certain regions. Accumulating evidence suggests that bone-protective therapy should be initiated early，administered in a standardized manner，and maintained long term once bone metastases are confirmed，in order to prevent or delay SREs and improve patient outcomes. Accordingly，the expert panel proposes strengthening follow-up surveillance，standardizing diagnostic and therapeutic pathways，improving adherence to bone-protective treatment，and promoting nationwide implementation of MDT-based management centered on bone metastases，with the aim of improving the quality of care and clinical benefits for patients with prostate cancer bone metastases in China.