Ключевые слова: гормональная терапия, рак предстательной железы, агонист лютеинизирующего гормона -рилизинг-гормон, лейпрорелин ацетат, тестостерон, ПСА, андрогенная блокада.The efficiency of hormone therapy was analyzed in patients with locally advanced or metastatic prostate cancer. Among all the drugs of a group of luteinizing hormone-releasing hormone agonists, leuprorelin acetate showed the best result in suppressing testosterone and PSA levels in urologic oncology practice. A clinical trial was done using different hormone treatment regimens, including orchiectomy, and different leuproprelin acetate therapy regimens. The drug was shown to be effective as compared to other hormone therapy options.
Purpose of the study. To evaluate the results of first‑line treatment in patients with metastatic castration‑resistant prostate cancer (mCRPC).Patients and methods. The evaluation of own clinical observations of 25 patients with mCRPC for the period from July 2014 to July 2021 by random sampling is given. Patients are divided into the ISUP group, the status of the initial treatment, and the type of previous treatment. Therapy was determined by the nature of progression. The following drugs were used as therapeutic agents: docetaxel, enzalutamide, abiraterone acetate + prednisolone, strontium (89 150 mBq). Results evaluation was carried out by RECIST 1.1. criteria. Statistical data processing was carried out using programs SPSS Statistica 2.0.Results. When assessing the tumor response to the therapy in 2 (8 %) patients, a complete therapeutic response was obtained, partial was registered in 4 (16 %) cases, stabilization in 9 (36 %), progression in 10 (40 %). The main response was stabilization and partial response, which was noted in 13 (52 %) patients. On 11 (44 %) patients with bone metastases as the cause of mCRPC, enzalutamide showed the best effect. Patients with lymph node metastases 3 (12 %) had a partial and complete response with a combined treatment regimen – lymphadenectomy + enzalutamide. In the group of patients n = 9 (36 %) – metastases to lymph nodes and bones, the best effect in the form of stabilization and partial response in enzalutamide. In 1 (4 %) patient with visceral progressing metastatic pleural lesion. Two patients had passed away by the end of the research.Conclusion. Enzalutamide and abiraterone showed the best responses in metastatic bone damage (as the cause of mCRPC). We observed more than 50 % of stabilizations during enzalutamide treatment. Combined treatment regimens should be used among patients with only metastatic lymph node lesion (oligo metastasis): this makes it possible to achieve a complete response and a greater number of stabilizations in some patients.
Purpose of the study. To determine the effectiveness of antiandrogenic therapy — 10-year General and tumor-specific survival (OV, OSV) depending on the type of hormone therapy, the stage of the disease, and the risk of progression.Patients and methods. The study was based on a retrospective analysis of 100 patients with localized, locally advanced, and metastatic prostate cancer over the period 2008–2018. The assessment was conducted in 2019. All patients received antiandrogenic treatment in the form of castration therapy (n=59) and combined (complex) treatment (n=41) in various variants and modes for more than 5 years. Patients had a 100% 5-year survival rate. The control point of the study was General and tumor- specific survival, as well as prognostic factors that determine this survival. Results. By the end of the study, 53 (53%) patients were alive, 8 (8%) died, and 39 (39%) patients were censored. The highest percentage of 10-year overall survival was achieved in localized stages of the disease and was 52% (31 patients) — stage 1, 38% (22 patients) — stage 2. Tumor specific survival rate (1–2 stages) — 62% (33 patients). At stage 3–30% (14 patients) and 51% (21 patients) and at stage 4–18% (1 patient) and 32% (2 patients), respectively. Depending on the risk of progression (Gleason index), high rates of both General and tumor- specific survival were achieved with low Gleason (2–5), and moderate risk of Gleason progression (6–7), and were 85% and 62%, respectively. The most effective method of treatment that determines the 10-year overall survival was combined (hormone radiation) therapy, which allowed to achieve results in 75% of patients. The tumor — specific survival rate was more than 80%.Conclusion. In real clinical practice, the use of antideprivation therapy in various variants and modes allows to obtain a 10-year General and tumor- specific survival rate in 75% and more than 80% of patients. Stratification of patients by risk groups forms a personalized approach to the treatment of each patient. Use of research treatment regimens in the work STAMPEDE, CHAARTED allows to increase the overall survival of patients with metastatic stage of the disease.
В настоящее время стандартом лечения пациентов, страдающих метастатическим раком почки, является таргетная терапия, а выбор препарата 1-й линии-сложная задача для врача-онколога в реальной клинической практике. В статье представлен анализ данных 15 пролеченных больных. Показана клиническая эффективность таргетного препарата пазопаниб в 1-й линии терапии у пациентов с метастатическим раком почки при различных локализациях метастатических очагов. Препарат показал убедительный ответ на лечение, особенно при наличии метастатических очагов в легких и надпочечниках.
At the present time primary-multiple malignancies are of interest in connection with the frequency of prevalence, which remains at the rather high level and continues to grow up, therefore increasing the relevance of this pathology in clinical oncology and everyday practice. With the exception of the treatment of primary multiple malignancies requiring a multimodal approach, as well as in the case of the use of complex treatment in conjunction with chemotherapists and radiotherapy specialists. In the past three decades, the development of screening tests that prevent and detect some cancers at an early, more treatable stage, and treatment advances have increased the 5‑year relative survival rate for all cancers to 66%. In addition to concerns about cancer recurrence, survivors also worry about their risk of developing a new cancer. Prostate cancer is a leader in terms of morbidity and mortality in the world, just as often are found in combination with other malignant tumors. However, given the high detectability of prostate cancer, primary patients are currently receiving radical treatment, and if metastatic prostate cancer is detected, they are receiving drug treatment, which improves the survival and quality of life of patients. Soft tissue sarcomas are rare malignant tumors that develop in the connective tissues and remain poorly understood due to the fact that they make up less than 1% of all malignant diseases. One of the main methods for treating soft tissue sarcomas is the surgical method. Soft tissue sarcomas are difficult to treat and therefore it is imperative that surgeons and other specialists have experience in treating this disease. Studies show that patients with this pathology show better results if they receive treatment in specialized cancer centers that have experience in treating soft tissue sarcoma. This article demonstrates the clinical case of surgical treatment of a patient with primary multiple retroperitoneal tumors and metastatic prostate cancer.
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