Title Multimodalno liječenje bolesnika s karcinomom prostate
Title (english) Multimodal treatment of patients with prostate cancer
Author Josip Došen
Mentor Dean Markić (mentor)
Committee member Romano Oguić (predsjednik povjerenstva)
Committee member Stanislav Sotošek (član povjerenstva)
Committee member Josip Španjol (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Urology) Rijeka
Defense date and country 2024-07-12, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Urology
Abstract Rak prostate druga je po učestalosti maligna novotvorina među muškom populacijom u svijetu stoga predstavlja ozbiljan globalni zdravstveni problem. Godišnje se na globalnoj razini zabilježi 1,4 milijuna novootkrivenih i 397 000 umrlih, što ovu bolest svrstava na četvrto mjesto prema incidenciji, a na osmo mjesto prema smrtnosti među malignim neoplazmama kod muškaraca. Rak prostate najprije se odnosi na maligne promjene epitela stoga se klasificira kao karcinom. Periferno žljezdano tkivo prostate najčešće je zahvaćeno neoplastičnim promjenama. Klinička slika raka prostate može se kretati od asimptomatskog, mikroskopskog, dobro diferenciranog tumora pa sve do pregledom otkrivenog simptomatskog, agresivnog raka koji uzrokuje udaljene metastaze i izaziva smrt. U trenutku postavljanja dijagnoze 78% bolesnika ima lokalizirani karcinom, 12% zahvaćene regionalne limfne čvorove, a 6% ima udaljene metastaze. Multimodalno liječenje obuhvaća sinkroniziranu primjenu farmakoloških i nefarmakoloških postupaka uz integriranje pacijenta u proces samog liječenja. Početna procjena pacijenta mora uključivati digitorektalni pregled, serumski prostata specifični antigen (PSA) prije ikakvog liječenja, a također treba odrediti i Gleason zbroj u početnoj biopsiji. Aktivni nadzor definira se kao odgoda definitivne terapije s uvođenjem liječenja ako postoje klinički dokazi progresije bolesti i najčešće se primjenjuje kod lokalnih i niskorizičnih karcinoma. Radikalna prostatektomija je kirurški zahvat kojim se odstranjuje prostata u cijelosti zajedno sa svojom kapsulom i sjemenim mjehurićima, a provodi se u pacijenata koji su u grupi srednjeg rizika dok se kod pacijenata u grupi visokog rizika provodi u sklopu multimodalnog liječenja. Radioterapija i brahiterapija također se koriste u sklopu multimodalnog liječenja i kombiniraju se s drugim oblicima liječenja. Neoadjuvantne hormonske terapije koriste se za smanjenje volumena tumora i poboljšanje stope resekcije.
Abstract (english) Prostate cancer is the second most frequent malignant neoplasm among the male population in the world, therefore it represents a serious global health problem. Annually, 1.4 million new cases and 397,000 deaths are recorded globally, which ranks this disease in fourth place in terms of incidence, and in eighth place in terms of mortality among malignant neoplasms in men. Prostate cancer primarily refers to malignant changes in the epithelium, therefore it is classified as cancer. The peripheral glandular tissue of the prostate is most often affected by neoplastic changes. The clinical picture of prostate cancer can range from an asymptomatic, microscopic, well-differentiated tumor to a symptomatic, aggressive cancer that causes distant metastases and causes death. At the time of diagnosis, 78% of patients have localized cancer, 12% have affected regional lymph nodes, and 6% have distant metastases. Multimodal treatment includes the synchronized application of pharmacological and non-pharmacological procedures while integrating the patient into the treatment process itself. The initial assessment of the patient must include a digital rectal examination, serum prostate specific antigen (PSA) before any treatment, and the Gleason score should also be determined in the initial biopsy. Active surveillance is defined as the postponement of definitive therapy with the introduction of treatment if there is clinical evidence of disease progression and is most often applied in local and low-risk cancers. Radical prostatectomy is a surgical procedure that removes the entire prostate along with its capsule and seminal vesicles, and is performed in patients who are in the medium-risk group, while in patients in the high-risk group, it is performed as part of multimodal treatment. Radiotherapy and brachytherapy are also used as part of multimodality treatment and are combined with other forms of treatment. Neoadjuvant hormonal therapies are used to reduce tumor volume and improve resection rates.
Keywords
Ključne riječi: brahiterapija
kombinirana terapija
neoplazme prostate
radioterapija stupnjevanje neoplazme
Keywords (english)
Key words: Brachytherapy
Combined Modality Therapy
Neoplasm Grading
Prostatic Neoplasms
Radiotherapy
Language croatian
URN:NBN urn:nbn:hr:184:084069
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-06-19 20:25:26