| Abstract | Rak prostate je jedan od najčešćih oblika raka među muškarcima diljem svijeta. Prava etiologija nastanka tog karcinoma nije poznata iako su čimbenici poput dobi, rase, pozitivne obiteljske anamneze, genetike, pretilosti, hormona, pušenja cigareta i alkohola povezani s većom učestalošću pojavljivanja raka prostate. Lokalno uznapredovali oblik raka prostate predstavlja stadij bolesti u kojem se tumor proširio izvan prostate na okolno tkivo i/ili regionalne limfne čvorove. Liječenje lokalno uznapredovalog raka prostate je terapijski izazov zbog potencijalnog rizika od daljnjeg napredovanja bolesti i smanjene stope preživljavanja bolesnika. Moderne dijagnostičke metode poput PSMA PET/CT-a i kolin PET/CT-a imaju bitnu ulogu u što ranijem prepoznavanju proširenosti bolesti i time ranije liječenje bolesnika s posljedično boljim rezultatima u smislu duljeg preživljavanja. U ovom radu obuhvaćene su analize različitih tehnika zračenja prostate poput radioterapije vanjskim snopom zračenja (EBRT) i brahiterapije te nekoliko razvijenijih metoda zračenja . Također, su prikazani različiti modaliteti sistemske terapije koji uključuju kemoterapiju i hormonsku terapiju. Primjena antiandrogene terapije, terapije LHRH agonistima/antagonistima, docetaksela razrađena je nizom meta-analiza koje su prikazane u radu. Naglasak je stavljen na kombinaciju zračenja i sistemne terapije koji u većini slučajeva pružaju bolju kontrolu bolesti i produljuju preživljavanje bolesnika.. Ovaj diplomski rad pruža pregled najnovijih saznanja o liječenju lokalno uznapredovalog raka prostate s naglaskom na zračenje i sistemsku terapiju i pruža osnovu za daljnje istraživanje. |
| Abstract (english) | Prostate cancer is one of the most common types of cancer among men worldwide. The exact etiology of prostate cancer is not known, although factors such as age, race, positive family history, genetics, obesity, hormones, smoking, and alcohol consumption have been associated with a higher prostate cancer incidence. Locally advanced prostate cancer represents a stage in which the tumour has spread beyond the prostate onto surrounding tissues and/or regional lymph nodes. Treating locally advanced prostate cancer poses a treatment challenge due to the potential risk of further disease progression and reduced survival rates. Modern diagnostic methods such as PSMA PET/CT and choline PET/CT play a crucial role in early identification of the cancer stage and thus, eralier treatment with subsequently better results, i.e., linger survival period. This study covers analysis of various prostate radiation techniques, such as external beam radiation therapy (EBRT) and brachytherapy, as well as several more advanced radiation methods. Additionally, different modalities of systemic therapy are presented, such as chemotherapy and hormone therapy. Usage of antiandrogen therapy, LHRH agonists/antagonists and docetaxel is elaborated through a series of meta-analyses presented in the study. Emphasis is placed on the combination of radiation and systemic therapy which in most cases provides a better disease control and prolongs patients' lifespan. This thesis provides an overview of the latest findings on the treatment of locally advanced prostate cancer, focus on radiation and systemic therapy and providing a basis for further research. |
