Stereotaktická radioterapie karcinomu prostaty je relativně novou technikou léčby tohoto onemocnění. Uplatňuje se jako alternativa k běžně užívaným frakcionačním schématům v kurativních indikacích při ozařovaní celé prostaty a části semenných váčků a v paliativních při ozařování vzdálených metastáz. Zvláštní uplatnění nachází v léčbě oligometastatického onemocnění.

Stereotactic radiotherapy of prostate cancer is a new technique for the treatment of this disease. It is used as an alternative to commonly used fractionation schemes in curative indications when irradiating the entire prostate and part of the seminal vesicles and in palliative cases when irradiating distant pathways. It is particularly useful in the treatment of oligometastatic disease.

• MeSH
• dávka záření MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• metaanalýza jako téma MeSH
• metastázy nádorů MeSH
• nádory prostaty * radioterapie   MeSH
• radiochirurgie * metody   MeSH
• randomizované kontrolované studie jako téma MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH

BACKGROUND: Accurate staging and identification of optimal candidates for local salvage therapy, such as salvage radical prostatectomy (SRP), is necessary to ensure optimal care in patients with radiorecurrent prostate cancer (PCa). We aimed to analyze performance of magnetic resonance imaging (MRI) and prostate-specific membrane antigen (PSMA)-positron emission tomography (PET)/computed tomography (CT) for predicting pathologic nonorgan confined disease (pT3) and lymph node involvement (pN+) in patients treated with SRP for radiorecurrent PCa. METHODS: We retrospectively reviewed the institutional database to identify patients who underwent MRI or 68 Ga-PSMA-PET/CT before SRP for radiorecurrent PCa. The diagnostic estimates of MRI and PSMA-PET/CT for pT3 and pN+, were calculated. RESULTS: We identified 113 patients with radiorecurrent PCa who underwent preoperative MRI followed by SRP; 53 had preoperative 68 Ga-PSMA-PET/CT. For the detection of pT3 disease, the overall accuracy of MRI was 70% (95% confidence interval [CI] 61-78), sensitivity 40% (95% CI 26-55) and specificity 94% (95% CI 85-98); PSMA-PET/CT had slightly higher accuracy of 77% (95% CI 64-88), and higher sensitivity of 90% (95% CI 68-99), but lower specificity of 70% (95% CI 51-84). For pN+ disease, MRI had poor sensitivity of 14% (95% CI 3-36), specificity of 50 (95% CI 39-61) and total accuracy of 43% (95% CI 34-53); PSMA-PET/CT had an accuracy of 85% (95% CI 72-93), sensitivity of 27% (95% CI 6-61), and specificity of 100% (95% CI 92-100). CONCLUSION: In patients with radiorecurrent PCa, both, MRI, and 68 Ga-PSMA PET/CT are valuable tools for the pre-SRP staging and should be integrated into the standard workup. For lymph node metastases, 68 Ga-PSMA PET/CT is a strong rule-in test with nearly perfect specificity; in contrast MRI had a low accuracy for lymph node metastases.

• MeSH
• lidé MeSH
• lymfatické metastázy patologie   MeSH
• magnetická rezonanční tomografie MeSH
• nádory prostaty * diagnostické zobrazování   radioterapie   chirurgie   MeSH
• PET/CT * metody   MeSH
• prostata patologie   MeSH
• prostatektomie MeSH
• radioizotopy galia MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• Enzalutamid,
• MeSH
• antagonisté androgenů aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• antitumorózní látky hormonální aplikace a dávkování   farmakologie   terapeutické užití   MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• nádory prostaty rezistentní na kastraci * farmakoterapie   MeSH
• nádory prostaty chirurgie   diagnóza   farmakoterapie   radioterapie   MeSH
• PET/CT MeSH
• přežití po terapii bez příznaků nemoci MeSH
• progrese nemoci MeSH
• prostatický specifický antigen MeSH
• senioři MeSH
• věkové faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• rozhovory MeSH

• MeSH
• lidé MeSH
• metastázy nádorů * radioterapie   MeSH
• nádory prostaty * radioterapie   MeSH
• radium terapeutické užití   MeSH
• senioři nad 80 let MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• Publikační typ
• kazuistiky MeSH

• Klíčová slova
• Pluvicto,
• MeSH
• lidé MeSH
• lutecium terapeutické užití   MeSH
• nádory prostaty rezistentní na kastraci diagnóza   radioterapie   MeSH
• nádory prostaty * diagnóza   radioterapie   MeSH
• PET/CT MeSH
• prostatický specifický antigen krev   MeSH
• radiofarmaka aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• teranostická nanomedicína MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• souhrny MeSH

• MeSH
• analýza přežití MeSH
• frakcionace dávky záření MeSH
• lidé MeSH
• nádory prostaty * radioterapie   MeSH
• protonová terapie * metody   škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH

AIM: To compare cancer-specific mortality (CSM) rates between radical prostatectomy (RP) vs. external beam radiotherapy (RT) in patients with ductal carcinoma (DC) of the prostate. MATERIALS AND METHODS: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2016), we identified 369 DC patients, of whom 303 (82%) vs. 66 (18%) were treated with RP vs. RT, respectively. Kaplan-Meier plots and uni- and stepwise multivariate Cox regression models addressed CSM in the unmatched population. After propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), Kaplan-Meier curve and Cox regression models tested the effect of RP vs RT on CSM. RESULTS: Overall, RT patients were older, harbored higher PSA values, higher clinical T and higher Gleason grade groups. 5-year CSM rates were respectively 4.2 vs. 10% for RP vs. RT (HR 0.40, 95% CI 0.16-0.99, p = 0.048, favoring RP). At step-by-step multivariate Cox regression, after adding possible confounders, the central tendency of the HR for RP vs. RT approached 1. PSM resulted into 124 vs. 53 patients treated respectively with RP vs. RT. After PSM, as well as after IPTW, the protective effect of RP was no longer present (HR 1.16, 95% CI 0.23-5.73, p = 0.9 and 0.97, 95% CI 0.35-2.66, p = 0.9, respectively). CONCLUSIONS: Although CSM rate of ductal carcinoma RP patients is lower of that of RT patients, this apparent benefit disappears after statistical adjustment for population differences.

• MeSH
• duktální karcinom mortalita   radioterapie   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• nádory prostaty mortalita   radioterapie   terapie   MeSH
• prostatektomie metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

• MeSH
• lidé MeSH
• nádory prostaty * radioterapie   chirurgie   MeSH
• prostata MeSH
• prostatektomie * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH

PURPOSE: To test for differences in cancer-specific mortality (CSM) rates in Hispanic/Latino prostate cancer patients according to treatment type, radical prostatectomy (RP) vs external beam radiotherapy (EBRT). METHODS: Within the Surveillance, Epidemiology, and End Results database (2010-2016), we identified 2290 NCCN (National Comprehensive Cancer Network) high-risk (HR) Hispanic/Latino prostate cancer patients. Of those, 893 (39.0%) were treated with RP vs 1397 (61.0%) with EBRT. First, cumulative incidence plots and competing risks regression models tested for CSM differences after adjustment for other cause mortality (OCM). Second, cumulative incidence plots and competing risks regression models were refitted after 1:1 propensity score matching (according to age, PSA, biopsy Gleason score, cT-stage, cN-stage). RESULTS: In NCCN HR patients, 5-year CSM rates for RP vs EBRT were 2.4 vs 4.7%, yielding a multivariable hazard ratio of 0.37 (95% CI 0.19-0.73, p = 0.004) favoring RP. However, after propensity score matching, the hazard ratio of 0.54 was no longer statistically significant (95% CI 0.21-1.39, p = 0.2). CONCLUSION: Without the use of strictest adjustment for population differences, NCCN high-risk Hispanic/Latino prostate cancer patients appear to benefit more of RP than EBRT. However, after strictest adjustment for baseline patient and tumor characteristics between RP and EBRT cohorts, the apparent CSM benefit of RP is no longer statistically significant. In consequence, in Hispanic/Latino NCCN high-risk patients, either treatment modality results in similar CSM outcome.

• MeSH
• Hispánci a Latinoameričané MeSH
• hodnocení rizik MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prostaty mortalita   radioterapie   terapie   MeSH
• prostatektomie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

BACKGROUND: To test for differences in cancer-specific mortality (CSM) rates between radical prostatectomy (RP) vs external beam radiotherapy (EBRT) in National Comprehensive Cancer Network (NCCN) high-risk African American patients, as well as Johns Hopkins University (JHU) high-risk and very high-risk patients. MATERIALS AND METHODS: Within the Surveillance, Epidemiology, and End Results database (2010-2016), we identified 4165 NCCN high-risk patients, of whom 1944 (46.7%) and 2221 (53.3%) patients qualified for JHU high-risk or very high-risk definitions. Of all 4165 patients, 1390 (33.5%) were treated with RP versus 2775 (66.6%) with EBRT. Cumulative incidence plots and competing risks regression models addressed CSM before and after 1:1 propensity score matching between RP and EBRT NCCN high-risk patients. Subsequently, analyses were repeated separately in JHU high-risk and very high-risk subgroups. Finally, all analyses were repeated after landmark analyses were applied. RESULTS: In the NCCN high-risk cohort, 5-year CSM rates for RP versus EBRT were 2.4 versus 5.2%, yielding a multivariable hazard ratio of 0.50 (95% confidence interval [CI] 0.30-0.84, p = 0.009) favoring RP. In JHU very high-risk patients 5-year CSM rates for RP versus EBRT were 3.7 versus 8.4%, respectively, yielding a multivariable hazard ratio of 0.51 (95% CI: 0.28-0.95, p = 0.03) favoring RP. Conversely, in JHU high-risk patients, no significant CSM difference was recorded between RP vs EBRT (5-year CSM rates: 1.3 vs 1.3%; multivariable hazard ratio: 0.55, 95% CI: 0.16-1.90, p = 0.3). Observations were confirmed in propensity score-matched and landmark analyses adjusted cohorts. CONCLUSIONS: In JHU very high-risk African American patients, RP may hold a CSM advantage over EBRT, but not in JHU high-risk African American patients.

• MeSH
• černoši nebo Afroameričané statistika a číselné údaje   MeSH
• hodnocení rizik * metody   statistika a číselné údaje   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita MeSH
• nádory prostaty * etnologie   patologie   radioterapie   chirurgie   MeSH
• program SEER statistika a číselné údaje   MeSH
• prostatektomie * metody   statistika a číselné údaje   MeSH
• radioterapie * metody   statistika a číselné údaje   MeSH
• staging nádorů MeSH
• stupeň nádoru MeSH
• tendenční skóre MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Spojené státy americké MeSH