Urologie pro praxi 3/2003
Současný pohled na hormonálně refrakterní karcinom prostaty z hlediska přežití v závislosti na druhu terapie
Present view on hormone refractory prostate cancer from the perspective of survival dependent on type of therapy For more than five decades, the preferred treatment for advanced prostate cancer has been suppression of androgen production by medical or surgical castration. However, all patients treated with androgen deprivation eventually develop resistant disease as manifested by increasing prostate-specific antigen levels, progressive disease on imaging studies and ultimately worsening symptoms. The treatment of patients with hormone-refractory prostate cancer, once thought to represent a relatively futile endeavor, has changed signif icantly in the past several years with the development of new therapeutics. One of the most important new treatment strategies involves secondary hormonal manipulation after the failure of primary androgen deprivation. Some patients may respond to alternative hormonal interventions despite the presence of castrate levels of testosteron. Furthermore, the application of chemotherapeutic regimens has provided viable treatment options. Key words: hormone-refractory prostate cancer, secondary hormonal manipulation, chemotherapy.
