Savremeni pristup u lečenju oligometastatskog karcinoma prostate

  • dr Jelena Stanić Institut za onkologiju i radiologiju Srbije
  • dr Vesna Stanković NS dr sc. med prim. dr
  • Prof. dr Marina Nikitović Profesor
DOI: https://doi.org/10.5937/mp74-36499
Ključne reči: karcinom prostate; oligometastaza; radioterapija

Sažetak


Oligometastatski stadijum bolesti predstavlja stepen širenja maligne bolesti između lokalizovanog tumorskog procesa i ekstenzivnih, udaljenih metastaza. Generalno, pacijenti sa uznapredovalim karcinomom prostate mogu imati kliničku prezentaciju i diseminovane metastatske kao i oligometastatsku bolest. Oligometastatskim karcinomom prostate smatra se bolest sa prisustvom do pet metastatskih lezija.

U eri personalizovane onkološke terapije, uvođenje preciznih tehnologija u oblasti dijagnostike kao i sve veća dostupnost bezbednih i efikasnih, lokalizovanih, ne- ili minimalno invazivnih opcija lečenja, doveli su do povećanja incidencije i kliničkog interesovanja za oligometastatski karcinom prostate. Pored toga, pristup u lečenju ovih pacijenata se sve više pomera ka agresivnijem. Brojne retrospektivne studije pokazale su da se u metastatskom stadijumu bolesti, procedure kao što su radikalna prostatektomija i lokalna radioterapija metastaza, izvode sa minimalnim rizikom od toksičnosti i mogu poboljšati terapijske ishode. Obzirom da i dalje nema dovoljno podataka da bi se izvukli pouzdani zaključci o njihovom uticaju na preživljavanje, agresivne pristupe u lečenju oligometastatskog karcinoma prostate treba razmatrati samo u kontekstu prospektivnih kliničkih studija, koji uključuju pacijente informisane o ograničenim dokazima o efikasnosti date terapije.

Aktuelni nesistematski pristup selektovanja i lečenja pacijenata sa oligometastatskim karcinomom prostate moraće da bude standardizovan u cilju pravilnog izvođenja budućih istraživanja  i, što je još važnije, kasnijeg upoređivanja rezultata istih. Ovo su ključni uslovi koji će razjasniti da li dijagnoza oligometastaza kod ovih pacijenata, kao i terapija, treba da budu uključeni u svakodnevnu kliničku praksu.

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Objavljeno
2023/05/18
Broj časopisa
Vol. 74 Br. 1 (2023): Medicinski podmladak
Rubrika
Mini pregledni članak