Karcinom prostaty - metastatický

Léčba

1. hormonoterapie
• bilaterální orchiektomie ( OE)
• LH-RH analog - pokles testosteronu pod  2 nmol/l se dostaví za  3 měsíce, pokud ne, je nutné přidání antiandrogenu nebo provedení OE
• LH-RH analog + antiandrogen
• orchiektomie + antiandrogen
• intermitentní léčba LHRH analogem snaha prodloužit hormonosenzitivní období s možností zachování sex.aktivity
• po 3m pokles PSA o  50% a testosteron pokles pod  2 nmol/l
• po 6m pokles \psa pod  80% nebo pod  4ng/ml
• pak je možné přerušení LHRH a sledování PSA  a testosteronu á 3m
• nasazení LHRH +50%PSA, PSA nad  20. klinické zhoršení
2. paliativní RT
3. chemoterapie

Ablative Therapies for Renal Tumors: Abstract and Introduction

Ablative Therapies for Renal Tumors: Abstract and Introduction

Owing to an increased use of diagnostic imaging for evaluating patients with other abdominal conditions, incidentally discovered kidney masses now account for a majority of renal tumors. Renal ablative therapy is assuming a more important role in patients with borderline renal impairment. Renal ablation uses heat or cold to bring about cell death. Radiofrequency ablation and cryoablation are two such procedures, and 5-year results are now emerging from both modalities. Renal biopsy at the time of ablation is extremely important in order to establish tissue diagnosis. Real-time temperature monitoring at the time of radiofrequency ablation is very useful to ensure adequacy of ablation.