Wyniki wyszukiwania - Biblioteka Nauki

1

Time to treatment of prostate cancer patients

100%

Rucińska M. , Osowiecka K. , Gałka S. , Środa R. , Wojciechowski P. , Sugajska A.

OncoReview

|

2018

|

tom 8

|

nr 3

86-93

EN

Prostate cancer is one of the most common cancers in men. The incidence of prostate cancer increases systematically. The correlation between waiting time for oncological treatment and survival prognosis in prostate cancer is not clearly determined. The aim of the study was to estimate the waiting time from suspicion until prostate cancer diagnosis and treatment in Warmia and Mazury Voivodeship. Ninety-six consecutive prostate cancer patients treated with radical radiotherapy between November 2016 and June 2017 in the Department of Radiation Oncology of the Hospital of the Ministry of Internal Affairs with Warmia and Mazury Oncology Center in Olsztyn were included in the analysis. A questionnaire prepared especially for this study, and individual interviews with patients were used in the study. The obtained data was supplemented with medical records and hospital databases. In the case of twenty-nine men, the PSA concentration was measured due to urinary disorders, and the median time from symptoms until the first PSA test in that group was 168 days. The median time from PSA concentration > 4 ng/ml to biopsy of prostate cancer and start of treatment for all patients was 62 and 156 days, respectively. Hormone therapy was administered the quickest. A positive correlation was observed between the waiting time from histopathological confirmation of prostate cancer until treatment, and the distance from one’s place of residence to the oncological center (p < 0.05).

2

New approach to prostate diagnosis - perfusion CT images analysis using "life belt" method

80%

Śmietański J. , Tadeusiewicz R.

Bio-Algorithms and Med-Systems

|

2012

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tom Vol. 8, no. 1

145--158

EN

The most important task that could improve the efficacy of managing the prostate cancer (PCa) is to develop the technique which will be able to detect an existing PCa even in cases when currently used methods are insufficient. It is supposed that the perfusion computed tomography technology (p-CT) can improve the diagnosis of early PCa. Unfortunately, the perfusion prostate images are very difficult to analyze especially for doctors who are not enough experienced with such a kind of images. Therefore there is a need to find a computational method which could help the doctors to make the decision whether the prostate cancer exists or not and (if the results are positive) to correctly point out the cancerous region. In research which results are presented in the paper we analyzed a great number of prostate images derived from over 50 patients with proven or suspected PCa. We propose the new method, named “life-belt” which has significant potential for identifying cancerous regions.

3

Development of an automation system for iodine-125 brachytherapy seed encapsulated by Nd:YAG laser welding

80%

Somessari S. L. , Feher A. , Sprenger F. E. , Rostelato M. E. C. M. , da Costa F. E. , Calvo W. A. P.

Nukleonika

|

2011

|

tom Vol. 56, No. 4

369-374

EN

The aim of this work is to develop an automation system for iodine-125 radioactive seed production by Nd:YAG laser welding, which has been used successfully in low dose rate (LDR) brachytherapy treatment. This small seed consists of a welded titanium capsule, with 0.8 mm in diameter and 4.5 mm in length, containing iodine-125 adsorbed onto a silver rod. The iodine-125 seeds are implanted into the human prostate to irradiate the tumor for cancer treatment. Nowadays, the Radiation Technology Center, at Institute for Nuclear and Energy Research, Săo Paulo, Brazil (IPEN-CNEN/SP) imports and distributes 36,000 iodine-125 seeds per year, for the clinics and hospitals in the country. However, the Brazilian market potential is now over 8,000 iodine-125 seeds per month. The local production of these iodine-125 radioactive sources became a priority for the Institute, in order to reduce the price and the problems of prostate cancer management. It will permit to spread their use to a larger number of patients in Brazil. On the other hand, the industrial automation plays an important role for iodine-125 seeds in order to increase the productivity, with high quality and assurance, avoiding human factors, implementing and operating with good manufacturing practices (GMP). The technology consists of appliance electronic and electro-mechanical parts and components to control machines and processes. The automation system technology for iodine-125 seed production developed in this work was mainly assembled employing a programmable logic controller (PLC), a stepper motor, an Nd:YAG laser welding machine and a supervisory. The statistical repeatability of correctly encapsulated sealed sources with this automation system is greater than 95 per cent.

4

Dosimetric impact of rotational set‑up errors in high-risk prostate cancer

80%

Poncyljusz M. , Bulski W.

Polish Journal of Medical Physics and Engineering

|

2022

|

tom Vol. 28, Iss. 4

200--206

EN

Introduction: Cone-beam computed tomography (CBCT) provides an excellent solution to quantitative assessment and correction of patient set-up errors during radiotherapy. However, most linear accelerators are equipped with conventional therapy tables that can be moved in three translational directions and perform only yaw rotation. Uncorrected roll and pitch result in rotational set-up errors, particularly when the distance from the isocenter to the target border is large. The aim of this study was to investigate the impact of rotational errors on the dose delivered to the clinical target volume (CTV), the planning target volume (PTV) and organs at risk (OAR). Material and methods: 30 patients with prostate cancer treated with VMAT technique had daily CBCT scans (840 CBCTs in total) prior to treatment delivery. The rotational errors remaining after on-line correction were retrospectively analysed. The sum plans simulating the dose distribution during the treatment course were calculated for selected patients with significant rotational errors. Results: The dose delivered to the prostate bed CTV reported in the sum plan was not lower than in the original plan for all selected patients. For four patients from the selected group, the D98% for prostate bed PTV was less than 95%. The V47.88Gy for pelvic lymph nodes PTV was less than 98% for two of the selected patients. Conclusions: The analysis of the dosimetric parameters showed that the impact of uncorrected rotations is not clinically significant in terms of the dose delivered to OAR and the dose coverage of CTV. However, the PTV dose coverage is correlated with distance away from the isocenter and is smaller than planned.

5

Complexity analysis of VMAT prostate plans: insights from dimensionality reduction and information theory techniques

80%

Kamperis E. , Kodona C. , Papalexandrou A. , Arsos G. , Heidich A.-B. , Hatziioannou K. , Giannouzakos V. , Papanastasiou E.

Polish Journal of Medical Physics and Engineering

|

2023

|

tom Vol. 29, Iss. 3

143--150

EN

Introduction: Volumetric Modulated Arc Therapy (VMAT) is a state-of-the-art prostate cancer treatment, defined by high dose gradients around targets. Its unique dose shaping incurs hidden complexity, impacting treatment deliverability, carcinogenesis, and machine strain. This study compares various aperture-based VMAT complexity indices in prostate cases using principal component and mutual information analyses. It suggests essential properties for an ideal complexity index from an information-theoretic viewpoint. Material and methods: The following ten complexity indices were calculated in 217 VMAT prostate plans: circumference over area (CoA), edge metric (EM), equivalent square field (ESF), leaf travel (LT), leaf travel modulation complexity score for VMAT (LTMCSV), mean-field area (MFA), modulation complexity score (standard MCS and VMAT variant MCSV), plan irregularity (PI), and small aperture score (SAS5mm). Principal component analysis (PCA) was applied to explore the correlations between the metrics. The differential entropy of all metrics was also calculated, along with the mutual information for all 45 metric pairs. Results: Whole-pelvis plans had greater complexity across all indices. The first three principal components explained 96.2% of the total variance. The complexity metrics formed three groups with similar conceptual characteristics, particularly ESF, LT, MFA, PI, and EM, SAS5. The differential entropy varied across the complexity metrics (PI having the smallest vs. EM the largest). Mutual information analysis (MIA) confirmed some metrics’ interdependence, although other pairs, such as LTMCSV/SAS5mm, LT/MCSV, and EM/SAS5mm, were found to share minimal MI. Conclusions: There are many complexity indices for VMAT described in the literature. PCA and MIA analyses can uncover significant overlap among them. However, this is not entirely reducible through dimensionality reduction techniques, suggesting that there also exists some reciprocity. When designing predictive models of quality assurance metrics, PCA and MIA may prove useful for feature engineering.

6

Tetraspanin CD151 mediates communication between PC3 prostate cancer cells and osteoblasts

80%

Grudowska A. , Czaplińska D. , Polom W. , Matuszewski M. , Sądej R. , Składanowski A.

Acta Biochimica Polonica

|

2017

|

tom 64

|

nr 1

135-141

EN

Invasion and migration of cancer cells are crucial for the formation of secondary lesions. These require activation of signalling cascades modulated by the number of regulatory molecules. One such molecule is CD151, a member of evolutionary conserved tetraspanin family. CD151 is involved in cell adhesion, motility and cancer progression due to formation of complexes with laminin-binding integrins and regulation of growth factor receptors function (e.g. HGFR, TGFβR, EGFR). Recent studies point to correlation between CD151 expression and high tumour grade in prostate cancer (PCa). Herein, we investigated a possible role of CD151 in communication between PC3 cancer cells and either cancer-associated fibroblasts (CAFs) or osteoblasts, an interplay which is significant for metastasis. The analysis showed that although CAFs strongly enhanced both migration and invasion of PC3 prostate cancer cells, the effect was not dependent on CD151. On the other hand, CD151 was found to promote 3D migration as well as invasive growth in response to osteoblasts-secreted growth factors. Obtained data revealed that knockdown of CD151 abolished activation of pro-migratory/pro-survival kinases (i.e FAK, Src, HSP27) triggered by osteoblasts, along with expression of matrix metalloproteinase-13. This suggests that CD151 participates in communication between PC3 cells and bone microenvironment and the process can be considered as a significant step of PCa progression and metastasis.

7

Abiraterone acetate – 10 clinically relevant facts

80%

Żołnierek J.

OncoReview

|

2021

|

tom 11

|

nr 3

80-84

EN

Prostate cancer is one of the most frequently diagnosed cancers in men. Number of newly diagnosed cases is increasing due to several factors and the most important ones seem to be: population ageing and more sensitive diagnostic procedures. Secondary – the higher efficacy of treatment with its influence on improving patients’ overall survival and the specific mechanism of action of drugs used in systemic therapy lead to growing population of men suffering from prostate cancer in general and, specifically – patients with castration resistance. It is hormone therapy to play the key role in systemic treatment of prostate cancer with increasing significance of novel drugs focused on inhibition of molecular signal transduction mediated by androgen receptor. Abiraterone acetate is the representative of this therapeutic class. The paper describes the most clinically relevant data regarding the drug.

8

Comparison of helical tomotherapy with multi-field intensity-modulated radiotherapy treatment plans using simultaneous integrated boost in high-risk prostate cancer

80%

Başaran H. , Karaca S. , Koca T. , Gündoğdu Y. Ö.

Polish Journal of Medical Physics and Engineering

|

2021

|

tom Vol. 27, Iss. 2

143--149

EN

Purpose: The aim of this study is to compare the dosimetric results of Helical Tomotherapy (HT) and Multi-field IMRT treatment plans using a Simultaneous Integrated Boost (SIB) technique in the treatment of High-Risk Prostate Cancer (HRPCa) with pelvic nodal radiation. Methods: Seventeen patients planned with HT and 7,8 and 9 fields IMRT were investigated. All plans were designed with the prescribed dose of 54.0 Gy to the PTVln while simultaneously delivering 74.0 Gy to the PTVPS in 30 fractions. Dosimetric data of PTV and OARs were compared. Results: HT gives a better CI and HI of PTVPS compared to multi-field IMRT plans. HT plans significantly improved target coverage (HT:0.95 vs multi-field IMRT: 0.52, 0.49 and 0.49 respectively, p < 0.001). Bladder mean dose(Gy) (HT: 45.6 vs multi-field IMRT: 53.6, 53.3 and 52.7 respectively, p = 0.004) and D66%(Gy) dose (HT: 35.3 vs multi-field IMRT: 46.7, 47.0 and 44.9 respectively, p = 0.006) were lower in HT. But multi-field IMRT plans significantly reduced the rectum volume receiving more than 75 Gy ; (HT V75% (%) 2.7 vs multi-field IMRT 0.8, 1.4 and 0.9 respectively, p = 0.008). HT provided better sparing of the right and left femoral head receiving a mean dose. The penile bulb and small bowel doses were the highest in HT compared with multi-field IMRT. Conclusions: HT achieved better dose distribution to target compared to multi-field IMRT. This study suggests HT as a reasonable option for the treatment of HRPCa patients.

9

Discriminatory Power of Co-Occurrence Features in Perfusion CT Prostate Images

80%

Śmietański J. , Tadeusiewicz R.

Machine Graphics and Vision

|

2010

|

tom Vol. 19, No. 2

185-199

EN

This paper presents an algorithm used to improve the effectiveness of early prostate cancer (PCa)detection. The necessity for using such a computational method lies in the fact that although perfusion computed tomography (p-CT) is considered a good technique for the detection of early PCa, the p-CT prostate images are very difficult to interpret manually by radiologists. We hereby propose a methodology for computational analysis of p-CT prostate images based on textural coefficients derived from co-occurrence matrices and their 21 coefficients. The selection of only a few of the considered features ensures the necessary balance between matching set of already known images and new, not yet clear cases. The proposed algorithm for automatic differentiation of the healthy area of the image from the cancerous region was tested on a set of 59 prostate images. Although the results were not entirely satisfactory (86% correct recognitions), this method may be considered as the base for the development of a better algorithm.

10

Texture analysis in perfusion images of prostate cancer - A case study

80%

Śmietański J. , Tadeusiewicz R. , Łuczyńska E.

International Journal of Applied Mathematics and Computer Science

|

2010

|

tom 20

|

nr 1

149-156

EN

The analysis of prostate images is one of the most complex tasks in medical images interpretation. It is sometimes very difficult to detect early prostate cancer using currently available diagnostic methods. But the examination based on perfusion computed tomography (p-CT) may avoid such problems even in particularly difficult cases. However, the lack of computational methods useful in the interpretation of perfusion prostate images makes it unreliable because the diagnosis depends mainly on the doctor's individual opinion and experience. In this paper some methods of automatic analysis of prostate perfusion tomographic images are presented and discussed. Some of the presented methods are adopted from papers of other researchers, and some are elaborated by the authors. This presentation of the method and algorithms is important, but it is not the master scope of the paper. The main purpose of this study is computational (deterministic and independent) verification of the usefulness of the p-CT technique in a specific case. It shows that it is possible to find computationally attainable properties of p-CT images which allow pointing out the cancerous lesion and can be used in computer aided medical diagnosis.

11

PDT of prostate cancer

80%

Sroka R. , Zaak D. , Stocker S. , Höppner M. , Knüchel R. , Reich O. , Hofstetter A.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

|

2004

|

tom Vol. 10, nr 1-2

22-22

12

Obesity, Physical Activity and Prostate Cancer: An Overview

70%

Kruk J. , Bernstein J. , Aboul-Enein B. H.

Central European Journal of Sport Sciences and Medicine

|

2022

|

tom 38

71-91

EN

Obesity and a lack of sufficient physical activity (PA) are recognized as risk factors for most civilization diseases, including cancer. This study synthesized the current evidence evaluating the relationship between excess body weight and prostate cancer (PCa) in the relation to the disease risk, progression, and mortality, and identifies biological plausibility of the association. We also estimated the importance of PA in intentional body weight loss. Several electronic major databases to identify eligible articles were searched until March 2022. A total 22 observational articles, the literature on the underlying biological mechanisms, and the crucial evidence of a role of PA in body weight maintenance and reduction were reviewed. The available knowledge suggests that association between body mass index and PCa is conflicting. However, the most research consistently shown that overweight/obesity was associated with higher risk of high-grade PCa and dying of PCa. Overweight/obesity can promote high-grade PCa through increased levels of secreted adipokines, increased formation of proinflammatory agents, and reduced concentration of adiponectin, among others. Being obese may by also linked with a higher risk of mortality. Exercise can decrease these health consequences related with obesity and may be effective in reduction of PCa-specific mortality, however, there are relative few studies on PA and PCa prevention among obese individuals.

13

Comparative pharmacokinetic study of bicalutamide administration alone and in combination with vitamin D in rats

70%

Shi W. , Di H. , Pang B. , Jin H. , Liu H. , Qiu B. , Ren B. , Pang G.

Acta Chromatographica

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2022

|

tom Vol. 34, no. 4

453--460

EN

Bicalutamide (BCL) has been approved for treatment of advanced prostate cancer (Pca), and vitamin D is inevitably used in combination with BCL in Pca patients for skeletal or anti-tumor strategies. Therefore, it is necessary to study the effect of vitamin D application on the pharmacokinetics of BCL. We developed and validated a specific, sensitive and rapid UHPLC–MS/MS method to investigate the pharmacokinetic behaviours of BCL in rat plasma with and without the combined use of vitamin D. Plasma samples were extracted by protein precipitation with ether/dichloromethane (2:1 v/v), and the analytes were separated by a Kinetex Biphenyl 100A column (2.1 × 100 mm, 2.6 μm) with a mobile phase composed of 0.5 mM ammonium acetate (PH 6.5) in water (A) and acetonitrile (B) in a ratio of A:B = 35:65 (v/v). Analysis of the ions was run in the multiple reactions monitoring (MRM) mode. The linear range of BCL was 5–2000 ng mL⁻¹. The intra- and inter-day precision were less than 14%, and the accuracy was in the range of 94.4–107.1%. The mean extraction recoveries, matrix effects and stabilities were acceptable for this method. The validated method was successfully applied to evaluate the pharmacokinetic behaviours of BCL in rat plasma. The results demonstrated that the pharmacokinetic property of BCL is significantly affected by combined use of vitamin D, which might help provide useful evidence for the clinical therapy and further pharmacokinetic study.

14

A Monte Carlo study on the radio-sensitization effect of gold nanoparticles in brachytherapy of prostate by 103Pd seeds

70%

Jangjoo A. G. , Ghiasi H. , Mesbahi A.

Polish Journal of Medical Physics and Engineering

|

2019

|

tom Vol. 25, Iss. 2

87--92

EN

103Pd seed is being used for prostate brachytherapy. Additionally, the dose enhancement effect of gold nanoparticles (GNP) has been reported in previous studies. The aim of this study was to characterize the dosimetric effect of gold nanoparticles in brachytherapy with a 103Pd source. Two brachytherapy seeds including 103Pd source was simulated using MCNPX Monte Carlo code. The seeds’ models were validated by comparing the MC with reported results. Then, GNPs (10 nm in diameter) with a concentration of 7mg Au/g were simulated uniformly inside the prostate of a humanoid computational phantom. Additionally, the dose enhancement factor (DEF) of nanoparticles was calculated for both modeled brachytherapy seeds. A good agreement was found between the MC calculated and the reported dosimetric parameters. For both seeds, an average DEF of 23% was obtained in tumor volume for prostate brachytherapy. The application of GNPs in conjunction with 103Pd seed in brachytherapy can enhance the delivered dose to the tumor and consequently leads to better treatment outcome.

15

The role of enzalutamide in the treatment of prostate cancer from the perspective of Polish oncologists

70%

Bal W. , Gajda M.

OncoReview

|

2022

|

tom 12

|

nr 2

45-49

EN

For several years, prostate cancer has remained the most common malignancy in male patients in Poland. A large number of patients combined with rising costs of therapy translate into a significant socio-economic burden. In a clinical oncologist’s practice, we usually deal with patients with advanced prostate cancer. Taking into account the poorer prognosis in advanced disease, development of new therapeutic options as well we their adequate selection is of paramount importance. Enzalutamide is one of the second-generation androgen axis inhibitors, which has the ability to overcome resistance to androgen deprivation therapy by inhibiting the androgen-DNA signalling on several levels. Its efficacy and safety had been proven in numerous phase II and phase III clinical studies and it has been registered by regulatory authorities in the United States and European Union in the treatment of mCRPC, mCSPC and nmCRPC. In this article selected issues related to the treatment of prostate cancer are discussed, with particular emphasis on the role of enzalutamide (including its mechanism of action, indications, efficacy and safety).

16

Leakage test evaluation used for qualification of iodine-125 seeds sealing

60%

Feher A. , Rostelato M. E. C. M. , Zeituni C. A. , Calvo W. A. P. , Somessari S. L. , Moura J. A. , Moura E. S. , Souza C. D. , Rela P. R.

Nukleonika

|

2011

|

tom Vol. 56, No. 4

375-379

EN

Brachytherapy is one of the possible treatments with ionizing radiation available for prostate cancer, in which small seeds containing iodine-125 radioisotope are implanted directly into the prostate. The seed consists of a sealed titanium tube containing a central silver wire with adsorbed iodine-125. The tube sealing is made with titanium at the ends, using plasma arc-welding (PAW) or laser process. This sealing must be leakage-resistant and free of cracks, therefore avoiding iodine-125 to deposit in the silver wire to escape and spread into the human body. To ensure that this problem is not occurring, rigorous leakage tests in accordance with the standard ISO-9978 should be applied. The aim of this study is to determine, implement and evaluate the leakage test to be used in the iodine-125 seeds production, in order to qualify the sealing procedure. The standard ISO-9978 presents a list of tests to be carried out according to the type of source. The preferential methods for brachytherapy sources are soaking and helium. To assess the seeds leakage, the method of immersion test at room temperature was applied. The seeds are considered leakage-free if the detected activity does not exceed 185 Bq (5 nCi). An iodine standard was prepared and its value determined in a sodium iodide detector. A liquid scintillation counter was calibrated with the standard for seed leakage tests. Forty-eight seeds were plasma arc-welded for these tests.

17

Evaluation of various common prostate IMRT techniques based on estimated tumor control and normal tissue complication probabilities in correlation with patients anatomical parameters derived from the CT scans

60%

Banaei A. , Hashemi B. , Bakhshandeh M. , Mofid B.

Polish Journal of Medical Physics and Engineering

|

2019

|

tom Vol. 25, Iss. 1

35--41

EN

Background: The relationship between the prostate IMRT techniques and patients anatomical parameters has been rarely investigated. Objective: to evaluate various prostate IMRT techniques based on tumor control and normal tissue complication probability (TCP and NTCP) values and also the correlation of such techniques with patients anatomical parameters. Methods: Four IMRT techniques (9, 7 and 5 fields and also automatic) were planned on the CT scans of 63 prostate cancer patients. The sum of distances between the organs at risk (OARs) and target tissue and also their average joint volumes were measured and assumed as anatomical parameters. Selected dosimetric and radiobiological parameters (TCP and NTCP) values were compared among various techniques and the correlation with the above anatomical parameters were assessed using Pearsons’ correlation. Results: High correlations were found between the dosimetric/radiobiological parameters of OARs with the joint volumes and with the distances between the OARs and target tissue in all the techniques. The TCP and complication free tumor control probability (P+) values were decreased with increasing the joint volume and decreasing the distances between the OARs and target tissue (as poly-nominal functions). The NTCP values were increased with increasing the joint volumes and decreasing the distances (3-degree poly-nominal functions). For the low percent joint volumes (<20%) and high distances (>7 cm), The TCP, NTCP and P+ showed no statistical differences between various techniques (P-value>0.07). However, 9 and 7 fields techniques indicated better radiobiological results (P-value<0.05) in almost other ranges (>20% joint volumes and <7 cm distances). Conclusion: Based on our results, it would be possible to compare radiobiological effects of various common IMRT techniques and choose the best one regarding to patients anatomical parameters derived from the CT scans.

18

Targeting clusterin in prostate cancer

60%

Rizzi F. , Bettuzzi S.

Journal of Physiology and Pharmacology. Supplement

|

2008

|

tom 59

|

nr 9

265-274

19

Ocena elastosonograficzna z wyznaczeniem stosunku ściśliwości symetrycznych obszarów gruczołu krokowego w celu diagnozy klinicznie istotnego raka stercza

60%

Przewor A. , Słapa R. Z. , Jakubowski W. S. , Migda B. , Dmowski T.

Journal of Ultrasonography

|

2014

|

tom 14

|

nr 57

130-141

EN

Aim: Sonoelastography is a technique that assesses tissue hardness/compressibility. Utility and sensitivity of the method in prostate cancer diagnostics were assessed compared to the current gold standard in prostate cancer diagnostics i.e. systematic biopsy. Material and methods: The study involved 84 patients suspected of prostate cancer based on elevated PSA levels or abnormal per rectal examination findings. Sonoelastography was used to evaluate the prostate gland. In the case of regions with hardness two-fold greater than that of symmetric prostate area (strain ratio >2), targeted biopsy was used; which was followed by an ultrasound-guided 8- or 10-core systematic biopsy (regardless of sonoelastography-indicated sites) as a reference point. Results: The mean age of patients was 69 years. PSA serum levels ranged between 1.02 and 885 ng/dl. The mean prostate volume was 62 ml (19–149 ml). Prostate cancer was found in 39 out of 84 individuals. Statistically significant differences in strain ratios between cancers and benign lesions were shown. Sonoelastography guided biopsy revealed 30 lesions – overall sensitivity 77% (sensitivity of the method – 81%). Sonoelastographic sensitivity increased depending on cancer stage according to the Gleason grading system: 6–60%, 7–75%, 8–83%, 9/10–100%. The estimated sensitivity of systematic biopsy was 92%. Conclusions: Sonoelastography shows higher diagnostic sensitivity in prostate cancer diagnostics compared to conventional imaging techniques, i.e. grey-scale TRUS, Doppler ultrasound. It allows to reduce the number of collected tissue cores, and thus limit the incidence of complications as well as the costs involved. Sonoelastography using the determination of compressibility ratio for symmetrical prostatic regions may prove useful in the detection of clinically significant prostate cancer.

PL

Cel pracy: Elastosonografia jest techniką oceniającą twardość/ściśliwość tkanek. Badano użyteczność i czułość tej metody w diagnostyce raka stercza w porównaniu z obecnie obowiązującym złotym standardem w diagnostyce raka gruczołu krokowego – biopsją systematyczną. Materiał i metoda: Badaniu poddano 84 chorych z podejrzeniem raka stercza na podstawie podwyższonego poziomu PSA lub nieprawidłowości w badaniu per rectum. Ocenę gruczołu krokowego wykonywano przy pomocy elastosonografii. W przypadku miejsc o twardości przekraczającej ponad dwukrotnie twardość symetrycznego obszaru prostaty (stosunek odkształcenia >2) stosowano biopsję celowaną; następnie u każdego chorego przeprowadzano pod kontrolą USG biopsję systematyczną 8- lub 10-rdzeniową (niezależnie od wskazań elastosonografii), jako punkt odniesienia. Wyniki: Średni wiek chorych wynosił 69 lat. Poziom PSA w surowicy krwi mieścił się w zakresie 1,02–885 ng/dl. Średnia objętość gruczołu krokowego wynosiła 62 ml (19–149 ml). Pośród 84 badanych raka prostaty ujawniono u 39 osób. Wykazano statystycznie istotne różnice wartości stosunku odkształcenia między rakami i zmianami łagodnymi. Biopsja pod kontrolą elastosonografii ujawniła 30 zmian – czułość (overall sensitivity) 77% (sensitivity of the method – 81%). Czułość elastosonografii wzrastała w zależności od stopnia zaawansowania w skali Gleasona: 6–60%, 7–75%, 8–83%, 9/10–100%. Czułość biopsji systematycznej oszacowano na 92%. Wnioski: Elastosonografia ma wyższą czułość w diagnostyce raka stercza niż konwencjonalnie używane techniki obrazowania, tj.: TRUS w skali szarości, USG dopplerowskie. Pozwala zredukować liczbę pobieranych rdzeni tkankowych, a co za tym idzie – zmniejszyć liczbę powikłań i ograniczyć koszty. Elastosonografia z oznaczeniem stosunku ściśliwości symetrycznych obszarów stercza może być pomocna w wykryciu klinicznie istotnego raka gruczołu krokowego.

20

The site of apalutamide in the treatment of prostate cancer

60%

Juszczak K. , Drewa T.

OncoReview

|

2021

|

tom 11

|

nr 4

120-122

EN

Apalutamide belongs to the ARTA group. This drug is a new generation selective androgen receptor inhibitor. Patients with prostate cancer develop resistance to castration testosterone levels over time during hormone therapy. Therefore, it is necessary to consider additional therapeutic options based on drugs from the ARTA group. The article presents the role of apalutamide in the treatment of prostate cancer and its effectiveness. Moreover, attention was drawn to the need for close cooperation between the urologist and the oncologist in order to optimize the treatment of a patient with progressive prostate cancer.