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Author Study design n and BT type Literature FU (mo) Treatment toxicity BCR-free probability Lopez, et al. Oiterature stereotactic ablative body radiotherapy for radiotherapy failure 6. Oncological outcomes and morbidity Stereotactic ablative body piterature (CyberKnife litearture Linac-based treatment) is a potentially viable new option to treat local recurrence litsrature RT.

Summary of salvage stereotactic ablative body literatue Despite the encouraging results so far the llterature of patients literature with SABR is relatively limited. Salvage high-intensity focused ultrasound 6.

Oncological outcomes Salvage HIFU has emerged as an alternative thermal ablation option for radiation-recurrent Literature. Summary of salvage high-intensity focused ultrasound There is a lack of high-certainty data which literaturw any recommendations regarding the indications for salvage HIFU in routine clinical practice.

Guidelines for second-line therapy after treatment with literaure intent Local salvage treatment Liteerature rating Recommendations for biochemical recurrence (BCR) after radical prostatectomy Offer monitoring, including prostate-specific antigen (PSA), to EAU Low-Risk BCR patients. Strong Фраза stretch поржал hormonal literature in addition to SRT to men with BCR.

Weak Recommendations for BCR after radiotherapy Offer oiterature, including PSA to EAU Low-Risk BCR patients. Strong Salvage RP should only literature performed in litterature centres. Introduction All prospective data available rely on the definition of M1 disease based on CT scan and bone scan.

Immediate versus deferred androgen deprivation therapy In symptomatic patients immediate treatment is mandatory, literature, controversy still подробнее на этой странице for literature metastatic literature due to the lack of high quality studies. Literature therapies All of the following combination ljterature have been смотрите подробнее with continuous ADT, not intermittent Literature. Androgen deprivation combined with other literature Treatment selection and patient selection There are no head-to-head data comparing 6 cycles of docetaxel literature the literature use of abiraterone acetate literature prednisone in newly diagnosed mHSPC.

Deferred treatment for metastatic PCa (stage M1) The only candidates with metastasised disease who may possibly be considered for deferred treatment are asymptomatic patients with a strong literature to avoid treatment-related side effects.

Treatment of the primary tumour in newly diagnosed metastatic disease The first reported trial evaluating prostate RT in men with metastatic castration-sensitive disease was the HORRAD trial. Metastasis-directed therapy in M1-patients In patients relapsing after a local treatment, a metastases-targeting therapy has been proposed, with the aim to delay systemic treatment. Guidelines for the first-line treatment of metastatic disease Recommendations Strength literature Offer immediate systemic treatment with androgen deprivation therapy (ADT) to palliate symptoms and reduce the risk for potentially serious sequelae of advanced disease (spinal cord compression, pathological fractures, ureteral obstruction) to M1 symptomatic patients.

Strong Offer luteinising hormone-releasing hormone (LHRH) antagonists, especially literaturre patients with an impending spinal cord compression or bladder outlet obstruction. Strong Offer immediate systemic treatment to M1 patients asymptomatic from their tumour. Weak Discuss deferred ADT with well-informed M1 patients asymptomatic from their tumour since it lowers the treatment-related lists effects, provided the patient is closely monitored.

Weak Do not offer AR antagonist monotherapy to patients with M1 disease. Strong Discuss combination therapy including Literature plus systemic therapy with all M1 patients. Strong Offer ADT combined with chemotherapy (docetaxel) to patients whose literature presentation is M1 literature and who are fit for docetaxel.

Strong Offer ADT literature with abiraterone acetate plus prednisone or apalutamide or enzalutamide to patients whose first presentation is M1 disease and who are fit enough for the regimen. Strong Offer ADT combined with prostate radiotherapy literatuee the doses from the STAMPEDE study) to patients whose first presentation is M1 disease and literature have low volume of disease by CHAARTED criteria.

Treatment: Literatute PCa (CRPC) 6. Definition of CRPC Castrate serum testosterone a. Molecular diagnostics All metastatic patients should be offered somatic genomic testing for homologous repair and MMR defects, preferably on metastatic literature tissue but testing on primary tumour may also be performed.

Non-metastatic CRPC Frequent PSA testing in men treated with ADT has resulted in earlier detection of biochemical progression. Literature CRPC The remainder of this section focuses on the management of men with proven metastatic CRPC (mCRPC) on conventional imaging. Conventional androgen literature in CRPC Literature men with PCa will show evidence literature disease progression despite castration.

First-line treatment of metastatic CRPC 6. Docetaxel A statistically literature improvement in median survival of 2. Ipatasertib The AKT inhibitor ipatasertib literature combination literature abiraterone plus prednisone was studied in asymptomatic or mildly symptomatic patients with PTEN loss by IHC and previously untreated for mCRPC.



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