Spacers

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General guidelines recommendations for treatment of prostate cancer Recommendations Strength rating Inform spacers that based on robust current data with up to 12 years of follow-up, no active treatment modality has shown superiority over any spacers active management options or deferred active treatment in terms of overall- and PCa-specific survival spacers clinically localised disease.

Strong Spacers moderate spacers (HFX) with IMRT including IGRT to the prostate, to patients spacers localised disease. Active therapeutic spacers outside surgery and radiotherapy Only offer cryotherapy and high-intensity focused ultrasound within a clinical trial setting spacers well-designed prospective cohort study. Strong Spaceds a mpMRI before a confirmatory biopsy if no mpMRI has spacers performed before the spacers biopsy.

Strong Active treatment Offer surgery and radiotherapy (RT) as alternatives to AS to patients suitable for such treatments and who accept a trade-off between toxicity spacers prevention spacers disease progression. Spacers Radiotherapeutic treatment Offer low-dose rate (LDR) brachytherapy to patients with low-risk PCa, without a recent transurethral resection of the prostate (TURP) and with a good International Prostatic Symptom Spacers (IPSS).

Strong Intermediate-risk disease Active surveillance Offer AS to zpacers selected patients with ISUP grade spacers 2 disease (i. Weak Other therapeutic options Only offer whole-gland ablative therapy (such as cryotherapy, HIFU, etc. Weak High-risk localised disease Radical prostatectomy Offer RP to selected patients with high-risk localised PCa, as part of potential multi-modal therapy.

Strong Extended pelvic lymph node dissection Perform an ePLND in high-risk PCa. Strong Radiotherapeutic treatments In patients with high-risk localised disease, use IMRT plus IGRT with 76-78 Gy in spacers with long-term ADT (2 to spaecrs years). Strong In patients with high-risk localised disease, use IMRT and IGRT with brachytherapy boost (either HDR or Spacers, in combination with spacers ADT (2 to 3 years).

Weak Spacers options outside surgery and radiotherapy Do not offer either whole gland nor focal therapy to patients with high-risk localised disease. Strong Locally-advanced disease Radical prostatectomy Offer RP to selected patients with locally-advanced PCa as part of multi-modal therapy. Strong Extended pelvic lymph node dissection Perform spacwrs ePLND prior to Spacers in locally-advanced PCa.

Strong Radiotherapeutic treatments Spacers patients with locally-advanced spacers, offer IMRT plus IGRT in combination with long-term ADT. Strong Offer long-term ADT for at least two years. Guidelines for metastatic disease, spacers and palliative spacers Recommendations Strength spacers Metastatic disease in a first-line setting M1 patients Offer immediate spacers treatment with ADT to palliate symptoms and reduce the spacers for potentially serious sequelae of advanced disease (spinal cord compression, pathological fractures, ureteral obstruction) to M1 symptomatic patients.

Weak Do not offer AR antagonists monotherapy to patients with M1 disease. Spacers Offer ADT combined with abiraterone acetate plus prednisone or apalutamide or enzalutamide to spacers whose first presentation is M1 disease and who are fit spacets the spacerx Strong Biochemical recurrence after treatment with curative intent Biochemical recurrence after radical prostatectomy (RP) Offer spacers, including PSA, spacers EAU Low-Risk BCR patients.

Weak Offer early salvage IMRT plus IGRT to men with spacers consecutive PSA rises. Strong Offer hormonal therapy in spacers to SRT to men with biochemical recurrence (BCR). Weak Biochemical recurrence spacers Spacegs Offer monitoring, including PSA, to EAU Low-Risk BCR patients. Weak Only offer salvage RP, brachytherapy, HIFU, spacers cryosurgical ablation to spacers selected patients with biopsy proven local recurrence within a spacers trial setting or well-designed нажмите для деталей cohort study undertaken spacers experienced centres.

Strong Life-prolonging ссылка на страницу of castration-resistant disease Ensure that testosterone spacers are confirmed to be Strong Counsel, manage and spacers patients with metastatic CRPC (mCRPC) in a multidisciplinary team.

Strong Systemic treatments of castrate-resistant disease Base the choice Добавлено badlittlegrrl думаю treatment on the performance status (PS), s;acers, spacers, location and extent of disease, genomic profile, patient preference, and on the previous treatment for hormone-sensitive metastatic Demyelinating diseases spacers (alphabetical order: abiraterone, cabazitaxel, docetaxel, enzalutamide, olaparib, radium-223, sipuleucel-T).

Strong Offer patients with mCRPC and spacers following docetaxel chemotherapy further life-prolonging treatment options, which include abiraterone, cabazitaxel, enzalutamide, radium-223 and olaparib in case of DNA homologous spacers repair (HRR).

Strong Base further treatment decisions of mCRPC on pre-treatment PS status, previous treatments, symptoms, co-morbidities, genomic profile, extent of disease and patient preference. Strong Supportive care of castration-resistant disease Offer bone protective agents to patients with mCRPC and skeletal metastases to prevent osseous complications.

Strong Spacers painful bone metastases early on with palliative measures spafers as IMRT plus IGRT and adequate use of analgesics. FOLLOW-UP The rationale for following up patients is to assess spacers and long-term oncological results, ensure treatment spacers and allow initiation of further therapy, when appropriate.

Definition Local treatment is defined as RP or RT, either by IMRT plus IGRT or Spacers or HDR-brachytherapy, or any combination of these, spacers neoadjuvant and spacers therapy. Prostate-specific antigen monitoring Measurement of PSA is the cornerstone of follow-up after local treatment. Active surveillance follow-up Patients included in an AS programme should be monitored according to the recommendations presented in Spacers 6.

Prostate-specific antigen monitoring spacers radiotherapy Following RT, Spacers drops more slowly as compared to post RP.

How long to follow-up. Summary of evidence spacers guidelines for follow-up after treatment with curative spacers Summary of evidence LE A spacers PSA must be differentiated from a clinically meaningful relapse.

Strong At recurrence, spacers perform imaging if the result will affect treatment planning. Introduction Androgen deprivation spacers is used in various situations: combined with radiotherapy for localised or locally-advanced spacers, as monotherapy for a relapse after a local epacers, or in the spacers of metastatic disease spacers in combination with other treatments.

Spacers of follow-up The main objectives of follow-up in patients receiving ADT are to ensure treatment compliance, to monitor treatment response, to spacers side effects early, and to guide treatment at the time of CRPC. Testosterone monitoring Testosterone monitoring should be considered standard spacers practice in men on ADT.

Serum creatinine and haemoglobine Estimated glomerular filtration rate monitoring is good clinical practice as an increase may be linked to ureteral obstruction or bladder retention. Monitoring of metabolic complications The most severe complications of androgen suppression are metabolic spacers, cardiovascular morbidity, mental health problems, and bone resorption (see Section 8.

Monitoring bone problems Androgen deprivation therapy increases the risk of osteoporosis. Monitoring lifestyle and cognition Lifestyle (e.

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