Ces Urol 2008, 12(3):165-172 | DOI: 10.48095/cccu2008017

Hormonal therapy of the prostate cancer, its new role and the Czech specificity

Jan Dvořáček

Urologická klinika 1. LF UK a VFN, Praha

PSA (prostate specif c antigen) era has brought the fundamental changes in the clinical course of the prostate cancer and also new diagnostic and therapeutic algorithms. Hormonal therapy (androgen deprivation) continuous to be a fundamental form of the systemic therapy this malignity. Androgen deprivation has underwent also a number of inovations and its traditionally main indication by the metastic PCa had moved to the earlier stadiums. T e importance of the hormonal therapy had especially increased with the recognition that the the local therapy of the high-risk localized prostate cancer is insuf cient.
Conclusions of the EBM trials focused on the ef ect of the combination of the androgen deprivation and radical prostatetomy or external beam radiotherapy, in neoadjuvant or adjuvant setting are presented. The findings of the EPC study are also mentioned.
Finally is discussed the "Czech way" of the androgen deprivation (bilateral orchiectomy or non-steroid antiandrogen) and compared with the world standard (LH-RH analogs). Incorrectness of this approach is documented by the literature and by the economic calculation.

Keywords: androgen suppression, androgen deprivatio, high-risk prostate cancer, intermediate-risk prostate cancer, low-risk prostate cancer, hormonal therapy, radical prostatectomy, external beam radiotherapy, brachytherapy, multimodal therapy

Received: September 7, 2008; Accepted: October 21, 2008; Published: June 1, 2008