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Exploring the new world of secretion---MDT selection of "Exploring the new world of secretion" is sponsored by the Beijing Medical Award Foundation, guided by the Chinese Anti-Cancer Association Urology and Andrology Reproductive Tumor Committee, and fully supported by Yimaitong
.
It aims to promote the communication and interaction of doctors in the field of urinary oncology-MDT resource sharing, academic cutting-edge broadcasts, and improvement of clinical diagnosis and treatment
.
Click to watch the highlights of MDT highlights.
This issue of the MDT team from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and Run Run Run Run Shaw Hospital of Zhejiang University Medical College will bring you wonderful discussions
.
Special report (1): The first-line new hormone therapy of mCRPC is deployed.
Professor Ma Liang from the Run Run Run Run Shaw Hospital of Zhejiang University School of Medicine mainly reported on the use of enzalutamide in the first-line treatment of metastatic castration-resistant prostate cancer (mCRPC) Advantage
.
Professor Ma said that enzalutamide is a better new type of endocrine drug.
Based on some clinical research subgroup analysis, real-world studies and meta-analysis, enzalutamide is more effective in treating mCRPC patients than abiraterone.
Broad benefits
.
He also proposed that for some mCRPC patients with high Gleason score, high metastatic load and some chronic disease comorbidities, the benefits of enzalutamide treatment are more clear
.
Case Sharing and Discussion (1) Professor Ni Kangxin from Run Run Run Run Run Run Shaw Hospital of Zhejiang University School of Medicine shared with us a case of "castration resistant prostate cancer".
Experts from the two hospitals published a report on the choice of new endocrine drugs for the case.
Own opinion
.
The patient was male, 71 years old
.
Main complaint: Prostate cancer has been diagnosed for more than 3 years, and PSA has been elevated for more than 8 months
.
Auxiliary examination: ◆Digital rectal examination: the prostate gland is enlarged with II degree, hard texture ◆MRI: the central gland mass of the prostate, cancer is considered, with metastasis of the lymph node adjacent to the right iliac blood vessel ◆Needle biopsy: prostate cancer, Gleason score 5+5 points= 10 points diagnosis: prostate cancer
.
Treatment experience: 1.
In December 2016, the patient was diagnosed with prostate cancer in an outside hospital and refused surgical treatment, so he underwent bicalutamide endocrine therapy, and regularly reviewed PSA and testosterone
.
2.
In September 2019, the patient's PSA gradually increased and was admitted to the hospital for laparoscopic radical resection of prostate cancer + bilateral pelvic lymph node dissection, and postoperative abiraterone + ADT treatment
.
3.
In April 2021, the patient met the treatment indications of enzalutamide, and the treatment plan was changed to receive enzalutamide + ADT treatment
.
For the follow-up treatment of this patient, what treatment options can be considered? Professor Han Weidong of the Run Run Run Run Shaw Hospital of Zhejiang University School of Medicine said that when giving patients systemic treatment, whether they choose chemotherapy or endocrine therapy, one must not forget the local treatment.
Like this patient, Professor Han believes that radiotherapy can be done earlier.
Get involved
.
At the same time, he said that in the conversion of endocrine drugs, when the disease has not progressed, the original plan can be considered.
When the original treatment plan is invalid, the new drug should be considered to "make the best use of the drug
.
"
Case sharing and discussion (2) Professor Yang Chunguang from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology shared a case of "oligometastatic prostate cancer".
Experts from the two hospitals also published their own on the clinical management of oligometastatic prostate cancer cases.
View
.
The patient was male, 56 years old
.
Main complaint: frequent urination, urgency, painful urination for more than 2 months, dysuria for more than 20 days
.
Auxiliary examination: ◆MRI: prostate occupying lesion, left seminal vesicle gland invaded, accompanied by pelvic lymph node metastasis ◆Needle biopsy: prostate cancer, Gleason score 5+5=10 diagnosis: prostate cancer with bone metastasis
.
Treatment experience: 1.
In September 2020, underwent laparoscopic radical resection of cytoreductive prostate cancer
.
2.
In November 2020, in order to control the patient's PSA, enzalutamide + degarelix treatment was performed, and the PSA was well controlled
.
How should patients with oligometastatic prostate cancer choose treatment options? Professor Mei Qi from Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology said that oligometastatic prostate cancer can be treated with ADT or ADT+radiotherapy, both of which are supported by strong evidence
.
In radiotherapy for oligometastatic lesions, radiotherapy can not only irradiate local prostate cancer, but also treat metastases.
Therefore, Professor Mei believes that the participation of radiotherapy is essential in the entire management process of prostate cancer.
However, the timing of radiotherapy needs to be discussed by the surgery, oncology, imaging team and the MDT team
.
In the special report, what evidence supports enzalutamide's superiority to other endocrine drugs in the treatment of mCRPC? During the case discussion, how should clinicians manage patients with oligometastatic prostate cancer? Click "Read the original text" below to watch the wonderful special report and MDT discussion
.
Click "Read the original text" below to watch the full wonderful special report and MDT discussion
.
It aims to promote the communication and interaction of doctors in the field of urinary oncology-MDT resource sharing, academic cutting-edge broadcasts, and improvement of clinical diagnosis and treatment
.
Click to watch the highlights of MDT highlights.
This issue of the MDT team from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and Run Run Run Run Shaw Hospital of Zhejiang University Medical College will bring you wonderful discussions
.
Special report (1): The first-line new hormone therapy of mCRPC is deployed.
Professor Ma Liang from the Run Run Run Run Shaw Hospital of Zhejiang University School of Medicine mainly reported on the use of enzalutamide in the first-line treatment of metastatic castration-resistant prostate cancer (mCRPC) Advantage
.
Professor Ma said that enzalutamide is a better new type of endocrine drug.
Based on some clinical research subgroup analysis, real-world studies and meta-analysis, enzalutamide is more effective in treating mCRPC patients than abiraterone.
Broad benefits
.
He also proposed that for some mCRPC patients with high Gleason score, high metastatic load and some chronic disease comorbidities, the benefits of enzalutamide treatment are more clear
.
Case Sharing and Discussion (1) Professor Ni Kangxin from Run Run Run Run Run Run Shaw Hospital of Zhejiang University School of Medicine shared with us a case of "castration resistant prostate cancer".
Experts from the two hospitals published a report on the choice of new endocrine drugs for the case.
Own opinion
.
The patient was male, 71 years old
.
Main complaint: Prostate cancer has been diagnosed for more than 3 years, and PSA has been elevated for more than 8 months
.
Auxiliary examination: ◆Digital rectal examination: the prostate gland is enlarged with II degree, hard texture ◆MRI: the central gland mass of the prostate, cancer is considered, with metastasis of the lymph node adjacent to the right iliac blood vessel ◆Needle biopsy: prostate cancer, Gleason score 5+5 points= 10 points diagnosis: prostate cancer
.
Treatment experience: 1.
In December 2016, the patient was diagnosed with prostate cancer in an outside hospital and refused surgical treatment, so he underwent bicalutamide endocrine therapy, and regularly reviewed PSA and testosterone
.
2.
In September 2019, the patient's PSA gradually increased and was admitted to the hospital for laparoscopic radical resection of prostate cancer + bilateral pelvic lymph node dissection, and postoperative abiraterone + ADT treatment
.
3.
In April 2021, the patient met the treatment indications of enzalutamide, and the treatment plan was changed to receive enzalutamide + ADT treatment
.
For the follow-up treatment of this patient, what treatment options can be considered? Professor Han Weidong of the Run Run Run Run Shaw Hospital of Zhejiang University School of Medicine said that when giving patients systemic treatment, whether they choose chemotherapy or endocrine therapy, one must not forget the local treatment.
Like this patient, Professor Han believes that radiotherapy can be done earlier.
Get involved
.
At the same time, he said that in the conversion of endocrine drugs, when the disease has not progressed, the original plan can be considered.
When the original treatment plan is invalid, the new drug should be considered to "make the best use of the drug
.
"
Case sharing and discussion (2) Professor Yang Chunguang from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology shared a case of "oligometastatic prostate cancer".
Experts from the two hospitals also published their own on the clinical management of oligometastatic prostate cancer cases.
View
.
The patient was male, 56 years old
.
Main complaint: frequent urination, urgency, painful urination for more than 2 months, dysuria for more than 20 days
.
Auxiliary examination: ◆MRI: prostate occupying lesion, left seminal vesicle gland invaded, accompanied by pelvic lymph node metastasis ◆Needle biopsy: prostate cancer, Gleason score 5+5=10 diagnosis: prostate cancer with bone metastasis
.
Treatment experience: 1.
In September 2020, underwent laparoscopic radical resection of cytoreductive prostate cancer
.
2.
In November 2020, in order to control the patient's PSA, enzalutamide + degarelix treatment was performed, and the PSA was well controlled
.
How should patients with oligometastatic prostate cancer choose treatment options? Professor Mei Qi from Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology said that oligometastatic prostate cancer can be treated with ADT or ADT+radiotherapy, both of which are supported by strong evidence
.
In radiotherapy for oligometastatic lesions, radiotherapy can not only irradiate local prostate cancer, but also treat metastases.
Therefore, Professor Mei believes that the participation of radiotherapy is essential in the entire management process of prostate cancer.
However, the timing of radiotherapy needs to be discussed by the surgery, oncology, imaging team and the MDT team
.
In the special report, what evidence supports enzalutamide's superiority to other endocrine drugs in the treatment of mCRPC? During the case discussion, how should clinicians manage patients with oligometastatic prostate cancer? Click "Read the original text" below to watch the wonderful special report and MDT discussion
.
Click "Read the original text" below to watch the full wonderful special report and MDT discussion
