. "L\u00E9\u010Debn\u00E9 mo\u017Enosti relabuj\u00EDc\u00EDho karcinomu ovaria" . . . "0862-8947" . . "V" . . . . "ovarian cancer; recurrence; chemotherapy; targeted molecular therapy"@en . "RIV/00843989:_____/12:00102353" . "8"^^ . . "L\u00E9\u010Debn\u00E9 mo\u017Enosti relabuj\u00EDc\u00EDho karcinomu ovaria"@cs . "L\u00E9\u010Debn\u00E9 mo\u017Enosti relabuj\u00EDc\u00EDho karcinomu ovaria" . "Therapeutic options for recurrent ovarian cancer"@en . "\u0160ev\u010D\u00EDk, Libor" . "[E5412F310036]" . "1" . "22" . . "Karcinom ovaria pat\u0159\u00ED mezi gynekologick\u00FDmi n\u00E1dory k onemocn\u011Bn\u00EDm s nejvy\u0161\u0161\u00ED \u00FAmrtnost\u00ED, kdy a\u017E u 75 % pacientek dojde po l\u00E9\u010Db\u011B k relapsu a \u00FAmrt\u00ED na toto n\u00E1dorov\u00E9 onemocn\u011Bn\u00ED. Prvn\u00ED skupinou pacientek, u nich\u017E je podez\u0159en\u00ED na relaps nemoci, jsou pacientky s elevac\u00ED tumor\u00F3zn\u00EDho markeru Ca 125, u nich\u017E v sou\u010Dasnosti nen\u00ED zah\u00E1jen\u00ED chemoterapie doporu\u010Dov\u00E1no. U pacientek s klinicky nebo radiologicky prok\u00E1zanou recidivou nemoci je nejv\u00FDznamn\u011Bj\u0161\u00EDm faktorem \u010Dasov\u00FD interval mezi ukon\u010Den\u00EDm chemoterapie 1. linie a objeven\u00EDm se recidivy nemoci. Za platina-rezistentn\u00ED je pova\u017Eov\u00E1na nemoc s progres\u00ED do 6 m\u011Bs\u00EDc\u016F po ukon\u010Den\u00ED l\u00E9\u010Dby. Sem pat\u0159\u00ED takt\u00E9\u017E prim\u00E1rn\u011B refraktern\u00ED nemoc, situace, kdy k progresi n\u00E1dorov\u00E9ho onemocn\u011Bn\u00ED dojde b\u011Bhem cytostatick\u00E9 l\u00E9\u010Dby 1. linie, nebo situace, kdy n\u00E1dor nen\u00ED l\u00E9\u010Dbou ovlivn\u011Bn. P\u0159i progresi nemoci pozd\u011Bji ne\u017E za 6 m\u011Bs\u00EDc\u016F je onemocn\u011Bn\u00ED pova\u017Eov\u00E1no za platina-senzitivn\u00ED. L\u00E9\u010Debn\u00FD z\u00E1m\u011Br p\u0159i aplikaci chemoterapie p\u0159i relapsu nemoci je, s v\u00FDjimkou za\u0159azen\u00ED chirurgick\u00E9 intervence s kompletn\u00EDm odstran\u011Bn\u00EDm metastatick\u00FDch lo\u017Eisek, paliativn\u00ED, jeho c\u00EDlem je prodlou\u017Een\u00ED intervalu bez nemoci (disease-free interval, DFI) a prodlou\u017Een\u00ED celkov\u00E9ho p\u0159e\u017Eit\u00ED (overall survival, OS) \u2013 s odd\u00E1len\u00EDm symptom\u016F nemoci a zv\u00FD\u0161en\u00EDm kvality \u017Eivota. U platina-refraktern\u00EDch nebo platina-rezistentn\u00EDch n\u00E1dor\u016F je doporu\u010Dov\u00E1na chemoterapie 2. linie zalo\u017Een\u00E1 na monoterapii neplatinov\u00FDm deriv\u00E1tem. U platina-senzitivn\u00EDch n\u00E1dor\u016F je doporu\u010Dov\u00E1na chemoterapie s platinov\u00FDm deriv\u00E1tem v\u011Bt\u0161inou v kombinaci s jin\u00FDm cytostatikem, jeho\u017E v\u00FDb\u011Br z\u00E1vis\u00ED na spektru ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F. P\u0159i vy\u010Derp\u00E1n\u00ED mo\u017Enosti cytostatick\u00E9 l\u00E9\u010Dby je mo\u017En\u00E9 doporu\u010Dit hormon\u00E1ln\u00ED l\u00E9\u010Dbu zalo\u017Eenou na antiestrogenn\u00EDm antiproliferativn\u00EDm p\u016Fsoben\u00ED hormon\u016F. Nov\u011B je v l\u00E9\u010Db\u011B recidivuj\u00EDc\u00EDho karcinomu ovaria vyu\u017E\u00EDv\u00E1na c\u00EDlen\u00E1 molekul\u00E1rn\u00ED terapie, kter\u00E1 je zalo\u017Eena na blokov\u00E1n\u00ED neoangiogeneze jako\u017Eto hlavn\u00ED podm\u00EDnky n\u00E1dorov\u00E9ho r\u016Fstu. Pacientky s karcinomem ovaria by m\u011Bly b\u00FDt l\u00E9\u010Deny v komplexn\u00EDch onkologick\u00FDch centrech, disponuj\u00EDc\u00EDch jak erudovan\u00FD..." . . "L\u00E9\u010Debn\u00E9 mo\u017Enosti relabuj\u00EDc\u00EDho karcinomu ovaria"@cs . . "Karcinom ovaria pat\u0159\u00ED mezi gynekologick\u00FDmi n\u00E1dory k onemocn\u011Bn\u00EDm s nejvy\u0161\u0161\u00ED \u00FAmrtnost\u00ED, kdy a\u017E u 75 % pacientek dojde po l\u00E9\u010Db\u011B k relapsu a \u00FAmrt\u00ED na toto n\u00E1dorov\u00E9 onemocn\u011Bn\u00ED. Prvn\u00ED skupinou pacientek, u nich\u017E je podez\u0159en\u00ED na relaps nemoci, jsou pacientky s elevac\u00ED tumor\u00F3zn\u00EDho markeru Ca 125, u nich\u017E v sou\u010Dasnosti nen\u00ED zah\u00E1jen\u00ED chemoterapie doporu\u010Dov\u00E1no. U pacientek s klinicky nebo radiologicky prok\u00E1zanou recidivou nemoci je nejv\u00FDznamn\u011Bj\u0161\u00EDm faktorem \u010Dasov\u00FD interval mezi ukon\u010Den\u00EDm chemoterapie 1. linie a objeven\u00EDm se recidivy nemoci. Za platina-rezistentn\u00ED je pova\u017Eov\u00E1na nemoc s progres\u00ED do 6 m\u011Bs\u00EDc\u016F po ukon\u010Den\u00ED l\u00E9\u010Dby. Sem pat\u0159\u00ED takt\u00E9\u017E prim\u00E1rn\u011B refraktern\u00ED nemoc, situace, kdy k progresi n\u00E1dorov\u00E9ho onemocn\u011Bn\u00ED dojde b\u011Bhem cytostatick\u00E9 l\u00E9\u010Dby 1. linie, nebo situace, kdy n\u00E1dor nen\u00ED l\u00E9\u010Dbou ovlivn\u011Bn. P\u0159i progresi nemoci pozd\u011Bji ne\u017E za 6 m\u011Bs\u00EDc\u016F je onemocn\u011Bn\u00ED pova\u017Eov\u00E1no za platina-senzitivn\u00ED. L\u00E9\u010Debn\u00FD z\u00E1m\u011Br p\u0159i aplikaci chemoterapie p\u0159i relapsu nemoci je, s v\u00FDjimkou za\u0159azen\u00ED chirurgick\u00E9 intervence s kompletn\u00EDm odstran\u011Bn\u00EDm metastatick\u00FDch lo\u017Eisek, paliativn\u00ED, jeho c\u00EDlem je prodlou\u017Een\u00ED intervalu bez nemoci (disease-free interval, DFI) a prodlou\u017Een\u00ED celkov\u00E9ho p\u0159e\u017Eit\u00ED (overall survival, OS) \u2013 s odd\u00E1len\u00EDm symptom\u016F nemoci a zv\u00FD\u0161en\u00EDm kvality \u017Eivota. U platina-refraktern\u00EDch nebo platina-rezistentn\u00EDch n\u00E1dor\u016F je doporu\u010Dov\u00E1na chemoterapie 2. linie zalo\u017Een\u00E1 na monoterapii neplatinov\u00FDm deriv\u00E1tem. U platina-senzitivn\u00EDch n\u00E1dor\u016F je doporu\u010Dov\u00E1na chemoterapie s platinov\u00FDm deriv\u00E1tem v\u011Bt\u0161inou v kombinaci s jin\u00FDm cytostatikem, jeho\u017E v\u00FDb\u011Br z\u00E1vis\u00ED na spektru ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F. P\u0159i vy\u010Derp\u00E1n\u00ED mo\u017Enosti cytostatick\u00E9 l\u00E9\u010Dby je mo\u017En\u00E9 doporu\u010Dit hormon\u00E1ln\u00ED l\u00E9\u010Dbu zalo\u017Eenou na antiestrogenn\u00EDm antiproliferativn\u00EDm p\u016Fsoben\u00ED hormon\u016F. Nov\u011B je v l\u00E9\u010Db\u011B recidivuj\u00EDc\u00EDho karcinomu ovaria vyu\u017E\u00EDv\u00E1na c\u00EDlen\u00E1 molekul\u00E1rn\u00ED terapie, kter\u00E1 je zalo\u017Eena na blokov\u00E1n\u00ED neoangiogeneze jako\u017Eto hlavn\u00ED podm\u00EDnky n\u00E1dorov\u00E9ho r\u016Fstu. Pacientky s karcinomem ovaria by m\u011Bly b\u00FDt l\u00E9\u010Deny v komplexn\u00EDch onkologick\u00FDch centrech, disponuj\u00EDc\u00EDch jak erudovan\u00FD..."@cs . . "Therapeutic options for recurrent ovarian cancer"@en . . "1"^^ . . "Ovarian cancer is one of the gynaecological malignancies with the highest mortality rates, with up to 75% of post-treatment recurrences, often fatal. Recurrent ovarian cancer is suspected in patients with an elevated tumor marker Ca 125. In this group, chemotherapy is not currently recommended. In patients clinically or radiologically diagnosed with recurrent ovarian cancer, the most important factor is the time from the end of the first-line chemotherapy to the emergence of recurrence. Disease progressive within six months from the end of chemotherapy is classified as platinum resistant. Primary refractory disease, i.e. disease progressive during first-line chemotherapy or unresponsive to first-line chemotherapy, is also considered as such. Disease progressive within more than six months after chemotherapy is platinum sensitive. The therapeutic goal in recurrent ovarian cancer, apart from surgical intervention to completely remove metastatic tumors, is palliative care aiming at prolonging the disease free interval (DFI) and overall survival (OS) \u2013 i.e. delaying symptoms and improving the quality of life. The second-line non-platinum based chemotherapy is recommended in platinum-refractory or platinum-resistant disease. Platinum based chemotherapy should be used in platinum-sensitive disease, mostly in combination with another cytostatic drug the choice of which depends on the spectrum of adverse effects. In patients who had run out of chemotherapy options, hormone therapy which has anti-estrogenic, anti-proliferative effects may be recommended. A novel approach in recurrent ovarian cancer is targeted molecular therapy to inhibit angiogenesis as the prerequisite for tumor progression. Patients with ovarian cancer should be treated in comprehensive cancer centres to benefit from access to both highly skilled cancer surgeons who are able to achieve radical tumor removal with no tumor residues and leading clinical oncologists who can tailor the therapy to the indivi..."@en . . "RIV/00843989:_____/12:00102353!RIV13-MZ0-00843989" . . "Remedia" . "CZ - \u010Cesk\u00E1 republika" . "146717" . "1"^^ .