{"id":4990,"date":"2024-02-08T13:36:44","date_gmt":"2024-02-08T12:36:44","guid":{"rendered":"https:\/\/www.ptc.cz\/sto-lijecimo\/lymfomy\/protonova-lecba-lymfomu\/indikace-k-protonove-radioterapii\/"},"modified":"2024-06-21T14:37:14","modified_gmt":"2024-06-21T12:37:14","slug":"indikacije-za-protonsko-zracenje","status":"publish","type":"page","link":"https:\/\/www.ptc.cz\/hr\/sto-lijecimo\/limfomi\/protonska-terapija-malignih-limfoma\/indikacije-za-protonsko-zracenje\/","title":{"rendered":"Indikacije za protonsko zra\u010denje"},"content":{"rendered":"
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Indikace, ve kter\u00fdch by m\u011bla b\u00fdt protonov\u00e1 radioterapie za\u0159azena do l\u00e9\u010debn\u00e9ho sch\u00e9matu jsou:<\/strong><\/p>\n

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  • posti\u017een\u00ed v oblasti mezihrud\u00ed, kdy oza\u0159ovan\u00fd objem (p\u016fvodn\u00ed posti\u017een\u00ed) zasahuje pod \u00farove\u0148 odstupu lev\u00e9 v\u011bn\u010dit\u00e9 tepny nebo pod \u00farove\u0148 7. hrudn\u00edho obratle,<\/li>\n
  • mlad\u00e9 \u017eeny s posti\u017een\u00edm podpa\u017en\u00ed jamky, kdy protonov\u00e1 radioterapie v\u00edce \u0161et\u0159\u00ed prsn\u00ed \u017el\u00e1zu, a t\u00edm sni\u017euje riziko v\u00fdvoje l\u00e9\u010dbou indukovan\u00e9ho n\u00e1doru prsu,<\/li>\n
  • pacienti po n\u011bkolika lini\u00edch chemoterapie nebo po transplantaci kostn\u00ed d\u0159en\u011b, kte\u0159\u00ed jsou ve vy\u0161\u0161\u00edm\u00a0riziku v\u00fdvoje komplikac\u00ed po oz\u00e1\u0159en\u00ed (p\u0159edev\u0161\u00edm plicn\u00edho posti\u017een\u00ed, kardiovaskul\u00e1rn\u00edho posti\u017een\u00ed a posti\u017een\u00ed kostn\u00ed d\u0159en\u011b),<\/li>\n
  • aktivn\u00ed onemocn\u011bn\u00ed omezen\u00e9 na jednu oblast br\u00e1nice (nadbr\u00e1ni\u010dn\u00ed \u010di podbr\u00e1ni\u010dn\u00ed posti\u017een\u00ed), kter\u00e9 neodpov\u011bd\u011blo optim\u00e1ln\u011b na chemoterapii \u010di biologickou l\u00e9\u010dbu a kde je nutn\u00e9 nav\u00fd\u0161it celkovou d\u00e1vku z\u00e1\u0159en\u00ed,<\/li>\n
  • pacienti po p\u0159edchoz\u00edm oz\u00e1\u0159en\u00ed na stejnou \u010di sousedn\u00ed oblast,<\/li>\n
  • pacienti s\u00a0ji\u017e existuj\u00edc\u00edm v\u00e1\u017en\u00fdm zdravotn\u00edm probl\u00e9mem (stav po infarktu myokardu, chlopenn\u00ed vada, posti\u017een\u00ed plic a dal\u0161\u00ed) a nutnost\u00ed oz\u00e1\u0159en\u00ed t\u00e9to oblasti.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n
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    U pacient\u016f s\u00a0mediastin\u00e1ln\u00edm posti\u017een\u00edm je v\u00a0PTC u\u017e\u00edv\u00e1na kombinace s\u00a0\u0159\u00edzen\u00fdm maxim\u00e1ln\u00edm n\u00e1dechem<\/strong> (deep inspiration breath hold-DIBH) ji\u017e od dubna 2015. Tato technologie p\u0159edstavuje v\u00a0sou\u010dasnosti nej\u0161etrn\u011bj\u0161\u00ed dostupnou techniku pro oz\u00e1\u0159en\u00ed mediastin\u00e1ln\u00edch n\u00e1dor\u016f<\/strong>, v n\u011bkter\u00fdch p\u0159\u00edpadech se d\u00e1le kombinuje s o\u0161et\u0159en\u00edm pohyb\u016f nesouvisej\u00edc\u00edch s d\u00fdch\u00e1n\u00edm, nap\u0159. pulsace velk\u00fdch c\u00e9v \u010di srdce (rescanning). Tyto mo\u017enosti zajist\u00ed bezpe\u010dn\u00e9 oz\u00e1\u0159en\u00ed i jinak problematick\u00fdch oblast\u00ed, jako je mediastinum (mezihrud\u00ed) a oblast horn\u00edho b\u0159icha (podjatern\u00ed oblast). Takto technologicky vysp\u011blou l\u00e9\u010dbu nab\u00edz\u00ed v sou\u010dasn\u00e9 dob\u011b pouze n\u011bkolik protonov\u00fdch center na sv\u011bt\u011b. I d\u00edky t\u00e9to\u00a0na\u0161\u00ed zku\u0161enosti jsme sou\u010d\u00e1st\u00ed mezin\u00e1rodn\u00edho t\u00fdmu ILROG, kter\u00fd formuloval konsenzu\u00e1ln\u00ed doporu\u010den\u00ed pro protonovou RT mediastin\u00e1ln\u00edch lymfom\u016f dosp\u011bl\u00fdch.<\/strong><\/p>\n

    L\u00e9ka\u0159i spolu s fyziky pra\u017esk\u00e9ho Protonov\u00e9ho centra se pod\u00edlej\u00ed na tvorb\u011b tuzemsk\u00fdch i zahrani\u010dn\u00edch doporu\u010den\u00ed pro l\u00e9\u010dbu lymfom\u016f, p\u0159edn\u00e1\u0161\u00ed na tuzemsk\u00fdch i zahrani\u010dn\u00edch kongresech a \u00fa\u010dastn\u00ed se klinick\u00fdch studi\u00ed t\u00fdkaj\u00edc\u00edch se radioterapie lymfom\u016f, jako jsou nap\u0159. anal\u00fdza dozimetrick\u00fdch a radiobiologick\u00fdch model\u016f srovn\u00e1vaj\u00edc\u00ed modern\u00ed technologie fotonov\u00e9 radioterapie s protonovou.<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":5,"featured_media":0,"parent":4986,"menu_order":369,"comment_status":"closed","ping_status":"closed","template":"template-service-detail-with-sidebar.php","meta":{"footnotes":""},"class_list":["post-4990","page","type-page","status-publish","hentry"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4990","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/comments?post=4990"}],"version-history":[{"count":2,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4990\/revisions"}],"predecessor-version":[{"id":5004,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4990\/revisions\/5004"}],"up":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4986"}],"wp:attachment":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/media?parent=4990"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}