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Gepubliceerd in: Tijdschrift voor Urologie 4/2014

01-06-2014 | Profylactische tepelbestraling bij bicalutamidegebruik vanwege prostaatkanker

Profylactische tepelbestraling bij bicalutamidegebruik vanwege prostaatkanker: klinische noodzaak?

Auteur: dr. A.N. Vis

Gepubliceerd in: Tijdschrift voor Urologie | Uitgave 4/2014

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Samenvatting

Gynaecomastie en pijn in de tepels (mastalgie) zijn frequent voorkomende bijwerkingen van bicalutamide 150 mg monotherapie. Profylactische tepelbestraling wordt in veel ziekenhuizen in Nederland toegepast. De door bicalutamide veroorzaakte gynaecomastie wordt vaak als mild ervaren en de mastalgie is meestal van voorbijgaande aard. Hoewel uit meerdere gerandomiseerde studies een statistisch significante afname van de frequentie van deze bijwerkingen blijkt, persisteert in de helft van de gevallen de gynaecomastie/mastalgie. Derhalve bestaat er twijfel over de effectiviteit en de klinische noodzaak tot profylactische tepelbestraling.
Het anti-oestrogeen tamoxifen heeft een zeer hoge effectiviteit bij de preventie en behandeling van door bicalutamide veroorzaakte gynaecomastie/mastalgie. Bij patiënten die onder bicalutamide monotherapie uiteindelijk toch cosmetische bezwaren aangeven van hun gynaecomastie en/of bezwaarlijke mastalgie ervaren, kan gestart worden met het anti-oestrogeen tamoxifen. Momenteel zijn er geen aanwijzingen dat het medicament een negatieve invloed heeft op het oncologisch beloop van prostaatkanker.
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Metagegevens
Titel
Profylactische tepelbestraling bij bicalutamidegebruik vanwege prostaatkanker: klinische noodzaak?
Auteur
dr. A.N. Vis
Publicatiedatum
01-06-2014
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Urologie / Uitgave 4/2014
Print ISSN: 2211-3037
Elektronisch ISSN: 2211-4718
DOI
https://doi.org/10.1007/s13629-014-0061-0

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