Εμφανίζονται 1 - 17 Αποτελέσματα από 17 για την αναζήτηση '"кастрационно-рефрактерный"', χρόνος αναζήτησης: 0,55δλ Περιορισμός αποτελεσμάτων
  1. 1
    Academic Journal

    Πηγή: Cancer Urology; Том 19, № 4 (2023); 167-175 ; Онкоурология; Том 19, № 4 (2023); 167-175 ; 1996-1812 ; 1726-9776

    Περιγραφή αρχείου: application/pdf

    Relation: https://oncourology.abvpress.ru/oncur/article/view/1790/1503; Шахзадова А.О., Старинский В.В., Лисичникова И.В. Состояние онкологической помощи населению России в 2022 году. Сибирский онкологический журнал 2023;22(5):5–13. DOI:10.21294/1814-4861-2023-22-5-5-13; Tannock I.F., de Wit R., Berry W.R. et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004;351(15):1502–12. DOI:10.1056/NEJMoa040720; Kyriakopoulos C.E., Chen Y.H., Carducci M.A. et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial. J Clin Oncol 2018;36(11):1080–7. DOI:10.1200/JCO.2017.75.3657; Fizazi K., Tran N., Fein L. et al. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N Engl J Med 2017;377(4):352–60. DOI:10.1056/NEJMoa1704174; Davis I.D., Martin A.J., Stockler M.R. et al. Enzalutamide with standard first-line therapy in metastatic prostate cancer. N Engl J Med 2019;381(2):121–31. DOI:10.1056/NEJMoa1903835; Armstrong A.J., Szmulewitz R.Z., Petrylak D.P. et al. ARCHES: a randomized, phase III study of androgen deprivation therapy with enzalutamide or placebo in men with metastatic hormonesensitive prostate cancer. J Clin Oncol 2019;37(32):2974–86. DOI:10.1200/JCO.19.00799; Chi K.N., Agarwal N., Bjartell A. et al. Apalutamide for metastatic, castration-sensitive prostate cancer. N Engl J Med 2019;381(1):13–24. DOI:10.1056/NEJMoa1903307; Fizazi K., Foulon S., Carles J. et al. Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2×2 factorial design. Lancet 2022;399(10336):1695–707. DOI:10.1016/S0140-6736(22)00367-1; Markham A., Duggan S. Darolutamide: first approval. Drugs 2019;79(16):1813–8. DOI:10.1007/s40265-019-01212-y; Smith M.R., Hussain M., Saad F. et al. Darolutamide and survival in metastatic, hormone-sensitive prostate cancer. N Engl J Med 2022;386(12):1132–42. DOI:10.1056/NEJMoa2119115; Bowling G.C., Dimitrakoff J.D. Darolutamide in metastatic prostate cancer. N Engl J Med 2022;386(24):2344. DOI:10.1056/NEJMc2205310; Sweeney C.J., Chen Y.H., Carducci M. et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med 2015;373(8):737–46. DOI:10.1056/NEJMoa1503747; Clarke N.W., Ali A., Ingleby F.C. et al. Addition of docetaxel to hormonal therapy in low- and high-burden metastatic hormone sensitive prostate cancer: long-term survival results from the STAMPEDE trial [published correction appears in Ann Oncol 2020;31(3):442]. Ann Oncol 2019;30(12):1992–2003. DOI:10.1093/annonc/mdz396; Fizazi K., Tran N., Fein L. et al. Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial. Lancet Oncol 2019;20(5):686–700. DOI:10.1016/S1470-2045(19)30082-8; James N.D., de Bono J.S., Spears M.R. et al. Abiraterone for prostate cancer not previously treated with hormone therapy. N Engl J Med 2017;377(4):338–51. DOI:10.1056/NEJMoa1702900; Hussain M., Tombal B., Saad F. et al. Darolutamide plus androgendeprivation therapy and docetaxel in metastatic hormone-sensitive prostate cancer by disease volume and risk subgroups in the phase III ARASENS trial. J Clin Oncol 2023;41(20):3595–607. DOI:10.1200/JCO.23.00041; Preisser F., Chun F.K., Banek S. et al. Management and treatment options for patients with de novo and recurrent hormone-sensitive oligometastatic prostate cancer. Prostate Int 2021;9(3):113–8. DOI:10.1016/j.prnil.2020.12.003; Wenzel M., Würnschimmel C., Nocera L. et al. Overall survival after systemic treatment in high-volume versus low-volume metastatic hormone-sensitive prostate cancer: systematic review and network meta-analysis. Eur Urol Focus 2022;8(2):399–408. DOI:10.1016/j.euf.2021.04.003; Mandel P., Hoeh B., Wenzel M. et al. Triplet or doublet therapy in metastatic hormone-sensitive prostate cancer patients: a systematic review and network meta-analysis. Eur Urol Focus 2023;9(1):96–105. DOI:10.1016/j.euf.2022.08.007; Sathianathen N.J., Pan H.Y.C., Lawrentschuk N. et al. Emergence of triplet therapy for metastatic castration-sensitive prostate cancer: an updated systematic review and network meta-analysis. Urol Oncol 2023;41(5):233–9. DOI:10.1016/j.urolonc.2022.10.016; Yanagisawa T., Rajwa P., Thibault C. et al. Androgen receptor signaling inhibitors in addition to docetaxel with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer: a systematic review and meta-analysis. Eur Urol 2022;82(6):584–98. DOI:10.1016/j.eururo.2022.08.002; Maiorano B.A., de Giorgi U., Roviello G. et al. Addition of androgen receptor-targeted agents to androgen-deprivation therapy and docetaxel in metastatic hormone-sensitive prostate cancer: a systematic review and meta-analysis. ESMO Open 2022;7(5):100575. DOI:10.1016/j.esmoop.2022.100575; Roy S., Sayyid R., Saad F. et al. Addition of docetaxel to androgen receptor axis-targeted therapy and androgen deprivation therapy in metastatic hormone-sensitive prostate cancer: a network metaanalysis. Eur Urol Oncol 2022;5(5):494–502. DOI:10.1016/j.euo.2022.06.003; Mori K., Mostafaei H., Sari Motlagh R. et al. Systemic therapies for metastatic hormone-sensitive prostate cancer: network metaanalysis. BJU Int 2022;129(4):423–33. DOI:10.1111/bju.15507; Chi K.N. LATITUDE study – final analysis of phase III study in patients with newly diagnosed high-risk metastatic castrationnaïve prostate cancer. Presented at the American Society of Clinical Oncology Genitourinary Cancers Symposium, February 14–16, 2019, San Francisco, CA.; Chi K.N., Chowdhury S., Bjartell A. et al. Apalutamide in patients with metastatic castration-sensitive prostate cancer: final survival analysis of the randomized, double-blind, phase III TITAN study. J Clin Oncol 2021;39(20):2294–303. DOI:10.1200/JCO.20.03488; Armstrong A. Final overall survival analysis from ARCHES: a phase 3, randomized, double-blind, placebo-controlled study of enzalutamide + ADT in men with mHSPC. Presented at the 2021 European Society for Medical Oncology Annual Congress, September 16–21, 2021.; Gravis G., Boher J.M., Joly F. et al. Androgen deprivation therapy (ADT) plus docetaxel versus ADT alone in metastatic non castrate prostate cancer: impact of metastatic burden and longterm survival analysis of the randomized phase 3 GETUG-AFU15 trial. Eur Urol 2016;70(2):256–62. DOI:10.1016/j.eururo.2015.11.005; James N.D. Abiraterone acetate plus prednisolone for hormonenaïve prostate cancer: long-term results from metastatic (M1) patients in the STAMPEDE randomized trial. Presented at the 2020 European Society for Medical Oncology Virtual Congress, September 19–21, 2020.; Gravis G., Fizazi K., Joly F. et al. Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol 2013;14(2):149–58. DOI:10.1016/S1470-2045(12)70560-0; Dou M., Liang H., Liu Y. et al. Based on ARASENS trial: efficacy and safety of darolutamide as an emerging option of endocrinotherapy for metastatic hormone-sensitive prostate cancer-an updated systematic review and network meta-analysis. J Cancer Res Clin Oncol 2023;149(10):7017–27. DOI:10.1007/s00432-023-04658-6; Borgmann H., Lallous N., Ozistanbullu D. et al. Moving towards precision urologic oncology: targeting enzalutamide-resistant prostate cancer and mutated forms of the androgen receptor using the novel inhibitor darolutamide (ODM-201). Eur Urol 2018;73(1):4–8. DOI:10.1016/j.eururo.2017.08.012; Shore N., Zurth C., Fricke R. et al. Evaluation of clinically relevant drug-drug interactions and population pharmacokinetics of darolutamide in patients with nonmetastatic castration-resistant prostate cancer: results of pre-specified and post hoc analyses of the phase III ARAMIS trial. Target Oncol 2019;14(5):527–39. DOI:10.1007/s11523-019-00674-0; Fizazi K., Shore N., Tammela T.L. et al. Darolutamide in nonmetastatic, castration-resistant prostate cancer [published correction appears in N Engl J Med 2022;387(9):860]. N Engl J Med 2019;380(13):1235–46. DOI:10.1056/NEJMoa1815671; https://oncourology.abvpress.ru/oncur/article/view/1790

  2. 2
    Academic Journal

    Πηγή: Cancer Urology; Том 17, № 3 (2021); 78-84 ; Онкоурология; Том 17, № 3 (2021); 78-84 ; 1996-1812 ; 1726-9776

    Περιγραφή αρχείου: application/pdf

    Relation: https://oncourology.abvpress.ru/oncur/article/view/1518/1300; Sung H., Ferlay J., Siegel R.L. et al. Global cancer statistics 2020: GLOBOCA Nestimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209—49. DOI:10.3322/caac.21660.; Gillessen S., Attard G., Beer T.M. et al. Management of patients with advanced prostate cancer: report of the advanced prostate cancer consensus conference 2019. Eur Urol 2020;77(4):508-47. DOI:10.1016/j.eururo.2020.01.012.; Saad F., Cella D., Basch E. et al. Effect of apalutamide on health-related quality of life in patients with nonmetastatic castration-resistant prostate cancer: an analysis of the SPARTAN randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2018;19(10):1404—16. DOI:10.1016/S1470-2045(18)30456-X.; Tombal B., Saad F., Penson D. et al. Patient-reported outcomes following enzalutamide or placebo in men with nonmetastatic, castration-resistant prostate cancer (PROSPER): a multicentre, randomised, double-blind, phase 3 trial. Lancet Oncol 2019;20(4):556—69. DOI:10.1016/S1470-2045(18)30898-2.; Mateo J., Fizazi K., Gillessen S. et al. Managing nonmetastatic castration-resistant prostate cancer. Eur Urol 2019;75(2):285—93. DOI:10.1016/j.eururo.2018.07.035.; Zurth C., Trummel D., Sandman S., Trummel D. Higher blood-brain barrier penetration of [14C] apalutamide and [14C] enzalutamide compared to [14C] darolutamide in rats using whole-body autoradiography. J Clin Oncol 2019;37(7_suppl):156. DOI:10.1200/JCO.2019.37.7_suppl.156.; Zurth C., Trummel D., Sandman S., Seidel D. Blood-brain barrier penetration of [14C] darolutamide compared with [14C] enzalutamide in rats using whole body autoradiography. J Clin Oncol 2018;36(6_suppl):345. DOI:10.1200/JCO.2018.36.6_suppl.345.; Moilanen A.M., Riikonen R., Oksala R. et al. Discovery of ODM-201, a new-generation androgen receptor inhibitor targeting resistance mechanisms to androgen signaling-directed prostate cancer therapies. Sci Rep 2015;5:12007. DOI:10.1038/srep12007.; Moilanen A. ODM-201-New Generation Androgen Receptor Inhibitor with Excellent Antiandrogenic and Antitumor Activity in Nonclinical Models of CRPC. Poster P376 presented at the European Cancer Congress 2013.; Shore N., Zurth C., Fricke R. et al. Evaluation of clinically relevant drug-drug interactions and population pharmacokinetics of darolutamide in patients with nonmetastatic castration-resistant prostate cancer: results of pre-specified and post hoc analyses of the phase III ARAMIS trial. Target Oncol 2019;14(5):527-39. DOI:10.1007/s11523-019-00674-0.; Fizazi K., Massard C., Bono P. et al. Activity and safety of ODM-201 in patients with progressive metastatic castration-resistant prostate cancer (ARADES): an open-label phase 1 dose-escalation and randomised phase 2 dose expansion trial. Lancet Oncol 2014;15(9):975—85. DOI:10.1016/S1470-2045(14)70240-2.; Massard C., Penttinen H.M., Viaters E. et al. Pharmacokinetics, antitumor activity, and safety of ODM-201 in patients with chemotherapy-naive metastatic castration-resistant prostate cancer: an open-label phase 1 study.Eur Urol 2016;69(5):834—40. DOI:10.1016/j.eururo.2015.09.046.; Fizazi K., Shore N., Tammela T.L. et al. Darolutamide in nonmetastatic, castration-resistant prostate cancer. N Engl J Med 2019;380(13):1235—46. DOI:10.1056/NEJMoa1815671.; Fizazi K. Nonmetastatic, castration-resistant prostate cancer and survival with darolutamide. N Engl J Med 2020;383(11):1040—9.; Zurth C., Koskinen M., Fricke R. et al. Drug-drug interaction (DDI) of darolutamide: in vitro and clinical studies. Eur J Drug Metab Pharmacokinet 2019;44(6):747-59. DOI:10.1007/s13318-019-00577-5.; Bayer HealthCare Pharmaceuticals Inc. Nubeqa (darolutamide) US prescribing information. 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/212099Orig1s000lbl.pdf. Accessed 31.07.2019.; Van Andel G., Vottomley A., Fossa S.D. et al. An international field study of the EORTC QLQ-PR25: a questionnaire for assessing the health-related quality of life of patients with prostate cancer. Eur J Cancer 2008;44(16):2418—24. DOI:10.1016/j.ejca.2008.07.030.; Saad F., Ivanescu C., Morlock R.J., Sugg J. Association between urinary, bowel, and hormonal treatment-related symptoms and clinical outcomes in nonmetastatic castration-resistant prostate cancer (nmCRPC): PROSPER study. J Clin Oncol 2019;37(7_suppl):233. DOI:10.1200/JCO.2019.37.7_suppl.233.; https://oncourology.abvpress.ru/oncur/article/view/1518

  3. 3
    Academic Journal

    Συνεισφορές: BAYER, JSC, АО БАЙЕР

    Πηγή: Research and Practical Medicine Journal; Том 4, № 4 (2017); 79-88 ; Research'n Practical Medicine Journal; Том 4, № 4 (2017); 79-88 ; 2410-1893 ; 10.17709/2409-2231-2017-4-4

    Περιγραφή αρχείου: application/pdf

    Relation: https://www.rpmj.ru/rpmj/article/view/223/210; Каприн А. Д., Старинский В. В., Петрова Г. В. Злокачественные новообразования в России в 2016 году (заболеваемость и смертность). М.: МНИОИ им. П. А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2018, 250 с. Доступно по: http://www.oncology.ru/service/statistics/malignant_tumors/2016.pdf; Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015 Mar 1;136 (5): E359–86. DOI:10.1002/ijc.29210.; Gupta N, Devgan A, Bansal I, Olsavsky TD, Li S, Abdelbaki A, Kumar Y. Usefulness of radium-223 in patients with bone metastases. Proc (Bayl Univ Med Cent). 2017 Oct;30 (4):424–426. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5595381/; Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol. 2000 May;31 (5):578–83.; Scher HI, Halabi S, Tannock I, Morris M, Sternberg CN, Carducci MA, et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol. 2008 Mar 1;26 (7):1148–59. DOI:10.1200/JCO.2007.12.4487; Taylor CD, Elson P, Trump DL. Importance of continued testicular suppression in hormone-refractory prostate cancer. J Clin Oncol. 1993 Nov;11 (11):2167–72. DOI:10.1200/JCO.1993.11.11.2167; Beer TM, Tombal B. Enzalutamide in Metastatic Prostate Cancer before Chemotherapy. N Engl J Med. 2014 Oct 30;371 (18):1755–6. DOI:10.1056/NEJMc1410239.; Fizazi K, Scher HI, Molina A, Logothetis CJ, Chi KN, Jones RJ, et al. Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer: final overall survival analysis of the COUAA-301 randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol. 2012 Oct;13 (10):983–92. DOI:10.1016/S1470–2045(12)70379–0; Ryan CJ, Smith MR, Fizazi K, Saad F, Mulders PF, Sternberg CN, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol. 2015 Feb;16 (2):152–60. DOI:10.1016/S1470–2045(14)71205–7; Berthold DR, Pond GR, Soban F, de Wit R, Eisenberger M, Tannock IF. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: updated survival in the TAX 327 study. J Clin Oncol. 2008 Jan 10;26 (2):242–5. DOI:10.1200/JCO.2007.12.4008; de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010 Oct 2;376 (9747):1147–54. DOI:10.1016/S0140–6736 (10)61389-X; Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer. N Engl J Med. 2004 Oct 7;351 (15):1502–12. DOI:10.1056/NEJMoa040720; Kantoff PW, Higano CS, Shore ND, Berger ER, Small EJ, Penson DF, et al. Sipuleucel-T Immunotherapy for Castration-Resistant Prostate Cancer. N Engl J Med. 2010 Jul 29;363 (5):411–22. DOI:10.1056/NEJMoa1001294.; Ibrahim T, Flamini E, Mercatali L, Sacanna E, Serra P, Amadori D. Pathogenesis of osteoblastic bone metastases from prostate cancer. Cancer. 2010 Mar 15;116 (6):1406–18. DOI:10.1002/cncr.24896; Logothetis CJ, Lin SH. Osteoblasts in prostate cancer metastasis to bone. Nat Rev Cancer. 2005 Jan;5 (1):21–8. DOI:10.1038/nrc1528; Festuccia C, Giunciuglio D, Guerra F, Villanova I, Angelucci A, Manduca P, et al. Osteoblasts modulate secretion of urokinase-type plasminogen activator (uPA) and matrix metalloproteinase-9 (MMP-9) in human prostate cancer cells promoting migration and matrigel invasion. Oncol Res. 1999;11 (1):17–31.; Armstrong AP, Miller RE, Jones JC, Zhang J, Keller ET, Dougall WC. RANKL acts directly on RANK-expressing prostate tumor cells and mediates migration and expression of tumor metastasis genes. Prostate. 2008 Jan 1;68 (1):92–104. DOI:10.1002/pros.20678; Suominen MI, Fagerlund KM, Rissanen JP, Konkol YM, Morko JP, Peng Z, et al. Radium-223 Inhibits Osseous Prostate Cancer Growth by Dual Targeting of Cancer Cells and Bone Microenvironment in Mouse Models. Clin Cancer Res. 2017 Aug 1;23 (15):4335–4346. DOI:10.1158/1078–0432.CCR-16–2955; Dauer LT, Williamson MJ, Humm J, O’Donoghue J, Ghani R, Awadallah R, et al. Radiation safety considerations for the use of 223RaCl₂ DE in men with castration-resistant prostate cancer. Health Phys. 2014 Apr;106 (4):494–504. DOI:10.1097/HP.0b013e3182a82b37.; Bruland OS, Nilsson S, Fisher DR, Larsen RH. High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the -Emitter 223Ra: Adjuvant or Alternative to Conventional Modalities? Clin Cancer Res. 2006 Oct 15;12 (20 Pt 2):6250s-6257s. DOI:10.1158/1078–0432.CCR-06–0841; File: Alfa beta gamma radiation penetration-RUS.svg — Wikimedia Commons [Internet]. URL: https://commons.wikimedia.org/wiki/File: Alfa_beta_gamma_radiation_penetration-RUS.svg (accessed 18.09.2017).; Nilsson S, Larsen RH, Fosså SD, Balteskard L, Borch KW, Westlin JE, et al. First Clinical Experience with -Emitting Radium-223 in the Treatment of Skeletal Metastases. Clin Cancer Res. 2005 Jun 15;11 (12):4451–9. DOI:10.1158/1078–0432.CCR-04–2244; Nilsson S, Franzén L, Parker C, Tyrrell C, Blom R, Tennvall J, et al. Bone-targeted radium-223 in symptomatic, hormone-refractory prostate cancer: a randomised, multicentre, placebo-controlled phase II study. Lancet Oncol. 2007 Jul;8 (7):587–94. DOI:10.1016/S1470–2045(07)70147-X; Nilsson S, Strang P, Aksnes AK, Franzèn L, Olivier P, Pecking A, et al. A randomized, dose-response, multicenter phase II study of radium-223 chloride for the palliation of painful bone metastases in patients with castration-resistant prostate cancer. Eur J Cancer. 2012 Mar;48 (5):678–86. DOI:10.1016/j.ejca.2011.12.023; Parker CC, Pascoe S, Chodacki A, O’Sullivan JM, Germá JR, O’Bryan-Tear CG, et al. A randomized, double-blind, dose-finding, multicenter, phase 2 study of radium chloride (Ra 223) in patients with bone metastases and castration-resistant prostate cancer. Eur Urol. 2013 Feb;63 (2):189–97. DOI:10.1016/j.eururo.2012.09.008; Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer. N Engl J Med. 2013 Jul 18;369 (3):213–23. DOI:10.1056/NEJMoa1213755; Sartor O, Hoskin P, Coleman RE, Nilsson S, Vogelzang NJ, Petrenciuc O, et al. Chemotherapy following radium-223 dichloride treatment in ALSYMPCA. Prostate. 2016 Jul;76 (10):905–16. DOI:10.1002/pros.23180; https://www.rpmj.ru/rpmj/article/view/223

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    Academic Journal

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    Academic Journal

    Πηγή: Андрология и генитальная хирургия.

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