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Abstract: Neuroendocrine carcinomas (NECs) of the head and neck are rare and the experience scanty. The Cancer Registry of Slovenia database was used to identify cases of laryngeal and pharyngeal NECs diagnosed between 1995%2020. Biopsies were analyzed for the expression of standard neuroendocrine markers (synaptophysin, chromogranin, CD56), INSM1, Ki-67, p16, and PD-L1 (using the combined positive score, CPS). In situ hybridization for human papillomavirus (HPV) and Epstein%Barr virus (EBV) was performed. Twenty patients (larynx, 12; pharynx, 8) were identified. One tumor was well differentiated (WD), five were moderately differentiated (MD), and 14 were poorly differentiated (PD). Disease control was achieved solely by surgery in 4/4 MD/PD T1-2N0-1 tumors. Eight patients died of the disease, seven of which were due to distant metastases. All three traditional markers were positive in 11/17 NECs and the INSM1 marker in all 20 tumors. Two of fourteen p16-positive tumors were HPV-positive, but all three nasopharyngeal NECs were EBV-negative. Three tumors had CPSs % 1. In conclusion, INSM1 was confirmed to be a reliable marker of neuroendocrine differentiation. Except in WD and early-stage MD/PD tumors, aggressive multimodal therapy is needed; the optimal systemic therapy remains to be determined. p16, HPV, and EBV seem to bear no prognostic information.
Keywords: electrochemotherapy, head and neck cancer, neuroendocrinic carcinoma
Published in DiRROS: 07.09.2022; Views: 482; Downloads: 218
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Abstract: Izhodišče: Optimizacija rehabilitacije onkoloških bolnikov in njihova vrnitev na delo sta pomembni tako zaradi izboljšanja počutja te ranljive skupine kot tudi zaradi zmanjšanja družbenih in finančnih vplivov na celotno družbo. Osebe, ki so prebolele raka, se poskušajo po zdravljenju vrniti na delo in znova vzpostaviti nekdanjo strukturo vsakdanjega življenja. Z raziskavo smo želeli razkriti stališča onkologov do bolniške odsotnosti bolnic z rakom dojk. Metode: Med slovenskimi onkologi, ki sodelujejo pri zdravljenju bolnic z rakom dojk, smo izvedli krajšo anonimno spletno anketo o stališčih do bolniške odsotnosti omenjenih bolnic. Rezultati: Na spletno anketo je od 52 povabljenih onkologov odgovorilo 24 (46,2 %), od tega 8 (33,3 %) specialistov internistične onkologije, 9 (37,5 %) specialistov onkologije z radioterapijo in 7 (29,2 %) specialistov kirurgov. Stališče onkologov, ocenjeno z 10-stopenjsko Likertovo lestvico, je, da sta pogovor z bolnico in obravnava vprašanj o vrnitvi na delovno mesto zelo pomemben del celostne obravnave (povprečna ocena 8,4/10). Hkrati pa ocenjujejo, da je razmerje med časom, ki ga imajo vsakodnevno na voljo za obravnavo bolnic z rakom dojk, in časom, ki ga lahko posvetijo vprašanjem o bolniški odsotnosti med zdravljenjem ali po zaključenem zdravljenju, slabo (povprečna ocena 3,6/10). Sorazmerno pogosto se srečujejo s t. i. pritiski bolnic zaradi podajanja mnenj v zvezi z bolniško odsotnostjo ali invalidsko upokojitvijo (povprečna ocena 6,5/10). V vprašalniku so bili prav tako zbrani predlogi za dolžino bolniškega staleža, upoštevajoč vrsto in zahtevnost zdravljenja ter individualne dejavnike. Predlagana je bila skupina strokovnjakov, ki bi sestavljala multidisciplinaren tim za obravnavo bolnic z bolniškim staležem
Keywords: rak dojke, zdravljenje, bolniška odsotnost, rehabilitacija
Published in DiRROS: 01.07.2022; Views: 1009; Downloads: 216
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Abstract: o establish a transborder virtual tumor board (VTB) fostering state-of-the-art management of cancer patients by exchanging knowledge and expertise among oncologists in Central and Southeastern Europe (CEE). Methods: We established and implemented a VTB based on the WebEx platform. This allowed for password-protected and secure upload of patient cases to be presented and discussed among colleagues from various oncology centers scattered throughout CEE in order to arrive at a recommendation for further diagnoses and/or treatment. Results: A total of 73 cases from 16 oncology centers located in 11 CEE countries were uploaded by 22 physicians; 71 were discussed over the course of 17 virtual meetings between June 2018 and May 2019 and 12 different kinds of malignant diseases were discussed with lung cancer (46.6%), melanoma (19.2%) and bladder cancer (13.6%) being the most commonly presented tumor entities. Of the discussed patients, 93.3% had stage IV disease at the time of presentation, 62.6% received chemotherapy or targeted treatment and 67.1% were treated with immune checkpoint inhibitors (ICPIs). The most common causes for presentation and discussion of patient cases were related to the use of ICPIs (80%). Conclusion: When the need for expertise exceeds locally available resources, web-based VTBs provide a feasible way to discuss patient cases and arrive at conclusions regarding diagnoses and/or treatment across large geographic distances. Moreover, VTBs provide an innovative way for proper, state-of-the-art management of patients with malignant diseases in times of social distancing and the resulting need for restricted interaction during the current SARS-CoV‑2 (severe acute respiratory syndrome coronavirus type 2) pandemic.
Keywords: CECOG, Osrednja in jugovzhodna Evropa, nadzorni imunski zaviralci, maligne bolezni
Published in DiRROS: 31.03.2022; Views: 684; Downloads: 409
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Keywords: obsevanje, radioterapija, onkološko zdravljenje
Published in DiRROS: 24.03.2022; Views: 415; Downloads: 163
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Abstract: Onkološki bolniki so bili že ob začetku pandemije covida-19 prepoznani kot skupina s povečanim tveganjem zapletov ob morebitni okužbi z virusom SARS-CoV-2, vendar so bili izključeni iz registracijskih raziskav cepiv proti covidu-19. Šele v zadnjih mesecih imamo na voljo več raziskav, ki so preučevale učinkovitost cepljenja pri onkoloških bolnikih z različnimi načini zdravljenja. Te so pokazale dobro učinkovitost (tako z razvojem humoralnega kot celičnega odgovora) in varnost cepiv predvsem pri bolnikih s solidnimi raki. Pričakovano slabši humoralni odziv je bil pri hematoloških bolnikih oziroma ga skoraj ni bilo pri bolnikih na terapiji anti-CD20 in terapiji z zaviralci Brutonove kinaze. Vendar je bil pri hematoloških bolnikih ohranjen celični odgovor in tako je smiselno cepljenje tudi pri tej skupini bolnikov, tudi s tretjim odmerkom. Pri bolnikih, ki so predhodno preboleli okužbo s SARS-CoV-2 ter bili nato cepljeni, so ugotavljali bistveno boljši humoralni odgovor kot pri cepljenju neprebolevnikov.
Keywords: cepljenje, onkološki bolniki, covid-19, humoralni odgovor, celični odgovor
Published in DiRROS: 14.12.2021; Views: 970; Downloads: 396
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