1. Preoperative treatment with radiochemotherapy for locally advanced gastroesophageal junction cancer and unresectable locally advanced gastric cancerIvica Ratoša, Irena Oblak, Franc Anderluh, Vaneja Velenik, Jasna But-Hadžić, Ajra Šečerov Ermenc, Ana Jeromen, 2015, original scientific article Abstract: To purpose of the study was to analyze the results of preoperative radiochemotherapy in patients with unresectable gastric or locoregionally advanced gastroesophageal junction (GEJ) cancer treated at a single institution. Between 1/2004 and 6/2012, 90 patients with locoregionally advanced GEJ or unresectable gastric cancer were treated with preoperative radiochemotherapy at the Institute of Oncology Ljubljana. Planned treatment schedule consisted of induction chemotherapy with 5-fluorouracil and cisplatin, followed by concomitant radiochemotherapy four weeks later. Three-dimensional conformal external beam radiotherapy was delivered by dual energy (6 and 15 MV) linear accelerator in 25 daily fractions of 1.8 Gy in 5 weeks with two additional cycles of chemotherapy repeated every 28 days. Surgery was performed 4-6 weeks after completing radiochemotherapy. Following the surgery, multidisciplinary advisory team reassessed patients for the need of adjuvant chemotherapy. The primary endpoints were histopathological R0 resection rate and pathological response rate. The secondary endpoints were toxicity of preoperative radiochemotherapy and survival. Treatment with preoperative radiochemotherapy was completed according to the protocol in 84 of 90 patients (93.3%). Twenty patients (22.2%) did not undergo the surgery because of the disease progression, serious comorbidity, poor performance status or still unresectable tumour. In 13 patients (14.4%) only exploration was performed because the tumour was assessed as unresectable or diffuse peritoneal carcinomatosis was established. Fifty-seven patients (63.4%) underwent surgery with the aim of complete removal of the tumour. Radical resection was achieved in 50 (55.6%) patients and the remaining seven (7.8%) patients underwent non-radical surgery (R1 in five and R2 in two patients). In this group of patients (n = 57), pathological complete response of tumour was achieved in five patients (5.6% of all treated patients or 8.8% of all operated patients). Down-staging was recorded in 49 patients (86%), in one patient (1.8%) the stage after radiochemotherapy was unchanged while in seven patients (12.3%) the pathological stage was higher than clinical, mainly due to higher pN stage. No death was recorded during preoperative radiochemotherapy. Most grade 3 and 4 toxicities were due to vomiting, nausea and bone marrow suppression (granulocytopenia). Twentysix (45.6%) patients died due to GEJ or gastric carcinoma, one died because of septic shock following the surgery and a reason for two deaths was unknown. Twenty-eight patients (49.1%) were disease free at the time of analysis, while 29 patients (50.9%) developed the recurrence, mostly as distant metastases. At two years, locoregional control, diseasefree survival, disease-specific survival and overall survival were 82.9%, 43.9%, 56.9% and 53.9%, respectively. Preoperative radiochemotherapy was feasible in our group of patients and had acceptable toxicity. Majority of patients achieved down-staging, allowing greater proportion of radical resections (R0), which are essential for patientsʼ cure. Keywords: neoadjuvant radiochemotherapy, perioperative chemotherapy, chemotherapy, adenocarcinoma, carcinoma, surgery Published in DiRROS: 23.04.2024; Views: 19; Downloads: 2 Full text (1,18 MB) |
2. Capecitabine in adjuvant radiochemotherapy for gastric adenocarcinomaIrena Oblak, Marija Skoblar Vidmar, Franc Anderluh, Vaneja Velenik, Ana Jeromen, Jasna But-Hadžić, 2014, original scientific article Abstract: Background. In patients with non-metastatic gastric cancer surgery still remains the treatment of choice. Postoperative radiochemotherapy with 5-fluorouracil and leucovorin significantly improves the treatment outcome. The oral fluoropyrimidines, such as capecitabine, mimic continuous 5-fluorouracil infusion, are at least as effective as 5-fluorouracil, and such treatment is more comfortable for the patients. Patients and methods. In the period from October 2006 to December 2009, 101 patients with gastric cancer in stages Ib-IIIc were treated with postoperative chemoradiation with capecitabine. Distal subtotal resection of the stomach was performed in 46.3%, total resection in 50.5% and multivisceral resection in 3.2% of patients. The main endpoints of this study were loco-regional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS). The rates of acute side-effects were also estimated. Results. Seventy-seven percent of patients completed the treatment according to the protocol. The median followup time of all patients was 3.9 years (range: 0.4-6.3 years) and in survivors it was 4.7 years (range: 3.2-6.3 years). No death occurred due to the therapy. Acute toxicity, such as nausea and vomiting, stomatitis, diarrhoea, hand-foot syndrome and infections of grade 3 or 4, occurred in 5%, 1%, 2%, 8.9% and 18.8% of patients, respectively. On the close-out date 63.4% patients were still alive and with no signs of the disease. The 4-years follow-up survey showed that LRC, DFS, DSS and OS were 95.5%, 69.2%, 70.7%, and 66.2%, respectively. Higher pN-stage and splenectomy were found to be independent prognostic factors for all four types of survival and perineural invasion and lower treatment intensity for DFS, DSS and OS. Keywords: gastric cancer, adjuvant therapy, radiochemotherapy Published in DiRROS: 11.04.2024; Views: 64; Downloads: 10 Full text (519,56 KB) |
3. Results of postoperative radiochemotherapy of the patients with resectable gastroesophageal junction adenocarcinoma in SloveniaAna Jeromen, Irena Oblak, Franc Anderluh, Vaneja Velenik, Marija Skoblar Vidmar, Ivica Ratoša, 2012, original scientific article Keywords: gastroesophageal junction adenocarcinoma, postoperative radiochemotherapy, toxicity Published in DiRROS: 21.03.2024; Views: 90; Downloads: 32 Full text (419,66 KB) |
4. Smernice za obravnavo bolnikov s skvamoznoceličnim karcinomom analnega kanala in kože perinealno (analnega roba)Franc Anderluh, Irena Oblak, Ajra Šečerov Ermenc, Ana Jeromen, Erik Brecelj, Martina Reberšek, Vaneja Velenik, 2022, professional article Keywords: rak analnega kanala, rak analnega roba, radiokemoterapija, obsevanje Published in DiRROS: 15.12.2022; Views: 500; Downloads: 110 Full text (134,47 KB) |
5. Smernice za zdravljenje bolnikov z rakom požiralnika in ezofagogastričnega stika (EGS)Franc Anderluh, Marko Boc, Goran Gačevski, Gorana Gašljević, Samo Horvat, Nežka Hribernik, Marija Ignjatović, Ana Jeromen, Jera Jeruc, Peter Korošec, Tanja Mesti, Srdjan Novaković, Irena Oblak, Janja Ocvirk, Martina Reberšek, Nada Rotovnik-Kozjek, Matevž Srpčič, Ajra Šečerov Ermenc, Borut Štabuc, Vaneja Velenik, Neva Volk, Vesna Zadnik, 2022, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: rak požiralnika, rak ezofagogastritičnega stika, smernice, zdravljenje Published in DiRROS: 07.09.2022; Views: 681; Downloads: 263 Full text (3,50 MB) This document has many files! More... |
6. Smernice za obravnavo bolnikov s skvamoznoceličnim karcinomom analnega kanala in kože perinealno (analnega roba)2020, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: rak analnega kanala, rak analnega roba, bolniki, zdravljenje Published in DiRROS: 18.03.2022; Views: 678; Downloads: 370 Full text (407,06 KB) This document has many files! More... |
7. Priporočila za obravnavo bolnikov z rakom debelega črevesa in danke2020, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: rak debelega črevesa, rak danke, bolniki, zdravljenje Published in DiRROS: 18.03.2022; Views: 790; Downloads: 433 Full text (1,30 MB) This document has many files! More... |
8. Priporočila Onkološkega inštituta za zdravljenje bolnikov z adenokarcinomom želodcaErik Brecelj, Vesna Zadnik, Neva Volk, Mateja Krajc, Ana Blatnik, Ksenija Strojnik, Nina Boc, Yasmin Marianna Hunt, Gorana Gašljević, Jera Jeruc, Srdjan Novaković, Marko Boc, Franc Anderluh, Martina Reberšek, Borut Štabuc, Irena Oblak, Janja Ocvirk, Ana Jeromen, Zvezdana Hlebanja, Tanja Mesti, Marija Ignjatović, Nežka Hribernik, Ibrahim Edhemović, Gašper Pilko, Rok Petrič, Ajra Šečerov Ermenc, Nada Rotovnik-Kozjek, Vaneja Velenik, Sonja Kramer, Maja Ebert Moltara, Jernej Benedik, 2021, professional article Keywords: adenokarcinom želodca, priporočila, prebavni trakt, multidisciplinarno zdravljenje Published in DiRROS: 16.12.2021; Views: 1116; Downloads: 499 Full text (355,48 KB) This document has many files! More... |
9. Priporočila Onkološkega inštituta za zdravljenje bolnikov z adenokarcinomom želodca2021, other monographs and other completed works Abstract: V Sloveniji vsako leto zboli zaradi raka želodca okrog 450 bolnikov, od tega ima tri četrtine bolnikov ob postavitvi diagnoze razširjeno ali razsejano bolezen. Zato je pomembno, da imamo razvito sodobno multidisciplinarno zdravljenje. Onkološki inštitut je na poti pridobitve evropske onkološke akreditacije, ki jo podeljuje priznana Evropska organizacija onkoloških inštitutov (OECI), katere član je tudi Onkološki inštitut Ljubljana. Namen tega projekta je razvoj kliničnih poti, ki bodo omogočile celostno obravnavo bolnikov z rakom. Slovenskih priporočil za zdravljenje adenokarcinoma želodca trenutno nimamo, zato smo bili primorani sprejeti te, ki jim bomo sledili na Onkološkem inštitutu. V teh priporočilih, zaradi drugačne narave bolezni, ni zajeto zdravljenje raka ezofagogastričnega stika. Keywords: rak želodca, adenokarcinom, onkološko zdravljenje, priporočila Published in DiRROS: 14.09.2021; Views: 1383; Downloads: 367 Full text (983,68 KB) |
10. Rak trebušne slinavke : kaj morate vedeti o bolezniMartina Reberšek, Marko Boc, Irena Oblak, Jernej Benedik, Zvezdana Hlebanja, Janja Ocvirk, Neva Volk, Tanja Mesti, Maja Ebert Moltara, Tomaž Milanez, Franc Anderluh, Vaneja Velenik, Jasna But-Hadžić, Ajra Šečerov Ermenc, Ana Jeromen, Nada Rotovnik-Kozjek, Katja Kogovšek, Aleš Tomažič, 2014, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: dejavniki tveganja, bolniki, simptomi, diagnostika, zdravljenje, bolečina, dietna terapija, paliativna oskrba Published in DiRROS: 04.06.2020; Views: 2103; Downloads: 646 Full text (1,22 MB) |