1. Excellent outcomes after radiotherapy alone for malignant spinal cord compression from myelomaDirk Rades, Antonio J. Conde-Moreno, Jon Cacicedo, Barbara Šegedin, Volker Rudat, Steven E. Schild, 2016, original scientific article Abstract: Uncertainty exists whether patients with spinal cord compression (SCC) from a highly radiosensitive tumor require decompressive spinal surgery in addition to radiotherapy (RT). This study addressed the question by evaluating patients receiving RT alone for SCC from myeloma. Patients and methods. Data of 238 patients were retrospectively analyzed for response to RT and local control of SCC. In addition, the effect of RT on motor function (improvement, no further progression, deterioration) was evaluated. Overall response was defined as improvement or no further progression of motor dysfunction. Prior to RT, patients were presented to a neurosurgeon for evaluation whether upfront decompressive surgery was indicated (e.g. vertebral fracture or unstable spine). Results. In the entire cohort, the overall response rate was 97% (53% improvement plus 44% no further progression). Following RT, 88% of the patients were able to walk. Of the 69 non-ambulatory patients 44 patients (64%) regained the ability to walk. Local control rates at 1, 2 and 3 years were 93%, 82% and 82%, respectively. A trend towards better local control was observed for patients who were ambulatory before starting RT (p = 0.08) and those with a more favorable performance status (p = 0.07). Conclusions. RT alone provided excellent response rates, functional outcomes and local control in patients with SCC from myeloma. These results should be confirmed in a prospective randomized trial.
Keywords: myeloma, spinal cord compression, radiotherapy
Published in DiRROS: 30.04.2024; Views: 17; Downloads: 4
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2. Uncertainties in target volume delineation in radiotherapy : are they relevant and what can we do about them?Barbara Šegedin, Primož Petrič, 2016, original scientific article Abstract: Modern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility of better local control while preserving good quality of life. Uncertainties in target volume delineation have been demonstrated for most tumour sites, and various studies indicate that inconsistencies in target volume delineation may be larger than errors in all other steps of the treatment planning and delivery process. The aim of this paper is to summarize the degree of delineation uncertainties for different tumour sites reported in the literature and review the effect of strategies to minimize them. Conclusions. Our review confirmed that interobserver variability in target volume contouring represents the largest uncertainty in the process for most tumour sites, potentially resulting in a systematic error in dose delivery, which could influence local control in individual patients. For most tumour sites the optimal combination of imaging modalities for target delineation still needs to be determined. Strict use of delineation guidelines and protocols is advisable both in every day clinical practice and in clinical studies to diminish interobserver variability. Continuing medical education of radiation oncologists cannot be overemphasized, intensive formal training on interpretation of sectional imaging should be included in the program for radiation oncology residents.
Keywords: target volume, interobserver variability, delineation uncertainties, imaging
Published in DiRROS: 30.04.2024; Views: 20; Downloads: 4
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3. Functional polymorphisms in antioxidant genes in Hurthle cell thyroid neoplasm - an association of GPX1 polymorphism and recurrent Hurthle cell thyroid carcinomaBlaž Krhin, Katja Goričar, Barbara Gazić, Vita Dolžan, Nikola Bešić, 2016, original scientific article Abstract: Hurthle cells of the thyroid gland are very rich in mitochondria and oxidative enzymes. As a high level oxidative metabolism may lead to higher level of oxidative stress and can be associated with an increased risk for cancer, we investigated whether common functional polymorphisms in antioxidant genes (SOD2, CAT, GPX, GSTP1, GSTM1 and GSTT1) are associated with the development or clinical course of Hurthle cell thyroid carcinoma (HCTC). Methods. A retrospective study was performed in 139 patients treated by thyroid surgery for a Hurthle cell neoplasm. HCTC, Hurthle cell thyroid adenoma (HCTA) or Hurthle cell thyroid nodule (HCTN) were diagnosed by pathomorphology. DNA was extracted from cores of histologically confirmed normal tissue obtained from formalin-fixed paraffinembedded specimens and genotyped for investigated polymorphisms. Logistic regression was used to compare genotype distributions between patient groups. Results. HCTC, HCTA and HCTN were diagnosed in 53, 47 and 21 patients, respectively. Metastatic disease and recurrence of HCTC were diagnosed in 20 and 16 HCTC patients, respectively. Genotypes and allele frequencies of investigated polymorphisms did not deviate from Hardy-Weinberg equilibrium in patients with HCTC, HCTA and HCTN. Under the dominant genetic model we observed no differences in the genotype frequency distribution of the investigated polymorphisms when the HCTA and HCTN group was compared to the HCTC group for diagnosis of HCTC or for the presence of metastatic disease. However, GPX1 polymorphism was associated with the occurrence of recurrent disease (p = 0.040). Conclusions. GPX1 polymorphism may influence the risk for recurrent disease in HCTC.
Keywords: Hurthle cell thyroid carcinoma, Hurthle cell neoplasm, thyroid, oxidative stress
Published in DiRROS: 30.04.2024; Views: 22; Downloads: 2
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4. Outcome of severe infections in afebrile neutropenic cancer patientsKsenija Strojnik, Ksenija Mahkovic Hergouth, Barbara Jezeršek Novaković, Boštjan Šeruga, 2016, original scientific article Abstract: In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia. Patients and methods. We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fishers exact test. Results. We identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had% a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% vs. 52%, p = 0.17).
Keywords: afebrile infection, neutropenia, hypothemia, cancer patients
Published in DiRROS: 30.04.2024; Views: 17; Downloads: 4
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5. Granulomatosis after autologous stem cell transplantation in nonHodgkin lymphoma : experience of single institution and a review of literatureLučka Boltežar, Ivana Žagar, Barbara Jezeršek Novaković, 2016, review article Abstract: Sarcoidosis before and after treatment of malignancy is an important differential diagnosis that has to be distinguished from lymphoma. Patients and methods. Hodgkin lymphoma, diffuse large B-cell lymphoma and aggressive follicular lymphoma are being staged and treatment effect is evaluated with PET-CT. We report three cases of aggressive lymphoma after high dose therapy and autologous stem cell transplantation with positive lymph nodes on PET-CT, which were histologically diagnosed as sarcoidosis/granulomatosis. In the literature, we found that false positive lymph nodes were more common after allogeneic than after autologous transplantation. Conclusions. Post-treatment PET-CT positive lymph nodes should always be examined histologically prior to any further treatment decision to avoid unnecessary toxic procedures.
Keywords: granulomatosis, nonHodgin lymphoma, PET-CT, differential diagnosis
Published in DiRROS: 30.04.2024; Views: 16; Downloads: 3
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6. Revealing subtle active tectonic deformation: integrating lidar, photogrammetry, field mapping, and geophysical surveys to assess the Late Quaternary activity of the Sava Fault (Southern Alps, Slovenia)Petra Jamšek Rupnik, Jure Atanackov, Barbara Horn, Branko Mušič, Marjana Zajc, Christoph Grützner, Kamil Ustaszewski, Sumiko Tsukamoto, Matevž Novak, Blaž Milanič, Anže Markelj, Kristina Ivančič, Ana Novak, Jernej Jež, Manja Žebre, Miloš Bavec, Marko Vrabec, 2024, original scientific article Abstract: We applied an interdisciplinary approach to analyze the late Quaternary activity of the Sava Fault in the Slovenian Southern Alps. The Sava Fault is an active strike-slip fault, and part of the Periadriatic Fault System that accommodated the convergence of Adria and Europe. It is one of the longest faults in the Southern Alps. Using high-resolution digital elevation models from lidar and photogrammetric surveys, we were able to overcome the challenges of assessing fault activity in a region with intense surface processes, dense vegetation, and relatively low fault slip rates. By integrating remote sensing analysis, geomorphological mapping, structural geological investigations, and near-surface geophysics (electrical resistivity tomography and ground penetrating radar), we were able to find subtle geomorphological indicators, detect near-surface deformation, and show distributed surface deformation and a complex fault pattern. Using optically stimulated luminescence dating, we tentatively estimated a slip rate of 1.8 ± 0.4 mm/a for the last 27 ka, which exceeds previous estimates and suggests temporal variability in fault behavior. Our study highlights the importance of modern high-resolution remote sensing techniques and interdisciplinary approaches in detecting tectonic deformation in relatively low-strain rate environments with intense surface processes. We show that slip rates can vary significantly depending on the studied time window. This is a critical piece of information since slip rates are a key input parameter for seismic hazard studies.
Keywords: active fault, lidar, photogrammetry, tectonic geomorphology, structural geology, geophysics, electrical resistivity tomography, ground penetrating radar, slip rate, Sava Fault
Published in DiRROS: 30.04.2024; Views: 17; Downloads: 3
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10. Poročilo o preskusu št.: LVG 2024-035 : vzorec št. 2024/00057Barbara Piškur, Špela Hočevar, Nikica Ogris, 2024, expertise, arbitration decision Keywords: varstvo gozdov, morfološke analize, duglazija, sadike, sušenje, poškodbe sadik
Published in DiRROS: 23.04.2024; Views: 62; Downloads: 0
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