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32. Radioterapija karcinoma Merklovih celicPrimož Strojan, 2023, published scientific conference contribution Abstract: Za karcinom Merklovih celic je značilna visoka stopnja radioobčutljivosti, zato ima radioterapija pomembno vlogo v zdravljenju vseh stopenj v razvoju te bolezni. Redkeje, čeprav primerljivo uspešno kot kirurgija, jo uporabljamo za zdravljenje primarnih tumorjev. Pogosteje dopolnjuje predhodno operacijo, bodisi primarnega tumorja ali področnih zasevkov. Indikacija za pooperativno obsevanje so vsa stanja, ki kažejo na povečano tveganje za ponovitev bolezni v operativnem polju. Radioterapija je učinkovita tudi kot paliativna metoda zdravljenja pri bolnikih z oddaljenimi zasevki ali v slabem splošnem stanju, ki ne dovoljuje intenzivnih kombiniranih zdravljenj.
Keywords: rak kože, melanom, radioterapija
Published in DiRROS: 18.05.2023; Views: 338; Downloads: 195
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33. Radioterapija bazalnoceličnega in ploščatoceličnega karcinoma kožePrimož Strojan, 2023, published scientific conference contribution Abstract: Radioterapija je eno izmed osnovnih zdravljenj bazalnoceličnega in ploščatoceličnega karcinoma kože. Indikacije za zdravljenje z radioterapijo izhajajo iz njenih prednosti in slabosti v primerjavi z ostalimi terapevtskimi možnostmi. Kot edino zdravljenje se uporablja pri starejših bolnikih z multiplimi tumorji, še posebej blizu oči, na nosu ali uhljih, in recidivih po predhodni operaciji. Po operaciji obsevamo ob povečanem tveganju za ponovitev tumorja v operativnem polju (nepopoln izrez, perinevralna invazija, infiltrativno rastoči tumorji). Ob pravilni indikaciji in izvedbi je učinkovitost radioterapije primerljiva s kirurgijo.
Keywords: rak kože, melanom, radioterapija
Published in DiRROS: 18.05.2023; Views: 330; Downloads: 170
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35. Načela zdravljenja raka glave in vratuPrimož Strojan, 2022, published professional conference contribution Abstract: V Sloveniji je zdravljenje rakov glave in vratu zaradi njihove nizke incidence centralizirano in multidisciplinarno. Poteka izključno v obeh univerzitetnih kliničnih centrih, v Ljubljani in Mariboru (kirurgija), in na Onkološkem inštitutu v Ljubljani (radioterapija, sistemska terapija). Odločitev o namenu in vrsti zdravljenja vedno sprejme multidisciplinarni konzilij, ki izbira med različnimi terapevtskimi možnostmi glede na njihovo učinkovitost, potencialno toksičnost ter splošno stanje in želje bolnika. Manjši (začetni) tumorji so lahko zdravljeni z enim samim terapevtskim načinom, kirurgijo ali radioterapijo, pri večjih, a še operabilnih tumorjih se odločamo med primarno operacijo oziroma nekirurškim zdravljenjem. Bolniki z neoperabilnimi tumorji so zdravljeni z različnimi kombinacijami radioterapije in sistemske terapije. Za paliacijo simptomov se uporabljajo prilagojeni režimi radioterapije in sistemska terapija. Ker je zdravljenje agresivno, je treba bolnika ves čas natančno spremljati, pomembno vlogo pa imajo tudi različne podporne dejavnosti, kot je protibolečinska in prehranska obravnava.
Keywords: rak glave in vratu, zdravljenje, onkologija
Published in DiRROS: 06.01.2023; Views: 448; Downloads: 136
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38. Electrochemotherapy in mucosal cancer of the head and neck : a systematic reviewPrimož Strojan, Aleš Grošelj, Gregor Serša, Christina Caroline Plaschke, Jan B. Vermorken, Sandra Nuyts, Remco De Bree, Avraham Eisbruch, William M. Mendenhall, Robert Smee, Alfio Ferlito, 2021, review article Abstract: Electrochemotherapy (ECT) is a local ablative treatment that is based on the reversible electroporation and intracellular accumulation of hydrophilic drug molecules, which greatly increases their cytotoxicity. In mucosal head and neck cancer (HNC), experience with ECT is limited due to the poor accessibility of tumors. In order to review the experience with ECT in mucosal HNC, we undertook a systematic review of the literature. In 22 articles, published between 1998 and 2020, 16 studies with 164 patients were described. Curative and palliative intent treatment were given to 36 (22%) and 128 patients (78%), respectively. The majority of tumors were squamous cell carcinomas (79.3%) and located in the oral cavity (62.8%). In the curative intent group, complete response after one ECT treatment was achieved in 80.5% of the patients, and in the palliative intent group, the objective (complete and partial) response rate was 73.1% (31.2% and 41.9%). No serious adverse events were reported during or soon after ECT and late effects were rare (19 events in 17 patients). The quality-of-life assessments did not show a significant deterioration at 12 months post-ECT. Provided these preliminary data are confirmed in randomized controlled trials, ECT may be an interesting treatment option in selected patients with HNC not amenable to standard local treatment.
Keywords: electrochemotherapy, head and neck cancer, mucosal cancer
Published in DiRROS: 23.09.2022; Views: 654; Downloads: 314
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39. Neuroendocrine carcinoma of the larynx and pharynx : a clinical and histopathological studyPrimož Strojan, Robert Šifrer, Alfio Ferlito, Cvetka Grašič-Kuhar, Boštjan Lanišnik, Gaber Plavc, Nina Zidar, 2021, original scientific article 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: 617; Downloads: 286
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40. Priporočila za zobozdravstveno obravnavo odraslih bolnikov z rakom glave in vratu v Sloveniji, zdravljenih z obsevanjemAleš Fidler, Aleksandar Aničin, Vojislav Didanovič, Tadej Dovšak, Boris Gašpirc, Aleš Grošelj, Andrej Kansky, Matic Koren, Jana Krapež, Hojka Kuralt, Marko Kuralt, Boštjan Lanišnik, Romana Mance Kristan, Jošt Pavčič, Luka Prodnik, Peter Pukl, Tadej Ostrc, Milan Kuhar, Eva Skalerič, Robert Šifrer, Valerija Skopec, Primož Strojan, 2022, original scientific article Abstract: Priporočila za zobozdravstveno obravnavo bolnikov z rakom glave in vratu (RGV) v Sloveniji, zdravljenih z obsevanjem sledijo priporočilom The Royal College of Surgeons of England v sodelovanju z The British Society for Disability and Oral Health, dopolnjujejo Priporočila za obravnavo bolnikov z rakom glave in vratu v Sloveniji in hkrati upoštevajo obstoječe zmožnosti slovenskega zdravstvenega sistema. Namen priporočil je prepre-čevanje oz. zmanjšanje zapletov v ustni votlini, ki nastanejo zaradi obsevanja. Opredeljujejo način zobozdravstvene oskrbe pred, med in po zdravljenju raka na vseh treh nivojih zobozdra-vstvene oskrbe, kar zagotavlja njeno pravočasnost in dostopnost. Priporočila predstavljajo poenoteno mnenje vseh deležnikov na področju zobozdravstvene obravnave bolnikov z RGV v državi.
Keywords: onkologija, zobozdravstvena obravnava, obsevanje, ustna votlina, priporočila
Published in DiRROS: 14.07.2022; Views: 710; Downloads: 258
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