21. Effect of graded exercise therapy and medical care on chronic fatigue syndromeTamara Zličić, Darinka Korovljev, Tijana Šćepanović, Ivana Milovanović, 2023, review article Abstract: Purpose: Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME) is a complex condition with debilitating symptoms that significantly impact individuals, particularly those in the working population. This study aims to investigate the effec-tiveness of Graded Exercise Therapy (GET) and Cognitive Behavioral Therapy (CBT) along with additional methods such as Graded Exercise Self-help (GES), Adaptive Pac-ing Therapy (APT), and Specialist Medical Care (SMC), in managing Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME) among the working population. Methods: A systematic analysis of five randomized controlled trials conducted be-tween 2013 and 2023, encompassing GET, CBT, APT, SMC, and GES was performed using PubMed.Results: The selected studies consistently demonstrate that GET positively impacts physical functioning and reduces fatigue levels in working individuals with CFS. Ad-ditionally, CBT proves valuable, emphasizing the importance of addressing the mental aspects of CFS in occupational contexts.Conclusion: This review underscores the need for further research, advocating for direct assessment methods like biomarkers to enhance our understanding of CFS and improve treatment outcomes. These insights are crucial for healthcare practitioners, researchers, and policymakers navigating the complexities of CFS within the work-place. Emphasizing the integration of psychological interventions with physical therapies is essential for a comprehensive approach to managing CFS among the working population. Keywords: Chronic Fatigue Syndrome / Myalgic Encephalomyelitis, CFS/ME, graded exercise therapy, cognitive behavioral therapy, adaptive pacing therapy, specialist medical care, working population Published in DiRROS: 17.04.2024; Views: 292; Downloads: 185
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22. The role of PET-CT in radiotherapy planning of solid tumoursStaša Jelerčič, Mirjana Rajer, 2015, review article Abstract: PET-CT is becoming more and more important in various aspects of oncology. Until recently it was used mainly as part of diagnostic procedures and for evaluation of treatment results. With development of personalized radiotherapy, volumetric and radiobiological characteristics of individual tumour have become integrated in the multistep radiotherapy (RT) planning process. Standard anatomical imaging used to select and delineate RT target volumes can be enriched by the information on tumour biology gained by PET-CT. In this review we explore the current and possible future role of PET-CT in radiotherapy treatment planning. After general explanation, we assess its role in radiotherapy of those solid tumours for which PET-CT is being used most. Conclusions. In the nearby future PET-CT will be an integral part of the most radiotherapy treatment planning procedures in an every-day clinical practice. Apart from a clear role in radiation planning of lung cancer, with forthcoming clinical trials, we will get more evidence of the optimal use of PET-CT in radiotherapy planning of other solid tumours. Keywords: positron emission therapy, radiotherapy, radiotherapy planning, tumour biology Published in DiRROS: 16.04.2024; Views: 381; Downloads: 94
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23. Induction gemcitabine in standard dose or prolonged low-dose with cisplatin followed by concurrent radiochemotherapy in locally advanced non-small cell lung cancer : a randomized phase II clinical trialMartina Vrankar, Matjaž Zwitter, Tanja Bavčar-Vodovnik, Ana Milič, Viljem Kovač, 2014, original scientific article Abstract: The optimal combination of chemotherapy with radiation therapy for treatment locally advanced non-small cell lung cancer (NSCLC) remains an open issue. This randomized phase II study compared gemcitabine in two different schedules and cisplatin - as induction chemotherapy, followed by radiation therapy concurrent with cisplatin and etoposid. Patients and methods. Eligible patients had microscopically confirmed inoperable non-metastatic non-small cell lung cancer; fulfilled the standard criteria for platin-based chemotherapy; and signed informed consent. Patients were treated with 3 cycles of induction chemotherapy with gemcitabine and cisplatin. Two different aplications of gemcitabine were compared: patients in arm A received gemcitabine at 1250 mg/m2 in a standard half hour i.v. infusion on days 1 and 8; patients in arm B received gemcitabine at 250 mg/m2 in prolonged 6-hours i.v. infusion on days 1 and 8. In both arms, cisplatin 75 mg/m2 on day 2 was administered. All patients continued treatment with radiation therapy with 60-66 Gy concurrent with cisplatin 50 mg/m2 on days 1, 8, 29 and 36 and etoposid 50 mg/m2 on days 1-5 and 29-33. The primary endpoint was response rate (RR) after induction chemotherapy; secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS). Results. From September 2005 to November 2010, 106 patients were recruited to this study. No statistically signifficant differences were found in RR after induction chemotherapy between the two arms (48.1% and 57.4%, p = 0.34). Toxicity profile was comparable and mild with grade 3/4 neutropenia as primary toxicity in both arms. One patient in arm B suffered from acute peripheral ischemia grade 4 and an amputation of lower limb was needed. With a median follow-up of 69.3 months, progression-free survival and median survival in arm A were 15.7 and 24.8 months compared to 18.9 and 28.6 months in arm B. The figures for 1- and 3-year overall survival were 73.1% and 30.8% in arm A, and 81.5 % and 44.4% in arm B, respectively. Conclusions. Among the two cisplatin-based doublets of induction chemotherapy for inoperable NSCLC, both schedules of gemcitabine have a comparable toxicity profile. Figures for RR, PFS and OS are among the best reported in current literature. While there is a trend towards better efficacy of the treament with prolonged infusion of gemcitabine, the difference between the two arms did not reach statistical significance Keywords: induction chemotherapy, non-small cell lung cancer, radiation therapy, randomized clinical trial Published in DiRROS: 11.04.2024; Views: 533; Downloads: 350
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24. 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: 290; Downloads: 87
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25. Thoracobiliary fistulas : literature review and a case report of fistula closure with omentum majusAnton Crnjac, Vid Pivec, Arpad Ivanecz, 2013, review article Abstract: Background. Thoracobiliary fistulas are pathological communications between the biliary tract and the bronchial tree (bronchobiliary fistulas) or the biliary tract and the pleural space (pleurobiliary fistulas). Review of the literature. We have reviewed aetiology, pathogenesis, predilection formation points, the clinical picture, diagnostic possibilities, and therapeutic options for thoracobiliary fistulas. Case report. A patient with an iatrogenic bronchobiliary fistula which developed after radiofrequency ablation of a colorectal carcinoma metastasis of the liver is present. We also describe the closure of the bronchobiliary fistula with the greater omentum as a possible manner of fistula closure, which was not reported previously according to the knowledge of the authors. Conclusions. Newer papers report of successful non-surgical therapy, although the bulk of the literature advocates surgical therapy. Fistula closure with the greater omentum is a possible method of the thoracobiliary fistula treatment. Keywords: thoracobiliary fistula, bronchobiliary fistula, therapy, omentum majus Published in DiRROS: 22.03.2024; Views: 323; Downloads: 105
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26. A web-application that extends functionality of medical device for tumor treatment by means of electrochemotherapyIvan Pavlović, Peter Kramar, Selma Čorović, David Cukjati, Damijan Miklavčič, 2004, original scientific article Abstract: Electrochemotherapy (ECT) is a novel method for efficient tumor treatment in clinical environment. It combines local drug delivery and application of shorthigh voltage pulses, which permeabilize the plasma membrane by electroporation. Drug can enter only the cells with permeabilzed membrane. Recently, medical device CliniporatorTM for controlled electroporation was developed. Here, we present a web-application that extends the functionality of this medical device. The aim of the application is to collect, store and toallow the analysis of every ECT application using this medical device. The application helps transferring data collected by devčce during the electroporation process to the central database, and enables filling of medical records through the web forms. The application is based on technologies ASP, HTML, Flash, JavaScript, XML and others. The application main advantages are easy and rapid data access, scalability and independence of client computer operating system as well as easy application debugging and upgrading. Keywords: neoplasms- drug therapy, drug delivery systems, elektroporation instrumentation Published in DiRROS: 07.02.2024; Views: 421; Downloads: 107
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27. Influence of hydralazine on interstitial fluid pressure in experimental tumors - a preliminary study : Vpliv hydralazina na tlak medcelične tekočine v poskusnih tumorjihBlaž Podobnik, Damijan Miklavčič, 2000, original scientific article Abstract: Background. Interstitial fluid pressure (IFP) has been recognised as the most important obstacle in macromolecular drug delivery to solid tumors. Our interest was to reduce differentialy tumor IFP with respect to IFP in surrounding and normal tissues in order to increase drug delivery to tumors aswell to increase tumor blood flow and potentialy tumor tissue oxygenation. In this preliminary study we used hydralazine, a longacting arterial vasodilator. Materials and methods. Measurements of interstitial fluid pressure were performed in vivo on CBA mice bearing SAF tumors using wick-in-needle technigue. Altogether eleven measurements were obtained on different animals with tumors of different size. Results. IFP in tumors after hydralazine administration was significantly lower than initial values in corresponding tumors. On average tumor IFP decreased for 33 % from initial value. On the contrary, no change in IFP in normal tissue was observed after hydralazine administration. Also, after injection of physiological saline instead of hydralazine there was no change in IFP neither in tumors nor in muscle. The results of our preliminary study on the effect of hydralazine on IFP in SAF tumor model is in accordance to previously reported studies. The decrease in tumor IFP was only observed in tumors, but not in muscle and surrounding subcutis. Conclusion. Hydralazine is a vasodilator which is capable of decreasing tumor IFP, reproducibly and with favorably long lasting dynamics. Keywords: sarcoma, experimental drug therapy, hydralazine, extracellular space, interstitial fluid pressure, manometry Published in DiRROS: 23.01.2024; Views: 375; Downloads: 113
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30. Electrochemotherapy with bleomycin : The first clinical experience in malignant melanoma patientsZvonimir Rudolf, Borut Štabuc, Maja Čemažar, Damijan Miklavčič, Lojze Vodovnik, Gregor Serša, 1995, original scientific article Keywords: melanoma therapy, bleomycin, electric stimulation therapy Published in DiRROS: 15.01.2024; Views: 390; Downloads: 86
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