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Povzetek: Background. The aim of the retrospective study was to evaluate the effectiveness and toxicity of radiochemotherapy in patients with squamous cellcarcinoma of the anal canal treated at a single institution. Patients and methods. Between 1/2003 and 9/2010, 84 patients were treated with radical radiochemotherapy at the Institute of Oncology Ljubljana, Slovenia. The treatment consisted of 3-dimensional conformal external beam radiotherapy with concurrent chemotherapy (5-fluorouracil and mytomycin C), followed by brachytherapy or external beam boost. The toxicity of therapy and its effectiveness were assessed. Results. The treatment was completed according tothe protocol in 79.8% of patients. The median follow-up time of 55 survivors was 53 months (range: 16-105 months). The 5-year locoregional control(LRC), disease-free survival (DFS), disease-specific survival (DSS), overall survival (OS) and colostomy-free survival (CFS) rates were 71%, 68%, 81%, 67% and 85%, respectively. No treatment-related mortality was observed. The most frequent acute side-effect of the treatment was radiodermatitis (grade 3-4 in 58.2% of patients). LENT-SOMA grade 3-4 late radiation side effects were observed in 15 (18%) patients. In patients with brachytherapy boost a trend of less late side effects was observed compared to patients with external beam boost (P=0.066). On multivariate analysis, complete clinicaldisease response was identified as an independent prognostic factor for LRC, DFS and DSS, the salvage surgery for LRC and DFS, whereas Hb below 120 g/l retained its independent prognostic value for OS. Conclusions. Radiochemotherapy provides an excellent disease control and the survival with preserving anal sphincter function in majority of patients. Surgical salvage with abdominoperineal resection for persistent or recurrent disease has curative potential.
Objavljeno v DiRROS: 21.03.2024; Ogledov: 286; Prenosov: 118
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Povzetek: Background. To analyze the efficacy of postoperative radiochemotherapy with 5-florouracil (5-FU) and leucovorin (LV) applied in the patients with gastric carcinoma treated in a single institution. Patients and methods. Between 2001 and 2004, 123 patients with resected gastric adenocarcinoma were treated with postoperative concomitant radiochemotherapy with 5-FU and LV. The adjuvant treatment consisted of five cycles of chemotherapy with 5-FU (425mg/m2 IV) andLV (20 mg/m2 IV) and concomitant radiotherapy with the total dose of 45 Gy.Results. The treatment was completed according to the protocol in 82% of patients. The frequency and severity of early toxic effects induced by radiochemotherapy were manageable. Median follow-up time of 56 survivors was 64.5 months (range: 51.7-96.4 months). The 5-year locoregional control (LRC), diseasefree survival (DFS), disease-specific survival (DSS) and overall survival (OS) were 81%, 48.3%, 50.4%, and 48.4%, respectively. The multivariate analysis showed that the tumor involvement of cardia and low intensity of chemotherapy were independent adverse prognostic factors for DSS and OS. More advanced pT-stage and tumors with diffuse growth type according to Lauren were identified as negative independent prognostic factor for OS. They were also on the threshold of statistical significance for DSS. Conclusions. Postoperative radiochemotherapy for gastric carcinoma has acceptable toxicity, and is effective particularly in regard to LRC. High incidence of distant metastases calls for more effective systemic regimens.
Objavljeno v DiRROS: 08.03.2024; Ogledov: 279; Prenosov: 81
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Povzetek: Background. Lymphangioleiomyomatosis is a rare disease of unknown origin, which affects women in their reproductive period. It is characterised by non-neoplastic proliferation of atypical smooth muscle cells in the lung parenchyma, lymphatic vessels and mediastinal and abdominal lymph nodes. The most common presenting symptoms are spontaneous pneumothorax, dyspnea, hemoptysis and chylothorax. Conclusions. High-resolution computed tomography (HRCT) and open lung biopsy followed by the immunohistologic studies are two diagnostic procedures with which diagnosis can be confirmed. Various treatmentmodalities are applied, particularly hormonal therapy, though their efficacy remain unknown. The prognosis of patients is bad.
Objavljeno v DiRROS: 31.01.2024; Ogledov: 302; Prenosov: 50
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Ključne besede: rak analnega kanala, rak analnega roba, radiokemoterapija, obsevanje
Objavljeno v DiRROS: 15.12.2022; Ogledov: 777; Prenosov: 180
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Povzetek: Sodobno standardizirano zdravljenje lokalno napredovalega raka danke (LNRD) je sestavljeno iz predoperativne kemoradioterapije (KTRT), resekcije s totalno mezorektalno ekscizijo (TME) in pri izbranih bolnikih iz pooperativne kemoterapije (KT). S stopnjevanjem intenzivnosti predoperativnega zdravljenja je prišlo do občutnega porasta patoloških (pCR) in kliničnih popolnih odgovorov (cCR). Pri skrbno izbranih bolnikih s cCR je namesto operativnega zdravljenja možno tudi skrbno spremljanje (angl. Watch & Wait – pristop W&W). Preživetje bolnikov, ki so samo sledeni, ni nič slabše od preživetja operiranih, ob tem pa se izognemo s kirurškim zdravljenjem povezano smrtnostjo in pooperativnim zapletom. V Sloveniji je pristop W&W vključen v zadnja nacionalna priporočila za zdravljenje raka debelega črevesa in danke. Kljub številnim prednostim pristopa W&W še vedno ostaja tveganje za ponovitev in napredovanje bolezni s sistemskim razsojem. Za ugoden izid zdravljenja je ključna skrbna selekcija bolnikov. Težava je predvsem subjektivnost ocene cCR. V prispevku je opisan primer bolnika z LNRD, ki je bil zdravljen s predoperativno KTRT, po čemer je prišlo do cCR. Nato je bil obravnavan s pristopom W&W. Po dveh letih od začetka zdravljenja je prišlo do razsoja bolezni, zaradi česar je bolnik pozneje umrl.
Ključne besede: rak danke, neoperativni pristop, neoadjuvantna terapija
Objavljeno v DiRROS: 01.07.2022; Ogledov: 967; Prenosov: 298
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