1. Obsevanje benignih bolezniIvica Ratoša, Blaž Grošelj, Boris Jančar, Uroš Smrdel, Jasna But-Hadžić, Helena Barbara Zobec Logar, 2024, pregledni znanstveni članek Povzetek: Cilja zdravljenja z obsevanjem benignih bolezni sta povrnitev funkcije in izboljšanje kakovosti življenja. Obsevanje benignih bolezni se običajno izvaja z nizko dnevno in celokupno obsevalno dozo. V primerjavi z dozo, ki se jo uporablja za zdravljenje malignih obolenj, je doza tukaj navadno precej nižja. S sodobnimi obsevalni-mi tehnikami, ki se uporabljajo v radioterapiji v zadnjem desetletju, je tveganje za poškodbe zdravega tkiva majhno. Z natančnim načrtovanjem obsevanja se žarki usmerijo na prizadeto območje, kar omogoča ohranitev zdravih tkiv. Obsevanje je tako varno in učinkovito, a je treba kljub temu vedno oceniti, kdaj je dobrobit obsevanja večja od morebitnih neželenih učinkov. Ključne besede: obsevanje, benigne bolezni, bolečina Objavljeno v DiRROS: 26.07.2024; Ogledov: 152; Prenosov: 100 Celotno besedilo (4,38 MB) |
2. Cognitive functioning in a cohort of high-grade glioma patientsAndreja Cirila Škufca Smrdel, Anja Podlesek, Marija Skoblar Vidmar, Jana Markovič, Jana Jereb, Manja Kuzma, Uroš Smrdel, 2023, izvirni znanstveni članek Povzetek: High grade gliomas are associated with cognitive problems. The aim of the study was to investigate cognitive functioning in a cohort of patients with high grade glioma, according to isocitrate dehydrogenase (IDH) and methyl guanine methyl transferase (MGMT) status and other clinical characteristics. The patients with the high-grade glioma treated in Slovenia in given period of time were included in study. Postoperatively they completed neuropsychological assessment consisting of Slovenian Verbal Learning Test, Slovenian Controlled Oral Word Association Test, Trail Making Test Part A and B and self-evaluation questionnaire. We analysed results (z-scores and dichotomized results) also according to IDH mutation and MGMT methylation. We examined differences between groups using T-test, Mann-Whitney U, χ2 and Kendall's Tau tests. Out of 275 patients in the cohort, we included 90. Forty-six percent of patients were unable to participate due to poor performance status and other conditions related to tumour. Patients with the IDH mutation were younger, with better performance status, larger proportions of grade III tumours and MGMT methylation. In this group cognitive functioning is significantly better in the domains of immediate recall, short delayed recall and delayed recall, and in the fields of executive functioning and recognition. There were no differences in cognitive functioning in regard to MGMT status. Grade III tumours were associated with more frequent MGMT methylation. Self-assessment proved week tool, associated only with immediate recall. We found no differences in cognitive functioning according to MGMT status, but cognition was better when IDH mutation was present. In a cohort study of patients with high-grade glioma, almost half were unable to participate in a study, which points to an overrepresentation of patients with better cognitive functioning in the research. Ključne besede: cognition, high grade glioma, IDH1 mutation Objavljeno v DiRROS: 25.07.2024; Ogledov: 127; Prenosov: 48 Celotno besedilo (649,88 KB) |
3. |
4. Long-term survival in glioblastoma : methyl guanine methyl transferase (MGMT) promoter methylation as independent favourable prognostic factorUroš Smrdel, Mara Popović, Matjaž Zwitter, Emanuela Boštjančič, Andrej Zupan, Viljem Kovač, Damjan Glavač, Drago Bokal, Janja Jerebic, 2016, izvirni znanstveni članek Povzetek: In spite of significant improvement after multi-modality treatment, prognosis of most patients with glioblastoma remains poor. Standard clinical prognostic factors (age, gender, extent of surgery and performance status) do not clearly predict long-term survival. The aim of this case-control study was to evaluate immuno-histochemical and genetic characteristics of the tumour as additional prognostic factors in glioblastoma. Long-term survivor group were 40 patients with glioblastoma with survival longer than 30 months. Control group were 40 patients with shorter survival and matched to the long-term survivor group according to the clinical prognostic factors. All patients underwent multimodality treatment with surgery, postoperative conformal radiotherapy and temozolomide during and after radiotherapy. Biopsy samples were tested for the methylation of MGMT promoter (with methylation specific polymerase chain reaction), IDH1 (with immunohistochemistry), IDH2, CDKN2A and CDKN2B (with multiplex ligation-dependent probe amplification), and 1p and 19q mutations (with fluorescent in situ hybridization). Methylation of MGMT promoter was found in 95% and in 36% in the long-term survivor and control groups, respectively (p < 0.001). IDH1 R132H mutated patients had a non-significant lower risk of dying from glioblastoma (p= 0.437), in comparison to patients without this mutation. Other mutations were rare, with no significant difference between the two groups. Molecular and genetic testing offers additional prognostic and predictive information for patients with glioblastoma. The most important finding of our analysis is that in the absence of MGMT promoter methylation, longterm survival is very rare. For patients without this mutation, alternative treatments should be explored. Ključne besede: glioblastoma, long-term survival, methyl guanine methyl transferase, MGMT, prognostic factor Objavljeno v DiRROS: 30.04.2024; Ogledov: 257; Prenosov: 255 Celotno besedilo (530,79 KB) Gradivo ima več datotek! Več... |
5. Glioblastoma patients in Slovenia from 1997 to 2008Uroš Smrdel, Viljem Kovač, Mara Popović, Matjaž Zwitter, 2014, izvirni znanstveni članek Povzetek: Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods. All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results. From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis. Ključne besede: glioblastoma, treatment, survival, surgery, radiotherapy, termozolomide Objavljeno v DiRROS: 11.04.2024; Ogledov: 516; Prenosov: 442 Celotno besedilo (423,05 KB) Gradivo ima več datotek! Več... |
6. Genetic markers in oligodendroglial tumoursTomaž Velnar, Uroš Smrdel, Mara Popović, Gorazd Bunc, 2010, pregledni znanstveni članek Povzetek: Background. Oliogodendrogliomas are brain tumours composed of the cells resembling oligodendrocytes. They represent the third most common glial tumour, comprising 2.5% of all primary brain tumours and 5-20% of all gliomas. Conclusions. Oligodendroglial tumours with 1p and 19q loss demonstrate a better overall prognosis due to more indolent clinical behaviour and higher sensitivity to treatment. Additionally, 1p and 19q loss is a marker of clinical utility, helping to assess tumour sensitivity to chemotherapy and harbouring the potential for improving the diagnosis and survival of oligodendroglioma patients as well as future clinical practice. Objavljeno v DiRROS: 15.03.2024; Ogledov: 298; Prenosov: 95 Celotno besedilo (616,34 KB) |
7. |
8. Brain metastases in lung cancer : impact of prognostic factors on patient survivalUroš Smrdel, Matjaž Zwitter, Viljem Kovač, 2003, izvirni znanstveni članek Povzetek: Background. Brain metastases are common patterns of dissemination in lung cancer patients. In this paper we would like to assess the pattern of brain metastases in lung cancer patients and the impact of prognostic factors on thesurvival of lung cancer patients with brain metastases. Patients and methods. In the year 1998 there were 974 registered patients with lung cancer in Slovenia, six hundred and fifteen of them were treated at the Institute of Oncology Ljubljana and we analyzed them. Among 615 patients 137 (22.3%) of them have had brain metastases during a natural course of disease. Results. For 12 patients presenting with solitary brain metastases (most of them were undertaken metastaseetomy) median survival was 7.6 months, while in patients with multiple brain metastases the median survival was 2.8 months (p = 0.0018). Of the 137 patients 45 (32.8%) were small cell lung cancer patients, 43 (31.4%) were adenocarcinoma patients and 19 (13.9%) were squamous cell carcinoma patients. Patients with performance status (WHO scale) less than 2 had the median survival time 3.7 months while patients with performance status2 or more had median survival time 2.7 moths (p=0.0448). Conclusions. Patients with solitary brain metastases had better survival comparing with those who had multiple metastases. It is surprisingly that the portion of brain metastases patients with adenocarcinoma is almost equal to those with small-call lung cancer therefore, the prophylactic cranial radiation becomes actual for both groups of patients. The performance status of patients with brain metastases remains very important prognostic factor. Objavljeno v DiRROS: 06.02.2024; Ogledov: 309; Prenosov: 80 Celotno besedilo (98,88 KB) |
9. Radiokirurgija možganskih zasevkov pri melanomuUroš Smrdel, 2023, objavljeni znanstveni prispevek na konferenci Povzetek: Melanom spada med tumorje, ki najpogosteje dajejo možganske zasevke. Sicer ne v absolutnem številu temveč relativno. Poleg simtomatskega zdravljenja, operacije, obsevanja celih možganov in sistemske terapije je ena od možnosti zdravljenja možganskih zasevkov tudi radiokirurgija. Radiokirurgija ni nova tehnika, jo je pa napredek tehnologije popeljal na nov nivo. Gre pri radiokirurgiji za neinvaziven poseg in so komplikacije zapleti zdravljenja bistvpomembnoeno nižjie kot pri operativnem zdravljenju. Pri zdravljenju z radiokirurgijo je pomembno to, da je zdravljenje zelo lokalno. Zaradi tega lahko bolnike zdravimo z radiokirurgijo tudi večkrat. Vsekakor je radiokirurgija možganskih zasevkov melanoma še en majhen delec v sestavljanki kako kontrolirati bolezen in je prav zaradi tega posvet strokovnjakov več strok pomembnih pri onkološkem zdravljenju na multidisciplinarnem konziliju bistvenega pomena. Ključne besede: rak kože, melanom, radiokirurgija Objavljeno v DiRROS: 18.05.2023; Ogledov: 453; Prenosov: 209 Celotno besedilo (214,00 KB) Gradivo ima več datotek! Več... |
10. Priporočila za obravnavo bolnikov z malignimi limfomiBarbara Jezeršek Novaković, Lučka Boltežar, Andreja Eberl, Gorana Gašljević, Biljana Grčar-Kuzmanov, Monika Jagodic, Tanja Južnič Šetina, Veronika Kloboves-Prevodnik, Gregor Kos, Aleš Christian Mihelač, Milica Miljković, Urška Rugelj, Marija Skoblar Vidmar, Uroš Smrdel, Danijela Štrbac, Miha Toplak, Lorna Zadravec-Zaletel, 2023, strokovna monografija Ključne besede: maligni limfomi, smernice, novotvorbe Objavljeno v DiRROS: 24.01.2023; Ogledov: 937; Prenosov: 394 Celotno besedilo (971,73 KB) Gradivo ima več datotek! Več... |