1. Gender impact on quality of life in colorectal cancer survivorsAleksandra Grbič, Majda Čaušević, Sara Brodarič, Mojca Birk, Irena Oblak, 2025, original scientific article Abstract: The aim of the study was to evaluate gender-specific differences in the quality of life (QoL) and late effects among colorectal cancer patients during the first two years after treatment, to inform and improve long-term follow-up care and clinical management strategies. Patients and methods A total of 239 colorectal cancer patients were included, 56% males and 44% females, mostly in the age range 60–69 years. They were treated at the Institute of Oncology Ljubljana, during the time period from 1st September 2023 to 1st May 2024. In addition to demographic data, we included clinical data on disease and outcomes collected using the standardized quality of life questionnaires of European Organization for Research and Treatment of Cancer (EORTC) named EORTC QLQ-30 and EORTC QLQ-CR29 for colorectal cancer, respectively. Results Females were more likely to experience emotional problems (p = 0.002), higher levels of fatigue (p < 0.001), insomnia (p = 0.015), nausea and vomiting (p = 0.007), which may also be associated with poorer appetite in females. Males reported better body image than female (p = 0.047), lower levels of anxiety (p = 0.029), less frequently reported perceived weight loss or gain (p = 0.010). Male reported more stool frequency (p = 0.045), and also had more sever dysuria compared to female (p = 0.008). Conclusions The results provide the opportunity to improve the clinical management of long-term follow-up and care planning, taking into consideration the gender-specific needs of colorectal cancer survivors.
Keywords: quality of life, late effects, colorectal cancer
Published in DiRROS: 26.11.2025; Views: 931; Downloads: 141
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2. Kapecitabin med obsevanjem : bolnikov dnevnikJanja Ocvirk, Vaneja Velenik, Irena Oblak, Franc Anderluh, Jasna But-Hadžić, Ajra Šečerov Ermenc, Martina Reberšek, Marko Boc, Jernej Benedik, Zvezdana Hlebanja, Neva Volk, Tanja Mesti, 2014, not set Keywords: citostatiki, kapecitabin, bolniki, obsevanje
Published in DiRROS: 02.09.2025; Views: 517; Downloads: 195
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3. Priporočila za sistemsko onkološko in radioterapevtsko zdravljenje rakov biliarnega traktaErik Brecelj, Martina Reberšek, Ajra Šečerov Ermenc, Vesna Zadnik, Maja Ebert Moltara, Nežka Hribernik, Peter Korošec, Tanja Mesti, Janja Ocvirk, Franc Anderluh, Marko Boc, Marija Ignjatović, Ana Jeromen, Irena Oblak, Vaneja Velenik, Jelena Azarija, Neva Volk, Nena Golob, 2025, professional article Abstract: Raki biliarnega trakta so redka in heterogena skupina z naraščajočo incidenco in visoko umrljivostjo. Imajo slabo prognozo s celokupnim preživetjem manj od 1 leta. Nova dognanja o molekularno genetski heterogenosti rakov biliarnega trakta in novi terapevtskih pristopi omogočajo tem bolnikom daljša preživetja in boljšo kvaliteto življenja. V Priporočilih so predstavljena najnovejša priporočila za sistemsko onkološko zdravljenje in radioterapijo te skupine rakov, med katere po mednarodnih propročilih sedaj prištevamo karcinom žolčnika, intrahepatalne holangiokarcinome in ekstrahepatične holangiokarcinome, s perihilarnim holangiokarcinomom in karcinomom distalnega žolčevoda. Priporočila za sistemsko zdravljenje so povzeta in pripravljena na podlagi mednarodnih priporočil, ameriških, National Comprehensive Cancer Network (NCCN) in evropskih, Evropskega združenja za internistično onkologijo – European Society of Medical oncology (ESMO).
Keywords: raki biliarnega trakta, sistemsko zdravljenje, priporočila
Published in DiRROS: 18.07.2025; Views: 735; Downloads: 294
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4. Celostna obravnava bolnikov z rakom : uvedba vprašalnika PROMIrena Oblak, Majda Čaušević, Barbara Perić, Aleksandra Grbič, 2025, original scientific article Abstract: Napredki na področju diagnostike in zdravljenja raka pomembno prispevajo k boljšemu preživetju bolnikov z rakom, kljub temu pa se številni bolniki zaradi bolezni in zdravljenja soočajo z različnimi težavami in potrebami, ki jih onkološka obravnava ne zajema vedno. Ustrezno obvladovanje teh težav z zagotavljanjem celostne oskrbe je ključno za izboljšanje kakovosti življenja bolnikov z rakom. Da bi bolje razumeli doživljanje in izkušnje bolnikov z diagnozo, zdravljenjem in v fazi okrevanja, smo na začetku leta 2023 na Onkološkem inštitutu uvedli novo orodje za zbiranje informacij. Bolnike smo začeli izpraševati z mednarodno uveljavljenim vprašalnikom PROM (angl. Patient-Reported Outcome Measures), ki omogoča boljše razumevanje vpliva bolezni in zdravljenja na kakovost življenja. Prav tako nam omogoča boljšo prilagoditev oskrbe glede na individualne želje in potrebe bolnikov. Bolnike s hujšimi težavami usmerjamo na obravnavo k ustreznim strokovnjakom. Z uvedbo celostne obravnave in uporabe vprašalnikov PROM smo dosegli pomemben napredek pri obravnavi bolnikov z rakom. Ti vprašalniki bolnikom omogočajo, da poročajo o svojem zdravstvenem stanju in počutju, kar zdravstvenemu osebju pomaga hitreje prepoznati individualne težave in potrebe ter prilagoditi oskrbo.
Keywords: rak, celostna obravnava, uvedba PROM
Published in DiRROS: 18.07.2025; Views: 659; Downloads: 233
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8. Onkološko zdravstveno svetovanje na daljavoAleksandra Grbič, Dajana Glavan, Sara Brodarič, Irena Oblak, 2024, review article Abstract: Izhodišče: V začetku leta 2023 smo v okviru klicnega centra vzpostavili zdravstveno svetovanje z namenom opolnomočenja in podpore bolnikov ter njihovih bližnjih. V raziskavi smo analizirali pogostost in stopnjo pojavljanja simptomov, povezanih z boleznijo in zdravljenjem, z uporabo ocenjevalnega protokola in nadaljnjih napotitev glede na izraženost težav.
Metode: Izvedena je bila retrospektivna analiza telefonskih klicev na linijo zdravstvenega svetovanja v klicnem centru od 1. 10. 2023 do 31. 1. 2024. Za zbiranje podatkov o klicateljih je bilo potrjeno in uporabljeno ocenjevalno orodje v podatkovni bazi Redcap. Za izračun odstotnih deležev smo uporabili program Microsoft® Excel® for Office 365 in opisno statistiko.
Rezultati: Vzorec je vključeval 144 telefonskih klicev, kar je predstavljalo 60 % telefonskih klicev bolnikov in 39 % klicev bol-nikovih bližnjih. Vzrok telefonskih klicev je bil v 60,4 % posledica neželenih učinkov sistemskega zdravljenja, ki so bili najpogostejši do tedna dni od prejetja zadnjega zdravljenja. V analizi telefon-skih klicev so bili najpogosteje izraženi simptomi bolečina (10 %), slabost (10 %), izguba apetita (7 %), driska (7 %). Na podlagi tega je bilo izvedenih 144 zdravstvenih svetovanj, 87 napotitev na osebnega zdravnika ali lečečega onkologa in 14 napotitev na nujno medicinsko pomoč.
Zaključek: Zdravstveno svetovanje na daljavo je treba uporabiti kot priložnost za zagotavljanje dostopnosti do informacij in pravo-časne zdravstvene oskrbe prek informacijskih in telekomunikacij-skih sistemov, saj vpliva na spodbujanje samooskrbe, zmanjšanje števila hospitalizacij, znižanje stroškov zdravstvene oskrbe in nenazadnje na kakovost življenja onkoloških bolnikov.
Keywords: zdravstveno svetovanje, oddaljen dostop, ocenjevalni triažni protokol
Published in DiRROS: 26.07.2024; Views: 1266; Downloads: 1308
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9. Impact of the COVID-19 epidemic on cancer burden and cancer care in Slovenia : a follow-up studyTina Žagar, Sonja Tomšič, Vesna Zadnik, Nika Bric, Mojca Birk, Blaž Vurzer, Ana Mihor, Katarina Lokar, Irena Oblak, 2022, original scientific article Abstract: In Slovenia, cancer care services were exempt from government decrees for COVID-19 containment. Nevertheless, cancer control can be impacted also by access to other health services and changes in health-seeking behaviour. In this follow up study, we explored changes in cancer burden and cancer care beyond the first months after the onset of the COVID-19 epidemic.Materials and methods. We analysed routinely collected data for the period January 2019 through July 2022 from three sources: (1) pathohistological and clinical practice cancer notifications from two major cancer centres in Ljubljana and Maribor (source: Slovenian Cancer Registry); (2) referrals issued for oncological services (source: e-referral system); and (3) outpatient appointments and diagnostic imaging performed (source: administrative data of the Institute of Oncology Ljubljana – IOL). Additionally, changes in certain clinical and demographic characteristics in patients diagnosed and treated during the epidemic were analysed using the Hospital-Based Cancer Registry of the IOL (period 2015–2021).Results. After a drop in referrals to follow-up cancer appointments in April 2020, in June-August 2020, there was an increase in referrals, but it did not make-up for the drop in the first wave; the numbers in 2021 and 2022 were even lower than 2020. Referrals to first cancer care appointments and genetic testing and counselling increased in 2021 compared to 2019 and in 2022 increased further by more than a quarter. First and follow-up outpatient appointments and cancer diagnostic imaging at the IOL dropped after the onset of the epidemic in March 2020 but were as high as expected according to 2019 baseline already in 2021. Some deficits remain for follow-up outpatients’ appointments in surgical and radiotherapy departments. There were more CT, MRI and PET scans performed during the COVID-19 period than before. New cancer diagnoses dropped in all observed years 2020, 2021 and until July 2022 by 6%, 3% and 8%, respectively, varying substantially by cancer type. The largest drop was seen in the 50−64 age group (almost 14% in 2020 and 16% in 2021), while for patients older than 80 years, the numbers were above expected according to the 2015–2019 average (4% in 2020, 8% in 2021).Conclusions. Our results show a varying effect of COVID-19 epidemic in Slovenia for different types of cancers and at different stages on the patient care pathway – it is probably a mixture of changes in health-seeking behaviour and systemic changes due to modifications in healthcare organisation on account of COVID-19. A general drop in new cancer cases reflects disruptions in the pre-diagnostic phase and could have profound long-term consequences on cancer burden indicators.
Keywords: cancer, covid-19, delay in diagnosis
Published in DiRROS: 25.07.2024; Views: 1169; Downloads: 667
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10. Breast size and dose to cardiac substructures in adjuvant three-dimensional conformal radiotherapy compared to tangential intensity modulated radiotherapyIvica Ratoša, Aljaša Jenko, Željko Šljivić, Maja Pirnat, Irena Oblak, 2020, original scientific article Abstract: The aim of the study was to quantify planned doses to the heart and specific cardiac substructures in free-breathing adjuvant three-dimensional radiation therapy (3D-CRT) and tangential intensity modulated radiotherapy (t-IMRT) for left-sided node-negative breast cancer, and to assess the differences in planned doses to organs at risk according to patients% individual anatomy, including breast volume. Patients and methods. In the study, the whole heart and cardiac substructures were delineated for 60 patients using cardiac atlas. For each patient, 3D-CRT and t-IMRT plans were generated. The prescribed dose was 42.72 Gy in 16 fractions. Patients were divided into groups with small, medium, and large clinical target volume (CTV). Calculated dose distributions were compared amongst the two techniques and the three different groups of CTV. Results. Mean absorbed dose to the whole heart (MWHD) (1.9 vs. 2.1 Gy, P < 0.005), left anterior descending coronary artery mean dose (8.2 vs. 8.4 Gy, P < 0.005) and left ventricle (LV) mean dose (3.0 vs. 3.2, P < 0.005) were all significantly lower with 3D-CRT technique compared to t-IMRT. Apical (8.5 vs. 9.0, P < 0.005) and anterior LV walls (5.0 vs. 5.4 Gy, P < 0.005) received the highest mean dose (Dmean). MWHD and LV-Dmean increased with increasing CTV size regardless of the technique. Low MWHD values (< 2.5 Gy) were achieved in 44 (73.3%) and 41 (68.3%) patients for 3D-CRT and t-IMRT techniques, correspondingly. Conclusions. Our study confirms a considerable range of the planned doses within the heart for adjuvant 3D-CRT or t-IMRT in node-negative breast cancer. We observed differences in heart dosimetric metrics between the three groups of CTV size, regardless of the radiotherapy planning technique.
Keywords: breast cancer, radiotherapy, 3D-CRT
Published in DiRROS: 16.07.2024; Views: 1061; Downloads: 445
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