1. Ocena pridobljenih let življenja v populacijskih presejalnih programih za rakaVesna Zadnik, Maja Pohar Perme, Tina Žagar, Bor Vratanar, Katja Jarm, Katarina Lokar, Maja Jurtela, Sonja Tomšič, 2024, professional article Abstract: Zaradi možnih negativnih zdravstvenih posledic presejalnih programov in velikih sredstev, vloženih vanje, je pomembno spremljati njihovo učinkovitost. Umrljivost v ciljni populaciji je eden od kazalnikov, ki služi za prikaz dolgoročne učinkovitosti organiziranih populacijskih presejalnih programov – po 10 do 20 letih se pričakuje padec umrljivosti v ciljni populaciji za 20 % do 30 %. Ena od glavnih omejitev kazalnika umrljivosti je, predvsem pri rakih z dobrim preživetjem, da pokaže učinkovitost presejanja šele v daljšem časovnem obdobju. Mnogokrat se zato za oceno učinkovitosti populacijskih presejalnih programov za raka uporablja analiza preživetja, pri kateri so rezultati dostopni prej. Tudi analiza preživetja ima svoje omejitve, saj se lahko v rezultate prikradejo številne pristranosti (npr. pristranost časa trajanja, prednosti in prediagnosticiranja). Nedavno smo slovenski raziskovalci predlagali nov analitični pristop, ki omogoča primerjavo preživetja pri rakih, ki so oz. niso odkriti v presejalnem programu, z upoštevanjem vseh pomembnih pristranosti. Izračunana preživetja so osnova za izračun pridobljenih let življenja, to je mere, ki izraža dodatno število let življenja, ki bi jih osebe preživele zaradi vključitve v presejalni program.V testnem primeru smo ocenili učinke uvedbe Državnega prese-jalnega program za raka dojk DOR A, ki smo ga prvim prebival-kam ponudili leta 2008, na celotno populacijo pa je bil razširjen leta 2018. Ženske, ki so bile povabljene v program DOR A v obdobju 2008–2018, so do leta 2022 pridobile skupaj 90,6 leta življenja, če bi bile v program DOR A že od leta 2008 vključene vse ženske, pa bi pridobile 552,7 leta življenja. Z vsakim dodatnim letom opazovanja, ko posamezne ženske od vključitve v program DOR A preživijo, se seštevek pridobljenih let življenja poveča.Nova metoda bo v pomoč pri upravljanju obstoječih presejalnih programov za raka, njihovi promociji in vrednotenju učinkov pri spremembah presejalnih politik.
Keywords: presejalni programi, kakovost, register raka
Published in DiRROS: 26.07.2024; Views: 11; Downloads: 3
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2. Long-term outcomes of high dose treatment and autologous stem cell transplantation in follicular and mantle cell lymphomas : a single centre experienceLučka Boltežar, Karlo Pintarić, Jože Pretnar, Maja Pohar Perme, Barbara Jezeršek Novaković, 2017, original scientific article Abstract: Background. Advanced follicular lymphoma (FL) and mantle cell lymphoma (MCL) are incurable diseases with conventional treatment. The high dose treatment (HDT) with autologous stem cell transplantation (ASCT), however, offers a certain proportion of these patients the prospect of a prolonged disease-free and overall survival. The aim of this study was to investigate the event free survival (EFS) and overall survival (OS) in patients with FL and MCL treated with ASCT. Patients and methods. Seventeen patients with FL and 29 patients with MCL were included, 15 of them were trans- planted to consolidate the response to second line treatment and 24 to consolidate their first remission, respectively. All were conditioned with total body irradiation (TBI) and high dose cyclophosphamide between 2006 and 2014 and all were transplanted with peripheral blood stem cells. Results. The estimated 5-year OS for FL was 87.8% (95% confidence interval [CI] 59.5%-96.8%) and for MCL 79.3% (95% CI 56.1%-91.1%), respectively. The estimated 5-year EFS for FL was 76.0% (95% CI 48.0%-90.3%) and for MCL 69.8% (95% CI 45.5%-84.8%), respectively. There were no secondary hematological malignancies observed in either group. Conclusions. Based on above results, the ASCT with TBI is a good treatment option in terms of long-term survival for patients with follicular and mantle cell lymphoma demonstrating a relatively low rate of late toxicities and secondary malignancies.
Keywords: follicular lymphoma, mantle cell lymphoma, autologous stem cell transplantation
Published in DiRROS: 03.06.2024; Views: 148; Downloads: 101
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3. Selection of non-small cell lung cancer patients for intercalated chemotherapy and tyrosine kinase inhibitorsMatjaž Zwitter, Antonio Rossi, Massimo Di Maio, Maja Pohar Perme, Gilberto Lopes, 2017, original scientific article Abstract: Background. When treating patients with advanced non-small cell lung cancer (NSCLC) with tyrosine kinase inhibitors and chemotherapy, intercalated schedule with time separation between the two classes of drugs should avoid their mutual antagonism. In a survey of published trials, we focus on relation between eligibility criteria and effectiveness of intercalated treatment. Methods. Published documents were identified using major medical databases, conference proceedings and references of published trials. Median progression-free survival (PFS) was taken as the basic parameter of treatment efficacy. Correlation between characteristics of patients and median PFS was assessed through the Pearson%s correlation coefficient and the coefficient of determination, separately for first-line and second-line setting. Results. The series includes 11 single-arm trials and 18 randomized phase II or phase III trials with a total of 2903 patients. Treatment-naive patients or those in progression after first-line treatment were included in 16 and 13 trials, respectively. In 14 trials, only patients with non-squamous histology were eligible. Proportion of patients with nonsquamous carcinoma (in first-line setting), proportion of never-smokers (both in first- and second-line setting) and proportion of epidermal growth factor receptor (EGFR) mutant patients (both in first- and second-line setting) showed a moderate or strong correlation with median PFS. In six trials of intercalated treatment applied to treatment-naive EGFR%mutant patients, objective response was confirmed in 83.1% of cases and median PFS was 18.6 months. Conclusions. Most suitable candidates for intercalated treatment are treatment-naive patients with EGFR%mutant tumors, as determined from biopsy or liquid biopsy. For these patients, experience with intercalated treatment is most promising and randomized trials with comparison to the best standard treatment are warranted.
Keywords: lung cancer, NSCLC, intercalated treatment, EGFR, tyrosine -kinase inhibitors
Published in DiRROS: 31.05.2024; Views: 180; Downloads: 129
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5. Pomen PIK3CA aktivirajočih mutacij za izid bolezni pri bolnicah z invazivnim lobularnim karcinomom dojke, zdravljenih z dopolnilno endokrino terapijoDomen Ribnikar, Valentina Jerič Horvat, Ivica Ratoša, Zachary Veitch, Biljana Grčar-Kuzmanov, Srdjan Novaković, Erik Langerholc, Maja Pohar Perme, Eitan Amir, Boštjan Šeruga, 2022, published professional conference contribution abstract Keywords: onkologija, rak dojke, kemoterapija
Published in DiRROS: 27.01.2023; Views: 587; Downloads: 147
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