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Query: "author" (Marta Dremelj) .

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1.
Locoregional disease control after external beam radiotherapy in 91 patients with differentiated thyroid carcinoma and pT4 tumor stage : a single institution experience
Nikola Bešić, Marta Dremelj, Gašper Pilko, 2018, original scientific article

Abstract: Locoregional recurrence is common in patients with locally advanced differentiated thyroid carcinoma (DTC). Our aim was to find out the rate of locoregional control of the disease after external beam radiotherapy (EBRT) of the neck and mediastinum in patients with DTC and pT4 tumor. Patients and methods Altogether 91 patients (47 males, 44 females, median age 61 years) with DTC had EBRT of the neck and mediastinum as part of the multimodal treatment of pT4 tumor (63 cases pT4a, 28 cases pT4b) from the year 1973 to 2015. Data on clinical factors, histopathology and recurrence were collected. Disease-free, disease-specific and overall survival was calculated. Results Median tumor size was 5 cm (range 1%30 cm). Out of 91 patients, 23 had distant and 38 regional metastases. A total or near-total thyroidectomy, lobectomy, subtotal thyroidectomy and lymph node dissection was performed in 70%, 14%, 2% and 30% of cases, respectively. Thirteen percent of patients were not treated with surgery. All patients had EBRT and 39 had chemotherapy. Radioiodine (RAI) ablation of thyroid remnant and RAI therapy was applied in 90% and 40% of cases, respectively. Recurrence was diagnosed in 29/64 patients without a persistent disease: locoregional and distant in 16 and 13 cases, respectively. Five-year and ten-year disease-free survival rate was 64% and 48%, respectively. Conclusions The majority of patients with DTC and pT4 tumors who were treated with EBRT of the neck and mediastinum region as part of multimodal treatment have long-lasting locoregional control of the disease.
Keywords: thyroid carcinoma, radiotherapy, survival, pathology
Published in DiRROS: 11.06.2024; Views: 100; Downloads: 32
.pdf Full text (300,30 KB)

2.
Neoadjuvant chemotherapy in 13 patients with locally advanced poorly differentiated thyroid carcinoma based on Turin proposal : a single institution experience
Nikola Bešić, Marta Dremelj, Andreja A. Schwarzbartl-Pevec, Barbara Gazić, 2015, original scientific article

Abstract: There is a paradigm that chemotherapy is ineffective in thyroid carcinoma. The aim of our study was to find out whether neoadjuvant chemotherapy before thyroid surgery had an effect on the size of primary tumour in patients with poorly differentiated thyroid carcinoma (PDTC) based on Turin proposal. Patients and methods. Altogether, 13 patients (8 women, 5 men; median age 61 years) with PDTC based on Turin proposal were treated with neoadjuvant chemotherapy between 1986 and 2005. Tumour diameter was from 4.5 to 18 cm (median 9 cm). Regional and distant metastases were detected in 6 and 9 patients, respectively. Eight patients had pT4 tumour. Results. Altogether, 29 (range 1%5) cycles of chemotherapy were given. Tumour diameter decreased in all the patients and by more than 30% in 5 patients (= 38%). Two of these five patients had also preoperative external beam irradiation (EBRT). Total thyroidectomy, lobectomy and neck dissection were performed in 10, 3 and 5 cases, respectively. R0 and R1 resection was done in 5 and 8 cases, respectively. Eight patients had postoperative EBRT of the neck and upper mediastinum. The 5-year and 10-year cause-specific survival rates of patients were 66% and 20%, respectively. Conclusions. After neoadjuvant chemotherapy a partial tumour regression was observed in 38% of patients with PDTC based on Turin proposal.
Keywords: poorly differentiated thyroid carcinoma, neoadjuvant, chemotherapy, survival
Published in DiRROS: 22.04.2024; Views: 355; Downloads: 320
.pdf Full text (459,46 KB)

3.
Sledenje po končanem zdravljenju raka glave in vratu
Marta Dremelj, 2022, published professional conference contribution

Abstract: S sledenjem bolnikov po končanem zdravljenju raka glave in vratu želimo doseči čim boljšo rehabilitacijo bolnikov in dovolj zgodaj prepoznati morebitne ponovitve bolezni, ko je še mogoče učinkovito rešilno zdravljenje. Večina ponovitev bolezni se zgodi v prvih dveh letih po koncu zdravljenja, zato so v tem času kontrolni pregledi pogostejši, tako klinični pregled kot slikovne preiskave, kasneje pa so klinično pregledi redkejši, slikovne preiskave pa indicirane predvsem glede na klinično sliko oziroma specifično lego tumorja. Učinkovit sistem sledenja omogoča tudi prepoznavo posledic po končanem zdravljenju, kot so motnje požiranja, govora, sluha, zobozdravstvene težave in ustrezno ukrepanje, za dosego čim boljše rehabilitacije bolnikov. Incidenca pojavljanja metakronih rakov zgornjega aerodigestivnega trakta je po zdravljenju raka glave in vratu visoka predvsem pri bolnikih z anamnezo uživanja tobaka in alkohola, zato je v sklopu sledenja pomembno prepoznati tudi te in bolnikom pomagati pri opustitvi škodljivih navad.
Keywords: rak glave in vratu, sledenje bolnikom, onkološko zdravljenje
Published in DiRROS: 06.01.2023; Views: 500; Downloads: 123
.pdf Full text (84,54 KB)

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Priporočila za obravnavo bolnikov z rakom glave in vratu v Sloveniji
Primož Strojan, Aleksandar Aničin, Jelena Azarija, Saba Battelino, Bogdan Čizmarevič, Vojislav Didanovič, Tadej Dovšak, Marta Dremelj, Aleš Fidler, Matic Glavan, Cvetka Grašič-Kuhar, Aleš Grošelj, Andrej Kansky, Katarina Barbara Karner, Marko Kokalj, Matic Koren, Jana Krapež, Hojka Kuralt, Boštjan Lanišnik, Primož Levart, Jure Orel, Jošt Pavčič, Gaber Plavc, Luka Prodnik, Peter Pukl, Robert Šifrer, Matija Švagan, Jure Urbančič, Branko Zakotnik, Nina Zidar, Barbara Žumer, 2021, professional article

Abstract: Priporočila za obravnavo rakov glave in vratu (RGV) v Sloveniji sledijo priporočilom in usmeritvam, povzetim v publikaciji neprofitne mreže 30 vodilnih severnoameriških inštitucij za obravnavo raka, National Comprehensive Cancer Network,1 in hkrati upoštevajo obstoječe zmožnosti slovenskega zdravstvenega sistema. Smernice predstavljajo poenoteno mnenje vseh štirih najpomembnejših deležnikov na področju obravnave rakov glave in vratu v državi: Klinike za otorinolaringologijo in cervikofacialno kirurgijo, Kliničnega oddelka za maksilofacialno in oralno kirurgijo ter Stomatološke klinike UKC Ljubljana, Klinike za otorinolaringologijo, cervikalno in maksilofacialno kirurgijo UKC Maribor ter Onkološkega inštituta Ljubljana
Keywords: rak glave in vratu, zdravljenje, onkolško zdravljenje
Published in DiRROS: 11.06.2021; Views: 1755; Downloads: 410
.pdf Full text (258,88 KB)

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