1. |
2. Sequencing of chemotherapy in total neoadjuvant treatment for rectal cancer does not predict radiation-induced lymphopeniaMiha Oražem, Vaneja Velenik, Alojz Ihan, 2025, original scientific article Abstract: Radiation-induced lymphopenia (RIL) is associated with an increased risk of death in solid tumors, including rectal cancer. The aim of this study was to determine whether the sequencing of chemotherapy in total neoadjuvant treatment (TNT) for rectal cancer predicts the development of RIL. Patients and methods We analyzed acute hematologic toxicity data from 53 patients who underwent TNT for locally or locoregionally advanced rectal cancer between July 2022 and April 2023. Twenty-eight patients received induction chemotherapy with capecitabine and oxaliplatin [CAPOX], and 25 received consolidation chemotherapy (6 cycles of CAPOX in both groups). The chemoradiation protocol consisted of Volumetric Modulated Arc Therapy with Simultaneous Integrated Boost Radiotherapy (VMAT-SIB RT) up to 48.4 Gy in 22 fractions, concomitantly with capecitabine twice a day (lat. bis in die, BID). The Mann-Whitney U test was performed to compare RIL between the two patient groups. Pelvic bone marrow was contoured as a non-limiting organ-at-risk to assess the received dose, and binary logistic regression was used to determine whether RIL depends on V5Gy~V42Gy or the planning target volume (PTV) size. Results Thirty-four patients (64.2%) developed RIL of any grade, which was not significantly associated with either the induction or consolidation chemotherapy TNT regimen (Wald = 3.159, p = 0.076). No significant differences were found in neutrophil counts or the neutrophil-to-lymphocyte ratio. In the logistic regression model predicting the likelihood of RIL, two variables were statistically significant: V10Gy (Wald = 4.366, p = 0.037) and V30Gy (Wald = 6.084, p = 0.014). These results indicate that V10Gy< 71% and V30Gy< 26.6% may reduce the likelihood of developing RIL. Conclusions In our study, the sequencing of chemotherapy in TNT for rectal cancer did not predict the development of RIL. However, the incidence of RIL may be reduced by applying RT dosimetric constraints to the pelvic bone marrow.
Keywords: radiation-induced lymphopenia, rectal cancer, total neoadjuvant treatment
Published in DiRROS: 26.11.2025; Views: 646; Downloads: 120
 Full text (508,29 KB) |
3. |
4. |
5. |
6. Obsevanje ginekoloških tumorjevBarbara Šegedin, Helena Barbara Zobec Logar, Manja Šešek, Ana Perpar, Blaž Grošelj, Miha Oražem, 2023, professional monograph Keywords: teleterapija, brahiterapija, prehrana, kemoterapija, stranski učinki
Published in DiRROS: 22.11.2023; Views: 2007; Downloads: 502
Full text (1,18 MB) |
7. |
8. |
9. Oligometastatski rakIvica Ratoša, Karmen Stanič, Tanja Ovčariček, Ajra Šečerov Ermenc, Janka Čarman, Blaž Grošelj, Staša Jelerčič, Peter Korošec, Manja Šešek, Marko Kokalj, Gaber Plavc, Miha Oražem, Helena Barbara Zobec Logar, 2022, review article Abstract: Oligometastatska bolezen (OMB) predstavlja vmesno stanje med lokalno napredovalo boleznijo in obsežnejšo metastatsko boleznijo. Zaenkrat ne poznamo specifičnih biomarkerjev, ki bi nam pomagali opredeliti bolnike z majhnim bremenom bolezni, zato diagnoza OMB temelji na slikovni diagnostiki. V zadnjih letih narašča zanimanje za optimizacijo zdravljenja OMB predvsem zaradi obetavnih rezultatov dodatka lokalnega k obstoječemu sistemskemu zdravljenju. S takšnim načinom zdravljenja se je prvič pokazala možnost doseganja dolgotrajnih zazdravitev ali redko celo ozdravitev teh bolnikov. Razlikovanje posameznih vrst OMB in njihovo enotno poimenovanje je pomembno zlasti v kliničnih raziskavah, saj nam omogoča medsebojno primerjavo rezultatov različnih raziskav.
Keywords: klasifikacija, oligometastatska bolezen, sistemsko zdravljenje, onkologija
Published in DiRROS: 06.12.2022; Views: 2099; Downloads: 608
Full text (246,61 KB) |
10. |
