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Ključne besede: algorithms, predictive models, machine learning
Objavljeno v DiRROS: 15.09.2023; Ogledov: 51; Prenosov: 36
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Povzetek: Zdravljenje s stereotaktično radioterapijo (SBRT) se je v zadnjih letih tudi pri oligometastatskem gastrointestinalnem raku izkazalo za eno izmed pomembnejših možnosti lokalnega ablativnega zdravljenja, ki izboljšuje tako lokalno kontrolo, preživetje brez bolezni, kot tudi celokupno preživetje. Ob tem pa se je stereotaktično obsevanje izkazalo za varno metodo. Glede na lokacijo zasevkov so najpogosteje obsevani zasevki v jetrih in pljučih. Zaradi višje radiorezistentence zasevkov je potrebna večja izsevana doza (BED ≥ 100 Gy). Za čim manj stranskih učinkov pa je potrebna uporaba sistemov, ki zmanjšujejo gibanje tarče in povečujejo natančnost obsevanja. Večina dokazov do sedaj sicer temelji na retrospektivnih analizah in manjših prospektivnih študijah faze I in II. Rezultati prospektivnih študij faze III pa nam bodo v prihodnosti potrdili kdaj in kateri pacienti bodo imeli od zdravljenja z obsevanjem največjo korist.
Ključne besede: gastrointestinalni rak, radioterapija, rak prebavil
Objavljeno v DiRROS: 13.01.2023; Ogledov: 246; Prenosov: 63
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Povzetek: 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.
Ključne besede: klasifikacija, oligometastatska bolezen, sistemsko zdravljenje, onkologija
Objavljeno v DiRROS: 06.12.2022; Ogledov: 271; Prenosov: 67
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Povzetek: Background: Worldwide, pollen of the weed mugwort (Artemisia vulgaris) is a major cause of severe respiratory allergy, with its major allergen, Art v 1, being the key pathogenic molecule for millions of patients. Humanized mice transgenic for a human T-cell receptor specific for the major Art v 1 T-cell epitope and the corresponding HLA have been made. Objective: We sought to characterize IgE epitopes of Art v 1–sensitized patients and humanized mice for molecular immunotherapy of mugwort allergy. Methods: Four overlapping peptides incorporating surface-exposed amino acids representing the full-length Art v 1 sequence were synthesized and used to search for IgE reactivity to sequential epitopes. For indirect mapping, peptide-specific rabbit antibodies were raised to block IgE against surface-exposed epitopes on folded Art v 1. IgE reactivity and basophil activation studies were performed in clinically defined mugwort-allergic patients. Secondary structure of recombinant (r) Art v 1 and peptides was determined by circular dichroism spectroscopy. Results: Mugwort-allergic patients and humanized mice sensitized by allergen inhalation showed IgE reactivity and/or basophil activation mainly to folded, complete Art v 1 but not to unfolded, sequential peptide epitopes. Blocking of allergic patients’ IgE with peptide-specific rabbit antisera identified a hitherto unknown major conformational IgE binding site in the C-terminal Art v 1 domain. Conclusions: Identification of the new major conformational IgE binding site on Art v 1, which can be blocked with IgG raised against non-IgE reactive Art v 1 peptides, is an important basis for the development of a hypoallergenic peptide vaccine for mugwort allergy.
Ključne besede: mugwort pollen allergy, IgE epitope, allergen-specific immunotherapy
Objavljeno v DiRROS: 31.08.2022; Ogledov: 313; Prenosov: 129
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Povzetek: The malignant pleural mesothelioma (MPM) response rate to chemotherapy is low. The identification of imaging biomarkers that could help guide the most effective therapy approach for individual patients is highly desirable. Our aim was to investigate the dynamic contrast-enhanced (DCE) MR parameters as predictors for progression-free (PFS) and overall survival (OS) in patients with MPM treated with cisplatin-based chemotherapy. Methods: Thirty-two consecutive patients with MPM were enrolled in this prospective study. Pretreatment and intratreatment DCE-MRI were scheduled in each patient. The DCE parameters were analyzed using the extended Tofts (ET) and the adiabatic approximation tissue homogeneity (AATH) model. Comparison analysis, logistic regression and ROC analysis were used to identify the predictors for the patient's outcome. Results: Patients with higher pretreatment ET and AATH-calculated Ktrans and ve values had longer OS (P≤.006). Patients with a more prominent reduction in ET-calculated Ktrans and kep values during the early phase of chemotherapy had longer PFS (P =.008). No parameter was identified to predict PFS. Pre-treatment ET-calculated Ktrans was found to be an independent predictive marker for longer OS (P=.02) demonstrating the most favourable discrimination performance compared to other DCE parameters with an estimated sensitivity of 89% and specificity of 78% (AUC 0.9, 95% CI 0.74-0.98, cut off > 0.08 min-1). Conclusions: In the present study, higher pre-treatment ET-calculated Ktrans values were associated with longer OS. The results suggest that DCE-MRI might provide additional information for identifying MPM patients that may respond to chemotherapy.
Ključne besede: cisplatin, magnetic resonance imaging, mesothelioma
Objavljeno v DiRROS: 06.04.2022; Ogledov: 740; Prenosov: 342
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