1. Primerjalna analiza dveh pristopov obsevanja v okviru totalnega neoadjuvantnega zdravljenja pri visokorizičnem lokalno napredovalem raku dankeManuel Ramanović, Erik Brecelj, Franc Anderluh, Ana Jeromen, Peter Korošec, Irena Oblak, Ajra Šečerov Ermenc, Vaneja Velenik, 2026, original scientific article Abstract: zhodišča: Totalno neoadjuvantno zdravljenje (angl. total neoadjuvant therapy, TNT) je uveljavljen standard pri bolnikih z lokalno napredovalim rakom danke (LNRD; angl. locally advanced rectal cancer, LARC) z magnetnoresonančno (angl. magnetic resonance imaging, MRI) opredeljenimi dejavniki visokega tveganja. Kljub vse večji uporabi TNT pa optimalno zaporedje posameznih terapevtskih komponent ter dolgoročni izidi neoperativnega pristopa watch and wait (W&W) ostajajo nepopolno opredeljeni. Prav tako vpliv izbrane radioterapevtske tehnike na uspešnost zdravljenja, lokalno kontrolo bolezni in dol-goročne izide v vsakodnevni klinični praksi še ni jasno razmejen.Bolniki in metode: V primerjalno analizo sta bili vključeni dve zaporedni kohorti bolnikov z LNRD in vsaj enim MRI oprede-ljenim dejavnikom visokega tveganja, zdravljenih na Onkolo-škem inštitutu Ljubljana po institucionalnem »sendvič« TNT protokolu. Študijska populacija je obsegala bolnike zdravljenih s 3D konformno tehniko obsevanja (angl. three dimensional conformal radiotherapy, 3D CRT kohorta), in zdravljenih z intenzitetno moduliranim in volumetrično moduliranim ločnim obsevanjem s simultanim integriranim dodatkom doze (angl. intensity modulated radiotherapy / volumetric modulated arc therapy with simultaneous integrated boost, IMRT/VMAT SIB kohorta). Primarni opazovani izid je bil skupni popolni odgovor, opredeljen kot patohistološko popolni odgovor (angl. pathological complete response, pCR) in klinični popolni odgovor (angl. clinical complete response, cCR) ob vključitvi v skrbno spremljanje po strategiji W&W. Sekundarni izidi so bili pCR, večji patološki odgovor (MPR; angl. major pathological response, MPR), delež R0 resekcij, znižanje stadija, lokalna ponovitev, preživetje brez bolezni (PBB; angl. disease free survival, DFS) in celokupno preživetje (CP; angl. overall survival, OS). Za primarni in ključne sekundarne izide smo izvedli neprilagojene formalne primerjave deležev ter eksploratorne prilagojene analize s Firthovo logistič-no regresijo, za CP do 36 mesecev smo izvedli še uteženi Coxov model.Rezultati: Skupno je bilo vključenih 240 bolnikov, 35 v 3D CRT kohorti in 205 v IMRT/VMAT SIB kohorti. Skupni popolni odgovor je bil v 3D CRT kohorti dosežen pri 14,3% bolnikov, v IMRT/VMAT SIB kohorti pa pri 29,5% bolnikov, pCR pri 9,4% bolnikov v 3D CRT kohorti in pri 19,3% v IMRT/VMAT SIB kohorti, MPR pa pri 30,8% v 3D CRT kohorti oziroma 37,6% bolnikov v IMRT/VMAT SIB kohorti. R0 resekcijo smo beležili pri vseh operiranih bolnikih v 3D CRT kohorti ter pri 94,5% operiranih bolnikov v IMRT/VMAT SIB kohorti. V Firthovem modelu je bil za IMRT/VMAT-SIB nakazan trend k višjemu ONKOLOGIJA | ISSN 1408-1741 | IZVIRNI ZNANSTVENI ČLANEK | LETO XXX | ŠT. 1 | JUNIJ 2026 | 45 skupnemu popolnemu odgovoru (OR 2,39; 95 % CI 0,95 – 7,08; p = 0,064), medtem ko pri pCR statistično značilnega učinka nismo potrdili (OR 2,20; 95 % CI 0,73–8,75; p = 0,171).Zaključki: Obe radioterapevtski tehniki omogočata izvedljivo in onkološko učinkovito izvajanje institucionalnega »sendvič« TNT protokola pri bolnikih z MRI opredeljenimi dejavniki visokega tveganja. V naši enoinstitucionalni izkušnji so bili v IMRT/VMAT-SIB kohorti doseženi numerično ugodnejši lokalni odzivni izidi kot v 3D-CRT kohorti, vendar formalne primerjave teh razlik statistično niso potrdile. Zaradi retrospek-tivne zasnove, deloma prekrivajočih se zgodovinskih kohort in omejenega števila dogodkov dokončnih sklepov o superiornosti ene tehnike ni mogoče podati.
Keywords: lokalno napredovali rak danke, totalno neoadjuvantno zdravljenje, radiokemoterapija
Published in DiRROS: 30.07.2026; Views: 150; Downloads: 54
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2. Prognostic factors for overall survival and safety of trans-arterial chemoembolization (TACE) with irinotecan-loaded drug-eluting beads (DEBIRI) in patients with colorectal liver metastasesMaja Šljivić, Maša Sever, Janja Ocvirk, Tanja Mesti, Erik Brecelj, Peter Popović, 2024, original scientific article Abstract: Transarterial chemoembolisation with irinotecan-loaded drug-eluting beads (DEBIRI TACE) can be considered in patients with unresectable colorectal cancer liver metastases (CRLM) who progress after all approved standard therapies or in patients unsuitable for systemic therapy. Patients and methods Between September 2010 and March 2020, thirty patients (22 men and 8 women; mean age 66.8 ± 13.2) were included in this retrospective study. DEBIRI TACE was conducted in 43% of patients unsuitable for systemic therapy as a first-line treatment and 57% as salvage therapy after the progression of systemic therapy. All the patients had liver-limited disease. In the case of unilobar disease, two treatments were performed at four-week intervals, and in the case of bilobar disease, four treatments were performed at two-week intervals. All patients were premedicated and monitored after the procedure. Adverse events were graded according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system for complications. Results The median overall survival (OS) from the beginning of DEBIRI TACE in the salvage group was 17.4 months; in the group without prior systemic therapy, it was 21.6 months. The median overall survival of all patients was 17.4 months (95% confidence interval [CI]: 10.0–24.7 months), and progression-free survival (PFS) was 4.2 months (95% CI: 0.9–7.4 months). The one-year survival rate after the procedure was 61%, and the two-year rate was 25%. Univariate analysis showed better survival of patients with four or fewer liver metastases (p = 0.002). There were no treatment-related deaths or grade 4 and 5 adverse events. Nonserious adverse events (Grades 1 and 2) were present in 53% of patients, and Grade 3 adverse events were present in 6% of the patients. Conclusions DEBIRI TACE is a well-tolerated treatment option for patients with liver metastases of colorectal cancer. Patients with four or fewer liver metastases correlated with better survival.
Keywords: colorectal cancer, liver metastases, irinotecan
Published in DiRROS: 26.06.2026; Views: 179; Downloads: 89
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3. The influence of periodontal disease and periodontal treatment on colorectal cancerUrša Potočnik, Erik Brecelj, Rok Schara, 2025, original scientific article Abstract: Background: Periodontal disease (PD) is associated with more than 50 diseases and conditions, including colorectal cancer. The study aimed to investigate if periodontal treatment influences the blood levels of C-reactive protein (CRP) in colorectal cancer patients. In addition, the aim was to isolate periodontal pathogenic bacteria Fusobacterium nucleatum (FN) and Porphyromonas gingivalis (PG), which are most linked to colorectal cancer (CRC), from the mucosa of the cancer-affected intestine. Patients and methods: To assess the effect of periodontal treatment on colorectal cancer, we measured the CRP levels in the blood during cancer therapy on the day of the initial examination by the oncological surgeon, two days following surgery, and at the first follow-up appointment. We compared the CRP levels between two groups: the group of subjects who underwent periodontal treatment and the patients who did not receive periodontal disease treatment. An attempt was made to isolate the periodontal pathogenic bacteria FN and PG from the mucosa of the cancerous tissue in the colon by using quantitative culture. Results We found no statistically significant difference between the groups in the initial CRP measurements before starting cancer treatment. There was no statistically significant difference between the groups in the CRP measurements taken 1st and 2nd day after surgery and at the follow-up appointment. We could not isolate periodontal pathogenic bacteria FN and PG from cancer-altered intestine mucosa using the quantitative culture method. Conclusions Our study did not find any correlation between periodontal treatment and CRC.
Keywords: periodontal disease, colorectal cancer, periodontal treatment, fusobacterium nucleatum, porphyromonas gingivalis, C-reactive protein
Published in DiRROS: 11.02.2026; Views: 638; Downloads: 325
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4. Smernice za zdravljenje bolnikov z rakom požiralnika in ezofagogastričnega stikaErik Brecelj, Franc Anderluh, Marko Boc, Goran Gačevski, Gorana Gašljević, Samo Horvat, Nežka Hribernik, Marija Ignjatović, Ana Jeromen, Jera Jeruc, 2022, professional article Keywords: rak požiralnika, smernice, onkologija
Published in DiRROS: 22.01.2026; Views: 1967; Downloads: 230
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6. 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: 990; Downloads: 397
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7. Phase angle as a prognostic indicator of surgical outcomes in patients with gastrointestinal cancerJana Gulin, Ester Ipavic, Denis Mlakar-Mastnak, Erik Brecelj, Ibrahim Edhemović, Nada Rotovnik-Kozjek, 2023, original scientific article Keywords: phase angle, colorectal cancer, postoperative complications, malnutrition
Published in DiRROS: 26.07.2024; Views: 1821; Downloads: 464
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8. Radiological findings of porcine liver after electrochemotherapy with bleomycinMaja Brložnik, Nina Boc, Gregor Serša, Jan Žmuc, Gorana Gašljević, Alenka Seliškar, Rok Dežman, Ibrahim Edhemović, Nina Milevoj, Tanja Plavec, Vladimira Erjavec, Darja Pavlin, Maša Omerzel, Erik Brecelj, Urša Lampreht Tratar, Bor Kos, Jani Izlakar, Marina Štukelj, Damijan Miklavčič, Maja Čemažar, 2019, original scientific article Published in DiRROS: 05.07.2024; Views: 1461; Downloads: 781
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9. Total neoadjuvant treatment of locally advanced rectal cancer with high risk factors in SloveniaMojca Tuta, Nina Boc, Erik Brecelj, Mirko Omejc, Franc Anderluh, Ajra Šečerov Ermenc, Ana Jeromen, Irena Oblak, Bojan Krebs, Vaneja Velenik, 2019, original scientific article Keywords: total neoadjuvant treatment, radiochemotherapy, rectal cancer
Published in DiRROS: 05.07.2024; Views: 1471; Downloads: 529
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10. Ultrasonographic changes in the liver tumors as indicators of adequate tumor coverage with electric field for effective electrochemotherapyNina Boc, Ibrahim Edhemović, Bor Kos, Maja Marolt-Mušič, Erik Brecelj, Blaž Trotovšek, Maša Omerzel, Mihajlo Djokić, Damijan Miklavčič, Maja Čemažar, Gregor Serša, 2018, original scientific article Abstract: The aim of the study was to characterize ultrasonographic (US) findings during and after electrochemotherapy of liver tumors to determine the actual ablation zone and to verify the coverage of the treated tumor with a sufficiently strong electric field for effective electrochemotherapy. Patients and methods. US findings from two representative patients that describe immediate and delayed tumor changes after electrochemotherapy of colorectal liver metastases are presented. Results. The US findings were interrelated with magnetic resonance imaging (MRI). Electrochemotherapy-treated tumors were exposed to electric pulses based on computational treatment planning. The US findings indicate immediate appearance of hyperechogenic microbubbles along the electrode tracks. Within minutes, the tumors became evenly hyperechogenic, and simultaneously, an oedematous rim was formed presenting as a hypoechogenic formation which persisted for several hours after treatment. The US findings overlapped with computed electric field distribution in the treated tissue, indicating adequate coverage of tumors with sufficiently strong electric field, which may predict an effective treatment outcome. Conclusions. US provides a tool for assessment of appropriate electrode insertion for intraoperative electrochemotherapy of liver tumors and assessment of the appropriate coverage of a tumor with a sufficiently strong electric field and can serve as predictor of the response of tumors.
Keywords: elctrochemotherapy, ultrasound, treatment plan, liver
Published in DiRROS: 11.06.2024; Views: 1538; Downloads: 524
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