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Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer : single center experience
Janja Ocvirk, Maja Ebert Moltara, Tanja Mesti, Marko Boc, Martina Reberšek, Neva Volk, Jernej Benedik, Zvezdana Hlebanja, 2016, izvirni znanstveni članek

Povzetek: Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients% register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer. Patients and methods. The registry of patients with mCRC was designed to prospectively evaluate the safety and efficacy of bevacizumab-containing chemotherapy as well as selection of patients in routine clinical practice. Patient baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected, evaluated and compared according to the age categories. Results. Between January 2008 and December 2010, 210 patients with mCRC (median age 63, male 61.4%) started bevacizumab-containing therapy in the 1st line setting. Majority of the 210 patients received irinotecan-based chemotherapy (68%) as 1st line treatment and 105 patients (50%) received bevacizumab maintenance therapy. Elderly (% 70 years) patients presented 22.9% of all patients and they had worse performance status (PS 1/2, 62.4%) than patients in < 70 years group (PS 1/2, 35.8%). Difference in disease control rate was mainly due to inability to assess response in elderly group (64.6% in elderly and 77.8% in < 70 years group, p = 0.066). The median progression free survival was 10.2 (95% CI, 6.7%16.2) and 11.3 (95% CI, 10.2%12.6) months in elderly and < 70 years group, respectively (p = 0.58). The median overall survival was 18.5 (95% CI, 12.4%28.9) and 27.4 (95% CI, 22.7%31.9) months for elderly and < 70 years group, respectively (p = 0.03). Three-year survival rate was 26% and 37.6% in elderly vs. < 70 years group (p = 0.03). Overall rates of bevacizumab-related adverse events were similar in both groups: proteinuria 21/22 %, hypertension 25/19 %, haemorrhage 2/4 % and thromboembolic events 10/6 %, for elderly and < 70 years group, respectively. Conclusions. In routine clinical practice, the combination of bevacizumab and chemotherapy is effective and welltolerated regimen in elderly patients with metastatic colorectal cancer.
Ključne besede: metastatic colorectal cancer, bevacizumab, chemotherapy, elderly
Objavljeno v DiRROS: 30.04.2024; Ogledov: 50; Prenosov: 6
.pdf Celotno besedilo (620,74 KB)

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Effectiveness of electrochemotherapy after IFN-[alpha] adjuvant therapy of melanoma patients
Andrejc Hribernik, Maja Čemažar, Gregor Serša, Maša Omerzel, Marko Snoj, 2016, izvirni znanstveni članek

Povzetek: The combination of electrochemotherapy with immuno-modulatory treatments has already been explored and proven effective. However, the role of interferon alpha (IFN-alpha) adjuvant therapy of melanoma patients and implication on electrochemotherapy effectiveness has not been explored yet. Therefore, the aim of the study was to retrospectively evaluate the effectiveness and safety of electrochemotherapy after the previous adjuvant treatment with IFN-alpha in melanoma patients. Patients and methods. The study was a retrospective single-center observational analysis of the patients with advanced melanoma, treated with electrochemotherapy after previous IFN-alpha adjuvant therapy. Five patients, treated between January 2008 and December 2014, were included into the study, regardless of the time point of IFN-alpha adjuvant therapy. Results. Electrochemotherapy of recurrent melanoma after the IFN-alpha adjuvant therapy proved to be a safe and effective treatment. Patients with one or two metastases responded completely. Among patients with multiple metastases, there was a variable response rate. In one patient all 23 metastases responded completely, in second patient more than 85% of all together 80 metastases responded completely and in third patient all 5 metastases had partial response. Taking into account all metastases from all patients together there was an 85% complete response rate. Conclusions. The study showed that electrochemotherapy of recurrent melanoma after the IFN-alpha adjuvant therapy is a safe and effective treatment modality, which results in a high complete response rate, not only in single metastasis, but also in multiple metastases. The high complete response rate might be due to an IFN-alpha immune-editing effect, however, further studies with a larger number of patients are needed to support this presumption.
Ključne besede: electrochemotherapy, IFN-alpha, melanoma
Objavljeno v DiRROS: 30.04.2024; Ogledov: 35; Prenosov: 6
.pdf Celotno besedilo (898,63 KB)

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Revealing subtle active tectonic deformation: integrating lidar, photogrammetry, field mapping, and geophysical surveys to assess the Late Quaternary activity of the Sava Fault (Southern Alps, Slovenia)
Petra Jamšek Rupnik, Jure Atanackov, Barbara Horn, Branko Mušič, Marjana Zajc, Christoph Grützner, Kamil Ustaszewski, Sumiko Tsukamoto, Matevž Novak, Blaž Milanič, Anže Markelj, Kristina Ivančič, Ana Novak, Jernej Jež, Manja Žebre, Miloš Bavec, Marko Vrabec, 2024, izvirni znanstveni članek

Povzetek: We applied an interdisciplinary approach to analyze the late Quaternary activity of the Sava Fault in the Slovenian Southern Alps. The Sava Fault is an active strike-slip fault, and part of the Periadriatic Fault System that accommodated the convergence of Adria and Europe. It is one of the longest faults in the Southern Alps. Using high-resolution digital elevation models from lidar and photogrammetric surveys, we were able to overcome the challenges of assessing fault activity in a region with intense surface processes, dense vegetation, and relatively low fault slip rates. By integrating remote sensing analysis, geomorphological mapping, structural geological investigations, and near-surface geophysics (electrical resistivity tomography and ground penetrating radar), we were able to find subtle geomorphological indicators, detect near-surface deformation, and show distributed surface deformation and a complex fault pattern. Using optically stimulated luminescence dating, we tentatively estimated a slip rate of 1.8 ± 0.4 mm/a for the last 27 ka, which exceeds previous estimates and suggests temporal variability in fault behavior. Our study highlights the importance of modern high-resolution remote sensing techniques and interdisciplinary approaches in detecting tectonic deformation in relatively low-strain rate environments with intense surface processes. We show that slip rates can vary significantly depending on the studied time window. This is a critical piece of information since slip rates are a key input parameter for seismic hazard studies.
Ključne besede: active fault, lidar, photogrammetry, tectonic geomorphology, structural geology, geophysics, electrical resistivity tomography, ground penetrating radar, slip rate, Sava Fault
Objavljeno v DiRROS: 30.04.2024; Ogledov: 37; Prenosov: 6
.pdf Celotno besedilo (53,23 MB)

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Treatment of tongue cavernous haemangioma with direct puncture and sclerotization with ethanol
Tomaž Šeruga, Jernej Lučev, Marko Jevšek, 2015, strokovni članek

Povzetek: Background. Haemangiomas of tongue are rare type of malformations. They can be treated mostly conservatively but in some cases they need more aggressive treatment with preoperative intra arterial embolization and surgical resection. Lesions of tongue that are localized superficially can also be treated with direct puncture and injection of sclerosing agent (absolute ethanol). Case report. We present a case of a 48 years old female patient, where we performed embolization of cavernous haemangioma with mixture of absolute ethanol and oil contrast. After the procedure the patient received analgetics and antioedematous therapy. After the sclerotization the planed surgery was abandoned. Control MRI examinations 6 and 12 months after the procedure showed only a small remnant of haemangioma and no signs of a larger relapse. Conclusion. In our case the direct puncture of haemangioma and sclerotherapy with ethanol proved to be a safe and effective method to achieve preoperative devascularization of the lesion. Direct puncture of the lesion is not limited by the anatomy of the vessels or vasospasm, which can occur during the intra-arterial approach.
Objavljeno v DiRROS: 23.04.2024; Ogledov: 51; Prenosov: 30
.pdf Celotno besedilo (736,73 KB)
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Thyroid lesions incidentally detected by [sup] 18F-FDG PET-CT : a two centre retrospective study
Jan Jamšek, Ivana Žagar, Simona Gaberšček, Marko Grmek, 2015, izvirni znanstveni članek

Povzetek: Incidental 18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax) is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions. We retrospectively evaluated 18F-FDG PET-CT examinations of 5,911 patients performed at two different medical centres from 2010 to 2011. If pathologically increased activity was accidentally detected in the thyroid, the SUVmax of the thyroid lesion was calculated. Patients with incidental 18F-FDG uptake in the thyroid were instructed to visit a thyroidologist, who performed further investigation including fine needle aspiration cytology (FNAC) if needed. Lesions deemed suspicious after FNAC were referred for surgery. Incidental 18F-FDG uptake in the thyroid was found in 3.89% - in 230 out of 5,911 patients investigated on PET-CT. Malignant thyroid lesions (represented with focal thyroid uptake) were detected in 10 of 66 patients (in 15.2%). In the first medical centre the SUVmax of 36 benign lesions was 5.6 +- 2.8 compared to 15.8 +- 9.2 of 5 malignant lesions (p < 0.001). In the second centre the SUVmax of 20 benign lesions was 3.7 +- 2.2 compared to 5.1 +- 2.3 of 5 malignant lesions (p = 0.217). All 29 further investigated diffuse thyroid lesions were benign. Incidental 18F-FDG uptake in the thyroid was found in 3.89% of patients who had a PET-CT examination. Only focal thyroid uptake represented a malignant lesion in our study - in 15.2% of all focal thyroid lesions. SUVmax should only serve as one of several parameters that alert the clinician on the possibility of thyroid malignancy.
Ključne besede: thyroid cancer, PET incidentaloma, PET-CT
Objavljeno v DiRROS: 22.04.2024; Ogledov: 53; Prenosov: 18
.pdf Celotno besedilo (654,61 KB)

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Bevacizumab and irinotecan in recurrent malignant glioma, a single institution experience
Tanja Mesti, Maja Ebert Moltara, Marko Boc, Martina Reberšek, Janja Ocvirk, 2015, izvirni znanstveni članek

Povzetek: Treatment options of recurrent malignant gliomas are very limited and with a poor survival benefit. The results from phase II trials suggest that the combination of bevacizumab and irinotecan is beneficial. Patients and methods. The medical documentation of 19 adult patients with recurrent malignant gliomas was retrospectively reviewed. All patients received bevacizumab (10 mg/kg) and irinotecan (340 mg/m2 or 125 mg/m2) every two weeks. Patient clinical characteristics, drug toxicities, response rate, progression free survival (PFS) and overall survival (OS) were evaluated. Results. Between August 2008 and November 2011, 19 patients with recurrent malignant gliomas (median age 44.7, male 73.7%, WHO performance status 0%2) were treated with bevacizumab/irinotecan regimen. Thirteen patients had glioblastoma, 5 anaplastic astrocytoma and 1 anaplastic oligoastrocytoma. With exception of one patient, all patients had initially a standard therapy with primary resection followed by postoperative chemoradiotherapy. Radiological response was confirmed after 3 months in 9 patients (1 complete response, 8 partial responses), seven patients had stable disease and three patients have progressed. The median PFS was 6.8 months (95% confidence interval [CI]: 5.3-8.3) with six-month PFS rate 52.6%. The median OS was 7.7 months (95% CI: 6.6-8.7), while six-month and twelve-month survival rates were 68.4% and 31.6%, respectively. There were 16 cases of hematopoietic toxicity grade (G) 1-2. Non-hematopoietic toxicity was present in 14 cases, all G1-2, except for one patient with proteinuria G3. No grade 4 toxicities, no thromboembolic event and no intracranial hemorrhage were observed. Conclusions. In recurrent malignant gliomas combination of bevacizumab and irinotecan might be an active regimen with acceptable toxicity.
Ključne besede: recurrent malignant glioma, systemic therapy, bevacizumab
Objavljeno v DiRROS: 17.04.2024; Ogledov: 83; Prenosov: 19
.pdf Celotno besedilo (534,06 KB)

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