Iskanje po repozitoriju

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Objavljeno v DiRROS: 12.06.2024; Ogledov: 54; Prenosov: 32
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Povzetek: The purpose of the study was to improve treatment efficacy for locally advanced rectal cancer (LARC) by shifting half of adjuvant chemotherapy preoperatively to one induction and two consolidation cycles. Patients and methods Between October 2011 and April 2013, 66 patients with LARC were treated with one induction chemotherapy cycle followed by chemoradiotherapy (CRT), two consolidation cycles, surgery and three adjuvant capecitabine cycles. Radiation doses were 50.4 Gy for T2-3 and 54 Gy for T4 tumours in 1.8 Gy daily fraction. The doses of concomitant and neo/adjuvant capecitabine were 825 mg/m2/12h and 1250mg/m2/12h, respectively. The primary endpoint was pathologic complete response (pCR). Results Forty-three (65.1%) patients were treated according to protocol. The compliance rates for induction, consolidation, and adjuvant chemotherapy were 98.5%, 93.8% and 87.3%, respectively. CRT was completed by 65/66 patients, with G % 3 non-hematologic toxicity at 13.6%. The rate of pCR (17.5%) was not increased, but N and the total-down staging rates were 77.7% and 79.3%, respectively. In a median follow-up of 55 months, we recorded one local relapse (LR) (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates were 64.0% (95% CI 63.89%64.11) and 69.5% (95% CI 69.39%69.61), respectively. Conclusions In LARC preoperative treatment intensification with capecitabine before and after radiotherapy is well tolerated, with a high compliance rate and acceptable toxicity. Though it does not improve the local effect, it achieves a high LR rate, DFS, and OS.
Ključne besede: rectal cancer, neoadjuvant chemotherapy, preoperative chemoradiotherapy
Objavljeno v DiRROS: 11.06.2024; Ogledov: 31; Prenosov: 17
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Povzetek: Ob rasti incidence raka, vse kompleksnejšem zdravljenju in vse boljši ozdravljivosti ter eksponentni rasti prevalence bodo potrebe po spremljanju bolnikov z rakom le še naraščale. Običajno tradicionalno intenzivno pet- ali več-letno spremljanje (angl. follow-up) bolnikov po zaključku zdravljenja, ki se izvaja v rednih časovnih intervalih v ustanovi zdravljenja ter vključuje poleg kliničnega pregleda tudi različne slikovne in druge preiskave in merjenje tumorskih označevalcev, potrebuje nadgradnjo in spremembe. Izkazalo se je namreč, da tovrstno intenzivno spremljanje bolnikov nima vpliva na izboljšanje preživetja. Pri bolnikih z rakom debelega črevesa in danke vpliva le na zgodnejše odkritje ponovitve bolezni in več reševalnih operacij, vendar pa le-to nima vpliva na preživetje bolnikov. V okviru spremljanja bolnikov bi se morali bolj približati bolnikovim težavam in potrebam in jih obravnavati celostno od postavitve diagnoze raka, pa ves čas zdravljenja in po njem, in to ne le pet let po zaključku zdravljenja. Obravnava bi morala poleg psiho-fizičnih vidikov vključevati tudi socialnoekonomski ter poklicni vidik. Ob tem je nujna tudi opolnomočenost bolnika, saj mora skrbeti za zdrav življenjski slog, znati premagovati stres, depresijo in anksioznost, poznati svojo bolezen in zdravljenje, možne znake ponovitve bolezni, si želeti čim prejšnje vrnitve nazaj v svoje življenje. Vse to pa presega zmožnosti onkologov, nujna bo večja vključenost družinskih zdravnikov in ostalih strokovnjakov.
Ključne besede: bolniki, rak debelega črevesa in danke, spremljanje bolnikov
Objavljeno v DiRROS: 06.06.2024; Ogledov: 95; Prenosov: 44
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Povzetek: Testicular cancer is the most common malignancy in young men. Considering increasing incidence, exceptionally high cure rate, as well as long life expectancy, assessment of long term toxicity in testicular cancer survivors is of great importance. In the last decades a major effort has been made in order to reduce toxicity of treatment, while maintaining its high effectiveness. Conclusions Actual knowledge on treatment toxicity is based on outdated treatment modalities. Hopefully, modern treatment modalities could reduce toxicity, but, there is no firm confirmation for that at the moment, as data dealing with late sequelae of modern treatment of testicular cancer are not available yet due to the short period of observation. The life-threatening cardiovascular toxicity in testicular cancer survivors is major complication of platinum-based chemotherapy, mediastinal radiotherapy and even subdiaphragmatic radiotherapy.
Ključne besede: testicular cancer, cardiovascular toxicity, long-term survivors
Objavljeno v DiRROS: 24.05.2024; Ogledov: 140; Prenosov: 103
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Povzetek: Introduction. Choroidal melanoma is the most common primary malignancy of the eye, which frequently metastasizes. The Cancer Registry of Slovenia reported the incidence of choroid melanoma from 1983 to 2009 as stable, at 7.8 cases/million for men and 7.4/million for women. The aim of the retrospective study was to determinate the prognostic factors of survival for choroidal melanoma patients in Slovenia. Patients and methods. From January 1986 to December 2008 we treated 288 patients with malignant choroidal melanoma; 127 patients were treated by brachytherapy with beta rays emitting ruthenium-106 applicators; 161 patients were treated by enucleation. Results. Patients with tumours thickness < 7.2 mm and base diameter < 16 mm were treated by brachytherapy and had 5- and 10-year overall mortality 13% and 32%, respectively. In enucleated patients, 5- and 10-year mortality was higher, 46% and 69%, respectively, because their tumours were larger. Thirty patients treated by brachytherapy developed local recurrence. Twenty five of 127 patients treated by brachytherapy and 86 of 161 enucleated patients developed distant metastases. Patients of age >/= 60 years had significantly lower survival in both treatment modalities. For patients treated by brachytherapy the diameter of the tumour base and treatment time were independent prognostic factors for overall survival, for patients treated by enucleation age and histological type of tumour were independent prognosticators. In first few years after either of treatments, the melanoma specific annual mortality rate increased, especially in older patients, and then slowly decreased. Conclusions. It seems that particularly younger patients with early tumours can be cured, whereby preference should be given to eyesight preserving brachytherapy over enucleation.
Ključne besede: choroidal melanoma, therapy, brachytherapy, prognostic factors
Objavljeno v DiRROS: 09.05.2024; Ogledov: 152; Prenosov: 102
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