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Preoperative concomitant chemoradiotherapy in esophageal cancer
Boštjan Šeruga, Mihael Sok, Janez Eržen, Jože Jerman, Boris Jančar, Branko Zakotnik, 2006, izvirni znanstveni članek

Povzetek: Background. Currently primary treatment options for esophageal cancer are surgery only or concomitant chemoradiotherapy (CRT) and the long-term survivalof patients with locally advanced disease is rare. Preoperative concomitant CRT seems to be beneficial, mostly in patients who achieve a complete pathologic response (pCR) after CRT. In this retrospective analysis the efficiency and toxicity of preoperative CRT in patients with locally advanced esophageal cancer was analysed as well as the influence of pCR on thesuraival. Patients and metkods From 1996 to 2002 41 patients with locoregionally confined esophageal cancerwere treated with cisplatin 75 mgžm2 and 5-FU 1000 mgžm2 as 4 day contonuous infusion starting on days 1. and 22. with concorrtitant radiotherapy 4500 cGy, 200-300 cGyžday. Esophagectomy followed 4-5 weeks after radiotherapy. After the surgery patients were followed-up regularly at 3-6 months intervals. Results. The pCR was achieved in 26.8% of patients. The overall median survival time was 18 months for all patients, 21.2 months for patients who achieved pCR and 16 months in those with residual disease (p= 0,79). Postoperative mortality rate was 22%. The median dose intensity for cisplatin was 92% and for 5-FU 71.5 of the planned dose. Disease recurred most often locoregionally (31.7%) and the overall recurrence rate was 43.9. Conclusion. Modern radiation techniques and the adequate dose intensity could further improve the locoregional control. The selection of patients without comorbid conditions and without already present distant metastases is essential for this combined treatment approach.
Objavljeno v DiRROS: 15.02.2024; Ogledov: 205; Prenosov: 51
.pdf Celotno besedilo (123,83 KB)

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Surgical treatment of malignant pleural mesothelioma
Janez Eržen, Stanko Vidmar, Mihael Sok, Andrej Debeljak, Peter Kecelj, Viljem Kovač, Marjeta Stanovnik, Tomaž Rott, Izidor Kern, 2005, izvirni znanstveni članek

Povzetek: Background. The aim of the study was to identify perioperative morbidity and mortality, the category and mode of adjuvant treatment, local recurrence and survival in patients treated by extrapleural pneumonectony (EPP) for malignantpleural mesothelioma (NLPM). Methods. From 2000 to 2003, 18 patients with MPM were referred to the Department of Thoracic Surgery in Ljubljana, and17 of them were operated on. Two patients underwent explorative thoracotomy, and 15 patients were evaluated. Five female and nine male patients (aged 52-68 years) were treated by EPP and one male patient by pleurectomy. Eight patients received both adjuvant chemotherapy (ChT) and radiotherapy (RT), with cisplatin 100 mg/m2 + mitomycin C 6-10 mg/m2 gemcitabine 1000 mg/m2 and external beam radiation with 24 Gy - 58 Gy respectively, three patients received no adjuvant therapy, three patients weretreated by adjuvant ChT, two of them were given cisplatin 100 mg/m2 + mitomycin C 6-10 mg/m2, and one patient cisplatin 100 mg/m2 on the first day and gemcitabine 250 mg/rn2 in prolonged 6 hours infusion on the first and on the eighth day. One patient was treated only by adjuvant RT. Results. There were no perioperative deaths and the postoperative morbidity was 42%. Of the 15 evaluable patients, and in the median follow up of 40 months (28-64), we noticed nine (60.0%) recurrences, seven local and two abdominal. Eight (53.3%)patients died, all because of the local progress of disease. (Abstract truncated at 2000 characters)
Objavljeno v DiRROS: 14.02.2024; Ogledov: 206; Prenosov: 51
.pdf Celotno besedilo (82,10 KB)

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Communication after laryngectomy
Irena Hočevar-Boltežar, Miha Žargi, 2001, pregledni znanstveni članek

Povzetek: Izhodišča. Pri bolnikih z napredovalim rakom grla in spodnjega žrela je kirurška odstranitev grla najbolj primeren način zdravljenja. To zdravljenje pa negativno vpliva na številne pomembne bolnikove funkcije in tudi na govor. Bolniki in metode dela. Po odstranitvi grla je možnih več različnih načinov tvorbe glasu, tako da se vsak laringektomirani bolnik lahko nauči katerega od teh načinov govornega sporazumevanja. Rezultati. Znanih je več različnih, tudielektronskih naprav, ki s pomočjo lastnih baterij proizvajajo zvok. Drugo možnost predstavlja ezofagalni govor, pri katerem se bolnik nauči uporabljati mišični segment na prehodu v zgornji požiralnik kot generator glasu. Kirurško možnost govorne rehabilitacije po laringektomiji pa predstavlja vstavitev proteze v kirurško narejeno fistulo med zgornjim požiralnikom in sapnikom. Proteza usmeri zrak iz pljuč v zgornji požiralnik, glas pa nastane pri prehoduzraka skozi že omenjeni mišični segment. Zaključki. Številni dejavniki vplivajo na izbiro najprimernejšega načina nadomestnega govora pri posameznem bolniku. V Sloveniji največ laringektomiranih bolnikov uporablja ezofagalni govor.
Objavljeno v DiRROS: 25.01.2024; Ogledov: 227; Prenosov: 56
.pdf Celotno besedilo (82,96 KB)

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Factors influencing rehabilitation in patients with head and neck cancer
Irena Hočevar-Boltežar, Alojz Šmid, Miha Žargi, Avgust Župevc, Igor Fajdiga, Janez Fischinger, Ana Jarc, 2000, izvirni znanstveni članek

Povzetek: Purpose. The purpose of the prospective study was to identify the factors adversely influencing the post-treatment rehabilitation in patients with head and neck cancer. Patients and methods. One hundred and ten patients with oral cavity, pharyngeal and laryngeal cancer were examined before surgical treatment in order to find unfavorable factors: hearing loss, defective teeth,impaired pulmonary function, and speech disorders. The patients evaluated the success of their rehabilitation 12 months after the treatment. The influence of possible unfavorable factors, tumor site, and type of surgeryon speech, swallowing and reintegration competence was determinated. Results. The site of the tumor and the type of surgery did not influence the quality of rehabilitation in general. Defective teeth influenced the ability of swallowing but not the speech. Hearing loss impaired the patient's reintegration in their home environment. Impaired pulmonary function did not affect patient's speech. Speech was the poorest in laryngectomized patients. However, about two thirds of the patients were satisfied with their capabilityof speech, swallowing and their rehabilitation in general. Conclusions. Early identification of unfavorable factors, and individually planned rehabilitation can ensure a suitable quality of life for patients thathave undergone surgery for head and neck cancer.
Objavljeno v DiRROS: 25.01.2024; Ogledov: 196; Prenosov: 53
.pdf Celotno besedilo (322,91 KB)

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