1. Is postmastectomy radiotherapy really needed in breast cancer patients with many positive axillary lymph nodes?Tanja Marinko, Karmen Stanič, 2018, izvirni znanstveni članek Povzetek: Postmastectomy radiotherapy (PMRT) improves survival by eliminating potential occult lesions in the chest wall and lymphatic drainage area. Meta-analysis has shown that PMRT reduces mortality and local recurrence of patients with node positive breast cancer (but there is no specific data about the effectiveness of PMRT in a subgroup of patients with a high number of positive axillary lymph nodes (PALN). The aim of the study was to analyse the impact of the number of PALN on local and distant metastasis occurrence, overall survival (OS) and distant metastases free survival (DMFS) in patients treated with PMRT. Patients and methods. We reviewed medical records of 129 consecutive breast cancer patients with PALN, treated at Institute of Oncology Ljubljana with PMRT between January 2003 and December 2004. We grouped patients according to the number of PALN as follows: Group 1 (less than 15 PALN) and Group 2 with more than 15 PALN. All patients received adjuvant systemic therapy according to the clinical guidelines. We analysed number of locoregional (LR) recurrences, distant metastasis, overall survival, progression free survival (PFS) and DMFS. Results. After the median follow-up time of 11.5 years, the Kaplan-Meier survival analysis of PALN showed significantly shorter OS (p = 0.006), shorter PFS (p = 0.002) and shorter DMFS (p < 0.001) in the group of > 15 PALN. Only one LR was found in the group of patients with more than 15 PALN. In multivariate analysis more than 15 PALN and treatment with anthracycline chemotherapy statistically significantly influenced OS and DMFS. For PFS presence of more than 15 PALN were the only independent factor of shorter survival. Conclusions. Patients with more than 15 PALN have shorter DMFS, PFS and OS as compared to patients with less than 15 PALN, though they receive the same LR treatment. More studies with higher number of patients included are needed to further evaluate our findings.
Ključne besede: radiotherapy, postmastectomy, axillary limph nodes, breast cancer
Objavljeno v DiRROS: 10.06.2024; Ogledov: 12; Prenosov: 5
 Celotno besedilo (300,04 KB)
Gradivo ima več datotek! Več... |
2. Early cardiotoxicity after adjuvant concomitant treatment with radiotherapy and trastuzumab in patients with breast cancerTanja Marinko, Simona Borštnar, Rok Blagus, Jure Dolenc, Cvetka Bilban-Jakopin, 2018, izvirni znanstveni članek Ključne besede: radiotherapy, adjuvant radiotherapy, cardiotoxicity, breast cancer
Objavljeno v DiRROS: 10.06.2024; Ogledov: 12; Prenosov: 3
Celotno besedilo (300,87 KB) |
3. |
4. Long term results of radiotherapy in vulvar cancer patients in Slovenia between 1997-2004Helena Barbara Zobec Logar, 2017, izvirni znanstveni članek Povzetek: The aim of this retrospective single institution study was to analyse long term results of vulvar cancer treatment with conventional 2D radiotherapy in Slovenia between years 1997%2004. Patients and methods. Fifty-six patients, median age 74.4 years +/- 9.7 years, mainly stage T2 or T3, were included in the study. All patients were treated with radiotherapy, which was combined with surgery (group A), used as the primary treatment (group B) or at the time of relapse (group C). Chemotherapy was added in some patients. Histology, grade, lymph node status, details of surgery, radiation dose to the primary tumour, inguinofemoral and pelvic area as well as local control (LC) and survival were evaluated. Results. Overall survival (OS), disease specific survival (DSS) and LC rates at 10-years for all patients were as follows: 22.7%, 34.5% and 41.1%, respectively. The best 10-years results of the treatment were achieved in the primary operated patients treated with adjuvant radiotherapy +/-chemotherapy (OS 31.9%, DSS 40.6% and LC 47.6%). Positive lymph nodes had a strong influence on LC. In case of positive nodes LC decreased by 60% (p = 0.03) and survival decreased by 50% (p = 0.2). There was a trend to a better LC with higher doses % 54.0 Gy (p = 0.05). Conclusions. The best treatment option for patients with advanced vulvar cancer is combined treatment with surgery and radiotherapy +/- chemotherapy, if feasible. Radiotherapy with the dose of % 54.0 Gy should be considered to achieve better LC if positive adverse factors are present.
Ključne besede: vulvar cancer, radiotherapy, surgery, survival
Objavljeno v DiRROS: 31.05.2024; Ogledov: 84; Prenosov: 53
Celotno besedilo (510,26 KB) |
5. Excellent outcomes after radiotherapy alone for malignant spinal cord compression from myelomaDirk Rades, Antonio J. Conde-Moreno, Jon Cacicedo, Barbara Šegedin, Volker Rudat, Steven E. Schild, 2016, izvirni znanstveni članek Povzetek: Uncertainty exists whether patients with spinal cord compression (SCC) from a highly radiosensitive tumor require decompressive spinal surgery in addition to radiotherapy (RT). This study addressed the question by evaluating patients receiving RT alone for SCC from myeloma. Patients and methods. Data of 238 patients were retrospectively analyzed for response to RT and local control of SCC. In addition, the effect of RT on motor function (improvement, no further progression, deterioration) was evaluated. Overall response was defined as improvement or no further progression of motor dysfunction. Prior to RT, patients were presented to a neurosurgeon for evaluation whether upfront decompressive surgery was indicated (e.g. vertebral fracture or unstable spine). Results. In the entire cohort, the overall response rate was 97% (53% improvement plus 44% no further progression). Following RT, 88% of the patients were able to walk. Of the 69 non-ambulatory patients 44 patients (64%) regained the ability to walk. Local control rates at 1, 2 and 3 years were 93%, 82% and 82%, respectively. A trend towards better local control was observed for patients who were ambulatory before starting RT (p = 0.08) and those with a more favorable performance status (p = 0.07). Conclusions. RT alone provided excellent response rates, functional outcomes and local control in patients with SCC from myeloma. These results should be confirmed in a prospective randomized trial.
Ključne besede: myeloma, spinal cord compression, radiotherapy
Objavljeno v DiRROS: 30.04.2024; Ogledov: 202; Prenosov: 94
Celotno besedilo (585,22 KB)
Gradivo ima več datotek! Več... |
6. The role of PET-CT in radiotherapy planning of solid tumoursStaša Jelerčič, Mirjana Rajer, 2015, pregledni znanstveni članek Povzetek: PET-CT is becoming more and more important in various aspects of oncology. Until recently it was used mainly as part of diagnostic procedures and for evaluation of treatment results. With development of personalized radiotherapy, volumetric and radiobiological characteristics of individual tumour have become integrated in the multistep radiotherapy (RT) planning process. Standard anatomical imaging used to select and delineate RT target volumes can be enriched by the information on tumour biology gained by PET-CT. In this review we explore the current and possible future role of PET-CT in radiotherapy treatment planning. After general explanation, we assess its role in radiotherapy of those solid tumours for which PET-CT is being used most. Conclusions. In the nearby future PET-CT will be an integral part of the most radiotherapy treatment planning procedures in an every-day clinical practice. Apart from a clear role in radiation planning of lung cancer, with forthcoming clinical trials, we will get more evidence of the optimal use of PET-CT in radiotherapy planning of other solid tumours.
Ključne besede: positron emission therapy, radiotherapy, radiotherapy planning, tumour biology
Objavljeno v DiRROS: 16.04.2024; Ogledov: 167; Prenosov: 33
Celotno besedilo (1,25 MB) |
7. Glioblastoma patients in Slovenia from 1997 to 2008Uroš Smrdel, Viljem Kovač, Mara Popović, Matjaž Zwitter, 2014, izvirni znanstveni članek Povzetek: Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods. All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results. From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis.
Ključne besede: glioblastoma, treatment, survival, surgery, radiotherapy, termozolomide
Objavljeno v DiRROS: 11.04.2024; Ogledov: 364; Prenosov: 392
Celotno besedilo (423,05 KB)
Gradivo ima več datotek! Več... |
8. Cardiotoxicity of concomitant radiotherapy and trastuzumab for early breast cancerTanja Marinko, Jure Dolenc, Cvetka Bilban-Jakopin, 2014, izvirni znanstveni članek Povzetek: Background. Trastuzumab therapy given in combination with one of several chemotherapy regimens is currently considered the standard of care for the treatment of early-stage, human epidermal growth factor receptor-2 (HER2) -positive breast cancer. The treatment with trastuzumab is due to a significant impact on the survival part of the standard adjuvant treatment of patients with HER2-positive breast cancer. Patients treated with postoperative breast or chest wall irradiation receive trastuzumab concomitant with radiotherapy. In a small proportion of patients trastuzumab causes cardiotoxicity. Preclinical findings indicate a radiosensibilizing effect of trastuzumab in breast cancer cells, but it is not yet clear whether it radiosensibilizes cells of healthy tissues too.Conclusions. Special attention is required when left breast or left thoracic wall is irradiated in patient receiving trastuzumab, because long-term effects of the concurrent treatment with trastuzumab and radiotherapy are not yet known. In an era where more patients are surviving a diagnosis of breast cancer, better understanding and earlier detection of therapy-induced cardiac toxicity will be of paramount importance.
Ključne besede: radiotherapy, cardiotoxicity, trastuzumab, early breast cancer
Objavljeno v DiRROS: 11.04.2024; Ogledov: 165; Prenosov: 76
Celotno besedilo (817,95 KB)
Gradivo ima več datotek! Več... |
9. |
10. A novel approach for the definition of small-field sizes using the concept of superellipseIgnasi Méndez Carot, Božidar Casar, 2021, izvirni znanstveni članek Povzetek: In radiotherapy, field sizes are defined in terms of the dimensions of the irradiation area. However, geometric square fields result in irradiation areas with rounded corners, which become almost elliptical for small fields. Superellipses are a family of curves encompassing shapes lying between ellipses and rectangles. The purpose of this work was to analyze the advantages and disadvantages of a novel approach that describes small-field sizes with superellipses. Square fields with nominal side lengths ranging from 0.5 to 10 cm were irradiated with two different linacs using 6 and 10 MV photon beams with and without flattening filters. Field size dimensions and output factors were measured by employing radiochromic films and the Radiochromic.com software. An alternative definition of equivalent square small-field size based on the superellipse (Sse) was introduced. The degree n of the superellipse for 10 cm nominal fields measured between 14.8 % 1.0 to 27.7 % 1.9. However, it decreased with the field size, down to between 2.26 % 0.10 and 2.64 % 0.15 for 0.5 cm nominal side lengths. A relation between the degree n and the equivalent square small-field size (Sclin) as defined by Cranmer-Sargison et al. [%A methodological approach to reporting corrected small field relative outputs,% Radiotherapy and Oncology 109, 350%355 (2013)] was found. For nominal side lengths of 10 cm, Sse was between 0.34 % 0.04% and 0.10 % 0.01% smaller than Sclin, while for 0.5 cm nominal side length Sse was between 9.5 % 0.6% and 7.4 % 0.7% smaller than Sclin. There was no significant difference in the goodness of the regression between using Sse or Sclin to fit field output factors with the function proposed by Sauer and Wilbert. Small fields were found to be more accurately characterized with superellipses. The advantages and disadvantages of describing field sizes with superellipses were examined. Field output factors can be derived with equivalent square small-field sizes based on the superellipse approach.
Ključne besede: superellipsa, small fields, dosimetry, radiotherapy
Objavljeno v DiRROS: 07.09.2022; Ogledov: 436; Prenosov: 275
Celotno besedilo (2,84 MB)
Gradivo ima več datotek! Več... |
