Radiotherapy in Slovenia

Zdravljenje z obsevanjem ali radioterapija je eden od treh temeljnih načinov zdravljenja raka. V Sloveniji zdravljenje z obsevanjem izvajamo na Onkološkem inštitutu v Ljubljani in v manjšem obsegu od novembra 2016 tudi na Oddelku za radioterapijo v Univerzitetnem kliničnem centru v Mariboru. V Sloveniji smo v zadnjih letih v povprečju vsako leto opravili preko 6.000 teleradioterapevtskih obsevanj pri skoraj 5.000 bolnikih, ob tem pa letno opravimo tudi približno 400 brahiterapevtskih posegov. V članku je prikazano trenutno stanje na področju radioterapije v Sloveniji, na osnovi rezultatov nekaterih mednarodnih raziskav pa tudi, kam nas trenutne strojne in kadrovske zmogljivosti na tem področju uvrščajo v evropskem merilu.Treatment with irradiation or radiotherapy is one of the three basic cancer treatment methods. In Slovenia, radiotherapy is carried out at the Institute of Oncology in Ljubljana and since November 2016 in a lesser extent also at the Department of Radiotherapy in the University Medical Centre in Maribor. In recent years in Slovenia, we performed on average over 6,000 teletherapy procedures in approximately 5,000 patients, and also around 400 brachytherapy procedures annually. This paper shows the current situation in the field of radiotherapy in Slovenia and also, based on the results of several international studies, where our current hardware and personnel capacities in this area put us in the European scale

[The radiation therapy oncologist\u27s view of gastric cancer treatment]

Gastric cancer is associated with a poor prognosis. At diagnosis, approximately 50% of patients have a non-resectable disease. In patients who underwent radical resection, the disease recurs in as many as 75%, of which 40-64% are local and/or regional recurrences (2-4). Despite this fact, we are observing that survival of patients has improved over the years. According to the SLORE data, relative 5-year survival was 14.7% in 1985, 17.8% in 1995, 22.1% in 2000 and 25.6% in 2005 (5). Surgical resection of the tumour and regional lymph nodes is the method of choice for treating gastric cancer with no distant metastases. Until 2000, it was also the only treatment method

Pogled radioterapevta onkologa na zdravljenje raka želodca

Gastric cancer is associated with a poor prognosis. At diagnosis, approximately 50% of patients have a non-resectable disease. In patients who underwent radical resection, the disease recurs in as many as 75%, of which 40-64% are local and/or regional recurrences (2-4). Despite this fact, we are observing that survival of patients has improved over the years. According to the SLORE data, relative 5-year survival was 14.7% in 1985, 17.8% in 1995, 22.1% in 2000 and 25.6% in 2005 (5). Surgical resection of the tumour and regional lymph nodes is the method of choice for treating gastric cancer with no distant metastases. Until 2000, it was also the only treatment method.Ni abstrakta

Follow-up of colorectal cancer patients after radical treatment

After completed treatment, either surgical or combined treatment of colorectal carcinoma, it is necessary to follow up patients regularly and in accordance with the recommended protocol. The purpose of such follow-up is to detect the disease or its recurrence as early as possible, including pre-cancerous lesions or potential metachronous (newly developed) tumours which can be treated successfully at an early stage. Follow-up is important also for the treatment of late complications, it enables psychological support to the patients, and finally, we can also track and assess our own performance. It is known that colorectal cancer recurs in 30 do 50% of patients. As many as 70% of recurrences are detected within the first two years, 80% in the first three years, and 90% or more disease recurrences are found within five years after surgery of the primary tumour. It has been shown that regular follow-up of patients after their treatment improves the outcome of their disease and reduces mortality in patients by 9% to 13%. We must adapt it to each patient separately, taking into account both his age and general condition, stage of the disease, concurrent diseases, and further treatment possibilities in the event of a recurrence

Sledenje bolnikov z rakom debelega črevesa in danke po radikalnem zdravljenju

After completed treatment, either surgical or combined treatment of colorectal carcinoma, it is necessary to follow up patients regularly and in accordance with the recommended protocol. The purpose of such follow-up is to detect the disease or its recurrence as early as possible, including pre-cancerous lesions or potential metachronous (newly developed) tumours which can be treated successfully at an early stage. Follow-up is important also for the treatment of late complications, it enables psychological support to the patients, and finally, we can also track and assess our own performance. It is known that colorectal cancer recurs in 30 do 50% of patients. As many as 70% of recurrences are detected within the first two years, 80% in the first three years, and 90% or more disease recurrences are found within five years after surgery of the primary tumour. It has been shown that regular follow-up of patients after their treatment improves the outcome of their disease and reduces mortality in patients by 9% to 13%. We must adapt it to each patient separately, taking into account both his age and general condition, stage of the disease, concurrent diseases, and further treatment possibilities in the event of a recurrence.Ni abstrakta

Postoperativna radiokemoterapija pri bolnikih z rakom želodca

Background. To analyze the efficacy of postoperative radiochemotherapy with 5-florouracil (5-FU) and leucovorin (LV) applied in the patients with gastric carcinoma treated in a single institution. Patients and methods. Between 2001 and 2004, 123 patients with resected gastric adenocarcinoma were treated with postoperative concomitant radiochemotherapy with 5-FU and LV. The adjuvant treatment consisted of five cycles of chemotherapy with 5-FU (425mg/m2 IV) andLV (20 mg/m2 IV) and concomitant radiotherapy with the total dose of 45 Gy.Results. The treatment was completed according to the protocol in 82% of patients. The frequency and severity of early toxic effects induced by radiochemotherapy were manageable. Median follow-up time of 56 survivors was 64.5 months (range: 51.7-96.4 months). The 5-year locoregional control (LRC), diseasefree survival (DFS), disease-specific survival (DSS) and overall survival (OS) were 81%, 48.3%, 50.4%, and 48.4%, respectively. The multivariate analysis showed that the tumor involvement of cardia and low intensity of chemotherapy were independent adverse prognostic factors for DSS and OS. More advanced pT-stage and tumors with diffuse growth type according to Lauren were identified as negative independent prognostic factor for OS. They were also on the threshold of statistical significance for DSS. Conclusions. Postoperative radiochemotherapy for gastric carcinoma has acceptable toxicity, and is effective particularly in regard to LRC. High incidence of distant metastases calls for more effective systemic regimens