[Pre-operative irradiation in a gastric cancer patient]

Pri bolnikih z neresektabilnim oz. mejno resektabilnim rakom želodca, ki nimajo razsoja bolezni, priporočamo predoperativno radiokemoterapijo, s katero poskušamo zmanjšati tumor in s tem zvišati možnost popolne odstranitve (R0 resekcija). V prispevku je prikazan primer bolnice z rakom želodca v kliničnem stadiju T4 N1 M0, ki je bila zdravljena s predoperativno radiokemoterapijo, ki ji je sledila totalna gastrektomija. Dosežen je bil zelo dober odgovor na predoperativno zdravljenje. Po operaciji je bolnica prejela še dopolnilno kemoterapijo in pet let po zaključku zdravljenja ni imela ponovitve bolezni.In patients with unresectable or borderline resectable gastric cancer with no spreading of the disease, we recommend pre-operative radiochemotherapy, which may reduce the tumour and thus increase the likelihood of complete removal (R0 resection). The article present a case of a female patient with clinical stage T4 N1 M0 gastric cancer treated with pre-operative chemotherapy followed by total gastrectomy. Pre-operative treatment showed a very good response. After surgery, the patient received complementary chemotherapy and had no recurrence of the disease five years after treatment

Treatment of intrahepatic cholangiocarcinom with stereotactic body radiation therapy : case report

V prispevku je opisan primer bolnice z lokalno napredovalim holangiokarcinomom intrahepatalnih žolčnih vodov, ki je redek malignom s svojevrstnim kliničnim potekom. Ob postavitvi diagnoze ima večina bolnikov napredovalo obliko bolezni in so posledično kandidati le za nekirurško zdravljenje – kemoterapijo, kombinacijo kemoterapije in radioterapije ali samo radioterapijo. Glavna omejitev pri zdravljenju z radioterapijo je doza, ki jo prejmejo jetra in priležni cevasti organi, zato se v zadnjem času čedalje bolj uveljavlja zdravljenje s stereotaktično radioterapijo. Ta omogoča, da dovedemo visoko dozo na tumor, pri čemer ščitimo rizične organe. Raziskave, ki so bile objavljene v zadnjih letih, so pokazale dobre rezultate zdravljenja inoperabilne bolezni z namenom poskusa zazdravitve bolezni in podaljšanja celokupnega preživetja.A case report of a patient with locally-advanced intrahepatic cholangiocarcinom, which is a rare malignancy with a unique clinical course, is presented in this paper. Most patients with this type of cancer have advanced disease at the time of diagnosis and are candidates for non-surgical treatments – chemotherapy, radiotherapy, or chemoradiotherapy. The main limiting factor with external beam radiotherapy is the dose that is delivered to the liver and adjacent radiosensitive organs. In particular, due to its ability to deliver a high and focused dose, stereotactic body radiation therapy is a promising treatment technique. Studies published on this topic have shown promising results regarding the treatment of patients with unresectable disease with the intention of extending the overall survivor

Second Cancers after Radiotherapy

The incidence of second cancers after radiotherapy is increasing in the last years as a result of a higher number of long term-survivors after treatment and as a result of a longer follow-up. The risk of radiation-induced second cancers is much greater among young patients and children. The majority of second cancers occur in the organs and tissues in the high-dose volumehowever, some may appear in the low dose volume. There are at least three different biological mechanisms leading to second cancers, depending on dose distribution and age of the irradiated patient

Oligometastatic colorectal cancer

Rak debelega črevesa in danke lahko napreduje v oligometastatsko bolezen. Napredki v zgodnjem odkrivanju in intenzivnem sistemskem zdravljenju omogočajo čedalje boljše odgovore na zdravljenje in dolgoročno sistemsko kontrolo bolezni. Pojavlja se vprašanje dolgoročnega vodenja oligometastatskih bolnikov. Kirurška resekcija zasevkov lahko pripomore k izboljšanem preživetju, omogoča kurativnost posega ali podaljša interval brez sistemskega zdravljenja, je pa pogosto omejena z anatomijo, invazivnostjo in morbiditeto takšnega pristopa. Stereotaktično obsevanje (SBRT) zasevkov omogoča zelo učinkovito in natančno zdravljenje zasevkov v nizkem številu obsevalnih odmerkov in s tem zelo dobro in dolgoročno lokalno kontrolo z minimalno invazivnostjo in morbidnostjo. Ta prikaz primera prikazuje zgodbo bolnika, zdravljenega na Onkološkem inštitutu v Ljubljani.Colorectal cancer can progress to oligometastatic disease. Advances in early detection and intensive systemic treatment enable increasingly better responses to treatment and long-term systemic control of the disease. The question of long-term management of oligometastatic patients arises. Surgical resection of implants may contribute to improved survival, enable curative intervention or prolong the systemic treatment-free interval, but is often limited by the anatomy, invasiveness and morbidity of such an approach. Stereotactic radiation (SRS) of metastases enables very effective and precise treatment with a low number of radiation doses and thus very good and long-term local control with minimal invasiveness and morbidity. This case report shows the story of a patient treated at the Oncology Institute in Ljubljana

Paliativni kirurški posegi pri napredovalih in neozdravljivih rakih

No abstract.Ni abstrakta