The state of Hungarian radiotherapy

BackgroundHungary suffers from one of the highest levels of cancer morbidity, with over 700 new cases per 100000 inhabitants per year. This situation necessitates, among others, investigation of the current state of radiotherapeutic care, and its infrastructural and staffing conditions.AimThe aim of this paper is to present the current state of Hungarian radiotherapy.ResultsAlthough the number of radiation treatments increased substantially between 1995 and 2003 (16544 vs. 26316), together with a considerable increase in the linear accelerator equivalent (LAE) value (15.9 vs 29.45), about one-third of the patients who would profit from radiotherapy do not receive this form of treatment. Radiotherapeutic care is provided at 13 centers in 7 geographical regions, with widely varying infrastructural and staffing conditions, characterized by a mean LAE value of 4.2 (range: 0–8.45), a 1 LAE value for a mean of 343500 inhabitants (range: 0–731500), and a mean annual workload of 353 patients per radiation oncologist (range: 255–424), 532 patients per physicist (range: 255–911) and 149 per radiation technologist (range: 71–300). These conditions result in a waiting list of between 0 and 42 days for non-emergency cases and a mean of 260 radiotherapy-treated patients per 100000 inhabitants (range: 111–434) in the different geographical regions, which is far below the expected Hungarian value of 403 radiotherapy-treated cases/year.ConclusionsAttainment of an adequate radiotherapeutic service with an acceptable waiting time throughout Hungary requires the creation of 2 additional centers and the reconstruction of 1 existing center, the provision of 9 new linacs, the replacement of 10 functioning telecobalt units with linacs, and increases of 54% in the number of radiation oncologists, 51% in the number of physicists and 65% in the number of radiation technologists

Hazai tapasztalatok metasztatikus kolorektális karcinóma bevacizumabbal kiegészített indukciós kemoterápiás kezelésével (AVACONT vizsgálat)

The primary aim of AVACONT was to collect data in the course of routine oncological care from patients with metastatic colorectal cancer (mCRC) treated with bevacizumab supplemented fluoropyrimidine-based chemotherapy doublet in an open, multicentre, observational study in Hungary. Primary endpoint of the study was to determine progression-free survival (PFS). The Full Analysis Set (FAS) comprised 280 patients. Median PFS calculated from enrolment was 270 days in the FAS population. The metastatic involvement of the liver or more than one organ significantly decreased (250 and 245 days), while a clinical response achieved significantly increased (partial response: 404, complete response: 623 days) the mPFS calculated from enrolment. PFS calculated from the start of the first-line treatment was significantly decreased by the presence of mutant RAS gene (481 vs. 395 days). The results confirm the efficacy, known prognostic factors and safety profile of bevacizumab in combination with chemotherapy dosed during standard oncology care in Hungarian centres

Az epipharynx rosszindulatú daganatai 10 éves beteganyagunkban

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Anafilaktoid reakció follikuláris lymphomás betegnél rituximab alkalmazását követően

A follikuláris lymphoma alapvetően gyógyíthatatlan betegség, csupán a betegek szűk csoportja számára jelenthet végleges gyógyulást az allogén csontvelő-transzplantáció. Ugyanakkor a monoklonális antitest terápia a betegek széles köre számára elérhető, alkalmazásával mind az eseménymentes túlélés, mind a teljes túlélési idő jelentős javulása érhető el. Irodalmi ritkaságként fordul elő, ha egy beteg az életkilátásait jelentősen javító rituximab-kezelést a kezelésre létrejövő anafilaxiás reakció miatt nem kaphatja meg. (Az anafilaxiás reakciót klinikai tünetek alapján diagnosztizálták.) A szerzők egy 57 éves follikuláris lymphomás nőbeteg (grade 3a, stádium IV/B, FLIPI: 4) esetét és a laboratóriumi vizsgálatok eredményeit ismertetik. Kiemelhető, hogy a beteg szérumában a kontrollokhoz képest emelkedett koncentrációban van jelen rituximab-ellenes IgM és IgA, valamint tisztított egér IgG-ellenes IgM antitest. A betegnél talált rituximab-ellenes IgM és tisztított egér IgG-ellenes IgM antitestek szérumbetegség kialakulásának veszélyére figyelmeztetnek. A rituximab-ellenes IgA anafilaxiás reakciót kiváltó hatásának hátterében felmerül, hogy az IgA eredetileg valamely más antigén ellen termelődött, s a betegnél keresztreagált a rituximabbal. Mivel nem IgE indukálta az anafilaxiás reakció tüneteit, hanem feltehetőleg IgA, az anafilaxiás reakció helyett anafilaktoid reakció kifejezést használna

Capecitabine in Combination with Docetaxel in First Line in HER2-Negative Metastatic Breast Cancer: an Observational Study

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Capecitabine in Combination with Docetaxel in First Line in HER2-Negatíve Metastatic Breast Cancer: an Observational Study

Due to the limited experience with capecitabine plus docetaxel (XT) combination in the first-line treatment of metastatic breast cancer in Hungary, the main objective of the study was to analyze the effectiveness and tolerability of XT therapy. A prospective, open-label, non-randomized, single-arm, multicenter, observational study was designed. All female patients were eligible whose metastatic breast cancer could be treated with the XT protocol according to the summary of product characteristics of the drugs. The median progression free survival was 9.9 ± 3.0 months. Time to treatment failure was 4.6 ± 5.1 months on average. The overall response rate was 28.9 %, the clinical benefit rate was 73.3 %. The treatment was discontinued in 35.6 % of patients due to disease progression and in 20.0 % due to adverse events (AE). 33 patients with a total of 73 AEs have been reported, and 13 of them had serious adverse events (SAE). The efficacy and the safety profile of XT chemotherapy proven in the study are consistent with the results demonstrated in randomized trials. First-line XT chemotherapy effectively improves the PFS in metastatic breast cancer. Keywords CapecitabineDocetaxelHER2-negative metastatic breast cancerToxicit

Petefészekrákos betegek kezelési eredményei a hazai centrumokban 2002-2003-ban

újratöltve - BIBFORM02040