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

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

[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

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

[Zdravljenje anemije z epoetinom alfa pri bolnikih z rakom danke]

Background. Anemia is one of the most challenging problems in clinical oncology due to its high prevalence among the patients with malignant diseases. The purposes of our study were: (1) to assess the potential of epoetin alfa therapy to prevent the decline in Hb concentrations that typically accompanies chemotherapy/radiotherapy (ChT/RT) of the patients with rectal cancer(2) to test the hypothesis that the use of epoetin alfa significantly reduces the transfusion requirements in the patients with rectalcancer treated with ChT/RTafter surgery, and (3) to evaluate the safety profile of the administration of epoetin alfa in the clinical setting. Methods. Sixty patients who underwent surgery for rectal cancer were prospectively enrolled. Group A consisted of 39 patients with Hb concentrations 13 g/dl at the start of ChT/RT following surgery, but whose Hb concentrations fell below 13 g/dl during the ChT/RT protocol. The starting dose of epoetin alfa in both proups was 10,000 IU subcutaneously (se) three times a week (tiw). The following major parameters were evaluated: (1) change in Hb concentrations relative to the baseline as measured at 4-week intervals, (2) allogenic blood transfusion requirements in relation to Hb concentrations, and (3) incidence and severity of adverse events and their potential relationship to epoetin alfa administration. (Abstract truncated at 2000 characters)Izhodišča. Anemija, ki povzroča zmanjšanje funkcionalne zmogljivosti in kakovosti bolnikovega življenja, je pogosto spremljevalka raka. V klinični raziskavi smo želeli ugotoviti, ali lahko z epoetinom alfa preprečimo padec invzdržujemo zadovoljive vrednosti hemoglobina (Hb) pri bolnikih s karcinomom danke, ki jih po operaciji zdravimo z radiokemoterapijo (RT-KT). Sledili smo tudi bolnikove potrebe po transfuziji in varnost epoetina alfa. Metode. V raziskavo smo vključili 60 bolnikov po radikalni operaciji raka danke. V skupini A je bilo 39 bolnikov s koncentracijo Hb AAA 13 g/dl ob pričetku pooperativne RT-KT, v skupini B pa 17 bolnikov s koncentracijo Hb VVV 13 g/dl ob pričetku pooperativnega zdravljenja in pri katerih je koncentracija Hb padla pod 12 g/dl v času KT-RT. Bolniki so prejemali epoetin alfa v odmerku 10.000 IE subkutano trikrat na teden. Ocenjevali smo naslednje parametre: (1) značilnost gibanja Hb med terapijo z epoetinom alfa in KT-RT, (2) delež bolnikov, ki so potrebovali transfuzijo in (3) delež bolnikov, pri katerih smoopazili neželene učinke zdravljenja z epoetinom alfa. Rezultati. Statistično smo obdelali 56/60 (93%) protokolov. Pri vseh bolnikih v skupini Aje bilo opaziti statistično pomemben porast (pZZZ0.001) Hb že po štirih tednih zdravljenja z epoetinom alfa (povprečen dvig Hb 1,97 I 0,91 g/dl). Kljub nihanju koncentracije Hb je bila ta ves čas statistično pomembno višja kot ob začetku raziskave (p=0,0017). V skupini B je bilo opaziti v prvih tednih spremljanja postopen padec koncentracije Hb, ki je dosegla v tretjem tednu statistično pomembno nižjo vrednost kot ob vključitvi v raziskavo (p=0,006). Po uvedbi epoetina alfa je bilo tudi v tej skupini bolnikov opazitinormalizacijo vrednosti Hb in ustalitev med 12-13 g/dl. Nihče od bolnikov v raziskavi ni prejel transfuzije. Nobeden od devetih opisanih neželenih učinkov pri 6 bolnikih ni bil povezan z epoetinom alfa. (Izvleček skrajšan na 2000 znakov