6 research outputs found
Colorectal carcinoma - case study of patient with liver metastases
Jetra je najÄeÅ”Äe sijelo metastaza karcinoma debeloga crijeva. U veÄini sluÄajeva se prilikom postavljanja dijagnoze metastaza u startu detektiraju viÅ”ebrojni sekundarni depoziti unutar jetrenog
parenhima koji se ne mogu operirati.
U ovom Älanku prikazan je rijedak sluÄaj postizanja viÅ”egodiÅ”nje kontrole bolesti kod pacijenta operiranoga zbog karcinoma debeloga crijeva, stadija IIIB, kod kojega su se postoperativno u dva navrata
razvile jetrene metastaze. U oba navrata prvo su metastaze kirurŔki odstranjene (metastazektomija), a nakon toga je sprovedena postoperativna kemoimunoterapija.
Kombinacija kirurÅ”koga lijeÄenja (metastazektomija) i postoperativne kemo(imuno)terapije predstavlja najuÄinkovitiji naÄin lijeÄenja u pacijenata s primarno resektibilnim jetrenim metastazama. Rezultat je dugotrajna kontrola bolesti.The liver is the most frequent center of metastases of colorectal carcinoma. In most cases, upon diagnosing metastases, numerous secondary deposits are detected at the beginning within the liver
parenchyme and these cannot be operated.
This article shows a rare case of achieving long-term follow up of the disease with patients having surgery due to colorectal carcinoma stage IIIB where liver metastases developed post-operatively on two
occasions. On both occasions, the metastases were surgically removed (metastasectomy) and later postoperative
chemoimmunotherapy was performed.
A combination of surgical treatment (metastasectomy) and post-operative chemoimmunotherapy represents the most efficient manner of treatment in patients with primary resectable liver metastases. The result is a long-term remision of the disease
DIETARY HABITS OF COLORECTAL CANCER PATIENTS ā COMPARISON BETWEEN SLAVONIA AND DALMATIA
Diet plays crucial role in colorectal cancer (CRC), from incidence to progression. It is the second cause of death due to carcinoma in Croatia, with significant regional differences. The aim of this observational study was to determine dietary habits of CRC patients, and whether their diet differs by region. A total of 60 patients with non-metastatic CRC, 30 from Slavonia and 30 from Dalmatia participated in the study. Two thirds of patients from both regions changed their diet for better after CRC diagnosis. However, one third of patients do not get any physical activity. Patients do not differ in their energy intake or intake of vitamins or minerals. Still, high contribution of fats (>40%) and low contribution of carbohydrates in the total daily energy intake was found. Contribution of proteins is higher in Slavonia (p=0.040). More patients from Dalmatia have intake of calcium <700 mg/day (43.3% vs 33.3%). Alcohol is consumed more often by patients from Dalmatia (p<0.001) and higher consumption of alcohol correlates with the high risk diet profile which was found in 66.7% of patients from Dalmatia in comparison to 36.7% patients from Slavonia (p=0.020). The results point out some regional differences in the diet which need further analysis
Mjesto i važnost nekliniÄkih bolniÄkih centara u lijeÄenju bolesnika sa zloÄudnim bolestima u Republici Hrvatskoj
Onkologija predstavlja važan segment sveukupnoga hrvatskoga zdravstvenog sustava. Sama onkologija
jedna je od trenutaÄno najpropulzivnijih medicinskih struka te smo svakodnevno svjedoci ekspanzivnog rasta
novih modaliteta onkoloÅ”kog lijeÄenja. Ove Äinjenice nameÄu imperativ stvaranja onkoloÅ”ke mreže koja bi kao
zadatak imala standardiziranje onkoloÅ”kog lijeÄenja i osiguravanje dostupnosti novih modaliteta lijeÄenja za sve
oboljele od zloÄudnih bolesti, neovisno o njihovom mjestu boravka.Ā¹ Hrvatska veÄ ima prepoznate i definirane
regionalne onkoloÅ”ke centre u sklopu kliniÄkih bolniÄkih centara u Zagrebu, Rijeci, Osijeku i Splitu. NasreÄu, u
Hrvatskoj postoji tradicija, stara nekoliko desetljeÄa, razvoja onkoloÅ”kih centara u opÄim i županijskim bolnicama.
Poimence, to su nekliniÄki onkoloÅ”ki centri u Županijskoj bolnici Äakovec, OpÄoj bolnici Dubrovnik, OpÄoj bolnici
Karlovac, OpÄoj bolnici Koprivnica, OpÄoj bolnici Pula, OpÄoj bolnici Slavonski Brod, OpÄoj bolnici Å ibenik, OpÄoj
bolnici Varaždin i OpÄoj bolnici Zadar. Svrha ovoga istraživanja, provedenog u svim nekliniÄkim onkoloÅ”kim
centrima
Hrvatske te koriŔtenjem podataka Državnog zavoda za statistiku i Hrvatskog zavoda za zdravstveno osiguranje,
bila je uvidjeti kako je trenutno organizirana onkoloÅ”ka skrb u Republici Hrvatskoj i koja je uloga nekliniÄkih
onkoloÅ”kih centara u lijeÄenju bolesnika sa zloÄudnim bolestima u Republici Hrvatskoj
Ishodi lijeÄenja bolesnica s BRCA mutiranim recidivom karcinoma jajnika u KliniÄkom bolniÄkom centru Split
Aim: To evaluate the treatment outcomes, with emphasis on the efficacy and safety of olaparib, in patients with platinum-sensitive, BRCA-mutated, recurrent ovarian cancer treated at the University Hospital Center Split in the period from June 2016 to April 2021.
Methods: Data were collected retrospectively from a medical history of 28 patients with platinum-sensitive, BRCAmutated, recurrent ovarian cancer. Medical records were reviewed for clinico-pathological characteristics, number of previous chemotherapy lines and platinum-free interval before olaparib, response to olaparib, survival outcomes (time to disease progression, time from first cycle of olaparib to the first cycle of chemotherapy for the first and second relapse / progression, overall survival) and safety. Median follow up time was 27 months.
Results: All patients were BRCA mutated, with a 75% predominance of BRCA1 mutation. The median platinum-free interval was 13 months. Most patients were treated after the first relapse (64%) with a three weekly TC protocol (68%). Olaparib maintenance therapy provided clinical control rate in 43% of cases. The median progression free survival was 24 months. Discontinuation of olaparib treatment was reported due to disease progression in 16 patients. The median time to first subsequent chemotherapy was 31 months and time to second subsequent chemotherapy was 38 months. The tolerability of olaparib was good and the side effects were low intensity. The median overall survival is not reached.
Conclusion: This retrospective analysis of patients with platinum-sensitive, BRCA-mutated, recurrent ovarian cancer showed that the treatment outcomes, ie efficacy and tolerability of olaparib after platinum based chemotherapy in everyday clinical practice, are comparable to those observed in clinical trials with olaparib in the same indications.Cilj: Ispitati ishode lijeÄenja, s naglaskom na uÄinkovitost i sigurnost olapariba, kod ispitanica s platina-osjetljivim, BRCA mutiranim recidivom karcinoma jajnika lijeÄenih u KliniÄkom bolniÄkom centru Split u razdoblju od lipnja 2016. do travnja 2021. godine.
Metode: Retrospektivno su prikupljeni podatci iz povijesti bolesti 28 bolesnica s platina-osjetljivim, BRCA mutiranim recidivom karcinoma jajnika. Iz medicinske dokumentacije pregledane su kliniÄko-patoloÅ”ke karakteristike, broj prethodnih linija kemoterapije i interval bez platine prije olapariba, odgovor na olaparib, ishodi preživljavanja (preživljenje do progresije bolesti, preživljenje od prvog ciklusa olapariba do prvog ciklusa kemoterapije za prvi i drugi recidiv/progresiju, ukupno preživljenje) i podnoÅ”ljivost lijeÄenja olaparibom. Medijan praÄenja bio je 27 mjeseci.
Rezultati: Sve bolesnice su bile BRCA mutirane, sa 75% prevlasti BRCA1 mutacije. Medijan platina slobodnog intervala iznosio je 13 mjeseci. VeÄina bolesnica lijeÄena je nakon prvog relapsa (64%) trotjednim TC protokolom (68%). Terapija održavanja olaparibom osigurala je kliniÄku kontrolu bolesti u 43% sluÄajeva. Medijan preživljavanja bez progresije bio je 24 mjeseca. Prekid lijeÄenja olaparibom prijavljen je zbog progresije bolesti u 16 bolesnica. Medijan vremena do prve sljedeÄe kemoterapije bio je 31 mjesec, a do druge sljedeÄe kemoterapije bilo je 38 mjeseci. PodnoÅ”ljivost olapariba bila je dobra, a nuspojave slabog intenziteta. Medijan ukupnog preživljenja nije postignut.
ZakljuÄak: Ova retrospektivna analiza lijeÄenja bolesnica s platina-osjetljivim, BRCA mutiranim recidivom karcinoma jajnika je pokazala da su ishodi lijeÄenja, odnosno uÄinkovitost i podnoÅ”ljivost olapariba nakon kemoterapije temeljene na platini u svakodnevnoj kliniÄkoj praksi, usporedivi s rezultatima kliniÄkih istraživanja s olaparibom u istoj indikaciji
Clinical guidelines for diagnosis, treatment and monitoring of patients with invasive breast cancer ā Croatian Oncology Society (BC-3 COS)
Rak dojke je najÄeÅ”Äi zloÄudni tumor u žena koji se može probirom, redovitim kontrolama i zdravstvenim odgojem otkriti u ranim stadijima bolesti i uspjeÅ”no lijeÄiti. Metode lijeÄenja ukljuÄuju kirurgiju, kemoterapiju, radioterapiju, endokrinu terapiju, imunoterapiju, ciljanu terapiju te simptomatsko-suportivnu terapiju, koja se primjenjuje ovisno o stadiju bolesti, bioloÅ”kim obilježjima tumora i opÄem stanju, dobi i komorbidetima bolesnica. Plan lijeÄenja definira multidisciplinarni tim. S obzirom na pojavnost ove bolesti, moguÄnost ranog otkrivanja i moguÄeg znaÄajnog uÄinka terapijskih postupaka na tijek bolesti, potrebno je definirati i pravilno standardizirati pristup u dijagnostici, lijeÄenju i praÄenju ovih bolesnica. U tekstu su iznesene smjernice s ciljem primjene standardiziranih postupaka u svakodnevnom radu s bolesnicama s rakom dojke u Republici Hrvatskoj.Breast cancer is the most common cancer in women, which can be diagnosed early through screening, early detection and through education. When diagnosed early, it can be successfully treated. Treatment modalities include surgery, chemotherapy, radiotherapy, endocrine therapy, immunotherapy, targeted therapy and supportive therapy applied depending on the stage of the disease, tumor and patientĀ“s characteristics. Treatment should be defined by a multidisciplinary team. Due to the incidence of this disease, opportunity of early detection and possible significant influence of various treatment modalities on the course of the disease, it is important to define and implement a standardized approach for diagnosis , treatment and monitoring algorithm. The following text presents the clinical guidelines in order to standardize the procedures and criteria for
diagnosis,treatment and monitoring of breast cancer patients in the Republic of Croatia