Multidisciplinary treatment of pain caused by bone metastases in cancer patients: two case reports

Over 50% patients with malignant neoplasms suffer pain. In Poland, about 200,000 people annually have to contend with this problem. It can arise from the prolonged lifespan of cancer patients, the development of iatrogenic pain syndromes, pain associated with cancer cachexia, or decreased efficacy of analgesics due to induced opioid tolerance. The commonly used term “cancer pain” actually refers to all types of pain. In order that each patient is optimally treated, it is necessary to identify the type and cause of their pain. One of the more difficult types of pain to treat is that due to bone metastases; with its inflammatory and neuropathic components. Every patient has the right to proper pain treatment, with the goal of achieving the maximum analgesic effect while minimizing any side effects.

Early diagnosis and treatment of refractory and recurrent classical Hodgkin's lymphoma

Although the prognosis of Hodgkin's lymphoma (HL) is relatively good, about 10% of patients with early and up to 30% with advanced stages do not respond to first line treatment (ABVD) or relapse. The chemoresistance is defined as: the progression of the disease during treatment, lack of complete metabolic response during or after treatment, or the very earl

Radiotherapy in the treatment of Hodgkin’s lymphoma

Chłoniak Hodgkina (HL) należy do wyjątkowo promieniowrażliwych i chemiowrażliwych nowotworów. Około 90% chorych na HL we wczesnych stopniach zaawansowania można wyleczyć, stosując standardową chemioterapię, radioterapię lub leczenie skojarzone. Doskonałe wyniki leczenia spowodowały poszukiwanie coraz mniej toksycznych metod terapii. W odniesieniu do radioterapii oznaczało to zmianę objętości napromienianych tkanek oraz obniżanie dawki całkowitej. W pracy przedstawiono współcześnie obowiązujące wskazania do napromieniania oraz zasady planowania.Hodgkin’s lymphoma (HL) is a very radiosensitive and chemosensitive neoplasm. Approximately 90% of patients with early-stage HL can be cured with standard chemotherapy, radiation or combined modalities. Excellent treatment outcomes resulted in searching for equally effective but less toxic therapies. Speaking about radiotherapy it meant changing the irradiated tissue volumes and/or decreasing the total dose. Here we discuss current indications for radiotherapy and principles of treatment planning

Pancoast tumor-like primary lung lymphoma

Okolica szczytu płuca jest wyjątkowo rzadką lokalizacją pierwotnych chłoniaków oskrzela. W pracy przedstawiono przypadek zaawansowanego pierwotnego chłoniaka szczytu lewego płuca rozpoznanego podczas badań przesiewowych u 72-letniej bezobjawowej pacjentki. Przezskórna biopsja cienkoigłowa nie przyniosła rozpoznania histopatologicznego. Było to powodem wykonania otwartej biopsji płuca, w której wykazano obecność zmian charakterystycznych dla chłoniaka B-komórkowego o niskiej złośliwości, marginal zone lymphoma (BALTL); CD20+, CD3-. Zastosowano leczenie skojarzone: 9 cykli chemioterapii i napromienianie masy resztkowej, co pozwoliło na uzyskanie długotrwałej całkowitej remisji.Apical lung location of lymphomas is extremely rare and may pose diagnostic problems. Here we present a case of advanced primary Pancoast-like left apical lung lymphoma incidentally diagnosed in a 72 year old asymptomatic woman after a routine, prophylactic chest X-ray performed in June 2005. FNB was not diagnostic therefore an open lung biopsy was attempted. Histopathological examination of the excised specimen was consistent with B-cell low-grade marginal zone extranodal NHL (BALTL); CD20+, CD3-. Treatment combined of 9 cycles of chemotherapy followed by radiotherapy of the residual mass allowed to achieve a long-term complete remission

Wielodyscyplinarne leczenie bólów spowodowanych przerzutami do kości u chorych na nowotwory — opis przypadku

Ból występuje u ponad 50% chorych na nowotwory złośliwe. W Polsce z problemem tym boryka się około 200 000 osób rocznie. Jest to wynikiem wydłużonego czasu życia chorych na nowotwory, rozwoju jatrogennych zespołów bólowych, bólów towarzyszących kacheksji nowotworowej czy zmniejszonej skuteczności leków przeciwbólowych w następstwie wyindukowanej tolerancji na opioidy. Zwyczajowe określenie „ból nowotworowy” odnosi się do wszystkich rodzajów bólu. Aby zastosować optymalne leczenie, u każdego chorego konieczne jest rozpoznanie rodzaju i przyczyny bólu. Jednym z trudniejszych do leczenia jest ból na podłożu przerzutów do kości, z jego zapalną i neuropatyczną komponentą. Każdy pacjent ma prawo do starannego leczenia bólu, a jego celem jest uzyskanie maksymalnego efektu przeciwbólowego przy jednoczesnym zminimalizowaniu działań niepożądanych

Książki nadesłane

„Genetyka i genomika zwierząt"Krystyna M. Charon, Marek Świtoński „Nowotwory przewodu pokarmowego”red. Ronald Fuchs, Dorothee Guggenberger, Ulf Neuman, Christian TrautweinRedakcja naukowa wydania polskiego: Wojciech Polkowski „Nowotwory złośliwe. Postępowanie wielodyscyplinarne:leczenie systemowe, chirurgia, radioterapia”Richard Pazdur, Lawrence D. Wagman, Kevin A. Camphausen, William J. HoskinsRedakcja naukowa wydania polskiego: Maciej Krzakowski i Andrzej Kaweck

What's happening? : uma plataforma de eventos

Os eventos são uma presença constante no nosso dia a dia e são divulgados através dos meios de comunicação, anúncios publicitários ou através de conversas entre amigos. A era digital trouxe consigo uma data de mudanças significativas no mundo das comunicações e consequentemente, a divulgação de eventos é facilitada devido às redes sociais que desempenham um papel importante na proliferação destes. No entanto, a procura de eventos, quer no tempo ou no espaço, não é uma tarefa fácil nos dias que correm. Apesar da evolução tecnológica ter permitido a criação de novas plataformas para divulgação de eventos, ainda existe dificuldade em saber o que está a acontecer em redor da nossa localização. Atualmente, um grande número de eventos sociais é criado e promovido nas redes sociais. Com o aglomerado de informação que estas redes geram, a experiência de procurar eventos não é a mais consistente para o utilizador porque os resultados obtidos nem sempre refletem os interesses do utilizador. Este trabalho propõe um novo conceito para uma plataforma de divulgação de eventos, intitulada de What’s Happening? com o objetivo de melhorar a experiência do utilizador na procura e recomendação destes. Em particular, é proposta uma arquitetura para a plataforma que utiliza técnicas de machine learning para classificar eventos provenientes de redes sociais populares, e.g. Facebook, com o objetivo de os categorizar. Tendo em conta que os serviços utilizados para a obtenção de eventos apresentam modelos de dados diferentes, é proposta a ontologia LODSE (Linking Open Descriptions of Social Events), tendo como base a ontologia LODE (Linking Open Descriptions of Events), com o objetivo de facilitar a integração dos dados obtidos dos serviços externos, modelar um evento social para ser posteriormente classificado e melhorar a classificação de eventos. Como forma de validação das técnicas de machine learning na arquitetura proposta bem como o modelo de dados criado a partir da ontologia LODSE, foram realizadas duas avaliações experimentais. A primeira avaliação experimental demonstrou que o melhor algoritmo para classificar os datasets de eventos criados é o Random Forest obtendo 83,33% de eventos corretamente classificados. A segunda avaliação experimental demonstrou que o modelo de dados baseado na ontologia LODSE traz benefícios na classificação de eventos demonstrando uma melhoria de 12,4% de eventos corretamente classificados bem como uma melhoria de 5,9% no tempo de processamento quando comparado com o modelo de dados baseado na ontologia LOD

Long-term outcome of patients with spinal myxopapillary ependymoma: treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network

Background Spinal myxopapillary ependymomas (MPEs) are slowly growing ependymal gliomas with preferential manifestation in young adults. The aim of this study was to assess the outcome of patients with MPE treated with surgery, radiotherapy (RT), and/or chemotherapy. Methods The medical records of 183 MPE patients (male: 59%) treated at the MD Anderson Cancer Center and 11 institutions from the Rare Cancer Network were retrospectively reviewed. Mean patient' age at diagnosis was 35.5 ± 15.8 years. Ninety-seven (53.0%) patients underwent surgery without RT, and 86 (47.0%) were treated with surgery and/or RT. Median RT dose was 50.4 Gy. Median follow-up was 83.9 months. Results Fifteen (8.2%) patients died, 7 of unrelated cause. The estimated 10-year overall survival was 92.4% (95% CI: 87.7-97.1). Treatment failure was observed in 58 (31.7%) patients. Local failure, distant spinal relapse, and brain failure were observed in 49 (26.8%), 17 (9.3%), and 11 (6.0%) patients, respectively. The estimated 10-year progression-free survival was 61.2% (95% CI: 52.8-69.6). Age (<36 vs ≥36 y), treatment modality (surgery alone vs surgery and RT), and extent of surgery were prognostic factors for local control and progression-free survival on univariate and multivariate analysis. Conclusions In this series, treatment failure of MPE occurred in approximately one third of patients. The observed recurrence pattern of primary spinal MPE was mainly local, but a substantial number of patients failed nonlocally. Younger patients and those not treated initially with adjuvant RT or not undergoing gross total resection were significantly more likely to present with tumor recurrence/progressio