Limfangioleiomiomatoza

Background. Lymphangioleiomyomatosis is a rare disease of unknown origin, which affects women in their reproductive period. It is characterised by non-neoplastic proliferation of atypical smooth muscle cells in the lung parenchyma, lymphatic vessels and mediastinal and abdominal lymph nodes. The most common presenting symptoms are spontaneous pneumothorax, dyspnea, hemoptysis and chylothorax. Conclusions. High-resolution computed tomography (HRCT) and open lung biopsy followed by the immunohistologic studies are two diagnostic procedures with which diagnosis can be confirmed. Various treatmentmodalities are applied, particularly hormonal therapy, though their efficacy remain unknown. The prognosis of patients is bad.lzhodišča. Limfangioleiomiomatoza je redka bolezen neznanega vzroka, za katerozbolevajo ženske v rodnem obdobju. Za bolezen je značilna neneoplastičnaproliferacija atipičnih gladkomišičnih celic v pljučnem parenhimu, limfnih žilah ter mediastinalnih in abdominalnih bezgavkah. V klinični sliki se pojavljajo spontani pnevmotoraksi, dispneja, hemoptize in hilotoraks. Zaključlti. Računalniška tomografija visoke ločljivosti in imunohistološke metode v bioptičnih vzorcih pljučnega tkiva nam omogočajo pravilno postavitev diagnoze. Načini zdravljenja so različni, običajno hormonski, vendar je zaenkrat njihov uspeh še vprašljiv, prognoza bolnikov pa slaba

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

Pre-operative irradiation of the pelvis with a short regimen of 5 x 5 Gy in a patient with rectal carcinoma - a case study

Pri bolnikih z lokalno in/ali regionalno napredovalim karcinomom danke je po trenutno veljavnih smernicah indicirano predoperativno zdravljenje. V prispevku je prikazan klinični primer starejšega bolnika s karcinomom danke v kliničnem stadiju T4 N0 M0, ki je bil zdravljen s predoperativnim obsevanjem medenice po kratkem režimu 5 x 5 Gy, čemur je po šestih tednih sledila abdominoperinealna ekscizija. Ob patološki kompletni remisiji bolnik pooperativne kemoterapije ni prejemal in je bil ob zadnji kontroli, slabo leto in pol po operaciji, brez znakov za ponovitev bolezni.In patients with locally and/or regionally advanced rectal carcinoma, the currently applicable guidelines indicate pre-operative treatment. In this study, we present a clinical case of an older patient with stage T4 N0 rectal carcinoma, who was treated with pre-operative irradiation using a short regimen of 5 x 5 Gy, which was followed by abdominoperineal excision six weeks later. With pathological complete remission, the patient did not underwent post-operative chemotherapy and showed no signs of disease recurrence at the last follow-up a year and a half after the the surgery

[The radiation therapy practitioner\u27s view of oesophageal cancer treatment]

Karcinom požiralnika je bolezen, katere incidenca po svetu narašča in katere prognoza je praviloma, kljub vsemu doseženemu napredku v onkologiji v zadnjih letih, še vedno slaba. V letu 2010 je bila objavljena revidirana, trenutno veljavna TNM klasifikacija za karcinome požiralnika, ki bolje upošteva naravni potek bolezni in biološke značilnosti ploščatoceličnih karcinomov v primerjavi z adenokarcinomi. Pri zdravljenju bolnikov s karcinomom požiralnika ima obsevanje pomembno vlogo, tako v sklopu predoperativnih zdravljenj kot (ob sočasni kemoterapiji) tudi pri neoperativnih načinih zdravljenja.Oesophageal carcinoma is a disease with an increasing incidence in the world, and the prognosis of which is generally still poor, despite the progress achieved in oncology in the last years. In 2010, a revised TNM classification for oesophageal carcinomas was published, which is currently still applicable and takes better account of the natural course of the disease and biological characteristics of squamous cell carcinomas compared to adenocarcinomas. Radiation plays an important part in the treatment of patients with oesophageal carcinoma, both in the scope of preoperative treatments (with concurrent chemotherapy) as well as in non-operative treatment methods

Pogled zdravnika radioterapevta na zdravljenje raka požiralnika

Oesophageal carcinoma is a disease with an increasing incidence in the world, and the prognosis of which is generally still poor, despite the progress achieved in oncology in the last years. In 2010, a revised TNM classification for oesophageal carcinomas was published, which is currently still applicable and takes better account of the natural course of the disease and biological characteristics of squamous cell carcinomas compared to adenocarcinomas. Radiation plays an important part in the treatment of patients with oesophageal carcinoma, both in the scope of preoperative treatments (with concurrent chemotherapy) as well as in non-operative treatment methods.Karcinom požiralnika je bolezen, katere incidenca po svetu narašča in katere prognoza je praviloma, kljub vsemu doseženemu napredku v onkologiji v zadnjih letih, še vedno slaba. V letu 2010 je bila objavljena revidirana, trenutno veljavna TNM klasifikacija za karcinome požiralnika, ki bolje upošteva naravni potek bolezni in biološke značilnosti ploščatoceličnih karcinomov v primerjavi z adenokarcinomi. Pri zdravljenju bolnikov s karcinomom požiralnika ima obsevanje pomembno vlogo, tako v sklopu predoperativnih zdravljenj kot (ob sočasni kemoterapiji) tudi pri neoperativnih načinih zdravljenja

Postoperativna radiokemoterapija pri bolnikih z rakom želodca

Background. To analyze the efficacy of postoperative radiochemotherapy with 5-florouracil (5-FU) and leucovorin (LV) applied in the patients with gastric carcinoma treated in a single institution. Patients and methods. Between 2001 and 2004, 123 patients with resected gastric adenocarcinoma were treated with postoperative concomitant radiochemotherapy with 5-FU and LV. The adjuvant treatment consisted of five cycles of chemotherapy with 5-FU (425mg/m2 IV) andLV (20 mg/m2 IV) and concomitant radiotherapy with the total dose of 45 Gy.Results. The treatment was completed according to the protocol in 82% of patients. The frequency and severity of early toxic effects induced by radiochemotherapy were manageable. Median follow-up time of 56 survivors was 64.5 months (range: 51.7-96.4 months). The 5-year locoregional control (LRC), diseasefree survival (DFS), disease-specific survival (DSS) and overall survival (OS) were 81%, 48.3%, 50.4%, and 48.4%, respectively. The multivariate analysis showed that the tumor involvement of cardia and low intensity of chemotherapy were independent adverse prognostic factors for DSS and OS. More advanced pT-stage and tumors with diffuse growth type according to Lauren were identified as negative independent prognostic factor for OS. They were also on the threshold of statistical significance for DSS. Conclusions. Postoperative radiochemotherapy for gastric carcinoma has acceptable toxicity, and is effective particularly in regard to LRC. High incidence of distant metastases calls for more effective systemic regimens

High-dose carbon ion irradiation in a patient with inoperable rectal carcinoma recurrence

V prispevku je prikazan klinični primer bolnika z inoperabilnim recidivom karcinoma danke, ki je bil zdravljen z visokodoznim obsevanjem z ogljikovimi ioni v protonskem centru v tujini. Obsevanja s protoni ali težkimi ioni v Sloveniji zaenkrat še ne moremo zagotoviti, zato moramo vse bolnike za katere presodimo, da bi imeli od tovrstnega zdravljenja korist, napotiti na zdravljenje v enega od protonskih centrov v tujini. V primerjavi z obsevanjem s fotoni, lahko zaradi specifičnih fizikalnih lastnosti protonskih delcev in težkih ionov, pri obsevanju z njimi bistveno zmanjšamo volumne v obsevalna polja zajetih zdravih tkiv, v določenih kliničnih situacijah pa tumorje tudi obsevamo z višjimi dozami.The article presents a clinical case of a patient with inoperable rectal carcinoma relapse who was treated with high-dose carbon ion irradiation at a proton center abroad. Irradiation with protons or heavy ions cannot be guaranteed in Slovenia for the time being, so we must refer all patients who we judge would benefit from this type of treatment to one of the proton centers abroad. Compared to irradiation with photons, due to the specific physical properties of proton particles and heavy ions, when irradiating with them, we can significantly reduce the volumes in the radiation fields of covered healthy tissues, and in certain clinical situations tumors can also be irradiated with higher doses

Radioterapija v Sloveniji

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.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