Prisotnost kromosomskih sprememb v somatskih celicah pri bolnikih s tumorji mod po različnih načinih zdravljenja

Background. The damage due to radiation or chemotherapeutic agents has been estimated successfully for the last 35 years from the numbers of the chromosome changes. This finding may serve as biological dosimeter. The aim ofthe study was to find persistent chromosomal aberrations in somatic cells intesticular cancer patients after different therapies. Patients and methods. This prospective study includes 60 patients with testicular tumours. With respect to the histological results and various therapies that they were giventhey were divided into four groups. Prior to treatment, we did not detectany deviations either in the genome picture of our patients or in that of the subjects of the control group without malignant disease. The changes inthe genome of individual cells after therapy were detected by the following tests: structural chromosomal aberrations (SCA) test, sister chromatid exchange (SCE) test and micronucleus (MN) test performed on binuclear lymphocytes. (Abstract truncated at 2000 characters)Izhodišča. Raziskave v zadnjih 35 letih so pokazale, da so spremembe v genomu posameznih celic povzročene tako zaradi zdravljenja s citostatiki, kot zaradi obsevanja z ionizirajočimi žarki. Te spremembe v celici nam lahko služijo kot biološki dozimeter. Namen raziskave je bil najti prisotnost kromosomskih sprememb v somatskih celicah pri bolnikih s tumorji mod po različnih načinih zdravljenja. Pacienti in metode. V prospektivno študijo smo vključili 60 bolnikov s tumorji mod, ki smo jih glede na histološke izvide in načine zdravljenja razdelili v štiri skupine. Pred zdravljenjem ni bilo odstopanj v genomski sliki v primerjavi z enako kontrolno skupino pregledovancev brez malignoma. Vpliv zdravljenja na genom bolnikov smo ugotavljali s pregledom genomske slike pred zdravljenjem, po zdravljenju in šest mesecev kasneje s priznanimi citogenetskimi testi, s katerimi smo pogledali strukturne spremembekromosomov - SCA, izmenjavo med sestrskimi kromatidami - SCE in mikronukleus - MN pri dvojedrnih limfocitih. Rezultati. Takoj po končanem obsevanju smo ugotovili močno inhibicijo mitotske aktivnosti limfocitov in zvečano število nestabilnih kromosomskih sprememb (dicentrikov). Kemoterapija je vplivala na genomsko sliko v manjšem odstotku, tip kromosomskih sprememb jebil drugačen. S citološko mutagenetskega vidika se je pokazalo, da je samo obsevanje bolj agresivno od kemoferapij e. Šest mesecev po zaključenem zdravljenju je mitotična aktivnost večinoma normalna, vendar pa je še vedno zelo velik odstotek sprememb glede na začetne vrednosti in v primerjavi z bolniki, ki so bili le operirani. Zaključek. Tako po obsevanju kot po zdravljenju s citostatiki pride do normalizacije genoma, kajti poškodovane celice odmrejo. Glede na to, da je pri obsevanih bolnikih le majhen tkivni celični volumen izpostavljen obsevanju, pri kemoterapiji pa je celotni organizem izpostavljen kemijskemu agensu, upravičeno pričakujemo hitrejšo popravo genoma pri obsevanih bolnikih

ASCO 2009

No abstract.Ni abstrakta

ASCO 2009: vloga radioterapije pri zdravljenju raka dojk

No abstract.Ni abstrakta

Vpliv pooperativne radioterapije pri multimodalnem zdravljenju lokalno napredovalega raka dojke

We retrospectively analyzed the data from 55 patients treated for noninflammatory locally advanced breast cancer (LABC) with neoadjuvant chemotherapy and surgery with or without radiotherapy. The mean follow-up was 55 months. The purpose was to evaluate and compare the impact of postoperative radiotherapy, whether it was indicated on the basis of clinical stage at presentation of the disease or on downstaged pathological disease after initial chemotherapy. The 3-year overall survival (OS) was 74%, disease-free survival (DFS) 73% and relapse-free survival (RFS) 87%. The OS and DFS benefit was seen in those receiving radiation, with a mean OS of 89 months vs. 68 months (p=0.029) and mean DFS of 72 months vs. 54 months (p=0.029). Total LRR was 11% (8% vs. 17% in no RT group, p=0,349) and mean RFS of 95 months vs. 86 months (p=0.164). Significantly lower OS and DFS of the patients who were not treated with radiotherapy suggest that the indication for radiation treatment should be based on clinical pre-chemotherapy stage rather than pathological post-chemotherapy stage for non-inflammatory LABC.Ni abstrakta

Patients with One to Three Positive Axillary Lymph Nodes Following Mastectomy: Dilemma Whether to Use Postoperative Radiation Therapy or No

Obsevanje po modificirani radikalni mastektomiji (MRM) pri bolnicah z 1-3 pozitivnimi pazdušnimi bezgavkami je že vrsto let predmet strokovnih razprav. Kljub čedalje pogostejšim dokazom o dobrobiti obsevanja po MRM pri bolnicah s t. i. vmesnim tveganjem za lokalno ponovitev pa še vedno ostajajo številna protislovja in nerešena vprašanja o pomenu učinka izboljšane lokalne kontrole na preživetje, o posledicah pozne kardiotoksičnosti obsevanja ob uporabi sodobnih sistemskih zdravil ter o izbiri območja obsevanja in podskupin bolnic, primernih za obsevanje. Večina mednarodnih smernic in sporazumov svetuje obsevanje po MRM v podskupinah bolnic z 1-3 pozitivnimi pazdušnimi bezgavkami, s tehtnim premislekom med koristjo in tveganjem tega zdravljenja.Radiation therapy following a modified radical mastectomy (MRM) applied in the patients with one to three positive axillary lymph nodes has long been a primary issue of many debates. Despite most convincing evidence of the benefits of the post-MRM radiation therapy of the patients at moderate risk for local recurrence, a number of issues and questions, such the effect of improved local control on survival as well as the late cardiotoxic sequelae of radiation therapy irrespective of the most up-to-date systemic therapy, accurate radiation field planning and proper selection of subgroups of patients eligible for radiation, have remained unresolved. In general, the majority of international guidelines and agreements recommend, though not without a careful benefit/risk assessment, performing post-MRM radiation therapy in the subgroup of patients with one to three positive axillary lymph nodes

The impact of radiotherapy in multimodal management of locally advanced breast cancer

We retrospectively analyzed the data from 55 patients treated for noninflammatory locally advanced breast cancer (LABC) with neoadjuvant chemotherapy and surgery with or without radiotherapy. The mean follow-up was 55 months. The purpose was to evaluate and compare the impact of postoperative radiotherapy, whether it was indicated on the basis of clinical stage at presentation of the disease or on downstaged pathological disease after initial chemotherapy. The 3-year overall survival (OS) was 74%, disease-free survival (DFS) 73% and relapse-free survival (RFS) 87%. The OS and DFS benefit was seen in those receiving radiation, with a mean OS of 89 months vs. 68 months (p=0.029) and mean DFS of 72 months vs. 54 months (p=0.029). Total LRR was 11% (8% vs. 17% in no RT group, p=0,349) and mean RFS of 95 months vs. 86 months (p=0.164). Significantly lower OS and DFS of the patients who were not treated with radiotherapy suggest that the indication for radiation treatment should be based on clinical pre-chemotherapy stage rather than pathological post-chemotherapy stage for non-inflammatory LABC

Zdravljenje raka dojke z obsevanjem

Knjižica je namenjena bolnicam z rakom dojk, ki imajo po operaciji dojke predvideno še pooperativno obsevanje. Opisuje namen in potek zdravljenja z obsevanjem ter zgodnje in pozne učinke obsevanja. Bolnicam nudi navodila za nego obsevane kože med zdravljenjem in po zaključenem zdravljenju