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Nový Jičín, Czech Republic

Petera J.,Charles University | Kasaova L.,Charles University | Paluska P.,Charles University | Sirak I.,Charles University | And 4 more authors.
Hepato-Gastroenterology | Year: 2011

Background/Aims: The aim of our study was to evaluate preliminary results of intensity modulated radiotherapy (IMRT) in patients with inoperable subhepatic tumors. Methodology: Thirteen patients with inoperable cholangiocarcinoma or gall bladder carcinoma were treated by biliary drainage and intensity modulated radiotherapy. In patients with tumors limited to the biliary duct only tumor stenosis was irradiated to the dose of 50-60Gy. In patients with bulky extraductal tumors the dose was 50Gy/25 fractions to the whole tumor and an integrated boost was used to raise the dose to the malignant stenosis to 60Gy/25 fractions. Results: Doses to organs at risk (duodenum, small intestine, liver) were in tolerable limits. In four patients transient fever occurred; one patient had duodenal bleeding that resolved after conservative treatment. Recurrent dilatation of the biliary tract was observed in 4 patients and was managed by exchange of the internal biliary drainage. Median survival was 10.4 months, 5 patients survived for more than one year following diagnosis. Conclusions: IMRT of inoperable extrahepatic biliary tract tumors allows application of high doses of radiation to the tumor with effective sparing of healthy tissues. The control of jaundice is good. In selected cases IMRT may prolong overall survival. © H.G.E. Update Medical Publishing S.A.

Petera J.,University of Hradec Kralove | Sirak I.,University of Hradec Kralove | Beranek M.,University of Hradec Kralove | Vosmik M.,University of Hradec Kralove | And 3 more authors.
Neoplasma | Year: 2011

Radical radiotherapy with concurrent cisplatin-based chemotherapy is an established treatment for cervical cancer patients with stage FIGO IIB and higher. The tumor control can be achieved in 40-80% of patients, the treatment is associated with the risk of late postiradiation complications in 10 - 15% of cases. Detection of the factors predictive for tumor control and late morbidity is a possible direction how to individualize radiotherapy dose and technique. The aim of our review is to summarize results of studies inquiring various molecular markers predicting tumor response to radiotherapy and a risk of late complications. A lot of candidate molecules were evaluated in histochemical studies: membrane receptors (EGFR, HER-2), cell cycle regulators (p53, p21), proliferative markers (Ki-67), hypoxia and angiogenetic factors (HIF, VEGF), HPV status, and others (COX-2), with promising results in some of them (HPV, HIF-1α, Ku80, ATM polymorphism). Microarray studies identified decades of genes with different expression in radiosensitive / radioresistant cervical tumors and sets of genes are able to comletely separate responding and nonresponding tumors, but these sets differ across studies. Further well designed studies will be necessary to achieve results matured for use in clinical practice.

Soumarova R.,Cancer Center Novy Jicin | Manasek V.,Cancer Center Novy Jicin | Perkova H.,Cancer Center Novy Jicin | Ferak I.,Cancer Center Novy Jicin
Onkologie | Year: 2012

Background: Primary epididymal carcinoma is an extremely rare disease with a bad prognosis. We describe the first report of radiotherapy for definitive treatment of such a tumour. Case Report: A 35-year-old man with a tumour of the epididymis underwent orchiectomy and elective retroperitoneal lymphadenectomy. Adenocarcinoma of the epididymis and lymph node metastasis were confirmed. The patient refused the suggested adjuvant chemotherapy and returned to our centre with a local recurrence after 6 months. We indicated palliative radiotherapy to the scrotal and groin region. Complete remission was achieved and continues 3.5 years after treatment. Late effects included teleangiectasia, fibrosis and thickening of subcutaneous tissue, and depigmentation in the groin, but the patient enjoys very good quality of life including penile erection. Conclusion: We presented very good results of radiotherapy in the treatment of this rare malignant disease. We achieved complete remission with a good quality of life and with tolerable chronic toxicity. Copyright © 2012 S. Karger AG, Basel.

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