Klinika Nowotworow Glowy I Szyi

Kraków, Poland

Klinika Nowotworow Glowy I Szyi

Kraków, Poland

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Jassem J.,Medical University of Gdańsk | Duchnowska R.,Klinika Onkologii | Kawecki A.,Klinika Nowotworow Glowy i Szyi | Krajewski R.,Klinika Nowotworow Glowy i Szyi | And 7 more authors.
Nowotwory | Year: 2014

Surveillance after oncological treatment constitutes a necessary element of comprehensive cancer care. Determining optimal follow-up schedules, including their cost effectiveness, is critical on clinical, organisational and economic grounds. Owing to a lack of prospective clinical studies providing the highest level of evidence, in most cancers optimal surveillance schemes cannot be determined. Hence, currently most recommendations are based on retrospective studies and expert opinions. In Poland comprehensive and uniform recommendations on post-treatment surveillance in cancer patients are not available. This article, prepared by a group of experts in oncology and family medicine, presents a proposal for the follow-up schemes after treatment in major solid malignancies in adults. © Polskie Towarzystwo Onkologiczne.


Kwapisz D.,Klinika Nowotworow Pluca i Klatki Piersiowej | Kawecki A.,Klinika Nowotworow Glowy i Szyi | Krzakowski M.,Klinika Nowotworow Pluca i Klatki Piersiowej
Nowotwory | Year: 2013

Surgery is the treatment of choice for patients with early-stage non-small-cell lung cancer. A proportion of patients cannot undergo surgery due to comorbid conditions and - in this situation - radical radiotherapy may be an alternative method of treatment. Compared with conventional photon irradiation proton beam treatment - either three-dimensional conformal or intensity-modulated radiation therapy - allows for dose escalation with reduction of the dose delivered to normal tissues. Proton beam therapy is safe and effective for treating patients with non-small-cell lung cancer. Clinical studies confirm the feasibility of proton irradiation for early-stage non-small-cell lung cancers and further trials are being performed in locally advanced tumors. In this paper, we present the physical aspects and the preliminary data from dosimetric and clinical studies for proton beam therapy in stage I-III non-small-cell lung cancer on the basis of the available literature.


Cybulska-Stopa B.,Klinika Nowotworow Ukladowych i Uogolnionych | Rolski J.,Klinika Nowotworow Glowy i Szyi | Ziobro M.,Klinika Nowotworow Ukladowych i Uogolnionych | Hetnal M.,Zaklad Radioterapii
Wspolczesna Onkologia | Year: 2010

Between 1980 and 2000, 30 patients with lymphoblastic lymphoma were treated at the Medical Oncology Clinic of the Centre of Oncology (Krakow Division). At first the APO and Coleman's treatment protocols were used. In 1993, in order to improve treatment results, a modification of Coleman's regimen was introduced, i.e. the dose of doxorubicin was intensified. In the original Coleman's regimen doxorubicin is admini stered at the dose of 50 mg/m 2 on days 1, 22 and 57 of the induction phase. According to our modification doxorubicin was administered on days 1, 15, 29, 43 and 57 of the induction phase. Complete remission of malignancy was achieved in 20 patients (67%). Partial remission was achieved in 3 patients (10%). In total, objective remission (CR + PR) was achieved in 23, i.e. 77% of treated patients, 37% survived 2 years and 33% survived 5 years. The most common adverse events observed during therapy were haematological complications: anaemia, granulocytopenia and thrombocytopenia. They were the cause of one treatment-related death (neutropenic fever). Hyperglycaemia was observed due to use of high doses of steroids in the chemotherapy regimens under consideration. Increased intensity of anthracycline administration in our modification of Coleman's regimen was not associated with increased frequency of cardiological complications; however, the total dose did not exceed the acceptable cumulative dose of this medication.


Socha J.,Zaklad Radioterapii | Kiprian D.,Klinika Nowotworow Glowy i Szyi | Kawecki A.,Klinika Nowotworow Glowy i Szyi
Nowotwory | Year: 2011

We report the case of a male patient, who was initially irradiated as a 23month old child, after surgical treatmemt for left optic glioma. 30 years after radiotherapy he developed a meningioma within the irradiated area. The patient, aged 32, underwent surgery and irradiation. 32 years later a radiation-induced sarcoma - Fusocellular sarcoma G3 - was diagnosed in the field of irradiation, together with multiple meningiomas. 2 months after surgery we observed rapid local progression and dermal dissemination.


Laryngopharygectomy followed by radiotherapy or radiochemotherapy has been a standard treatment for patients with advanced hypopharyngeal cancer. These treatment modalities lead to permanent tracheostomy, which has a negative influence on the quality of life. For this reason new treatment methods have been investigated for a number of years. The aim of the study: To evaluate the results and the toxicity of larynx preservation treatment for locally advanced squamous cell hypopharyngeal cancer. Material and methods: Between December 2004 and January 2007 56 patients with confirmed squamous cell hypopharyngeal cancer (stage III and IVa) were treated with concomitant radiochemotherapy with an intention to preserve the larynx. Conformal 3D radiotherapy was applied in all cases. Chemotherapy consisted of cisplatin 100 mg/m2 per die administered twice during irradiation (day 1 and 22, day 43 of treatment) or once a week (35 mg/m2). Results: Median followiup is 32 months. 5-year OS is 72%, DFS - 57%, 3-year laryngectomy-free survival - LFS is 72%, 5-year LFS - 68% of patients (alive with larynx preservation). 11 patients have been diagnosed with local recurrence, 3 patients with nodal failure and one with locoregional failure. No severe life-threatening early and late complications were observed. Only 2 patients required temporary tracheostomy because of dyspnea due to laryngeal edema. C o n c l u s i o n. We conclude that organ-preservation treatment is a valuable alternative to surgical treatment in patients diagnosed with stage III and IVa laryngeal and hypopharyngeal cancer.


Wojtowicz M.,Klinika Nowotworow Glowy i Szyi | Glinski B.,Klinika Nowotworow Glowy i Szyi | Mucha-Malecka A.,Klinika Nowotworow Glowy i Szyi | Wojton-Dziewonska D.,Klinika Nowotworow Glowy i Szyi | Hebzda P.,Klinika Nowotworow Glowy i Szyi
Onkologia i Radioterapia | Year: 2013

We describe the case of a 39 year-old woman who was diagnosed with Hodgkin's lymphoma (NSHL stage IIA) in 1995. She received 3 series MOPP/AVB chemotherapy and radiation therapy to the lymph node groups above the diaphragm by mantle field radiation technique, and in the second stage to the paraaortic lymph nodes and the spleen. Complete remission was obtained. 17 years after the treatment the patient was diagnosed with synovial sarcoma, which was localized at the left lung and considered most likely as a secondary cancer induced by radiotherapy.


To determine predictive and prognostic value of p53, Ki-67 and EGFR in patients with advanced oral cavity and oropharyngeal cancer treated with induction chemotherapy. The data form 40 patients with advanced oral cavity and oropharyngeal cancer treated between January 1988 and December 1997 were analyzed retrospectively. All patients received 1 to 3 cycles of induction chemotherapy (ICHT) consisting of cisplatin and fluoruracil. Twenty two patiemts (68%) underwent subsequent radical radiotherapy. Histologic and immunohistochemical analyzes of p53, Ki-67 and EGFR were performed in all patients. Response to induction chemotherapy was obtained in 18 patients (45%). None of the analyzed factors significantly influenced the chance to obtain the response to chemotherapy. The 3-year loco-regional control and overall survival rates in the group of 22 patients treated radically were 20% and 23%, respectively. Lack of EGFR expression is favorable prognostic factor for overall survival in patients with advanced oral cavity and oropharyngeal cancer treated with induction chemotherapy.


Recognition of the characteristic and the prognostic value of HPV (human papillomavirus) infection in oropharyngeal cancer is one of the greatest successes of head and neck oncology during recent years. Histoclinical and molecular appearance of HPV-related tumours are different as compared to typical squamous cell head and neck cancers. HPV-related oropharyngeal cancer often occurs in younger groups of patients with relatively high socioeconomic status. Performance status is usually excellent or good. HPV-related cancers are more sensitive for radiotherapy and chemotherapy. Finally, outcome in HPV-related oropharyngeal cancer is significantly better in comparison to typical head and neck cancers. This has been confirmed in many clinical analyses. HPV-positive status was connected with 2.5-4 times reduced risk of death. This fact supports investigations of the less aggressive treatment options which would be less toxic and similarly effective as compared to standard radiotherapy or concomitant chemoradiotherapy. Review of the concepts and the most important clinical trials dedicated to treatment de-escalation in HPV-related oropharyngeal cancer was made. All are in progress and currently there is not sufficient data to recommend any less toxic regimen for routine clinical practice. It's very important to remember that better prognosis does not necessarily mean satisfactory outcome of less aggressive regimens. Results of well planned, prospective, randomised trials, like RTOG 1016, are needed to establish the optimal treatment for HPV-related oropharyngeal cancer. © Polskie Towarzystwo Onkologiczne.


Aim of the study. The analysis of early and late toxicity was assessed comparing two schedules of irradiation - conventional fractionation (CF) and accelerated fractionation (AF). Our population of patients had squamous cell carcinoma of the larynx stage T1-T3N0M0. All were treated with radical intent. Material and method. Patients treated 1995-1998 in the Centre of Oncology in Warsaw were separately analyzed in a phase III multicentre clinical trial. Patients were irradiated with Co-60, in the CF arm to a total dose of 66 Gy in 33 fractions with an overall treatment time of 45 days. In the AF arm the overall treatment time was 7 days shorter but the rest of parameters were not changed. Results. A higher percentage of acute post-irradiation reactions was observed in patients who underwent AF. The early reactions settled down after termination in 5 to 8 weeks in both fractionation methods. There were no serious late post-irradiation complications stated in both group of patients examined. © Polskie Towarzystwo Onkologiczne.


PubMed | Klinika Nowotworow Glowy i Szyi
Type: Journal Article | Journal: Przeglad lekarski | Year: 2012

To determine predictive and prognostic value of p53, Ki-67 and EGFR in patients with advanced oral cavity and oropharyngeal cancer treated with induction chemotherapy.The data form 40 patients with advanced oral cavity and oropharyngeal cancer treated between January 1988 and December 1997 were analyzed retrospectively. All patients received 1 to 3 cycles of induction chemotherapy (ICHT) consisting of cisplatin and fluoruracil. Twenty two patiemts (68%) underwent subsequent radical radiotherapy. Histologic and immunohistochemical analyzes of p53, Ki-67 and EGFR were performed in all patients.Response to induction chemotherapy was obtained in 18 patients (45%). None of the analyzed factors significantly influenced the chance to obtain the response to chemotherapy. The 3-year loco-regional control and overall survival rates in the group of 22 patients treated radically were 20% and 23%, respectively.Lack of EGFR expression is favorable prognostic factor for overall survival in patients with advanced oral cavity and oropharyngeal cancer treated with induction chemotherapy.

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