Klinika onkologie a radioterapie

Hradec Králové, Czech Republic

Klinika onkologie a radioterapie

Hradec Králové, Czech Republic
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Sirak I.,Klinika onkologie a radioterapie | Hodek M.,Klinika onkologie a radioterapie | Zoul Z.,Klinika onkologie a radioterapie
Onkologie (Czech Republic) | Year: 2017

Comprehensive treatment of cervical carcinoma patients necessarily requires interdisciplinary cooperation. Early stage disease is radically solved by adequate surgical intervention. Locally or regionally advanced disease is treated by definitive chemoradiation with curative intent. Surgery and radiotherapy may be utilized effectively in the palliative treatment of recurrent, persistent, or metastatic disease. Systemic treatment has its use across most stages of this malignancy, whether in the neoadjuvant, concomitant, or palliative setting. The aim of this article is to provide the review of systemic therapy utilization in the treatment of uterine cervix carcinoma.

Kostysyn R.,Neurochirurgicka Klinika | Pleskacova Z.,Klinika Onkologie a Radioterapie | Malek V.,Neurochirurgicka Klinika
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2015

Hemangioma is the most common primary benign hamartoma type spine tumor. Malignant degeneration has never been reported. In the majority of cases, this is an asymptomatic solitary lesion of the thoracic spine found incidentally during a radiographic examination. Only 1% of cases manifests clinically and this benign lesion is considered aggressive because of the expansive nature of the tumor and because it may cause pathological fracture of the vertebrae. Clinical symptoms then include dorsalgia and either root or spinal neurological symptoms. Radiological diagnosis is relatively easy because vertebral hemangioma is associated with quite typical graphic signs; graphic criteria to confirm the diagnosis of aggressive vertebral hemangioma have been clearly defined. The range of treatment options is very wide, from conservative treatment through frequently used vertebroplasty to radical surgical treatment. Embolization procedures, alcohol sclerotherapy and local radiotherapy are often used as complementary procedures. Aggressive vertebral hemangioma is a relatively rare diagnosis, so far there are no large cohorts or clinical studies from which it would be possible to determine an optimal therapeutic approach.

Petera J.,Klinika Onkologie a Radioterapie | Dusek L.,Institute Biostatistiky a Analyz
Klinicka Onkologie | Year: 2014

Background: Population ageing in developed countries associated with increasing cancer incidence in higher age categories becomes a serious challenge in oncology nowadays. Aim: To review the present policy of management of senior cancer patients and to outline strategies of its improvement Elderly patiens are generally undertreated if we address current treatment standards. The elderly population is heterogenous in terms of functional status, physical and psychical impairment, comorbidities, functional reserve, socioeconomic backgroud and geriatric symptoms. There is a lack of consensus on guidelines for elderly population due to underrepresentation of older patiens in clinical trials. Geriatric assessments could be a useful tool for medical decision making and adjusting treatment plan for a certain group of patients -those suitable for standard treatment, vulnerable group - advisable to treatment reduction, and frail patients - indicated for paliative approach. However, studies confirming effectiveness of this age-specific approach in comparison with routine clinical practice remain to be conducted. Conclusion: Clinical studies focused on senior cancer patients are urgently needed.

Richter I.,Onkologicke oddeleni | Dvorak J.,Klinika onkologie a radioterapie | Bartos J.,Krajska nemocnice Liberec a.s
Onkologie (Switzerland) | Year: 2013

Treatment of the rectal adenocarcinoma is multidisciplinary. Radiotherapy is the important component of the treatment. Neoadjuvant chemoradiotherapy is indicated in tumours T3-4 or in the case of positive lymph nodes. 5-fluorouracil (5-FU) and capecitabine are the most used cytostatik in combination with radiotherapy. The aim the neoadjuavnt treatment is attainment circumeferential radial margin (CRM) after total mesorectal excision (TME).

Kopecky J.,Klinika Onkologie a Radioterapie | Kubecek O.,Klinika Onkologie a Radioterapie | Trojanova P.,Klinika Onkologie a Radioterapie | Kubala E.,Klinika Onkologie a Radioterapie | Kopecky O.,Oddeleni klinicke onkologie
Klinicka Onkologie | Year: 2014

Background: Malignant melanoma belongs to the most deadly human tumours and despite all preventive programs its incidence continues to rise. Until 2011, chemotherapy was the only therapeutic option for inoperable or metastatic disease in the Czech Republic. However, new treatment modalities (e.g. targeted therapy) have been introduced recently. Aim: Since most of the modern drugs are still available only in clinical trials, the aim of this article is to provide a brief and comprehensive review of current treatment options for metastatic disease. The attention is focused on their potential side effects, so that doctors who do not usually deal with these drugs would get acquainted with them. This could contribute to a prompt management of associated symptoms or an early referral of the patient to an appropriate clinical centre without undue delay.

Kopecky J.,Klinika Onkologie a Radioterapie | Kubecek O.,Klinika Onkologie a Radioterapie
Klinicka Onkologie | Year: 2016

Background: Metastatic malignant melanoma belongs to a group of cancers with high mortality. In recent years, advances in our knowledge of the pathogenesis of melanoma and the discovery of new drugs has resulted in significant progress in the treatment of metastatic malignant melanoma patients. The development of resistance to these drugs, however, remains a challenge. One way how to avoid resistance, or at least delay it, is to administer combination therapy. Observation and Conclusion: This case study demonstrates that combination therapy with a BRAF and a MEK inhibitor can be used to successfully treat metastatic malignant melanoma patients and suggests they should be employed in therapeutic algorithms for patients with metastatic malignant melanoma and BRAF gene mutations.

Slovacek L.,Klinika onkologie a radioterapie | Slovackova B.,Psychiatricka klinika
Onkologie | Year: 2012

The authors report on a case of drug-induced hallucinatory syndrome after paclitaxel infusion in a 42-year-old woman with breast carcinoma treated with adjuvant chemotherapy AC-T. This case report highlights the potential risk of paclitaxel causing hallucinatory syndrome. At the same time it indicates the need to cooperate with the psychiatrist. Early symptomatic psychopharmacological treatment enabled the smooth completion of chemotherapy.

Kopecky J.,Klinika Onkologie a Radioterapie | Kopecky O.,II. Interni Klinika
Klinicka Onkologie | Year: 2010

NK cells are an important component of natural immunity, which provides a defence response against viruses, bacterial and parasitic intracellular pathogens and tumour cells. NK cells are capable of rapid responses without prior sensitization and cytotoxic response is independent of the presence of the antigens of the major histocompatibility system. NK cells produce a number of cytokines (e.g. INF-y, GM-CSF and TNF-β) and chemokines and in this way they regulate both the natural and acquired immune response. By contrast, NK cells are regulated both positively and negatively by cytokines and chemokines produced by other immune cells. Attention is focused on the possibility of influencing the tumour process by using cytokine- and chemokine-activated NK cells. In studies in mice models as well as in several clinical trials, it has been shown that the presence of cytotoxic cells in tumour stroma is associated with a more favourable prognosis of cancer. There is also plenty of evidence that in tumour stroma a number of cytokines and chemokines are produced which may have ambivalent effects.

Petera J.,Klinika onkologie a radioterapie
Onkologie | Year: 2012

Brachytherapy is a method of radiation treatment, when the radioactive sources are directly applicated into the tumor region. Brachytherapy allows to deliver high doses to the tumor in a short time with excellent local tumor control. The largest experience was achieved with continual low dose rate brachytherapy (0.4-2Gy/hr) and manual insertion of sources. Recently this method was mostly replaced by automatic afterloading devices and high dose rate (> 12Gy/hr) fractionated treatment. Brachytherapy can be used in early stages of head and neck cancer as a sole treatment method. The advantage in comparison with surgery is a better functional and cosmetic outcome and in comparison with external beam radiotherapy a better tumor control and absence of xerostomia. In locally advanced tumors brachytherapy can be used for dose escalation of external beam radiotherapy. Brachytherapy is also useful for salvage treatment of recurrences after previous radiotherapy. Classical indications are oral cancer, oropharyngeal and nasopharyngeal tumors. Despite technological advances of external beam radiotherapy brachytherapy remains a very important treatment method in head and neck tumors.

Vanaskova J.,Klinika Onkologie A Radioterapie | Grim J.,Klinika Onkologie A Radioterapie | Kopecky J.,Klinika Onkologie A Radioterapie | Kubala E.,Klinika Onkologie A Radioterapie | Filip S.,Klinika Onkologie A Radioterapie
Klinicka Onkologie | Year: 2011

Backrounds: The incidence of malignant melanoma is increasing by about 2-5% per year, exceeding an incidence of all other tumors. Adjuvant immunotherapy with high-dose interferon (HDI) as per the ECOG 1684 trial Kirkwood's schema is still recommended as a standard. HDI should be started within 60 days after a surgical procedure. Meaningful adjuvant immuno-therapy is based on radical surgical excision, an investigation of the sentinel node and regional lymph node dissection, if indicated. Current research aims to utilize routinely usable biomarkers in order to define patients who would explicitly profit from HDI. Design: The authors present a review of HDI trials, focusing on the management of adverse effects of HDI and on biomarkers. This review also discusses the initial own experiences at the Oncology Centre in Hradec Králové. Conclusion: Malignant melanoma is a very immunogenic tumour. Immunotherapy with HDI is considered to be the only therapeutic modality so far that has been proven to prolong relapse-free survival and overall survival (in short-time criterion) in adjuvant setting. However, the results of these trials are inconsistent and particular biomarkers of therapeutic response have not been defined yet.

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