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Background. CA125 is a key marker in the monitoring of ovarian cancer treatment. Until now, the measurement of CA125 levels was the standard in the follow up to the first line of treatment (in addition to clinical examination and imaging tests). An increase in the CA125 marker has been found to precede the recurrence of cancer at 4 to 6 months. Material and methods. The MRC OV05/EORTC 55955 study has responded to the question of whether the treatment of patients who observed an only asymptomatic rise of CA125 would result in an increase in survival. Results. It was shown that an early start of treatment, as compared to a delay in treatment, does not affect survival. The originator of the study was Gordon Rustin, whose work defined the concept of disease progression based on changes in CA125 levels. Conclusions. He has provided evidence based on a prospective randomized clinical trial, which has changed the rules for surveillance following treatment. © Copyright by Wydawnictwo Continuo. Source

At present there is no direct comparison between everolimus and axitinib to assess which one is more effective in patients with uneffective treatment with TKIs. Randomized phase II clinical trial - RECORD-3 may eventually indicate the proper sequence of axitinib and everolimus in the treatment of patients with metastatic kidney cancer. This trial indicates that the TKI-mTOR sequence is more efficient. The results of two non-interventional, observational, clinical studies also support this concept. The efficacy of axitinib and everolimus (in AXIS and RECORD-1) is comparable - PFS is about 5 months, and OS is about 15 months. Everolimus has a different toxicity profile in comparison to axitinib, thus avoiding adverse events associated with treatment with TKIs (accumulation of similar adverse events in the sequence TKI-TKI). Everolimus has a more simple dosage of 10 mg once a day, while axitinib requires the dose modification. While the efficacy of both drugs is comparable, the therapeutic decision should be made on the basis of the profile of drug toxicity and patient'sconcomitant diseases. © Polskie Towarzystwo Onkologiczne. Source

Wachowiak J.,Klinika Onkologii | Krawczynski M.,Klinika Gastroenterologii Dzieciecej i Chorob Metabolicznych UM
Pediatria Polska | Year: 2016

Every physician's duty is management consistent with the actual medical knowledge. Legal aspects of therapy in Poland are defined by the Act on Physician and Dentist Professions and Pharmaceutical Law. This latter one introduces a term "therapeutic product characteristics" that is equivalent to its registration. The problem of the choice of the drugs, especially for pediatric therapies, is difficult, because many of the drugs were not an object of research in children. A special legal importance is particularly observed in the off-label use of drugs in children, especially in neonatology and pediatric oncology. The physician must optimally treat his patient not only according to the actual medical knowledge, but also to the appropriate thoroughness. The above mentioned topics and the problem of standards and algorithms in medical management and responsibility for medical errors are discussed in this work. © 2016. Source

Miazga A.,Szpital Kliniczny Przemienienia | Osinski M.,Szpital Kliniczny Im. Heliodora | Derwich K.,Klinika Onkologii
Pediatria Polska | Year: 2014

Neurofibromatosis type 1 (NF1) eponymically called von Recklinghausen disease is autosomal dominant disease and remains an example of phakomatose. They are congenital, genetic disorders affecting mainly nervous and integumentary system. The aim of this study is to report six cases of NF1 in which diagnostic management is based on clinical findings in physical examination: observing characteristic dermatological and ophthalmological manifestations such as cafe au lait spots, Crowe sign (axillary and inguinal freckling), neurofibromas or Lish nodules within the eyes. Existence of those characteristic findings frequently precedes important pathologies (neoplasia) in different areas of the body, especially in nervous system. In the paper we emphasize that genetic MLPA test does not always correlate with clinical manifestation, what had been observed in our patients as well. © 2014 Polish Pediatric Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved. Source

Background. Lung cancer was a leading cause of all cancer-related deaths among men and was strongly related to long-term tobacco smoking. Clinical staging of lung cancer was one of the most important prognostic factors: the higher prevalence of early detection of lung cancer, the better results of lung cancer treatment. The purpose of the study was to present morphological characteristics and additional findings in LDCT in males with a high risk of lung cancer. Methods. We included 900 male subjects, residents in the Krakow area and its suburbs, who were current and former smokers between 50 and 74 years of age. Risk factors such as age, duration of tobacco use, exposure to asbestos, family history of non-malignant lung diseases, cancer and current respiratory symptoms were analysed for all participants Pulmonary nodules detected in all participants in low-dose chest CT were classified into non-malignant, indeterminate and potentially malignant and all were classified into one of three groups of low (A), indeterminate (B) and high risk of lung cancer (C). Additional pulmonary findings detected in LDCT were also analysed. Results. In 831 of subjects (92.3%) 4575 pulmonary nodules were detected, among which 66.6% (n = 3048) were solid, non-calcified. 47 potentially malignant nodules were revealed (1.5% of all solid non-calcified nodules). The oldest participants, who had the longest smoking duration were males with potentially malignant nodules. Additional pulmonary findings were revealed significantly more often among the high lung cancer risk group. Among 39 participants with potentially malignant pulmonary nodules, lung cancer was detected in 17.9% (n = 7) participants (0.78% of the study group). Conclusions. Low dose chest computed tomography revealed 94.6% specificity. Statistically significant differences among participants from the high lung cancer risk group were found for median age, number of packyears, positive history of bronchitis, presence of emphysema, bronchiectasis, bronchial wall thickening, ground glass opacities and consolidations. Analyses of risk factors revealed statistically significant differences among those in a subgroup of histologically proven lung cancer, for median age over 60 years, duration of cigarettes smoking over 45 years (with number of packyears at least at the level of 37), mediastinal lymphadenopathy (especially of high grade) and GGOs (grounds glass opacities). © Polskie Towarzystwo Onkologiczne. Source

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