Klinika Ustni

Prague, Czech Republic

Klinika Ustni

Prague, Czech Republic
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Cvek J.,Klinika Onkologicka LF OU A FN Ostrava | Knybel L.,Klinika Onkologicka LF OU A FN Ostrava | Stransky J.,Klinika Ustni | Matousek P.,Klinika Otorinolaryngologie A Chirurgie Hlavy A Krku LF OU A FN Ostrava | And 8 more authors.
Klinicka Onkologie | Year: 2017

Aim: The aim of this study was to evaluate over all survival (OS) and prognostic factors in patients ineligible for chemotherapy who were treated with a hyperfractionated accelerated schedule with simultaneous integrated boost. Material and Methods: From May, 2008, to April, 2013, 122 patients with locally advanced nonmetastatic squamous laryngeal (14%), hypopharyngeal (30%), oropharyngeal (30%), and oral cavity (27%) cancer were treated at our institution. The median age, Karnofsky Performance Status (KPS), and gross tumor volume (GTV) of the patients were 63 years (range, 46- 87 years), 80% (range, 50- 100%), and 46 ml (range, 5- 250 ml), resp. The median total dose of radiotherapy was 72.6 Gy (range, 62- 77 Gy) at 1.4- 1.5 Gy per fraction, and 55 Gy at 1.1 Gy per fraction was delivered for GTV (primary and lymphadenopathy) with a margin of 0.7 cm and regional lymphatic areas with a margin of 0.3 cm. The dose was delivered 2× a day, with a 6- 8 hour interval between doses, via a 6 MeV linear accelerator. OS was estimated using the Kaplan-Meier method, and predictors of OS were analyzed using Cox proportional hazards regression. Results: The median duration of the radiotherapy series was 37 days (range, 32-45 days). The incidence of grade 3 acute toxicity was 62% for mucosa (oral cavity and/ or pharynx) and 0% for skin. Confl uent mucositis cleared in all cases within 21 days. No grade 4 or 5 toxicities were recorded. PEG was introduced before treatment in 55 patients (45%). The 1- and 2-year OS was 65% and 32%, resp. KPS less than 80% (RR 2.4, 95% CI 1.3- 4.2; p = 0.004), cancers other than oropharyngeal or laryngeal cancer (RR 2.0, 95% CI 1.1- 3.5; p = 0.016), and capacity of high GTV (RR 1.006, 95% CI 1.001- 1.011; p = 0.017) were found to be negative prognostic factors for OS. Conclusion: More than 30% of patients with poor prognosis survived for longer than 2 years. KPS before treatment was the strongest prognostic factor for better OS.

Pink R.,Klinika ustni | Flodr P.,Ustav patologie | Tvrdy P.,Klinika ustni | Pazdera J.,Klinika ustni
Onkologie (Switzerland) | Year: 2013

Introduction: Malignant mesenchymal tumours of the orofacial region are extremely rare and comprise only 1% of all malignant orofacial tumours with more than 50 subtypes. Angiosarcomas are highly malignant neoplasms that originate from blood or lymphatic vessels. Angiosarcomas form 5,4 % of all sarcomas and in the head and neck region are the most frequent type of sarcoma. Aim: The aim of this case report is to describe a rare malignant neoplasm in the head and neck topography which can be diagnostic difficulty and may be missed or unrecognised with fatal consequences for the patient. Materials, methods, results: The authors describe the clinical manifestations of the disease, the diagnosis and therapy of mandibular angiosarcoma in a seriously ill patient. The diagnosis was made on the basis of the histopathological findings and immunohistochemistry. The following treatment was radical surgery with subsequent radiotherapy and 18 months later, the 84 year old female patient remains alive and apparently healthy. Conclusions: Angiosarcoma has currently been literary described only in small number of patients. Guidelines for optimal treatment are still unknown and the average survival is one year and a half.

Bulik O.,Klinika Ustni | Machalka M.,Klinika Ustni | Liberda O.,Klinika Ustni | Jarkovsky J.,Institute Biostatistiky A Analyz LF A PrF MU | And 2 more authors.
Otorinolaryngologie a Foniatrie | Year: 2010

The evaluation of resection margins in surgical treatment of oral cavity carcinoma is an important prognostic factor. Sometimes it is difficult to perform the resection in the healthy tissue because of relatively small field of operation, presence of important anatomical structures in the region of oral cavity, and advanced stage of the oncogenic disease in most patients. The outcome of resection margin zone examination modifies individually further therapeutic procedure. Lot of studies point out both increased occurrence of relapses and overall survival outcome setback in patients with positive surgical margin with regard to the presence of tumor cells. This paper analyses a file of 71 patients with oral cavity spinocellular carcinoma in whom the surgery was a treatment part of oncogenic disease. Either the occurrence or the tumor proximity in the resection margin was detected in 28.2 % of findings. Dates of 65 patients in total were processed with focus on local relapse occurrence during there years. In case of either positive or proximate margin a local relapse occurred in 47.4 % (9/19) of patients, in case of negative margin in local relapse occurred in 26.1 % (12/46) of patients. Positive or proximate margin occurred most frequently in category T3; upper alveolar process and palate was the most frequent localization, i.e. in 55.6 % (9/15) of patients. Expressive decrease in occurrence of local relapses was recorded in case of negative surgical margin.

Rosa J.,Mediscan Group | Pavlikova G.,Klinika Ustni | Palicka V.,Osteocentrum FN
Osteologicky Bulletin | Year: 2013

Osteonecrosis of the jaw (ONJ) is a known complication of high-dose antiresorptive therapy (AR) for bone malignancies, and is rarely (incidence rates of 1/10,000 and < 1/100,000 patient-years) seen also in patients receiving AR for osteoporosis. ONJ, defined as exposure of the jaw bone lasting for more than 8 weeks, causes many complications. ONJ is frequently associated with an intervention in the oral cavity, which either accelerates its progression or is needed due to already existing ONJ. The dominant pathogenetic factor is likely to be decreased bone remodeling in the jaw bone tissue with physiologically high bone turnover, leading to changes in characteristics of the alveolus and inhibiting the full range of physiological recovery mechanisms. Classification of ONJ has been elaborated and diagnostic methods are being improved. By strictly following simple preventive measures, this rare but serious complication of AR for osteoporosis may become less frequent.

Michl P.,Klinika Ustni | Prochazka M.,Ustav Mikrobiologie | Stosova T.,Porodnicko Gynekologicka Klinika | Pink R.,Klinika Ustni | And 2 more authors.
Ceska Gynekologie | Year: 2015

Objective: The objective of this study is to confirm or exclude the presence of the HPV in oral cavity according to sexual activity. Design: Prospective not blinded study. Setting: Clinic of Oral and Maxillofacial Surgery, Clinic of Obsterics and Gynecology, Department of Microbiology, Medical Faculty Palacky University and University Hospital Olomouc. Methods: The patients were examined during the scree-nig for cervix carcioma at the Clinic of Obsterics and Gynecology. After filling the Consent Form and the questionnaire for possible exposure to potentional risk the swabs from cervix and mouth were sampled. The samples have been processed at the Department of Microbiology by the Real Time PCR. Results: The results have not confirmed the relation between sexual practices and infection of oral cavity by the HPV. Conclusion: Our results correspond with certain authors. There is unclear correlation between total number of sexual partners and infection of mouth with the HPV. Nevertheless the HPV related tumors have been proven - especially in the oropharynx-but the way how the infection enters the mouth remains still unclear, according to us.

Juhasz S.,Oddeleni ustni | Pink R.,Klinika ustni | Simek J.,Oddeleni ustni | Tvrdy P.,Klinika ustni
Onkologie (Czech Republic) | Year: 2014

Distant metastasis of malignant tumors in the facial area are rare. They occur both in the soft tissues of the oral cavity and face and skeletal jaw bones and their diagnosis is not always easy. In planning therapeutic procedures, one must take into account the patient's general health, prognosis and degree of cancer generalization. The authors present their own experience in the diagnosis and therapy of three cases of oral cancer metastasis with extraoral primary localisation. The histories are accompanied by a summary of available information on the incidence of metastatic malignant tumors in the orofacial region.

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