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Cullen J.J.,Univerzity of Hospitals and Clinics | Kubecova M.,Radioterapeuticka a onkologicka klinika | Majirsky M.,Radioterapeuticka a onkologicka klinika | Kostiuk P.,Edukafarm | And 3 more authors.
Onkologie (Switzerland) | Year: 2013

The possibility of use of vitamin C in oncology emerged about 30 years ago and became topic of expert discussions. Recent discoveries in pharmacokinetics and pharmacodynamics of ascorbate and laboratory and clinical research demonstrated that vitamin C has dual properties (antioxidant and prooxidant) depending on the dose and on the conditions of the microenvironment in which operates. Based on these new findings, it appears that for antitumour effect high concentrations of ascorbate is needed (mmol/l), which is attainable only by administration of doses of the gram order. Milimolar plazmatic concentration of ascorbate is selectively cytotoxic for many tumor cell lines. The desired post-infusion plazma concentration is established to 18-22mmol/l. Appropriate dose of vitamin C was established in recent studies with in the range from 0.75 to 1.75g/kg of body weight. Phase I clinical studies organized in recent years proved safety of intravenous vitamin C in gram order and possibility of combination of the substance with standard chemotherapy. The studies showed that application of intravenous vitamin C (IVC) belongs to the basic anti-tumor therapy, becuase it improves quality of life of oncological patients and reduces intensity of undesirable effects caused by chemo/radiotherapy.


Svoboda B.,Gynekologicko porodnickaklinika | Libalova P.,Gynekologicko porodnickaklinika | Kubecova M.,Radioterapeuticka a Onkologicka Klinika | Rob L.,Gynekologicko porodnicka Klinika | And 5 more authors.
Ceska Gynekologie | Year: 2011

Objective: To develop guideline for primary surgical treatment of endometrial carcinoma. Design: Review, consensus of expert group. Setting: Dept. of Gynaecology and Obstetrics, 3rd Medical Faculty of Charles University in Prague. Method: A retrospective review of published data, analysis of statistic data from Czech Republic, consensus among proposers and opponents. Results: The guideline recognizes endometrial carcinoma patients based on their risk and recommends type of surgical treatment for certain group. It emphasizes the importance of centralized oncogynaecological treatment. Surgical staging remains the basic principle for treatment of endometrial carcinoma patients. The aim of pre-operative diagnostics is to estimate the extent of the disease - "interim staging", that can be different from definitive histopathological staging. Based on risk factors patients are divided into low or high risk group. Standard procedure for low risk patients is hysterectomy and bilateral salpingoophorectomy. It is advisable to use peroperative biopsy in these patients that can shift the patient to high risk group. High risk patients are recommended for hysterectomy, bilateral salpingoophorectomy, and systematic aortopelvic lymphadenectomy. The guideline contains recommendation for young patients wishing to preserve their fertility, for cases of inadequate surgery and for follow-up. Conclusion: Guideline for treatment of endometrial carcinoma is recommendation for clinicians and other subjects who participate on the process of the diagnostics/treatment of endometrial carcinoma patients. All points of the guideline were discussed and voted about by all participants of expert group.


Libalova P.,Gynekologicko Porodnicka Klinika | Vernerova Z.,Ustav patologie | Hubiekova-Heringova L.,Ustav Histologie a Embryologie | Pinterova D.,Gynekologicko Porodnicka Klinika Oddeleni nadorove Biologie | And 3 more authors.
Ceska Gynekologie | Year: 2012

Objective: To evaluate risk factors for development of recurrent disease in borderline ovarian tumors. Design: Retrospective study of 10-years single institution population. Setting: Dept. of Gynecology and Obstetrics, 3rd Medical Faculty of Charles University in Prague. Method: 59 consecutive cases of borderline ovarian tumors (BOT) were analyzed for age, histopathological type, DNA ploidy, stage, presence of invasive and non-invasive peritoneal implants, type of surgical procedure, residual disease, adjuvant therapy, recurrence and long-time prognosis of the patients. Results: Median follow-up was 47 months (range 1-144). There were 5 (8.5%) patients with DNA aneuploid tumors in the study group; 4 of them were younger than 50 years, 4 of them were early stage serous BOT; no one recur so far. No death of disease was described in the whole study group; only 2 patients (3.4%) developed recurrent disease - both were young patients after conservative surgery for serous diploid stage I/II BOT. Conservative surgery was the only significant factor for recurrence in univariate analysis (p = 0.0159) in our setting. Conclusion: DNA ploidy was not proved to be prognostic factor in borderline ovarian tumors in our study group. The only significant risk factor for development of recurrent disease was conservative surgery, with no influence on overall survival.


Grimmichova T.,II. Interni Klinika | Seoeek A.,Otorinolaryngologicka Klinika | Ambrus M.,Radioterapeuticka A Onkologicka Klinika
Diabetologie Metabolismus Endokrinologie Vyziva | Year: 2015

Prevalence of malignant lymphadenopathy in the primary care is reported to be less than 0.4 % in patients younger than 40 years and 4 % in patients older than 40 years. In 75 % it is a localized lymphadenopathy. In 50 % head and neck region is involved, where the substantial part of all the lymph nodes are present. Patients younger than 30 years are diagnosed with inflammatory diseases in 80 %, while patients over 50 years are present with neoplastic process in up to 60 %. The differential diagnosis is certainly necessary to consider many common, but also rarer causes. The presented case report describes a patient concurrently diagnosed with a medullary thyroid cancer and tuberculous lymphadenitis. Medullary thyroid cancer is not the most common tumor of the thyroid gland, it represents 4 to 10 %. The disease is advanced in the majority of patients, because medullary carcinoma metastasizes early. Extrapulmonary tuberculosis is also a rare cause of lymphadenopathy in the developed countries in contrast to the developing areas, where tuberculosis is still a frequent cause of death.


Kubecova M.,Radioterapeuticka a onkologicka klinika | Reginacova K.,Radioterapeuticka a onkologicka klinika
Onkologie (Czech Republic) | Year: 2016

Malignant gyneacological tumors recurrence rate depends on many factors. Most significant ones are primary tumor volume, its biological properties, and radicality of performed therapy. Relapses treatment is always more and more difficult and possibility of recovery depends not only on size of local relapse, its deposition, and patient's condition, but especially on previously performed therapy. Treatment plan has to be created for every patient individually, in which surgery, radiotherapy, chemotherapy, and most frequently a combination of all these methods are considered. Our research suggests that relatively high percentage of gyneacological relapses are curable.

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