Onkologicke oddeleni

Liberec, Czech Republic

Onkologicke oddeleni

Liberec, Czech Republic
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Colorectal cancer (C18-20) is the second leading malignancy in women as well as men. Its incidence has been rising constantly and the good news is that, in the recent years, its mortality has been declining slowly, which can be, in part, caused by the introduction of a screening programme (www.kolorektum.cz). On the contrary, the bad news is that as many as 20 % of patients with a primary diagnosis of colorectal cancer are found to have metastatic involvement. In another 20 to 30 % of patients, metastases occur within the subsequent two years. In patients with the presence of liver metastatic foci, the option of resecting these foci always has to be considered. In case a radical resection of liver metastases is performed, it results in significant increase in survival. In treating metastatic colorectal cancer disease, it is therefore important to determine the course of treatment in a multidisciplinary team and to thoroughly plan the individual therapy sequences. The present case report describes the treatment of metastatic colorectal cancer and highlights the importance of interdisciplinary coordination in improving treatment outcomes.


Aim: The aim of this retrospective study was to compare the efficacy of the sequence docetaxel-cabazitaxel-enzalutamide vs. docetaxel-enzalutamide in patients with metastatic castration-resistant prostate cancer. Patients and Methods: Of the cohort of 35 patients, 11 were treated with the sequence docetaxel- cabazitaxel- enzalutamide and 24 were treated with the sequence docetaxel- enzalutamide. The doses were as follows: docetaxel, 75 mg/ m2; cabazitaxel, 25 mg/ m2; and enzalutamide, 160 mg/ day. Over all survival (OS) was defined as the interval between the initial dose of docetaxel and death or the date of the last control for survivors (censored). OS was assessed using the Kaplan-Meier method, and the two arms were compared using the log-rank test. The significance level for all statistical tests was set at α = 0.05. Results: The median OS of patients treated with the sequence docetaxel- cabazitaxel- enzalutamide was 28.8 months, vs. 24.4 months in patients treated with the sequence docetaxel- enzalutamide. No statistically significance differences in OS were found between the two arms (HR 0.678, 95% CI 0.264- 1.744; p = 0.418). Grade 3- 4 toxicity was observed for each drug, as follows: docetaxel: fatigue and peripheral neuropathy in six patients, nausea in three patients, and diarrhea and neutropenia in one patient; cabazitaxel: anemia in two patients and neutropenia in one patient; and enzalutamide: anemia in six patients, thrombocytopenia in two patients, and cerebral hemorrhage in one patient. Conclusion: No statistically significant differences in OS were found between the sequences docetaxel- cabazitaxel- enzalutamide and docetaxel- enzalutamide.


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).


Siffnerova H.,Onkologicke Oddeleni
Onkologie | Year: 2012

Case history of 55 years old man with neuroendocrine tumor of liver, pankreas, mesentery, small intestine and mediastinum is decribed. The treatment started with somatostatin analogs. The treatment with sunitinib was added due to progression of disease.


Extravasation is the leakage of a drug (intended primarily for intravenous administration) into tissues surrounding the vascular system. The damage to surrounding varies depending on the nature and volume of extravasation. Cytostatic extravasation is associated with poor outcomes for patients. This paper summarizes the types of risk associated with cytostatic extravasation, and the preventative measures that can be used when such an event occurs. We also provide information on potential treatments. However, justification for their use has only been substantiated in papers with different levels of significance and these papers are not available in all countries. We summarize current international recommendations for actions to be taken in the event of extravasation.


Richter I.,Onkologicke oddeleni | Dvorak J.,Onkologicka klinika | Hejzlarova V.,Onkologicke oddeleni | Bartos J.,Onkologicke oddeleni
Onkologie (Czech Republic) | Year: 2016

Aim: A retrospective evaluation of efficacy and toleration of axitinib. Patients and methods: A total of 11 patients with metastatic renal cell carcinoma previously treated by sunitinib were evaluated. Axitinib was applied in doses 10 mg/kg twice a day. Response rate was evaluated by RECIST 1.1. We defined two parameters: Overall survival (OS) and progression free survival (PFS). Results: We described the toxicity in all patiens, predominantly grade I-II. Three patiens were hospitalized. One patiens died of hemoptysis. We did not described the complete remission, partial remission we desribed in 3 patients (27.2 %) and stabilization in 5 patients (45.5 %). Primary progression we finded in 3 patients (27.2 %). The median of PFS was 13.9 months (95 % CI 4.2-14.9 mesíce). Median of OS was not reached. 1-year OS we desribed in 59 % of patiens. Conclusion: The treatment with axitinib we evaluate positively. Axitinib is integral part of treatment in patiens with metastatic renal cell carcinoma.


Treatment selection is difficult in metastatic renal cell cancer. It is based mainly on tumour histology and biologic behaviour, patients characteristics such as comorbidities and performance status, and expected treatment toxicity. Several recently published studies have identified prognostic factors for patients treated with targeted agents including sunitinib, sorafenib, pazopanib, bevacizumab, temsirolimus, and everolimus. These prognostic factors should be considered when selecting the treatment strategy.


Buchler T.,Onkologicke Oddeleni | Vorsilkova E.,Onkologicke Oddeleni | Koukolik F.,Oddeleni Patologie | Melinova H.,Radiodiagnosticke Oddeleni | Abrahamova J.,Onkologicke Oddeleni
Klinicka Onkologie | Year: 2010

Cystosarcoma phyllodes is an uncommon type of breast tumour. Benign, borderline, and malignant subtypes have been described. Central nervous system metastases of the malignant subtype of cystosarcoma phyllodes are rare and associated with poor prognosis. We report on a patient with malignant cystosarcoma phyllodes who developed metastatic disease six years after resection of the primary breast tumour. Partial regression of a brain metastasis was achieved using radiotherapy but the patient later died due to widespread metastatic disease which was uncontrollable by systemic chemotherapy. Because metastatic malignant cystosarcoma phyllodes are largely resistant to treatment, the most important objective is to provide optimal management of the primary tumour before dissemination occurs.


Richter I.,Onkologicke oddeleni | Dvorak J.,Onkologicka klinika 1 | Jirasek T.,Oddeleni patologie | Bartos J.,Onkologicke oddeleni
Klinicka Onkologie | Year: 2015

Anal cancer is a relatively rare tumour. In local and locally advanced disease, concomitant che- moradiation based on mitomycin C and 5-fluorouracil, remains golden standard of treatment. However, this treatment is associated with significant morbidity. With the developing of molecular biology, new treatment strategies can be investigated. Epidermal growth factor receptor (EGFR) expression in anal cancer is observed in 55-100% of cases. Some studies demonstrated that KRAS mutations, mechanism marker of resistance to antiEGFR therapy, are rare in anal cancer. This paper presents current view on the possibilities of antiEGFR therapy in locally advanced and metastatic anal cancer.


PubMed | Onkologicke oddeleni
Type: Case Reports | Journal: Klinicka onkologie : casopis Ceske a Slovenske onkologicke spolecnosti | Year: 2011

Cystosarcoma phyllodes is an uncommon type of breast tumour. Benign, borderline, and malignant subtypes have been described. Central nervous system metastases of the malignant subtype of cystosarcoma phyllodes are rare and associated with poor prognosis. We report on a patient with malignant cystosarcoma phyllodes who developed metastatic disease six years after resection of the primary breast tumour. Partial regression of a brain metastasis was achieved using radiotherapy but the patient later died due to widespread metastatic disease which was uncontrollable by systemic chemotherapy. Because metastatic malignant cystosarcoma phyllodes are largely resistant to treatment, the most important objective is to provide optimal management of the primary tumour before dissemination occurs.

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