P. Kedzierawski, K. Buliński, T. Kuszewski, K. Wnuk, A. Dabrowski, K. Lis, J. Braziewicz, K. Slosarek
Introduction. Medical physicists planning radiation treatment are increasingly confronted with situations that require special attention. Undoubtedly, one such situation is the postoperative irradiation of a patient with breast cancer in which there is a prosthesis or an expander. In recent years, expanders have appeared in this location, which, due to the density of the device’s valve makes it difficult to prepare an acceptable treatment plan. The study aims to present treatment planning in these situation in various Polish cancer centres and to compare overall patient preparation for the treatment. Material and methods. A questionnaire was prepared and sent to more than 20 radiotherapy departments, which included basic questions regarding the preparation of an irradiation plan for patients treated for breast cancer after a subcutaneous mastectomy with immediate reconstruction with a prosthesis or expander. The survey encompassed eight radiotherapy departments. Results. Not all radiotherapy departments require a manufacturer’s certificate, which shows that the manufacturer does not prohibit the use of a prosthesis/expander during treatment with ionizing radiation. The X 6MV photons and the supine position, total and fraction doses: from 40 to 60 Gy and from 2 to 2.67 Gy, respectively, are the most commonly used. The way of defining them also depends on the oncological centre. The most commonly used irradiation technique is VMAT. Conclusion. The conclusion from the questionnaire – no standardisation of treatment planning – should encourage the community, at least medical physicists, to develop rules of conduct in this case. Irradiation techniques are mainly dynamic ones. The expander or prosthesis does not significantly affect the dose distributions.
{"title":"Radiotherapy treatment planning for breast cancer patients after a subcutaneous mastectomy with the use of a prosthesis or expander","authors":"P. Kedzierawski, K. Buliński, T. Kuszewski, K. Wnuk, A. Dabrowski, K. Lis, J. Braziewicz, K. Slosarek","doi":"10.5603/NJO.2021.0029","DOIUrl":"https://doi.org/10.5603/NJO.2021.0029","url":null,"abstract":"Introduction. Medical physicists planning radiation treatment are increasingly confronted with situations that require special attention. Undoubtedly, one such situation is the postoperative irradiation of a patient with breast cancer in which there is a prosthesis or an expander. In recent years, expanders have appeared in this location, which, due to the density of the device’s valve makes it difficult to prepare an acceptable treatment plan. The study aims to present treatment planning in these situation in various Polish cancer centres and to compare overall patient preparation for the treatment. Material and methods. A questionnaire was prepared and sent to more than 20 radiotherapy departments, which included basic questions regarding the preparation of an irradiation plan for patients treated for breast cancer after a subcutaneous mastectomy with immediate reconstruction with a prosthesis or expander. The survey encompassed eight radiotherapy departments. Results. Not all radiotherapy departments require a manufacturer’s certificate, which shows that the manufacturer does not prohibit the use of a prosthesis/expander during treatment with ionizing radiation. The X 6MV photons and the supine position, total and fraction doses: from 40 to 60 Gy and from 2 to 2.67 Gy, respectively, are the most commonly used. The way of defining them also depends on the oncological centre. The most commonly used irradiation technique is VMAT. Conclusion. The conclusion from the questionnaire – no standardisation of treatment planning – should encourage the community, at least medical physicists, to develop rules of conduct in this case. Irradiation techniques are mainly dynamic ones. The expander or prosthesis does not significantly affect the dose distributions.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"59 1","pages":"146-152"},"PeriodicalIF":0.0,"publicationDate":"2021-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84848447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zbigniew I. Nowecki, A. Jagiełło-Gruszfeld, K. Pogoda, A. Niwińska, W. Olszewski, Paweł Winter, R. Matkowski, W. Wysocki
Neoadjuvant therapy (NAT) is increasingly applied in patients with initially inoperable breast cancers and, frequently, in those with tumours that are initially operable, too. In most cases, the response to the applied NAT affects the scope of surgical treatment and radiotherapy, and in some situations also the complementary systemic postoperative treatment. The available studies indicate importance of response to NAT within the breast and regional lymph nodes. Assessment of response to treatment allows personalization of treatment and in some cases a change of therapy, which improves long-term outcomes. This article summarizes the current rules of conduct in patients with early breast cancer qualified for neoadjuvant therapy, paying attention to the practical aspects and possibilities of national health insurance-covered therapies in Poland. It discusses in detail the applied regimens of systemic therapy, surgical techniques, eligibility rules and complementary radiotherapy. Systems for assessing response to neoadjuvant treatment are also presented.
{"title":"Leczenie przedoperacyjne chorych na raka piersi i jego wpływ na postępowanie operacyjne oraz radioterapeutyczne. Część 1.","authors":"Zbigniew I. Nowecki, A. Jagiełło-Gruszfeld, K. Pogoda, A. Niwińska, W. Olszewski, Paweł Winter, R. Matkowski, W. Wysocki","doi":"10.5603/NJO.2021.0004","DOIUrl":"https://doi.org/10.5603/NJO.2021.0004","url":null,"abstract":"Neoadjuvant therapy (NAT) is increasingly applied in patients with initially inoperable breast cancers and, frequently, in those with tumours that are initially operable, too. In most cases, the response to the applied NAT affects the scope of surgical treatment and radiotherapy, and in some situations also the complementary systemic postoperative treatment. The available studies indicate importance of response to NAT within the breast and regional lymph nodes. Assessment of response to treatment allows personalization of treatment and in some cases a change of therapy, which improves long-term outcomes. This article summarizes the current rules of conduct in patients with early breast cancer qualified for neoadjuvant therapy, paying attention to the practical aspects and possibilities of national health insurance-covered therapies in Poland. It discusses in detail the applied regimens of systemic therapy, surgical techniques, eligibility rules and complementary radiotherapy. Systems for assessing response to neoadjuvant treatment are also presented.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"139 1","pages":"17-25"},"PeriodicalIF":0.0,"publicationDate":"2021-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80533561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Artur Wróbel-Roztropiński, B. Zielińska-Kaźmierska, Hubert Roztropiński, Weronika Lucas-Grzelczyk, J. Szemraj, M. Józefowicz-Korczynska
Introduction. To investigate the mRNA and protein expression of MMP-2, MMP-9, MMP-7 and their tissue inhibitor TIMP-2 in tissue specimens with oral squamous cell cancer (OSCC) and in healthy tissues. Material and methods. The expression genes of MMP-2, MMP-9, MMP-7 and TIMP-2 on mRNA levels were detected by the RT-PCR method in 31 samples with oral squamous cell carcinoma and in 31 healthy, control tissues. Secondly, the concentration of the analysed metalloproteinases and their inhibitor was assessed in tumor and non-tumor tissues using the enzyme-linked immunosorbent assay (ELISA) method. Results. The mean values of gene expression of MMP-2, MMP-7, MMP-9 and TIMP in tissues with oral squamous cell cancer were significantly higher in comparison to normal ones (p < 0.0001). Similar observations were found for concentration levels of analysed MMPs and TIMP in tissues with and without oral cancer (p < 0.0001). Conclusions. The present study demonstrated that MMP-2, MMP-7, MMP-9 and TIMP-2 gene expression on protein and mRNA levels is higher in oral squamous cell carcinoma tissues than in healthy control tissues. This may suggest that MMPs and TIMP play an important role in tumorogenesis. We did not observe any correlation between the clinicopathological characteristics of patients with OSCC and expression levels of MMPs and TIMP.
{"title":"Expression of matrix metalloproteinases (MMPs) and their inhibitor (TIMP) genes on mRNA and protein levels in oral squamous cell carcinoma","authors":"Artur Wróbel-Roztropiński, B. Zielińska-Kaźmierska, Hubert Roztropiński, Weronika Lucas-Grzelczyk, J. Szemraj, M. Józefowicz-Korczynska","doi":"10.5603/NJO.2021.0003","DOIUrl":"https://doi.org/10.5603/NJO.2021.0003","url":null,"abstract":"Introduction. To investigate the mRNA and protein expression of MMP-2, MMP-9, MMP-7 and their tissue inhibitor TIMP-2 in tissue specimens with oral squamous cell cancer (OSCC) and in healthy tissues. Material and methods. The expression genes of MMP-2, MMP-9, MMP-7 and TIMP-2 on mRNA levels were detected by the RT-PCR method in 31 samples with oral squamous cell carcinoma and in 31 healthy, control tissues. Secondly, the concentration of the analysed metalloproteinases and their inhibitor was assessed in tumor and non-tumor tissues using the enzyme-linked immunosorbent assay (ELISA) method. Results. The mean values of gene expression of MMP-2, MMP-7, MMP-9 and TIMP in tissues with oral squamous cell cancer were significantly higher in comparison to normal ones (p < 0.0001). Similar observations were found for concentration levels of analysed MMPs and TIMP in tissues with and without oral cancer (p < 0.0001). Conclusions. The present study demonstrated that MMP-2, MMP-7, MMP-9 and TIMP-2 gene expression on protein and mRNA levels is higher in oral squamous cell carcinoma tissues than in healthy control tissues. This may suggest that MMPs and TIMP play an important role in tumorogenesis. We did not observe any correlation between the clinicopathological characteristics of patients with OSCC and expression levels of MMPs and TIMP.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"40 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2021-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88531793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Grela-Wojewoda, R. Pacholczak-Madej, W. Wysocki, M. Ziobro
Colorectal cancer is one of the most frequent malignant tumours in Poland, making up the third cause of cancer deaths both in women and in men with regards to the frequency of occurrence. The therapy of patients with high-stage colorectal cancer is palliative and should be conducted in a continual manner until the disease progression or unacceptable toxicity of treatment. By definition, palliative care aims at prolongation of the period to the exacerbation of the disease and of the overall survival with simultaneous guarantee of appropriate quality of life to the patients. A long-term use of a multidrug chemotherapy is often connected with the presence of clinically significant toxicity, therefore, de-escalation of systemic treatment is currently the subject of numerous analyses. The studies evaluating the effect of maintenance therapy on patient survival, prove that this kind of treatment makes up a valuable option in the case of patients in whom a good clinical effect is maintained with a concurrent reduction of toxicity of treatment. Especially in the context of the ongoing SARS-CoV-2 pandemic, monotherapy or less aggressive therapy should be discussed with patients.
{"title":"De-escalation of the systemic therapy in advanced colorectal cancer - justified clinical practice from the point of view of efficiency and safety","authors":"A. Grela-Wojewoda, R. Pacholczak-Madej, W. Wysocki, M. Ziobro","doi":"10.5603/NJO.2021.0055","DOIUrl":"https://doi.org/10.5603/NJO.2021.0055","url":null,"abstract":"Colorectal cancer is one of the most frequent malignant tumours in Poland, making up the third cause of cancer deaths both in women and in men with regards to the frequency of occurrence. The therapy of patients with high-stage colorectal cancer is palliative and should be conducted in a continual manner until the disease progression or unacceptable toxicity of treatment. By definition, palliative care aims at prolongation of the period to the exacerbation of the disease and of the overall survival with simultaneous guarantee of appropriate quality of life to the patients. A long-term use of a multidrug chemotherapy is often connected with the presence of clinically significant toxicity, therefore, de-escalation of systemic treatment is currently the subject of numerous analyses. The studies evaluating the effect of maintenance therapy on patient survival, prove that this kind of treatment makes up a valuable option in the case of patients in whom a good clinical effect is maintained with a concurrent reduction of toxicity of treatment. Especially in the context of the ongoing SARS-CoV-2 pandemic, monotherapy or less aggressive therapy should be discussed with patients.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75024711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim of this paper is to answer to the question whether various dose fractionation regimens are highly effective up to the summit of normal tissue tolerance. Data of 45 trials on altered fractionation, radio-response of the HPV(+) oropharyngeal cancer (OPC) and concurrent chemoradiation (11 533 data) are selected from the published papers and re-analysed. Altered fractionation regimens showed average Therapeutic Gain (TG) of local tumour control (LTC) of about 2.7% per each 1 izoGy 2.0 above 65 Gy. For HPV(+) OPC, TG increased by 3-3.5% / 1izoGy 2.0 . Concurrent chemoradiation for locally advanced H&N cancer produced about 60% LTC using 65 Gy (about 20% more than altered RT). Despite randomization, data sets in the trials remain clinically and biologically heterogeneous. It is not possible separate the TG rate as the result of change in dose per fraction from that caused by changing overall treatment time. There are major weak points of the trials. Moreover, the results are presented as an average value of the LTC or survival. Overstepped tolerance summit is very rarely precisely presented. It likely seems that tolerance summit is not a single value and is only partly related to dose fractionation intensity, and mainly depends on radiosensitivity and irradiation volume of normal tissue(s) and its potential repair capacity, and activation of immunological defense. Finally, it is difficult to accept average trial’ results as evidence based guidelines for personalized radiotherapy for individual patients, all the more individual tolerance summit is not universal and well quantified.
{"title":"Does fractionation in radiotherapy of head and neck cancer reach a summit or is there still a room for novel therapeutic strategies?","authors":"B. Maciejewski, L. Miszczyk, K. Składowski","doi":"10.5603/NJO.2021.0022","DOIUrl":"https://doi.org/10.5603/NJO.2021.0022","url":null,"abstract":"Aim of this paper is to answer to the question whether various dose fractionation regimens are highly effective up to the summit of normal tissue tolerance. Data of 45 trials on altered fractionation, radio-response of the HPV(+) oropharyngeal cancer (OPC) and concurrent chemoradiation (11 533 data) are selected from the published papers and re-analysed. Altered fractionation regimens showed average Therapeutic Gain (TG) of local tumour control (LTC) of about 2.7% per each 1 izoGy 2.0 above 65 Gy. For HPV(+) OPC, TG increased by 3-3.5% / 1izoGy 2.0 . Concurrent chemoradiation for locally advanced H&N cancer produced about 60% LTC using 65 Gy (about 20% more than altered RT). Despite randomization, data sets in the trials remain clinically and biologically heterogeneous. It is not possible separate the TG rate as the result of change in dose per fraction from that caused by changing overall treatment time. There are major weak points of the trials. Moreover, the results are presented as an average value of the LTC or survival. Overstepped tolerance summit is very rarely precisely presented. It likely seems that tolerance summit is not a single value and is only partly related to dose fractionation intensity, and mainly depends on radiosensitivity and irradiation volume of normal tissue(s) and its potential repair capacity, and activation of immunological defense. Finally, it is difficult to accept average trial’ results as evidence based guidelines for personalized radiotherapy for individual patients, all the more individual tolerance summit is not universal and well quantified.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"141 1","pages":"94-102"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86743143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joanna Kufel-Grabowska, B. Radecka, J. Streb, A. Jagiełło-Gruszfeld, J. Hudała-Klecha, E. Szombara, R. Sienkiewicz, B. Czartoryska-Arłukowicz, Piotr Witasik, Katarzyna Sokołowska, W. Wysocki
Breast cancer is the most common cancer among women in Poland and worldwide; after lung cancer it is the second highest cause of death among females with malignancies. HER2 positive breast cancer occurs in ca.15–20% of all cases. More often than other subtypes, it affects younger patients and more often spreads metastasises to internal organs. The new drugs against the HER2 receptor significantly improve patients’ prognoses, regardless of the initial stage. The authors of the study involved 1503 patients with HER2 positive breast cancer from all stages (I–IV); 482 patients received preoperative systemic therapy (chemotherapy or hormonal therapy), 385 trastuzumab. Among the 1219 females qualified to surgery, 734 (60%) underwent a mastectomy, 485 (40%) had breast conserving therapy with adjuvant radiotherapy, some of them had preoperative systemic treatment.
{"title":"Breast-conserving surgeries in HER-positive breast cancer patients are performed too rarely in Poland","authors":"Joanna Kufel-Grabowska, B. Radecka, J. Streb, A. Jagiełło-Gruszfeld, J. Hudała-Klecha, E. Szombara, R. Sienkiewicz, B. Czartoryska-Arłukowicz, Piotr Witasik, Katarzyna Sokołowska, W. Wysocki","doi":"10.5603/njo.2020.0047","DOIUrl":"https://doi.org/10.5603/njo.2020.0047","url":null,"abstract":"Breast cancer is the most common cancer among women in Poland and worldwide; after lung cancer it is the second highest cause of death among females with malignancies. HER2 positive breast cancer occurs in ca.15–20% of all cases. More often than other subtypes, it affects younger patients and more often spreads metastasises to internal organs. The new drugs against the HER2 receptor significantly improve patients’ prognoses, regardless of the initial stage. The authors of the study involved 1503 patients with HER2 positive breast cancer from all stages (I–IV); 482 patients received preoperative systemic therapy (chemotherapy or hormonal therapy), 385 trastuzumab. Among the 1219 females qualified to surgery, 734 (60%) underwent a mastectomy, 485 (40%) had breast conserving therapy with adjuvant radiotherapy, some of them had preoperative systemic treatment.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"41 1","pages":"225-229"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73426559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Sokół, B. Szostakowski, Maria Chraszczewska, T. Goryń, M. Wągrodzki, M. Prochorec-Sobieszek, A. Szumera-Ciećkiewicz
We present the case of a 43-year old patient with inguinal lymphadenopathy 22 years after distal femoral resection for osteosarcoma with cemented distal femoral replacement reconstruction. Seven years after initial distal femoral resection patient underwent metal on metal hip resurfacing arthroplasty on the affected side. Twenty years after distal femoral replacement and 13 years after metal on metal hip resurfacing procedure, the patient underwent left inguinal lymphadenectomy for an enlarged mass of inguinal lymph nodes on suspicion for a sarcoma recurrence. On microscopic examination, excised lymph nodes were massively infiltrated with macrophages and multinucleated giant cells with focal asteroid bodies. An examination in polarized light revealed numerous metal particles; immunohistochemical stainings confirmed reactive character of changes, and florid metal-related sinus histiocytosis was finally diagnosed. Microscopic assessment of lymph nodes in the course of malignancy is a standard procedure; we present a rare case of non-neoplastic lymph node enlargement due to the late onset of metallosis, which might be a diagnostic challenge.
{"title":"Histiocytic lymphadenopathy secondary to metallosis following endoprosthetic replacement in osteosarcoma patient – a potential diagnostic pitfall","authors":"K. Sokół, B. Szostakowski, Maria Chraszczewska, T. Goryń, M. Wągrodzki, M. Prochorec-Sobieszek, A. Szumera-Ciećkiewicz","doi":"10.5603/njo.2020.0053","DOIUrl":"https://doi.org/10.5603/njo.2020.0053","url":null,"abstract":"We present the case of a 43-year old patient with inguinal lymphadenopathy 22 years after distal femoral resection for osteosarcoma with cemented distal femoral replacement reconstruction. Seven years after initial distal femoral resection patient underwent metal on metal hip resurfacing arthroplasty on the affected side. Twenty years after distal femoral replacement and 13 years after metal on metal hip resurfacing procedure, the patient underwent left inguinal lymphadenectomy for an enlarged mass of inguinal lymph nodes on suspicion for a sarcoma recurrence. On microscopic examination, excised lymph nodes were massively infiltrated with macrophages and multinucleated giant cells with focal asteroid bodies. An examination in polarized light revealed numerous metal particles; immunohistochemical stainings confirmed reactive character of changes, and florid metal-related sinus histiocytosis was finally diagnosed. Microscopic assessment of lymph nodes in the course of malignancy is a standard procedure; we present a rare case of non-neoplastic lymph node enlargement due to the late onset of metallosis, which might be a diagnostic challenge.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"11 1","pages":"272-275"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77801423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magdalena Stawarz-Janeczek, Katarzyna Szczeklik, Jolanta Pytko-Polończyk
Oral mucositis (OM) caused by ionizing radiation is a significant therapeutic problem concerning almost all patients with head and neck cancers undergoing irradiation, however, an effective treatment method is still missing. Therapeutic actions concentrate mostly on prophylaxis, including the maintenance of the correct hygiene of the oral cavity. In 2014 the International Society of Oral Oncology (ISOO) together with the (Multinational Association of Supportive Care in Cancer (MASCC) worked out the guidelines for the treatment of patients with z OM induced by radiotherapy and chemotherapy. In 2019 these guidelines were updated. Research is ongoing to find medication which could be applicable for the prevention and treatment of OM. The problem is grave as it might complicate the progress of oncological treatment, deteriorate the patient’s quality of life or even affect the prognosis. This paper describes the pathogenesis of oral mucositis, the current trends in treatment and discusses the role of a dentistry doctors in the care of the patient with symptoms of this condition. The article also refers to the role of a multidisciplinary team – the OM prophylaxis – as part of the preparation of an oncological patient for irradiation.
{"title":"Oral mucositis - problem nadal aktualny w medycynie i stomatologii","authors":"Magdalena Stawarz-Janeczek, Katarzyna Szczeklik, Jolanta Pytko-Polończyk","doi":"10.5603/njo.2020.0049","DOIUrl":"https://doi.org/10.5603/njo.2020.0049","url":null,"abstract":"Oral mucositis (OM) caused by ionizing radiation is a significant therapeutic problem concerning almost all patients with head and neck cancers undergoing irradiation, however, an effective treatment method is still missing. Therapeutic actions concentrate mostly on prophylaxis, including the maintenance of the correct hygiene of the oral cavity. In 2014 the International Society of Oral Oncology (ISOO) together with the (Multinational Association of Supportive Care in Cancer (MASCC) worked out the guidelines for the treatment of patients with z OM induced by radiotherapy and chemotherapy. In 2019 these guidelines were updated. Research is ongoing to find medication which could be applicable for the prevention and treatment of OM. The problem is grave as it might complicate the progress of oncological treatment, deteriorate the patient’s quality of life or even affect the prognosis. This paper describes the pathogenesis of oral mucositis, the current trends in treatment and discusses the role of a dentistry doctors in the care of the patient with symptoms of this condition. The article also refers to the role of a multidisciplinary team – the OM prophylaxis – as part of the preparation of an oncological patient for irradiation.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"85 1","pages":"253-259"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79701385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The introduction of immunotherapy with checkpoint inhibitors into clinical practice has radically changed the treatment and prognosis of patients with cancer. This treatment is also extensively studied in patients diagnosed with advanced sarcomas, where the number of effective therapies is limited. The following review presents the latest reports on the use of immunotherapy in the treatment of patients with sarcomas.
{"title":"Immunotherapy in sarcoma","authors":"H. Koseła-Paterczyk","doi":"10.5603/njo.2020.0057","DOIUrl":"https://doi.org/10.5603/njo.2020.0057","url":null,"abstract":"The introduction of immunotherapy with checkpoint inhibitors into clinical practice has radically changed the treatment and prognosis of patients with cancer. This treatment is also extensively studied in patients diagnosed with advanced sarcomas, where the number of effective therapies is limited. The following review presents the latest reports on the use of immunotherapy in the treatment of patients with sarcomas.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"8 1","pages":"296-302"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74711399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biological and clinical interest on HPV-associated oropharyngeal cancer (OPC) is rapidly increasing. The genetic and biological characteristics of HPV and p16 expression are presented. The significantly better prognosis (overall survival, locoregional control) of HPV p16(+) OPC patients has been well documented. The leading studies and clinical trials in this field are selected and discussed in details. There is a convincing suggestion that some, low-risk HPV(+) OPC patients might be overtreated. Different approaches with varying degrees of radiotherapy dose de-intensification are critically reviewed and the current de-escalated treatment paradigms are presented and discussed.
{"title":"A review of combined treatment strategies for HPV(+), p16(+) oropharyngeal cancer – is de-escalated radiotherapy a convincing and promising paradigm?","authors":"B. Maciejewski, K. Składowski","doi":"10.5603/njo.2020.0048","DOIUrl":"https://doi.org/10.5603/njo.2020.0048","url":null,"abstract":"Biological and clinical interest on HPV-associated oropharyngeal cancer (OPC) is rapidly increasing. The genetic and biological characteristics of HPV and p16 expression are presented. The significantly better prognosis (overall survival, locoregional control) of HPV p16(+) OPC patients has been well documented. The leading studies and clinical trials in this field are selected and discussed in details. There is a convincing suggestion that some, low-risk HPV(+) OPC patients might be overtreated. Different approaches with varying degrees of radiotherapy dose de-intensification are critically reviewed and the current de-escalated treatment paradigms are presented and discussed.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"75 4 1","pages":"236-243"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77389433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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