Marcin Kurowicki, K. Osowiecka, S. Nawrocki, Łukasz Cieśliński, B. Szostakiewicz, A. Badzio
Introduction. The study aimed to report the efficiency of radical radiotherapy and chemoradiotherapy in patients with non-small cell lung cancer (NSCLC) treated in the Nu-Med Radiotherapy Center in Elbląg. Material and methods. Ninety-two patients diagnosed with NSCLC treated between 2013 and 2016 were included in the analysis. Overall survival (OS) was estimated by the Kaplan-Meier method. Results. The 2-year OS for all patients was 36% (median 1.5 years). Two prognostic factors had a significant impact: treatment method and performance status (PS). Patients who underwent concurrent radiochemotherapy and were treated sequentially had a better 2-year OS in comparison with those treated with radiotherapy alone (respectively 46% and 37% vs. 25%, p ≤ 0.05). Patients with PS 0–1 had better OS (median 1.6 years) compared with PS 2 (median 0.7 years, p = 0.04). Other prognostic factors analysed had no impact on OS in our study. Conclusions. The treatment results of our patients are comparable to those in published trials and meta-analyses.
介绍。该研究旨在报道在Elbląg Nu-Med放疗中心治疗的非小细胞肺癌(NSCLC)患者的根治性放疗和放化疗的疗效。材料和方法。在2013年至2016年期间接受治疗的92名确诊为非小细胞肺癌的患者被纳入分析。用Kaplan-Meier法估计总生存期(OS)。结果。所有患者的2年OS为36%(中位1.5年)。两个预后因素有显著影响:治疗方法和性能状态(PS)。同时接受放化疗并顺序治疗的患者2年OS较单纯放疗患者更好(分别为46%和37% vs. 25%， p≤0.05)。PS 0-1患者的OS(中位1.6年)优于PS 2患者(中位0.7年，p = 0.04)。在我们的研究中，分析的其他预后因素对OS没有影响。结论。我们患者的治疗结果与已发表的试验和荟萃分析的结果相当。
{"title":"Survival analysis of patients with locally advanced non-small cell lung cancer treated at the Nu-Med Radiotherapy Center in Elbląg","authors":"Marcin Kurowicki, K. Osowiecka, S. Nawrocki, Łukasz Cieśliński, B. Szostakiewicz, A. Badzio","doi":"10.5603/njo.2020.0028","DOIUrl":"https://doi.org/10.5603/njo.2020.0028","url":null,"abstract":"Introduction. The study aimed to report the efficiency of radical radiotherapy and chemoradiotherapy in patients with non-small cell lung cancer (NSCLC) treated in the Nu-Med Radiotherapy Center in Elbląg. Material and methods. Ninety-two patients diagnosed with NSCLC treated between 2013 and 2016 were included in the analysis. Overall survival (OS) was estimated by the Kaplan-Meier method. Results. The 2-year OS for all patients was 36% (median 1.5 years). Two prognostic factors had a significant impact: treatment method and performance status (PS). Patients who underwent concurrent radiochemotherapy and were treated sequentially had a better 2-year OS in comparison with those treated with radiotherapy alone (respectively 46% and 37% vs. 25%, p ≤ 0.05). Patients with PS 0–1 had better OS (median 1.6 years) compared with PS 2 (median 0.7 years, p = 0.04). Other prognostic factors analysed had no impact on OS in our study. Conclusions. The treatment results of our patients are comparable to those in published trials and meta-analyses.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"19 1","pages":"135-143"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87245755","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 term “microbiome” is used to describe the substantial number and diverse spectrum of microorganisms that inhabit the body. It plays an essential role in health conditions and diseases. Recent years have brought a further intensification of experimental studies on the impact of the microbiome on the human body, particularly with the aim of identifying and clarifying this impact. Many studies indicate that diet, lifestyle and drugs can affect the composition of the intestinal microflora, which, in turn, can modulate the development and progression of gastrointestinal tract tumors. It is suspected that the gut microbiome plays a significant role in the formation of gastrointestinal tumors. On the other hand, the role of the intestinal microflora in inhibiting the processes of oncogenesis suggests that this mechanism may be used to prevent and treat gastrointestinal cancer. Using probiotics to modify the microbiome may be beneficial in cancer therapy and may be used as a supportive treatment for classic cancer therapies such as chemotherapy, radiotherapy and surgical treatment. Intestinal microbiome analysis can be potentially used to develop non-invasive diagnostic tests. These tests could be useful as new protective markers for colorectal cancer, or as prognostic markers and predictive markers of response to treatment, especially immunotherapy.
{"title":"Gut microbiota and neoplastic diseases of the gastrointestinal tract","authors":"A. Pilśniak, U. Dworzecka, E. Otto-Buczkowska","doi":"10.5603/njo.2020.0030","DOIUrl":"https://doi.org/10.5603/njo.2020.0030","url":null,"abstract":"The term “microbiome” is used to describe the substantial number and diverse spectrum of microorganisms that inhabit the body. It plays an essential role in health conditions and diseases. Recent years have brought a further intensification of experimental studies on the impact of the microbiome on the human body, particularly with the aim of identifying and clarifying this impact. Many studies indicate that diet, lifestyle and drugs can affect the composition of the intestinal microflora, which, in turn, can modulate the development and progression of gastrointestinal tract tumors. It is suspected that the gut microbiome plays a significant role in the formation of gastrointestinal tumors. On the other hand, the role of the intestinal microflora in inhibiting the processes of oncogenesis suggests that this mechanism may be used to prevent and treat gastrointestinal cancer. Using probiotics to modify the microbiome may be beneficial in cancer therapy and may be used as a supportive treatment for classic cancer therapies such as chemotherapy, radiotherapy and surgical treatment. Intestinal microbiome analysis can be potentially used to develop non-invasive diagnostic tests. These tests could be useful as new protective markers for colorectal cancer, or as prognostic markers and predictive markers of response to treatment, especially immunotherapy.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"60 1","pages":"150-152"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74109616","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}
{"title":"Does the type of a centre in which the resection of extensive tumours of the limbs and truck is performed, affect the patients’ survival?","authors":"P. Drozdowski, Ł. Krakowczyk, A. Maciejewski","doi":"10.5603/njo.2020.0032","DOIUrl":"https://doi.org/10.5603/njo.2020.0032","url":null,"abstract":"","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"58 1","pages":"158-160"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74366200","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}
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of many malignancies. Toxicities of immunotherapy are variable, can involve almost every organ, therefore appropriate diagnosis and management of Immune Related Adverse Events (irAEs) is important. Immune-mediated pneumonitis is an uncommon, but potentially life-threatening toxicity of ICIs. Pre-existing lung disease, a history of lung radiotherapy, age > 70 years and male gender are suggested as the risk factors of pneumonitis. Dyspnoea, dry cough, fever and chest pain are typical symptoms. Diagnostic algorithms recommend radiological investigation with a chest computed tomography scan. Additional diagnostic procedures – such as pulse oximetry, spirometry, measurement of carbon monoxide diffusing capacity, bronchoscopy with BAL may be helpful. The therapeutic approach is determined by the intensity of the symptoms and CT findings. Corticosteroids and antibiotics are the drugs of choice. Hospitalisation is necessary in severe cases, and other forms of immunosuppression (infliximab, mycophenolate mofetil) may be considered. Continuation of immunotherapy can be considered with caution in patients with G1-2 toxicity, when clinical improvement was achieved and steroids were tapered.
{"title":"Pulmonary toxicities of immune checkpoint inhibitors","authors":"M. Knetki-Wróblewska, J. Domagała-Kulawik","doi":"10.5603/njo.2020.0023","DOIUrl":"https://doi.org/10.5603/njo.2020.0023","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of many malignancies. Toxicities of immunotherapy are variable, can involve almost every organ, therefore appropriate diagnosis and management of Immune Related Adverse Events (irAEs) is important. Immune-mediated pneumonitis is an uncommon, but potentially life-threatening toxicity of ICIs. Pre-existing lung disease, a history of lung radiotherapy, age > 70 years and male gender are suggested as the risk factors of pneumonitis. Dyspnoea, dry cough, fever and chest pain are typical symptoms. Diagnostic algorithms recommend radiological investigation with a chest computed tomography scan. Additional diagnostic procedures – such as pulse oximetry, spirometry, measurement of carbon monoxide diffusing capacity, bronchoscopy with BAL may be helpful. The therapeutic approach is determined by the intensity of the symptoms and CT findings. Corticosteroids and antibiotics are the drugs of choice. Hospitalisation is necessary in severe cases, and other forms of immunosuppression (infliximab, mycophenolate mofetil) may be considered. Continuation of immunotherapy can be considered with caution in patients with G1-2 toxicity, when clinical improvement was achieved and steroids were tapered.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"27 1","pages":"105-110"},"PeriodicalIF":0.0,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87815575","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}
Maciej Mielczarek, Anna Kubica, Mateusz Szylberg, K. Zielińska, Jakub Przybył, Agata Sierzputowska, M. Harat
Introduction. The incidence of brain metastases (BM) is rapidly increasing, with most cases occurring in patients aged 50–80 years and in 10–40% of patients with systemic neoplastic disease. The Graded Prognostic Assessment (GPA) is the most impartial prognostic method, according to which the average survival rate of patients with brain metastases is only 7.18 months. Purpose. To present a systematic review of the currently available evidence-based literature on the epidemiology, diagnosis, and treatment of BM. Methods. The authors searched PubMed up to March 2020 using the phrases “brain metastases”, “brain metastasis surgery”, and “brain metastases treatment”, which returned 65 citations. Conclusions. The choice of imaging and therapy for brain metastases remains a significant clinical problem. MRI, including T1, T1 + C, T2, FLAIR, and SWI sequences, is the most sensitive method for solitary BM detection, while other techniques such as spectroscopy, perfusion imaging, or fractional anisotropy contribute to diagnosis precision and neurological deficit avoidance in cases eligible for surgery. According to current treatment algorithms, three main methods are used to manage BM: surgery, chemotherapy, and radiotherapy, depending on the expected effect and the patient’s clinical condition. Surgery is most often used, offering neurological deficit remission in 60 to 90% of patients. Most chemotherapeutics do not cross the blood-brain barrier, so immunotherapy with antibodies such as pembrolizumab and ipilimumab, as well as antineoplastic vaccines, are a promising therapeutic prospect.
{"title":"An update on the epidemiology, imaging and therapy of brain metastases","authors":"Maciej Mielczarek, Anna Kubica, Mateusz Szylberg, K. Zielińska, Jakub Przybył, Agata Sierzputowska, M. Harat","doi":"10.5603/njo.2020.0024","DOIUrl":"https://doi.org/10.5603/njo.2020.0024","url":null,"abstract":"Introduction. The incidence of brain metastases (BM) is rapidly increasing, with most cases occurring in patients aged 50–80 years and in 10–40% of patients with systemic neoplastic disease. The Graded Prognostic Assessment (GPA) is the most impartial prognostic method, according to which the average survival rate of patients with brain metastases is only 7.18 months. Purpose. To present a systematic review of the currently available evidence-based literature on the epidemiology, diagnosis, and treatment of BM. Methods. The authors searched PubMed up to March 2020 using the phrases “brain metastases”, “brain metastasis surgery”, and “brain metastases treatment”, which returned 65 citations. Conclusions. The choice of imaging and therapy for brain metastases remains a significant clinical problem. MRI, including T1, T1 + C, T2, FLAIR, and SWI sequences, is the most sensitive method for solitary BM detection, while other techniques such as spectroscopy, perfusion imaging, or fractional anisotropy contribute to diagnosis precision and neurological deficit avoidance in cases eligible for surgery. According to current treatment algorithms, three main methods are used to manage BM: surgery, chemotherapy, and radiotherapy, depending on the expected effect and the patient’s clinical condition. Surgery is most often used, offering neurological deficit remission in 60 to 90% of patients. Most chemotherapeutics do not cross the blood-brain barrier, so immunotherapy with antibodies such as pembrolizumab and ipilimumab, as well as antineoplastic vaccines, are a promising therapeutic prospect.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"19 1","pages":"111-117"},"PeriodicalIF":0.0,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80085805","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}
With the advent of breast conservation options in the 1970s, as well as wider acceptance of breast reconstruction in cancer patients in 1980/1990, ending up with evolution of oncoplastic concepts in the early 2000s, detailed surgical anatomy of the breast became important. This short article reviews surgical anatomy of breast with particular emphasis on innervation and blood supply to the skin and nipple-areolar complex, as well as points out the concept of compartmental breast cancer anatomy. Meticulous dissection and avoidance of transection of major vessels and nerves constitutes the crucial factor for satisfactory results of surgery in terms of preservation of sensation as well as appropriate vitality of skin.
{"title":"Surgical anatomy of the breast revisited","authors":"W. Wysocki, G. Libondi, A. Juszczak","doi":"10.5603/njo.2020.0005","DOIUrl":"https://doi.org/10.5603/njo.2020.0005","url":null,"abstract":"With the advent of breast conservation options in the 1970s, as well as wider acceptance of breast reconstruction in cancer patients in 1980/1990, ending up with evolution of oncoplastic concepts in the early 2000s, detailed surgical anatomy of the breast became important. This short article reviews surgical anatomy of breast with particular emphasis on innervation and blood supply to the skin and nipple-areolar complex, as well as points out the concept of compartmental breast cancer anatomy. Meticulous dissection and avoidance of transection of major vessels and nerves constitutes the crucial factor for satisfactory results of surgery in terms of preservation of sensation as well as appropriate vitality of skin.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"10 1","pages":"26-28"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90504592","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}
O. Stanowska, T. Morysiński, P. Rutkowski, A. Klimczak, A. Szumera-Ciećkiewicz
We report an unusual case of a malignant granular cell tumor of the left lumbar region in 63-year old woman – diagnosed, consulted and treated with surgical resection (R1) and radiotherapy, followed up for 2 years with lung metastases after 22 months. Furthermore, we discuss histopathological differential diagnosis and current criteria for malignancy, as well as available options for systemic treatment in view of cytogenetic and molecular genetic characteristics of the tumor.
{"title":"Malignant granular cell tumor of the lumbar region – a case report and review of the criteria for diagnosis","authors":"O. Stanowska, T. Morysiński, P. Rutkowski, A. Klimczak, A. Szumera-Ciećkiewicz","doi":"10.5603/njo.2020.0007","DOIUrl":"https://doi.org/10.5603/njo.2020.0007","url":null,"abstract":"We report an unusual case of a malignant granular cell tumor of the left lumbar region in 63-year old woman – diagnosed, consulted and treated with surgical resection (R1) and radiotherapy, followed up for 2 years with lung metastases after 22 months. Furthermore, we discuss histopathological differential diagnosis and current criteria for malignancy, as well as available options for systemic treatment in view of cytogenetic and molecular genetic characteristics of the tumor.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"31 3 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79901582","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. Osowiecka, M. Rucińska, A. Andrzejczak, E. Żarłok, Iwona Chrostek, S. Nawrocki
Introduction. Due to the multidisciplinary nature of oncological treatment, it is necessary to coordinate it properly. In response to this need, an idea emerged to create a new profession in the system of oncological care, the so-called oncological treatment coordinator. The aim of the study was to assess the actual role of coordinators in hospitals in Poland. Material and methods. The study was carried out by means of a questionnaire among persons employed as coordinators and persons who act as coordinators within additional duties. Results. The study involved 95 coordinators from various centers in Poland, half of which were recruited on purpose as coordinators. Less than half (40%) have received training on their work. The main task of the coordinators is to ensure that the documentation related to the patient’s Diagnostic and Oncological Treatment Card (DiLO) is complete, to set appointments for diagnostic tests and visits to doctors’ offices and to cooperate with medical statistics departments. Only half of the coordinators inform or provide non-medical support to the patient. Coordinators face very different difficulties in their work. Conclusions. Coordinators are a valuable professional group in the Polish oncological care system. However, there is a lack of clearly defined tasks, systematic training and support.
{"title":"What was supposed to be the role of a coordinator of oncological treatment, and what is it really like?","authors":"K. Osowiecka, M. Rucińska, A. Andrzejczak, E. Żarłok, Iwona Chrostek, S. Nawrocki","doi":"10.5603/njo.2020.0001","DOIUrl":"https://doi.org/10.5603/njo.2020.0001","url":null,"abstract":"Introduction. Due to the multidisciplinary nature of oncological treatment, it is necessary to coordinate it properly. In response to this need, an idea emerged to create a new profession in the system of oncological care, the so-called oncological treatment coordinator. The aim of the study was to assess the actual role of coordinators in hospitals in Poland. Material and methods. The study was carried out by means of a questionnaire among persons employed as coordinators and persons who act as coordinators within additional duties. Results. The study involved 95 coordinators from various centers in Poland, half of which were recruited on purpose as coordinators. Less than half (40%) have received training on their work. The main task of the coordinators is to ensure that the documentation related to the patient’s Diagnostic and Oncological Treatment Card (DiLO) is complete, to set appointments for diagnostic tests and visits to doctors’ offices and to cooperate with medical statistics departments. Only half of the coordinators inform or provide non-medical support to the patient. Coordinators face very different difficulties in their work. Conclusions. Coordinators are a valuable professional group in the Polish oncological care system. However, there is a lack of clearly defined tasks, systematic training and support.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"110 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79261447","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}
Hodgkin’s lymphoma (HL) belongs to the most radiosensitive and chemosensitive cancers. Combined modality therapy is the preferred treatment for patients with classical favorable early-stage HL. However, late toxicity still remains an issue. A modern approach in HL radiotherapy includes implementation of sophisticated and dedicated delivery techniques together with the lower doses and smaller fields, which allow for reduction of early and late toxicity. In recent years, the question on the need for complementary radiotherapy in the early stages of Hodgkin’s lymphoma has been increasingly raised. The aim of the present review is to discuss the current role of radiotherapy and its potential future developments, with a focus on major clinical trials.
{"title":"Should adjuvant radiotherapy be used in patients with early stage Hodgkin’s lymphoma? A vote for yes","authors":"E. Łata-Woźniak, A. Łacko","doi":"10.5603/njo.2020.0006","DOIUrl":"https://doi.org/10.5603/njo.2020.0006","url":null,"abstract":"Hodgkin’s lymphoma (HL) belongs to the most radiosensitive and chemosensitive cancers. Combined modality therapy is the preferred treatment for patients with classical favorable early-stage HL. However, late toxicity still remains an issue. A modern approach in HL radiotherapy includes implementation of sophisticated and dedicated delivery techniques together with the lower doses and smaller fields, which allow for reduction of early and late toxicity. In recent years, the question on the need for complementary radiotherapy in the early stages of Hodgkin’s lymphoma has been increasingly raised. The aim of the present review is to discuss the current role of radiotherapy and its potential future developments, with a focus on major clinical trials.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"99 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74175966","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 role of radiotherapy in the postmastectomy setting with substantial lymph node burden or locally advanced disease has been well described. In the last decade, the indications for postmastectomy radiotherapy (PMRT) have expanded in light of a measurable disease-free survival benefit, even in T1–2N1-patient subgroup. Concurrently, immediate breast reconstruction (IBR) rates after mastectomy are rapidly increasing. Optimal integration of IBR and PMRT is challenging, as PMRT has a known deleterious effect on reconstruction outcomes and IBR has been reported to pose challenges to PMRT delivery. Implant-based reconstruction is the most common type of IBR performed nowadays. This article reviews the current problems regarding integration of the implant-based IBR with optimum radiation delivery and discusses the advantages and disadvantages of each reconstruction method with PMRT.
{"title":"Adjuvant radiation therapy after immediate implant-based breast reconstruction","authors":"J. Socha","doi":"10.5603/njo.2020.0004","DOIUrl":"https://doi.org/10.5603/njo.2020.0004","url":null,"abstract":"The role of radiotherapy in the postmastectomy setting with substantial lymph node burden or locally advanced disease has been well described. In the last decade, the indications for postmastectomy radiotherapy (PMRT) have expanded in light of a measurable disease-free survival benefit, even in T1–2N1-patient subgroup. Concurrently, immediate breast reconstruction (IBR) rates after mastectomy are rapidly increasing. Optimal integration of IBR and PMRT is challenging, as PMRT has a known deleterious effect on reconstruction outcomes and IBR has been reported to pose challenges to PMRT delivery. Implant-based reconstruction is the most common type of IBR performed nowadays. This article reviews the current problems regarding integration of the implant-based IBR with optimum radiation delivery and discusses the advantages and disadvantages of each reconstruction method with PMRT.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"8 1","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86088302","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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