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Immunochemotherapy in a 25-year-old male patient with small-cell lung cancer 25岁男性小细胞肺癌患者的免疫化疗
Q4 ONCOLOGY Pub Date : 2023-10-27 DOI: 10.5603/ocp.97487
Aleksandra Łomża, Bernadeta Maliszewska, Łukasz Łaba, Izabela Chmielewska, Iwona Paśnik, Renata Langfort, Michał Gil, Krawczyk Paweł
Lung cancer is the leading cause of cancer-related deaths, both in males and females. Small-cell lung cancer (SCLC) is a strongly tobacco-dependent type of lung cancer characterized by aggressiveness, rapid growth, and a high tendency to metastasize. SCLC is the most commonly diagnosed in an advanced — metastatic — stage in patients with many comorbidities and inadequate performance status. However, based on the most current recommendations, chemotherapy in combination with immunotherapy at the extensive stage (ES) of SCLC, significantly improves the therapeutic efficiency. Here, we present a case of a 25-year-old man, diagnosed with SCLC, with a medical history of 10 years of smoking e-cigarettes and marijuana as well as the use of amphetamine and alcohol. In the diagnosis process, considering the young age of the patient, the next-generation sequencing (NGS) was performed, but no molecular alterations in oncogenes were found. During the immunochemotherapy with atezolizumab, carboplatin, and etoposide, immune-related adverse events (irAEs), in the form of hepatotoxicity, were observed. After the toxicity subsided, the immunotherapy was continued with a very good effect and tolerance. The patient has remained in partial remission for 9 months. The presented case highlights the possibility of treatment continuation despite mild adverse events triggered by immunotherapy and the need for more research in the group of young patients diagnosed with SCLC.
肺癌是导致男性和女性癌症相关死亡的主要原因。小细胞肺癌(SCLC)是一种高度依赖烟草的肺癌类型,其特点是侵袭性强、生长迅速、转移倾向高。SCLC最常见于有许多合并症和表现不佳的晚期转移期患者。然而,根据目前的建议,在SCLC的广泛期(ES)化疗联合免疫治疗可显著提高治疗效率。在这里,我们提出了一个25岁的男性病例,诊断为SCLC,有10年吸电子烟和大麻以及使用安非他明和酒精的病史。在诊断过程中,考虑到患者年龄小,进行了下一代测序(NGS),但未发现癌基因的分子改变。在用阿特唑单抗、卡铂和依托泊苷进行免疫化疗期间,观察到以肝毒性形式出现的免疫相关不良事件(irAEs)。毒性消退后继续免疫治疗,效果良好,耐受性良好。病人的部分缓解持续了9个月。该病例强调了尽管免疫治疗引发轻微不良事件,但继续治疗的可能性,以及对诊断为SCLC的年轻患者进行更多研究的必要性。
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引用次数: 0
Commentary on Trastuzumab deruxtecan in the treatment of adult patients with HER-positive breast cancer 关于曲妥珠单抗德鲁德替康治疗her阳性乳腺癌成人患者的评论
Q4 ONCOLOGY Pub Date : 2023-10-27 DOI: 10.5603/ocp.97613
Maciej Krzakowski
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引用次数: 0
Systemic treatment of patients with advanced pancreatic cancer — is there still a place for gemcitabine in the first-line setting? Experience of Polish oncology centers 晚期胰腺癌患者的全身治疗——吉西他滨在一线是否仍有一席之地?有波兰肿瘤中心的工作经验
Q4 ONCOLOGY Pub Date : 2023-10-25 DOI: 10.5603/ocp.97305
Ireneusz Raczyński, Patryk Zając, Joanna Streb, Bogumiła Czartoryska-Arłukowicz, Aleksandra Chruściana-Bołtuć, Małgorzata Talerczyk, Katarzyna Wierzbicka, Agnieszka Siedlaczek, Weronika Radecka, Michał Jurczyk, Barbara Radecka
Introduction. Despite some progress in the treatment of patients with pancreatic cancer, it is still a malignancy with a poor prognosis, which results from its rapid local growth with a tendency to infiltrate surrounding tissues and metastasize, and late diagnosis at the advanced stage. The use of multi-drug regimens and modern targeted therapies did not completely eliminate the use of gemcitabine in monotherapy, which is a therapeutic option mainly in patients with poor performance status, ineligible for more advanced therapies. This study aimed to evaluate the results of treatment with single-agent gemcitabine in everyday clinical practice in Poland and to attempt to identify the predictors of obtaining long-term responses resulting from this treatment. Material and methods. A retrospective analysis of 167 patients with advanced pancreatic cancer treated with single-agent gemcitabine in five oncology centers in Poland in the years 2017–2022 was conducted. Gemcitabine was used as monotherapy at an initial dose of 1000 mg/m2 of body surface area (BSA) weekly, 7 times in an 8-week cycle, then 3 times in a 4-week cycle. Results. Median overall survival (OS) in the entire group of patients was 6.1 months (range — 0.2–32.3 months), and median progression-free survival (PFS) was 4.2 months (range — 0.2–31.3 months). A group of 60 patients was identified as “long responders” (LR), with a response of at least 6 months and a group of 107 as “short responders” (SR). Median PFS in the LR group was 9.15 months (range — 6.0–31.3 months) and in the SR group, it was 3.2 months (range — 0.2–5.8 months). Median OS was 11.6 months (range — 5.9–30.8) and 3.8 months (range — 0.2–32.3 months), respectively. In multivariate analysis, the likelihood of achieving at least a 6-month response (LR) was assessed using a logistic regression model. The model takes into account four variables: the neutrophil/lymphocyte (NLR) ratio, liver metastases, sex, and Hb level. Conclusions. The obtained results confirm that gemcitabine monotherapy is still useful in the first-line treatment of patients with advanced and metastatic pancreatic adenocarcinoma. An appropriate selection of patients for this treatment may improve the results while maintaining lower toxicity compared to combined treatment.
介绍。尽管胰腺癌患者的治疗取得了一些进展,但它仍然是一种预后较差的恶性肿瘤,这是因为它局部生长迅速,容易浸润周围组织并转移,晚期诊断较晚。多药方案和现代靶向治疗的使用并没有完全消除吉西他滨在单药治疗中的使用,单药治疗主要是治疗状态不佳、不符合更先进治疗条件的患者。本研究旨在评估波兰日常临床实践中单药吉西他滨治疗的结果,并试图确定这种治疗获得长期疗效的预测因素。材料和方法。回顾性分析了2017-2022年波兰5个肿瘤中心接受单药吉西他滨治疗的167例晚期胰腺癌患者。吉西他滨作为单药治疗,初始剂量为每周1000mg /m2体表面积(BSA), 8周周期7次,4周周期3次。结果。全组患者的中位总生存期(OS)为6.1个月(范围- 0.2-32.3个月),中位无进展生存期(PFS)为4.2个月(范围- 0.2-31.3个月)。一组60名患者被确定为“长反应者”(LR),反应至少6个月,一组107名患者被确定为“短反应者”(SR)。LR组的中位PFS为9.15个月(范围- 6.0-31.3个月),SR组为3.2个月(范围- 0.2-5.8个月)。中位OS分别为11.6个月(范围- 5.9-30.8)和3.8个月(范围- 0.2-32.3)。在多变量分析中,使用逻辑回归模型评估实现至少6个月缓解(LR)的可能性。该模型考虑了四个变量:中性粒细胞/淋巴细胞(NLR)比率、肝转移、性别和Hb水平。结论。获得的结果证实,吉西他滨单药治疗在晚期和转移性胰腺腺癌患者的一线治疗中仍然有用。与联合治疗相比,适当选择患者进行这种治疗可以改善结果,同时保持较低的毒性。
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引用次数: 0
The relationship between inflammation markers, positron emission tomography/ /computed tomography parameters and disease prognosis in advanced non-small-cell lung cancer patients 晚期非小细胞肺癌患者炎症标志物、正电子发射断层扫描/ /计算机断层扫描参数与疾病预后的关系
Q4 ONCOLOGY Pub Date : 2023-10-25 DOI: 10.5603/ocp.97451
Esra Pirinççi, Zeynep Oruç, Senar Ebinç, Yunus Güzel, Halil Kömek, Mehmet Küçüköner, Zuhat Urakçı, Muhammet Ali Kaplan, Bekir Taşdemir, Abdurrahman Işıkdoğan
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引用次数: 0
Tracheal cancers 气管肿瘤
Q4 ONCOLOGY Pub Date : 2023-10-25 DOI: 10.5603/ocp.97601
Aleksandra Piórek, Adam Płużański, Kinga Winiarczyk, Sylwia Tabor, Magdalena Knetki-Wróblewska, Dariusz M. Kowalski, Maciej Krzakowski
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引用次数: 0
Diagnosis and treatment of patients with breast cancer and mutation in the BRCA1/2 genes 乳腺癌患者的诊断和治疗与BRCA1/2基因突变
Q4 ONCOLOGY Pub Date : 2023-10-25 DOI: 10.5603/ocp.2023.0035
Joanna Kufel-Grabowska, Bartosz Wasąg
Breast cancer is the most common cancer among women in Poland and worldwide, second only to lung cancer in terms of mortality. Germline mutations account for approximately 5–10% of all breast cancer cases, with mutations in the BRCA1/2 genes being the most frequently identified. The presence of pathogenic variants in the BRCA1/2 genes is associated with a more than 60% risk of developing breast cancer, a 40–60% risk of ovarian cancer in women with a BRCA1 mutation, and a 13–30% risk in women with a BRCA2 variant. Breast cancer is often diagnosed at a younger age in BRCA1/2 mutation carriers. The prevalence and increased accessibility of genetic testing, especially next-generation sequencing, lead to a higher number of diagnosed individuals and healthy family members. Identifying a pathogenic variant in the BRCA1/2 genes, analyzing a family history, and genetic counseling enables the development of individual recommendations for further management. This article aims to present the diagnostic and therapeutic approach in breast cancer patients with a pathogenic variant in the BRCA1/2 genes.
乳腺癌是波兰和全世界妇女中最常见的癌症,死亡率仅次于肺癌。生殖系突变约占所有乳腺癌病例的5-10%,其中BRCA1/2基因突变是最常见的。BRCA1/2基因中致病性变异的存在与患乳腺癌的风险超过60%有关,BRCA1突变女性患卵巢癌的风险为40-60%,BRCA2突变女性患卵巢癌的风险为13-30%。在BRCA1/2突变携带者中,乳腺癌通常在较年轻时被诊断出来。基因检测的普及和可及性的提高,特别是下一代测序,导致确诊的个人和健康的家庭成员人数增加。确定BRCA1/2基因的致病变异,分析家族史,并进行遗传咨询,可以为进一步的管理提供个人建议。本文旨在介绍BRCA1/2基因致病性变异的乳腺癌患者的诊断和治疗方法。
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引用次数: 0
Ripretinib in the treatment of patients with advanced gastrointestinal stromal tumors (GIST) 利普雷替尼治疗晚期胃肠道间质瘤(GIST)
Q4 ONCOLOGY Pub Date : 2023-10-20 DOI: 10.5603/ocp.96771
Emilia Babula, Aleksandra Sikora, Paweł Sobczuk, Piotr Rutkowski
Gastrointestinal stromal tumors (GISTs) are relatively rare in the population (0.4 to 2 cases per 100 000 per year) and account for approximately 1–2% of gastrointestinal cancers. According to the latest 2020 World Health Organization (WHO) classification of sarcomas, all GISTs are malignant, regardless of their size or mitotic index. In the systemic treatment of GIST, KIT tyrosine kinase receptor and platelet-derived growth factor receptor (PDGFRA) inhibitors, such as imatinib, sunitinib, or regorafenib, are used. The effectiveness of imatinib is significantly reduced in the case of secondary mutations in the KIT gene. The latest drug from the group of KIT inhibitors, ripretinib, was the first to show efficacy against most mutations associated with resistance, as well as in wild-type GIST, in which mutations in KIT and PDGFRA are not found. Analysis of the INVICTUS study showed a beneficial effect of ripretinib at the recommended dose of 150 mg/day on progression-free survival (PFS) in patients with advanced or metastatic GIST previously treated with at least three other inhibitors. However, the preliminary results of the phase III INTRIGUE study did not show an improvement in PFS in patients receiving ripretinib compared to sunitinib in the second-line therapy of GIST patients. Ripretinib has a favorable and acceptable safety profile and is recommended for treating patients with advanced GIST in the fourth line of treatment. In this article, we summarize the most essential data on the efficacy and safety of ripretinib in treating GIST patients and the recommendations for its use.
胃肠道间质瘤(gist)在人群中相对罕见(每年每10万人中有0.4至2例),约占胃肠道癌症的1-2%。根据世界卫生组织(WHO)最新的2020年肉瘤分类,所有gist都是恶性的,无论其大小或有丝分裂指数如何。在GIST的全身治疗中,使用KIT酪氨酸激酶受体和血小板衍生生长因子受体(PDGFRA)抑制剂,如伊马替尼、舒尼替尼或瑞非尼。在KIT基因继发性突变的情况下,伊马替尼的有效性显着降低。KIT抑制剂组中的最新药物利普雷替尼(ripretinib)首次显示出对大多数与耐药相关的突变以及未发现KIT和PDGFRA突变的野生型GIST有效。INVICTUS研究的分析显示,推荐剂量为150mg /天的利普雷替尼对先前接受过至少三种其他抑制剂治疗的晚期或转移性GIST患者的无进展生存期(PFS)有有益影响。然而,III期研究的初步结果显示,与舒尼替尼相比,接受利普雷替尼的胃肠道间质瘤患者的PFS在二线治疗中没有改善。利普雷替尼具有良好且可接受的安全性,被推荐用于晚期GIST患者的第四线治疗。在这篇文章中,我们总结了利普雷替尼治疗胃肠道间质瘤患者的有效性和安全性的最重要的数据和使用的建议。
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引用次数: 0
Diagnostic and therapeutic management of cancer patients with pain: recommendations of the Expert Group of the Polish Association for Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology 癌症患者疼痛的诊断和治疗管理:波兰姑息治疗协会、波兰疼痛研究协会和波兰临床肿瘤协会专家组的建议
Q4 ONCOLOGY Pub Date : 2023-10-20 DOI: 10.5603/ocp.2023.0029
Wojciech Leppert, Jerzy Wordliczek, Małgorzata Malec-Milewska, Mahdalena Kocot-Kępska, Jarosław Woroń, Renata Zajączkowska, Jan Dobrogowski, Maciej Krzakowski, Małgorzata Krajnik
In order to elaborate diagnostic and therapeutic recommendations regarding the management of cancer patients with pain, a narrative review of the literature in PubMed and Cochrane database was conducted for the period of 2000–2022. An Expert Group of three scientific associations: Polish Association of Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology was appointed, which made a literature review and formulated guidelines with strength of recommendations and quality of evidence. To achieve optimal effect of pain treatment cancer patients require complex clinical assessment of pain with detailed recognition of pathophysiology, intensity and time frame (baseline and breakthrough — episodic) of pain. Pain evaluation should encompass other symptoms, comorbidities, disturbances in psychological, social, and spiritual dimensions, which may induce patients’ suffering and total pain appearance. An important role plays anticancer local and systemic treatment, which may induce or exacerbate pain induced by cancer or comorbidities. A standard approach in patients with chronic pain in the course of cancer and other diseases is based on World Health Organization (WHO) analgesic ladder algorithm, which is supplemented with non-pharmacological management. It is recommended an individual approach in pain treatment depending on clinical situation of a concrete patient. Efforts should be made to effectively manage other symptoms, which accompany cancer. An introduction of specific treatment taking into account given pathophysiology, time frame and intensity of pain increase effectiveness and significantly shorten time necessary to achieve effective analgesia, and moreover contribute to decrease intensity and frequency of adverse effects of analgesics used.
为了详细阐述癌症患者疼痛管理的诊断和治疗建议,我们对PubMed和Cochrane数据库2000-2022年期间的文献进行了叙述性回顾。任命由波兰姑息治疗协会、波兰疼痛研究协会和波兰临床肿瘤协会三个科学协会组成的专家组,对文献进行综述,制定具有建议力度和证据质量的指南。为了达到最佳的疼痛治疗效果,癌症患者需要对疼痛进行复杂的临床评估,详细了解疼痛的病理生理、强度和时间框架(基线和突破-发作)。疼痛评估应包括其他症状、合并症、心理、社会和精神方面的干扰,这些可能导致患者的痛苦和疼痛的外观。局部和全身的抗癌治疗可能会诱发或加重癌症或合并症引起的疼痛。癌症和其他疾病过程中慢性疼痛患者的标准方法是基于世界卫生组织(WHO)镇痛阶梯算法,并辅以非药物管理。建议根据具体患者的临床情况采取个体化的疼痛治疗方法。应该努力有效地控制伴随癌症的其他症状。考虑到给定的病理生理、时间框架和疼痛强度的特定治疗方法的引入提高了有效性,显著缩短了实现有效镇痛所需的时间,而且有助于减少使用镇痛药的不良反应的强度和频率。
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引用次数: 0
Convolutional neural networks in auto-segmentation of nasopharyngeal carcinoma tumor — a systematic review and meta-analysis 卷积神经网络在鼻咽癌肿瘤自动分割中的应用综述及meta分析
Q4 ONCOLOGY Pub Date : 2023-10-17 DOI: 10.5603/ocp.2023.0040
Maryam Zamanian, Iraj Abedi
{"title":"Convolutional neural networks in auto-segmentation of nasopharyngeal carcinoma tumor — a systematic review and meta-analysis","authors":"Maryam Zamanian, Iraj Abedi","doi":"10.5603/ocp.2023.0040","DOIUrl":"https://doi.org/10.5603/ocp.2023.0040","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136077640","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}
引用次数: 0
Cardiac metastasis of lung cancer diagnosed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) 氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG PET/CT)诊断肺癌心脏转移
Q4 ONCOLOGY Pub Date : 2023-10-17 DOI: 10.5603/ocp.95808
Yassir Benameur, Salah Nabih Oueriagli, Omar Ait Sahel, Abderrahim Doudouh
Lung cancer is currently one of the most common malignancies worldwide. Among all metastatic sites of this cancer, cardiac metastases are exceptional, and long-term prognosis in these patients is very poor. 18F-FDG PET/CT is a valuable imaging tool for initial staging and assessment of treatment response of various neoplasms. In the case of lung cancer, its role is clearly defined, and its effectiveness is superior to other diagnostic imaging methods. We present a rare 18F-FDG PET/CT image finding in a 71-year-old man with biopsy-proven lung squamous cell carcinoma, showing increased cardiac 18F-FDG uptake subsequently found to be compatible cardiac metastasis.
肺癌是目前世界上最常见的恶性肿瘤之一。在这种癌症的所有转移部位中,心脏转移是罕见的,这些患者的长期预后非常差。18F-FDG PET/CT是一种有价值的影像学工具,用于各种肿瘤的初始分期和治疗反应评估。在肺癌的情况下,其作用明确,其有效性优于其他诊断成像方法。我们在一例71岁男性活检证实的肺鳞状细胞癌中发现罕见的18F-FDG PET/CT图像,显示心脏18F-FDG摄取增加,随后发现相容的心脏转移。
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引用次数: 0
期刊
Oncology in Clinical Practice
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