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Social support and quality of life among oncology patients
No full textIntroduction. Advances in medicine have improved cancer survival rates, but treatment remains lengthy and exhausting. The disease and therapy significantly impact patients’ well-being, making quality of life a key concern. More and more research indicates that social support, particularly emotional and informational, may play a significant role in coping with cancer and its treatment.
Material and methods. The study included adult cancer patients from the Pomeranian Hospitals in Gdynia. Data were collected using a custom questionnaire and four standardized tools: Berlin Social Support Scales (BSSS), WHO Quality of Life Scale (WHOQOL-BREF), Hospital Anxiety and Depression — modified scale (HADS-M), and Mini-COPE.
Results. The study involved 102 participants. Quality of life assessments indicated that physical functioning was the most affected domain. The most common coping strategies were Active coping, Seeking support, and Acceptance. Statistical analysis showed that Helplessness correlated positively with Anxiety and Depression, whereas Active coping and Seeking support correlated negatively. Emotional and instrumental social support strongly correlated with lower Anxiety and Depression levels. Strong negative correlations were observed, particularly between Actually received emotional support and Depression (r = –0.52, p < 0.001), as well as Anxiety (r = –0.48, p < 0.001).
Conclusions. Social support may play an important role in reducing psychological distress in cancer patients. Greater perceived and received emotional and instrumental support are linked to lower anxiety and depression. Strengthening support systems can enhance coping strategies and improve quality of life. These findings emphasize the need for psychosocial interventions to optimize treatment outcomes and overall well-being
Lung adenocarcinoma metastatic to the paranasal sinuses — hypotheses on tumor spread and considerations on the role of radiotherapy
No full textIntroduction. Metastases to the paranasal sinuses from primary lung cancer are exceedingly rare and often present with nonspecific symptoms such as epistaxis, facial pain, and nasal congestion. These lesions usually indicate advanced, disseminated disease with poor prognosis. Management is primarily palliative, focusing on symptom relief.
Case report. An 82-year-old man presented with recurrent epistaxis and other nonspecific symptoms. Imaging revealed metastatic involvement, among others, of multiple paranasal sinuses characterized by a lepidic-like growth pattern without bone erosion. Biopsy confirmed EGFR-mutated lung adenocarcinoma. Palliative hemostatic radiotherapy was administered to the sinonasal region, achieving rapid bleeding control. EGFR-targeted therapy was initiated, but the patient died shortly thereafter due to systemic progression and renal failure.
Conclusions. Paranasal sinus metastases from lung cancer represent an uncommon, late-stage manifestation associated with dismal outcomes. Early recognition and multidisciplinary palliative approaches are crucial. Further molecular research is needed to improve systemic treatments in EGFR-mutated advanced lung adenocarcinoma
Diagnostyka różnicowa polineuropatii w przebiegu dziedzicznej amyloidozy transtyretynowej i przewlekłej zapalnej polineuropatii demielinizacyjnej
No full textW niniejszej pracy przedstawiono opis przypadku 48-letniego mężczyzny z przewlekłą demielinizacyjno-aksonalną polineuropatią spełniającą elektrofizjologiczne kryteria diagnostyczne przewlekłej zapalnej polineuropatii demielinizacyjnej (CIDP, chronic inflammatory demyelinating polyneuropathy). Brak poprawy po zastosowaniu pierwszej i drugiej linii terapii dla CIDP oraz współwystępowanie kardiomiopatii i objawów dysautonomii pozwoliły jednak na rozpoznanie dziedzicznej amyloidozy transtyretynowej (ATTR-FAP, transthyretin familial amyloid polyneuropathy). W artykule zwrócono uwagę na kluczowe elementy fenotypu, w tym wieloukładowy charakter objawów amyloidozy transtyretynowej oraz konieczność uwzględnienia ATTR-FAP w diagnostyce różnicowej pacjentów z cechami niehomogennej demielinizacji w badaniu neurofizjologicznym. Zagadnienia badań pomocniczych niezbędnych do przeprowadzenia diagnostyki różnicowej zaprezentowano na podstawie kryteriów rozpoznania dziedzicznej amyloidozy transtyretynowej. Rozpoznanie ATTR-FAP pozwala na wdrożenie dedykowanej terapii
The coexistence of achondroplasia and congenital neuroblastoma — case report
No full textNeuroblastoma is the most common extracranial solid tumor in childhood and is more frequently associated with genetic syndromes predisposing to malignancy. However, the co-occurrence of neuroblastoma with achondroplasia has not been previously documented. This study reports the first case of congenital neuroblastoma in a patient with achondroplasia, detailing the diagnostic process and management. A four-day-old female was postnatally diagnosed with achondroplasia and an abnormal mass in the adrenal gland. Neuroblastoma was diagnosed and treated surgically and with adjuvant chemotherapy. Achondroplasia was confirmed by genetic testing, which identified a heterozygous c.1138G>C (p.Gly380Arg) mutation in the FGFR3 gene. While the concurrent occurrence of these conditions appears incidental, the role of somatic FGFR mutations in various cancers suggests a potential involvement in carcinogenesis. This case underscores the importance of early diagnosis for both conditions and highlights FGFR3 as a possible target for future neuroblastoma therapies
Trastuzumab derukstekan (T-DXd) w leczeniu chorych na zaawansowanego raka piersi z niską i ultraniską ekspresją receptora HER2
No full textWprowadzenie. Wprowadzenie przeciwciał połączonych z cytotoksycznym lekiem (ADC, antibody–drug conjugates) doprowadziło do znaczących zmian w leczeniu chorych na raka piersi, rozszerzając możliwości terapii anty-HER2 poza klasyczną kategorię HER2-dodatnich nowotworów. Trastuzumab derukstekan (T-DXd, trastuzumab deruxtecan) jest koniugatem drugiej generacji, który wykazał skuteczność u chorych na raka piersi z ekspresją receptorów steroidowych (HR+) i niską ekspresją HER2 (HER2-low).
Cel. Celem niniejszego opracowania jest omówienie mechanizmu działania T-DXd, przedstawienie wyników badań DESTINY-Breast04 i DESTINY-Breast06 oraz analiza implikacji dla praktyki klinicznej u chorych na raka piersi z cechą HR+/HER2-low.
Wyniki. W badaniu DESTINY-Breast06 T-DXd istotnie wydłużał medianę czasu przeżycia wolnego od progresji (PFS, progression-free survival) w porównaniu z leczeniem standardowym [13,2 wobec 8,1 miesiąca; iloraz ryzyka (HR, hazard ratio) = 0,62; p < 0,0001]. Korzyść była obserwowana także w całej populacji analizowanej z intencją leczenia (ITT, intention to treat) — w tym u chorych z niską ekspresją HER2 (HER2-low + ultralow; HR = 0,64). Profil bezpieczeństwa był zgodny z wcześniejszymi badaniami, a jakość życia utrzymywała się na wyższym poziomie niż w grupie kontrolnej.
Wnioski. T-DXd stanowi nowy standard postępowania u chorych z HR+/HER2-low rakiem piersi po niepowodzeniu terapii hormonalnej, oferując przewagę nad klasyczną chemioterapią. Dane z podgrupy HER2-ultralow sugerują możliwość dalszego rozszerzenia wskazań
Terapia radioligandowa w Polsce — rekomendacje multidyscyplinarnego Zespołu Ekspertów
No full textThis document presents the current status, challenges, opportunities, and expert recommendations regarding the implementation of radioligand therapy (RLT) in Poland. RLT is a novel, rapidly developing form of cancer treatment that involves the use of ligands labeled with beta- or alpha-emitting radionuclides, which selectively accumulate in tumor cells. Following intravenous administration of the radiopharmaceutical, this enables targeted irradiation of pathological lesions.
In Poland, this procedure is currently reimbursed for the treatment of neuroendocrine tumors. In the near future, the introduction of RLT for prostate cancer is planned. Evidence supporting the efficacy of this method in prostate cancer management is based on the experience of many countries, including France, Germany, and the United Kingdom.
The implementation of RLT within the Polish healthcare system requires multidisciplinary collaboration and the development of comprehensive guidelines covering patient eligibility, treatment protocols, outcome monitoring, as well as the provision of adequate organizational frameworks and trained personnel. This document was prepared by a panel of Polish experts in the fields of nuclear medicine, oncology, surgical oncology, radiotherapy, endocrinology, radiopharmacy, radiation protection, medical physics, and electroradiology. As a result, the recommendations presented address the various aspects of RLT.
The authors emphasize the importance of molecular imaging methods in patient selection and treatment monitoring, the necessity of implementing procedures that minimize the adverse effects of ionizing radiation associated with RLT, and the establishment of a national patient registry. Such a registry would allow for the assessment of treatment efficacy and safety at the population level, supporting long-term evaluation of RLT procedures and providing a basis for their future modification.
In summary, this document outlines the principles for the safe, effective, and sustainable implementation of RLT in Poland, tailored to local conditions and aligned with international standards. Its overarching aim is to optimize personalized oncology and to highlight the critical role of nuclear medicine procedures in this process.Niniejszy dokument przedstawia aktualny stan, wyzwania, możliwości oraz zalecenia ekspertów dotyczące wdrażania terapii radioligandowej (RLT) w Polsce. RLT jest nową, szybko rozwijającą się formą leczenia chorych onkologicznych, polegającą na zastosowaniu ligandów znakowanych emiterami promieniowania beta/alfa, swoiście gromadzonych przez komórki nowotworowe. Dzięki temu, po podaniu dożylnym radiofarmaceutyku, możliwe jest celowane napromienianie zmian chorobowych. W Polsce procedura ta jest obecnie refundowana w leczeniu chorych na nowotwory neuroendokrynne. W najbliższym czasie planowane jest wprowadzenie procedury leczenia chorych na raka gruczołu krokowego. Dane wskazujące na skuteczność tej metody w leczeniu chorych na raka gruczołu krokowego opierają się na doświadczeniach wielu krajów, między innymi Francji, Niemiec czy Wielkiej Brytanii.
Wdrożenie RLT w polskim systemie ochrony zdrowia wymaga współpracy wielodyscyplinarnej oraz opracowania kompleksowych wytycznych dotyczących kwalifikacji chorych, prowadzenia leczenia, monitorowania efektów oraz zapewnienia odpowiedniej organizacji i kadry. Niniejszy dokument został przygotowany przez panel polskich ekspertów z dziedzin: medycyny nuklearnej, onkologii, chirurgii onkologicznej, radioterapii, endokrynologii, radiofarmacji, ochrony radiologicznej oraz fizyki medycznej i elektroradiologii. Dzięki temu przedstawione rekomendacje obejmują różne aspekty RLT. Autorzy podkreślają znaczenie metod obrazowania molekularnego w procesie kwalifikacji chorych do RLT i kontroli leczenia, konieczność uwzględnienia procedur ograniczających niepożądane działania promieniowania jonizującego towarzyszące RLT oraz sugerują powołanie krajowego systemu rejestracji chorych, który będzie umożliwiał ocenę skuteczności i bezpieczeństwa leczenia na poziomie populacyjnym. System ten będzie służył długoterminowej ocenie procedur RLT i stanie się podstawą ich ewentualnej modyfikacji.
Podsumowując, dokument przedstawia zasady bezpiecznego, skutecznego oraz zrównoważonego wdrożenia RLT w Polsce, dostosowanego do lokalnych warunków i standardów międzynarodowych, co ma na celu optymalizację spersonalizowanej onkologii i podkreślenie znaczenia procedur z zakresu medycyny nuklearnej w tym procesie
Olaparyb w terapiach skojarzonych — nowe możliwości leczenia
No full textIntroduction. Olaparib, the first approved poly(ADP)-ribose polymerase (PARP) inhibitor (PARPi), is a cornerstone of targeted therapy in patients with homologous recombination deficiency (HRD), in particular with pathogenic (P) or likely pathogenic (LP) variants in the BRCA1/2 genes. Growing evidence also indicates its efficacy in combination therapies, regardless of the presence of classical HRD markers.
Material and methods. A narrative literature review was conducted, including the results of clinical trials with olaparib in monotherapy and combination therapies, preclinical data, current guidelines of scientific societies (ESMO, NCCN, PTOK, PTGO) and the role of molecular diagnostics, including the presence of P/LP variants, both germline and somatic, in the qualification for therapy in ovarian, endometrial and prostate cancer.
Results. Combination therapy with olaparib and bevacizumab shows high efficacy in patients with ovarian cancer and HRD. The DUO-E study confirmed the clinical benefit of olaparib in combination with durvalumab in patients with endometrial cancer and proficient mismatch repair (pMMR), usually poorly responding to immunotherapy. Olaparib also shows efficacy in patients with prostate cancer and P/LP variants in BRCA1/2 genes, both as monotherapy and in combination with new hormonal agents, regardless of HRD status.
Conclusions. Olaparib in monotherapy is effective in patients with P/LP variants in the BRCA1/2 genes, while its use in combination therapies allows for the extension of indications for targeted treatment. Comprehensive molecular diagnostics and further research on the mechanisms of resistance and new strategies for personalizing oncological treatment are of key importance.Wprowadzenie. Olaparyb, jako pierwszy zarejestrowany inhibitor polimerazy poli(ADP-rybozy) (iPARP), stanowi podstawę leczenia celowanego u chorych z deficytem rekombinacji homologicznej (HRD), w szczególności przy obecności wariantów patogennych (P) lub prawdopodobnie patogennych (LP) w genach BRCA1/2. Coraz więcej danych wskazuje również na jego skuteczność w terapiach skojarzonych, niezależnie od obecności klasycznych markerów HRD.
Materiał i metody. Przeprowadzono ekspercki, narracyjny przegląd literatury obejmujący w yniki badań klinicznych z zastosowaniem olaparybu w monoterapii i terapiach skojarzonych, dane przedkliniczne, aktualne wytyczne towarzystw naukowych (ESMO, NCCN, PTOK, PTGO) oraz znaczenie diagnostyki molekularnej, w tym obecności wariantów P/LP — zarówno germinalnych, jak i somatycznych — w kwalifikacji do terapii chorych na raki jajnika, endometrium i gruczołu krokowego.
Wyniki. W leczeniu chorych na raka jajnika połączenie olaparybu z bewacyzumabem wykazuje wysoką skuteczność u osób z HRD. W raku endometrium badanie DUO-E potwierdziło korzyść kliniczną terapii olaparybu w skojarzeniu z durwalumabem w populacji o prawidłowej naprawie niesparowanych zasad DNA (pMMR, proficient mismatch repair), tradycyjnie mniej podatnej na immunoterapię. W raku prostaty olaparyb wykazuje skuteczność zarówno w monoterapii u chorych z obecnością wariantów P/LP w genach BRCA1/2, jak i w skojarzeniu z nowymi lekami hormonalnymi — niezależnie od statusu HRD.
Wnioski. Olaparyb w monoterapii pozostaje skuteczny u chorych z obecnością wariantów P/LP w genach BRCA1/2, natomiast zastosowanie terapii skojarzonych pozwala na rozszerzenie wskazań do leczenia celowanego. Kluczowe znaczenie ma kompleksowa diagnostyka molekularna oraz dalsze badania nad mechanizmami oporności i nowymi strategiami personalizacji leczenia onkologicznego
Where there’s smoke, there’s fire — a brief report on skin malignancy incidence in renal, heart, and liver transplant recipients in Poland
Full text linkIntroduction. The number of solid organ transplants is rising, increasing the population of long-term survivors. Immunosuppressive drugs, particularly calcineurin inhibitors, are linked to higher skin malignancy incidence, but large-scale studies on melanoma and non-melanoma skin cancer (NMSC) in Polish transplant recipients are lacking.
Materials and methods. This study combines findings from a systematic review and meta-analysis on the risks of NMSC and melanoma in renal transplant patients using calcineurin inhibitors. It also presents a large dataset from Poland’s National Health Fund on skin malignancies incidence in kidney, heart, and liver transplant recipients (2010–2022).
Results. The authors of this article analyzed data from over 17,000 Polish transplant recipients and compared skin malignancy incidence versus the general population. Renal transplant patients had higher NMSC risk: 1-year (0.09% vs. 0.04%, p < 0.001), 5-year (1.21% vs. 0.18%, p < 0.001), and 10-year (4.18% vs. 0.36%, p < 0.001). Liver transplant recipients showed increased NMSC risk at 1-year (0.09% vs. 0.04%, p < 0.001), 5-year (0.83% vs. 0.18%, p < 0.001), and 10-year (2.65% vs. 0.36%, p < 0.001). Heart recipients had higher NMSC risk at 5 years (0.8871% vs. 0.1774%, p < 0.001) and 10 years (4.0609% vs. 0.3597%, p < 0.001). Melanoma risk in renal recipients was increased: 1-year (0.02% vs. 0.01%, p < 0.001), 5-year (0.17% vs. 0.05%, p < 0.001), 10-year (0.36% vs. 0.1%, p < 0.001). Liver recipients had higher melanoma risk at 1 year (0.03% vs. 0.01%, p < 0.001), 5 years (0.2% vs. 0.05%, p < 0.001) and 10 years (0.2% vs. 0.1%, p < 0.001).
Conclusions. The authors of this article nationwide dataset showed a significant association between heart, kidney, and liver transplantation followed by immunosuppression and an increased incidence of melanoma and NMSC. The melanoma risk in renal, liver, and heart transplant recipients in Poland was, on average, twice as high compared to the general population at 1 year, four and half times higher after 5 years, and almost nine times higher after 10 years. Similarly, the NMSC risk in this population was two and a half times higher after 1 year, seven and a half times higher after 5 years, and remained twenty two times higher after 10 years
Angiomatoid fibrous histiocytoma of the spermatic cord — case report and literature review
Full text linkIn this article, we present a case of a 77-year-old patient with a tumor of the spermatic cord. The tumor infiltrated the structures of the spermatic cord, had a hard and solid structure, and was located in the middle part of the spermatic cord. Since it was found during a procedure, the tumor, along with the spermatic cord and the left testicle, was resected. The entire specimen was sent for histopathological examination. The histopathological examination revealed that the tumor was a non-epithelial neoplasm with a sarcomatous component. Immunohistochemical studies indicated that the tumor corresponded most closely to angiomatoid fibrous histiocytoma. We conducted a review of available literature using a database from 1979 (when this type of tumor was first described) to 2024 and did not find any publications describing a case of angiomatoid fibrous histiocytoma located in the spermatic cord. The search phrases used included angiomatoid fibrous histiocytoma, pampiniform plexus, and spermatic cord. Therefore, it appears that this case is the first known instance of angiomatoid fibrous histiocytoma in this location. In this article, we also reviewed the available literature on the diagnosis and treatment of patients with angiomatoid fibrous histiocytoma and discussed the current approach to diagnosing and treating this rare neoplasm based on our secondary research
VE1 immunohistochemistry as a screening tool for BRAFV600E mutation in lung adenocarcinoma: evidence from a Montenegro National Cohort
No full textIntroduction. Lung cancer remains the leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) representing the majority of cases. Molecular profiling of NSCLC has identified multiple genomic alterations, including BRAFV600E mutation, which occurs in 1–5% of patients, predominantly in adenocarcinomas. Detection of this mutation is clinically relevant due to the availability of targeted therapies. Immunohistochemistry using the VE1 antibody offers a rapid and practical screening method, although interpretation criteria and methodological variability remain challenging.
Material and methods. This study represents the first systematic evaluation of BRAFV600E immunohistochemical (IHC) and molecular status in the Montenegrin population. A total of 135 patients undergoing surgical resection for primary lung adenocarcinoma were analyzed retrospectively. Clinicopathological data were collected, and tissue microarrays (TMA) were constructed. Immunohistochemical staining was performed with the VE1 monoclonal antibody, and results were scored based on cytoplasmic staining intensity and homogeneity. Positive cases, along with matched negative controls, were further analyzed using fully automated Biocartis Idylla real-time polymerase chain reaction (PCR).
Results. VE1 IHC positivity was observed in 7 patients (5.2%), with strong, homogeneous staining (3+) in 2 cases. BRAFV600E mutations were confirmed by PCR exclusively in these 3+ cases, giving a prevalence of 1.5% overall and 28.6% relative to IHC-positive cases. Statistical analysis demonstrated perfect concordance between strong, homogeneous VE1 staining and PCR results. Weak or focal staining presented interpretative challenges, highlighting the need for standardized criteria and molecular confirmation.
Conclusions. Immunohistochemistry using VE1 antibody is a reliable and accessible initial screening tool for BRAFV600E mutation in lung adenocarcinoma. Strong, homogeneous cytoplasmic staining predicts mutation status with high accuracy, while weak or heterogeneous staining requires confirmatory molecular testing. The present findings provide essential local epidemiological data and support universal IHC testing to guide personalized therapy in NSCLC