Onkologija
Not a member yet
431 research outputs found
Sort by
Presejanje za raka na debelem črevesu in danki: program SVIT
Get PDFAccording to the data of the Cancer Registry, the incidence of colorectal cancer in Slovenia has been increasing since 1961. Most cases of this disease are diagnosed when already at an advanced stage. In the period 2005-2009, colon cancer was detected in a locally-limited form only in 12.3% and rectal cancer only in 14.9%. The consequences are a high mortality rate, poor quality of life of patients, and high treatment costs. In line with the recommendations of the European Council and the European Guidelines for Quality Assurance in Colorectal Cancer Screening, Slovenia in 2009 established the National Programme for Screening and Early Detection of Pre-cancerous Lesions and Colorectal Cancer - the SVIT Programme. The positive effects of the Programme were seen already after the first round of screening.Po podatkih Registra raka se incidenca raka na debelem črevesu in danki v Sloveniji od leta 1961 povečuje. Največ primerov bolezni se odkrije, ko je ta v napredovali obliki. V obdobju 2005 - 2009 je bil rak na debelem črevesu odkrit v lokalno omejeni obliki le v 12,3 % in rak danke le v 14,9 %. Posledice se kažejo kot visoka stopnja umrljivosti, slaba kakovost življenja bolnikov in visoki stroški zdravljenja. V skladu s priporočili Evropskega sveta in Evropskimi smernicami za zagotavljanje kakovosti v presejanju za raka na debelem črevesu in danki se je v Sloveniji leta 2009 vzpostavil Državni program presejanja in zgodnjega odkrivanja predrakavih sprememb in raka na debelem črevesu in danki – Program Svit. Pozitivni učinki programa so se pokazali že po izvedbi prvega presejalnega kroga
Paliacija malignega plevralnega izliva
Get PDFMalignant pleural effusion is a frequent finding in a malignant disease. In patients, it commonly causes dyspnoea, cough and chest pain. The objectives of palliative treatment are: alleviation of symptoms, improvement in the patient's performance and quality of life, and reduction in the number of hospitalisations. The most effective method of palliative treatment is talc pleurodesis, which is, however, not possible due to non-expansion of the lungs and poor performance status of the patient. In such cases, we use a permanent pleural catheter and pleural punctions, especially when the expected survival of the patient is short. It is important that palliation of malignant pleural effusion is planned early in the treatment course to increase the chances of a successful pleurodesis.Maligni plevralni izliv je pogost spremljevalec maligne bolezni. Pri bolnikih najpogosteje povzroča dispnejo, kašelj in bolečino v prsnem košu. Cilji paliativnega zdravljenja so: lajšanje simptomov, izboljšanje bolnikove zmogljivosti in kakovosti življenja ter znižanje števila hospitalizacij. Najučinkovitejša metoda paliativnega zdravljenja je plevrodeza s talkom, ki pa ni vedno možna zaradi nerazpenjanja pljuč ali slabega stanja zmogljivosti bolnika. Takrat uporabimo trajni plevralni kateter ali razbremenilne plevralne punkcije, še posebej, če je pričakovano preživetje bolnika kratko. Pomembno je, da paliacijo malignega plevralnega izliva načrtujemo zgodaj v poteku zdravljenja, ko je možnost za uspešno plevrodezo večja
Smernice za obravnavo bolnikov s skvamoznoceličnim karcinomom analnega kanala in kože perinealno (analnega roba)
Get PDFCancer of the anal canal and anal margin is a rare disease. In Slovenia, on average 20 patients are diagnosed with this disease each year, more women than men. However, the incidence has increased in the last year, mainly in young, homosexual men, most probably due to infections with the sexually-transmitted human papillomavirus (HPV) and human immunodeficiency virus (HIV), which are known causal agents of this disease. Cancer of the anal canal and anal margin is primarily a locoregional disease, as distant metastases are found in less than 10% of the patients. Radical radiochemotherapy plays the central role in the treatment of anal canal and anal margin carcinomas with no distant metastases, except in well-differentiated anal margin carcinomas smaller than 2 cm, where local excision is advised. Radical radiochemotherapy provides a complete response in as many as 80-90%, which is reflected also in an excellent treatment outcome with 5-year survival of 80%. Patients clinically staged as cT1-2 stand a 6.5% chance of developing inguinal lymph node metastases, while the likelihood in patients staged as cT3-4 is 16%. Surgery, namely abdominoperineal excision, has a role in the treatment of residual disease after radical radiochemotherapy. In the future, HPV vaccines hold great promise for the prevention of this virus-induced disease.Ni abstrakta
Klinični register bolnikov z rakom pljuč
Get PDFIn the last decades, considerable progress was made in the field of cancer management. This progress is based on extensive research work in the field of new methods of diagnostics and treatment and on careful monitoring of epidemiological data on cancer through population-based registries. Cancer Registry of Slovenia is one of the first population-based registries offering data on the incidence, prevalence and mortality rate of individual types of cancer in Slovenia. The occurrence of new diagnostic and therapeutic methods, and mainly the expansion of molecular diagnostics, have given rise to the need for additional careful management of data within the framework of individual clinic cancer registries. These registries enable new findings on the efficiency and safety of individual diagnostic and therapeutic approaches in patients managed within the scope of everyday clinical practice Moreover, the doctors and hospital managements have thus access to invaluable data on the efficiency and quality of their work. For that reason, the University Clinic Golnik in 2010 started working on the clinical registry of lung cancer patients, where we collect data on the patients diagnosed and treated for lung cancer at the University Clinic Golnik. A few months ago, we presented our first semi-annual report on this registry for 2010. In cooperation with other institutions, we want to supply the registry with all data on lung cancer patients, regardless of where they were diagnosed and treated.V zadnjih desetletjih je bil narejen velik napredek na področju obvladovanja raka. Ta napredek temelji na obsežnem raziskovalnem delu na področju novih načinov diagnostike in zdravljenja ter na dobrem spremljanju epidemioloških podatkov o raku preko populacijskih registrov. Register raka Slovenije je eden prvih populacijskih registrov v svetu, ki nam že desetletja nudi podatke o pojavnosti, prevalenci in umrljivosti za posameznimi raki v Sloveniji. S pojavom novih diagnostičnih in terapevtskih metod, predvsem pa z razmahom molekularne diagnostike in tarčnega zdravljenja raka, se je pojavila potreba po dodatnem natančnem vodenju podatkov v okviru kliničnih registrov posameznih rakov. Ti registri omogočajo pridobivanje novih spoznanj o učinkovitosti in varnosti posameznih diagnostičnih ter terapevtskih pristopov pri bolnikih, oskrbljenih v okviru vsakodnevne klinične prakse. Zdravnikom in vodstvom bolnišnic pa nudijo neprecenljive podatke o učinkovitosti in kakovosti njihovega dela. Na Kliniki Golnik smo zato leta 2010 pričeli z delom na kliničnem registru raka pljuč, v okviru katerega zbiramo podatke o bolnikih, diagnosticiranih in zdravljenih zaradi raka pljuč na Kliniki Golnik. Pred meseci smo predstavili prvo polletno poročilo tega registra za leto 2010. Naša želja je v sodelovanju z ostalimi institucijami združiti v tem registru podatke o bolnikih z rakom pljuč, ne glede na to, kje v državi so diagnosticirani ali zdravljeni
Imunomodulatorji pri zdravljenju malignega melanoma: klinični primer
Get PDFThe incidence of melanoma is increasing, both in Slovenia and world-wide, more than any other form of cancer. According to the Cancer Registry of Slovenia, 415 patients were diagnosed with this disease in 2009 (1). Surgical removal of skin melanoma is the primary curative treatment for patients with early-stage disease. There are approximately 80% of such patients. In high-risk patients (around 10%), we also recommend treatment with high doses of interferon-α2b (2, 3). Metastatic melanoma is still an incurable disease with a 5-year survival of less than 5%. However, the prognosis for these patients has improved in the last few years, thanks to new developments in the field of systemic treatment. Besides standard treatment with systemic chemotherapy, new registered medicines are now also available with a different mechanism of action than chemotherapy, such as immunotherapy with the monoclonal antibody ipilimumab, BRAF inhibitors vemurafenib and dabrafenib, and MEK inhibitors (2, 3).Ni abstrakta
Elektrokemoterapija melanoma
Get PDFElectrochemotherapy is an anti-cancer treatment that combines the use of standard chemotherapeutics and application of electric pulses at the tumour site. This increases the effectiveness of bleomycin or cisplatin but only in the area of the delivered electric pulses. In Europe, electrochemotherapy is currently the established method for treating different skin tumours, and it is particularly effective in the treatment of skin and subcutaneous melanoma metastases. Its effectiveness is around 80% in terms of objective responses and around 60% in terms of complete responses after a single therapy, with the possibility of improving the response with ongoing therapy. Electrochemotherapy is used primarily in the treatment of skin, subcutaneous and transit melanoma metastases and bleeding tumours and metastases at previously treated sites.Elektrokemoterapija je način zdravljenja raka, ki združuje uporabo standardnih kemoterapevtikov in aplikacijo električnih pulzov na območje tumorja. S tem se večkrat poveča učinkovitost bleomicina ali cisplatina samo na področju dovedenih električnih pulzov. Elektrokemoterapija je sedaj v Evropi uveljavljen način zdravljenja različnih kožnih tumorjev, predvsem pa se je uveljavila pri zdravljenju kožnih in podkožnih zasevkov melanoma. Njena učinkovitost je okrog 80 % objektivnih odgovorov in okrog 60 % popolnih odgovorov po enkratni terapiji, z možnostjo izboljšanja odgovora ob ponavljajoči se terapiji. Elektrokemoterapijo uporabljamo predvsem pri zdravljenju kožnih, podkožnih in tranzit zasevkov melanoma ter krvavečih tumorjev in zasevkov v predhodno tretiranih področjih
Epidemiologija raka debelega črevesa in danke
Get PDFIn the recent years, colon and rectum have become the most common sites (apart from skin) where the population of the developed world, and also in Slovenia, develops one of the cancer diseases. In 2008, it was estimated that 1,235,108 people were diagnosed with colorectal cancer around the world (9.8% of all new cancer cases), and 609,051 died of the disease. It was estimated that in Europe in 2008, 229,229 men and 203,185 women were diagnosed with colorectal cancer, and 110,059 men and 102,160 died of it. In both genders, colorectal cancer represents one of the most common cancer diseases; in men, it was in third place with 12.8% (after prostate and lung cancers), and in women, it was in second place with 13.1%, right after breast cancer.
According to the data of the Cancer Registry of the Republic of Slovenia, 1,453 people were diagnosed with colorectal cancer in 2008, of which 827 were men (83.0/100,000) and 626 were women (61.0/100,000), and 758 patients died from that disease, which is 13% of all cancer deaths. Most cancers were found in the colon (57%), 9% were located in the rectosigmoid area, and 44% were developed in the rectum. The incidence has been increasing since the middle of the 1950s, and even more rapidly in the last 20 years. The five-year relative survival is improving gradually due to a higher percentage of treated patients, improved surgical techniques and systemic treatment, but in too many cases, the disease is still diagnosed at an advanced stage.
A healthy lifestyle, maintenance of a normal weight, non-smoking, healthy nutrition and physical activities are the most important factors in the prevention of colorectal cancer. In addition, organised population-based screening under the Screening for Colorectal Cancer (SVIT) will contribute the most to the detection of the disease at an early stage and eradication of pre-cancerous lesions.Debelo črevo in danka sta v zadnjih letih najpogostejše mesto (razen kože), na katerem pri prebivalstvu razvitega sveta, tudi v Sloveniji, nastane ena od rakavih bolezni. Za leto 2008 je ocenjeno, da je za rakom debelega črevesa in danke po svetu zbolelo 1.235.108 ljudi (9,8 % vseh novih primerov raka), umrlo pa 609.051 ljudi. Ocenjujejo, da je v Evropi leta 2008 za rakom debelega črevesa in danke zbolelo 229.229 moških in 203.185 žensk, umrlo pa 110.059 moških in 102.160 žensk. Pri obeh spolih sodi rak debelega črevesa in danke med najpogostejše rakave bolezni; pri moških je bil z 12,8 % na tretjem mestu (za rakom prostate in pljučnim rakom), pri ženskah pa s 13,1 % na drugem, za rakom dojk. Po podatkih Registra raka Republike Slovenije je leta 2008 pri nas za rakom debelega črevesa in danke zbolelo 1.453 ljudi, od tega 827 moških (83,0/100.000) in 626 žensk (61,0/100.000), umrlo pa 758 bolnic in bolnikov, kar je 13 % vseh smrti zaradi raka. Največ rakov je vzniknilo na debelem črevesu (57 %), 9 % na rektosigmoidni zvezi, 44 % pa jih je nastalo v danki. Incidenca se veča od sredine 50. let prejšnjega stoletja, strmeje v zadnjih dvajsetih letih. Petletno relativno preživetje se postopno izboljšuje zaradi večjega odstotnega deleža zdravljenih bolnikov, izboljšanja operacijske tehnike in več sistemskega zdravljenja, bolezen pa je še vedno pri preveč primerih odkrita v napredovali obliki. V preventivi raka debelega črevesa je najpomembnejši zdrav življenjski slog z vzdrževanjem normalne telesne teže, z nekajenjem, zdravo prehrano in telesno dejavnostjo. K odkrivanju bolezni v začetnem stadiju oz. odstranitvi predrakavih sprememb pa bo največ prispevalo organizirano populacijsko presejanje prebivalcev v programu Svit. ; slv - slovensk
Predoperativno obsevanje medenice po kratkem režimu 5 x 5 Gy pri bolniku s karcinomom danke: prikaz primera
No full textIn patients with locally and/or regionally advanced rectal carcinoma, the currently applicable guidelines indicate pre-operative treatment. In this study, we present a clinical case of an older patient with stage T4 N0 rectal carcinoma, who was treated with pre-operative irradiation using a short regimen of 5 x 5 Gy, which was followed by abdominoperineal excision six weeks later. With pathological complete remission, the patient did not underwent post-operative chemotherapy and showed no signs of disease recurrence at the last follow-up a year and a half after the the surgery.Pri bolnikih z lokalno in/ali regionalno napredovalim karcinomom danke je po trenutno veljavnih smernicah indicirano predoperativno zdravljenje. V prispevku je prikazan klinični primer starejšega bolnika s karcinomom danke v kliničnem stadiju T4 N0 M0, ki je bil zdravljen s predoperativnim obsevanjem medenice po kratkem režimu 5 x 5 Gy, čemur je po šestih tednih sledila abdominoperinealna ekscizija. Ob patološki kompletni remisiji bolnik pooperativne kemoterapije ni prejemal in je bil ob zadnji kontroli, slabo leto in pol po operaciji, brez znakov za ponovitev bolezni
Adjuvantno zdravljenje raka debelega črevesa
Get PDFThe incidence of colon cancer is still increasing. If detected at an early stage, it is already curable by surgery alone. In patients with stage I disease and in the majority of patients with stage II disease, surgery is sufficient, and no additional treatment is required. However, stage III patients require additional treatment with adjuvant chemotherapy, as the latter reduces the number of disease recurrences, thus prolonging the overall survival and leading to a larger number of cured patients. Considering the results of the recent studies, stage II patients are also recommended to undergo adjuvant chemotherapy, depending on the presence of risk factors.Incidenca raka debelega črevesa še vedno narašča. Odkrit v zgodnjem stadiju je ozdravljiva bolezen že s samo kirurškim posegom. Pri bolnikih stadija I in večini stadija II je operacija dovolj ter ne potrebujejo dodatnega zdravljenja. Bolniki stadija III potrebujejo dodatno zdravljenje z adjuvantno kemoterapijo, saj ta zmanjša število ponovitev bolezni in s tem podaljša celotno preživetje ter vodi k večjemu številu ozdravljenih bolnikov. Glede na rezultate nedavnih raziskav pa tudi bolnikom stadija II glede na prisotnost rizičnih dejavnikov priporočamo zdravljenje z adjuvantno kemoterapijo