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Niščáková V, Almáši M, Capková D, Kazda T, Čech O, Čudek P, Petruš O, Volavka D, Oriňaková R, Fedorková AS. Novel Cu(II)-based metal-organic framework STAM-1 as a sulfur host for Li-S batteries. Sci Rep 2024; 14:9232. [PMID: 38649384 PMCID: PMC11035644 DOI: 10.1038/s41598-024-59600-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024] Open
Abstract
Due to the increasing demand for energy storage devices, the development of high-energy density batteries is very necessary. Lithium-sulfur (Li-S) batteries have gained wide interest due to their particularly high-energy density. However, even this type of battery still needs to be improved. Novel Cu(II)-based metal-organic framework STAM-1 was synthesized and applied as a composite cathode material as a sulfur host in the lithium-sulfur battery with the aim of regulating the redox kinetics of sulfur cathodes. Prepared STAM-1 was characterized by infrared spectroscopy at ambient temperature and after in-situ heating, elemental analysis, X-ray photoelectron spectroscopy and textural properties by nitrogen and carbon dioxide adsorption at - 196 and 0 °C, respectively. Results of the SEM showed that crystals of STAM-1 created a flake-like structure, the surface was uniform and porous enough for electrolyte and sulfur infiltration. Subsequently, STAM-1 was used as a sulfur carrier in the cathode construction of a Li-S battery. The charge/discharge measurements of the novel S/STAM-1/Super P/PVDF cathode demonstrated the initial discharge capacity of 452 mAh g-1 at 0.5 C and after 100 cycles of 430 mAh g-1, with Coulombic efficiency of 97% during the whole cycling procedure at 0.5 C. It was confirmed that novel Cu-based STAM-1 flakes could accelerate the conversion of sulfur species in the cathode material.
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Affiliation(s)
- V Niščáková
- Department of Physical Chemistry, Faculty of Sciences, Pavol Jozef Šafárik University in Košice, Moyzesova 11, 04154, Kosice, Slovak Republic
| | - M Almáši
- Department of Inorganic Chemistry, Faculty of Sciences, Pavol Jozef Šafárik University in Košice, Moyzesova 11, 04154, Kosice, Slovak Republic
| | - D Capková
- Department of Physical Chemistry, Faculty of Sciences, Pavol Jozef Šafárik University in Košice, Moyzesova 11, 04154, Kosice, Slovak Republic
- Department of Chemical Sciences, Bernal Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - T Kazda
- Department of Electrical and Electronic Technology, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technická 10, 616 00, Brno, Czech Republic
| | - O Čech
- Department of Electrical and Electronic Technology, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technická 10, 616 00, Brno, Czech Republic
| | - P Čudek
- Department of Electrical and Electronic Technology, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technická 10, 616 00, Brno, Czech Republic
| | - O Petruš
- Institute of Materials Research, Slovak Academy of Sciences, Watsonova 47, 040 01, Kosice, Slovak Republic
| | - D Volavka
- Department of Solid State Physics, Faculty of Science, P. J. Šafárik University, Park Angelinum 9, 041 01, Kosice, Slovak Republic
| | - R Oriňaková
- Department of Physical Chemistry, Faculty of Sciences, Pavol Jozef Šafárik University in Košice, Moyzesova 11, 04154, Kosice, Slovak Republic
- Centre of Polymer Systems, Tomas Bata University in Zlín, Třída Tomáše Bati 5678, 760 01, Zlín, Czech Republic
| | - A S Fedorková
- Department of Physical Chemistry, Faculty of Sciences, Pavol Jozef Šafárik University in Košice, Moyzesova 11, 04154, Kosice, Slovak Republic.
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Kalita O, Kazda T, Reguli S, Jancalek R, Fadrus P, Krska L, Slachta M, Valosek J, Vrbkova J, Hrabalek L, Smrcka M, Lipina R. P17.14.B Strategy of the recurrent Glioblastoma treatment. Three neuro-oncology centers study. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The prognosis for patients with Glioblastoma (GBM) remains dismal. The most aggressive multimodal therapy (maximally radical and safe tumor resection, followed by the Stupp protocol oncotherapy) has yielded the best treatment outcomes. Notwithstanding the slowly prolonged patient′s overall survival, this tumor inevitable recurs. An optimal therapy of the recurrent GBM is still a controversial theme.The aim of our study is to evaluate our treatment strategy of recurrent GBM.
Material and Methods
For this study, we retrospectively selected a group of resected recurrent GBM patients in a period from June 1, 2009 to December 31, 2019, which were treated in tree Czech neuro-oncologic centers. All patients underwent early post-surgical MRI (within 72 h) to determine resection radicality. Following resection, patients received periodic checkups with MRI every 3 months until death. Patients with psedoprogession were excluded. Information about all surgeries, oncotherapies, patient clinical condition, MRI, PET/CT, and results of histological, immunohistochemical, molecular genetic, and cytogenetic investigations was gathered.We consider surgery for recurrent GBM in case, if:
1.The tumor volume increasing > 20-30% or tumor rediscovery after radiologic disappearing.
2.Clinic condition - Karnofsky score (KS) ≥ 70% and Performance status (PS) WHO ≤ gr. 2.
3.Localized tumor, without multilfocality.
4.Assumed the least tumor volume reduction > 80%.
Results
We gathered 122 patients with recurrent GBM, 98,9% of tumors was determined as wild-type, age median was 53,36 years. All patients underwent Stupp protocol oncotherapy after prime surgery. Median of OS from prime surgery was 21 months (15.8, 29.6). The best results proved a surgery of GBM recurrency proceeding more than 6 months after diagnosis. OS2 (from redo up to the death) was 7.4 months (6.41, 11.3). 43.3% of patients recalled temozolomide chemotherapy. We confirmed positive link between OS and resection radicality, negative relations between OS and a postoperative neurologic deficits. Only limited relation was presented between OS and repeated oncotherapy. Relation to the further histologic, imunohistochemic, cytogenetic and molecular markers will be discussed.
Conclusion
Due to the common unfavorable outcomes of GBM therapy, out of despair, we often decided for repeated surgery. The aim of our study was avoid ineffective surgical overtreatment. The best results of surgery yield right selected recurrent GBMs. Surgery of GBM regrown during initial oncotherapy (6 months after prime surgery) presented unsatisfactory effects. Positive effect of the surgical radicality and clinic status were confirmed. Again, necessity of second-line oncotherapy has been emerged. Supported by Ministry of Health of the Czech Republic, grant nr. NV19- 04-00281 and grant nr. NU21-03-00195
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Affiliation(s)
- O Kalita
- University Hospital Olomouc , Olomouc , Czech Republic
- Faculty of Medicine and Dentistry, Palacky University in Olomouc , Olomouc , Czech Republic
| | - T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute and Faculty of Medicine of Masaryk University , Brno , Czech Republic
| | - S Reguli
- Department of Neurosurgery, University Hospital Ostrava , Ostrava , Czech Republic
| | - R Jancalek
- Department of Neurosurgery, St. Anne's University Hospital and Faculty of Medicine of Masaryk University , Brno , Czech Republic
| | - P Fadrus
- Dpt of Neurosurgery, University Hospital Brno, Faculty of Medicine, Masaryk University , Brno , Czech Republic
| | - L Krska
- Department of Neurosurgery, University Hospital Ostrava , Ostrava , Czech Republic
| | - M Slachta
- University Hospital Olomouc , Olomouc , Czech Republic
| | - J Valosek
- University Hospital Olomouc , Olomouc , Czech Republic
| | - J Vrbkova
- Institute of Molecular and Translational Medicine of Faculty of Medicine and Dentistry, Palacky University in Olomouc, , Olomouc , Czech Republic
| | - L Hrabalek
- University Hospital Olomouc , Olomouc , Czech Republic
| | - M Smrcka
- University Hospital Brno, Faculty of Medicine, Masaryk University , Brno , Czech Republic
| | - R Lipina
- Department of Neurosurgery, University Hospital Ostrava , Ostrava , Czech Republic
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Kazda T, Fadrus P, Selingerova I, Jancalek R, Pospisil P, Hynkova L, Garcic J, Vybihal V, Roskova I, Belanova R, Smrcka M, Svajdova M, Slampa P. P11.57.B Combined surgery and radiotherapy for brain metastases. Retrospective analysis of a consecutive cohort of 118 patients. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite current advances in systemic therapy for brain metastases, neurosurgery remains the preferred method of choice in patients with limited brain metastases. Postoperative radiotherapy indicated to reduce the risk of local recurrence is recommended in all patients after surgery. The aim of this retrospective study is to describe clinical characteristics and survival outcomes in consecutive cohorts of patients treated by this combined local treatment.
Material and Methods
Clinical data were retrieved from electronic medical records for consecutive patients who underwent surgery for brain metastases between 2007 and 2019. All patients underwent postsurgery radiotherapy. Local progression free survival (localPFS) evaluated the local control at the operated site. DistalPFS at the other parts of the brain. Univariable and multivariable analysis of survival characteristics was performed. The Median follow-up was 49 months.
Results
A total of 118 patients were included (54% women, median age 60 years, median Karnofsky index 80% at the time of radiotherapy). Single metastasis was treated in 66%, while 11% presented with more than 3 metastases. The most common primary diagnosis was lung cancer (33%) and breast (20%). Radical surgery was achieved in 92/117 (79 % of patients). In total, only 48/118 (41%) of patients underwent targeted radiotherapy (mostly fractionated stereotactic radiotherapy of 25Gy in 5 fractions). Significantly more patients (p<0.001) underwent targeted radiotherapy during 2016-2019 (45/48) compared to 2007-2015 period (3/48). A total of 20% of those who underwent postsurgery whole brain radiotherapy (WBRT) had a special technic of hippocampal sparing WBRT of WBRT with simultaneous integrated boost to remaining brain metastases. Median overall survival (OS) for all patients was 9 months (6.2 - 12), median localPFS 22 months (14 - not reached), median distalPFS 11 months (6.8 - 27) and median extracranialPFS 11 months (5.9 - 15). A significant (p=0.00017) difference in OS was while grouping patients according to Graded prognostic assessment (brainmetgpa.com). Significantly better OS was in the cohort of patients with targeted stereotactic radiotherapy (17months) vs. WBRT (5.6 months; p=0.00069) with no difference in local PFS, distal PFS or extracranialPFS. Multivariable analysis revealed type or radiotherapy, control of primary tumor, number of brain metastases 1-2 and the possibility to discontinue corticosteroids to be independent variables for OS.
Conclusion
Targeted fractionated stereotactic radiotherapy to tumor bed after metastasectomy was associated with improved survival compared to postsurgery WBRT in our cohort. Stereotactic radiotherapy should be preferred in all workplaces with adequate radiotherapy technology. Supported by Ministry of Health of the Czech Republic AZV, NV18-03-00469 and NV18-03-00398.
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Affiliation(s)
- T Kazda
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
| | - P Fadrus
- University Hospital Brno , Brno , Czech Republic
| | - I Selingerova
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
| | - R Jancalek
- St. Anne's University Hospital , Brno , Czech Republic
| | - P Pospisil
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
| | - L Hynkova
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
| | - J Garcic
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
| | - V Vybihal
- University Hospital Brno , Brno , Czech Republic
| | - I Roskova
- University Hospital Brno , Brno , Czech Republic
| | - R Belanova
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
| | - M Smrcka
- University Hospital Brno , Brno , Czech Republic
| | - M Svajdova
- Masaryk University , Brno , Czech Republic
| | - P Slampa
- Masaryk Memorial Cancer Institute , Brno , Czech Republic
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Kazda T, Lakomy R, Selingerova I, Pospisil P, Hynkova L, Belanova R, Slampa P. P14.59 Rapid early progression of glioblastoma is not related to cortical/neural stem cells regions. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Rapid early progression (REP) of glioblastoma after surgery observed on pre-radiotherapy MRI scan is common. Subventricular zone (SVZ) and hippocampal regions are supposed to harbor astrocyte-like neural stem cells (NSC) with tumors arising from these transformed stem cells threatening of higher risk of REP. REP is defined as a new enhancing tumor or >25% increase in enhancement before radiotherapy. Lim′s classification of initial glioblastoma location related to these NSC regions predicts invasive and multifocal tumor phenotype. Glioblastomas are classified preoperatively into four groups by the spatial relationship of the contrast-enhancing lesion with the SVZ and cortex. The aim of this retrospective single-institutional study is to evaluate the relations of this Lim classification on REP in unselected cohort of glioblastoma patients.
MATERIAL AND METHODS
Patients receiving radiotherapy between 2014–2017 were analyzed, 95 were evaluable. 47 patients (30.5%) were treated with the Stupp regimen. Lim1 classification (contact with cortex as well as SVZ) was presented in 74(48%) patients, Lim2 (contact with SVZ only) in 22(14.3%), Lim3 (contact with cortex only) in 50(32.5%) and Lim4 in 8(5.2%) patients. A total of 52% of patients developed REP.
RESULTS
Significantly better overall survival was with Stupp regimen (23.3 vs. 8.6 months, p<0.001) and without REP (18.5 vs. 10.2 months, p=0.001). There was no significant impact of time to start of radiotherapy. No significant relation between REP and Lim classification was observed.
CONCLUSION
The initial location is not predictive for REP. Patients experiencing REP have significantly worse overall survival and modification of their management represents an urgent unmet clinical need. Molecular and clinical biomarkers indicating an increased risk of REP are needed.Presented will also be an already published analysis of clinical factors associated with REP in glioblastoma and the effect of REP and treatment on survival outcomes. Newly, we will introduce the investigator-initiated prospective academic clinical trial (GlioMET) focused on optimization of glioblastoma radiotherapy by 11C-Methionine PET scan in patients with REP. Supported by Ministry of Health of the Czech Republic AZV, No.18-03-00469 and AZV NU20-03-00148.
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Affiliation(s)
- T Kazda
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Lakomy
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - I Selingerova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Pospisil
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - L Hynkova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Belanova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Slampa
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
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Burkon P, Selingerova I, Slavik M, Kazda T, Vrzal M, Slampa P. PO-1106 External beam APBI in early breast cancer: randomised prospective single institution study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07557-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hendrych M, Valeková H, Kazda T, Lakomý R, Šána J, Jančálek R, Slabý O, Hermanová M. Integrated dia-gnostics of diffuse gliomas. Klin Onkol 2021; 33:248-259. [PMID: 32894953 DOI: 10.14735/amko2020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recently, the World Health Organization (WHO) classification of tumours of the central nervous system (CNS) has brought essential changes. The currently valid revised WHO 2016 classification of CNS tumours introduced the concept of integrated dia-gnostics, which incorporated not only histopathological morphological finding and immunophenotype but also molecular-genetic characteristics of the tumour. Thus, the final integrated dia-gnosis comprises the traditional morphological and growth pattern characteristics of a tumour including histopathological grade and also specific molecular bio-markers. The classification of tumour based on a combination of both tumour phenotype and genotype enables more precise prognostic stratification, increases the objectivity of dia-gnostics and prediction of response to treatment. In 2017, an international platform, The Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy - not official WHO (cIMPACT-NOW), was established to create and formulate practical recommendations for integrated dia-gnostics of CNS tumours and upcoming WHO classification. The incorporation of molecular bio-markers into the integrated dia-gnostics radically changed the classification of diffuse gliomas, which include entities with different morphological characteristics, genetic alterations and bio-logical behaviour. This review article summarizes essential morphological, immunophenotypical and molecular genetic characteristics of diffuse gliomas within the scope of integrated dia-gnostics according to the valid WHO classification of tumours of the CNS and subsequent recommendations of dia-gnostic approaches. This work was supported by grant of the Ministry of Health of the Czech Republic - Conceptual Development of a Research Organization (MMCI 00209805) and Grant Agency of Masaryk University (MUNI/A/1562/2018). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
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Švajdová M, Kazda T, Dubinský P, Šlampa P. Radical external beam reirradiation of recurrent head and neck cancer. Klin Onkol 2021; 34:103-112. [PMID: 33906358 DOI: 10.48095/ccko2021103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recurrent head and neck carcinomas represent a therapeutic challenge for the surgeons as well as for the treating radiation oncologists. Despite advances in the treatment of newly dia-gnosed head and neck carcinomas, relapses occur very frequently and contribute significantly to patient mortality. External beam reirradiation is still considered to be a controversial therapeutic intervention. Historically, in the era of 2- and 3-dimensional conformal radiotherapy, its narrow therapeutic ratio has long led to a general concern that the potential benefit could not sufficiently outweigh the high risk associated with the treatment. The unfavorable therapeutic ratio, however, could be positively influenced by the use of modern techniques of intensity-modulated radiation therapy (IMRT), volumetric-modulated arc therapy (VMAT), stereotactic body radiation therapy (SBRT) and heavy-ion radiotherapy (protons, carbon ions). PURPOSE The purpose of this review is to create a practical tool for clinical decision-making on the type of patient suitable for reirradiation and the exact type of radiotherapy technique with respect to its expected therapeutic effect, toxicity profile and availability throughout the institutions. In the introductory section, selection of patients is defined with an emphasis on factors that significantly affect overall survival and may be particularly useful in shared decision-making approach within multidisciplinary teams. Furthermore, the text deals with the individual types of external beam radiotherapy techniques (IMRT, SBRT, heavy-ion radiotherapy) with a clear summary of therapeutic outcomes and toxicity from published scientific evidence that had a significant impact on clinical practice.
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Lakomý R, Poprach A, Kazda T. Management of Immune-Related Endocrinopathies in Anticancer Treatment with Checkpoint Inhibitors. Klin Onkol 2020; 33:15-19. [PMID: 32075383 DOI: 10.14735/amko202015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Modern immunotherapy with checkpoint inhibitors has become the backbone treatment for many cancers. However, it is often accompanied by immune-related side effects, which may differ depending on the nature of the treatment. The frequency of adverse reactions increases with the number of patients receiving immunotherapy. The situation has become even more difficult with the advent of combination immunotherapy. Although the kinetics of the onset and duration of toxicity have been well described, caution should be exercised. In clinical practice, cases with atypical courses often occur. Ignorance of the problem can lead to underestimation of symptoms and damage to the patient. Immune-related side effects are variable and any organ can be affected. In addition to skin, intestinal and liver toxicity, immune-related endocrinopathy is another relatively frequent toxicity. Thyroid, pituitary and adrenal glands are most commonly affected. Symptoms of endocrinopathy are often nonspecific, which may complicate a differential diagnosis. Fortunately, most toxicities are grade 1 and 2; however, in routine clinical practice, care must be exercised to detect the onset of life-threatening toxicity such as an adrenal crisis or type 1 diabetes mellitus with ketoacidosis. It is unclear whether high doses of corticosteroids are effective in preserving endocrine gland function. Long-term hormone replacement therapy is essential because immune-related endocrinopathy is often irreversible, unlike other immune-related toxicities. Close cooperation with an endocrinologist is therefore very important. This work was supported by MH CZ - DRO (MMCI, 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
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Bílek O, Holánek M, Berkovcová J, Horký O, Kazda T, Čoupková H, Špelda S, Kristková L, Zvaríková M, Podhorec J, Bořilová S, Bohovicová L, Zdražilová Dubská L. Uncommon EGFR Mutations in Non-Small Cell Lung Cancer and Their Impact on the Treatment. Klin Onkol 2019; 32:6-12. [PMID: 31627700 DOI: 10.14735/amko20193s6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) mutations play an important role in the pathogenesis of non-small cell lung cancer. Because these alterations are so-called targetable mutations, their identification is important in daily clinical practice. The diagnostic standard of EGFR mutations is currently based on polymerase chain reaction methods, particularly the quantitative real-time polymerase chain reaction. In recent years, new generation sequencing has become increasingly important. In patients with EGFR mutations, a significant improvement in therapeutic outcomes was achieved with the administration of targeted therapy using tyrosine kinase inhibitors. EGFR is composed of four domains: extracellular with a ligand binding site, a transmembrane domain, a cytoplasmic tyrosine kinase catalytic domain, and a C-terminal domain. The key structures of the tyrosine kinase domain responsible for signal activation and transmission are encoded within exons 18-21 on chromosome 7. EGFR mutations are highly heterogeneous. About 90% of EGFR mutations are deletions of exon 19 and point mutation L858R in exon 21. These are referred to as classic mutations. Approximately 10% of the total number of EGFR mutations is attributable to less frequent alterations in the EGFR gene. Due to the low incidence of non-small cell lung cancer with less frequent EGFR mutations, information on their predictive significance is still incomplete. Most of the data for the treatment of cases with uncommon mutations were gathered from retrospective analyses and evaluations of small cohorts. PURPOSE The aim of this review is to summarise the current options for diagnosing and treating non-small cell lung cancer patients with uncommon EGFR mutations. This work was supported by the MEYS - NPS I - LO1413 and MH CR - DRO (MMCI, 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 2. 6. 2019 Accepted: 26. 8. 2019.
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Kazda T, Jancalek R, Belanova R, Pospisil P, Burkon P, Hynkova L, Slampa P, Lakomy R. P14.101 Glioblastoma survival outcomes related to cortical/neural stem cells regions. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Subventricular brain zone (SVZ) and hippocampal regions are supposed to harbor astrocyte-like neural stem cells. While some tumors may arise from transformed SVZ stem cells, other may be initiated by neo-plastic transformation of non-SVZ progenitor cells or mature glial cells. Lim′s et al classification (Neuro-Oncology 2007) of initial glioblastoma location, related to these neural stem cells regions, was predictive for invasive and multifocal tumor phenotype. The aim of this retrospective single-institutional study is to evaluate the relations of this Lim classification on survival parameters in unselected cohort of glioblastoma patients.
MATERIAL AND METHODS
Patients treated between 2014–2017 were grouped according to initial location of their contrast enhancing lesion as follows: Lim1 (SVZ+⋯SVZ/hippocampal involvement and Cortex+⋯cortex involvement), Lim2 (SVZ+ and Cortex-), Lim3 (SVZ- and Cortex+) and Lim4 (SVZ- and Cortex-). All patients underwent radiotherapy, some patients were indicated to full treatment according to Stupp regimen (at least 3 cycles of adjuvant chemotherapy after postsurgery chemoradiotherapy).
RESULTS
In total, 144 patients were analyzed (94 men, mean age 59 years). 47 patients (30.5%) were treated according to Stupp regimen. Lim1 classification was presented in 74 (48%) patients, Lim2 in 22 (14.3%), Lim3 in 50 (32.5%) and Lim4 in 8 (5.2%) patients. Cortical structures (Lim1 and Lim3) were involved in 124 (80.5%) patients. Median overall survival was significantly better in patients treated according to Stupp regimen (23.3 vs. 8.6 months, p<0.001). Median overall survival differs in respective Lim groups: 12.3, 5.6, 11.8 and 6.6 months (p=0.07). Better survival was in patients with cortical involvement (Lim1+Lim3): 12.3 vs. 6.4 months (p=0.02), especially in subgroup of patients who were not treated according to Stupp regimen (8.9 vs. 4.4 months, p=0.02) vs. those after Stupp regimen (23 vs. 23.4 months, p=0.7).
CONCLUSION
Initial location of enhancing glioblastoma was prognostic for overall survival, with better outcomes in patients presented by involvement of cortical structures comparing to subventricular/hippocampal zones. Molecular patterns may further clarify potential effects of neural stem cells in glioma genesis mirrored in different clinical behavior and location of initial tumor. Supported by Ministry of Health of the Czech Republic, grant No. 18-03-00469
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Affiliation(s)
- T Kazda
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Jancalek
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - R Belanova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Pospisil
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Burkon
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - L Hynkova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Slampa
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Lakomy
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
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Jancalek R, Kazda T, Belanova R, Pospisil P, Burkon P, Hynkova L, Slampa P, Lakomy R. P14.107 Rapid early progression of glioblastoma is not related to cortical/neural stem cells regions. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Rapid early progression (REP) of glioblastoma after surgery is quite often observed on pre-radiotherapy MR scan. Clinical and molecular biomarkers indicating increased risk of this REP may be of high clinical need. Subventricular brain zone (SVZ) and hippocampal regions are supposed to harbor astrocyte-like neural stem cells with tumors arising from these transformed SVZ stem cells dreaded to be of higher risk of REP. Lim′s et al classification of initial glioblastoma location related to these neural stem cells regions was predictive for invasive and multifocal tumor phenotype. The aim of this retrospective single-institutional study is to evaluate the relations of this Lim classification on REP in unselected cohort of glioblastoma patients.
MATERIAL AND METHODS
Patients treated by radiotherapy between 2014–2017 were grouped as follows: Lim1 (SVZ+⋯SVZ/hippocampal involvement and Cortex+⋯cortex involvement), Lim2 (SVZ+ and Cortex-), Lim3 (SVZ- and Cortex+) and Lim4 (SVZ- and Cortex-). Some patients were indicated to Stupp regimen. REP was defined on pre-radiotherapy MR as new distant lesion, progression of residuum, or new enhancement in postsurgery cavity.
RESULTS
In total, 144 patients were analyzed (94 men, mean age 59 years). 47 patients (30.5%) were treated according to Stupp regimen. Lim1 classification was presented in 74 (48%) patients, Lim2 in 22 (14.3%), Lim3 in 50 (32.5%) and Lim4 in 8 (5.2%) patients. Cortical structures (Lim1 and Lim3) were involved in 124 (80.5%) patients. Median overall survival was significantly better in patients treated according to Stupp regimen (23.3 vs. 8.6 months, p<0.001) and in those without REP (18.5 vs. 10.2 months, p=0.001). REP was presented in 52% of 95 evaluable patients who underwent both post-surgery and pre-radiotherapy MR scans and there was no significant impact of time to start of radiotherapy. No significant relation between REP and Lim classification was observed (REP in 23/47 Lim1, in 8/13 Lim2, in 16/31 Lim3 and in 2/4 Lim4 patients).
CONCLUSION
Initial location of enhancing glioblastoma is not predictive for REP. Patients experiencing REP have significantly worse overall survival and modification of their management represents urgent unmet clinical need. Molecular and clinical biomarkers indicating increased risk of REP are needed. Supported by Ministry of Health of the Czech Republic, grant No. 18-03-00469.
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Affiliation(s)
- R Jancalek
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- St. Anne’s University Hospital, Brno, Czech Republic
| | - T Kazda
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Belanova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Pospisil
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Burkon
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - L Hynkova
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Slampa
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Lakomy
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
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Burkoň P, Slavik M, Kazda T, Pospíšil P, Prochazka T, Vrzal M, Šlampa P. Stereotactic Body Radiotherapy - Current Indications. Klin Onkol 2019; 32:10-24. [PMID: 30894002 DOI: 10.14735/amko201910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Stereotactic body radiotherapy (SBRT) is used to treat localized tumor lesions and consists of applying high doses of radiation to a small number of fractions using specially equipped linear accelerators, modern immobilization devices, and imaging methods, which are considered special, advanced techniques in modern day radiotherapy. SBRT is a very well tolerated, non-invasive, short-term treatment that does not require hospitalization or any complicated preparation. Compared to standard radiotherapy techniques, SBRT allows, due to its precision, significantly higher doses to be applied to the target with less damage to surrounding healthy tissues. If dose constraints are not exceeded, the risk of damage to tissues and organs around the irradiated volume is reduced to minimum. The principle of SBRT is the application of ablative doses of radiation that cause necrosis of the irradiated tissue. PURPOSE The aim of this review is to provide a basic overview of SBRT indications, radiation doses used, and potential side effects. It is not intended to be a detailed description of treatment itself (such as discussion of patient fixation systems, management of respiratory movements, or image guided strategies of treatment). This review also discusses rarer indications for SBRT, such as pancreatic carcinoma or hepatocellular carcinoma. CONCLUSION Advances in image navigation, radiation planning, and dose application have enabled successful introduction of SBRT as a treatment regimen for many primary tumors and oligometastatic disease. If surgery is not possible or the patient refuses surgery, it is always reasonable to consider SBRT. SBRT has curative potential for the treatment of primary lung or prostate tumors. High-dose irradiation of oligometastases of various primary tumors can lead to long-term survival without disease symptoms, delay administration of toxic systemic therapies, and improve the quality of life of oncological patients. Key words radiotherapy - stereotactic body radiotherapy - review - ablative radiotherapy - lung cancer - prostate cancer - oligometastatic disease This work was supported in part by the Ministry of Health, Czech Republic - Conceptual Development of Research Organization (MMCI 00209805). The results of this research have been acquired within CEITEC 2020 (LQ1601) project with the financial contribution made by the Minis-try of Education, Youths and Sports of the Czech Republic within special support paid from the National Programme for Sustainability II funds. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 30. 10. 2018 Accepted: 4. 11. 2018.
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Slavik M, Kazda T, Selingerová I, Šána J, Ahmad P, Gurín D, Hermanová M, Novotný T, Červená R, Dymáčková R, Burkoň P, Slabý O, Šlampa P. Effect of Tumor Size and p16 Status on Treatment Outcomes - Achievement of Complete Remission in Prospectively Followed Patients with Oropharyngeal Tumors. Klin Onkol 2019; 32:58-65. [PMID: 30764631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Oropharyngeal squamous cell tumors associated with human papillomavirus infection (p16 positive tumors) have better prognosis than p16 negative tumors regardless of the more advanced stage of the disease. Tumor volume (GTVt+n) is generally an important factor affecting treatment results of ionizing radiation. The aim of this prospective non-randomized study is to evaluate the effect of tumor volume on the (chemo)radiation treatment results in a group of patients with p16 negative and p16 positive oropharyngeal tumors. PATIENTS AND METHODS Patients with confirmed squamous cell tumor of the oropharynx of stages III and IV, according to the 7th version of the TNM (tumor-nodes-metastases) classification, were eligible for this study. The main exclusion criteria were palliative treatment, neoadjuvant chemotherapy or planned concomitant therapy with cetuximab. Patients were treated according to standardized protocols with curative intent. Primary tumor volume (GTVt) and involved nodes volume (GTVn) were obtained from radiotherapy planning system for further statistical analysis. The differences in tumor volumes between the groups according to p16 expression were assessed with subsequent testing of probability to achieve complete remission (CR) of the disease in both groups. RESULTS In total, 49 patients - 84% men, median age 60.5 years, 25 (51%) patients p16 positive, 40 (82%) underwent concomitant chemoradiotherapy. Median of GTVt in the whole patients group is 40.2 ccm, GTVn 11.78 ccm and median volume of the whole tumor burden (GTVt+n) 70.21 ccm (range 11.05-249). Median of GTVn was greater in the p16 positive cohort (p = 0.041). In the entire group, the median time to reach CR was 91 days (95% CI 86-107 days) from the end of radiotherapy. In the group of p16 negative patients, 14 achieved CR (61%) out of 23 patients, in p16 positive group 20 (80%) out of 25 patients (p = 0.111). P16 negative patients had a longer time to CR (p = 0.196, HR 1.58, 95% CI 0.79-3.18). None of the independently assessed volumetric parameters of the tumor (GTVt, GTVn, GTVt+n) affected CR in the p16 positive patients group, while there was a significant impact of the whole tumor burden (GTVt+n) in the p16 negative cohort (median 58.1 ccm in CR patients vs. 101.9 ccm, p = 0.018). CONCLUSION We have showed less GTVt+n dependence to achieve CR in p16 positive tumors in comparison with p16 negative tumors. Thus, p16 positive oropharyngeal squamous cell cancers should not be withdrawn from the curative treatment intent based on the greater GTVt+n. Key words oropharyngeal neoplasms - p16 status - treatment outcome - tumor burden - complete remission This work was supported by grant of the Ministry of Health of the Czech Republic AZV 15-31627A and by grant of the Ministry of Health of the Czech Republic - Conceptual development of a research organization (MMCI 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 2. 11. 2018 Accepted: 11. 11. 2018.
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Burkon P, Kazda T, Pospisil P, Slavik M, Kominek L, Selingerova I, Blakaj DM, Prochazka T, Vrzal M, Rehak Z, Slampa P. Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study. Neoplasma 2018; 66:315-325. [PMID: 30509112 DOI: 10.4149/neo_2018_180731n558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/16/2018] [Indexed: 11/08/2022]
Abstract
Localized, metastasis-directed stereotactic body radiation therapy (SBRT) of oligometastatic disease (OD) is currently rapidly evolving standard of care in many institutions. Further reports of outcomes are required to strengthen the level of evidence in the absence of comparative trials evaluating different practical procedures. The aim of this prospective single institutional study is to analyse, in unselected cohort of patients from real-world clinical practice, the long-term survival, tumor control outcomes and safety of SBRT in OD (radical ablative radiotherapy with biological equivalent dose BED10>100 Gy). In addition to standard toxicity and survival parameters, we report unique outcomes as FFWD - Freedom from widespread dissemination, FFNT - Freedom from the need of subsequent treatment and functional survival with Karnofsky performance status higher than 70%. A total of 110 patients were prospectively evaluated, 60% and 40% were treated for lung and liver oligometastatic disease, respectively. No grade 3 or 4 acute toxicities (CTCAE) were reported. With median follow up of 22.2 months and 2-year overall survival of 88.3%, four patients (6.1%) experienced local progression in the lung SBRT cohort. In the liver SBRT cohort, median follow up was 33 months, 2-year overall survival was 68.5% and 11 patients (25%) experienced local and 36 (81.8%) distal progression. Higher BED10 of 150-170 Gy compared to 100-150 Gy was an independent positive prognostic factor for local progression-free survival for all patients with hazard ratio 0.25. This confirms SBRT ablative radiobiology effects to be independent of OD primary histology and location. The best outcomes in terms of FFNT were observed in the multivariable analysis of patients with 1-2 lung OD compared to both the liver OD cohort and patients with more than 2 lung metastases. Better FFNT in the liver SBRT cohort was observed in patients with 1-2 liver metastases and in patients whose liver OD was irradiated by higher BED10. In conclusion, SBRT is a suitable option for patients who are not surgical candidates; with approximately 30% of patients not requiring subsequent treatment 2 years after SBRT. We believe that this treatment represents a safe and effective option for oligometastatic involvement in patients with various primary tumors.
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Affiliation(s)
- P Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - P Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - M Slavik
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - L Kominek
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - I Selingerova
- Regional Center for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Mathematics and Statistics, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - D M Blakaj
- Radiation Oncology Department, Arthur James Cancer Center, The Ohio State University, Columbus, Ohio, United States
| | - T Prochazka
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - M Vrzal
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Z Rehak
- Regional Center for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute, Masaryk University, Brno, Czech Republic
| | - P Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Regional Center for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic
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15
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Pospisil P, Solar P, Bulik M, Burkon P, Slampa P, Sana J, Slaby O, Jancalek R, Kazda T. P05.18 Comparison of N-acetylaspartate concentration decrease in hippocampal and white brain tissue after whole brain radiotherapy. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Solar
- Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - M Bulik
- Department of Medical Imaging - St. Anne’s University Hospital Brno, Faculty of Medicine, Brno, Czech Republic
- Department of Medical Imaging, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - P Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - J Sana
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - O Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - R Jancalek
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
- Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Jancalek R, Solar P, Pospisil P, Bulik M, Burkon P, Hynkova L, Slampa P, Sana J, Slaby O, Kazda T. P05.19 Hippocampal N - acetylaspartate concentration correlates to verbal memory before radiotherapy for brain metastases. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Jancalek
- Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - P Solar
- Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - P Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - M Bulik
- Department of Medical Imaging, St. Anne’s University Hospital Brno, Brno, Czech Republic
- Department of Medical Imaging - St. Anne’s University Hospital Brno, Faculty of Medicine, Brno, Czech Republic
| | - P Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - L Hynkova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - J Sana
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - O Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Kazda T, Kuklova A, Belanova R, Pospisil P, Burkon P, Hynkova L, Slampa P, Sana J, Slaby O, Jancalek R. P05.20 Laterality of hipoccampal metastases: MRI analysis of 260 patients with 2595 brain metastases. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - A Kuklova
- Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - R Belanova
- Department of Radiology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - L Hynkova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - J Sana
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - O Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - R Jancalek
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
- Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Belanova R, Sprlakova-Pukova A, Standara M, Janu E, Koukalova R, Burkon P, Pospisil P, Jancalek R, Slampa P, Kazda T. P01.027 Pseudoprogression in glioblastoma: how sure are radiologists in location of “high-dose RT region”. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Belanova
- Department of Radiology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - A Sprlakova-Pukova
- Department of Radiology, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - M Standara
- Department of Radiology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - E Janu
- Department of Radiology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - R Koukalova
- Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - P Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - R Jancalek
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
- Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Slavik M, Shatokhina T, Sana J, Ahmad P, Hermanova M, Kazda T, Slampa P, Slaby O. EP-2292: CD44, EGFR and p16 expressions in oropharyngeal squamous cell cancer patients treated by IMRT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Ahmad P, Slavík M, Šána J, Hermanová M, Šlampa P, Smilek P, Kazda T, Slabý O. [MicroRNAs in Prediction of Response to Radiotherapy in Head and Neck Cancer Patients - Pilot Study]. Klin Onkol 2018; 31:137-139. [PMID: 29808687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Radiotherapy plays a key role in the treatment of squamous cell head and neck cancers (HNSCC). The effectivity of radiation therapy is often limited by radioresistance of these tumours. microRNAs (miRNAs) are endogenous, evolutionary conserved, small non-coding RNAs involved in regulation of cellular processes associated with radioresistance. The objective of this study was to identify miRNA profile enabling to predict the radiation treatment outcomes in HNSCC patients. MATERIAL AND METHODS The retrospective study included HNSCC patients who underwent a definitive radiotherapy. Patients were divided into two groups according to loco-regional control (LRC) as follows - short LRC (n = 22; median 5.1 months (min. 1.3, max, 18.6)) vs. long LRC (n = 21; 60.4 (min. 46.8, max. 98.8)) group. Global miRNA expression profiles were obtained by use of Affymetrix microarray technology (GeneChip miRNA 4.0 Array). RESULTS We identified 24 miRNAs to be significantly associated with LRC (p < 0.05), all of these miRNAs were upregulated in patients with short LRC. Out of these miRNAs, 12 miRNAs with p < 0.025 and 4 miRNAs with p < 0.01 have been identified. CONCLUSION miRNAs seems to be promising as potential biomarkers predicting radiotherapy treatment outcomes in patients with HNSCC.Key words: microRNAs - radiotherapy - head and neck cancer The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Supported by Ministry of Health of the Czech Republic, grant No. 15-31627A. All rights reserved.Submitted: 19. 3. 2018Accepted: 20. 3. 2018.
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Kazda T, Lakomý R, Poprach A, Pospíšil P, Jančálek R, Šlampa P. [Controversy in the Postoperative Treatment of Low-grade Gliomas]. Klin Onkol 2017; 30:337-342. [PMID: 29031035 DOI: 10.14735/amko2017337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The optimal treatment for low-grade gliomas remains controversial. Neurosurgery, radiotherapy, and chemotherapy are the main treatment options. Despite advances in oncology, there are still a lot of uncertainties, and the optimal sequences, combinations, and timings of these procedures have not yet been optimized. It is still unclear whether temozolomide can replace effective, but toxic PCV chemotherapy (procarbazine, lomustine, vincristine) and whether temozolomide can be used upfront alone instead of radiotherapy alone. Mature results from phase III trials (CODEL, EORTC 22033-26033) will provide answers to these questions. Correlative analyses of survival data and molecular marker findings (1p/19q codeletion, IDH1/2 mutation, and MGMT promoter methylation status) are essential. Due to slow progressive nature of the disease, all clinical trials with low-grade gliomas are complicated by the need for long-term follow-up to obtain valid mature data, which makes any new treatment procedures or developments in basic research developed during the course of closed clinical trials difficult to apply in daily clinical practice. An example is the recently published RTOG 9802 study evaluating the role of adjuvant PCV in combination with radiotherapy for the treatment of high-risk low-grade glioma patients where the recruitment of patients was initiated almost two decades ago. Health-related quality of life after treatment of patients with expected long-term survival is also very important and its maintenance is currently the focus of considerable interest. AIM The main objective of the present review is to summarize the results of key clinical trials and highlight controversial issues that could have an impact on future daily practice. Another aim is to discuss these issues in the light of newly established molecular markers from the new 2016 WHO Classification of Tumors of the Central Nervous System.Key words: glioma - astrocytoma - radiotherapy - temozolomide - PCV - cognition This work was supported by MH CZ - RVO (MMCI, 00209805) and by project of the Ministry of Education, Youths and Sports of the Czech Republic CEITEC 2020 (LQ1601). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 21. 2. 2017Accepted: 20. 3. 2017.
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Lakomý R, Kazda T, Poprach A, Pospíšil P, Jančálek R, Šlampa P. [The Role of Chemotherapy in the Treatment of Low-grade Gliomas]. Klin Onkol 2017; 30:343-348. [PMID: 29031036 DOI: 10.14735/amko2017343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The standard postsurgical options for low-grade gliomas include watchful waiting or radiotherapy depending on the risk factors for recurrence. The use of chemotherapy for the treatment of this disease is generally controversial, although the recently published results of the first of two large randomized phase III clinical trials (RTOG 9802 a EORTC 22033-26033), focusing on the evaluation of chemotherapy for the upfront treatment of newly diagnosed low-grade gliomas, are reassuring in this respect. The long-term results of a RTOG 9802 comparing radiotherapy alone with radiotherapy and six cycles of adjuvant PCV chemotherapy (procarbazine, lomustine, vincristine) in patients with high-risk low-grade gliomas will probably have an impact on daily clinical practice. The increase in median overall survival from 7.8 years to 13.3 years, mainly for patients with oligodendrogliomas, is unprecedented, but the toxicity of PCV is too high and molecular marker analysis remains inadequate. It is still unclear whether less toxic temozolomide can replace PCV and whether temozolomide can be used upfront alone instead of with radiotherapy. This question is addressed by the ongoing EORTC 22033-26033 study. The preliminary results show no significant difference in progression-free survival between patients receiving radiotherapy and those receiving temozolomide alone. Treatment with temozolomide was not associated with an improvement in cognitive function compared with treatment with radiotherapy. Despite limited follow-up, the study clearly confirmed the importance of molecular characterization of low-grade gliomas, as currently defined in the new 2016 WHO Classification of Tumors of the Central Nervous System. AIM The aim of the review is to summarize available information from listed key clinical trials of chemotherapy for low-grade gliomas and draw attention to unresolved issues concerning the use of chemotherapy for the treatment of this disease.Key words: glioma - astrocytoma - chemotherapy - PCV - temozolomide - RTOG 9802 This work was supported by MH CZ - RVO (MMCI, 00209805) and by project of the Ministry of Education, Youths and Sports of the Czech Republic CEITEC 2020 (LQ1601). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 21. 2. 2017Accepted: 20. 3. 2017.
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Kazda T, Čudek P, Vondrák J, Sedlaříková M, Tichý J, Slávik M, Fafilek G, Čech O. Lithium-sulphur batteries based on biological 3D structures. J Solid State Electrochem 2017. [DOI: 10.1007/s10008-017-3791-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jancalek R, Bulik M, Kazda T. P04.10 Use of MR spectroscopy and diffusion weighted MR imaging for differentiation of glioblastoma relapse and pseudoprogression after complex oncology treatment: final study results. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kazda T, Bulik M, Pospisil P, Nahodilova J, Holikova K, Burkon P, Hynkova L, Lakomy R, Slampa P, Jancalek R. P05.05 Post whole-brain radiotherapy hippocampal volumetry and neuronal changes measured by MR spectroscopy. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pospisil P, Kazda T, Hynkova L, Bulik M, Dobiaskova M, Slampa P, Jancalek R. P05.03 Post-radiation cognitive inpairment and hippocampal neuronal depletion measured by in-vivo metabolic MR spectroscopy: Results of prospective investigational study. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kazda T, Vrzal M, Prochazka T, Pospisil P, Nikl T, Dvoracek P, Dziacky A, Slampa P, Jancalek R. P05.04 Dosimetrical consequences of unilateral (left) hippocampus sparing WBRT. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kuklova A, Kazda T, Burkon P, Pospisil P, Hynkova L, Dziacky A, Belanova R, Lakomy R, Slampa P, Jancalek R. P14.09 Incidence of left-right hippocampal metastases:analysis of 473 patients with 4063 brain metastases. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lakomy R, Hynkova L, Pospisil P, Burkon P, Slavik M, Slampa P, Jancalek R, Kazda T. Patterns of failure after brain metastases radiotherapy: reflections on the importance for treatment and clinical trials reporting. Neoplasma 2017; 64:329-337. [PMID: 28253711 DOI: 10.4149/neo_2017_302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In many ongoing clinical trials, new strategies for radiotherapy of brain metastases are currently being investigated. A post surgical focal cavity stereotactic radiosurgery and the developing role of a hippocampal-sparing whole brain radiotherapy are of the highest importance. The evaluation of spatial patterns of metastases failure after radiotherapy is a powerful tool for assessing the potential benefit of new different radiotherapy approaches, which enables to identify possible directions leading to better radiotherapy techniques and to modify general management for newly diagnosed brain metastases. The purpose of this article is to present a mix between trial data and philosophical point of view for discussion about the importance of systematic evaluation of spatial patterns of failure in all ongoing trials investigating new approaches in local brain metastases treatment.
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Rehak Z, Vasina J, Ptacek J, Kazda T, Fojtik Z, Nemec P. PET/CT in giant cell arteritis: High 18F-FDG uptake in the temporal, occipital and vertebral arteries. Rev Esp Med Nucl Imagen Mol 2016; 35:398-401. [PMID: 27177856 DOI: 10.1016/j.remn.2016.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/14/2016] [Accepted: 03/24/2016] [Indexed: 11/17/2022]
Abstract
18F-FDG PET/CT imaging is useful in patients with fever of unknown origin and can detect giant cell arteritis in extracranial large arteries. However, it is usually assumed that temporal arteries cannot be visualized with a PET/CT scanner due to their small diameter. Three patients with clinical symptoms of temporal arteritis were examined using a standard whole body PET/CT protocol (skull base - mid thighs) followed by a head PET/CT scan using the brain protocol. High 18F-FDG uptake in the aorta and some arterial branches were detected in all 3 patients with the whole body protocol. Using the brain protocol, head imaging led to detection of high 18F-FDG uptake in temporal arteries as well as in their branches (3 patients), in occipital arteries (2 patients) and also in vertebral arteries (3 patients).
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Affiliation(s)
- Z Rehak
- Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Regional Center for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic; Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - J Vasina
- Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Center of Molecular Imaging, International Clinical Research Center (ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - J Ptacek
- Department of Nuclear Medicine and Department of Medical Physics and Radiation Protection, University Hospital, Olomouc, Czech Republic
| | - T Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Z Fojtik
- Rheumatology Unit, Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - P Nemec
- Rheumatology Unit, 2nd Department of Internal Medicine, St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
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Rehak Z, Vasina J, Ptacek J, Kazda T, Fojtik Z, Nemec P. PET/CT in giant cell arteritis: High 18F-FDG uptake in the temporal, occipital and vertebral arteries. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Jancalek R, Kazda T, Bulik M, Pospisil P. P07.11 Advanced MRI increases accuracy for glioblastoma recurrence diagnosis: Single institution thresholds and validation of MR spectroscopy and diffuse weighted MR imaging. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pospisil P, Kazda T, Slampa P, Bulik M, Dobiaskova M, Nahodilova J, Jancalek R. OS7.5 Post-radiation cognitive impairment and hippocampal neuronal depletion measured by in-vivo metabolic MR spectroscopy: Final results of prospective investigational study. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pospisil P, Kazda T, Jancalek R, Slampa P. OC-0350: Post-radiation neuronal depletion in hippocampus measured by in-vivo magnetic resonance spectroscopy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31599-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kazda T, Kuklova A, Pospisil P, Burkoň P, Slavík M, Hynková L, Prochazka T, Vrzal M, Stavik M, Slampa P, Jancalek R. Utilization of Prognostic Indexes for Patients with Brain Metastases in Daily Radiotherapy Routine - is the Complexity and Intricacy Still an Issue? Klin Onkol 2015; 28:352-8. [PMID: 26480863 DOI: 10.14735/amko2015352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Many prognostic indexes are available for patients with brain metastases in order to estimate remaining lifetime before selection of appropriate treatment including palliative radiotherapy. Their routine utilization is often deprecated for their complexity. We developed a practical tool based on widely available spreadsheet editors for facilitation of daily clinical use of selected indexes (RPA, GPA and WBRT 30) and evaluated its usage for retrospective single institutional survival analysis of patients irradiated for brain metastases. PATIENTS AND METHODS Spreadsheet platform was prepared and adjusted for automatic calculation of selected prognostic indexes after input of the relevant parameters. The consecutive series of newly diagnosed patients referred during 2011 to the palliative brain radiotherapy were analyzed, and real calculated survival parameters of individual subgroups of RPA, GPA and WBRT 30 were compared with estimated ones. Correlation of radiotherapy technique and estimated survival at the time of treatment indication was evaluated. RESULTS Total of 121 patients (61% with multiple metastases) were irradiated with the majority undergoing whole brain radiotherapy. Median overall survival from the time of radiotherapy indication was 3.13 months. Non balanced distribution into individual scoring systems subgroups was observed with 8 (7%), 89 (73%) and 24 (20%) patients assigned to RPA 1, 2 and 3 subgroup, 3 (3%), 9 (7%), 57 (47%) and 52 (43%) patients assigned to GPA 3.5- 4, GPA 3.0, GPA 1.5- 2.5 and GPA 0- 1.0 subgroup and 10 (8%), 88 (73%) and 23 (19%) patients assigned to WBRT 30 subgroup D, B and A. Entire differences in overall survival between subgroups are significant among all three scoring systems. CONCLUSION Routine calculation of available prognostic indexes is useful in decision making regarding the best radiotherapy of brain metastases, and their calculation is greatly facilitated by properly prepared widely available spreadsheet tools.
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Kazda T, Pospisil P, Vrzal M, Sevela O, Prochazka T, Jancalek R, Slampa P, Laack NN. Volumetric modulated arc therapy for hippocampal-sparing radiotherapy in transformed low-grade glioma: A treatment planning case report. Cancer Radiother 2015; 19:187-91. [PMID: 25835374 DOI: 10.1016/j.canrad.2014.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 11/19/2014] [Accepted: 11/25/2014] [Indexed: 12/25/2022]
Abstract
Timing of radiotherapy for low-grade gliomas is still controversial due to concerns of possible adverse late effects. Prevention of possible late cognitive sequelae by hippocampal avoidance has shown promise in phase II trials. A patient with progressive low-grade glioma with gradual dedifferentiation into anaplastic astrocytoma is presented along with description of radiotherapy planning process attempting to spare the hippocampus. To our knowledge, this is the first described case using volumetric modulated arc technique to spare hippocampus during transformed low-grade glioma radiotherapy. Using modern intensity-modulated radiotherapy systems it is possible to selectively spare hippocampus together with other standard organs at risk. For selected patients, an attempt to spare hippocampus can be considered as long as other dose characteristics are not significantly compromised compared to standard treatment plan created without any effort to avoid hippocampus.
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Affiliation(s)
- T Kazda
- Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic; International clinical research center, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic.
| | - P Pospisil
- Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic
| | - M Vrzal
- Department of medical physics, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic
| | - O Sevela
- Department of medical physics, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic
| | - T Prochazka
- Department of medical physics, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic
| | - R Jancalek
- International clinical research center, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic; Department of neurosurgery, faculty of medicine, Masaryk university, St. Anne's university hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic
| | - P Slampa
- Department of radiation oncology, faculty of medicine, Masaryk university, Masaryk memorial cancer institute, Zlutykopec 7, 656 53 Brno, Czech Republic
| | - N N Laack
- Department of radiation oncology, Mayo Clinic, 200, First Street SW, 55905 Rochester, MN, United States
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Kazda T, Vondrák J, Di Noto V, Sedlaříková M, Čudek P, Omelka L, Šafaříková L, Kašpárek V. Study of electrochemical properties and thermal stability of the high-voltage spinel cathode material for lithium-ion accumulators. J Solid State Electrochem 2015. [DOI: 10.1007/s10008-015-2772-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jancalek R, Pospisil P, Bulik M, Dobiaskova M, Kazda T, Slampa P. NC-07 * CORRELATION OF MR SPECTROSCOPY IMAGE OF HIPPOCAMPUS REGION AND IMPAIRMENT OF NEUROCOGNITIVE FUNCTIONS IN PATIENTS AFTER WHOLE BRAIN RADIOTHERAPY - PRELIMINARY DATA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou263.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Smrcka M, Jancalek R, Bulik M, Kazda T, Pospisil P, Slampa P. NI-71 * DEVELOPING ROLE OF ADVANCED MRI TECHNIQUES FOR DIAGNOSIS OF HIGH-GRADE GLIOMA RELAPSE AFTER COMPLEX ONCOLOGY TREATMENT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou264.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kazda T, Vondrák J, Di Noto V, Straková Fedorková A, Sedlaříková M, Čudek P, Vyroubal P. The influence of used precursors on the properties of high-voltage cathode materials. J Solid State Electrochem 2014. [DOI: 10.1007/s10008-014-2633-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kazda T, Hardie JG, Pafundi DH, Brinkmann DH, Laack NN. P16.16 * INFLUENCE OF DETERMINATION OF PROGRESSION ON PATTERNS OF FLAIR FAILURE ANALYSIS IN PATIENTS WITH GRADE III ANAPLASTIC ASTROCYTOMA (AA) AND ASSOCIATION OF PATTERN OF FAILURE (POF) WITH SURVIVAL. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hardie J, Kazda T, Pafundi D, Brinkmann D, Laack N. Evaluation of RANO Response Criteria Compared to Clinician Evaluation in Grade 3 Anaplastic Astrocytoma (AA): Implications for Clinical Trial Reporting. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jancalek R, Bulik M, Kazda T, Pospisil P, Slampa P, Smrcka M. P16.15 * DEVELOPING ROLE OF ADVANCED MRI TECHNIQUES FOR DIAGNOSIS OF HIGH-GRADE GLIOMA RELAPSE AFTER COMPLEX ONCOLOGY TREATMENT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Slavik M, Burkon P, Kazda T, Budikova M, Slavikova M, Dvorakova E, Pospisil P, Gombosova J, Navratilova P, Slampa P. Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience. Neoplasma 2014; 61:739-746. [PMID: 25150319 DOI: 10.4149/neo_2014_090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Surgical resection is the mainstay of gastric or gastroesophageal junction cancer treatment and has curative potential for patients with early-stage disease. In order to improve the poor survival rates, there are two complementary treatment strategies used at most - perioperative chemotherapy based on UK Magic trial or adjuvant chemoradiation based on INT-0116 trial. Daily treatment decision making should be led also by institutional experiences with toxicity evaluation. We evaluated survival and toxicity outcomes of 47 consecutive patients who underwent adjuvant chemoradiation in our institution in the years 2006-2009. 45Gy in 5 weeks with concurrent two cycles of FUFA Mayo regimen chemotherapy were administrated as part of combined treatment. The acute toxicity was relatively mild (CTCAE scale): grade 2 nausea in 26%, vomiting in 13%, and diarrhoea grade 1 in 15% and general abdominal discomfort in 57% of patients. Grade 3 haematological and infectious complications in 6% and 2% respectively. Late adverse events were as follows: grade 1 esophageal toxicity in 17%, signs of mild chronic esophageal ulceration and esophageal stenosis in 9% of patients (50% of them had tracheoesophageal fistula). The Kaplan- Meier estimate of the median overall survival was 30.5 months with median 25.7 months disease free survival. The overall survival was statistically significantly affected by the amount of removed positive lymph nodes. For the proper evaluation of radiotherapy role in multimodal treatment approach, results of other clinical trials investigating role of concurrent radiotherapy in administration of perioperative chemotherapy will be necessary. Meanwhile, two equally approaches are possible, all having their pros and cons. Institutional toxicity evaluation is recommended in order to provide the best care possible. Keywords: adjuvant chemoradiation, gastric cancer, early toxicity, late toxicity, survival outcomes.
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Arakawa Y, Fujimoto KI, Murata D, Nakamoto Y, Okada T, Miyamoto S, Bahr O, Harter PN, Weise L, You SJ, Ronellenfitsch MW, Rieger J, Steinbach JP, Hattingen E, Bahr O, Jurcoane A, Daneshvar K, Pilatus U, Mittelbronn M, Steinbach JP, Hattingen E, Carrillo J, Bota D, Handwerker J, Su LMY, Chen T, Stathopoulos A, Yu H, Chang JH, Kim EH, Kim SH, Mi, Yun J, Pytel P, Collins J, Choi Y, Lukas R, Nicholas M, Colen R, Jafrani R, Zinn P, Colen R, Ashour O, Zinn P, Colen R, Vangel M, Gutman D, Hwang S, Wintermark M, Jain R, Jilwan-Nicolas M, Chen J, Raghavan P, Holder C, Rubin D, Huang E, Kirby J, Freymann J, Jaffe C, Flanders A, Zinn P, Colen R, Ashour O, Zinn P, Colen R, Zinn P, Dahiya S, Statsevych V, Elson P, Xie H, Chao S, Peereboom D, Stevens G, Barnett G, Ahluwalia M, Daras M, Karimi S, Abrey L, Sanchez J, Beal K, Gutin P, Kaley T, Grommes C, Correa D, Reiner A, Briggs S, Omuro A, Verburg N, Hoefnagels F, Pouwels P, Boellaard R, Barkhof F, Hoekstra O, Wesseling P, Reijneveld J, Heimans J, Vandertop P, Zwinderman K, Hamer HDW, Elinzano H, Kadivar F, Yadav PO, Breese VL, Jackson CL, Donahue JE, Boxerman JL, Ellingson B, Pope W, Lai A, Nghiemphu P, Cloughesy T, Ellingson B, Pope W, Chen W, Czernin J, Phelps M, Lai A, Nghiemphu P, Liau L, Cloughesy T, Ellingson B, Leu K, Tran A, Pope W, Lai A, Nghiemphu P, Harris R, Woodworth D, Cloughesy T, Ellingson B, Pope W, Leu K, Chen W, Czernin J, Phelps M, Lai A, Nghiemphu P, Liau L, Cloughesy T, Ellingson B, Enzmann D, Pope W, Lai A, Nghiemphu P, Liau L, Cloughesy T, Eoli M, Di Stefano AL, Aquino D, Scotti A, Anghileri E, Cuppini L, Prodi E, Finocchiaro G, Bruzzone MG, Fujimoto K, Arakawa Y, Murata D, Nakamoto Y, Okada T, Miyamoto S, Galldiks N, Stoffels G, Filss C, Dunkl V, Rapp M, Sabel M, Ruge MI, Goldbrunner R, Shah NJ, Fink GR, Coenen HH, Langen KJ, Guha-Thakurta N, Langford L, Collet S, Valable S, Constans JM, Lechapt-Zalcman E, Roussel S, Delcroix N, Bernaudin M, Abbas A, Ibazizene E, Barre L, Derlon JM, Guillamo JS, Harris R, Bookheimer S, Cloughesy T, Kim H, Pope W, Yang K, Lai A, Nghiemphu P, Ellingson B, Huang R, Rahman R, Hamdan A, Kane C, Chen C, Norden A, Reardon D, Mukundan S, Wen P, Jafrani R, Zinn P, Colen R, Jafrani R, Zinn P, Colen R, Jancalek R, Bulik M, Kazda T, Jensen R, Salzman K, Kamson D, Lee T, Varadarajan K, Robinette N, Muzik O, Chakraborty P, Barger G, Mittal S, Juhasz C, Kamson D, Barger G, Robinette N, Muzik O, Chakraborty P, Kupsky W, Mittal S, Juhasz C, Kinoshita M, Sasayama T, Narita Y, Kawaguchi A, Yamashita F, Chiba Y, Kagawa N, Tanaka K, Kohmura E, Arita H, Okita Y, Ohno M, Miyakita Y, Shibui S, Hashimoto N, Yoshimine T, Ronan LK, Eskey C, Hampton T, Fadul C, LaMontagne P, Milchenko M, Sylvester P, Benzinger T, Marcus D, Fouke SJ, Lupo J, Bian W, Anwar M, Banerjee S, Hess C, Chang S, Nelson S, Mabray M, Sanchez L, Valles F, Barajas R, Rubenstein J, Cha S, Miyake K, Ogawa D, Hatakeyama T, Kawai N, Tamiya T, Mori K, Ishikura R, Tomogane Y, Ando K, Izumoto S, Nelson S, Lieberman F, Lupo J, Viziri S, Nabors LB, Crane J, Wen P, Cote A, Peereboom D, Wen Q, Cloughesy T, Robins HI, Fisher J, Desideri S, Grossman S, Ye X, Blakeley J, Nonaka M, Nakajima S, Shofuda T, Kanemura Y, Nowosielski M, Wiestler B, Gobel G, Hutterer M, Schlemmer H, Stockhammer G, Wick W, Bendszus M, Radbruch A, Perreault S, Yeom K, Ramaswamy V, Shih D, Remke M, Luu B, Schubert S, Fisher P, Partap S, Vogel H, Poussaint TY, Taylor M, Cho YJ, Piludu F, Pace A, Fabi A, Anelli V, Villani V, Carapella C, Marzi S, Vidiri A, Pungavkar S, Tanawde P, Epari S, Patkar D, Lawande M, Moiyadi A, Gupta T, Jalali R, Rahman R, Akgoz A, You H, Hamdan A, Seethamraju R, Wen P, Young G, Rao A, Rao G, Flanders A, Ghosh P, Rao G, Martinez J, Rao A, Roh TH, Kim EH, Chang JH, Kushnirsky M, Katz J, Knisely J, Schulder M, Steinklein J, Rosen L, Warshall C, Nguyen V, Tiwari P, Rogers L, Wolansky L, Sloan A, Barnholtz-Sloan J, Tatsauka C, Cohen M, Madabhushi A, Rachinger W, Thon N, Haug A, Schuller U, Schichor C, Tonn JC, Tran A, Lai A, Li S, Pope W, Teixeira S, Harris R, Woodworth D, Nghiemphu P, Cloughesy T, Ellingson B, Villanueva-Meyer J, Barajas R, Mabray M, Barani I, Chen W, Shankaranarayanan A, Koon P, Cha S, Wen Q, Elkhaled A, Essock-Burns E, Molinaro A, Phillips J, Chang S, Cha S, Nelson S, Wolf D, Ye X, Lim M, Zhu H, Wang M, Quinones-Hinojosa A, Weingart J, Olivi A, van Zijl P, Laterra J, Zhou J, Blakeley J, Zakaria R, Das K, Sluming V, Bhojak M, Walker C, Jenkinson MD, (Tiger) Yuan S, Tao R, Yang G, Chen Z, Mu D, Zhao S, Fu Z, Li W, Yu J. RADIOLOGY. Neuro Oncol 2013; 15:iii191-iii205. [PMCID: PMC3823904 DOI: 10.1093/neuonc/not189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Doleželová H, Hynková L, Pospíšil P, Kazda T, Slampa P, Coupková I, Siková I, Fardus P, Svoboda T, Garčic J, Vrzal M, Selingerová I, Horová I. [Therapeutic results of the treatment brain tumors using radiosurgery and stereotactic radiotherapy]. Klin Onkol 2012; 25:445-451. [PMID: 23301647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND We reviewed the results of treatment of patients treated with stereotactic radiation methods in our department. MATERIAL AND METHODS Patients with primary brain tumor or brain metastases underwent CT and MR examination. Then they were treated on X knife in the Clinic of Radiation Oncology in Masaryk Memorial Cancer Institute Brno. RESULTS A total of 101 patients with primary brain tumors underwent stereotactic treatment. These were mainly meningeomas, high-grade gliomas and low-grade gliomas. In 37% of cases patients underwent reiradiation. Stereotactic radiosurgery was applied with a median dose of 18 Gy. Hypofrakcionated stereotactic radiotherapy was applied at a doses of mostly 5 × 5 Gy. Total toxicity of treatment was low: 8% acute G1, late toxicity in 1% of cases. In the whole group achieved partial remission 10 patients (9,9%). One patient had complete remission (0,99%). It was a diagnosis of pituitary adenoma. In 69 patients stable disease was observed (68,3%) and 12 patients had progression (11,88%). Median follow up the entire group was 22,4 months. A statistically significant difference in survival was found in the comparison of different diagnosis, patients who received prior radiotherapy and patients without previous irradiation. Another significant difference in survival was observed compared to patients treated with stereotactic treatment or stereotactic radiosurgery and the size of the tumor volume larger / smaller 10 cm3. In the group with brain metastases there were 56 patients. In 10% of cases preceded radiotherapy neurosurgical performance. Twenty four patients underwent cranial irradiation entire dose of 30 Gy. Median stereotactic radiosurgery dose was 20 Gy, the application of stereotactic treatment were mostly of 5 × 5 Gy. G1 acute toxicity occurred in 2 patients (3.8%), grade G2 in one patient (1.9%). Late toxicity was observed in 2 patients (one G1 and one G3). Complete remission was achieved in 4 patients (7.1%), partial remission in 27 patients (48.2%), stable disease in 9 (16.1%) and progression was observed in 5 patients (8.9%). Median follow-up the entire group was 13.3 months. There was no statistically significant difference in survival with respect to gender, age, KI, irradiation of the whole brain or type of treatment used. Patients who have undergone neurosurgery prior to irradiation had no difference in survival compared to patients without surgery, but the time to progression was significantly longer (p = 0.016). CONCLUSION Stereotactic radiation methods are part of modern radiotherapy. Their indication is necessary to consider with regard to the benefit of the patient. Quality equipment radiotherapy department and trained personnel are the condition for their correct using.
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Burkon P, Slampa P, Kazda T, Slavik M, Prochazka T, Vrzal M. Stereotactic body radiation therapy for colorectal cancer liver metastases; early results. Klin Onkol 2012; 25 Suppl 2:2S93-2S97. [PMID: 23581024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Stereotactic body radiation therapy (SBRT) is well feasible and effective method for treatment of colorectal cancer liver metastases. MATERIALS AND METHODS From September 2009 to December 2011, 11 patients with 15 inoperable liver metastases of colorectal cancer were treated by SBRT using Varian Clinac iX linear accelerator. We treated 6 men and 5 women of age from 51 to 81 years (median 68). SBRT doses ranged from 40 to 56 Gy (median 54 Gy) and were administered in 3 to 8 fractions. RESULTS Local control rates at 2, 4, 6, 9 and 12 months after completion of SBRT were 100%, 91%, 91%, 67% and 50%, respectively. Disease progression-free survival rates at 2, 4, 6, 9 and 12 months were 82%, 82%, 64%, 50% and 50%, respectively. Median follow-up was 15 months. No severe side effects were attributed to the therapy. CONCLUSION Our study assessed the feasibility of SBRT in selected group of patients with 1 to 3 colorectal cancer liver metastases with no other treatment option. We achieved excellent local control and very moderate acute and late side effects. Distant metastases were the most common recurrence form after SBRT. SBRT demonstrated excellent local control and resulted in occasional long-term survivors without any serious side effects of therapy.
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Affiliation(s)
- P Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno and Faculty of medicine, Masaryk University, Brno, Czech Republic.
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Svoboda M, Navrátil J, Fabian P, Palácová M, Gombošová J, Slámová L, Princ D, Syptáková B, Kudláček A, Bílek O, Pospíšil P, Kazda T, Grell P, Poprach A, Selingerová I, Nenutil R, Juráček J, Héžová R, Slabý O, Vyzula R. [Triple-negative breast cancer: analysis of patients diagnosed and/or treated at the Masaryk Memorial Cancer Institute between 2004 and 2009]. Klin Onkol 2012; 25:188-198. [PMID: 22724568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) represents a heterogeneous group of breast cancers that do not express ER-α, PgR and Her-2 receptors. Generally, these tumors are aggressive and more common in younger women, in which an association of TNBC with mutations in the BRCA1 gene was documented. The aim of our study was to create a representative group of patients with TNBC, which could be analyzed and the data gathered to build basic epidemiological, molecular and clinical characteristics of Czech patients with TNBC. PATIENTS AND METHODS We performed basic clinical-pathologic correlations in a group of 335 patients diagnosed and/or treated for TNBC at the Masaryk Memorial Cancer Institute between 2004 and 2009. We also performed immunohistochemical examination of expression of cytokeratin 5/6, cytokeratin 14 and EGFR to identify the basal-like subset of TNBC. RESULTS The median age of patients with TNBC was 56 years, range 25-88 years. A total of 9.25% of TNBC cases were diagnosed in patients under the age of 34, and another 15.22% of cases were in the age group of 35 to 44 years. 'Basal-like' carcinomas accounted for 75% of TNBC. We confirmed the aggressive nature of this disease: in the follow-up period we observed a relapse in 25% of patients: 55% of deaths due to disease progression occured within 2 years after diagnosis of the disease. Treatment strategies include chemotherapy, in most cases (88.4%). Chemotherapy was mostly based on regimens with anthracyclines or in combination with taxanes. The most important negative prognostic factors in relation to OS (disease specific OS) were: higher clinical stage (p < 0.0001), pN - positive status (p < 0.0001), high proliferative activity (as measured by Ki-67, cut-off 50%, HR = 0.4740, p = 0.0411) and positive expression of CK5/6 (HR = 0.4274, p = 0.0338). In relation to DFS, the negative prognostic significance was found for these factors: higher clinical stage (p < 0.0001), pN positive status (p < 0.0001), high proliferative activity (Ki-67, cut-off 50%, HR = 0.04993, p = 0.0240). DFS was longer in patients with a higher number of applied cycles of anthracycline-based chemotherapy (> 4 cycles, HR = 1.7273, p = 0.0467). CONCLUSION TNBC is an aggressive form of breast cancer, which may occur in patients of all ages, but more frequently in younger patients. Only early detection of disease and intensive treatment gives a high chance of cure. Unfortunately, no reliable predictive factors have been identified so far. Better therapeutic results can be expected from targeted therapy.
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Affiliation(s)
- M Svoboda
- Klinika komplexní onkologické péče, MOÚ
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