The role of the nurse in supporting post-traumatic growth in cancer patients and their close onesFor nurses

Olga Klepáčková, Martina Černá

Onkologie. 2022:16(4):226-230 | DOI: 10.36290/xon.2022.043  

Part of the current trend to strengthen integrated and comprehensive care for cancer patients is to strive for quality provision of their psychosocial needs. In this regard, more attention is paid to the impact of the disease on the functioning of the family as a whole and the needs of the patient and his loved ones. The issue of post-traumatic stress and growth concerning cancer is one of the areas in which a deeper understanding of simulations into practice can bring noticeable positive changes to the lives of patients and their loved ones and consequently bring benefits to all other stakeholders. Nurses represent an important link in the care and...

Rapid, deep and long lasting respnose to cetuximabCase report

Marián Liberko, Renata Soumarová

Onkologie. 2022:16(4):222-225 | DOI: 10.36290/xon.2022.042  

We describe a case-report of patient with massively disseminated mCRC to the liver with incipient signs of liver failure. Combined treatment with use of chemotherapy + anti-EGFR antibody lead to rapid, deep and long lasting response.

Trifluridine/tipiracil treatment in a patient with mucinous metastatic colorectal carcinomaCase report

Jiří Švec, Vladimír Kořínek, Renata Soumarová

Onkologie. 2022:16(4):216-221 | DOI: 10.36290/xon.2022.041  

Systemic oncologic treatment of metastatic colorectal carcinoma is currently based on chemotherapy in combination with targeted therapy based on the presence of activating mutations in the EGFR-RAS-RAF pathway, regardless of the histological subgroup of the tumor. In this case report, we describe a patient with a mucinous variant of colorectal carcinoma who responded very well to trifluridine/tipiracil in the third-line treatment. We briefly review the basic features of this histologic subtype, which accounts for 5-15% of all cases, is characterized by high extracellular mucin production, and is associated with a poorer prognosis related to a lower...

Treatment of a senior patient with cardiovascular comorbidities using checkpoint inhibitor therapyCase report

Kristián Hrušák, Tomáš Büchler, Jana Votrubová

Onkologie. 2022:16(4):212-214 | DOI: 10.36290/xon.2022.040  

This case study describes a long-term survival of a senior patient with metastatic kidney cancer and a number of cardiovascular comorbidities after a treatment by checkpoint inhibitors.

New treatment options for cutaneous T-cell lymphomasReview articles

Miriam Ladická

Onkologie. 2022:16(4):206-211 | DOI: 10.36290/xon.2022.039  

Review article summarizing new treatment options for cutaneous T-cell lymphomas.

News in treatment of gastrointestinal cancerReview articles

Kateřina Šašková

Onkologie. 2022:16(4):200-205 | DOI: 10.36290/xon.2022.038  

Following article summarizes selected, important, recently evaluated studies that will influence guidelines for treatment of gastrointestinal tumours - oesophageal cancer, gastroesophageal junction tumours, colorectal carcinoma, hepatobiliary cancer and gastrointestinal stromal tumours. In particular, Phase III studies related to the clinical part of oncology were selected.

Genetic testing in ovarian cancerReview articles

Jana Soukupová

Onkologie. 2022:16(4):195-199 | DOI: 10.36290/xon.2022.037  

Ovarian cancer is a disease with a significant hereditary component. Hereditary mutations in clinically relevant genes (including BRCA1 and BRCA2) are found in one in four patients in our population. Therefore, genetic testing for germline mutations is indicated for every patient with this disease (epithelial ovarian, fallopian tube or peritoneal cancer), regardless of the histopathological type of ovarian tumour or age at diagnosis. Nearly one in five patients (up to 20% of all patients with ovarian cancer) carries a pathogenic germline mutation in the BRCA1 and BRCA2 genes. Genetic testing has prognostic and predictive...

Specifics of cancer care for LGBTQI+ patientsMain topic

Zdeňka Pechačová, Radka Lohynská, Tereza Drbohlavová

Onkologie. 2022:16(4):189-194  

Background: In Europe, approximately 6% of people identify as LGBTQI+ and approximately 1% as transgender. This community remains less visible to the healthcare system, as sexual orientation and gender identity (SOGI) data is not structurally collected and patients are often reluctant to disclose SOGI to healthcare professionals due to fear of discrimination. Therefore, many of the specific needs of these patients remain unmet. Specific risks, including cancer risk factors, can be identified in LGBTQI+ subgroups. Purpose: The aim of this contribution is to summarise the specifics of cancer care for LGBTQI+ patients. This includes risk...

Supportive Care for Patients with Head and Neck Cancer during RadiotherapyMain topic

Petra Holečková

Onkologie. 2022:16(4):184-188 | DOI: 10.36290/xon.2022.035  

Supportive care plays an important role in cancer therapy. Good supportive care helps to control toxicity, maintain or improve quality of life and lenghten overall survival. Supportive care includes anagotherapy, therapy of nauzea, vomitus diarhoea, infectious complications, therapy of hematotoxicity, dyspnoea, fatigue and in radiotherapy of haed and neck cancers also therapy of skin toxicity and oral mucositis. Nutritional care is very important part of supportive care, because malnutrition is an independent prognostic and predictive factor. The artice concludes recomendation not only of two working groups of Czech oncology society - for supportive...

Pathologic fractures as a late complication of postoperative radiotherapy of soft tissue sarcomas of the lower extremitiesMain topic

Tereza Drbohlavová, Zdeňka Pechačová, Jan Lesenský, Radka Lohynská

Onkologie. 2022:16(4):177-183 | DOI: 10.36290/xon.2022.034  

Background: The mainstay of treatment of soft tissue sarcomas is surgery, in indicated cases followed by postoperative radiotherapy. Pathological fracture resulting from late toxicity of radiotherapy, especially in the lower extremities, significantly affects the patient's quality of life. The aim of this report is to analyze the frequency of pathological fractures in patients treated with adjuvant radiotherapy. Patients and methods: During the period 2007-2018 forty one patients were treated with adjuvant radiotherapy at the Institute of Radiation Oncology of Bulovka University Hospital (IRO BUH). All patients underwent 3D conformal radiotherapy....

Internal clinical audit at a radiotherapy department - our own experienceMain topic

Zdeňka Pechačová, Jarmila Suková, Radka Lohynská, Lucie Štelciková, Zuzana Šebelová, Marie Vosyková, Pavla Nováková, Tereza Drbohlavová

Onkologie. 2022:16(4):173-176 | DOI: 10.36290/xon.2022.033  

Background: An audit is an independent documented process for checking the accuracy of the activities performed and is intended to increase the quality of provided healthcare and more efficient working procedures. There are two basic types of audits: internal, which is performed within the organization, and external, performed by an accredited company. The purpose of the audit is to provide independent feedback, verify the functionality of the system and analyse risks. Procedures for quality assurance in radiotherapy, including audits, are delineated by international and Czech legislation. The specific form of internal clinical audit is defined within...

Impact of comorbidities and lifestyle factors on treatment outcomes in patients with laryngeal cancer - a single institution retrospective reviewMain topic

Zdeňka Pechačová, Radka Lohynská, Miloslav Pála, Tereza Drbohlavová

Onkologie. 2022:16(4):166-172 | DOI: 10.36290/xon.2022.032  

Background: Surgical approaches that preserve laryngeal function are the mainstay of treatment for early-stage laryngeal cancer. In advanced stages, total laryngectomy is associated with a significant mutilation of the patient and (chemo)radiotherapy may provide an organ-preserving treatment. The aim of this report is to present the influence of comorbidities and lifestyle factors on treatment outcomes in a cohort of patients irradiated for laryngeal cancer at the Institute of Radiation Oncology of Bulovka University Hospital (IRO FNB), Prague, Czech Republic, in the years 2009-2018. Patients and methods: During this period, curative radiotherapy for...

Imunoterapie v méně častých indikacíchEditorial

MUDr. Jindřich Kopecký, Ph.D.

Onkologie. 2022:16(3):111 | DOI: 10.36290/xon.2022.031  

Chemoresistant myeloid sarcoma responding to salvage therapy with combined azacitidine and venetoclaxCase report

Miloslava Hisemová, Václav Ptáčník

Onkologie. 2022:16(3):155-158 | DOI: 10.36290/xon.2022.030  

The case report presents a female patient with multifocal myeloid sarcoma in the soft tissues, skin, and lymph nodes in the presence of concomitant myelodysplastic syndrome in whom two series of inpatient induction chemotherapy (high-dose cyta­rabine and mitoxantrone, i.e. the HAM protocol) failed to induce complete remission and resolution of extramedullary lesions. Combined outpatient treatment with azacitidine (a hypomethylating agent) and venetoclax (a Bcl-2 inhibitor) has been shown to have a potential to overcome tumour chemoresistance.

Severe secondary immune thrombocytopenia in a patient with chronic lymphocytic leukemiaCase report

Dominika Écsiová, Pavel Vodárek, Petra Rozsívalová, Filip Vrbacký, Kateřina Hrochová, Petr Hoffmann, Pavel Žák, Lukáš Smolej, Martin Šimkovič

Onkologie. 2022:16(3):151-154 | DOI: 10.36290/xon.2022.029  

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in Euro-American population and is often complicated by autoimmune cytopenias. In patients with anemia and thrombocytopenia, one of the possible causes is autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), and rarely pure red cell aplasia (PRCA). For the last few years, oral targeted inhibitors have been available for the treatment of CLL. The use of these molecules has significantly improved the prognosis of patients. Our case report describes the successful administration of thrombopoietin receptor agonist eltrombopag before targeted therapy with the Bruton tyrosine...

The issue of assessing the degree of dependence for the purposes of the care allowance for people with cancerReview articles

Libuše Čeledová, Rostislav Čevela

Onkologie. 2022:16(3):142-150 | DOI: 10.36290/xon.2022.028  

The authors clearly acquaint with the issue of assessing the degree of addiction, especially for people with cancer. The fragmentation of the care allowance process, the long processing times, even beyond the statutory deadlines, require a rapid change in the whole process, including the dependency assessment system. The authors propose to prepare new criteria for assessing dependence for the purposes of the care allowance inspired by the German system, to leave the assessment to the competence of assessment assistants at the regional branches of the Labor Office and to concentrate the whole management process under the Labor Office of the Czech Republic.

Immunotherapy in non-melanoma skin cancerMain topic

Miroslav Důra

Onkologie. 2022:16(3):134-141 | DOI: 10.36290/xon.2022.027  

Antitumoral immunotherapy is a golden standard in modern therapy in the increasing number of metastatic or locally advanced solid tumors. This treatment achieves significant and long-lasting treatment responses and reveals prolongation of progression free survival, overall survival, together with quality-of-life improvement. In the field of malignant cutaneous tumors, the therapeutic effect of immunotherapy is well-known in metastatic melanoma, in which the immunotherapy became a standard of the modern systemic treatment. The effect of the immunotherapeutic drugs was also established in metastatic and locally advanced non-melanoma skin cancer, namely...

Immunotherapy for the treatment of metastatic uveal melanomaMain topic

Ján Podhorec, Radek Lakomý, Alexandr Poprach, Igor Kiss

Onkologie. 2022:16(3):130-133 | DOI: 10.36290/xon.2022.026  

Uveal melanoma is the most common ocular malignancy. Despite its common origin in melanocytes, it differs fundamentally from cutaneous melanoma in its biological properties. Metastatic disease has a poor prognosis. It is a chemoresistant disease and the effect of immunotherapy, which marked a breakthrough in the treatment of cutaneous melanoma, is unsatisfactory in uveal melanoma. A clear shift in treatment is tebentafusp, which belongs to the group immTAC (immuno-mobilizing monoclonal TCR against cancer). Tebentafusp was the first drug to demonstrate prolongation of overall survival in a recently published phase III study. The possibilities and benefits...

Immunotherapy for patients with pancreatic adenocarcinomaMain topic

Stanislav John

Onkologie. 2022:16(3):127-129 | DOI: 10.36290/xon.2022.025  

Pancreatic ductal adenocarcinoma has been long count to one of the most severe diagnosis in solid oncology. Increasing incidence and persistently high mortality lead to intensive research into this highly malignant disease. Chemotherapy, in specific cases supplemented with radiotherapy, is still the most effective treatment modality. The use of targeted therapy is also limited. As with other cancers, great hopes are placed in the renaissance of immunotherapy. The following article aims to provide a brief summary of the knowledge so far gained on the treatment of patients with PDAC by modulating the immune system and outlining new possibilities and...

Immunotherapy in upper gastrointestinal malignanciesMain topic

Miroslav Žiaran

Onkologie. 2022:16(3):123-126 | DOI: 10.36290/xon.2022.024  

Since the introduction of the anti-CTLA4 antibody ipilimumab in 2011 in the palliative treatment of malignant melanoma with previously unprecedented results, immunotherapy has become firmly established in the treatment of a number of cancers. Given the encouraging results of immunotherapy in the first-line and the second-line setting compared to standard of care, checkpoint inhibitors (anti-CTLA-4, anti-PD1, anti-PD-L1) begin to permeate into the adjuvant setting or within the tumor-agnostic approach, including upper gastrointestinal (GI) tumors. This review offers a summary of clinical trials investigating immunotherapy with checkpoint inhibitors...

News in immunotherapy of dMMR/MSI-H CRCMain topic

Marián Liberko, Renata Soumarová

Onkologie. 2022:16(3):118-122 | DOI: 10.36290/xon.2022.023  

Colorectal carcinoma is a heterogenous disease. Advancements in molecular biology of tumors lead to definition of specific subtypes. For many of them targeted therapy known as personalized (precision) treatment is available. dMMR/MSI-H CRC is one of these subtypes, where immunotherapy leads to significant and long lasting response. This review summarizes current options in treatment of dMMR/MSI-H CRC.

New potential checkpoint inhibitors in cancer therapyMain topic

Jindřich Kopecký

Onkologie. 2022:16(3):115-117 | DOI: 10.36290/xon.2022.022  

Over the last decade, immunotherapy has been established as part of various treatment algorithms across solid tumors. And although the use of checkpoint inhibitors like anti-PD-1 and anti-CTLA-4 receptors and anti-PD-1 ligand provides a therapeutic benefit, there is still a large group of patients in whom this therapy is not effective. Further research is currently underway to find other possible ways to make improvements. In the following article, we present less known checkpoint inhibitors which have therapeutic potential in the near future.

Nivolumab as second-line therapy for patients with advanced NSCLC (non-small cell lung cancer)Case report

Marie Drösslerová

Onkologie. 2022:16(2):104-106 | DOI: 10.36290/xon.2022.020  

Immunotherapy has become integrated into the standard treatment of patients with advanced NSCLC. There are available diffe­rent immunotherapy drugs, one of them is nivolumab. Nivolumab in combination with ipilimumab and 2 cycles of platinum-based chemotherapy is indicated for the first-line treatment of metastatic NSCLC. Nivolumab as monotherapy is indicated for the treatment of locally advanced or metastatic NSCLC after prior chemotherapy in adults. In both cases, nivolumab is for patients without EGFR mutation or ALK translocation. We present a clinical case of a 73 years old patient successfully treated...

Disability assessment for people with cancerReview articles

Rostislav Čevela, Libuše Čeledová

Onkologie. 2022:16(2):95-103 | DOI: 10.36290/xon.2022.019  

The article clearly introduces the issue of assessing disability in cancer patients. The authors express the opinion that the current assessment criteria for assessing disability in oncological diseases correspond to the standards of modern medicine. For other groups of diseases, however, they propose to update the assessment criteria according to the suggestions of the professional medical public. At the end of the article, on the contrary, in connection with the results of the MLSA public contract from 2016, they propose to legislatively amend the form and requirements of the disability decision and the disability report. Optimization of the medical...

Therapeutic possibilities of selected gastrointestinal complications in oncology patientsReview articles

Kateřina Šašková

Onkologie. 2022:16(2):91-94 | DOI: 10.36290/xon.2022.018  

Nausea, vomitus, diarrhea and constipation rank among the most frequent gastrointestinal complications in oncology patients. It is necessary to prevent nausea and vomitus before the therapy administration. Convenient antiemetics are chosen depending on emetogenic potential of ongoing therapeutic regimen. Main trouble in diarrhea treatment is its various etiology, even sometimes the etiology is multifactorial. Therefore it is very important to make a good differential diagnosis and to focus on patient´s anamnesis: past surgeries, ongoing therapy and patient´s regimen and diet. Constipation in oncology patient is very commonly caused by his medication,...

Local therapy of uveal melanomasReview articles

Johana Glezgová

Onkologie. 2022:16(2):87-90 | DOI: 10.36290/xon.2022.017  

Uveal melanomas are the most common primary intraocular malignity in adults and accounting for about 5-10% of all melanomas. The choise of treatment for uveal melanomas depends on the place of growth of melanoma, its spread, size, visual acuity and the general condition of the patient. Options for small melanomas are transpupillary thermotherapy, for small amelanotic melanomas photodynamic therapy and for small and medium tumors brachytherapy or for large tumors teletherapy. Surgical solutions is offered mainly for melanomas of the iris and ciliary body and endoresection is performed in selected cases for large tumors with not too wide a base. For...

Vaccination of cancer patientsReview articles

Šárka Rumlarová, Lucie Siráková, Petr Šmahel, Josef Chmelař, Roman Chlíbek

Onkologie. 2022:16(2):81-86 | DOI: 10.36290/xon.2022.016  

Cancer patients have an increased risk of infectious complications, the main cause of which is an immunodeficiency condition caused by the cancer itself and its therapy. Therefore, it is appropriate to protect patients by vaccination, in particular vaccination against influenza, pneumococcal infections and covid-19. Appropriately chosen vaccines and the right timing of their administration can as a part of supportive care contribute to the success of cancer therapy.

Physician´s role in communication with the patient and his family in the context of pediatric oncology
What does the involvement of palliative care physician look like in the care of children with cancer  who undergo curative treatment?Main topic

Lucie Hrdličková

Onkologie. 2022:16(2):77-80 | DOI: 10.36290/xon.2022.015  

Early integration of palliative care is understood to be the standard of care in pediatric oncology in children with unfavorable prognosis according to the international guidelines. Early integration of palliative care improves effective communication with the patient and the parents, helps information delivery to the family and facilitates advance care planning. Palliative care team is addressed and involved while the patient undergoes curative anticancer treatment. Physician´s role in early phase of palliative care is mostly focused on communication, because other palliative care physician´s competencies, such as discussion of expected scenarios...

Social work in children with cancer admitted to Pediatric palliative care team in University Motol Hospital
Case report of a boy with advanced rhabdomyosarcoma with lung and central nervous system metastasisMain topic

Hana Benešová, Denisa Makešová, Lucie Hrdličková

Onkologie. 2022:16(2):74-76 | DOI: 10.36290/xon.2022.014  

The article describes the importance of social work in pediatric palliative care and the specific tools used. It offers an insight into this area of palliative medicine and also a brief overview of the social support available for children and their families, such as financial charity support and health and social services, which can increase the quality of life of the whole family. The article introduces a case report of an adolescent boy with cancer.

Parallel role of a nurse in pediatric oncology setting and palliative care team
Professional and competency challenges in the care of children with cancerMain topic

Aneta Balvínová, Markéta Mičková, Lenka Nováková, Lucie Hrdličková

Onkologie. 2022:16(2):71-73 | DOI: 10.36290/xon.2022.013  

In palliative care team in hospital setting, role of a nurse is essential. Nurse coordinates palliative care delivered by the team, she provides contact with the sick child and his family during the anticancer treatment and she visits the patient during the regular rounds at the ward. As a part of her role, she seeks for new patients and their families who may profit from palliative care. The article introduces a role of a nurse working both in pediatric oncology and palliative care team, benefits of such working engagement and highlights the importance of a well-functioning team.