Oncology, 2010, issue 1

Editorial

Jak pečovat o pacienta, který nemá domov?

MUDr. Libor Kvapil

Onkologie. 2010:4(1):3

Main topic

GIST - slovo úvodem

Zdeněk Linke

Onkologie. 2010:4(1):8

Surgical treatment of gastrointestinal stromal tumours

Martin Oliverius, Martin Varga, Eva Honsová

Onkologie. 2010:4(1):9-12

Gastrointestinal stromal tumours (GISTs) are the most common gastrointestinal mesenchymal tumours with an incidence of about 7–19 cases per one million population. They occur in the whole gastrointestinal tract; the predilection sites include the stomach (65 %), small intestine (25 %), large intestine and rectum (5–10 %) and rarely the oesophagus and other sites (5 %). The incidence in the Czech Republic is not exactly known but it is estimated to be 300–350 new cases per year. The treatment is primarily surgical. Unlike malignant epithelial GIT tumours that are very likely to metastasize and require, in addition to being...

Pathological diagnostics of gastrointestinal stromal tumor

Ondřej Daum, Radek Šíma, Michal Michal

Onkologie. 2010:4(1):13-17

Gastrointestinal stromal tumor is the most frequent mesenchymal tumor of the alimentary tract, currently being defined as a tumor composed of spindle and/or epithelioid cells presumably differentiating towards interstitial cells of Cajal. The most common location of gastrointestinal stromal tumor is stomach followed by other sites of gastrointestinal tract. Occasional sites of occurrence are mesenterium, omentum, retroperitoneum, gallbladder, urinary bladder, pancreas and vagina. Light microscopic examination of slides stained with haematoxylin and eosin is highly reliable in most cases. Immunohistochemical investigation relies on expression...

Treatment of gastrointestinal stromal tumours

Zdeněk Linke, Jana Prausová

Onkologie. 2010:4(1):18-23

The article deals with possibilities of gastrointestinal stromal tumour therapy – one of the first solid tumour, whose chemical and radiation treatment was completely displaced by biologic treatment. Imatinib mesylát represents primary target treatment of progressed inoperable gastrointestinal stromal tumour. Except overview of clinical studies and treatment results the article responses to controversial questions – initial imatinib dosage, predictive factors, which cal lead to standards primary dosage escalation, question of treatment continuation after complete remission. The article also refers to others possibilities continuation...

Review articles

Biological therapy of seniors

Mária Wagnerová

Onkologie. 2010:4(1):24-28

More than 50 % of cases of cancer are diagnosed in patients older than age 65. Elderly patients with cancer often present with medical and physiological challenges that make the selection of their optimal treatment daunting. Unfortunately as a result, these patients are often undertreated. Elderly are often excluded from participation in clinical trials and receive untested or inadeguate treatment. Targeted therapy, characterized by a low toxicity profile, are potential treatment option for elderly patients. The key of successful management is to define appropriate goals (cure or palliation) based on the natural history and extent of disease,...

The position of neoadjuvant treatment in livermetastatic colorectal carcinoma

Petr Kysela

Onkologie. 2010:4(1):28-31

A multimodal tretmant in patients with resectable liver-metastatic colorectal carcinoma is highly required. However, suitable treatment combinations are not known yet as well as the position of neoadjuvant therapy. Current data: A non-defined group of patients exists that might profit from the neoadjuvant therapy (elevated CEA, synchronous metastases, metastases greater than 5 cm or with more than 2, patients with advanced stadium of primary tumours, with other molecular markers, likelihood of a difficult surgery with a higher blood loss, small future liver remnant, previous treatment). The neoadjuvant setting has not been proven superior...

Update on Erythropoiesis-Stimulating Agents and Clinical Trials in Oncology

Matti Aapro, Jerry L.Spivak

Onkologie. 2010:4(1):32-39

Anemia commonly occurs among cancer patients receiving chemotherapy. In these patients, erythropoiesisstimulating agents (ESAs) are effective in managing anemia but there is an increased risk for thrombovascular events. In more recent randomized clinical trials, there have been differing results regarding the impact of ESAs on overall survival and mortality. The balance between studies that show higher ESA-associated mortality and those that don’t show ESA-associated mortality is examined in this review. This review discusses where we stand today on anemia management in cancer patients. Preliminary results from a recent independent patient...

Antiangiogenic therapy in oncology

Peter Kružliak, Jana Benkovičová, Ján Šlapák

Onkologie. 2010:4(1):40-42

Antiangiogenic therapy currently represents one of the new exciting prospects in oncology. It is a treatment that is focused on suppression of the release of proangiogenic factors produced in the cell or directed against the receptors for angiogenic factors on endothelial cells. This paper explains the principles and current issues of antiangiogenic therapy.

Case report

Duplicity of primary brain tumours

Václav Vybíhal, George Hanoun, Marek Sova, Pavel Fadrus, Miloš Keřkovský

Onkologie. 2010:4(1):46-50

The authors present a case report of duplicity of primary brain tumours. It occurs very rarely with an incidence reported to be 1/1 000 000. A 69-year-old patient was diagnosed with a glioblastoma multiforme localized frontotemporally on the right which caused clinical symptomatology and with a clinically silent, small meningioma in the left pontocerebellar angle. The glioblastoma was removed subtotally using craniotomy and the small asymptomatic meningioma was left for observation.

Erlotinib in the treatment of metastatic pancreatic carcinoma - a single-center experience

Martin Šafanda, Martin Oliverius, Kristina Trsková

Onkologie. 2010:4(1):51-52

Pancreatic carcinoma has the poorest overall survival (OS) rate of any major cancer. The typical median OS for resectable disease is 12–22 months; for locally advanced 9–14 months; and for metastatic up to 8 months. Since 1997, when gemcitabin became the standard treatment in metastatic settings, only insignificant progress has been seen. The combination of gemcitabin with targeted therapy, a new modality in cancer treatment, has shown great potential.But the targeting of vascular endothelial growth factor (VEGFR) and epidermal growth factor receptor I (EGFR/HER1) with monoclonal antibodies has been a failure. Erlotinib (Tarceva®)...

Information

Zenith Meeting 2010

Zdeněk Mechl, Lenka Ostřížková

Onkologie. 2010:4(1):53-55

CME-certified 2010 ZENITH Meeting in Vienna effective balanced didactic presentations with many oportunities for participation through interactive, case-study-based workshops and panel discussions. The objectives of the meeting were to discuss the scientific radionale for the use of bisphophonates to achieve clinical anticancer benefits in patients with early breast cancer and discuss, if these benefits cancer be extened to patients with other cancer types and other topics. Discuss the role of current and emerging bone.targeted treatment options in the context of current standard of care for patients with cancer. This meeting was an oportunity...