Radioterapie dnes: mezi klinickou praxí a vědeckým pokrokem

MUDr. Miloslav Pála, Ph.D., MBA

Onkologie. 2025:19(4):179

Influence of selected factors on the development of radiotherapy toxicity in patients with laryngeal cancer

Zdeňka Pechačová, Tomáš Kořínek, Radka Lohynská, Tereza Drbohlavová, Miloslav Pála

Onkologie. 2025:19(4):182-188 | DOI: 10.36290/xon.2025.034

Background: Radiotherapy is one of the most effective modalities of cancer treatment, but its application is burdened by the risk of toxicity. The risk of adverse effects can be modelled using radiobiological analyses. Patients and methods: In a cohort of 189 patients treated with (chemo)radiotherapy for laryngeal cancer at the Institute of Radiation Oncology, First Faculty of Medicine, Charles University in Prague and Bulovka University Hospital between 2009-2018, data were analysed using radiobiological tools based on the Lyman-Kutcher-Burman model with the use of artificial intelligence. Results: Significant influence of patient-side characteristics,...

Impact of selected nutritional factors on patients with esophageal and gastroesophageal junction cancers

Karolína Votavová, Zdeňka Pechačová, Radka Lohynská, Tereza Drbohlavová, Miloslav Pála

Onkologie. 2025:19(4):189-193 | DOI: 10.36290/xon.2025.035

Malignant tumors of the esophagus and gastroesophageal junction are among the cancers with a poor prognosis. A long-term increase in incidence has been observed, particularly in adenocarcinomas, while mortality has remained relatively stable. The five-year survival rate, regardless of diseases stage, is only around 20 % (1). Between 2009 and 2018, a total of 138 patients with malignant tumors of the esophagus or gastroesophageal junction were treated at the Department of Radiation Oncology, Bulovka University Hospital. In these patients, the influence of individual factors on survival was retrospectively analyzed. Sarcopenia and hypoalbuminemia were...

Radiotherapy for soft tissue sarcomas of the head and neck

Tereza Drbohlavová

Onkologie. 2025:19(4):194-197 | DOI: 10.36290/xon.2025.036

Head and neck soft tissue sarcomas (HNSTS) represent a rare group of mesenchymal tumors. Their histological heterogeneity, distinct biological behavior, and the anatomical complexity of the region make their management particularly challenging. Surgical resection remains the cornerstone of curative treatment; however, due to the frequent difficulty in achieving negative margins, radiotherapy (RT) is an essential component of multimodal therapy. Adjuvant RT improves local control (LC), especially in cases with positive or close margins. The neoadjuvant approach may offer advantages in terms of lower dose, smaller irradiated volumes, and reduced late...

Head and Neck carcinoma reirradiation. Does it make sense? - Experience and results of the treatment between years 2003 and 2023 from Radiation oncology dep., Universty Hospital Bulovka, Prague

Antonín Vrána, Tereza Drbohlavová, Jana Vránová, Miloslav Pála

Onkologie. 2025:19(4):198-203 | DOI: 10.36290/xon.2025.037

Head and neck cancer reirradiation represents difficult chapter in treatment of these malignancies. The biggest challenge is to reach narrow therapeutic window and to help our patients and not to harm them. But often it is the only therapeutic modality which we can use to achieve long term control of oncological disease. Especially in cases where we cannot use salvage surgical resection. Patients with reccurent head and neck cancer in very good performance status can be also treated by systemic therapy (chemoptherapy and in reasonable cases by immunotherapy). In certain cases where the volume and localization of reccurrence allow Stereotactic body...

Pitfalls in larynx-preservation for laryngeal and hypopharyngeal cancer

Miloslav Pála

Onkologie. 2025:19(4):204-207 | DOI: 10.36290/xon.2025.038

A larynx preservation protocol is recommended for locally advanced laryngeal and hypopharyngeal carcinomas as an evidence-based treatment option. However, a re-evaluation of the current literature raises questions about whether there is indeed reliable evidence to support larynx preservation for locally advanced T4 tumors. According to both the results of retrospective studies and our cohort study, we can recommend a larynx preservation strategy in patients with limited tumor volume and minimal cartilage infiltration. Patients with T4 tumors who reject total laryngectomy should be informed that opting for larynx preservation with primary conservative...

Trifluridine-tipiracil + bevacizumab in the treatment of metastatic colorectal cancer - from the SUNLIGHT trial to routine clinical practice

Marián Liberko, Renata Soumarová

Onkologie. 2025:19(4):208-213 | DOI: 10.36290/xon.2025.039

The aim of this article is to provide an overview of the data with regard to the combination trifluridine-tipiracil + bevacizumab in the third line treatment of metastatic disease. The main results of the SUNLIGHT registration study, the current meta-analysis and a subgroup analysis of the SUNLIGHT study are presented. At the same time, data from real-world clinical practice are discussed, including results from our own cohort of patients treated with this combination.

Durvalumab in the treatment of limited-stage SCLC

Juraj Kultan

Onkologie. 2025:19(4):214-218 | DOI: 10.36290/xon.2025.040

Despite general advances in the systemic treatment of solid malignant tumours in recent decades, limited-stage small cell lung cancer has remained one of the few in which novel types of anticancer therapy (immunotherapy or targeted therapy with tyrosine kinase inhibitors) had not been implemented into the therapeutic algorithm. This was logically associated with a limited progress in the parameters of overall survival, speci­fically the 5-year survival rates of patients. Currently, we are witnessing the introduction of adjuvant immunotherapy after chemoradiotherapy in real-world clinical practice for limited-stage small cell lung cancer. This option...

Treatment of patients with myelofibrosis and anemia

Natália Podstavková

Onkologie. 2025:19(4):219-222 | DOI: 10.36290/xon.2025.041

Myelofibrosis has the highest symptom burden and frequency of hepatosplenomegaly from all myeloproliferative neoplasms. In addition patients with MF often develop anemia with varying degrees of severity, which can be related to myelofibrosis pathogenesis or develop as a result of therapy with JAK2 inhibitors. Although symptoms can be similar between the two anemia types, only anemia as a result of myelofibrosis itself is negative prognostic factor of reduced overall survival. JAK2 inhibitors differ in their effect on anemia from one another.

Brachytherapy for prostate cancer in 2025: Present landscape, key challenges, and perspectives for the future

Miroslav Hodek, Denisa Pohanková, Petr Paluska, Linda Kašaová, Jakub Grepl, Jiří Petera, Igor Sirák

Onkologie. 2025:19(4):223-229 | DOI: 10.36290/xon.2025.042

Introduction: Brachytherapy is one of the key curative modalities in the treatment of localized prostate cancer, enabling the delivery of high-dose ionizing radiation directly into the prostate tissue while relatively sparing surrounding organs. Over the past three decades, significant technological and clinical advances have reshaped its indications, technical implementation, and outcomes. Nevertheless, the utilization of brachytherapy remains uneven across countries and institutions, and the method still faces multiple challenges, both technical and organizational. Objective: The aim of this review article is to provide a comprehensive and up-to-date...

Biliary tract cancer

Marián Liberko, Renata Soumarová

Onkologie. 2025:19(4):230-236 | DOI: 10.36290/xon.2025.043

Biliary tract tumors represent a serious medical problem due to the high mortality rate. In the case of early stages, after potentially curative surgery, patients are indicated for postoperative therapy to reduce the risk of recurrence and prolong survival. Most patients with biliary tract cancer are diagnosed at locoregionally advanced and/or metastatic stages. The standard of care for these patients is systemic therapy, now combined with immunotherapy. Increasing knowledge of the molecular biology of this disease allows tailored treatment to be selected in a proportion of patients according to the presence of a specific targetable alteration. This...

Stereotactic radiotherapy with the CyberKnife System: An Effective and safe modality in the treatment of recurrent squamous cell carcinoma of the head and neck

Tomáš Blažek, Jana Jackaninová, Zuzana Čermáková, Lukáš Knybel, Jan Štembírek, Jakub Cvek

Onkologie. 2025:19(4):237-242 | DOI: 10.36290/xon.2025.044

Treatment of locoregional recurrences of squamous cell carcinoma of the head and neck represents a challenge in clinical practice requiring advanced therapeutic approaches and multidisciplinary collaboration. The optimal treatment strategy has a significant impact on the prognosis of patient survival. Choosing the appropriate local treatment modality can lead to excellent results with curative effect. However, careful patient selection and evaluation of key factors such as size and location of recurrence, primary treatment characteristics and time to recurrence are important. Modern external beam radiotherapy techniques, such as stereotactic radiotherapy...

Trifluridin/tipiracil and bevacizumab as a treatment after rapid progression of rectal carcinoma after total neoadjuvant therapy and first line of systemic therapy

Aleš Langer

Onkologie. 2025:19(4):243-245 | DOI: 10.36290/xon.2025.045

This case report describes 63-year-old women with rectal adenocarcinoma. She was treated with initial curative goal with total neoadjuvant approach. She received short course of radiotherapy followed by mFOLFOX6 chemotherapy. This was followed radical surgery. We found an early local relapse and our patient underwent an amputation of the rectum. Eight months later we observed metastatic stage and we began the first line of systemic therapy cetuximab + FOLFIRI. The effect was short-lived and the disease progressed after six cycles of therapy. Our patient then started combined therapy trifluridin/tipiracil and bevacizumab with an ongoing effect after...

Toxicity of combined immunotherapy with ipilimumab and nivolumab in advanced renal cell carcinoma

Michaela Tkadlecová, Luboš Mastný

Onkologie. 2025:19(4):246-249 | DOI: 10.36290/xon.2025.046

Systemic Antitumor Immunotherapy (IT) is now the cornerstone of systemic treatment for advanced renal carcinoma. Despite the significant benefits of this therapy, its associated toxicity must not be overlooked. This case report discusses a 51-year-old patient with generalized clear cell renal carcinoma. The patient was indicated for immunotherapy in combination with a monoclonal antibody against the CTLA-4 antigen (ipilimumab at a dose of 1 mg/kg) and an antibody against the programmed cell death receptor PD-1 (nivolumab 3 mg/kg).Initially, the treatment was well tolerated, but after four cycles of the mentioned combination, the patient developed grade...

Hypomagnezemie jako nejčastější nediagnostikovaná iontová nerovnováha v klinické praxi a jak ji řešit

MUDr. Jiří Havel, MSc.

Onkologie. 2025:19(4):250-254