Social and psychological effects on disease courseSupplementum

prof. MUDr. Zdeněk Adam, CSc., PhDr. Mgr. Jeroným Klimeš, Ph.D., doc. MUDr. Zdeněk Boleloucký, CSc.

Onkologie 2022: 16(Suppl.B): 103-110 | DOI: 10.36290/xon.2022.059  

The diagnosis of a malignant disease fundamentally changes the identity of the patient, turning a healthy person into a sick one. Numerous studies have aimed to analyse how an individual’s future destiny is influenced by whether they live alone or in a firmly established cohabitation relationship or in a marriage. Most analyses dealing with this issue concluded that living in a couple relationship was a positive prognostic factor. On the other hand, developing a malignant disease at a young age increases the risk of couple breakup. It is also stress that the patient is exposed to during treatment that has a negative impact on the course of the...

Waldenström´s macroglobulinemia, overview of clinical symptoms, and therapy and our experience with ibrutinib therapySupplementum

prof. MUDr. Zdeněk Adam, CSc., MUDr. Ing. David Zeman, Ph.D., prof. MUDr. Luděk Pour, Ph.D., prof. MUDr. Marta Krejčí, Ph.D., MUDr. Martin Krejčí, doc. MUDr. Zdeněk Řehák, Ph.D., MUDr. Renata Koukalová, Ph.D., MUDr. Viera Sandecká, Ph.D., MUDr. Martin Štork, Ph.D., MUDr. Gabriela Romanová, MUDr. Zuzana Adamová, Ph.D., MUDr. Zdeněk Král, CSc.

Onkologie 2022: 16(Suppl.B): 83-102 | DOI: 10.36290/xon.2022.058  

Waldenström macroglobulinemia (WM) is a lymphoplasmacytic lymphoma with immunoglobulin M (IgM) monoclonal protein. Clinical features include anemia, thrombocytopenia, hepatosplenomegaly, lymphadenopathy, in advanced disease hyperviscosity, kryoglobulinemia, B-symptoms and in rare cases the disease can infiltrate CNS (Big-Neel syndrom) or lungs. Presence of IgM monoclonal protein associated with clonal lymphoplasmacytic cells in bone marrow confirms the diagnosis. The L265P mutation in MYD88 is detectable in more than 90% of patients and is found in the majority of IgM MGUS patients. Not all patients who fulfill WM criteria require therapy; these patients...

Review of daratumumab efficacy in all monoclonal gammopathies and other diseases and our experience with daratumumab, lenalidomide and dexamethasone therapy in 74 patientsSupplementum

prof. MUDr. Zdeněk Adam, CSc., prof. MUDr. Luděk Pour, Ph.D., prof. MUDr. Marta Krejčí, Ph.D., MUDr. Ing. David Zeman, Ph.D., doc. MUDr. Zdeněk Řehák, Ph.D., MUDr. Renata Koukalová, Ph.D., MUDr. Viera Sandecká, Ph.D., MUDr. Martin Štork, Ph.D., MUDr. Zdeněk Král, CSc.

Onkologie 2022: 16(Suppl.B): 61-82 | DOI: 10.36290/xon.2022.057  

Multiple myeloma (MM) is a hematological malignancy characterized by renal insufficiency, bone lesions, anaemia, and hypercalcemia. In this modern era of medicine, even with the development of drugs like immunomodulatory drugs (IMiDs) and proteasome inhibitors (PI), the treatment of MM prevails as a challenge. However, even after the attainment of total remission, relapse of MM and disease progression is frequent. That is why there is an urgent requirement to develop novel monoclonal antibody drugs. The latest drugs for the treatment of relapsed and refractory MM (RRMM) approved by the Food and Drug Administration (FDA) is daratumumab. In this article,...

Necrobiotic xanthogranuloma and monoclonal gammopathySupplementum

MUDr. Viera Sandecká, Ph.D.

Onkologie 2022: 16(Suppl.B): 57-60 | DOI: 10.36290/xon.2022.056  

Necrobiotic xanthogranuloma is a progressive and destructive disease associated with paraproteinemia, multiple organ involvement, and an increased risk of developing lymphoproliferative malignancy, such as multiple myeloma, chronic lymphocytic leukemia, or Hodgkin and non-Hodgkin lymphoma. The present article describes a complicated case of a female patient diagnosed with multiple myeloma and necrobiotic xanthogranuloma whose serious health complications were not typical for the diagnosis of multiple myeloma. A thorough diagnostic algorithm and multidisciplinary cooperation of various experts led to the definitive diagnosis. The article also includes...

Monoclonal gammopathy of undetermined signifikace (MGUS and monoclonal gammopathy of clinical significance (MGCS)Supplementum

prof. MUDr. Zdeněk Adam, CSc., MUDr. Ing. David Zeman, Ph.D., prof. MUDr. Luděk Pour, Ph.D., prof. MUDr. Marta Krejčí, Ph.D., MUDr. Soňa Štěpánková, Ph.D., prof. MUDr. Vladimír Vašků, Ph.D., doc. MUDr. Eva Vlčková, Ph.D., doc. MUDr. Zdeněk Řehák, Ph.D., MUDr. Renata Koukalová, Ph.D., MUDr. Gabriela Romanová, MUDr. Zuzana Adamová, Ph.D., MUDr. Zdeněk Král, CSc., MUDr. Viera Sandecká, Ph.D.

Onkologie 2022: 16(Suppl.B): 33-56  

Monoclonal gammopathy of undetermined significance (MGUS) is characterized by the presence of a monoclonal protein (M-protein) without evidence of multiple myeloma (MM), Waldenstrom‘s macroglobulinemia (WM), amyloidosis (AL), or a related plasma cell proliferative disorder. MGUS is found in approximately 3 % of persons > 70 years of age and in about 1 % of those > 50 years old. At Mayo Clinic from 1960 through 1994, the risk of progression was 1 % per year. This risk of progression continued even after  of a stable M-protein. The risk for developing MM, WM, or AL was increased 25-fold, 46-fold, and 8.4-fold,...

Plasma cell neoplasms, multiple myeloma, solitary plasmocytoma a plasma cell leukemia. Clinical symptoms, diagnostic criteria and therapySupplementum

prof. MUDr. Zdeněk Adam, CSc., prof. MUDr. Luděk Pour, Ph.D., prof. MUDr. Marta Krejčí, Ph.D., MUDr. Ing. David Zeman, Ph.D., doc. MUDr. Eva Vlčková, Ph.D., doc. MUDr. Milan Krtička, Ph.D., prof. MUDr. Pavel Šlampa, CSc., MUDr. Soňa Štěpánková, Ph.D., MUDr. Gabriela Romanová, MUDr. Zuzana Adamová, Ph.D., doc. MUDr. Jiří Vaníček, Ph.D., doc. MUDr. Zdeněk Řehák, Ph.D., MUDr. Renata Koukalová, Ph.D., doc. MUDr. Veronika Matušková, Ph.D., MUDr. Zdeněk Král, CSc., MUDr. Libor Červinek, Ph.D., MUDr. Viera Sandecká, Ph.D.

Onkologie 2022: 16(Suppl.B): 7-32 | DOI: 10.36290/xon.2022.054  

According the WHO classification of malignant hematologic diseases the group plasma cell neoplasms consists of multiple myeloma, solitary plasmocytoma and plasmocytic leukemia. Diagnosis of multiple myeloma requires ≥10% clonal bone marrow plasma cells or a biopsy proven plasmacytoma plus evidence of one or more multiple myeloma defining events (MDE) namely CRAB (hypercalcemia, renal failure, anemia, or lytic bone lesions) features felt related to the plasma cell disorder, bone marrow clonal plasmacytosis ≥60%, serum involved/uninvolved free light chain (FLC) ratio ≥100 (provided involved FLC is ≥100 mg/L), or >1 focal lesion...

Monoclonal gammopathy of undetermined signifikace (MGUS and monoclonal gammopathy of clinical significance (MGCS)Supplementum

prof. MUDr. Zdeněk Adam, CSc., MUDr. Ing. David Zeman, Ph.D., prof. MUDr. Luděk Pour, Ph.D., prof. MUDr. Marta Krejčí, Ph.D., MUDr. Soňa Štěpánková, Ph.D., prof. MUDr. Vladimír Vašků, Ph.D., doc. MUDr. Eva Vlčková, Ph.D., doc. MUDr. Zdeněk Řehák, Ph.D., MUDr. Renata Koukalová, Ph.D., MUDr. Gabriela Romanová, MUDr. Zuzana Adamová, Ph.D., MUDr. Zdeněk Král, CSc., MUDr. Viera Sandecká, Ph.D.

Onkologie 2022: 16(Suppl.B): 33-56 | DOI: 10.36290/xon.2022.055  

Monoclonal gammopathy of undetermined significance (MGUS) is characterized by the presence of a monoclonal protein (M-protein) without evidence of multiple myeloma (MM), Waldenstrom‘s macroglobulinemia (WM), amyloidosis (AL), or a related plasma cell proliferative disorder. MGUS is found in approximately 3 % of persons > 70 years of age and in about 1 % of those > 50 years old. At Mayo Clinic from 1960 through 1994, the risk of progression was 1 % per year. This risk of progression continued even after  of a stable M-protein. The risk for developing MM, WM, or AL was increased 25-fold, 46-fold, and 8.4-fold,...

Podpůrná a paliativní léčba v onkologii Editorial

doc. MUDr. Pavel Fadrus, Ph.D.

Onkologie. 2022:16(6):283  

Health service of the First Czechoslovak Republic and its approach to oncological diseasesFrom the history of medicine

Andrej Tóth, Valérie Tóthová, Jan Hladík, Jakub Drábek, Lukáš Novotný, Martin Červený

Onkologie. 2022:16(6):337-342  

Changes in the composition of human society and the living conditions in which people live are causing changes in the social meaning of illness. In a certain period, specific serious health problems come to the fore and the health service has to focus on them more intensively to bring them under control and gradually eliminate them. However, other diseases will then take their place, which will once again trigger the attention of public authorities, who must focus on tackling the next major challenge to population health. The First Czechoslovak Republic provided an opportunity for a general political, social and socio-economic modernisation of society,...

Schwannomatosis of the spinal canal - case report of father and daughterCase report

Sabina Muzikářová, Martin Smrčka

Onkologie. 2022:16(6):332-336 | DOI: 10.36290/xon.2022.070  

This case report describes the case of two patients of Neurosurgical clinic of the University Hospital Brno - father and daughter with diagnosed neurofibromatosis of spinal canal. Patient Father is under observation at our clinic since 2009, for MRI findings of multiple schwannomas in cervical, thoracic and lumbar spine. Patient was indicated for multiple neurosurgical interventions. While undergoing outpatient follow-ups, new schwannomas were discovered along the spinal canal. A total of five surgeries were performed over 13 years leading to removal of the tumours and relief of the original clinical symptomatology. The patient's daughter with an identical...

Lung cancer screening and the Population pilot program for the early detection of lung cancer in the Czech RepublicReview articles

Hynek Mírka, Martina Koziar Vašáková, Ivana Čierná-Peterová, Jana Skřičková, Petr Šonka, Bohumil Seifert, Marcela Koudelková, Karel Hejduk, Ondřej Ngo, Renata Chloupková, Ondřej Májek

Onkologie. 2022:16(6):327-331 | DOI: 10.36290/xon.2022.069  

Lung cancer is one of the most common and most serious oncological diseases. Despite progress in diagnostic methods, most tumors are detected in advanced stages associated with an unfavorable prognosis. One of the possibilities to change this situation is the search for early stages of tumors in the asymptomatic risk population using low-dose computed tomography. The benefit of this approach has been confirmed by clinical studies (the largest are NLST and NELSON). It is currently recommended by a number of professional societies. The introduction of lung cancer screening is also part of the Europe´s Beating Cancer Plan and the National Oncology Plan...

Malignant ureteral obstructionReview articles

Vladimír Šámal, Igor Richter, Vít Paldus, Jan Mečl, Jiří Špaček

Onkologie. 2022:16(6):322-325 | DOI: 10.36290/xon.2022.068  

Malignant ureteral obstruction (MUO) can be caused by ureteral cancer but also by extramural obstruction by a number of tumors located in the pelvis and abdominal cavity. Generally, these are late-stage tumors that cause obstruction of the ureters by their own tumor or nodal process. Untreated MUO eventually leads to hydronephrosis, obstructive uropathy, manifestations of uremia, and subsequently death. Historically, the approach to MUO has evolved from open surgical methods burdened with high morbidity to minimally invasive methods. Potential solutions to MUO include the insertion of ureteral stents or percutaneous nephrostomy. While both methods...

Advances in the treatment of anal squamous cell cancerReview articles

Radka Lohynská, Filip Pazdírek, Jana Čejková

Onkologie. 2022:16(6):317-321 | DOI: 10.36290/xon.2022.067  

A specialized multidisciplinary team (MDT) plays a crucial role in optimizing the treatment procedure for anal squamous cell cancer (ASCC). Very early stages are treated only with surgery (<5%), more advanced stages with chemoradiotherapy (CHRT). New regimens of radical CHRT and palliative chemotherapy (CHT) and immunotherapy have shown improved survival. Modern techniques of radiotherapy (RT) lead to a significant reduction in the toxicity of the treatment and enable ambulatory administration of the treatment.

Testicular tumors and radiotherapy - minireviewReview articles

Jiří Petera, Denisa Pohanková, Jan Jansa

Onkologie. 2022:16(6):312-316 | DOI: 10.36290/xon.2022.066  

Radiotherapy was till 1960s-1970s of the last century principal part of treatment of both seminomas and nonseminomas. Recognition of relative radiorezistence of nonseminoma limited radiotherapy indication to seminomas only. Further development led to the revisions of indication of adjuvant treatment, to reduction of radiotherapy volumes and doses and to use of chemotherapy as alternative to irradiation. Contemporary radiotherapy has a role in the treatment in stage I-II seminoma in patients not suitable for surveillance or chemotherapy. Three-dimensional conformal radiotherapy is a preferred technique.

Palliative care in patients with primary brain tumoursMain topic

Pavel Fadrus, Ondřej Sláma, Ludmila Hynková, Tomáš Kazda, Radek Lakomý, Lucie Světláková, Markéta Hanušová, Irena Henzlová, Regina Slámová, Soňa Kryštofová, Marek Sova, Vilém Juráň, Miloš Duba, Eduard Neuman, Pavel Šlampa, Martin Smrčka, Václav Vybíhal

Onkologie. 2022:16(6):305-311 | DOI: 10.36290/xon.2022.065  

Palliative care (PP) is active multidisciplinary care, which is not primarily aimed at prolonging life or treatment of cancer patients, but at alleviating the symptoms of the underlying disease and thereby improving their quality of life. PP should already be provided during complex oncological care and be an integral part of it. This trend also applies to neuro-oncology patients with a primary brain tumour. Patients with a primary brain tumour do not belong to the most numerous group of oncology patients, but given that, in addition to general symptoms of oncological disease, they are also affected by a progressive neurological disease, they are a...

Radiotherapy options in palliative careMain topic

Ludmila Hynková, Miroslava Sláviková, Ondřej Sláma, Tomáš Kazda, Pavel Fadrus, Pavel Šlampa

Onkologie. 2022:16(6):299-304 | DOI: 10.36290/xon.2022.064  

Almost one third of adult cancer patients undergo palliative radiation therapy. This review article provides basic information on the methods radiotherapy uses to affect the most common symptoms in patients undergoing palliative treatment. It also focuses on the toxicity and effectiveness of radiotherapy.

Home hospice care for cancer patientsMain topic

Regina Slámová

Onkologie. 2022:16(6):296-298 | DOI: 10.36290/xon.2022.063  

Mobile specialised palliative care ("home hospice") is a form of specialised palliative care in the patient's home environment in the mode of so-called home hospitalization with permanent availability of a doctor and a nurse (24/7/365 availability). The basic characteristics of MSPP activities and the indication criteria for admission of a cancer patient are presented in this article.

The inpatient hospice role in palliative careMain topic

Lucie Světláková, Miroslav Světlák, Markéta Hanušová

Onkologie. 2022:16(6):293-295 | DOI: 10.36290/xon.2022.062  

Currently, hospice is defined as a medical facility that provides a comprehensive health and social care to patients in the terminal phase of the disease and their relatives, to help them to live as fully and comfortably as possible, while the duration of care usually does not exceed three months. Hospice care is a key pillar of palliative care and is an essential part of modern medicine. Knowledge of the functioning, possibilities and organization of hospice care is a necessary condition for its early and adequate indication in suitable patients. The acceptance of the vision and mission of hospice care by doctors of all specialities also represents...

Some notes on the management of palliative care in cancer centres in accordance with the 2030 National Oncology Plan in the Czech RepublicMain topic

Ondřej Sláma

Onkologie. 2022:16(6):287-291 | DOI: 10.36290/xon.2022.061  

Cancer patients with advanced disease need comprehensive supportive and palliative care during and after cancer treatment. The provision of this care represents a challenge for Czech oncology, which has not yet been systematically addressed. In our article, we present the basic goals and objectives for the development of palliative care in cancer centres as outlined in the 2030 National Oncology Plan of the Czech Republic 2030 (NOP), and provide a more detailed description of the different forms of specialised palliative care referred to in the NOP: palliative medicine outpatient clinics, palliative care consultation teams, and palliative care inpatient...

Deset let činnosti pražského Protonového centraEditorial

prof. MUDr. Jitka Abrahámová, DrSc.

Onkologie. 2022:16(5):235  

Nursing management of fatigue in cancer patientsFor nurses

Lenka Machálková, Lenka Štureková, Šárka Ročková

Onkologie. 2022:16(5):276-278 | DOI: 10.36290/xon.2022.053  

Fatigue related to oncological disease is a very serious symptom not only for the patients themselves, but also for the nursing staff. The prevalence is reported to be up to 96%. The information presented is focused on the possibilities of early detection of fatigue, fatigue assessment and planning of adequate interventions that are in accordance with the competences of the general nurse. To assess the perception of fatigue, a subjective assessment by the patient is indispensable. The general nurse can use assessment tools to objectify the patient's fatigue status. Open communication between the patient and the staff is a necessity for planning further...

Pharmacological profile - trastuzumab emtansinePharmacological profile

Jiří Slíva

Onkologie. 2022:16(5):273-275 | DOI: 10.36290/xon.2022.052  

Trastuzumab emtansine, a conjugate of trastuzumab with a DM1 microtubule inhibitor, provides direct intracellular delivery of the potent cytotoxin DM1 to HER2-overexpressing cells while retaining trastuzumab activity. It is currently approved in the Czech Republic for the treatment of patients with early or metastatic breast cancer. This article briefly describes its basic pharmacological properties and clinical experience with registered medicinal product Kadcyla®.

Locally advanced pancreatic cancer - a complete morpho-metabolic response of primary tumor after non-surgical treatmentReview articles

Marián Liberko, Renata Soumarová

Onkologie. 2022:16(5):268-272 | DOI: 10.36290/xon.2022.051  

We describe a case-report of patient with locally advanced pancreatic cancer. Chemotherapy (gemcitabine + nab-paclitaxel) followed by chemoradiotherapy lead to long-term disease control and survival lasting 26 months. However radiotherapy in the treatment of locally advanced pancreatic cancer is controversial. There are studies which aims to identify subgroup of patients, in which adding locoregional therapy in the treatment of locally advanced pancreatic will lead in improvement in survival.

Avelumab plus axitinib combination in treating metastatic renal cell carcinomaReview articles

Igor Richter, Adrián Hraboš, Josef Dvořák, Sofya Al-Samsan, Jiří Bartoš, Vladimír Šámal

Onkologie. 2022:16(5):263-266 | DOI: 10.36290/xon.2022.050  

The incidence of renal cell carcinoma (RCC) in the Czech Republic is among the highest worldwide. In the treatment of metastatic RCC (mRCC), even methods of local therapy can be considered individually; however, systemic cancer therapy has a dominant role and has recently made significant advances. Targeted therapy and immunotherapy consisting in the inhibition of PD1 (programmed cell death protein 1) receptor and its ligand (PD-L1) or in CTLA4 (cytotoxic T-lymphocyte antigen 4) inhibition have reached the greatest importance. In the case of mRCC, similar to other cancer diseases, the choice of first-line treatment is of major importance. The current...

Feasibility, dosimetric evaluation and early results of proton radiotherapy in the treatment of bilateral breast cancerMain topic

Alexandra Haas, Michal Andrlík, Sarah Falah Abass Alhamami, Andrea Pásztorová

Onkologie. 2022:16(5):258-262 | DOI: 10.36290/xon.2022.049  

Primary synchronously detected bilateral breast cancer (PSBBC) is a relatively rare clinical entity. The adjuvant radiotherapy is a standard part of non-metastatic breast cancer treatment. Despite the fact that this treatment is irreplaceable, it bears the burden of side effects, which may lead to an unacceptable increase of cardiovascular risk and risk of developing secondary malignancy in some patients. Cardiovascular complications have been shown to reduce the survival in breast cancer patients, and therefore efforts should be made to reduce the dose to the heart and cardiac structure as much as possible. Due to its dosimetric advantages, proton...

Proton therapy in the treatment of meningiomasMain topic

Stěpan Vinakurau, Renata Emmerová

Onkologie. 2022:16(5):254-257 | DOI: 10.36290/xon.2022.048  

Meningiomas are among the most common tumors of the brain and spinal cord. Invasive (neurosurgical) and non-invasive (radiothera­py) methods are used in the treatment. Radiotherapy can be delivered by stereotactic or non-stereotactic methods, with photons or particles (protons or carbon ions). Proton therapy uses the physical properties of protons to spare non-target brain tissues.

Hypofractionated proton radiotherapy for prostate cancer: six-year dataMain topic

Jiří Kubeš, Pavel Vítek, Vladimír Vondráček

Onkologie. 2022:16(5):250-253 | DOI: 10.36290/xon.2022.047  

Objective: The aim of the paper is an analysis of the six-year biochemical disease-free survival (bDFS) rate and of the late toxicity profile in patients with prostate cancer treated with ultra-hypofractionated proton radiotherapy. Material and methods: Between March 2013 and February 2016, a total of 275 patients were treated with ultra-hypofractionated proton radiotherapy (36.25 GyE/5 fractions). The median follow-up time is 69 months. There were 118 (42.9%) patients with low and 157 (57.1%) patients with intermediate-risk prostate cancer. Fifty (18.2%) patients received neoadjuvant hormone therapy, while none had adjuvant hormone therapy. Results:...

Dose escalation in the treatment of NSCLC with proton radiotherapyMain topic

Alexandra Haas

Onkologie. 2022:16(5):246-249 | DOI: 10.36290/xon.2022.046  

Radiation therapy is an essential component of treatment for early stages and also for locally advanced non-small cell lung cancer (NSCLC), but can be technically challenging because of the proximity of lung tumors to nearby critical organs. Using proton therapy offers the potential for further advantages because of the unique depth-dose characteristics of the particles (Bragg peak), which can allow higher dose escalation to tumors with greater sparing of normal tissues, with the ultimate goal of improving local tumor control and survival while preserving quality of life by reducing treatment-related toxicity.

What are the benefits of proton beam therapy for esophageal cancer?Main topic

Pavel Vítek, Jiří Kubeš

Onkologie. 2022:16(5):239-245 | DOI: 10.36290/xon.2022.045  

The treatment strategy for esophageal cancer evolves continuously, with radiotherapy having an irreplaceable position. The growing availability of proton beam therapy raises the timely question of its real benefit. The answer is substantially complicated by a number of circumstances - multiple areas of indication for use, inconsistent dosage strategies, little evidence of dose escalation benefit, and nonuniform determination of target volumes. The dosimetric advantages of proton beam therapy over conventional photon radiotherapy are clear and convincing. To date, the issue of demonstrating dosimetric advantages in the clinical practice has largely...

Radioterapie v méně častých indikacíchEditorial

MUDr. Miloslav Pála, Ph.D., MBA

Onkologie. 2022:16(4):163