Vitamin D and its clinical applicationsReview articles

Michal Kršek

Onkologie. 2025:19(3):144-151

The article reviews current knowledge about vitamin D from the clinical point of view. The basic facts about its forms, physiological effects and metabolism are summarized. From clinical point of view the article deals with the state of supply of vitamin D, vitamin D deficiency and its clinical signs, symptoms and therapy. In paragraphs devoted to the treatment the current knowledge about forms of vitamin D, their indication, doses and dosage regimens are summarized.

Febrile neutropeniaReview articles

Ondřej Lukáč, Lukáš Kohout

Onkologie. 2025:19(3):137-143 | DOI: 10.36290/xon.2025.027

Febrile neutropenia represents one of the most serious and common acute situations in oncology. It is defined as a condition in which a cancer patient's temperature rises above 38 °C for more than 1 hour or rises above 38 °C twice in 12 hours, and the neutrophil count is ≤ 0.5 × 10⁹/l or below 1.0 × 10⁹/l with a further decline expected. These infections tend to be very aggressive and unrestricted, and less frequent viral (e. g. CMV infections) or mycotic infections occur. They therefore represent a significant clinical challenge.

Looking back at the eight years of providing Mobile Specialized Palliative CareInformation

Monika Marková

Onkologie. 2025:19(3):134-136 | DOI: 10.36290/xon.2025.026

In this paper, I look back at the eight years since the moment that mobile hospices acquired their own expertise and the provision of their services, until then unanchored in the system, became a common reimbursed service. I will introduce the rules for the provision of Mobile Specialized Palliative Care services, address the myths that are still encountered when providing these services, and conclude by outlining the possible directions for the development of this young type of health service in one's own social environment.

The important role of existential distress in symptom managementMain topic

Pavla Navrátilová

Onkologie. 2025:19(3):131-133 | DOI: 10.36290/xon.2025.025

This case report describes the case of a patient in whom existential distress significantly contributed to the clinical symptoms of advanced cancer. It highlights the need for a comprehensive approach to assessing symptoms so that they can be treated correctly and in a targeted manner. It provides practical guidance on managing existential issues with the patient.

Anxiety, depression, and delirium in hospital palliative care - a brief overviewMain topic

Tereza Foretová, Miroslav Žiaran

Onkologie. 2025:19(3):124-130 | DOI: 10.36290/xon.2025.024

One of the fundamental objectives of palliative care is to ensure patient comfort and enhance quality of life in the context of incurable illness. While clinical attention has traditionally centred on the management of physical symptoms, the significance of psychological well-being should not be underestimated. Mental health constitutes an integral component of comprehensive palliative care, influencing the overall care trajectory. Anxiety, depression, and delirium represent the most prevalent psychiatric disorders encountered in palliative settings, each exerting a substantial impact on patients and their families. Despite their high prevalence, these...

Early integration of palliative care (not only) in oncologyMain topic

Miroslav Žiaran, Kateřina Nechvátalová

Onkologie. 2025:19(3):119-123 | DOI: 10.36290/xon.2025.023

Early integration of palliative care in oncology has gained traction for its potential to improve the quality of life of patients with cancer. This approach provides comprehensive support from the moment of diagnosis, addressing both physical and emotional needs alongside anticancer treatment. Available data highlight the advantages of this approach. Beyond enhancing quality of life, it also improves symptom management, reduces healthcare costs and, in some cases, extends overall survival. Despite these well-documented benefits of integrating palliative care, practical implementation remains significantly far behind. The reasons include low awareness...

Pokroky v léčbě uroteliálního karcinomu: Nové horizonty a výzvyEditorial

MUDr. Jindřich Kopecký, Ph.D.

Onkologie. 2025:19(2):67

Management of epitheloid inflammatory myofibroblastic sarcoma of pulmonary originCase report

Simona Laštíková, Michal Urda, Robert Vyšehradský, Tomáš Šišmiš

Onkologie. 2025:19(2):108-110 | DOI: 10.36290/xon.2025.022

Epitheloid inflammatory myofibroblastic sarcoma (EIMS) is a rare variant of the inflammatory myofibroblastic tumour (IMT). Unlike the classic IMT, EIMS typically occurs intra-abdominally and is characterized by an adverse prognosis due to its aggressive nature, high rate of recurrence, and metastatic potential. Histologically, it exhibits epitheloid morphology and a unique immunohistochemical profile, which allows to distinguish EIMS from other mesenchymal tumours, thus significantly contributing to diagnostic accuracy. Immunohistochemically, ALK (anaplastic lymphoma kinase) protein positivity is characteristic with perinuclear or membrane staining...

Complete remission of metastatic squamous esophageal carcinomaCase report

Marián Liberko, Renata Soumarová

Onkologie. 2025:19(2):104-107 | DOI: 10.36290/xon.2025.021

Metastatic esophageal cancer is a disease with an infaust prognosis, with a median survival of approximately 12 months. New treatment options using chemotherapy in combination with immunotherapy may lead to long-term disease control and, in a small percentage of patients, complete remission. This case report describes a patient with primary metastatic disease, where chemoimmunotherapy led to rapid resolution of clinical symptoms, improvement of clinical status and ultimately to induction of a durable complete remission of the disease.

Patient with primary metastasizing anorectal mucosal melanomaCase report

Linda Řandová, Ivana Krajsová, Miroslav Důra

Onkologie. 2025:19(2):100-103 | DOI: 10.36290/xon.2025.020

The presented case report describes the case of a patient with mucosal primary metastasizing malignant melanoma of the anorectum. Due to the synchronous generalization to the lymph nodes and lungs and therefore the impossibility of a curative surgical or radiotherapy solution, the patient was treated with several lines of systemic treatment. In accordance with guidelines and for BRAF negativity, combined immunotherapy with ipilimumab and nivolumab was indicated in the 1st line of treatment. Subsequently, due to repeated progression of the disease, the patient completed two more lines of conventional chemotherapy and then, regarding metastatic spread...

Venous access in oncology - the choice between PICC and portReview articles

Viktor Maňásek

Onkologie. 2025:19(2):91-99 | DOI: 10.36290/xon.2025.019

The choice of an adequate venous access in oncology is essential for an optimally mana­ged anticancer treatment, if parenteral administration is necessary. The treatment is usually longterm with the need to prefer to introduce such a venous access that offers the maximum benefits for the patient. It is not only a matter of safe introduction, taking into account the type and duration of the treatment, the patient's general condition, including comorbidities, and the quality of the venous system, but also a strategy for the care of the venous access device during its use. Education of the patient and his preferences are very important. In practice, we...

Radiotherapy as an organ-preserving approach in treating muscle-invasive bladder cancerMain topic

Martin Palkovský, Renata Soumarová

Onkologie. 2025:19(2):84-90 | DOI: 10.36290/xon.2025.018

Muscle-invasive bladder cancer (MIBC) has traditionally been treated with neoadjuvant chemotherapy (NAC) and radical cystectomy (RACE). Although trimodal therapy (TMT), involving maximal transurethral resection (TUR) and chemoradiotherapy (CRT), yields comparable results, it is not yet considered standard treatment. This paper analyses the results of recent studies and recommendations concerning TMT in the treatment of MIBC. Retrospective analyses suggest that TMT achieves metastasis-free survival (MFS) and disease-free survival (DFS) rates similar to those obtained by NAC with RACE. However, the lack of direct comparison of TMT and NAC plus RACE limits...

Neoadjuvant therapy of bladder cancersMain topic

Tomáš Büchler

Onkologie. 2025:19(2):80-82 | DOI: 10.36290/xon.2025.017

Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy with a high risk of metastases and recurrence. The standard treatment involves neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy, yet approximately 50 % of patients relapse within three years. Neoadjuvant chemotherapy improves overall survival (OS) and pathological complete response (pCR). Emerging treatment strategies include neoadjuvant immunotherapy, with phase II trials demonstrating increased pCR rates with pembrolizumab and atezolizumab. The recently published NIAGARA trial established that perioperative durvalumab combined with chemotherapy reduces disease...

Immunotherapy in the treatment of metastatic urothelial carcinomaMain topic

Martina Spisarová, Andrea Kopová

Onkologie. 2025:19(2):76-79 | DOI: 10.36290/xon.2025.016

Urothelial carcinoma is one of the most common cancers in its early stages. Oncologists, however, more frequently encounter patients with advanced disease. Unresec­table or metastatic urothelial carcinoma remains a significant therapeutic challenge. Traditional treatment has long relied on platinum-based chemotherapy. In recent years, this approach has evolved with the introduction of checkpoint inhibitors. A breakthrough came with combination immunotherapy regimens involving antibody-drug conjugates. The combination of pembrolizumab and enfortumab vedotin has redefined first-line treatment recommendations for urothelial carcinoma. Combination therapy...

Current options for adjuvant treatment of urothelial carcinomasMain topic

Jindřich Kopecký, Alexandr Poprach

Onkologie. 2025:19(2):69-75 | DOI: 10.36290/xon.2025.015

Urothelial carcinoma (UC) represents a significant oncological challenge with high mortality, particularly in advanced stages. Adjuvant therapy, whether chemotherapy or immunotherapy, plays a crucial role in reducing the risk of relapse and improving survival after radical surgery. This review summarises current knowledge on the use of adjuvant treatment in UC and upper tract urothelial carcinoma (UTUC), including its histological variants. The most established modality remains cisplatin-based chemotherapy, which has demonstrated benefits, particularly in patients at high risk of relapse (pT3-4, N+) without prior neoadjuvant chemotherapy. A major breakthrough...

Intersticiální brachyterapieEditorial

doc. MUDr. Igor Sirák, Ph.D.

Onkologie. 2025:19(1):3  

Trastuzumab deruxtecan u pacientů s předléčeným metastatickým nemalobuněčným karcinomem plic s HER2 (ERBB2) mutacíHeard at a congress

MUDr. Zuzana Zafarová

Onkologie. 2025:19(1):58-60  

Nové možnosti terčové léčby v kombinaci s chemoterapiíHeard at a congress

MUDr. Zuzana Zafarová

Onkologie. 2025:19(1):55-57  

Imunoonkologická léčba NSCLC napříč stadiiHeard at a congress

MUDr. Zuzana Zafarová

Onkologie. 2025:19(1):50-52  

Coping strategies during treatment and recovery among oncology patients engaged in patient groupsFor nurses

Olga Klepáčková, Milan Tomka

Onkologie. 2025:19(1):46-49 | DOI: 10.36290/xon.2025.011  

The research of individual patient coping strategies is a topic of interest in the current global trend of developing psycho-oncology and psychosocial support in oncology. Implementing knowledge in nursing care can support more effective planning and meeting patient needs in line with a holistic approach, which is central to modern person-centered care. This article presents the findings of a pilot study focused on coping strategies for difficult life situations during treatment and recovery among oncology patients engaged in patient groups within the context of nursing in oncology.

Pleomorphic dermal sarcomaCase report

Vladimír Bartoš, Dagmar Hurtová

Onkologie. 2025:19(1):42-45 | DOI: 10.36290/xon.2025.010  

Introduction: Pleomorphic dermal sarcoma (PDS) is a rare malignant mesenchymal tumor of the skin. It clinically and histogenetically shares similar features with atypical fibroxanthoma (AFX) and they are thought to represent the morphologic spectrum of one neoplasia. Case report: A 60-year-old man with a history of vocal cord carcinoma had observed an ulcerated skin tumor in the scalp growing for several months. It was removed by surgical excision. Histology revealed a solid mesenchymal tumor consisting of atypical cells population of epithelioid and histiocytoid appearance. At the base, it infiltrated the subcutaneous fat and extended into the deep...

Case report of a patient with a long-term effect trifludine/tipiracilCase report

Anna Nohejlová Medková

Onkologie. 2025:19(1):38-41 | DOI: 10.36290/xon.2025.009  

Colorectal cancer is among the most common malignancies in the Czech Republic. Over the past decades, significant advances in its treatment have been achieved, leading to prolonged overall survival of patients. In 2016, based on the results of the RECOURSE study, a new drug for pretreated patients - trifluridine/tipiracil (TAS-102), was approved. Compared to placebo, it prolongs overall survival without compromi­sing quality of life. We present the case of a patient who has experienced long-term benefits from this therapy.

Treatment options for KRAS G12C mutated metastatic colorectal cancerReview articles

Marián Liberko

Onkologie. 2025:19(1):33-36 | DOI: 10.36290/xon.2025.008  

Metastatic colorectal cancer is a heterogeneous disease where treatment is individually selected according to the knowledge of the molecular characteristics of the tumour. As the knowledge of the molecular biology of the disease increases, the number of potential targets for specific therapies increases. In recent years, KRAS G12C inhibitor therapy has become a new treatment option for patients with metastatic colorectal cancer with a proven KRAS G12C mutation. The aim of this article is to provide an overview of current treatment options for this entity.

Second-line therapy for KRAS-positive metastatic non-small cell lung cancerReview articles

Martin Svatoň

Onkologie. 2025:19(1):29-32 | DOI: 10.36290/xon.2025.007  

Non-small cell lung cancer (NSCLC) with a KRAS mutation is the most common type of lung tumour with a sensitive mutation. At the same time, KRAS mutation is associated with a poor prognosis for patients. Therefore, the outlook for longer survival of patients with KRAS-mutated metastatic NSCLC has not been good for a long time. However, the prognosis of these patients has changed dramatically in recent years. The possibility of immunotherapy treatment as well as targeted treatment using tyrosine kinase inhibitors for the KRAS G12C point mutation has increased prognosis of this patients. The article presents these option of targeted therapy for the second...

Interstitial brachytherapy in the treatment of uterine cervical cancerMain topic

Igor Sirák, Denisa Pohanková, Miroslav Hodek, Petr Paluska, Linda Kašaová, Jakub Grepl, Munachiso Onyedikachi Ndukwe, Ivan Práznovec, Martin Kopeček, Petra Bretová, Jiří Petera

Onkologie. 2025:19(1):25-28 | DOI: 10.36290/xon.2025.006  

The standard treatment for locally or regionally advanced cervical cancer is definitive chemoradiotherapy, which combines systemic cisplatin chemotherapy with external-beam radiotherapy followed by intracavitary, so-called uterovaginal brachytherapy. The current standard of brachytherapy for cervical cancer is MR-guided 4D-adaptive brachytherapy. Thanks to MR navigation, the current extent of residual tumor involvement and the coverage of target volumes by intracavitary application into the uterus is visible during each brachytherapy fraction. In more than a third of patients, however, it is impossible to cover the target structures with a therapeutic...

Care of patients undergoing interstitial brachytherapy from the nurse's perspectiveMain topic

Martina Šůnová, Igor Sirák, Denisa Pohanková, Miroslava Čapková, Miroslav Hodek

Onkologie. 2025:19(1):22-24 | DOI: 10.36290/xon.2025.005  

Brachytherapy is an advanced method of radiotherapy used in the treatment of cancer. It allows us to introduce a radioactive source directly into the tumour or in close proximity to it. This method allows radiation to be applied with minimal impact on surrounding healthy tissue and is used in the treatment of specific types of tumours. However, this method can also cause unwanted side effects, so it is important that the patient cooperates with the medical staff. Emphasis is placed on proper patient education about the care of the irradiated area and the plastic catheters. This article focuses on the role of the nurse in the care of patients undergoing...

Physical aspects of HDR interstitial brachytherapy planningMain topic

Petr Paluska

Onkologie. 2025:19(1):18-21 | DOI: 10.36290/xon.2025.004  

High dose rate brachytherapy is realized solely by automatic afterloading irradiators nowadays. The most common are intracavitary and interstitial applications. Cooperation between a physician and a physicist before insertion of applicators is a very important aspect. Changes of applicators' geometry are usually not possible afterwards. A range of imaging modalities can be used for brachytherapy planning. A physical parameters useful for quality assessment and optimization of the plans are presented in this article.

Accelerated partial radiotherapy of early breast cancer using perioperative interstitial HDR brachytherapyMain topic

Denisa Pohanková, Igor Sirák, Miroslav Hodek, Linda Kašaová, Martina Šůnová, Miroslava Čapková, Petr Paluska, Jakub Grepl, Jiří Petera

Onkologie. 2025:19(1):15-17 | DOI: 10.36290/xon.2025.003  

Accelerated partial breast irradiation (APBI) is a well-established technique for irradiating patients with early-stage breast cancer who meet the indication criteria. The perioperative insertion of brachytherapy catheters reduces the overall treatment time from several weeks to approximately 14 days and allows for catheter placement under direct visual control immediately after tumor removal. Thanks to screening programs and early-stage diagnosis, the number of patients eligible for this treatment continues to rise.

Interstitial HDR brachytherapy of penile cancerMain topic

Denisa Pohanková, Igor Sirák, Miroslav Hodek, Petr Paluska, Jakub Grepl, Linda Kašaová, Martina Šůnová, Miroslava Čapková, Jiří Petera

Onkologie. 2025:19(1):11-14 | DOI: 10.36290/xon.2025.002  

Interstitial high-dose rate brachytherapy (HDR BRT) is a promising treatment method for early-stage penile cancer, which in many cases serves as an alternative to primary surgical treatment. This technique allows for the preservation of the penis integrity in up to 80% of patients who would otherwise require radical surgery. As a result, patients experience not only a better quality of life but also significantly fewer post-treatment psychological issues. An important benefit is also the ability to maintain sexual function at a level comparable to that before the treatment.

Interstitial brachytherapy of head and neck tumorsMain topic

Miroslav Hodek, Denisa Pohanková, Petr Paluska, Martina Šůnová, Igor Sirák

Onkologie. 2025:19(1):6-10 | DOI: 10.36290/xon.2025.001  

Interstitial brachytherapy (BT) is an effective method for the treatment of head and neck tumours, especially as an adjunct to external beam radiotherapy (EBRT) and surgery, and in some cases as a stand-alone treatment. This method consists in the implantation of a radionuclide source directly into the tumour or the postoperative bed, allowing targeted radiation dosing with high local control and minimal damage to surrounding tissues. BT is most commonly used for tumours of the lips, tongue, floor of the mouth and buccal mucosa. The use of BT alone is suitable for early stages, while more advanced cases can be treated in combination with EBRT, when...