Oncology, 2009, issue 4

Editorial

Podpůrná péče jako integrální součást individualizované onkologické léčby

Petra Tesařová

Onkologie. 2009:3(4):207

Main topic

Dětská onkologie - slovo úvodem

prof. MUDr. Jaroslav Štěrba Ph.D

Onkologie. 2009:3(4):212

Mannose binding lectin in pediatric oncology patients

MUDr. Peter Múdry, Michal Kýr, Tomáš Freiberger, Jiří Jarkovský, prof. MUDr. Jaroslav Štěrba Ph.D, Jitka Chumchalová

Onkologie. 2009:3(4):214-218

Mannose binding lectin, a serum protein produced in liver as acute phase reactant, represents a substantial part of innate immune res ponse. Several polymorphisms in MBL encoding gene MBL-2 are known thus expressing MBL deficiency (MBLD). Well known are worse coursies of neonatal sepsis or infections in cystic fibrosis patients with MBLD. During last decade, attention is focused also to infections in oncology patients with chemotherapy induced immunodeficiency. The results are rather controversial. Further research is done on field of cancer ethiology in MBLD patients and some papers point an association of MBLD and several cancers. Infusion therapy...

Infusion - related acute reaction in patient receiving different forms of Amphotericin B

Renata Foralová, MUDr. Peter Múdry, Lenka Dubská, Michal Kýr, Stefan Weiler, Romuald Bellmann, Dalibor Valík, prof. MUDr. Jaroslav Štěrba Ph.D

Onkologie. 2009:3(4):219-222

The invasive mycotic infections belong to serious life- threatening diseases. The therapy using different forms of Amphotericin B (AmB) improved treatment outcomes for immunocompromised patients with invasive mycosis (1). Recently the mortality for invasive mycosis is lower then it was before AmB introduction (1), however the acute and even the late nephrotoxicity of AmB as well as the Infusion- related reaction (IRR) limit its use in clinical practice. The choice of AmB´s form and the adequate supportive care (hyperhydratation) can minimize the AmB´s nephrotoxicity (2). There was an endeavor to pre-medicate patients to minimize fevers, chills...

Renal toxicity of high cummulative doses of ifosfamide in patients with Ewing sarcoma/PNET

Lucia Kútniková, Michal Kýr, MUDr. Peter Múdry, Andrea Fabryová, MUDr. Tomáš Kepák, prof. MUDr. Jaroslav Štěrba Ph.D

Onkologie. 2009:3(4):224-226

Overall survival in pediatric oncology patients with Ewing sarcoma/primitive neuroectodermal tumor correlates with cumulative doses of alkylating agents. Especially high doses of ifosfamide, one of those alkylating agents, induce renal impairments that are caused by its toxic metabolites. Renal toxicity in patients suffering from ES/PNET is the subject of interest mainly due to the need for many concomitant nephrotoxic drugs during the treatment. Total of 20 patients on EE 99 protocol who received cumulative dose of ifosfamide above 60 g/ m2 were included in this observational retrospective study. Renal toxicity was determined on the basis of glomerular...

Metronomic therapy as new challange in medical oncology

Danica Bronišová, MUDr. Peter Múdry, prof. MUDr. Jaroslav Štěrba Ph.D, Viera Bajčiová, Dalibor Valík, Lenka Dubská, MUDr. Pavel Mazánek, Petr Lokaj, Karel Zitterbart

Onkologie. 2009:3(4):227-229

The outcome of patients with progressive cancer, relaps or high risk tumor remains very poor. For these patients metronomic chemotherapy begins to be suitable alternative to conventional chemotherapy. Metronomic therapy refers to long term, chronic administration of low doses of conventional cytotoxic agents. Unlike „dose dense“ chemotherapy, it is minimally toxic and can be taken on out-patient basis. Mechanism responsible for the antitumor effect of metronomic therapy is under investigation, it is thought to be combination of antiangiogenic effect, stimulation of the immune response and direct cytotoxic action on tumour cells. This...

Review articles

Diagnosis and treatment of invasive fungal infections in patients with hematological malignancies

Ľuboš Drgoňa

Onkologie. 2009:3(4):231-234

Recent basic knowledge on epidemiology, clinical features and diagnostic procedures of invasive fungal infections in hemato-oncology is mentioned in the article. Recommendation of antifungal therapy based on up-to-date international and national consensus guidelines are presented.

Sorafenib in the treatment of generalized malignant melanoma: An overview of clinical trials

MUDr. Josef Dvořák

Onkologie. 2009:3(4):235-241

The current therapeutic options for generalized melanoma are very limited. The current standard treatment of stage IV melanoma is palliative cytostatic chemotherapy, complemented by immunotherapy and/or palliative radiotherapy in individual cases. The median survival of patients with generalized melanoma ranges between 6 and 10 months. Patients with generalized melanoma should be offered participation in clinical trials. This paper presents an overview of the clinical trials of sorafenib in the treatment of generalized melanoma. Sorafenib showed a statistically significant improvement in survival in randomized phase III clinical trials in the treatment...

Some aspects of combined treatment of pelvic tumors

Jan Žaloudík

Onkologie. 2009:3(4):242-246

Carcinomas of pelvic organs together with two hundreds of pelvic sarcomas represent annually almost 15,000 new oncological cases in the Czech Republic, which is 30 % of all life-threatening malignancies. Despite of subdivision of this field among abdominal surgery, gastronterology, gynaecological and urological oncology, solution of many problems must be based on multidisciplinary co-operation, especially in advanced and complicated cases. Integrated approach is required by endoscopic, imaging and laboratory diagnostic methods as well as by treatment, which includes surgery, radiotherapy and chemotherapy. Important and often underestimated topics include...

Use of supplemental enteral nutrition during hospitalization

Luboš Sobotka

Onkologie. 2009:3(4):248-250

The paper deals with malnutrition states suffered by chronically ill patients in both hospital and home settings and with their management by means of nutritional screening and nutritional support.

Case report

Toxoplazma infection of the central nervous system in a female patient in long-term remission of Hodgkin lymphoma

Peter Turcsányi, Vít Procházka, Renata Urbanová, MUDr. Tomáš Papajík CSc, Luděk Raida

Onkologie. 2009:3(4):251-253

We present a case of 45 years old woman with Hodgkin´s lymphoma, 5 years in complete remission, after primary chemo and radiotherapy. It seems that the immune system has not recuperated yet, and in the patient was diagnosted active toxoplasmosis with not quite typical symptoms. It was successfully treated with intensive antitoxoplasmosis therapy.

Avascular necrosis of the femoral head in patient with diffuse large B-cell lymphoma treated with high dose immunochemotheraphy

Zuzana Kubová, Antonín Hluší, MUDr. Tomáš Papajík CSc, Jan Špička, Miroslav Mysliveček, Karel Indrák

Onkologie. 2009:3(4):254-257

Corticosteroid-induced avascular necrosis (AVN) of the femoral head is a rare, but well-known complication of lymphoma and leukemia treatment. It is a pathological process characterized by impaired microcirculation with subsequent ischaemia which gradually leads to necrosis of the bone segment. There is the case report of young patient with primary mediastinal diffuse large B-cell lymphoma described. She was treated with sequential immunochemotherapy with intermittent administration of high dose corticosteroids. In 106 days after initiation of therapy AVN of the left femoral head was observed.

For nurses

Truth telling about the health status

PaedDr. Mgr. Eva Zacharová Ph.D

Onkologie. 2009:3(4):261-262

Truth telling about the health status is an extraordinarily serious issue not only because of its impact on the patient's life so far, but also because it creates totally individual and specific communication situations. Communication with the patient is affected by changes in the social, physical, and mental areas. The nurse as a member of the healthcare team needs to have basic information on the patient's health status in order to not only support the physician, but also to assist the patient in coping with a difficult situation.