Deset let činnosti pražského Protonového centra

prof. MUDr. Jitka Abrahámová, DrSc.

Onkologie. 2022:16(5):235  

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

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...

Dose escalation in the treatment of NSCLC with proton radiotherapy

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.

Hypofractionated proton radiotherapy for prostate cancer: six-year data

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:...

Proton therapy in the treatment of meningiomas

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.

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

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...

Avelumab plus axitinib combination in treating metastatic renal cell carcinoma

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...

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

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.

Pharmacological profile - trastuzumab emtansine

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®.

Nursing management of fatigue in cancer patients

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...