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The impact of PET/CT scanning in the radioteraphy planning of non-small cell lung cancer
Vojtíšek, Radovan ; Petera, Jiří (advisor) ; Feltl, David (referee) ; Zemanová, Milada (referee)
The impact of PET/CT scanning in the radiotherapy planning of non-small cell lung cancer Background: In the current practice of radiotherapy planning and target volume determination in patients suffering from the non-small cell lung cancer (NSCLC), a contrast-enhanced CT is standard procedure. Contemporary studies have proven that PET/CT examination attains higher sensitivity and specificity in the diagnosis of lung cancer and also leads to higher accuracy in the process of target-volume delineation in NSCLC. Aim: To compare radiotherapy plans made according to CT and PET/CT examinations in the same patient and to investigate the impact of changes in target volume sizes on tumor control probability (TCP) and normal tissue complication probability (NTCP) and the impact of combined PET/CT examination on the staging of the disease and treatment strategy. Materials and Methods: Between October 2008 and November 2013, 42 patients suffering from pathologically proven inoperable locally advanced NSCLC that were referred to radical radiotherapy were involved in our study. They all underwent planning PET/CT examination. I carried out two separate delineations of target volumes and two radiotherapy plans, both with their own dose-volume histograms (DVH). I compared the following parameters of radiotherapy...
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The role of human papilloma viruses in ethiopathogenesis malignant tumors in sinonasal area
Sieglová, Kateřina ; Nachtigal, Petr (advisor) ; Petera, Jiří (referee)
The aim of this thesis is the comparison of immunohistochemical and molecular biological methods for the detection of human papillomavirus (HPV) in tumour tissue and their subsequent use in the study of HPV role in the etiopathogenesis of malignant tumors of sinonasal region. Several methods for the purpose of HPV detection were applied: in situ hybridization, immunohistochemical detection of expression of p16INK4a protein, classic polymerase chain reaction combined with two different enzyme immunoassay detection methods, and reverse hybridization, followed by polymerase chain reaction with real time reverse transcription. All methods (p16 DNA in situ hybridization, RNA in situ hybridization, quantitative polymerase chain reaction with reverse transcription - RT-qPCR mRNA) used for the detection of HPV performed very well when compared, showing concordance with statistical significance p ˂ 0,0001. Detection of p16 vs. DNA polymerase chain reaction (PCR) had correlation coefficient p = 0.004 in the whole group, and p = 0.002 in the subgroup of squamous cell carcinoma (SCC). Correlation coefficient between detection of p16 and overall HPV status was 0,659 for entire set and 0,864 for set of SCC, indicating significant linear dependence. Immunohistochemical detection of p16 in combination with the...
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Interstitial Brachytherapy of the Breast and Penis
Pohanková, Denisa ; Petera, Jiří (advisor) ; Doležel, Martin (referee) ; Cvek, Jakub (referee)
Interstitial brachytherapy of the breast and penis Summary Aims: Interstitial brachytherapy (BT) is a therapeutic method with a proven history used in treatment of various cancers. In our work we focused on accelerated partial breast irradiation with multicatheter interstitial brachytherapy (MIB APBI) of early breast cancer due to the high incidence of this disease and on BT of early penile cancer as an alternative to primary surgical treatment. Methods and materials: 1) High dose rate brachytherapy (HDR BT) for MIB APBI of early breast cancer has been used at the Department of Oncology and Radiotherapy, University Hospital and Medical Faculty, Hradec Králové since 2012. Brachytherapy catheters are inserted perioperatively in the time of tumorectomy and sentinel node biopsy. APBI starts on day 6 after surgery. The prescribed dose was 34 Gy in 10 fractions applied twice a day. We evaluated 125 patients with minimum follow up of 2 years. 2) Twenty-eight patients with early penile cancer underwent HDR brachytherapy between 2002-2020. The prescribed dose was 18x 3 Gy applied twice a day. Results: 1) One hundred twenty-five patients were indicated for APBI, 12 patients of these did not receive this treatment (9.6 %) due to adverse prognostic factors in the final histology. In these patients the inserted...
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The Changes of the Tumor Vascular Endothelial Growth Factor Expression and the Density CD8+ Tumor Infiltrating Lymphocytes after Neoadjuvant Chemoradiation in Patients with Rectal Adenocarcinoma
Buka, David ; Petera, Jiří (advisor) ; Vrána, David (referee) ; Mohelníková Duchoňová, Beatrice (referee)
Rectum adenocarcinoma is one of the most frequent tumour diseases in the Czech Republic. Therefore any progress in therapy or prevention of this disease can have a significant impact on mortality and morbidity of major amount of oncological patients. Within therapy the neoadjuvant concomitant radiochemotherapy or the sole radiotherapy is used before surgical resection in one third to half of all newly diagnosed cases. The goal is to achieve tumor downstaging and local relaps probability decrease. There is a large amount of processes on molecular and cellular level in organism reaction to neoplasia genesis, whose understanding can have a substantial impact on therapy's success rate or on therapy's efficiency prediction. One of these processes is angiogenesis induced by high production of vascular endothelial growth factor (VEGF). As per immunohistochemical studies VEGF is not expressed in typical colorectum mucous membrane. However it is strongly expressed in case of adenocarcinoma. Another important process of organism's malignancy response is tumour tissue infiltration by CD8+ T lymphocytes (TIL), which are one of the important components of cellular immunity against tumour and which significantly contribute to tumour cells elimination. Potential of CD8+ T lymphocytes is considerable not just in...
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The role of human papilloma viruses in ethiopathogenesis malignant tumors in sinonasal area
Sieglová, Kateřina ; Nachtigal, Petr (advisor) ; Petera, Jiří (referee)
The aim of this thesis is the comparison of immunohistochemical and molecular biological methods for the detection of human papillomavirus (HPV) in tumour tissue and their subsequent use in the study of HPV role in the etiopathogenesis of malignant tumors of sinonasal region. Several methods for the purpose of HPV detection were applied: in situ hybridization, immunohistochemical detection of expression of p16INK4a protein, classic polymerase chain reaction combined with two different enzyme immunoassay detection methods, and reverse hybridization, followed by polymerase chain reaction with real time reverse transcription. All methods (p16 DNA in situ hybridization, RNA in situ hybridization, quantitative polymerase chain reaction with reverse transcription - RT-qPCR mRNA) used for the detection of HPV performed very well when compared, showing concordance with statistical significance p ˂ 0,0001. Detection of p16 vs. DNA polymerase chain reaction (PCR) had correlation coefficient p = 0.004 in the whole group, and p = 0.002 in the subgroup of squamous cell carcinoma (SCC). Correlation coefficient between detection of p16 and overall HPV status was 0,659 for entire set and 0,864 for set of SCC, indicating significant linear dependence. Immunohistochemical detection of p16 in combination with the...
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Baseline Hematologic Parameters Influencing Outcomes in Patients with Locally Advanced Rectal Cancer
Hodek, Miroslav ; Petera, Jiří (advisor) ; Feltl, David (referee) ; Soumarová, Renata (referee)
Baseline Hematologic Parameters Influencing Outcomes in Patients with Locally Advanced Rectal Cancer Aim of the study: The link between the blood count and a systemic inflammatory response (SIR) is indisputable and well described. Pretreatment hematological parameters may predict the overall clinical outcomes in many types of cancer. Thus, this study aims to systematically evaluate the relationship between baseline blood count levels and treatment response in rectal cancer patients treated with neoadjuvant chemoradiotherapy. Patients and methods: From 2009-2015, 173 patients with locally advanced rectal cancer were retrospectively enrolled in the study and analyzed. The baseline blood count was recorded in all patients 1 week before chemoradiation. Tumor response was evaluated through pathologic findings. Blood count levels which included RBC (red blood cells), Hb (hemoglobin), PLT (platelet count), neutrophil count, WBC (white blood cells), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio) were analyzed in relation to tumor downstaging, pCR (pathologic complete response), OS (overall survival), and DFS (disease-free survival). Results: Hb levels were associated with a response in logistic regression analysis: pCR (p = 0.05; OR 1.04, 95% CI 1.00-1.07); T downstaging (p =...
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The impact of PET/CT scanning in the radioteraphy planning of non-small cell lung cancer
Vojtíšek, Radovan ; Petera, Jiří (advisor) ; Feltl, David (referee) ; Zemanová, Milada (referee)
The impact of PET/CT scanning in the radiotherapy planning of non-small cell lung cancer Background: In the current practice of radiotherapy planning and target volume determination in patients suffering from the non-small cell lung cancer (NSCLC), a contrast-enhanced CT is standard procedure. Contemporary studies have proven that PET/CT examination attains higher sensitivity and specificity in the diagnosis of lung cancer and also leads to higher accuracy in the process of target-volume delineation in NSCLC. Aim: To compare radiotherapy plans made according to CT and PET/CT examinations in the same patient and to investigate the impact of changes in target volume sizes on tumor control probability (TCP) and normal tissue complication probability (NTCP) and the impact of combined PET/CT examination on the staging of the disease and treatment strategy. Materials and Methods: Between October 2008 and November 2013, 42 patients suffering from pathologically proven inoperable locally advanced NSCLC that were referred to radical radiotherapy were involved in our study. They all underwent planning PET/CT examination. I carried out two separate delineations of target volumes and two radiotherapy plans, both with their own dose-volume histograms (DVH). I compared the following parameters of radiotherapy...
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The role of human papilloma viruses in ethiopathogenesis malignant tumors in sinonasal area
Sieglová, Kateřina ; Nachtigal, Petr (advisor) ; Petera, Jiří (referee)
The aim of this thesis is the comparison of immunohistochemical and molecular biological methods for the detection of human papillomavirus (HPV) in tumour tissue and their subsequent use in the study of HPV role in the etiopathogenesis of malignant tumors of sinonasal region. Several methods for the purpose of HPV detection were applied: in situ hybridization, immunohistochemical detection of expression of p16INK4a protein, classic polymerase chain reaction combined with two different enzyme immunoassay detection methods, and reverse hybridization, followed by polymerase chain reaction with real time reverse transcription. All methods (p16 DNA in situ hybridization, RNA in situ hybridization, quantitative polymerase chain reaction with reverse transcription - RT-qPCR mRNA) used for the detection of HPV performed very well when compared, showing concordance with statistical significance p ˂ 0,0001. Detection of p16 vs. DNA polymerase chain reaction (PCR) had correlation coefficient p = 0.004 in the whole group, and p = 0.002 in the subgroup of squamous cell carcinoma (SCC). Correlation coefficient between detection of p16 and overall HPV status was 0,659 for entire set and 0,864 for set of SCC, indicating significant linear dependence. Immunohistochemical detection of p16 in combination with the...
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ATM and TGFB1 polymorphism in prediction of late complications of chemoreadiotherapy in patients with locally advanced cervical cancer
Paulíková, Simona ; Petera, Jiří (advisor) ; Kubecová, Martina (referee) ; Fínek, Jindřich (referee)
Cervical cancer is due to high incidence the third most commonly diagnosed gynecological cancer in the Czech republic. More than 50% of these tumors are diagnosed in advanced stage (st. IIB and higher) and therapy is more difficult than in lower stage tumors. The standard treatement method for locally advanced cervical cancers is combined oncological therapy including external beam radiotherapy, brachytherapy and concomitant chemotherapy. This treatement provides good tumor control, but there is also a risk of late complications in irradiated area. Severe late complications affect 10-15% of patients. It is still not possible to predict late complications and therefore detection of valid predictive factors for high tissue radiosensitivity could help to identify patients with increased risk before therapy. Knowledge of such predictive factors would also help to individualize the treatement. New molecular biological methods brought new findings about cancerogenesis, cell cycle regulation and cellular reaction to the radiation damage. It was hypothized, that mutation of genes involved in DNA damage reparation or cell proliferation are one of causes of high tissue radiosensitivity. The aim of our study was to evaluate relations between ATM and TGFß1 polymorphisms and late tissue toxicity in patients treated for...
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