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Use of spectroscopic methods in colorectal cancer detection.
Miškovičová, Michaela ; Petruželka, Luboš (advisor) ; Soumarová, Renata (referee) ; Kiss, Igor (referee)
Colorectal cancer is one of the most common cancers and a global health problem. Approximately 8,000 new cases are diagnosed annually in the Czech Republic and about half of them die from this malignancy, with 20 % patients being under 60 years of age. It is still true that the greatest hope for successful treatment and management of the disease is given to patients by early diagnosis of cancer. There is still a remarkably high proportion of detection of colorectal cancer in the advanced stage, which is mainly due to the absence of reliable and sensitive clinical methods. The still unfavorable epidemiological situation is a clear challenge to further strengthen all activities aimed at active prevention and early diagnosis. Colorectal cancer is the best preventable disease of the gastrointestinal tract, it lasts for several years, when an invasive lesion gradually develops through a precursor lesion. This offers a sufficiently long diagnostic window, Therefore, attention is currently being focused to find affordable, sensitive and minimally invasive techniques that can provide early, simple, rapid, inexpensive and reliable diagnosis of this disease and could thus support or replace conventional diagnostic methods in the future. In our work, we focused on the use of completely new diagnostic...
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Postoperative brachytherapy in the treatment of the early oral cancer
Tuček, Luboš ; Šimůnek, Antonín (advisor) ; Feltl, David (referee) ; Soumarová, Renata (referee)
2 Summary Purpose: Evaluation of the postoperative high-dose-rate brachytherapy (HDR BT) in the treatment of early oral cancer and factors influencing tumour control. Material and methods: Thirty patients with T1-T3N0 tongue and floor of mouth cancer were treated with tumour excision elective neck dissection and HDR BT 18 x 3 Gy bid. The Kaplan- Meier model was used for survival analyses and the log-rank test and Cox regression analyses were used to evaluate the influence of T-stage, histological grade, resection margin, depth of invasion, and vascular endothelial growth factor (VEGF) intensity on local control (LC), nodal control (NC), disease-free survival (DFS) and overall survival (OS). Median follow up was 40 months (6 - 145). Results: Actuarial 5 year LC, NC, DFS, DFS after salvage treatment and OS were 85.4%, 69.2%, 65.4%, 75.6% and 73.0%, respectively. The log-rank test and univariate Cox regression analysis revealed the following correlations: tumour grade correlated with LC, DFS and OS; T- stage with NC and DFS; depth of invasion and VEGF intensity with NC, DFS and OS. Associations detected on the multivariate analysis were as follows: tumour grade with LC; depth of invasion with NC; depth of invasion and tumour grade with DFS; and VEGF intensity with DFS after salvage treatment. Only one case of...
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Postoperative brachytherapy in the treatment of the early oral cancer
Tuček, Luboš ; Šimůnek, Antonín (advisor) ; Feltl, David (referee) ; Soumarová, Renata (referee)
2 Summary Purpose: Evaluation of the postoperative high-dose-rate brachytherapy (HDR BT) in the treatment of early oral cancer and factors influencing tumour control. Material and methods: Thirty patients with T1-T3N0 tongue and floor of mouth cancer were treated with tumour excision elective neck dissection and HDR BT 18 x 3 Gy bid. The Kaplan- Meier model was used for survival analyses and the log-rank test and Cox regression analyses were used to evaluate the influence of T-stage, histological grade, resection margin, depth of invasion, and vascular endothelial growth factor (VEGF) intensity on local control (LC), nodal control (NC), disease-free survival (DFS) and overall survival (OS). Median follow up was 40 months (6 - 145). Results: Actuarial 5 year LC, NC, DFS, DFS after salvage treatment and OS were 85.4%, 69.2%, 65.4%, 75.6% and 73.0%, respectively. The log-rank test and univariate Cox regression analysis revealed the following correlations: tumour grade correlated with LC, DFS and OS; T- stage with NC and DFS; depth of invasion and VEGF intensity with NC, DFS and OS. Associations detected on the multivariate analysis were as follows: tumour grade with LC; depth of invasion with NC; depth of invasion and tumour grade with DFS; and VEGF intensity with DFS after salvage treatment. Only one case of...
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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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Combined treatment of advanced head and neck cancer with radiotherapy and cycooxygenase-2 inhibitors (phase I study)
Halámka, Magdalena ; Petera, Jiří (advisor) ; Soumarová, Renata (referee) ; Kubeš, Jiří (referee)
Combined treatment of advanced head and neck cancer with radiotherapy and cycooxygenase-2 inhibitors (phase I study) This paper describes the course and presents the outcomes of a original phase I study of combined treatment of advanced head and neck cancer using standard radiotherapeutic technique and COX2 inhibitor (Celebrex) as a potentiating agent. The primary goal of the study was identifying of the maximum tolerated dose of Celebrex for the purpose of further clinical investigation. In the theoretical introduction I present data on the incidence and mortality of HaN cancer worldwide and in the Czech republic, further preclinical data justifying use of Celebrex in combined treatment with radiotherapy. Special emphasis was put on presentation of local data systematically gained in Clinic of Oncology in Ostrava where this study has been conducted. These data include an overview of incidence, mortality, therapeutic methods and treatment toxicity profiles. Since the phase I study as such does not include comparison with control patient group, it is necessary to be aware of local standards. This is the background to establish inclusion criteria for patient recruitment, toxicity evaluation and setting maximum tolerance dose criteria. This study furthermore investigates expression of COX2 in tumor tissue and...
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Radiochemotherapy with weekly cisplatin in the treatment of head and neck cancer
Pála, Miloslav ; Odrážka, Karel (advisor) ; Soumarová, Renata (referee) ; Klozar, Jan (referee)
Radiochemotherapy with weekly cisplatin in the treatment of head and neck cancer. Purpose: The objective of this study was to evaluate the feasibility, toxicity and efficacy of postoperative and definitive radiochemotherapy with weekly cisplatin in locoregionally advanced or high risk head and neck cancer. Material and methods: Patients with head and neck cancer of stage III-IVb or patients with insufficient margins of resection after initial surgery were included in the study of postoperative radiotherapy. Radiotherapy consisted of 70 Gy/ 7 weeks/ 35 fraction after R1/2 resection and 60- 64 Gy/ 6-6,5 weeks/ 30-32 fraction after R0 resection, respectively. Patients with head and neck cancer of stage II-IVb without initial resection were included in the study of definitive radiochemotherapy. Radiotherapy consisted of 70 Gy / 7 weeks / 35 fraction. All patients received concurrent cisplatin 40 mg/m2 weekly. Results: Postoperative radiochemotherapy: Between 6/2002 and 12/2008, 100 consecutive patients WHO 2, male to female ratio 84/16, median age 54 years were treated. Tumours of the oropharynx were the most frequent (49%) and stage IV was predominant (86%). 96% patients received the full radiation treatment as planned. Median total tumor dose was 66 Gy. Omission of weekly cisplatin had been...
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Epidermal growth factor receptor as a predictor of tumor response to preoperative chemoradiation in locally advanced gastric carcinoma
Sirák, Igor ; Petera, Jiří (advisor) ; Šlampa, Pavel (referee) ; Soumarová, Renata (referee)
The purpose of my doctoral thesis was a retrospective evaluation whether the intensity of epidermal growth factor receptor (EGFR) expression in tumor biopsy predicts tumor response to preoperative chemoradiotherapy in patients with locally advanced gastric carcinoma. Thirty-six patients with gastric adenocarcinoma in clinical T2-4 stage and/or with nodal metastases were studied. Preoperative treatment consisted of 30-45 Gy of gastric irradiation with continuous 5-fluorouracil and weekly cisplatin. Surgical resection was performed 4-6 weeks later. EGFR expression in pretreatment tumor biopsies was assessed by immunohistochemistry. Level of EGFR expression was determined from the intensity and extent of staining. Tumor response after chemoradiotherapy was defined as a reduction of at least one T-stage level and/or finding of intense tumor regression in histopathologic examination. Seventeen patients responded to preoperative chemoradiation - 8 patients (22%) had pathologic complete response, 9 patients (25%) were downstaged. Positive EGFR expression was found in 8 tumors (22%), and represented a significant predictive marker of poor tumor response in multivariate logistic regression analysis (p = 0.015). Response to chemoradiotherapy was found in 57% (16/28) of EGFR negative patients and in 13% (1/8)...
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