Jiří Petera

Radioterapie byla do 60.-70. let minul?ho stolet? pevnou sou??st? l??by jak seminom?, tak nonseminom?. Pozn?n? relativn? radio?rezistence nonseminom? omezilo jej? indikace jen na seminomy. Dal?? v?voj sm??oval k revizi indikac? adjuvantn? l??b...

Population ageing presents a challenge to oncological care due to the particularities of cancer treatment in this population. We evaluate cancer epidemiology, treatment and survival, in the Czech Republic by age groups. Data published by the Czech National Cancer Registry from the years 2006 to 2010 were used for this study. The following cancer types were evaluated: colorectal, pancreatic, head and neck, lung, skin melanoma, breast, gynaecological, prostate, kidney and stomach cancers. The following data were recorded and analysed: crude incidence by 5-year age group; dynamics of crude incidence rates in the age group ≥70 years; disease stage; percentage of patients treated by surgery, radiotherapy and chemotherapy; and age standardised 1-year mortality and 5-year relative survival according to age group. Patients over age 70 accounted for 41% and 46%, respectively, of the cancer incidence and mortality of the whole population. Anticancer therapies are significantly less common in patients over age 70 (P < 0.050), with the exception of skin melanoma. Survival was markedly worse in older patients (P < 0.050) when radical treatment modalities were significantly underused (P < 0.050). In the Czech Republic, the crude cancer incidence in seniors is increasing. In general, elderly patients are undertreated, with worse treatment results compared with younger patients.

Brachytherapy is an alternative to surgery in the treatment of the early stages of oral tongue cancer. The aim of this retrospective study was to analyze the clinical risk factors and possible candidate biomarkers of local and regional tumor control. Twenty-four patients were treated between the years 2001 and 2010. Median follow-up was 37.4 months. Correlation between disease-free survival and clinical stage, tumor grade, resection margin, depth of invasion, and p16, EGF receptor, NF-κB, HIF-1α, HER2, Ku-80, COX-2 and VEGF expression was evaluated. The estimated 5-year local control was 81% and locoregional control was 62%. Depth of tumor invasion (p = 0.018) and higher VEGF expression (p = 0.016) were significantly predictive for worse disease-free survival in Cox multivariate analysis. Intensity of VEGF expression and depth of tumor invasion may be significantly negative predictors of disease-free survival in tongue cancer patients treated by brachytherapy alone. Predictive value of VEGF deserves evaluation in larger studies.

Successful radiotherapy treatment of lacrimal gland infiltration in patient with Sjögren΄s syndrome

Low-dose rate brachytherapy is a well established treatment modality of oral cancer. Data about high-dose rate (HDR) brachytherapy are still sparse with various fractionation schedules and heterogeneous results. The aim of our retrospective study was to evaluate the results of HDR brachytherapy with doses of 3 Gy twice daily. Twenty patients with squamous cell tongue cancer were treated in the years 2001-2009 by exclusive HDR BT 18 × 3 Gy twice daily. The plastic tube technique was used. Median follow up was 47 months (7.8-118) since brachytherapy. The local and locoregional control was 85% and 68%, respectively. Bone necrosis developed in one case treated without mandibular shielding and soft tissue necrosis in 2 cases. It can be concluded that HDR brachytherapy with 18 × 3 Gy twice daily is safe with promising local control. The risk of nodal recurrences is substantial.