Clinical Oncology

[Foreword]

A szerkesztők

FEBRUARY 10, 2017

Clinical Oncology - 2017;4(01)

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Further articles in this publication

Clinical Oncology

[The role of PET in clinical oncology]

LENGYEL Zsolt

[Positron emission tomography (PET) has earned an important role in clinical imaging, where it is used almost exclusively as hybrid modality such as PET/CT and PET/MR. The driving force behind the development of the method and the increasing clinical penetration of PET in the past two decades was clearly its use in Oncology. The most used tracer in PET is the 18 F-labeled fl uoro-deoxy-glucose (FDG). With the help of this molecule malignant tumors and their metastases, in which anaerobic glycolysis is typically increased, can be identifi ed with high sensitivity in the total body volume. However, FDG is not a tumor specifi c tracer, thus both false positivity and false negativity may occure which reduces the diagnostic accuracy. Indications of FDG PET studies in Oncology continuously evolved, owing to scientifi c publications, large scale national programs and even health-economic considerations. This publication describes the well-established indications of FDG PET/CT(MR) tests in cancer diagnostics and furthermore discusses more recent new PET tracers already being applied as well as those expected to be used in the future.]

Clinical Oncology

[News from the World]

Clinical Oncology

[Radiochemotherapy - questions/answers]

PIKÓ Béla, LACZÓ Ibolya

[During chemoradiotherapy the two main non-surgical anticancer methods are combined to improve the treatment outcomes. The theoretical possibilities of interactions and the most frequently used drugs will be presented here, emphasizing that although both the radiation therapy and the drugs need to be administered in full dose in practice considering the summarization of side effects we often have to make compromises. The treatments of the most frequent indications (brain, head and neck, oesophagus, lung, stomach, pancreas, rectum, bladder, cervix, soft tissue sarcoma) will be demonstrated. Since there are several drugs and drug combinations that are not included in the Hungarian registered anticancer therapies, for their off-label use the permission of the National Institute of Pharmacy and Nutrition is required. To choose the optimal treatment (during planning the optimal place of chemoradiotherapy, agents and doses) the opinion of a multidisciplinary team is necessary]

Clinical Oncology

[Gene modifi ed T cell therapy for patients with cancer]

HECZEY András

[T cells genetically modifi ed to express chimeric antigen receptors can combine the antigen specifi city of monoclonal antibodies with the cytotoxic function, active biodistribution and long term persistence of T cells. The approach can induce 90% complete remission rate in patients with CD19+ lymphoid leukemias; however, the in patients with solid tumors the antitumor effi cacy of CAR T cells have not reached similar levels yet. The increased levels of interleukin-6 due to T cell activation play key roles in the majority of side effects and using anti-IL-6 monoclonal antibody, tocilizumab can effectively treat these complications. Novel gene modifi cation strategies and improvements in CAR T cell manufacturing, the approach has the potential to fundamentally change the way patients with cancer are treated in the not too distant future.]

Clinical Oncology

[Cancer treatment induced gastrointestinal complications]

AL-FARHAT Yousuf, AUTH Péter

[Systemic therapy (ST) (including chemotherapy, targeted therapy, and immunotherapy) or radiation therapy (RT) can induce gastrointestinal side effects, which frequently affect patient’s quality of life. Sometimes side effects could be dose-limiting, or a reason to stop the treatment. The incidence and severity of gastrointestinal complications in patient’s receiving ST, RT, or chemoradiotherapy are affected by numerous factors, including: therapeutic agents, doses and route of administration, target of the RT (upper, lower abdomen or body) and individual patient variability (age, sex, prior cancer therapy, comorbidities, performance status). Mucositis occurs in approximately 20% to 40% of patients receiving conventional chemotherapy, 80% of patients receiving high-dose chemotherapy, nearly all patients receiving head and neck radiation therapy. mTOR inhibitor-associated stomatitis (mIAS) is the most frequent dose-limiting toxicity (52.5%). More than 90% of patients receiving highly emetogenic chemotherapy will have episodes of vomiting. However, only about 30% of these patients will vomit if they receive prophylactic antiemetic regimens.]

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