Clinical Oncology

[The benefits of vaccination in risk groups]

BÉRES Zsuzsanna Katalin1

FEBRUARY 28, 2021

Clinical Oncology - 2021;8(1)

[As the average age increases, the prevention of infectious diseases is of paramount importance, not just during a pandemic. In terms of volume and complications, pneumococcal and influenza infections are among the top 10 most common causes of death. Timely and properly applied vaccination is an effective weapon against both diseases. This fact is confirmed by several clinical trials. The advent of conjugate vaccination has been a milestone in the history of vaccination. It is important that affected groups are protected from the two seasonal infectious diseases as soon as possible. Always use the conjugate vaccine first to develop protection against pneumococcus, the polysaccharide vaccination, which only broadens the spectrum, is proposed in the second step and needs to be considered for at-risk groups. Influenza vaccination should be repeated annually. The two vaccines can be given at the same time, there is no need to keep the interval.]

AFFILIATIONS

  1. Budai Oltóközpont, Budapest

COMMENTS

0 comments

Further articles in this publication

Clinical Oncology

[Comprehensive care of the carcinoma of the uterine cervix]

ÁROKSZÁLLÁSI Anita

[Cancer of the uterine cervix is a major world health problem for women. Yearly around half a million new cases are diagnosed with cervical cancer having leaded nearly 300,000 deaths in 2018 globally. In developed countries epidemiological data is improving due to the vaccination policy against “high risk” human papilloma viruses (hrHPV) and the population-based screening programs by cytology or hrHPV-testing. However, in developing regions the incidence and mortality data are still dismal. Precancerous lesions and early-stage cervical cancer can be cured solely by surgical approach. Pathological risk factors will determine the need of postoperative radio- or chemoradiotherapy. In advanced-stage disease chemoradiotherapy or systemic therapy are the available options. As a considerable part of the patients are young female, there are some special issues to be faced with like the desire of fertility-sparing or cervical cancer diagnosed in pregnancy. Clinically occult cervical carcinoma recognized after simple hysterectomy is another complex therapeutic field. In modern oncology, the biological agents have also emerged in the therapeutic field of advanced cases: bevacizumab combined with cisplatin and paclitaxel as first line therapy; and pembrolizumab as second line option for tumors with microsatellite instability-high (MSI-H)/mismatch repair deficiency (dMMR) or for tumors express PD-L1 (Combined Positive Score [CPS] ≥1.) The present work provides a short summary of the current literature about the screening, staging, comprehensive management and follow-up of uterine cervical cancer.]

Clinical Oncology

[SARS-CoV-2 infection-lung demage. Lung cancer and Covid-19 in the TERAVOLT clinical studys]

SZONDY Klára, FUTÁCSI Balázs, KIS Sándor

[Hopefully, towards the end of the Covid-19 pandemic, we intend to provide a brief overview of the infection, the pathogen, most effective treatment options, lung damage, and the results of TERAVOLT clinical trial, about patients with lung cancer, treated or not-treated, infected by SARS-CoV-2 virus. Tried to summarize the new diagnostic and therapy rules (bronchoscopy, chest x-ray, chest CT), and the potential new vaccinations. Authors provide a brief overview of the treatment of respiratory and cancer patients during infection, the continuation of inhalation drugs, immunotherapy and/or chemotherapy.]

Clinical Oncology

[Treatment of cancer associated venous thromboembolism in the age of direct oral anticoagulants]

AY C, BEYER-WESTENDORF J, PABINGER I

[Anticoagulation for cancer-associated venous thromboembolism (VTE) can be challenging due to complications-including bleeding and potential drug-drug interactions with chemotherapy-associated with vitamin K antagonists and inconvenience of low-molecular-weight heparin (LMWH). Direct oral anticoagulants (DOACs) could partially overcome these issues, but until recently there were no large clinical trials assessing their efficacy and safety in cancer patients. This review summarizes clinical treatment guidelines, prior clinical and real-world evidence for anticoagulant choice, recent clinical trials assessing DOACs for cancer-associated VTE (i.e. Hokusai-VTE Cancer, SELECT-D, CARAVAGGIO, and ADAM VTE), and special considerations for DOAC use. Based on established data, clinical guidelines recommend patients with cancer-associated VTE receive LMWH treatment of at least 3-6 months. Nevertheless, LMWH is underused and associated with poor compliance and persistence in these patients relative to oral anticoagulants. Clinical data supporting DOAC use in cancer patients are becoming available. In Hokusai-VTE Cancer, edoxaban was noninferior to dalteparin for the composite of recurrent VTE and major bleeding (12.8% versus 13.5%), with numerically lower recurrent VTE (7.9% versus 11.3%) and significantly higher major bleeding (6.9% versus 4.0%); only patients with gastrointestinal cancer had significantly higher risk of bleeding with edoxaban. In SELECT-D, rivaroxaban had numerically lower VTE recurrence (4% versus 11%), comparable major bleeding (6% versus 4%), and numerically higher clinically relevant nonmajor bleeding (13% versus 4%) versus dalteparin. Most bleeding events were gastrointestinal or urologic; patients with esophageal/gastroesophageal cancer had higher rates of major bleeding with rivaroxaban (36% versus 11%). For comparison of apixaban versus dalteparin, CARAVAGGIO is ongoing, and preliminary results from ADAM VTE are favorable. This review concludes that DOACs appear to be reasonable alternatives to LMWH for treatment of cancer-associated VTE. In patients with gastrointestinal cancer, DOAC use should be considered on a case-by-case basis with consideration of the relative risks and benefits. Kulcsszavak: venous thromboembolism, cancer, treatment, direct oral anticoagulants Nevertheless, LMWH is underused and associated with poor compliance and persistence in these patients relative to oral anticoagulants. Clinical data supporting DOAC use in cancer patients are becoming available. In Hokusai-VTE Cancer, edoxaban was noninferior to dalteparin for the composite of recurrent VTE and major bleeding (12.8% versus 13.5%), with numerically lower recurrent VTE (7.9% versus 11.3%) and significantly higher major bleeding (6.9% versus 4.0%); only patients with gastrointestinal cancer had significantly higher risk of bleeding with edoxaban. In SELECT-D, rivaroxaban had numerically lower VTE recurrence (4% versus 11%), comparable major bleeding (6% versus 4%), and numerically higher clinically relevant nonmajor bleeding (13% versus 4%) versus dalteparin. Most bleeding events were gastrointestinal or urologic; patients with esophageal/gastroesophageal cancer had higher rates of major bleeding with rivaroxaban (36% versus 11%). For comparison of apixaban versus dalteparin, CARAVAGGIO is ongoing, and preliminary results from ADAM VTE are favorable. This review concludes that DOACs appear to be reasonable alternatives to LMWH for treatment of cancer-associated VTE. In patients with gastrointestinal cancer, DOAC use should be considered on a case-by-case basis with consideration of the relative risks and benefits.]

Clinical Oncology

[(K)RAS mutant human cancers]

TÍMÁR József, RÁSÓ Erzsébet

[RAS mutation is the most frequent oncogenic alteration in human cancers and K-RAS is far the most frequently involved among the RAS family members followed by N-RAS. Beside the emblematic K-RAS mutant cancers, pancreatic-, colorectal- and lung adenocarcinomas, urogenital cancers are also belong to this family of malignancies. It is important that K-RAS mutation frequencies are relatively stable around the world in various cancer types with one exeption: lung adenocarcinoma. The variant allele frequencies of K-RAS seems to be cancer-type specific reflecting various carcinogenic processes. Beside point mutation K-RAS allelic imbalances are also frequent in human cancers leading to the predominance of the mutant allele. K-RAS mutant cancers are characterized by typical cancer-type specific co-occurring mutations and well-defined gene expression signatures. ]

Clinical Oncology

[Rehabilitation of cancer patients]

DANK Magdolna, PÉNTEK Irén, JUHÁSZ Ágnes, HAJDÚ Anett

[In our country, the number of neoplastic diseases is constantly increasing. Based on the KSH data 376,709 people had neoplastic diseases in 2017. The disease is a long-term, chronic process, and the physical burden caused by treatments makes it difficult to maintain the physical and mental balance of patients. The quality of life of the neoplastic diseases patient changes, his ability to work will be reduced, his role in the family will be changed, his physical and emotional strength. These problems can be remedied by rehabilitation interventions, but oncology rehabilitation in many places in Hungary is unfortunately not part of the standard of care. In fact, oncology rehabilitation differs from the rehabilitation plan for other diseases. The oncology rehabilitation plan should be treated more flexible and more differentiated, changes due to disease and treatment should always be considered. As a result, the demand for evidence-based rehabilitation interventions is growing therefore, our aim is to apply international literature overview of rehabilitation options for neoplastic diseases patients, including metastatic patients which can be used to reduce pain as a side effect of treatments, musculoskeletal and nutritional problems this will allow for a significant improvement in the quality of life of patients.]

All articles in the issue

Related contents

Ca&Bone

[The role of physiotherapy/therapeutic exercise in the treatment of osteoporotic hip fractures]

MAKOVICSNÉ Landor Erika, KOLTAI Endréné

[The authors briefly present the role of the physiotherapist in the treatment of osteoporosis. Primary, secondary, and tertiary prevention of locomotion system problems is analyzed. The authors’ specific focus is the complex physiotherapeutic treatment of osteoporotic hip fractures. They propose a prevention program involving locomotion exercises for the prevention of falls. Analyzing the physiotherapists’ activities, the authors describe the most important aspects of patient education and patient information.]

Clinical Neuroscience

[Prevalence of stroke/cardiovascular risk factors in rural Hungary - A cross-sectional descriptive study (in English language)]

BODO Michael, THURÓCZY György, PÁNCZÉL Gyula, SIPOS Kornél, ILIÁS Lajos, SZÕNYI Péter, BADÓ Mike Jr, NEBELLA Tamás, BÁNYÁSZ Attila, NAGY Zoltán

[A multi-faceted survey was conducted in 1992-94 to ascertain the somatic, mental and socio-economic conditions of the residents of a village in eastern Hungary. Here we report data on prevalence of somatic disorders from the survey. Objectives - a) To collect and compare prevalence of known cardiovascular disease, including stroke risk factors, in a specific population (a Hungarian village); b) to test a computer-based mass screening device ("Cerberus") designed to identify individuals in the test population at high risk for stroke; c) to compare results obtained with Cerberus with known stroke risk/cardiovascular disease factors and traditional medical records. Methods - A cross-sectional survey (546 subjects) was conducted in Csengersima in the early 1990s, using the Cerberus screening system, which includes: 1. a questionnaire addressing the risk factors for stroke/cardiovascular disease; 2. amplifiers to record the pulse waves of cerebral (rheoencephalography) and peripheral arteries, electrocardiogram and electroencephalogram. Additionally, subjects were measured for carotid stenosis by Doppler ultrasound and 12-lead electrocardiogram; they were also screened for blood cholesterol, glucose, and triglyceride levels. Findings - Prevalence of the following stroke risk factors was identified: overweight, 63.25%; sclerotic brain arteries by rheoencephalogram, 54.29%; heart disease, 37.92%; pathologic carotid flow, 34.24%; smoking, 30.55%; high blood cholesterol, 28.70%; hypertension, 27.83%; high triglyceride, 24.35%; abnormality of electrocardiogram, 20%; high glucose, 15.95%; symptoms of transient ischemic attack, 16.07%; alcohol abuse, 6.74%; and diabetes, 4.53%. Conclusion - The study demonstrates a possible model for primary cardiovascular disease/stroke prevention. The simple, noninvasive test uses the bioimpedance method of measurement. This method offers a standardizable, costeffective, practical technique for mass screenings by identifying the population at high risk for cardiovascular disturbances, especially cerebrovascular disease. In this model, the rheoencephalogram can detect cerebrovascular arteriosclerosis in the susceptibility/presymptomatic phase, earlier than the Doppler ultrasound technique. The method also provides a model for storing analog physiological signals in a computer-based medical record and the first steps of turning it into an expert system also tested.]

Lege Artis Medicinae

[Public health prevention in Hungary II.: established methods, adequate information, real screening results „Comprehensive Health Screening of Hungary 2010-2020” - four-year results]

KISS István, BARNA István, DANKOVICS Gergely, DAIKI Tenno

[In the past 10 years, a number of screening programs with various goals have been started in Hungary, with varying degrees of success. The „Comprehensive Health Screening of Hungary 2010-2020” program has been touring the country (with a screening truck), either joining organised events or as an independent screening, collaborating with local healthcare centers (primary care, occupational healthcare etc). The screening program has been conducted in a special truck, in which various examinations were performed in a set time. Those who participated in the screening received a prevention information pack (for studying and reading at home) and the official publication of the program (Health Book), in which the program and the screening results were described. In the past four years the screening truck has been to 725 places in Hungary and travelled 83,145 kilometers. 87,935 people have participated in comprehensive screening. 194,549 visitors received lifestyle counseling and 142,319 received Prevention Packs. In total 2,901,855 examinations have been performed, which required 6711 hours of work of 1132 healthcare professionals. 5,856,114 answers were given to queries of the survey related to the health status of the Hungarian population. The program has already overfulfiled its original goals to visit 1500 locations and perform 8 million examination during this period. It is of particular significance that the average age of participants was 40 years. As cardiovascular risk is still the leading health risk, screening for such risk factors has to be part of all general and complex screening programs. In this program, an increasing number of validated, rapid and effective risk-estimation tests were used. It is remarkable that 20% of the tests related to colorectal cancer risk has positive results. Also of importance are the test results for hearing loss (7% positive) and various degrees of visual impairment (over 50%). Both results have significant social and economical implications for both individuals and the society. Unfortunately, the general level of health consciousness is still low. This might be improved not only by the screening itself but the opportunity to inform the public and provide organised counselling and printed materials, for which the activity and expertise of professional healthcare worker is essential. ]