PURPOSE: This paper compares individual radiation therapy techniques used for prostate cancer and their benefits in clinical practice. METHODS: We retrospectively analyzed 921 patients with localized prostate tumors treated between 1997 and 2012. We divided the patients into four groups according to the selected treatment technique (conformal radiation therapy [3DCRT], intensity-modulated radiation therapy [IMRT], image-guided radiation therapy [IGRT], and volumetric-modulated arc therapy [VMAT]) and evaluated the incidence of acute and chronic gastrointestinal (GI) and genitourinary (GU) toxicity. RESULTS: The incidence of grade 2 or greater acute GU and GI toxicity was significantly higher among techniques other than IGRT (p˂0.001). We found the same results in the case of grade 3 or greater acute GU toxicity (p˂0.001). Grade 3 or higher acute GI toxicity occurred only in one patient treated by 3DCRT. Cumulative late GI toxicity of grade 2 or higher and grade 3 or higher was recorded over 3 years significantly more frequently among non-IGRT techniques as compared to IGRT (p˂0.001). As regards GU toxicity, we found significantly higher incidence only for grade 2 or higher (p˂0.001), not for grade 3 or higher. No occurrence of grade 4 toxicity was recorded. The greatest incidence of patients without acute and chronic GI/GU toxicity was recorded in connection with VMAT. CONCLUSION: IGRT demonstrated a pronounced reduction in acute and chronic GU and GI toxicity as compared to non-IGRT techniques in the treatment of localized prostate cancer.

• MeSH
• akutní nemoc MeSH
• chronická nemoc MeSH
• gastrointestinální trakt patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prostaty komplikace   MeSH
• radioterapie řízená obrazem metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• urogenitální systém patofyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Prolongation of radiotherapy worsens the results of treatment of head and neck squamous cell carcinoma (HNSCC). The purpose of this study was to identify the prognostic factors most affected by the prolongation of treatment. METHODS: 184 patients with locally advanced HNSCC were treated with curative chemo-radiation using SIB-IMRT from 2008 to 2016 and the influence of radiotherapy time (RTT) in groups of patients according to prognostic factors was retrospectively evaluated. RESULTS: Median overall survival (OS) was 45 months, median disease-free survival (DFS) was 41 months and median local control (LC) was not reached (mean LRC 68 months). In the multivariate analysis the radiotherapy prolongation negatively affected the LC in stage IV patients, T3/T4, in neck nodes positive disease, in oropharyngeal and oral cavity cancers, after neoadjuvant chemotherapy and in men. The RTT effect on DFS was significant in stage IV patients, patients with neck nodes positive disease and oropharyngeal cancer. RTT prolongation decreased OS within the groups of stage IV and grade 3 tumours. CONCLUSION: Prolonged RTT was associated with worsened OS and LRC, especially in stage IV patients and/or neck node positive disease and/or oropharyngeal cancer and we recommend that these patients should be prioritized in treatment gap compensation in radical radiotherapy for locally advanced HNSCC.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory hlavy a krku patologie   radioterapie   MeSH
• radioterapie s modulovanou intenzitou metody   MeSH
• retrospektivní studie MeSH
• riziko MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• staging nádorů MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

New non-invasive approaches have developed for diagnosis and treatment of malignant diseases. Cells shed from the primary tumor circulating in the bloodstream with metastasis potential are called Circulating Tumor Cells (CTCs). These cells are easily acquired from the peripheral blood of patients, while several enrichment and isolation methods are available nowadays with different benefits and positive detection rates. A brief characterization of three major categories of detection is described (nucleic acid-based, physical properties-based, antibody-based). In this review we concentrate on gynecological malignancies and how CTCs could be used in the diagnosis of cancer, treatment management and its effective prognosis and early recurrence detection. Presence of CTCs in endometrial cancer patients show worse overall survival, while gene analysis could identify patients in need of systemic therapy after surgical treatment to prevent metastasis and recurrence. Based on the influence of human papillomavirus (HPV) in the etiology of cervical cancer, viral oncogene transcripts could be used as an ideal marker for cervical cancer cells detection. In ovarian cancer, CTCs could help in the differentiation from benign adnexal masses and show a high independence from other biomarkers such as CA125 and HE4. While detection of CTC after complete cytoreductive surgery could indicate invisible lesions, combination of tumor associated genes rises the specificity of CTC detection.

• MeSH
• lidé MeSH
• nádorové cirkulující buňky metabolismus   MeSH
• nádory ženských pohlavních orgánů metabolismus   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

PURPOSE: To detect the expression of programmed death-ligand 1 (PD-L1) in Merkel cell carcinoma (MCC) and to determine the prognostic influence of the PD-L1 expression. METHODS: A total of 13 patients with MCC were retrospectively evaluated (12 patients with primary skin lesion, one patient was diagnosed as unknown primary MCC). All patients underwent surgical resection. PD-L1 was determinated by imunohistochemistry. Immunostaining results were evaluated semiquantitatively. The prognostic influence of the expression of PD-L1 on overall survival (OS) was calculated with the Kaplan-Meier method and log-rank test. RESULTS: PD-L1 positivity was detected in 8 patients (61.5%), in all cases the result was 1+. PD-L1 negativity was shown in the remaining 5 patients. In patients with PD-L1 positivity median OS was 42.1 months (95% CI 9.3-42.1) compared with median OS of 9.4 months (95% CI 2.1-80.9) in the group of patients without PD-L1 positivity (p=0.417). CONCLUSIONS: PD-L1 positivity was found in 61.5% of patients with MCC. No prognostic significance of PD-L1 expression for OS was demonstrated.

• MeSH
• antigeny CD274 genetika   MeSH
• dospělí MeSH
• Kaplanův-Meierův odhad MeSH
• lidé středního věku MeSH
• lidé MeSH
• Merkelův nádor diagnóza   diagnostické zobrazování   genetika   patologie   MeSH
• přežití bez známek nemoci MeSH
• prognóza * MeSH
• regulace genové exprese u nádorů genetika   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• staging nádorů MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: The aim of the present study was to analyze a single-center experience with hepatic arterial infusion (HAI) in patients with unknown or uncertain primary or tumors not usually treated with HAI. METHODS: A retrospective analysis of 14 patients treated between 1996 and 2003 for liver tumors of unknown, uncertain or unusual primary was performed. RESULTS: All patients were treated with HAI combination regimens based on 5-fluorouracil and folinic acid. The response was not evaluable in most patients, predominantly because of only a single course of therapy could be administered and no cases of partial or complete response were noted. The median survival of all patients was 6.6 months (5-year survival 14%). CONCLUSION: The present data demonstrate limited efficacy of HAI in patients with liver tumors of unknown, uncertain or unusual primary. HAI should not be offered to these patients.

• MeSH
• arteria hepatica * MeSH
• dospělí MeSH
• fluoruracil aplikace a dávkování   MeSH
• intraarteriální infuze * MeSH
• leukovorin aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• nádory jater farmakoterapie   mortalita   sekundární   MeSH
• nádory farmakoterapie   mortalita   patologie   MeSH
• následné studie MeSH
• prognóza MeSH
• protokoly protinádorové kombinované chemoterapie aplikace a dávkování   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH

PURPOSE: The aim of this study was to investigate the potential association and combined prognostic significance of the frequency of primary cilia (PC), programmed cell death protein-1 receptor (PD1) and CD8+ tumor infiltrating lymphocytes (TIL) in patients with clear cell renal cancer (ccRCC). METHODS: The frequency of PC, PD1 expression and the frequency of intratumoral CD8+ TIL were evaluated in 104 ccRCC patients. RESULTS: The median frequency of PC was 0.003. The expression of PD1+ cells were <5% in 52 patients, 5-25% in 34 patients and 26-50% in 13 patients and >50% in 5 patients. Intratumoral CD8+ TIL were evaluable in all patients: negative in 1 patient, <25% in 63, 26-50% in 29 and >50% in 11 patients. Overall survival (OS) according to the frequency of PC was significantly shorter in patients with higher frequency (≥0.002) than in patients with lower frequency (<0.002) (p<0.001). Median OS was significantly shorter in patients with higher (25%) CD8+ TIL and higher (>25%) PD1+ expression than in patients with lower (<25%) expression (4.6 vs. 97. years, p=0.006 and 2.9 vs. 8.9 years, p=0.006, respectively). CONCLUSIONS: The present study provides the first data on the potential association and combined prognostic significance of frequency of PC, PD1+ cells and CD8+ TIL in patients with clear cell renal cancer.

• MeSH
• antigeny CD279 genetika   MeSH
• CD8-pozitivní T-lymfocyty patologie   MeSH
• cilie genetika   patologie   MeSH
• dospělí MeSH
• Kaplanův-Meierův odhad MeSH
• karcinom z renálních buněk genetika   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• přežití bez známek nemoci MeSH
• prognóza * MeSH
• regulace genové exprese u nádorů MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tumor infiltrující lymfocyty patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: The purpose of our retrospectively study was to evaluate the PD-L1 expression in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with enzalutamide. METHODS: A total of 33 patients with mCRPC were treated with enzalutamide. All patients were previously treated by one or two lines of chemotherapy. Enzalutamide was administered in the standard dose (160 mg orally once daily as four 40 mg capsules). No corticosteroids were concomitantly administered. PD-L1 expression was determined semiquantitavely by immunohistochemistry. RESULTS: Enzalutamide was well tolerated with predominantly G1-2 toxicity. G3-4 anaemia was found in 6 patients and G3-4 thrombocytopenia in 2 patients. One patient had cerebral hemorrhage. The median progression free survival (PFS) was 7.0 months (95% CI 6.1-7.9). The median overall survival (OS) was 8.4 months (95% CI: 5.1-11.7). The shorter OS was noted in the subgroup of patients with decreasing hemoglobin levels during enzalutamide treatment with hazard ratio (HR) 0.155 (95% CI 0.053-0.449) and in patients with Gleason score 8-10 with HR 0.334 (95% CI 0.12-0.927) according to the regression analysis. All tissue samples were scored as negative in the detection of PD-L1. CONCLUSIONS: The expression of PD-L1 in prostate cancer cells as potential new predictive biomarker was not confirmed. Further studies are needed to clarify this topic.

• MeSH
• antigeny CD274 genetika   metabolismus   MeSH
• apoptóza MeSH
• buněčný cyklus MeSH
• fenylthiohydantoin analogy a deriváty   terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• nádorové biomarkery genetika   metabolismus   MeSH
• nádorové buňky kultivované MeSH
• nádory prostaty rezistentní na kastraci farmakoterapie   metabolismus   patologie   MeSH
• následné studie MeSH
• prognóza MeSH
• proliferace buněk MeSH
• regulace genové exprese u nádorů účinky léků   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

The immune synapse (IS) is a temporary interface between an antigen-presenting cell and an effector lymphocyte. Viral synapse is a molecularly organized cellular junction that is structurally similar to the IS. Primary cilium is considered as a functional homologue of the IS due to the morphological and functional similarities in architecture between both micotubule structures. It has been hypothesized that endogenous electromagnetic field in the cell is generated by a unique cooperating system between mitochondria and microtubules. We are extending this prior hypothesis of the endogenous electromagnetic field in the cell postulating that polarized centriole in immune and viral synapse could serve as a monopole antenna. This is an addition to our hypothesis that primary cilium could serve as a monopole antenna. We simulated the distribution of electric field of centriole of polarized centrosome as a monopole antenna in immune and viral synapse. Very weak electromagnetic field of polarized centriole of CD8+ T lymphocyte in IS can contribute to the transport of cytolytic granules into the attacked (cancer) cell. Analogically, very weak electromagnetic field of polarized centriole in viral synapse of infected CD4 cells can aid the transport of viruses (human immunodeficiency virus) to non-infected CD4 cells. We hypothesized that healthy organisms need these monopole antennas. If, during the neoplastic transformation, healthy cells lose monopole antennas in form of primary cilia, the IS aims to replace them by monopole antennas of polarized centrioles in IS to restore homeostasis.

• MeSH
• CD8-pozitivní T-lymfocyty imunologie   MeSH
• centrioly genetika   MeSH
• centrozom imunologie   MeSH
• elektromagnetická pole MeSH
• imunitní systém * MeSH
• lidé MeSH
• mikrotubuly genetika   metabolismus   MeSH
• nádory genetika   imunologie   patologie   MeSH
• polarita buněk genetika   imunologie   MeSH
• synapse genetika   virologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Primary cilium (PC) is considered to be a functional homologue of the immune synapse. Microtubule structures, PC of cancer associated fibroblasts and immune synapses between cytotoxic CD8+ tumor infiltrating lymphocytes (TILs) and cancer cells, are regularly found in varying amounts in the microenvironment of solid tumors. The purpose of this study was to find out the potential association and combined prognostic significance of the frequency of PC, PD-1 and CD8+ TILs in patients with intestinal cancer. METHODS: The frequency of PC, programmed cell death protein-1 receptor (PD-1) expression and the frequency of stromal and intraepithelial CD8+TILs were evaluated in samples of colorectal adenocarcinoma (32 patiens) and small bowel cancer (8 patients). RESULTS: The median frequency of PC was 0.25%. The expression of PD1 was <5% in 34 patients, 5-25% in 5 patients and 26-50% in 1 patient. The frequency of stromal CD8+ TILs was negative in 3 patients, <25% in 26, 26-50% in 10 and >50% in 1 patient, respectively. Intraepithelial CD8+ TILs were not detectable in 14, <25% in 24 and 26-50% in 2 patients, respectively. Statistically, the frequency of PC and PD-1 positivity were significantly associated (p=0.004). An association between the PC frequency and intraepithelial CD8+ TILs was of borderline statistical significance (p=0.059). An index combining the frequency of PC and stromal CD8+ TILs, but not the combination of frequency of PC and intraepithelial CD8+ TILs, was of borderline prognostic significance (p=0.067). CONCLUSIONS: The present study provides the first data on the potential association and combined prognostic significance of frequency of PC, PD-1 and CD8+ TILs in patients with intestinal cancer.

• MeSH
• antigeny CD279 metabolismus   MeSH
• CD8-pozitivní T-lymfocyty metabolismus   MeSH
• cilie patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• senioři MeSH
• střevní nádory genetika   metabolismus   patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the prognostic effect of neoadjuvant chemoradiotherapy on the change of programmed death ligand 1 (PD-L1) expression in patients with locally advanced rectal adenocarcinoma, by comparing PD-L1 expression in pretreatment biopsies and PD-L1 expression in pathological specimens after neoadjuvant chemoradiotherapy. METHODS: A total of 25 patients with rectal adenocarcinoma were evaluated. Patients were treated by neoadjuvant chemoradiotherapy (radiotherapy:44Gy normofraxionation; chemotherapy: capecitabine 825 mg/m2 in two daily doses). Surgery was performed 6-8 weeks after the chemoradiotherapy completion. PD-L1 expression was determined in endoscopic biopsies and in resected specimens with immunohistochemistry. RESULTS: All 25 patients received radiotherapy without interruption, while concomitant chemotherapy was discontinued prematurely in one patient because of hematological toxicity. In 13 patients sphincter-saving surgery were performed, and 12 patients underwent rectum resection. Downstaging was noticed in 17 patients. Stable disease was found in 5 patients, and progression in 3. The median disease free survival (DFS) was not reached. Three-year DFS was 54.3% (95% CI 34.3-74.2). The median overall survival (OS) was 60 months (95% CI 48-60). Three-year OS was 75 % (95% CI 57.7-92.3). No PD-L1 expression was noticed in pretreatment biopsy and in resected tissue after chemoradiotherapy. CONCLUSION: No prognostic effect of neoadjuvant chemoradiotherapy on the change of PD-L1 expression was demonstrated in patients with locally advanced rectal adenocarcinoma.

• MeSH
• adenokarcinom farmakoterapie   patologie   radioterapie   MeSH
• antigeny CD274 metabolismus   MeSH
• chemoradioterapie metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory rekta farmakoterapie   patologie   radioterapie   MeSH
• neoadjuvantní terapie metody   MeSH
• prognóza MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH