Cisplatin is a commonly used chemotherapeutic drugs. It is known for its nephrotoxic side effects with an increased risk of acute kidney injury. Finding of clinically feasible cisplatin nephrotoxicity markers is of importance. In our study, we compared neutrophil gelatinase-associated lipocalin (NGAL) in serum and urine, the estimated glomerular filtration rate (based on serum cystatin C) and urine albumin as markers of nephrotoxicity. The study involved 11 men and 9 women (mean ± SD age 58.2±9.5 years) with different malignancies treated with cisplatin in four cycles of chemotherapy (I - IV). Samples 0-4 were taken before, immediately after, in 3, 6 and 24 hours after administering chemotherapy. We detected significant increase of ACR in Sample 2 (p=0.03) and decrease of eGFR in Sample 4 (p=0.03) up to 24 hours after cisplatin administration in the first chemotherapy cycle only. When cumulative effect of cisplatin was assessed, significantly increased values of urine albumin (vs cycle I) were found in Sample 0 (p=0.00058), 1 (p=0.00256), 2 (p=0.00456), 3 (p=0.00006) and 4 (p=0.00319) in cycles II to IV. We found a correlation between values of urine NGAL and urine albumin (r=0.68, p<0.0001). In conclusion, urine albumin was the only measured marker that consistently and statistically significantly increased after cisplatin containing chemotherapy cycles.
- MeSH
- antitumorózní látky terapeutické užití MeSH
- cisplatina terapeutické užití MeSH
- cystatin C moč MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lidský sérový albumin moč MeSH
- lipokalin-2 moč MeSH
- nádorové biomarkery moč MeSH
- nádory farmakoterapie moč 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
- Názvy látek
- antitumorózní látky MeSH
- cisplatina MeSH
- CST3 protein, human MeSH Prohlížeč
- cystatin C MeSH
- LCN2 protein, human MeSH Prohlížeč
- lidský sérový albumin MeSH
- lipokalin-2 MeSH
- nádorové biomarkery MeSH
BACKGROUND: Chemotherapy (CHT), surgery and radiotherapy (RT) are essential modalities in the treatment of pancreatic malignancies. Their use in practice may be influenced by a number of factors. PATIENTS AND METHODS: Retrospective analysis of CHT, surgery and RT indications and CHT results in patients reported with pancreatic tumor in Pilsen in 2012-2016. RESULTS: A total of 348 patients with median age 68 (19-89) years with newly diagnosed pancreatic tumor, resp., with histology/cytology verified carcinoma in 74.5% cases, with v. s. carcinoma without verification in 21% and with other malignancy not further analyzed here in 4.5% (mostly neuroendocrine tumor). In patients with generalized malignancy (n = 195), exploratory laparotomy was performed in 23% to get tissue samples or verify staging - palliative anastomoses were done in 25% of operated patients, CHT was performed in 29% of the generalized tumors, palliative RT of tumor was performed in 1 patient, and RT of metastases in 3 patients. In patients with local or regional nodal affection (n = 137) laparotomy was done in 59%, R0 resection in 34 (42%) of 81 operated, R1 in 6%, palliative anastomoses were done in 17% and irreversible electroporation in one patients, CHT or radiochemotherapy after R0 and R1 resections was provided in 61% operated patients. The most commonly used CHT was monotherapy with gemcitabine or FOLFIRINOX. The indication of CHT in cytology/histology verified generalized cancers and with excluding patients refusing CHT was proposed in 2012 to 16%, in 2014 to 49% and in 2016 to 84% of patients. In the case of a local or regional nodal involvement the CHT was proposed to 40, 55 and 86% of patients. Median overall survival in generalized tumor patients receiving CHT (n = 137) vs. not-receiving CHT (n = 56) was 2 vs. 8 months (p = 0.0001), and in the local or regional nodal involvement patients receiving CHT (n = 74) vs. not-receiving CHT (n = 62) was 5 vs. 16 months (p = 0.0001). CONCLUSION: CHT and surgery are the dominant treatment modalities. There has been a marked increase in the CHT and histology/cytology verifications indications, with a major factor being a clinician evaluation of a patient to be fit for CHT and its benefit or to complete pancreatic tumor verification. With still very limited results in pancreatic cancer treatment, a careful assessment of each patients indication, respecting patients desire, is always required, knowing that even in the case of advanced disease, CHT can bring benefit, albeit limited.Key words: pancreas - carcinoma - chemotherapy The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. This study was supported by the grant of Ministry of Health of the Czech Republic - Conceptual Development of Research Organization (Faculty Hospital in Pilsen - FNPl, 00669806).Submitted: 13. 3. 2018Accepted: 18. 4. 2018.
- MeSH
- deoxycytidin analogy a deriváty terapeutické užití MeSH
- dospělí MeSH
- fluorouracil terapeutické užití MeSH
- gemcitabin MeSH
- irinotekan terapeutické užití MeSH
- kombinovaná terapie MeSH
- leukovorin terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- nádory slinivky břišní * diagnóza farmakoterapie radioterapie chirurgie MeSH
- oxaliplatin terapeutické užití MeSH
- protokoly antitumorózní kombinované chemoterapie terapeutické užití MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- deoxycytidin MeSH
- fluorouracil MeSH
- folfirinox MeSH Prohlížeč
- gemcitabin MeSH
- irinotekan MeSH
- leukovorin MeSH
- oxaliplatin MeSH
BACKGROUND: Metastasis, recurrence, and resistance to chemotherapy are leading causes of the majority of cancer-related mortality worldwide. The process of metastasis can be artificially divided into a series of sequential, highly organized, and organ-specific steps. The underlying mechanisms are still poorly understood, but are believed to be mediated by epithelial-mesenchymal transition (EMT). First described in embryogenesis, EMT is a cellular reprogramming process in which epithelial cells acquire a mesenchymal phenotype. During this transformation, epithelial cells lose their shape, epithelial markers, and ability to grow in colonies. They acquire a spindle-shaped morphology and exhibit more motile and invasive behavior. These phenotypic changes are associated with modifications in different interconnected protein and gene families, such as transcription factors, cadherins, catenins, matrix metalloproteases, and growth receptors. EMT has been observed in many cancers, such as breast, ovarian, colon, and esophageal cancers, and is associated with poor prognosis and metastasis. Also, resistance to cytotoxic treatments is associated with reactivation of embryonic programs. Understanding this process is necessary to provide a better understanding of cancer progression and could lead to the development of new therapeutic or prognostic strategies for the treatment of cancer. CONCLUSION: This article summarizes the known molecular pathways involved in EMT in cancer.Key words: epithelial-mesenchymal transition - carcinoma - metastasisThe authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 24. 6. 2016Accepted: 14. 11. 2016.
- MeSH
- chemorezistence MeSH
- epitelo-mezenchymální tranzice * MeSH
- epitelové buňky patologie fyziologie MeSH
- kadheriny metabolismus MeSH
- lidé MeSH
- metastázy nádorů patofyziologie MeSH
- mikro RNA metabolismus MeSH
- nádory patologie patofyziologie MeSH
- proteiny hedgehog metabolismus MeSH
- receptory Notch metabolismus MeSH
- signální dráha Wnt MeSH
- transformující růstový faktor beta metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- kadheriny MeSH
- mikro RNA MeSH
- proteiny hedgehog MeSH
- receptory Notch MeSH
- transformující růstový faktor beta MeSH
BACKGROUND: Oral mucositis, mTOR associated stomatitis, is a major complication in everolimus (EVE) treatment with an incidence of 44-64%. The management of it in the daily practice has not been described enough, so far. PATIENTS AND METHODS: Retrospective analysis of patients treated with EVE in 2016 at our center, n = 42 patients (69% female), median age 66 (37-81) years, breast cancer in 20 (48%) and renal cell carcinoma in 22 (52%), starting EVE dose of 10mg/day in 34 (81%) and 5mg/day in 8 (19%) patients. RESULTS: Discomfort and/or dysgeusia without mucosa defects (grade 1 NCI-CTC) was in 4/34 (12%) patients, mucosal defects without oral intake limitation (grade 2) in 6/34 (17.5%), mucosal defects limiting oral intake (grade 3) in 7/34 (20.5%) patients. ACTIONS TAKEN: in grade 1 EVE dose reduced to 5mg/day in 1/4 affected patients, in grade 2 locally administered dexamethasone solution recommended in 2/6, reduction of EVE to 5mg/day in 4/6 (in two cases the reduced dose left because of complications recurrences), in grade 3 locally administered dexamehasone solution recommended in 5/7, transient reduction of EVE to 5mg/day in 1/7, permanent reduction of EVE in 5/7 (recurrent aphthous lesions), EVE terminated in 1/7. In patients with EVE starting dose of 5mg/day there was one case (1/8, 12.5%) of grade 2 complication requiring no intervention. The complications developed within 2-20 weeks after EVE initiation (median of 8 weeks). CONCLUSION: The incidence of stomatitis and its severity in this cohort is comparable with published trials data, it confirms the significant incidence of damage affecting the quality of life, oral intake and anti-cancer treatment in daily practice. The interventions used in groups of similarly affected patients appears slightly heterogeneous, influenced by individual physician approach. There is tendency not to interrupt the EVE treatment and keep it either in a dosage of 10 or 5mg/day if the oral damage is tolerable. Local treatment with dexamethasone is not yet fully exploited.Key words: everolimus - stomatitis - mucositis - oral cavity Supported by the grant of Ministry of Health of the Czech Republic - Conceptual Development of Research Organization (Faculty Hospital in Pilsen - FNPl, 00669806) and National Sustainability Program I (NPU I) No. LO1503 provided by the Ministry of Education Youth and Sports of the Czech Republic. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 27. 2. 2017Accepted: 26. 3. 2017.
- MeSH
- antitumorózní látky škodlivé účinky MeSH
- dospělí MeSH
- everolimus škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stomatitida chemicky indukované MeSH
- ústní sliznice účinky léků 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
- Názvy látek
- antitumorózní látky MeSH
- everolimus MeSH
Goblet cell carcinoid (GCC) of the appendix is extremely rare, representing approximately 5% of all primary appendiceal neoplasms. Histologically there are three groups of GCC: group A (typical GCC), adenocarcinoma ex GCC signet ring cell type (group B), and adenocarcinoma ex GCC poorly differentiated carcinoma type (group C), which is the most aggressive. GCC metastasizes in 15-60% of cases, mainly to the ovaries, pelvis, abdominal cavity, ribs, vertebrae, and lymph nodes. Hematogenous metastasis to the liver or other parenchymal organs can occur, but this is very rare. The different organs metastases havent been described yet. The primary mode of treatment is radical surgical resection or debulking, followed by chemotherapy; however, patients with unresectable or recurrent GCC are candidates for systemic therapy. Here, we report a case of very aggressive GCC of the appendix, which had metastazed to the liver at the time of diagnosis and subsequently metastasized to the orbit.
- MeSH
- karcinoid sekundární MeSH
- lidé MeSH
- nádory apendixu patologie MeSH
- nádory orbity sekundární MeSH
- pohárkové buňky patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
BACKGROUND: Chylous ascites is a rare complication of the gastrointestinal neuroendocrine tumor. There are two mechanisms of its origin: mechanical obstruction by the tumor mass and fibrosis of the surrounding tissue due to overproduction of serotonin. Its presence restricts treatment options. CASE: We report a case of 66year old man suffering from recurrent diarrhoea and ascites. We found elevated tumor marker Chromogranin A and elevation of hydroxyindoleacetic acid (5- HIAA) in the urine. A subsequent whole body scintigraphy scan by octreoscan confirmed multinodal process with increased somatostatin receptors activity in the wall of the ileum, rectosigmoideum, lymph nodes of the retroperitoneum and mesenterium and left supraclavicular area. We performed bio-psy from the lymph node of supraclavicular area, and there was metastasis of the neuroendocrine tumor. Start of cytostatic therapy was repeatedly complicated by recurrent massive chylous ascites. The patient underwent only one series of palliative chemotherapy. Another procedure was again complicated by chylous ascites that caused hospitalization at the internal department, and the patient died four months after dia-gnosis. CONCLUSION: Chylous ascites is a very rare complication of gastrointestinal neuroendocrine tumor. It is not only a marker of poor prognosis, but also a complication that makes systemic treatment very difficult.
- Klíčová slova
- case report - neuroendocrine tumors - chylous ascites - malignant carcinoid syndrome,
- MeSH
- chylózní ascites diagnóza etiologie MeSH
- fatální výsledek MeSH
- lidé MeSH
- nádorové biomarkery MeSH
- nádory ilea komplikace diagnóza MeSH
- neuroendokrinní nádory komplikace diagnóza MeSH
- paliativní péče MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- nádorové biomarkery MeSH
BACKGROUND: Tapentadol is a µ -opioid receptors agonist as well as an inhibitor of noradrenaline reuptake. This pharmacologic profile of tapentadol makes it a suitable drug of choice in nociceptive and neuropathic pain control. CASE REPORT: This clinical report pressents a 65year old man with poorly differentiated prostate cancer - Gleason score 8 (4 + 4) with metastatic bone disease. Besides the initial application of bisphosphonates, the patient had been treated with androgen deprivation therapy (cyproterone acetate + leuprolide acetate) for the period of 18 months. This therapy was terminated due to an increase of PSA levels. Subsequently, the patient underwent palliative docetaxelbased chemotherapy. There were eight cycles applied with positive clinical and laboratory effect. However, the further application was limited by the averse effects, namely the peripheral neuropathy manifested by pain in arms and legs. The peripheral neuropathy had progressive tendency even after the end of chemotherapy, and supportive treatment with gabapentin and amitryptiline failed to succeed. Four months after zoledronic acid monotherapy, the patient was started on tapentadol in 50-mg dose b.i.d., consequently escalated to 100 mg b.i.d. (to this point, 25 µg of transdermal fentanyl were used for pain management). Significant relief from neuropathic discomfort was observed three weeks from the onset of tapentadol therapy. Patients state of health normalized within three months after the initiation of therapy. Consequently, the patient was able to receive docetaxel chemotherapy again, without any neuropathic pain exacerbation on the maintenance dose of tapentadol 50 mg b.i.d. CONCLUSION: Tapentadol administration resulted in stable and longtime relief from neuropathic pain which is a frequent side effect in the course of castrate-resistant prostate cancer therapy with taxanes.
- Klíčová slova
- case study - tapentadol - neuropathic pain - prostate cancer,
- MeSH
- analgetika terapeutické užití MeSH
- antagonisté androgenů terapeutické užití MeSH
- chemorezistence MeSH
- docetaxel MeSH
- fenoly terapeutické užití MeSH
- lidé MeSH
- management bolesti metody MeSH
- nádory prostaty komplikace farmakoterapie MeSH
- polyneuropatie farmakoterapie etiologie MeSH
- prostatický specifický antigen krev MeSH
- protokoly antitumorózní kombinované chemoterapie terapeutické užití MeSH
- senioři MeSH
- tapentadol MeSH
- taxoidy terapeutické užití MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- analgetika MeSH
- antagonisté androgenů MeSH
- docetaxel MeSH
- fenoly MeSH
- prostatický specifický antigen MeSH
- tapentadol MeSH
- taxoidy MeSH
INTRODUCTION: The use of biological glues and their application between the two dissection layers and into the anastomosis region is a common integral part of surgical management of thoracic aortic dissections. AIM: The aim of the experimental study was to assess and evaluate histopathological changes of vascular wall following deposition of the following three types of glue--GRF, Tissucol, Bioglue, based on qualitative and quantitative parameters. The secondary aim of the study was to assess dynamics of these changes depending on the glue effect duration and to formulate expected behaviour of the vascular wall during the time beyond the experimental period. METHODOLOGY: The dissection model was performed with pigs of the same gender and age, assigned to four groups. Different glues were used to close artificial infrarenal aortic dissections in Group 1-3, while direct suturing and no glue was used to close false lumini in Group 4. Samples of the dissected aorta were then collected at Month 1, 6 and 12 and then histologically examined. RESULTS: Upon assessment of the whole group of qualitative and quantitative parameters, the most significant changes in the smooth muscle histological picture were observed with the use GRF glue. The smooth muscle changes following the Bioglue application and, in particular, Tissucol glue application, are similar to changes observed in Group 4, where no glue was used. CONCLUSION: Based on the results, the authors present a hypothesis that, in a long-time horizont, vascular wall destructions, eventually redissections, are likely to occur more frequently in patients, in whom GRF glue is used.
- MeSH
- aorta účinky léků patologie MeSH
- aortální aneurysma terapie MeSH
- disekce aorty terapie MeSH
- fibrinová tkáňová adheziva farmakologie MeSH
- fixní kombinace léků MeSH
- formaldehyd farmakologie MeSH
- modely u zvířat MeSH
- proteiny farmakologie MeSH
- resorcinoly farmakologie MeSH
- Sus scrofa MeSH
- tkáňová adheziva farmakologie MeSH
- želatina farmakologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- Bio-glue MeSH Prohlížeč
- fibrinová tkáňová adheziva MeSH
- fixní kombinace léků MeSH
- formaldehyd MeSH
- gelatin-resorcinol-formaldehyde tissue adhesive MeSH Prohlížeč
- proteiny MeSH
- resorcinoly MeSH
- tkáňová adheziva MeSH
- želatina MeSH
