Archive of Oncology

Impressum

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Intro with Editorial Board

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Hypoxia modulation vs. chemotherapy and tumor shrinkage on early response assessment in diffuse large B-cell lymphoma

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Background: Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy remains the standard of first-line treatment for diffuse large B-cell lymphoma (DLBCL). Up to 40% of DLBCL is characterized by relapse and refractory after treatment. Preliminary study reported Hypoxia-inducible factor-1 (HIF-1 ) overexpression in 88.5% of DLBCL tumors in the Dr. Kariadi Hospital. Moreover, the role of hypoxia and HIF-1 has previously never been explored in DLBCL.

Objectives: To evaluate the effect of hypoxia modulation to increased chemotherapeutic response in DLBCL.

Methods: Single blind randomized control study was performed, with pre-test and post-test control group design.

Research sampling consisted of DLBCL patients. The inclusion criteria include newly diagnosed DLBCL with HIF-1 overexpression and randomized to receive hypoxia modulation consisting of carbogen inhalation and nicotinamide administration, before R-CHOP chemotherapy. The tissue biopsy, histopathology and immunohistochemical studies were done. Chemotherapeutic responses were evaluated after 10-14 days following the first cycle of R-CHOP chemotherapy.

Results: Out of twenty-six DLBCL participants with HIF-1 overexpression, there were 20 participants who completed the research protocol: 10 participants each in the intervention and control group. Demographic, clinicopathological, laboratory and disease characteristics were not statistically different between the two research groups (p>0.05). Baseline tumor volume to be evaluated was also considered equal (172.3 cm³ vs. 152.8 cm³, p=0.597). Following the carbogen inhalation and nicotinamide administration, serum HIF-1 and lactate reduction can be observed. There was also a significant tumor volume shrinkage in both the intervention and control (mean –85.7 cm³vs. –118.27 cm³) group, though the reduction was not statistically different (Delta 58.85% vs. 65.63%, p=0.474).

Conclusion: The addition of hypoxia modulation to R-CHOP chemotherapy for DLBCL has shown beneficial effects on both serum HIF-1 and lactate concentration. However, the benefits did not correlate to increase a better tumor response compared to the control group.

Immunotoxicity of Pembrolizumab in patients with metastatic non-small cell lung cancer: A single-centre study

2024-08-13T12:22:33+02:00

Background: Immunotherapy represents a new form of treatment, that stimulates immune system to destroy cancer cells. Pembrolizumab is a humanized monoclonal antibody that binds to the PD-1 programmed cell death receptor and blocks its interaction with the PD-L1 and PD-L2 ligands. The aim of this study was to determine the efficacy and safety of the drug pembrolizumab, in the first line of treatment in patients with metastatic NSCLC. Methods: The research was retrospective and was conducted at the Institute for Pulmonary Diseases of Vojvodina, it included patients treated in the period from January 2018 to December 2019, in whom metastatic NSCLC was verified. Results: The study included a total of 20 patients, 10 men and 10 women. The average age was 61.75 years. The average length of therapy was 15 cycles (45 weeks), the minimum was 1, and the maximum was 33. 12 patients (60%) had a lethal outcome. The median time to disease progression was 8.1 months and overall survival was 14.6 months. Of the total number of patients, 13 (65%) had side effects to pembrolizumab therapy, and 7 (35%) did not experience any. Out of a total of 13 patients who had side effects, 9 had only one isolated, 4 had more associated side effects, of which 3 patients had 2 associated, and 1 patient had 3 associated side effects. Conclusion: Based on the results, immunotherapy certainly occupies an important place in the treatment of metastatic NSCLC. Namely, the lack of severe side effects linked to cytotoxic chemotherapy and the relative ease of treating immune related adverse effects (irAEs) that occur with immunotherapy, good overall survival and later onset of disease progression opens the door to the possibility of a better quality of life for these patients and the prolongation of their lifespan.

Cervical cancer in the Autonomous Province of Vojvodina, Serbia, 2016-2021

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Background: Cervical cancer is a major global health problem, and one of the most common causes of cancer in women. This descriptive epidemiological study aimed to provide an overview of the cervical cancer incidence and mortality in Vojvodina. Methods: The data from the Serbian Cancer Registry regarding the cervical cancer incidence and mortality for the period 2016–2021 were analyzed. Results: During the observed 6-year period, the average age-standardized incidence rates of cervical cancer in Vojvodina and Serbia were 20.4 and 19.1 per 100,000 women, respectively. The average age-standardized incidence rates by the district of Vojvodina ranged from 16.8 to 30.2/100,000. The average age-standardized cervical cancer mortality rate in Vojvodina and Serbia was 7.0 and 6.6/100,000, respectively. The average mortality rates by the district of Vojvodina ranged between 5.6/100,000 and 9.9/100,000. Conclusion: The cervical cancer incidence and mortality rates in Vojvodina exhibited significant variation across different districts and observed years, with their average values surpassing the national average. To improve the epidemiological situation of cervical cancer in Vojvodina, it is imperative to enhance the implementation of organized screening at the district level, coupled with intensified efforts to promote HPV vaccination throughout Vojvodina. Additionally, more research on screening coverage and vaccination rates and improved reporting cervical cancer cases and deaths are needed.

Lymphoepithelioma-like carcinoma of the cervix-diagnostics, treatment, monitoring

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Lymphoepithelioma-like carcinoma of the cervix (LELC) is a rare subtype of squamous cell carcinoma.

This is a case report of a 40-year-old female patient diagnosed with LELC. The tumor is clinically presented as an exophytic mass on the front lip of the cervix. Magnetic resonance imaging (MRI) of the pelvis revealed a cervical tumor mass with a diameter of 21 mm. The findings of the preoperative pathohistological analysis of the biopsy tissue indicated LELC. The disease was clinically and radiologically staged as IB1 stage according to the 2009 FIGO classification, and the patient underwent surgical treatment. A total radical hysterectomy with pelvic lymphadenectomy was performed, followed by external beam radiotherapy.

The patient was regularly monitored oncologically with the last check-up on February 2024 (36 months) and control MRI of the pelvis and abdomen without signs of recurrence of the underlying disease. The patient is in good general condition, without subjective complaints and side effects of the applied therapy.

Key words: lymphoepithelioma-like carcinoma of the cervix, LELC, cervical carcinoma, radical hysterectomy.

Case report: Pancreatic cancer-the insidious disease

2024-08-13T12:22:33+02:00

Pancreatic cancer is one of the most aggressive forms of malignant disease, often with a long asymptomatic course, early metastases to distant organs and with an extremely poor prognosis.

Here we present the case of a 70-year-old female patient, who was hospitalized in a pulmonology institution with a severe general condition. Due to bilateral lung changes seen on the chest radiograph, she was under suspicion for pneumonia, respiratory insufficiency and had elevated markers of inflammation. On physical examination, paraumbilically on the right, a subcutaneous swelling had been palpated with a harder consistency measuring 7 cm in diameter. She presented an ulcerated umbilicus with a purulent discharge. Nineteen hours after admission, a fatal outcome occurred and the autopsy proved an extended malignant disease (pancreatic ductal adenocarcinoma (aT3N2M1, Stage IV)) with multiple metastases.

It is necessary to adhere to the differential diagnostic algorithm of bilateral lung lesions. Each umbilical nodule should arouse suspicion of the existence of malignant diseases in the abdominal-pelvic region. Therefore, it is of great importance to raise people's awareness about taking control of their health.

Erratum to: Literature review on breast cancer-related lymphedema and related factors (vol. 29 (2): p. 25, 2023.)

2024-08-13T12:22:34+02:00

A potential complication that affects a patient's quality of life is breast cancer - related lymphedema (BCRL). Due to lymphatic system failure brought on by breast cancer treatment, it is secondary lymphedema. This literature review examines 50 articles that are connected to BCRL.

The reason for the correction is an error in the paper's Conclusion which occurred due to an oversight by the Editorial Team during preparation for electronic publication.

Instructions for Authors

2024-08-13T12:22:34+02:00