Magyar Onkológia

Publications in this journal

• Article: [Assessment of Hungarian ESA and G-CSF treatments to national and international guidelines and protocols].

  Zsolt Nagy
  [show abstract] [hide abstract]
  ABSTRACT: Chemotherapy induced neutropenia (CIN), febrile neutropenia (FN), chemotherapy induced anemia (CIA) frequently occur following myelosuppressive chemotherapy and are associated with morbidity, mortality, costs, and relative dose intensity (RDI), hence influencing overall survival (OS). Given prophylactically, granulocyte colony-stimulating factors (G-CSFs) can stimulate neutrophil production and depletion, they may thus reduce FN incidence when following chemotherapy. Erythropoietins are widely used to treat chemotherapy induced anemia. Several guidelines have been published to help onco-hematologists design their supportive therapy. The aim of our study was to assess the guidelines concerning everyday routine in supportive care. The final conclusion is that the Hungarian therapy support guidelines are up to date, are highly compliant with international standards [ASCO (1), EORTC (2), ESMO (3, 4), NCCN (5-7)], and that the clinicians have a deep understanding and comprehensive usage in their everyday practice.
  Magyar Onkológia 04/2013; 57(1):50-5.
• Article: [The place of functional genomics in oncological research].

  Bálint L Bálint, László Nagy
  [show abstract] [hide abstract]
  ABSTRACT: The 1000 genomes project changed the way how we see the human genome. The rapid development of the deep sequencing technologies is raising several practical questions, and the way how we answer these questions will affect deeply the future of the oncological reseach in Hungary. In our manuscript we give a short overview of the results of the 1000 genomes project and we present the place of the functional genomic investigations between other genomic tools. Based on the recent development in the field we summarize the challenges that have to be addressed in the next couple of years.
  Magyar Onkológia 04/2013; 57(1):21-5.
• Article: [Role of contemporary pathological diagnostics in the personalized treatment of cancer].

  József Tímár
  [show abstract] [hide abstract]
  ABSTRACT: Due to the developments of pathology in the past decades (immunohistochemistry and molecular pathology) classification of cancers changed fundamentally, laying a ground for personalized management of cancer patients. Our picture of cancer is more complex today, identifying the genetic basis of the morphological variants. On the other hand, this picture has a much higher resolution enabling us to subclassify similar histological cancer types based on molecular markers. This redefined classification of cancers helps us to better predict the possible biological behavior of the disease and/or the therapeutic sensitivity, opening the way toward a more personalized treatment of this disease. The redefined molecular classification of cancer may affect the universal application of treatment protocols. To achieve this goal molecular diagnostics must be an integral and reimbursed part of the routine pathological diagnostics. On the other hand, it is time to extend the multidisciplinary team with molecular pathologist to improve the decision making process of the management of cancer patients.
  Magyar Onkológia 04/2013; 57(1):26-32.
• Article: [Significance of genetic tests in the era of personalized medicine].

  Judit Mária Molnár, Szilvia Magyarósi, György Németh
  [show abstract] [hide abstract]
  ABSTRACT: Due to the rapid development in genomics, genetic markers gain importance in all areas of medicine including prevention, management and therapy of patients. As a result, medicine started to shift away from evidence based procedures to a more personalized one. However, the later one requires high quality validated genetic tests. These new tests appeared as preconceptional, preimplantational, prenatal, presymptomatic, diagnostic and direct to consumer forms. Before approval such tests must be analytically and clinically validated. Broader use of these genetic tests is dependent on their price and reimbursement schemes.
  Magyar Onkológia 04/2013; 57(1):16-20.
• Article: [Analysis of drug therapy of lung cancer in Hungary].

  Judit Moldvay, György Rokszin, Zsolt Abonyi-Tóth, Lajos Katona, Gábor Kovács
  [show abstract] [hide abstract]
  ABSTRACT: Hungary is a world leader in the field of lung cancer deaths, so it is particularly important that patients could have access to modern treatments. The aim of our analysis was to find how drug treatments are used in Hungary and how they are compatible with international practice. The in-patient and prescription database of the National Health Insurance Fund for three years (2008-2010) was used to study the frequency of certain chemotherapy protocols, the duration of therapies, and the changes in the individual protocols and drugs used for lung cancer treatment (ICD: C33H0-C34) during the reviewed period. We did not differentiate between neoadjuvant and adjuvant treatment and therapy after progression. During the study period 12326 lung cancer patients received first-line chemotherapy, one third of those (n=3791) received second-line, and one third of those (n=1174) third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of NSCLC mainly consisted of platinum treatment in combination with third generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with the increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among new agents the use of pemetrexed and bevacizumab has increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib also in second, but mostly in third line. The first-line treatment of SCLC consisted of a platinum-etoposide combination, and in second-line setting topotecan was the most commonly used drug. According to our results the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain more accurate picture of the efficacy of lung cancer treatments as well.
  Magyar Onkológia 04/2013; 57(1):33-8.
• Article: [New directions in drug development, biomarker research and personalized medicine].

  György Németh, Ivett Jelinek
  [show abstract] [hide abstract]
  ABSTRACT: In the recent years, medicine has taken some first important steps toward a major paradigm shift that could result in a landslide for personalized therapies. Indeed, evidence-based medicine seems to yield to personalized medicine in multiple areas, including both the thinking patterns of healthcare workers and everyday medical practice. Nevertheless, although a steadily increasing number of personalized treatment modalities have recently become available for patients, so far, no breakthrough can be seen in the paradigm shift from evidence-based medicine to personalized therapy. We believe that a more efficient identification and utilisation of future and already known biomarkers, respectively, might be the key to speed up this progress. In line with this, biomarkers are becoming increasingly important tools in late stage research, drug development and in clinical practice, as well. Correct classification of biomarkers becomes especially important, as different types of biomarkers provide markedly different information to drug developers and health care professionals.
  Magyar Onkológia 04/2013; 57(1):5-10.
• Article: [Biomarkers in solid tumors].

  Zsuzsanna Nagy
  [show abstract] [hide abstract]
  ABSTRACT: In the past decade the revolutionary development of molecular technology contributed a lot to the increase of our knowledge on cancer. These informations led to the discovery and understanding of those key regulatory changes in the genesis and progression of malignancies that can serve as targets in tumor diagnostics and therapy. One of the main challenges in the research field is to identify the most important molecular networks, the molecular targets, the markers (biomarkers) which can predict therapeutic responsiveness in order to select the appropriate patients, as well as markers to judge the prognosis of the disease. The aims of our study approached some details of the biomarker area and reached certain conclusions: (1) The anti-EGFR therapy, used in the second line or even further, proved to be effective, providing clinical advantage (operability, regression) in 36% of patients carrying wild-type KRAS. G13D mutations were the most frequent among the KRAS-mutants, which, according to current data, could react to anti-EGFR therapy. (2) Extended immunohistochemical (IHC) analysis on colorectal cancer samples (using tissue microarray) found rather few correlations between the IHC estimation and the clinical characteristics related mainly to survival. According to the results with anti-EGFR antibodies in the diagnostic histological samples, the regulatory pathway which rules the proliferation of normal colonic mucosa is also present in colonic cancer cells. This finding is supported by the increased ativity of the downstream members (as RAS, RAF, ERK) of the EGFR signalling. (3) The level of D-dimer increased at least as much as the level of classical tumor markers in the early stages of tumor growth. D-dimer can be considered as a prognostic factor in tumor types studied (breast-, colorectal-, ovarian cancers) and its measurement is advised besides the classical markers. We hope that these results may contribute to the design of a more individual-based and more effective antitumor strategy.
  Magyar Onkológia 04/2013; 57(1):56-62.
• Article: [The treatment of chemotherapy induced anemia in lung cancer patients].

  Gabriella Gálffy
  [show abstract] [hide abstract]
  ABSTRACT: Anemia is common among patients with malignant tumors, due to the disease and chemotherapy. Active oncotherapy, combination chemotherapy of lung cancer is accompanied with many side effects which may impair the patient's quality of life and compromise the effectiveness of chemotherapy, the most frequent one of them being chemotherapy induced anemia. Anemia decreases not only the patient's quality of life, but also worsens the dose- intensity of chemotherapy. One of the potential treatments of chemotherapy-induced anemia is erythropoietin-stimulating agents (ESAs) using the appropriate indications. Several national and international studies have shown that ESA therapy effectively increases hemoglobin level. However, in recent times, contradictory results were published on ESA treatment in terms of survival and progression of the tumor. The background of this may be that the tumor cells and endothelial cells as well may express erythropoietin receptor, the role of which has not yet been fully elucidated in tumor progression.
  Magyar Onkológia 04/2013; 57(1):39-49.
• Article: [Personalized medicine in the eye of patients and their relatives].

  Gábor Pogány
  [show abstract] [hide abstract]
  ABSTRACT: Our goal was to overview the situation of personalized medicine, especially to characterize the role of patient organizations. We embedded this process into the on-going procedures of the transformation of health care system, outlining the Hungarian and international tendencies. We introduce the exceptional role of rare diseases, among others the rare cancers, thanks to their special status. Some results of the recent Hungarian and international surveys are also demonstrated. The presented global tendencies give the frame for the necessary alteration of the Hungarian health care system. Beside the solution of the country-specific problems of our health care system, the main principles of the new paradigm of 21st century medicine are also influencing: personalized, participatory, preventive, predictive and proactive. The new medicine is continuously associated with the patients, instead of separated interventions. The changing of attitude is necessary for spreading these principles and also gives the basis of future medical service of society. The role of patient organizations is vital during this progress. The development is possible to the direction of patient-centred health care model by changing the structure of residential expenditure, even during the time of global financial crisis. However, a stronger community involvement is required. Good examples of this patient organization involvement are presented in the case of rare diseases, which can be, together with orphan drugs, the precursors to personalized medicine, paving the path to this direction. A closer participation of patients and their organizations is essential to transform the present health care system to the route of personalized medicine and to alter the public outlook.
  Magyar Onkológia 04/2013; 57(1):11-5.
• Article: [Quality of life analysis of postmenopausal, early breast cancer patients treated with anastrozole (RADAR-II)].

  Zsolt Horváth
  [show abstract] [hide abstract]
  ABSTRACT: Due to the recognition and diagnosis of breast cancer in increasingly early stages, quality of life becomes an important part of treatment beyond the efficacy indicators. In the scientific literature quality of life data related to adjuvant treament of early breast cancer is poorly represented. Our aim was collecting data to capture the changes in quality of life of postmenopausal, early breast cancer patients. This multicenter, prospective, observational, non-interventional study enrolled 1502 postmenopausal, early stage breast cancer patients. The answers to the QoL questionnaire were rated on a scale from 0 to 100. Overall the patients judged their working ability fairly negative at the start however, this parameter improved by the end of the survey. According to earlier studies the physical parameters deteriorated more significantly among patients belonging to the elderly (≥65 years) age group compared to younger patients. This correlation was confirmed by our study as well. Our results however are somewhat conflicting with the observations by Fehlauer et al (14) that younger patients show greater absolute and relative functional deterioration in their physical status compared to middle-aged or elderly patients. Fatigue appeared in the same rate among different age groups, while deterioration in vitality and daily functionality levels could persist for several years. Based on our findings the elderly patient's care needs special attention from treating personnel.
  Magyar Onkológia 12/2012; 56(4):242-6.
• Article: [Accelerated partial breast irradiation with three-dimensional conformal external beam radiotherapy following breast-conserving surgery - Preliminary results of a phase II clinical study].

  Emõke Mózsa, Csaba Polgár, Georgina Fröhlich, Tibor Major, Levente Jánváry, Katalin Lövey, Zoltán Sulyok, László Takácsi Nagy, János Fodor, Miklós Kásler
  [show abstract] [hide abstract]
  ABSTRACT: The aim of the study was to implement accelerated partial breast irradiation (APBI) by means of three-dimensional conformal radiotherapy (3D-CRT) following breast-conserving surgery (BCS) for early-stage breast cancer. Between December 2006 and February 2011, in 45 cases of low-risk, stage I-II breast cancer the tumour bed was marked with titanium clips during BCS. Postoperative APBI was given by means of 3D-CRT using 3 to 5 non-coplanar fields. The total dose of APBI was 36.9 Gy (9 x 4.1 Gy) using a twice-a-day fractionation over 5 consecutive days. Early and late radiation side effects and cosmetic results were analysed for the first 30 patients with a minimum follow-up of 1 year. At a mean follow-up of 25.2 months neither loco-regional nor distant failure was observed. Excellent, good, fair, and poor cosmetic outcome was detected in 10 (33.3%), 16 (53.4%), 4 (13.3%), and 0 (0%) patients, respectively. Grade 2 or worse acute side effect was not observed. Grade 1 fibrosis, grade 2 teleangiectasia and asymptomatic fat necrosis occurred in 4 (13.3%), 1 (3.3%) and 5 (16.7%) patients, respectively. No grade 3-4 late side effects were detected. 3D-CRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. The preliminary results are promising, early- and mid-term radiation side effects are rare, and cosmetic results are excellent.
  Magyar Onkológia 12/2012; 56(4):235-41.
• Article: [Complex psycho-social intervention program complementing conventional antitumor therapy - promising results].

  Zsuzsanna Kovács, Adrien Rigó, Gyöngyi Kökönyei, Eva Szabó, Dorottya Kovács, Arpád Sebestyén, Béla Balogh, Zsuzsanna Prezenszki, Melánia Nagy
  [show abstract] [hide abstract]
  ABSTRACT: The aim of the research was to assess the effectiveness of a comprehensive, complex psycho-social intervention program, operating on different levels of spiritual plane, life management and behavioural health, among women with breast cancer. The general objective of the study was to help in coping, promote cognitive and emotional processing, encourage psychological and spiritual growth, improve the quality of life, and reduce the chances of remission. The research has been carried out in Budapest at the Radiology Diagnostic Department of the National Oncology Institute, involving 173 women treated for malignant breast tumour (C50) (experimental group: n=86, control group: n=87). Thirty-four women from the experimental group participated in the complex intervention program. We carried out two tests: one before the start and one after the end of the program. Research tools: Shortened Beck Depression Inventory, Quality of Life Questionnaire (EORTC QLQ-C30, QLQ-BR23), Spielberger's State-Trait Anxiety Inventory (STAI-T), the Revised Illness Perception Questionnaire (IPQ-R), the Posttraumatic Growth Inventory, and the Benefit Finding Questionnaire. The women participating the experimental program showed a significant positive change in comparison to the control group: in anxiety F (1, 65)=6.021, p=0.017; in depression: F(1, 72)=4.347, p=0.041; in experience of personal control: F(1, 69)=7.346, p=0.008; in EORTC General Health/Quality of Life Subscale F(1, 78)=7.531, p=0.008; in EORTC physical functioning F(1, 78)=4.874, p=0.014; in EORTC fatigue F(1, 78)=15.060, p=0.000; in BR23 body-image F(1, 79)=8.828, p=0.004; in BR23 arm symptoms F(1, 78)=7.229, p=0.009; in benefit finding F(1, 80)=21.171, p=0.000, and in posttraumatic growth F(1, 31)=24.186, p=0.000). The program has proven effective, its widespread use in practice is recommended.
  Magyar Onkológia 12/2012; 56(4):247-57.
• Article: [The treatment of castration-resistant prostate cancer].

  Agota Petrányi
  [show abstract] [hide abstract]
  ABSTRACT: The last several years have seen extraordinary progress in the management of patients with castration resistant prostate cancer (CRPC). Although metastatic prostate cancer remains an incurable disease, substantial advances have been made in therapeutic options. Development of novel agents that modulate the androgen receptor pathway, growth factor signalling pathways, and immune function and bone targeting pathways has been the focus of therapeutic strategies because of its significance in the biology of prostate cancer progression. In 2004, docetaxel/prednisone was the first therapy shown to prolong survival. For the next 6 years, no substantial progress was made in prolonging survival, but the latest 2 years have marked the beginning of a new and exciting era for the treatment of mCRPC. Based on phase III clinical trials cabazitaxel, abiraterone acetate, sipuleucel-T and denosumab represent available therapeutic options in this setting, radium-223 chloride and MDV3100 demonstrated a survival advantage in phase III trials and the road for their introduction in clinical practice is rapidly ongoing. Results are also awaited for phase III studies currently underway or planned with new drugs given as monotherapy (TAK-700, cabozantinib, tasquinimod, PROSTVAC-VF, ipilimumab) or in combination with docetaxel (custirsen, aflibercept, dasatinib, zibotentan), while other emerging molecules have shown hopeful results. The aim of this review is to summarize the most important new findings for metastatic CRPC (mCRPC) according to the different molecular pathways and to discuss their potential influence on future management of this disease.
  Magyar Onkológia 12/2012; 56(4):219-28.
• Article: [Comparison of CT- and MRI-based clinical target volumes for 3 dimensional conformal external-beam radiotherapy of prostate cancer].

  Zoltán Szabó, Péter Agoston, Tibor Major, Katalin Horváth, Eva Jederán, Csaba Polgár
  [show abstract] [hide abstract]
  ABSTRACT: The aim of the study was to compare clinical target volumes defined by CT and MRI for 3 dimensional conformal external beam radiotherapy of prostate cancer. CT and T2-weighed MRI images with 3 mm slice thickness were acquired for 13 patients with clinically organ-confined prostate cancer. Target volumes were contoured by two clinicians ("AP" and "SZ") experienced in prostate radiotherapy. Two clinical target volumes were defined: prostate (CTVpros) and prostate with a margin including the proximal 1 cm of the seminal vesicles (CTVpvs). Eight clinical target volumes were outlined for all patients: CTVprosAPCT, CTVprosAPMR, CTVpvsAPCT, CTVpvsAPMR, CTVprosSZCT, CTVprosSZMR, CTVpvsSZCT, CTVpvsSZMR. Volumes were measured in cm3. The volumes of different PTVs were compared using the Student's t-test. Mean CTVpros and CTVpvs using CT vs. MRI were 36.9 (range:13.8-121) vs. 32.0 (9.7-120.1) (p=0.0002), and 77.2 (30.5-209.5) vs. 67.6 (29.8-191.1) (p=0.0001), respectively. Mean CTVprosAPCT vs. CTVprosAPMR were 39.2 vs. 32.0 (p<0.00005), respectively. Mean CTVprosSZCT vs. CTVprosSZMR were 34.6 vs. 31.9 (p=0.15). Mean CTVpvsAPCT vs. CTVpvsAPMR were 85.8 vs. 70.9 (p<0.00006). Mean CTVpvsSZCT vs. CTVpvsSZMR were 68.6 vs. 64.4 (p=0.14). Interobserver difference for CTVpros defined by CT images was significant (39.2 vs. 34.6; p=0,0058). However, the difference was not significant using MRI images (32.0 vs. 31.9; p=0.93). Interobserver differences for CTVpvs were significant using either CT (85.8 vs. 68.6; p=0.0001) or MRI (70.9 vs. 64.4; p=0.004). Ratio of mean volumes contoured by the two observers were 1,12 (CT) vs. 1 (MRI) for CTVpros and 1,2 (CT) vs. 1,09 (MRI) for CTVpvs. Clinical target volumes defined for prostate cancer external beam radiotherapy by MRI images are significantly smaller compared to CT image based contouring. The magnitudes of differences are observer dependent. The use of MRI decreases the interobserver difference of mean volumes with 11% and 12% for CTVpvs and CTVpros.
  Magyar Onkológia 12/2012; 56(4):267-73.
• Article: [Burkitt's lymphoma presenting as ovarian tumor].

  Anna Dudnyikova, Erika Tóth, Beáta Deák, Imre Pete
  [show abstract] [hide abstract]
  ABSTRACT: Burkitt's lymphoma is a rapidly progressing tumor, which could be cured in 60-80% of cases. Its infiltration of the ileo-cecal region often spreads to the ovaries, though primary ovarian manifestation is also common. By presenting our case of a 27-year-old nulliparous patient with primary ovarian Burkitt's lymphoma, we would like to draw attention to its diagnostic and therapeutic difficulties.
  Magyar Onkológia 12/2012; 56(4):282-6.
• Article: [The role of PET/CT in decision-making during cancer treatment. Clinical experience].

  Dániel Sinkó, László Landherr
  [show abstract] [hide abstract]
  ABSTRACT: Nowadays PET/CT examinations have got more and more important role during cancer treatment. It has importance not only in diagnostic examination and staging but also in the radiation planning process and measuring the therapeutic effect. From November 2006 to November 2010 there were 153 PET/CT examinations requested by the Oncology Outpatient Clinic, Uzsoki Hospital. Nine patients were excluded from the examination. In the clinical trial we have aimed to measure what the correlation between the oncologists' questions and the PET/CT results was, in how many cases the PET/CT had influence on therapeutic decision-making. In the case of the patients waiting for the operation we compared the results of the pathological examinations to the results of the PET/CT. The oncologists got the expected answers in 79 cases, while in 45 cases the answers were negative. In 10 cases there were no definite answers. Ten cases proved to be false negative or false positive based on the later pathological examination. As a result of the PET/CT findings the originally planned therapeutic decisions or the therapies in process have been modified in 77 cases. To sum up, the PET/CT gave the expected answers to the oncologists' questions in more than half of the cases (54.9%) and modified the originally prescribed therapy in 53.5% of the cases.
  Magyar Onkológia 12/2012; 56(4):230-4.
• Article: [Application of image-guided radiotherapy in external beam radiation of cancer patients].

  Tibor Major, Péter Agoston, Kliton Jorgo, Csaba Polgár
  [show abstract] [hide abstract]
  ABSTRACT: The aim of the study was to present the clinical application of megavoltage cone beam CT (MV-CBCT) for image-guided radiotherapy at different tumour sites in our department. Altogether 2772 CT examinations were performed to verify the accuracy of patient setup before irradiation of 462 patients with pelvic (n=281), thoracic (n=107), head and neck (n=33) and cranial (n=41) tumours. A MV-CBCT with 6 MV photon beam integrated into a linear accelerator was used for imaging. The verification CT images were registered to planning CTs using bony structures, and in the three main directions (lateral, longitudinal, vertical) deviation between treatment and planning isocentres was determined in order to characterise the accuracy of patient setup. The verifications were performed before the first four fractions, and weekly-biweekly thereafter. From data obtained during the first three measurements systematic error of patient setup was calculated "off line", and the setup was corrected with the calculated value. At errors larger than 5 mm "on line" table correction was applied. The measured data were grouped and analysed according to location, and systematic and random errors were determined. From the data safety zone around clinical target volume (CTV) was calculated to create planning target volume (PTV). Following isocentre correction after the first three fractions the patient setup became more accurate at all site locations. At pelvic irradiation the mean error in all the three directions was below 1 mm, and the range of standard deviation was 0.32-0.38. At pelvic and thoracic irradiation the CTV-PTV safety zone calculated without any correction was 9-13 mm depending on direction, while at head and neck and cranial irradiation it was 6-9 mm. After correction of systematic error these data were 7-9 mm and 3-6 mm. After on line correction of setup errors larger than 5 mm the safety zone was 5-6 mm at pelvic and thoracic irradiation, 5 mm at head and neck, and 3-5 mm at cranial irradiation. Verification of patient setup with MV-CBCT at different locations can be easily performed. The initial systematic error can be corrected with a simple verification protocol which results in a few millimeter decrease of the CTV-PTV safety zone. Use of smaller safety zone is possible only with more frequent verifications and on line corrections.
  Magyar Onkológia 12/2012; 56(4):258-65.
• Article: [DSC data of blood plasma in breast cancer patients].

  István Zapf, Tamás Fekecs, Medhi Moezzi, György Tizedes, Gábor Pavlovics, Endre Kálmán, Péter Ors Horváth, Andrea Ferencz
  [show abstract] [hide abstract]
  ABSTRACT: Breast cancer is the commonest cause of cancer death in women worldwide. Its incidence has been increasing for many years in economically developed countries. Differential scanning calorimetry (DSC) is a thermoanalytical technique which monitors small heat changes between sample and reference materials. This examination is a validly efficient method for the demonstration of structural changes not only in the physical sciences, but in numerous human oncological diseases. The goal of this study was to measure DSC thermogram of blood plasma in breast cancer patients with different stages. Nineteen women with different tumor diameter (0.5-7.5 mm) and with or without regional lymph node metastases were involved in the study. Preoperatively peripheral blood samples were collected from the patients and from healthy controls, and plasma components were analysed by SETARAM micro DSC-II calorimeter. The diameter of the tumor tissue and the number of metastatic lymph nodes were evaluated on the basis of postoperative histological results. In the current study we found difference in changes of the thermal parameters (transition temperature, calorimetric enthalpy) of breast cancer patients' plasma components. Moreover, a tendency has been found for association of these results with tumor size and with the degree of regional lymph node involvement. Preliminary study of the clinical utility of DSC technology arises, even though there is no data in the literature. In cases of breast cancer the blood plasma may be suitable for DSC analysis for diagnosis or staging as well. In order to clarify the relationships we are planning further studies.
  Magyar Onkológia 12/2012; 56(4):274-9.
• Article: [Practice of supportive care during lung cancer chemotherapy].

  Veronika Müller, Lilla Tamási, Gabriella Gálffy, György Losonczy
  [show abstract] [hide abstract]
  ABSTRACT: Active oncotherapy, combination chemotherapy of lung cancer is accompanied with many side effects which may impair patients' quality of life and compromise the effectiveness of chemotherapy. Most side effects of chemotherapy are preventable or treatable with optimal supportive care which enhances success in patient care and treatment. The aim of this review is to summarize the most important conditions that may be associated with combined chemotherapy of lung cancer from the practical point of view.
  Magyar Onkológia 09/2012; 56(3):159-65.
• Article: [Evaluation of patient positioning using in-room kV CT for image-guided radiotherapy (IGRT) of prostate cancer].

  Jorgo Kliton, Péter Agoston, Tibor Major, Csaba Polgár
  [show abstract] [hide abstract]
  ABSTRACT: The purpose of the study was to evaluate accuracy of patients' set up verified by kV CT-on-rails system and compare automatic and manual image registration of planning and verification kVCT-s. Between January 2001 and March 2011, at ten patients with prostate cancer the clinical target volumes (CTVs) for prostate (CTV-PROS), and prostate plus caudal 1 cm of seminal vesicles (CTV-PVS) with or without pelvic lymph node region were contoured on the treatment planning CT, according to risk category of the patient. Planning target volumes (PTVs) were created with 1 cm margin extended around the CTVs in each direction. The isocentre was marked on the skin with three radiopaque markers. After the set up, treatment couch with the patient was turned by 180 degree and images were acquired of the region of the isocentre with a kV helical CT-on-rails system (treatment CT). An image registration software was used to co-register planning and treatment CT images. Automatic CT image co-registration was followed by manual co-registration taking into account the CTV-PROS contour and soft tissue informations. Deviations of the isocentres in lateral (LAT), longitudinal (LONG) and vertical (VERT) directions were recorded after each image co-registration. Corresponding data were compared using the t-probe. Systematic (S) and random (s) errors of the set up were calculated. Adequate PTV to CTV margins were calculated by van Herk's formula (2.5xS + 0,7xs). Overall 252 deviations were analysed on fourty-two CT series of 10 patients. The mean errors of the set up with automatic and manual image co-registrations were 0.19 cm and 0.07 cm (p=0.001) in LAT, 0.05 cm and 0.03 cm (p=0.07) in LONG and 0.16 cm and 0.22 cm (p=0.16) in VERT directions, respectively. The systematic errors of the set up for automatic and manual image registrations were 0.22 cm and 0.26 cm in LAT, 0.17 cm and 0.18 cm in LONG, 0.25 cm and 0.26 cm in VERT directions, respectively. The random errors of the set up for automatic and manual image registrations were 0.31 cm and 0.26 cm in LAT, 0.27 cm and 0.27 cm in LONG and 0.24 cm and 0.33 cm in VERT directions, respectively. In case of manual image co-registration, the required PTV to CTV margins to cover at least 95% of the CTVs with at least 95% percent of the prescribed dose were calculated to 0.93 cm in LAT, 0.65 cm in LONG, and 0.89 cm in VERT directions. Patients set up can be verified with manual image co-registration based on soft tissues around the prostate using a kV CT-on-rails system installed in the treatment room. The difference between automatic and manual image co-registration was significant in LAT direction. A PTV to CTV margin <1 cm seems to be appropriate to cover the CTVs in image-guided prostate radiotherapy. These findings support our recent clinical protocol.
  Magyar Onkológia 09/2012; 56(3):193-8.