[Reducing the risk of radiation-induced cardiotoxicity in patients with left breast tumor]. / A sugárkezelés okozta cardiotoxicitas kockázatának csökkentése bal oldali emlotumoros betegek kezelése során.

INTRODUCTION: Breast cancer is one of the most common malignancies affecting women. Treatment with drugs and radiotherapy increases the incidence of late cardiovascular disease. It is therefore particularly important to protect the heart from radiation exposure. METHOD: We prepared an irradiation plan for 45 patients with left breast cancer using deep breathing and normal breathing techniques. The plans were compared and analyzed. The irradiation plans were created in the Philips Pinnacle v. 16 planning system. RESULTS: At the same target volume coverage, the use of the deep breathing technique leads to a reduction of the dose burden to the heart and to the left descending coronary branch, thus reducing the incidence of late cardiovascular complications. DISCUSSION: The results obtained show that the use of the deep breathing technique during adjuvant radiotherapy of left-sided breast cancer patients has a beneficial effect on the radiation exposure of the heart. Our results are in good agreement with similar data from national centres. We were not only able to maintain planning target volume coverage, but also to achieve an improvement of 1%. There is a significant difference in dose to the heart and coronary artery. By using the deep breathing technique, we were able to reduce the average cardiac dose by almost half (deep breathing: 2.87 Gy, normal breathing: 5.4 Gy). The coronary exposure was reduced from 19.5 Gy to 10.98 Gy. CONCLUSION: The accuracy of treatment can be further improved by using a respiratory gating system with a surface-guided radiotherapy system. The successful use of deep breathing technique requires professionalism of the treatment staff and good patient cooperation. It is less equipment intensive than a respiration-guided system. The deep breathing technique is no longer considered state-of-the-art in the era of breath-holding, but the experience gained in our department is worth describing because of its relevance to oncocardiology. Orv Hetil. 2023; 164(11): 420-425.

[Introduction of high-precision stereotactic body radiotherapy of lung tumors at Markusovszky Hospital]. / Tüdodaganatok nagy pontosságú stereotaxiás kezelésének bevezetése a Markusovszky Kórházban.

INTRODUCTION: A new, modern computed tomograph simulator was installed in the Oncology Department of the Markusovsky University Teaching Hospital from September 2021. The computed tomography simulator not only makes the work of specialists easier with its automatic contouring tool, but is also able to produce four-dimensional computed tomography scans. This facility is essential for radiotherapy of lung and breast cancer patients. OBJECTIVE: In this paper, we briefly review lung tumors and their treatment options, focusing on radiotherapy requiring high precision. We summarize patient selection criteria, the quality assurance processes for planning and treatment, and the experience gained in treating patients. METHOD: 5 patients were selected for our study. Their disease met the following criteria: 1 nodule, tumor diameter not exceeding 5 cm, patient was inoperable or negated surgery. The planning computed tomography scan was performed with Siemens Somatom go.Sim. At each respiratory phase, the tumor conturs were drawn and then aggregated as an integrated volume and an irradiation plan was prepared on this image. The treatments were performed on a Varian TrueBeam accelerator. RESULTS: Before each treatment, an adjusting CT scan was taken. The higher dose (4 × 12 Gy) treatment caused a reduction in tumor size on the last adjustment scan. DISCUSSION: Stereotaxic treatment, which is already available in Szombathely, may be a good alternative in the treatment of patients with inoperable lung cancer. The method is not burdensome for patients: fewer sessions, short treatment time. CONCLUSION: In the future, we would like to improve the accelerator with a breath capture system, which will allow even more precise treatment. Orv Hetil. 2022; 163(52): 2079-2087.

[Experience with cabazitaxel therapy for patients with metastatic castrate resistant prostate cancer in Hungary]. / Hazai tapasztalatok kasztrációrezisztens metasztatikus prosztatadaganatos betegek kabazitaxelterápiájával.

Our aim was to assess the efficacy and adverse effects of cabazitaxel (CBZ), a chemotherapeutic agent that can be administered to patients with metastatic castrate resistant prostate cancer (mCRPC) after docetaxel (DOC) therapy. We retrospectively analyzed data of CBZ received by mCRPC patients in 12 Hungarian oncological centers between 01/2016 and 06/2017. CBZ (25 or 20 mg/m2 q3w) was administered after DOC. Physical and laboratory examinations were performed in every cycle, tumor response was evaluated in every third cycle based on PCWG2 criteria. Adverse effects were evaluated based on CTCAE 4.0. Data of 60 patients were analyzed. CBZ was administered in 2nd and 3rd lines in 31.6% and 46.6%, while in 4th and 5th lines in 15% and 6.6% patients, respectively. Its starting dose was 25 mg/m2 and 20 mg/m2 in 65% and 35% of cases, respectively. The median number of cycles was 5. Progression-free survival and overall survival were 5.52 and 15.77 months, respectively. Survival results were similar in case of DOC-CBZ-ART/alfaradin and DOC-ART/alfaradin-CBZ sequences. Adverse effects were detected in 63,3% of patients. The most common adverse effects were neutropenia, anemia, and diarrhea. Our observations suggest that CBZ, with the appropriate support and chemotherapeutic experience, is well-tolerated and effective therapy of mCRPC after DOC.