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1
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Difficulties in diagnosis of carcinoma of the tongue

100%
Dwijesh Kumar Panda D. K.
European Journal of Clinical and Experimental Medicine
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2019
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issue 4
368-370
EN
Introduction. Oral cancer is the second most common malignancy and there is an epidemic alert by WHO for oral cancers projected for 2030. The tongue remains the most common intraoral site for oral cancer worldwide. Aim. To present a case report. Description of the case. A 56-year-old patient was suffering from carcinoma of the tongue. He developed metastases in the lungs and upper part of the vertebral column. The PET scan report revealed the presence of hypermetabolic cells in the metastatic tissue. The biopsy of the lesion on the upper part of the back did not show neoplastic cells, epithelioid cells and giant cells. Radiotherapy was given for 25 cycles. Both the lungs were affected by metastases. Lastly the patient expired due to cardio-respiratory failure. Conclusion. Tobacco is the most important known risk factor for the development of tongue cancer. The tumors in their early stage with complete excisional treatment have good prognosis. There is usually a history of long standing leukoplakia or erythroplakia. Ideally, imaging should take place prior to biopsy. Surgical procedures such as hemiglossectomy can cause functional defects in speech and swallowing. Difficulty in diagnosis results in inappropriate treatment.
2
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Compliance of temozolamide with concurrent radiotherapy as an adjuvant in patients with high grade glioma – a retrospective study

100%
Ramanan V. A., Jeeva S., Sowmiya K.
European Journal of Clinical and Experimental Medicine
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2023
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issue 1
68-72
EN
Introduction and aim. High grade glioma is the most aggressive form of primary brain tumour with a median survival of one year. Maximal safe resection followed by temozolamide-based concurrent chemoradiation and adjuvant chemotherapy is the standard of care. To assess the compliance of temozolamide in patients of high-grade glioma who underwent concurrent chemoradiation followed by adjuvant chemotherapy. Material and methods. 30 patients of high grade glioma diagnosed and treated in our Oncology department during the period of March 2016 to March 2018 were analyzed retrospectively. Cases included in this study were patients with biopsy proven high grade glioma who underwent maximal safe surgery, temozolamide-based concurrent chemoradiation, followed by adjuvant chemotherapy with temozolamide. Data regarding age, gender, histopathology, extent of surgery, performance status, radiotherapy dose, chemotherapy cycles and treatment toxicity profiles were recorded. Results. Treatment was generally well tolerated with most patients experiencing grade 1 and 2 toxicities, which were managed with supportive care. Grade 3 toxicities were noted as follows: anaemia (6.7%, n=2), neutropenia (16.7%, n=5) and thrombocytopenia (16.7%, n=5). Treatment with TMZ was discontinued in 6.7% (n=2) of individuals due to myelosupression. No grade 4 hematological toxicities were observed in the study group. Conclusion. The compliance of temozolamide in high grade gliomas is high with less treatment interruptions and manageable side effect profile.
3
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Żele radiochromiczne przyszłością dozymetrii radioterapeutycznej

100%
Bruszewska A., Górska M., Mizgajska E., Poświatowska K.
Alcumena. Pismo Interdyscyplinarne
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2020
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issue 3(3)
19-33
EN
In a present work an attempt was made to describe the radiochromic gels used in radiotherapeutic dosimetry to review the available solutions. Articles related to the composition and production of these gels were analyzed. Additionally, the application and properties of 3D dosimeters, such as radiochromic gels, were discussed. Cancer is one of the biggest problem of modern medicine and the reason to develop new and more accurate dosimeters. The gels discussed in this article allow to obtain promising results and confirm the validity of the continuation of research on both current and new solutions used in teleradiotherapy dosimetry.
4
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Distance to Radiotherapy and Demand – Projection of the Effects of Establishing New Radiotherapy Facilities in Poland by 2025

100%
Czerwiński A. M.
Central European Economic Journal
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2017
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vol. 4
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issue 51
EN
In 2015, the Ministry of Health of the Republic of Poland introduced the Polish strategic plan for radiotherapy development and investment. Given that radiotherapy utilisation depends on the distance a patient must travel to undergo the treatment, the main goal of the plan was to increase equitable access to radiotherapy in Poland by establishing new facilities in new locations by 2025. This study constitutes the first step towards an economic evaluation of this plan by adopting spatial interaction models to project the expected increase in the demand for radiotherapy (3%). Moreover, it adds to the current research on the relation between distance and demand for healthcare services in the following ways. First, it flags the importance of using spatial econometrics to healthcare utilisation studies in the presence of spatial autocorrelation. Furthermore, it proposes a quantitative method for assessing the expected impact of establishing new facilities on utilisation. Finally, it formally confirms the dependence between radiotherapy utilisation and distance in Poland, which has been previously shown to exist in other countries.
5
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Zróżnicowanie w dostępie do onkologicznych usług zdrowotnych w województwach Polski

75%
Kujawska J.
Nierówności społeczne a wzrost gospodarczy
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2016
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vol. 48
246-255
PL
Nowotwory złośliwe to druga w kolejności przyczyna śmiertelności na świecie. Liczba zachorowań na raka w ostatniej dekadzie wzrosła. W Polsce występują trudności w dostępie do lecznictwa onkologicznego. Pierwszą trudnością jest zbyt długi czas oczekiwania na wizytę u specjalisty. Kolejna to nieskuteczna diagnostyka, która powoduje, że nowotwór jest wykrywany w zaawansowanym stadium. Pochodną tych problemów jest rozmieszczenie ośrodków onkologicznych, przede wszystkim w dużych miastach, co powoduje długi czas dojazdu do punktu ambulatoryjnych świadczeń onkologicznych. Następną trudnością w dostępności jest organizacja systemu opieki zdrowotnej oparta na limitowaniu liczby udzielanych świadczeń. Celem opracowania jest wskazanie nierówności w dostępie do usług onkologicznych (w tym radioterapii) w województwach z wykorzystaniem metody DEA. Wyniki badań pokazują duże zróżnicowanie w dostępie do posiadanych zasobów osobowych i rzeczowych związanych z onkologiczną opieką zdrowotną. W województwie opolskim jest prawie 5 razy mniej lekarzy niż w mazowieckim, a koszty lecznictwa onkologicznego są dwa razy niższe. Częściowym rozwiązaniem poprawiającym sprawność opieki onkologicznej jest rezygnacja z kosztownych usług stacjonarnych na rzecz zwiększenia udziału usług realizowanych w formie ambulatoryjnej lub opieki jednodniowej. Z zastosowanego modelu DEA wynika, że w pełni efektywne województwa pod względem dostępu do opieki onkologicznej to: lubuskie, opolskie i podlaskie. W województwach tych są najniższe koszty jednostkowe na pacjenta. Należy jednak pamiętać, że wczesne wykrycie nowo-tworu i skuteczna terapia powodują niższe koszty bezpośrednie i pośrednie absencji chorobowej.
EN
Malignant neoplasms are the second leading cause of death in the world. The number of cancer cases in the last decade has increased significantly. In Poland there are difficulties in access to the oncological treatment. The first difficulty is too long time for a visit for medical specialist. Another is the ineffective diagnostic, which causes the cancer is detected at an advanced stage. Moreover, in Poland, we have the distribution of medical centers primarily in large cities only and long travel time to the point outpatient cancer services. Another difficulty in accessibility is the poor organization of the health care system, based on limited number of services provided. The aim of the study is to identify differences in access to cancer services (including radiotherapy) in Polish provinces using the DEA method. The results show wide variation in access to personal and tangible resources associated with oncological health. In the Opole province is almost 5 times less doctors than in the Mazowieckie but the oncology treatment costs are two times lower. Solution for improving the efficiency of cancer care is to give up costly fixed-line services in favor of increasing the share of services provided in the form of outpatient or daycare. DEA model shows that the most effective province in terms of access to cancer care are: Lu-buskie, Opole and Podlasie. These provinces have lowest unit costs per patient. Note, however, that early detection of cancer and effective therapy contribute to incur lower direct and indirect costs of sickness absence.
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