Terapijski pristup HPV pozitivnim karcinomima orofarinksa

master's thesis

• Title (english): Treatment of human papillomavirus oropharyngeal carcinoma
• Author: Krešimir Jemrić
• Mentor: Vladimir Bedeković (mentor)
• Committee member: Livije Kalogjera (predsjednik povjerenstva)
• Committee member: Nikola Đaković (član povjerenstva)
• Committee member: Vladimir Bedeković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2018-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Tumori glave i vrata nalaze se na šestom mjestu po učestalosti tumora u svijetu. U posljednih nekoliko desetljeća zabilježen je porast broja oboljelih od karcinoma orofarinksa u razvijenim zemljama svijeta, dok ostatak tumora područja glave i vrata bilježi pad ili stagnaciju. Prema istraživanjima, glavni je uzrok porast broja oboljelih od HPV pozitivnih karcinoma orofarinksa. Glavni čimbenik rizika za nastanak HPV pozitivnog karcinoma orofarinksa je dugotrajna infekcija visokorizičnim tipovima HPV virusa (16 i 18) stečena, u većini slučajeva, rizičnim seksualnim ponašanjem. Način na koji infekcija napreduje u karicnogenezu zahtijeva nekoliko mehanizama poput bijega od imunološkog odogovora, aktivaciju ranih virusnih onkogena E6 i E7 u bazalnim epitelnim stanicama, poremećaj stabilnosti genoma domaćina, integraciju virusne DNA u genom domaćina te mnoge druge još nedovoljno istražene mehanizme. S obzirom na specifične karakteristike bolesnika oboljelih od HPV pozitivnih tumora orofarinksa, a to su mlađa životna dob, viši socioekonomski status, oženjeni, viši stupanj obrazovanja, nepušači i umjereni konzumenti alkoholnih pića, te na bolji odgovor na liječenje i bolju prognozu, javila se potreba za procjenom dosadašnjih terapijskih mogućnosti i njihovom prilagodbom čime bi se smanjio rizik za nastanak nuspojava uz što veću učinkovitost u izlječenju od karcinoma. Ovaj pregledni rad opisuje trenutne terapijske mogućnosti u liječenju bolesnika oboljelih od HPV pozitivnih karcinoma orofarinksa uz dodatak opisa novih metoda liječenja koje su još uvijek u fazi istraživanja učinkovitosti.

Abstract (english)

Head and neck carcinoma is the sixth most common cancer worldwide. In the last few decades an increase in the incidence of oropharyngeal carcinoma has been noted in developed countries, while the incidence of other head and neck tumors has been decreasing or stagnating. According to researches, the main cause of it is the increase in number of HPV- positive oropharyngeal carcinoma. The main risk factor for developing HPV-positive oropharyngeal carcinoma is chronic infection with high-risk HPV genotypes (16 and 18), mostly acquired via risky sexual behavior. Progression of infection into a carcinogenesis requires few mechanisms such as evasion of immune response, the activation of early viral oncogenes E6 and E7 in basal epithilial cells, the deregulation of cell-cycle and genom instability, viral DNA integration and other still unsufficiently researched mechanisms. Regarding specific patient's charachteristics, such as younger age, higher socioeconomic status, married, higher education level, non-smokers, non-drinkers or moderate drinkers, and better treatment response and prognosis in general, there has been a need for evaluation of current therapeutic options and their adjustment in order to decrease the risk of side effects with maximum efficiency of carcinoma eradication. This review paper describes current therapeutic options in the treatment of HPV-positive oropharyngeal carcinoma with addition of newest methods that are still in the phase of efficiency estimation.

• Keywords: HPV-pozitivni karcinomi orofarinksa; HPV; HPV dijagnoza; liječenje tumora orofarinksa
• Keywords (english): HPV-positive oropharyngeal carcinoma; HPV; HPV diagnosis; oropharyngeal cancer treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:929091
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-09 10:47:45