Optimalno liječenje uznapredovalog kolorektalnog karcinoma

master's thesis

• Title (english): Optimal treatment of advanced colorectal cancer
• Author: Josip Mavrek
• Mentor: Hrvoje Silovski (mentor)
• Committee member: Goran Augustin (predsjednik povjerenstva)
• Committee member: Davor Mijatović (član povjerenstva)
• Committee member: Hrvoje Silovski (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Kolorektalni karcinom jedna je od najčešćih malignih bolesti kako u Hrvatskoj tako i u ostatku svijeta. Posebno su pogođene razvijene zemlje i zemlje u razvoju. Liječenje bolesti u ranijim stadijima daje vrlo dobre rezultate no nerijetko se do dijagnoze dolazi tek kada se karcinom prezentira sa simptomima poput krvi u stolici i gubitkom tijelesne mase. Više od 20% bolesnika već u trenutku postavljanja dijagnoze ima uznapredovalu bolest sa razvijenim udaljenim metastazama, najčešće lokaliziranima u jetri. Unatoč napretku medicine, osnova liječenja i jedina metoda koja nudi mogućnost postizanja potpunog odsustva bolesti je kirurška resekcija primarnog tumora s pripadajućim metastazama. Resekcija se može kombinirati s različitim lokalnim ablativnim tehnikama poput radiofrekventne ablacije, stereotaktičke radioterapije ili embolizacije. Kod neresektabilnih metastaza, primjenom kemoterapije se pokušava dijelovati na smanjenje njihove veličine kako bi postale resektabilne. Liječenje pacijenata koji imaju kontraindikacije za kirurško liječenje ili onih kod kojih konverzivna terapija nije bila uspješna, bazira se na primjeni određenih režima kemoterapije. U novije vrijeme, uz bolje poznavanje mutacija koje dovode do nastanka karcinoma, kemoterapija se može kombinirati sa anti-EGFR i anti-VEGF protutijelima. Zbog toga je u liječenju uznapredovalog kolorektalnog karcinoma i odabiru najpovoljnije terapije za svakog bolesnika vrlo važan dobar probir te multidisciplinaran i individualan pristup.

Abstract (english)

Colorectal cancer is one of the most common malignant diseases in Croatia as well as in the rest of the world. Developed and developing countries are affected to a greater extent. Treatment in earlier stages of the disease gives very good results, but the diagnosis is often made only after the patients present with symptoms such as blood in the stool and weight loss. At the time of diagnosis, over 20% of patients already have an advanced disease that has developed distant metastases predominantly in the liver. Despite the advances in medicine, surgical resection of the primary tumor and its metastases is still fundamental and only method of treatment that can achieve the status of no evidence of disease (NED). Surgical resection can be combined with numerous local ablative techniques such as radiofrequency ablation, stereotactic radiation or embolisation. In treatment of unresectable metastases, chemotherapy is used to try to decrease their size so that they may become resectable. Treatment of patients that have contraindications for surgery, or in which conversion therapy has failed, is based on chemotherapy. Recently, with better understanding of different mutations that lead to cancer development, chemotherapy can be combined with anti-EGFR and anti-VEGF antibodies. Therefore, patient selection, as well as multidisciplinary and individual approach are highly important in the treatment of patients with advanced colorectal cancer.

• Keywords: kolorektalni karcinom; liječenje; metastaze; kirurgija; kemoterapija
• Keywords (english): colorectal cancer; treatment; metastases; surgery; chemotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:854066
• 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: 2021-04-16 08:29:32