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Significance of clinical, biomolecular and pathological parameters for outcome of Ewingʼs sarcoma of bone in children

dc.contributor.advisorNikitović, Marina
dc.contributor.otherVujić, Dragana
dc.contributor.otherKrivokapić-Dokmanović, Lidija
dc.contributor.otherJanković, Radmila
dc.creatorParipović, Lejla
dc.date.accessioned2019-02-08T15:53:03Z
dc.date.available2019-02-08T15:53:03Z
dc.date.issued2018-09-27
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=6594
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:19387/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=50789647
dc.identifier.urihttp://nardus.mpn.gov.rs/123456789/10749
dc.description.abstractSavremenim multidisciplinarnim lečenjem Ewing sarcoma (ES) koji podrazumeva primenu hemioterapije i lokalne kontrole bolesti u vidu hirurgije i/ili zračne terapije značajno je poboljšano preživljavanje pacijenata. Cilj ove studije je da se analiziraju rezultati lečenja dece obolele od ES kosti u referentnom centru u Srbiji kao i da se definišu mogući prognostički parametri a sve u cilju selektovanja pacijenata koji pripadaju različitim prognostičkim grupama (standardni rizik, visoki rizik) i planiranja optimalnog terapijskog pristupa. Metod: Po svom karakteru ovo je bila retrospektivno-prospektivna studija koja je obuhvatila grupu od 107 pacijenata obolelih od ES kosti koji su lečeni savremenim multidisciplinarnim pristupom na Službi za pedijatrijsku onkologiju Instituta za onkologiju i radiologiju Srbije (IORS) u periodu od januara 2000 godine do decembra 2014 godine. Tok i ishod bolesti su praćeni do decembra 2016 godine. Rezultati: Od ukupno 107 pacijenata, 64 (59.81%) je bilo muškog a 43 (40.19%) ženskog pola (odnos 1.48:1). Srednji uzrast pacijenata je bio 13.07 godina (rang 3-19), oboleli pacijenti su češće uzrasta ispod 14 godina (56.7%). Najčešća lokalizacija tumora je bila u predelu ekstremiteta (48.6%) i karlice (25.23%). Tumor veći od 8 cm dijagnostikovan je kod 61.68% pacijenata. Vrednost LDH na prijemu je bila povišena kod 45.79% pacijenata. Metastatski oblik bolesti potvrđen je kod 31.78% pacijenata i to: 50% pacijenata je imalo izolovane plućne metastaze, 26.47% izolovane koštane metastaze dok je 23.53% metastatskih pacijenata imalo i koštane i plućne metastaze. Histopatološki odgovor na primenjenu neoadjuvantnu hemioterapiju je bio dobar kod 39 /65 a loš kod 26/65 pacijenata kod kojih je učinjena hirurška intervencija nakon neoadjuvantne hemioterapije. Kao jedini modalitet lokalne kontrole bolesti, hirurgija je sprovedena kod 24 (22.43%) pacijenata, zračna terapija takođe kod 24 (22.43%) pacijenata dok su oba modaliteta lokalnog lečenja (hirurgija i zračna terapija) sprovedena kod 51.4% pacijenata.U trenutku zatvaranja studije, 43.93% pacijenata je bilo živo dok je kod 56.07% pacijenata došlo do smrtnog ishoda...sr
dc.description.abstractModern multidisciplinary treatment of Ewing’s sarcoma that implies usage of chemotherapy and local disease control in form of surgery and/or radiotherapy has significantly improved survival of patients. The purpose of this study was to analyze the results of treatment of children with ES of bone treated in referral centers in Serbia as well as to define possible prognostic parameters and all of it is aimed at selecting the patients that belong to different prognostic groups (standard risk, high risk) and planning of optimal treatment approach. Method: In its character, this is a retrospective-prospective study that includes a group of 107 patients with Ewing sarcoma of bone treated according to a modern multidisciplinary approach at the Department for Pediatric Oncology of the Institute for Oncology and Radiology of Serbia (IORS) in period from January of 2000 until December of 2014. The course and the outcome of the disease were monitored until 31 of December of 2016. Results: Out of totally 107 patients 64 (59.81%) were male and 43 (40.19%) were female (ratio 1.48:1) The median age of patients was 13.07 years (range 3-19), the patients were for the most part under the age of 14 (56,7%). The most common sites of the tumor were in the region of extremities (48.6%) and pelvis (25.23%). Tumor larger that 8cm were diagnosed in 61.68% patients. LDH at initial diagnosis was increased in 45.79% of patients. Metastatic disease was confirmed in 31.78%: 50% had isolated lung metastases, 26, 47% had isolated bone metastases while 23,53% metastatic patients had both bone and lung metastases. Histopathological response to neoadjuvant chemotherapy was “good” in 39/65 and “poor” in 26/65 patients that underwent surgery after adjuvant chemotherapy. As the only modality of local disease control, surgery was performed in 24 (22,43%) patients, radiotherapy in 24 (22,43%), as well, while both local treatment modalities (surgery and radiotherapy) were performed in 51,4% patients...en
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dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsAutorstvo-Nekomercijalno 3.0 Srbija (CC BY-NC 3.0)
dc.sourceУниверзитет у Београдуsr
dc.subjectEwing sarkom, kosti, deca, prognostički parametri, preživljavanjesr
dc.subjectEwing sarcoma, bone, children, prognostic parameters, survivalen
dc.titleZnačaj kliničkih, biomolekularnih i patoloških parametara za prognozu Ewing sarkoma kosti kod decesr
dc.title.alternativeSignificance of clinical, biomolecular and pathological parameters for outcome of Ewingʼs sarcoma of bone in childrenen
dc.typePhD thesis


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