Onkologija : Slovenian Journal of Oncology

Comprehenisive care for oncology patients

2024-12-02T13:27:19+01:00

Advances in cancer diagnosis and treatment have made an important contribution to improving patient survival. However, many patients face different problems and needs as a result of their disease and treatment, which are not always covered by oncology care. Appropriately managing these problems by providing supportive care is key to improving the quality of life of cancer patients. To better understand patients' experiences and confrontation with diagnosis, treatment and in the recovery phase, we launched an important information-gathering tool at the Institute of Oncology at the beginning of 2023. We started interviewing patients using the internationally validated Patient-Reported Outcome Measures (PROMs) questionnaire to better understand the impact of disease and treatment on quality of life. It also allows us to better tailor care to patients' individual preferences and needs. Patients with more severe problems are referred to appropriate specialists. We have made significant progress in the management of cancer patients by introducing supportive care and the use of PROM questionnaires. These questionnaires allow patients to report on their health and well-being, which helps healthcare staff to identify individual patient problems and needs more quickly and to better tailor care.

Recommendations for diagnosis, treatment and follow-up of patients with uveal melanoma

2025-06-05T11:29:48+02:00

Uveal melanoma is the most common primary malignant intraocular tumor in adults. Uveal melanomas include choroidal melanoma (90%), ciliary body melanoma (6%), and iris melanoma (4%). Between 2017 and 2021, an average of 23 people were diagnosed with uveal melanoma annually in Slovenia, representing 3.7% of all melanomas.
The first comprehensive and multidisciplinary treatment guidelines in Slovenia cover choroidal and ciliary body melanomas and are based on the American NCCN guidelines. These recommendations provide a holistic overview of risk factors, clinical presentation, and
local treatment options for this cancer, as well as modern approaches to the multidisciplinary management of distant metastases—including the possibility of full blood genotyping for the presence of the human leukocyte antigen (HLA)-A*02:01. The aim of these guidelines is to support specialists from various fields in both communicating with patients and their families, and in
choosing the most appropriate treatment options.

Recommendations for systemic oncological and radiation treatment of the biliary tract cancers

2025-06-05T14:46:49+02:00

Biliary tract cancers are a rare and heterogeneous group with increasing incidence and high mortality. They have a poor prognosis with an overall survival of less than 1 year. New insights into the molecular genetic heterogeneity of biliary tract cancers and new therapeutic approaches allow these patients to survive longer and have a better quality of life. The Recommendations present the latest recommendations for systemic oncological treatment and radiotherapy of this group of cancers, which, according to international agreements, now include gallbladder carcinoma, intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, with perihilar cholangiocarcinoma and carcinoma of the distal bile duct. The recommendations for systemic treatment are summarized and prepared on the basis of international recommendations, American National Comprehensive Cancer Network (NCCN) and European, European Association for Internal Oncology - European Society of Medical Oncology (ESMO).

Neurological adverse events of immune checkpoint inhibitors

2025-06-05T10:41:15+02:00

The significant beneficial effect of treatment with immune checkpoint inhibitors is relatively often accompanied by adverse events, of which neurological events are rare but can be life-threatening.
The article presents neurological complications of treatment with immune checkpoint inhibitors. Two given clinical cases describe neurological adverse events with a clinical picture of peripheral nervous system involvement, namely myositis and acute inflammatory demyelinating polyneuropathy.

Pleural, abdominal, and pericardial lymphocytic effusion

2025-06-05T11:13:57+02:00

Lymphocytic effusion is a complication of several diseases. The main causes of most lymphocytic effusions are malignomas and tuberculosis. Lymphocytes in effusion can be reactive or neoplastic. Reactive lymphocytic effusion develops due to inflammation, systemic and autoimmune diseases, carcinosis, and other rare causes. Malignant lymphocytic effusions are mostly found in patients during the progression of nodal and extranodal lymphomas to the pleural, pericardial or abdominal cavity while effusions caused by lymphomas evolving from serous surfaces are very rare. Cytopathological diagnostic of lymphomas in effusions is based on clinical, morphological, immunophenotypic and molecular features of the disease. According to the international guideless we categorize lymphoproliferative diseases in effusions in five categories: nondiagnostic, benign, atypical cells of undetermined significance, suspicious for malignancy and malignant.

A quarter of a century of specialization in medical oncology in Slovenia

2025-02-24T16:30:47+01:00

Systemic therapy has been shown to improve survival in many cancer patients. The number of anticancer drugs has increased dramatically in recent decades and more than half of all cancer patients are treated with these drugs. The specificity of the disease, the specificity of the treatment, and the drugs, which often have a very narrow therapeutic window, have necessitated the development of a new specialty, medical oncology, separate from internal medicine. Since 2000, medical oncology has been recognized in Slovenia as an independent specialization separate from internal medicine. The incidence of cancer in Slovenia is increasing, and there are more and more patients who need systemic treatment and management by medical oncologists. Unfortunately, the number of oncologists is not increasing at the same rate as the number of patients, and the existing facilities are becoming inadequate.

Chemotherapy induced peripheral nevropathy (CIPN)

2025-06-05T12:01:59+02:00

Chemotherapy induced peripheral nevropathy (CIPN) is a dysfunction of the peripheral nervous system as a result of treatment with
one or a combination of several cytostatic agents. The most common
causative agents of CIPN are taxanes, platinum derivatives and
vinca alkaloids, their causative mechanisms of CIPN differ and are
related to their cytotoxic activity. CIPN is most often manifested
by the sensory symptoms, motor disorders and disorders of the
autonomic nervous system are rare. The risk factors for CIPN are
general, which we know well and can be limited to a certain extent,
while genetic risk factors are currently under intensive research.
The pathophysiological processes of the formation of CIPN are
partially known, they involve several overlapping mechanisms that
cause defects at the level of nerve endings, axonal defects, sensory
ganglia disorders, as well as spinal cord injury. Neuro-immune
processes are also involved. The diagnosis of CIPN is clinical,
specific questionnaires for semi-objective quality of life assessment
can be helpful, however the objective method of assessing CIPN is
EMG. As a rule, CIPN has a reversible course, but in individual
cases we find a chronic irreversible condition. For the treatment
of CIPN, non-pharmacological measures are mostly used, and in
severe cases also medical support with gabapentin, pregabalin and
amitriptyline can be beneficial.

Modern radiotherapy

2025-06-05T10:36:32+02:00

The evolution of modern radiotherapy aligns seamlessly with the principles of Citius, Altius, Fortius—faster, higher, stronger— while embracing the Less is More philosophy. In recent years, the 5-fraction radiotherapy regimen has emerged as a transformative approach, offering shorter treatment durations, higher precision, and enhanced therapeutic efficacy, all while optimizing healthcare resources. Evidence from large prospective trials has confirmed its efficacy in breast, prostate, lung, and rectal cancers, as well as in the management of oligometastatic disease. Furthermore, technological advancements in imaging, stereotactic techniques, and dose delivery have played a crucial role in ensuring the safety and precision of these treatments. Beyond clinical efficacy, the benefits of 5-fraction radiotherapy extend to improving patient quality of life, reducing treatment burden, and enhancing healthcare efficiency. In the era of modern radiotherapy, Citius, Altius, Fortius prevails—because Less is More, and the future is now.