Author/Editor		Zakotnik, Branko; Pajk, Bojana; Pretnar, Jože
Title		Zdravljenje solidnih tumorjev odraslih z zelo velikimi odmerki citostatikov in avtologno presaditvijo krvotvornih matičnih celic
Translated title		High dose chemotherapy with autologous peripheral blood stem cell support in solid tumours in adults
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 67, št. Suppl 1
Publication year		1998
Volume		str. I-19-22
Language		slo
Abstract		Background. Chemotherapy is besides surgery and radiotherapy an important mode of treatment in patients with solid tumours (carcinoma, germinal tumours, sarcoma, melanoma). There has been little improvement in the effectiveness of conventional dose chemotherapy in most common solid tumors in recent years. It as been demonstrated that the dose response curve is very steep for most cytostatic agents, and therefore it seemed rational that with higher doses of these drugs a higher cure rate could be achieved. Very high doses of some cytostatic drugs could be applied with many new approaches of supportive care, mainly autologous peripheral stem cells that substantially shourten the period of aplasia. Such treatment is currently used in many prospective clinical trials in breast cancer, germinal tumours, ovarian cancer, microcellular lung cancer, gliomas and ewing sarcoma. In other solid tumours it seems that high dose chemotherapy as it is used today is not appropriate. Conclusions. The place of high dose chemotherapy as standard treatment in solid tumours has still to be defined. We expect that this will be known soon after year 2000 when most of prospective randomised clinical trials that are ongoing will reach a conclusion.
Summary		Izhodišča. Zdravljenje s citostatiki je poleg kirurške odstranitve tumorja in obsevanja z ionizirajočimi žarki pomenben način zdravljenja pri bolnikih s solidnimi tumorji (karcinomi, germinalni tumorji, sarkomi, melanom). Z običajnimi odmerki citostatikov se uspeh zdravljenja pri večini razsejanih solidnih tumorjev (razen germinalnih) v zadnjih letih ni izboljšal. Za vrsto citostatikov so dokazali, da je učinek na tumor sorazmeren z odmerkom zdravila. Večanje odmerkov nekaterih citostatikov je omogočila uporaba citokinov, predvsem pa avtologna presaditev krvotvornih matičnih celic, ki znatno skrajšajo obnovitev kostnega mozga po zdravljenju. Z velikimi odmerki citostatikov in avtologno presaditvijo krvotvornih matičnih celic zdravimo nekatere bolnice s karcinomom dojke in bolnike z germinalnimi tumorji, v majši meri pa bolnice s karcinomom jajčnikov, mikrocelularnim karcinomom pljuč, gliomom in Ewingovim sarkomom. Pri drugih solidnih tumorjih ta način zdravljenja zaenkrat ni uspešen. Zaključki. Končno oceno tega načina zdravljenja pričakujemo kmalu po letu 2000, ko bo zaključenih veliko prospektivnih randomiziranih raziskav.
Descriptors		NEOPLASMS ANTINEOPLASTIC AGENTS HEMATOPOIETIC STEM CELL TRANSPLANTATION ADULT BREAST NEOPLASMS OVARIAN NEOPLASMS LUNG NEOPLASMS GERMINOMA