Browsing by Author "Stepanović, Aleksandar (57201691091)"

Background: The goal of research was to investigate the possible relations between serum concentrations of IL-6 and TGF-β1, individual and clinical characteristics, and adverse effects of radiotherapy in patients with prostate cancer: acute and late genitourinary and gastrointestinal toxicity, and fatigue. Methods: Thirty-nine patients with localized or locally advanced prostate cancer who were treated with radiotherapy were enrolled in this study. The acute radiotoxicity grades and fatigue levels were assessed during the radiotherapy and 1 month after the radiotherapy. Estimation of the late radiotoxicity was performed every three months in the first year, every four months in the second year, and then every six months. Serum levels of IL-6 and TGF-β1 were determined before radiotherapy and after the 25th radiotherapy fraction by ELISA. Results: The significant positive association between diabetes mellitus and changes in acute genitourinary toxicity grades during the radiotherapy was observed in prostate cancer patients. In addition, patients who were smokers had significantly higher maximum fatigue levels in comparison with patients who were non-smokers. The circulating IL-6 levels were significantly higher after the 25th radiotherapy fraction in comparison with levels determined before radiotherapy. The significant positive correlations between pretreatment TGF-β1 levels and maximum genitourinary toxicity grades and between TGF-β1 levels after the 25th fraction and genitourinary toxicity grades after the 25th fraction, were found. The pretreatment IL-6 concentrations and TGF-β1 concentrations after the 25th fraction were positively correlated with maximum genitourinary toxicity grades. The IL-6 levels after the 25th fraction were positively associated with genitourinary toxicity grades after this fraction. The pretreatment IL-6 concentrations were significantly positively correlated with maximum fatigue scores. The significant positive correlation between IL-6 concentrations and fatigue scores after the 25th fraction was determined. The positive correlations between IL-6 and TGF-β1 concentrations measured after the 25th fraction and maximum fatigue scores were observed. Conclusions: Our results suggest that serum levels of IL-6 and TGF-β1 might influence the severity of acute genitourinary radiotoxicity and fatigue in patients with prostate cancer. Combining clinical parameters and circulating cytokine levels might be useful for the prediction of adverse reactions to radiotherapy. © 2022, The Author(s).

Background: The goal of research was to investigate the possible relations between serum concentrations of IL-6 and TGF-β1, individual and clinical characteristics, and adverse effects of radiotherapy in patients with prostate cancer: acute and late genitourinary and gastrointestinal toxicity, and fatigue. Methods: Thirty-nine patients with localized or locally advanced prostate cancer who were treated with radiotherapy were enrolled in this study. The acute radiotoxicity grades and fatigue levels were assessed during the radiotherapy and 1 month after the radiotherapy. Estimation of the late radiotoxicity was performed every three months in the first year, every four months in the second year, and then every six months. Serum levels of IL-6 and TGF-β1 were determined before radiotherapy and after the 25th radiotherapy fraction by ELISA. Results: The significant positive association between diabetes mellitus and changes in acute genitourinary toxicity grades during the radiotherapy was observed in prostate cancer patients. In addition, patients who were smokers had significantly higher maximum fatigue levels in comparison with patients who were non-smokers. The circulating IL-6 levels were significantly higher after the 25th radiotherapy fraction in comparison with levels determined before radiotherapy. The significant positive correlations between pretreatment TGF-β1 levels and maximum genitourinary toxicity grades and between TGF-β1 levels after the 25th fraction and genitourinary toxicity grades after the 25th fraction, were found. The pretreatment IL-6 concentrations and TGF-β1 concentrations after the 25th fraction were positively correlated with maximum genitourinary toxicity grades. The IL-6 levels after the 25th fraction were positively associated with genitourinary toxicity grades after this fraction. The pretreatment IL-6 concentrations were significantly positively correlated with maximum fatigue scores. The significant positive correlation between IL-6 concentrations and fatigue scores after the 25th fraction was determined. The positive correlations between IL-6 and TGF-β1 concentrations measured after the 25th fraction and maximum fatigue scores were observed. Conclusions: Our results suggest that serum levels of IL-6 and TGF-β1 might influence the severity of acute genitourinary radiotoxicity and fatigue in patients with prostate cancer. Combining clinical parameters and circulating cytokine levels might be useful for the prediction of adverse reactions to radiotherapy. © 2022, The Author(s).

Introduction/Objective Isocitrate dehydrogenase (IDH) mutations play a significant role in gliomagenesis. Specific microRNAs, such as microRNA-10b and microRNA-21, act as oncogenic microRNAs, whereas microRNA-34a acts as a tumor suppressor in glioblastoma. Our study aimed to investigate whether the IDH1 mutation status correlates with microRNA-10b,-21, and-34a expression levels in patients with glioblastoma. Methods The study included 43 patients diagnosed with glioblastoma. We examined microRNA-10b,-21, and-34a expression levels in peripheral blood mononuclear cells after surgery and prior to concurrent radiotherapy with temozolomide, as well as at the 15th and 30th fractions of radiotherapy with temozolomide. Data on IDH1 mutation status were gathered from medical histories and histopathology. Results Two groups were created to assess the association of microRNA-10b,-21, and-34a expression levels: glioblastoma IDH1-wildtype and glioblastoma IDH1-mutant + not otherwise specified (NOS). The median microRNA-10b expression level before the initiation of concurrent radiotherapy with temozolomide was 130.44 (52.2–622.53) in the IDH1-wildtype group and 94.61 (2.13–816.89) in the IDH1-mutant + NOS group. The median microRNA-21 expression level was 57.16 (2.68–278.98) in the IDH1-wildtype group and 69.74 (4.6–825.43) in the IDH1-mutant + NOS group. The median microRNA-34a expression level was 13.52 (3.16–105.20) in the IDH1-wildtype group and 10.11 (1–210.55) in the IDH1-mutant + NOS group. The results showed no statistically significant difference in the expression levels of microRNA-10b,-21, or-34a between the two groups (p > 0.05). Conclusion Our findings suggest that IDH1 mutation status may not be a critical factor for altered expression of microRNA-10b,-21, and-34a in glioblastoma patients. © 2025, Serbia Medical Society. All rights reserved.

We describe long-lasting and incompletely resolved thrombocytopenia after transient profound pancytopenia in a 62-year-old female patient with glioblastoma after short-term radiotherapy with temozolomide. Pancytopenia was present for more than 4 weeks and thrombocytopenia for more than 6 months, without platelet recovery to normal levels. Learning Points • Some patients may experience severe haematological manifestations after even short-term radiotherapy with temozolomide. • In everyday practice, clinical models precisely predicting the haematological toxicity of concomitant treatment with temozolomide and radiotherapy is necessary, especially in countries where genetic tests are not available. • Incomplete recovery of the cells of a particular bloodline over a long period may necessitate permanent discontinuation of chemotherapy or radiotherapy. © 2020 EFIM.

Cancer patients are at high risk for developing severe symptoms with a high mortality rate due to infection of COVID-19. Radiation therapy is one of the main treatment modalities of central nervous system tumors and lung cancer. Radiotherapy is often delivered in a number of fractions, which implies many visits to the radiotherapy center and thus possibly more exposure to the COVID-19. The convenient compromise between the exposure of the patients to the SARS-CoV-2 virus and the optimal treatment is questionable. The most used measures in radiotherapy centers are classification of patients into priority groups and frequent use of hypofractionation. From the beginning of the COVID-19 outbreak, only a few expert group consensuses of radiotherapy treatment are published. In this paper we briefly review available practical recommendations of the expert groups for radiation therapy and oncology as well as the expert opinions for radiotherapy of the central nervous system tumors and lung cancer during the COVID-19 pandemic. © 2020, Serbia Medical Society. All rights reserved.

Introduction/Objective In glioblastoma, upregulation of oncogenic microRNA-10b (miR-10b) and microRNA-21 (miR-21) is often found. Our study aimed to investigate whether there is a link between miR-10b and miR-21 expression levels and tumor size and tumor localization. Methods The research involved 43 patients diagnosed with glioblastoma. We analyzed the expression levels of miR-10b and miR-21 post-surgery. The data on tumor size and tumor localization were obtained from magnetic resonance imaging. Results The median expression level of miR-10b in patients with tumors < 4 cm was 214.86 (min–max: 2.13–816.89), while in patients with tumors ≥ 4 cm, the median expression level was 92.99 (min–max: 19.24–491.82). The median expression level of miR-21 in patients with tumors < 4 cm was 81.69 (min– max: 11.39–825.43), whereas in patients with tumors ≥ 4 cm, the median expression level was 40.84 (min–max: 2.68–278.98). For both miR-10b and miR-21, a statistically significant difference was found for tumors < 4 cm (p = 0.027 and p = 0.047, respectively) compared to those ≥ 4 cm. There was no statistically significant difference in the expression levels of miR-10b (p = 0.675) and miR-21 (p = 0.183) in relation to tumor localization. Conclusion Glioblastomas smaller than 4 cm have statistically significantly higher expression levels of miR-10b and miR-21 compared to glioblastomas equal to or larger than 4 cm. Although this result is unexpected, it could mean that miR expression levels dynamically change after surgery and according to the altered microenvironment. © 2025, Serbia Medical Society. All rights reserved.

Stereotactic body radiotherapy (SBRT) is the standard treatment for early-stage inoperable non-small cell lung cancer. SBRT achieves a high local control rate (74–100%), preserves the quality of life, and the treatment is of low-toxicity. Different fractionation regimens are used, depending on the localization and size of the tumor, the proximity of the organs at risk, and the general condition of the patient. The radiobiology behind SBRT is largely unknown, precisely defined radiation doses and the number of fractions are still a matter of debate. Numerous studies are ongoing regarding the standardization of SBRT in lung cancer treatment. © 2024, Serbia Medical Society. All rights reserved.

Malignant pleural mesothelioma (MPM) is a rare malignancy with poor prognosis. In recent years, sig-nificant progress has been made in the treatment of this disease, including surgical and radiotherapy techniques, systemic therapy, and immunotherapy. Due to the wide range of clinical presentations, a lack of phase-III randomized trials, and heterogeneity in treatment approach, the treatment of MPM remains challenging regardless of available diagnostic and therapeutic guidelines. The limited possibility to avoid critical healthy organs (particularly lungs), overexposure of which can lead to severe, and even fatal, radiation-induced toxicity, makes high-dose radical radiotherapy very demanding. Thus, the majority of patients in the era of conventional radiotherapy were mostly referred to no more than palliative radiotherapy. Technological development in radiotherapy such as respiratory gating, 4D computed tomography, intensity-modulated radiotherapy, volumetric modulated arc therapy, stereotactic techniques, and proton therapy, made a step forward in treating MPM with this modality. Today, MPM radiotherapy can be considered in various indications, alone or in combination with surgery and systemic treatment. However, many questions remain open, and further investigation is needed especially in dose escalation possibility and lung sparing. © 2024, Serbia Medical Society. All rights reserved.

Background: Choosing the optimal treatment approach for patients with painful bone metastases during the COVID-19 pandemic became challenging. A simple technique, single fraction radiotherapy was recommended for these patients usually referring to bone metastases as a single entity, although it is a very heterogeneous group of patients. Aim: This study aimed to analyze the response to palliative single fraction radiotherapy in relation to age, performance status, primary tumor, histopathology, and bone localization in the group of patients with painful bone metastases. Methods: A clinical, prospective, non-randomized study was conducted at the Institute for Oncology and Radiology of Serbia, which included 64 patients with noncomplicated, painful bone metastases who underwent palliative, pain-relieving radiation therapy with a single tumor dose of 8Gy in a single hospital visit. Response to treatment was patient reported via telephone interview using visual analog scale. The response assessment was based on the international consensus panel of radiation oncologists. Results: In the entire group of patients, 83% responded to radiotherapy. No statistically significant difference was observed in response to therapy, time to reach the maximum response, degree of pain reduction, nor in response duration depending on the patient's age, performance status, the primary origin of the tumor, histopathology, or location of the metastasis (bone) that was irradiated. Conclusion: Regardless of clinical parameters, palliative radiotherapy with a single dose of 8Gy can be considered very effective in quick pain relief in patients with noncomplicated painful bone metastases. Single fraction radiotherapy in a single hospital visit, as well as patient-reported outcome for these patients may be considered favorable beyond Covid pandemics. © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Background: Choosing the optimal treatment approach for patients with painful bone metastases during the COVID-19 pandemic became challenging. A simple technique, single fraction radiotherapy was recommended for these patients usually referring to bone metastases as a single entity, although it is a very heterogeneous group of patients. Aim: This study aimed to analyze the response to palliative single fraction radiotherapy in relation to age, performance status, primary tumor, histopathology, and bone localization in the group of patients with painful bone metastases. Methods: A clinical, prospective, non-randomized study was conducted at the Institute for Oncology and Radiology of Serbia, which included 64 patients with noncomplicated, painful bone metastases who underwent palliative, pain-relieving radiation therapy with a single tumor dose of 8Gy in a single hospital visit. Response to treatment was patient reported via telephone interview using visual analog scale. The response assessment was based on the international consensus panel of radiation oncologists. Results: In the entire group of patients, 83% responded to radiotherapy. No statistically significant difference was observed in response to therapy, time to reach the maximum response, degree of pain reduction, nor in response duration depending on the patient's age, performance status, the primary origin of the tumor, histopathology, or location of the metastasis (bone) that was irradiated. Conclusion: Regardless of clinical parameters, palliative radiotherapy with a single dose of 8Gy can be considered very effective in quick pain relief in patients with noncomplicated painful bone metastases. Single fraction radiotherapy in a single hospital visit, as well as patient-reported outcome for these patients may be considered favorable beyond Covid pandemics. © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.