Browsing by Author "Stepanovic, Aleksandar (57201691091)"

Introduction: The outbreak of COVID-19 has had an impact on global healthcare as well as on radiotherapy practice in many countries. This study aimed to identify clinical characteristics of Coronavirus Disease 2019 (COVID-19) infected cancer inpatients, as well as what impact this infection had on radiation treatment of the patients. Methodology: In this retrospective study, we included cancer inpatients with laboratory confirmed COVID-19 infection during the radiotherapy or chemoradiation in April 2020 in National Cancer Research Center in Serbia. Data were obtained from the medical records between 1 April and 1 July 2020. Results: A total of 49 COVID-19 infected cancer inpatients were included. The most frequently reported cancers were head and neck cancers, in twenty-three patients (46.8%). Lymphopenia was present in 77.5% of the patients. Red blood cells, haemoglobin and platelets were significantly lower during incubation or diagnosis of COVID-19. Twenty-seven (55.1%) patients did not finish radiotherapy. The age of patients who finished radiotherapy after COVID-19 infection was significantly lower compared to the patients who did not finish radiotherapy (60.5 ± 7.8 vs. 68.6 ± 11.2; p < 0.005). Conclusions: COVID-19 infected cancer patients in radiotherapy practice show similar symptoms and demographic characteristics as the general population infected with SARS-CoV-2 virus. Patients with head and neck cancers may be susceptible to infection with COVID-19. Old age and male gender may be risk factors for discontinuation of radiotherapy in COVID-19 infected cancer patients. © 2021 Stepanovic et al.

Introduction: The outbreak of COVID-19 has had an impact on global healthcare as well as on radiotherapy practice in many countries. This study aimed to identify clinical characteristics of Coronavirus Disease 2019 (COVID-19) infected cancer inpatients, as well as what impact this infection had on radiation treatment of the patients. Methodology: In this retrospective study, we included cancer inpatients with laboratory confirmed COVID-19 infection during the radiotherapy or chemoradiation in April 2020 in National Cancer Research Center in Serbia. Data were obtained from the medical records between 1 April and 1 July 2020. Results: A total of 49 COVID-19 infected cancer inpatients were included. The most frequently reported cancers were head and neck cancers, in twenty-three patients (46.8%). Lymphopenia was present in 77.5% of the patients. Red blood cells, haemoglobin and platelets were significantly lower during incubation or diagnosis of COVID-19. Twenty-seven (55.1%) patients did not finish radiotherapy. The age of patients who finished radiotherapy after COVID-19 infection was significantly lower compared to the patients who did not finish radiotherapy (60.5 ± 7.8 vs. 68.6 ± 11.2; p < 0.005). Conclusions: COVID-19 infected cancer patients in radiotherapy practice show similar symptoms and demographic characteristics as the general population infected with SARS-CoV-2 virus. Patients with head and neck cancers may be susceptible to infection with COVID-19. Old age and male gender may be risk factors for discontinuation of radiotherapy in COVID-19 infected cancer patients. © 2021 Stepanovic et al.

Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery. Methods: We performed a retrospective study of the 333 adult patients who received surgery for supratentorial meningioma at our center. Various clinical, radiological, and surgical variables were included in the multivariate regression, and the outcomes measured were the occurrence of seizure(s) preoperatively, during the hospitalization, and during the follow-up period. Results: A total of 89 (26.7%) patients experienced preoperative seizures, of whom 62.9% were seizure free after the surgery. Of 244 patients without epilepsy before surgery, 11.9% had at least one seizure postoperatively. In total, 63 of our patients (18.9%) experienced seizures after the surgery, of whom 20 had refractory epilepsy. Multivariate analysis identified the following predictors of preoperative seizures: the absence of headache (OR: 0.23, CI: 2.55–8.50), the presence of significant peritumoral edema (OR: 4.35, CI: 2.57–7.35), and younger age (OR: 0.97 per year increase, CI: 0.95–0.99). Factors associated with early postoperative seizures were: younger age (OR: 0.96 per year increase, CI: 0.93–0.99) and the presence of preoperative seizures (OR: 2.73, CI: 1.13–6.57), while the presence of preoperative seizures (OR: 4.73, CI: 2.05–10.92), tumor progression (OR: 5.38, CI: 2.25–12.89), and neurological worsening (OR: 5.21 CI: 1.72–15.81) were significant for late postoperative seizures. Significance: Our results from a single-center meningioma cohort confirm, in general, data from some previous studies regarding patients' characteristics for both preoperative and overall postoperative epilepsy. Besides previously described risk factors, younger age was important for preoperative and early postoperative seizures. Epilepsy is common in patients with recurrence of meningioma, but the variables of significance for refractory seizures in these patients require further examination. © 2023 International League Against Epilepsy.

Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery. Methods: We performed a retrospective study of the 333 adult patients who received surgery for supratentorial meningioma at our center. Various clinical, radiological, and surgical variables were included in the multivariate regression, and the outcomes measured were the occurrence of seizure(s) preoperatively, during the hospitalization, and during the follow-up period. Results: A total of 89 (26.7%) patients experienced preoperative seizures, of whom 62.9% were seizure free after the surgery. Of 244 patients without epilepsy before surgery, 11.9% had at least one seizure postoperatively. In total, 63 of our patients (18.9%) experienced seizures after the surgery, of whom 20 had refractory epilepsy. Multivariate analysis identified the following predictors of preoperative seizures: the absence of headache (OR: 0.23, CI: 2.55–8.50), the presence of significant peritumoral edema (OR: 4.35, CI: 2.57–7.35), and younger age (OR: 0.97 per year increase, CI: 0.95–0.99). Factors associated with early postoperative seizures were: younger age (OR: 0.96 per year increase, CI: 0.93–0.99) and the presence of preoperative seizures (OR: 2.73, CI: 1.13–6.57), while the presence of preoperative seizures (OR: 4.73, CI: 2.05–10.92), tumor progression (OR: 5.38, CI: 2.25–12.89), and neurological worsening (OR: 5.21 CI: 1.72–15.81) were significant for late postoperative seizures. Significance: Our results from a single-center meningioma cohort confirm, in general, data from some previous studies regarding patients' characteristics for both preoperative and overall postoperative epilepsy. Besides previously described risk factors, younger age was important for preoperative and early postoperative seizures. Epilepsy is common in patients with recurrence of meningioma, but the variables of significance for refractory seizures in these patients require further examination. © 2023 International League Against Epilepsy.

Glioblastoma is the most frequent primary malignant brain tumor in adults. With the number of symptoms and signs, it belongs to diseases where a lot of treatment modalities are often applied. A standard treatment for patients with glioblastoma includes surgical resection followed by radiotherapy with concomitant and adjuvant temozolomide. Each type of treatment has its own toxicity. Temozolomide is an oral alkylating cytotoxic drug and like any other alkylating agent can induce side effects. Although temozolomide is generally a well tolerated drug, with rare severe toxic effects, sometimes certain toxicities can overcome the life risk of the underlying malignancy. By reviewing the literature, we have selected the cases with severe clinical presentation where some of them had a lethal outcome and we have chosen to present them in this article. In some patients with noticeable hematological toxic effects, as well as those with serious infections, attention must be paid to their treatment, as toxic effects can deepen and develop new toxicity, which all lead to a vicious circle without a favorable outcome. Preventive use of antiviral drugs should be considered before the treatment with temozolomide in patients with a positive history of viral infections such as Hepatitis B infection. In order to prevent rare but possible opportunistic infections, it is necessary to familiarize the patients with the treatment, toxicity and rare opportunistic infections. These infections can be triggered by various factors from the nearest environment, including both domestic and wild animals and pets. © 2018 Zerbinis Publications. All rights reserved.

Glioblastoma is the most frequent primary malignant brain tumor in adults. With the number of symptoms and signs, it belongs to diseases where a lot of treatment modalities are often applied. A standard treatment for patients with glioblastoma includes surgical resection followed by radiotherapy with concomitant and adjuvant temozolomide. Each type of treatment has its own toxicity. Temozolomide is an oral alkylating cytotoxic drug and like any other alkylating agent can induce side effects. Although temozolomide is generally a well tolerated drug, with rare severe toxic effects, sometimes certain toxicities can overcome the life risk of the underlying malignancy. By reviewing the literature, we have selected the cases with severe clinical presentation where some of them had a lethal outcome and we have chosen to present them in this article. In some patients with noticeable hematological toxic effects, as well as those with serious infections, attention must be paid to their treatment, as toxic effects can deepen and develop new toxicity, which all lead to a vicious circle without a favorable outcome. Preventive use of antiviral drugs should be considered before the treatment with temozolomide in patients with a positive history of viral infections such as Hepatitis B infection. In order to prevent rare but possible opportunistic infections, it is necessary to familiarize the patients with the treatment, toxicity and rare opportunistic infections. These infections can be triggered by various factors from the nearest environment, including both domestic and wild animals and pets. © 2018 Zerbinis Publications. All rights reserved.