Vol. 30 No. 1 (2024): Review of Medical Practice
Dear Readers,
I would like to present to you the first issue of this year’s XXX volume of the quarterly „Review of Medical Practice”. In the current issue, we present you with many interesting publications, among them a study entitled Long-term Survival of a Patient with Unresectable Ductal Adenocarcinoma of the Pancreas – Case Report and Review of the Literature.
Tumours of the pancreas are very often characterised by rapid growth rates, difficult treatment, patients and short survival from diagnosis. The only treatment option is radical surgery. The five-year survival rate after resection does not exceed 20 per cent, and for unresectable tumours without distant metastases only about 5 per cent. The incidence of pancreatic cancer increases with age, with more than 80% of pancreatic cancers occurring after 55 years of age, and the most common occurrence in the seventh to eighth decade of life. We present the case of a 51-year-old female patient diagnosed 13 years ago with inoperable adenocarcinoma of the pancreas. This case highlights the need to look for genetic causes of the disease and to use individualised therapy and personalised medicine.
Also of interest is the paper Small Cell Carcinoma of the Lung (SCLC) and Squamous Cell Carcinoma (SCC) of the External Auditory Canal as an Example of Synchronous Tumours – a Case Report. A 66-year-old (now 74-year-old) female patient diagnosed with a tumour of the external auditory canal due to deterioration of hearing. In the course of the diagnosis, inter alia PET-CT examinations were performed to exclude metastatic foci. A metabolically active lesion was visualised in the left lung cavity and right adrenal gland. On further diagnosis, the lesion was diagnosed as an independent neoplastic focus originally located in the lung with stage IV small-cell carcinoma morphology with metastasis to the right adrenal gland. The aim of this paper is to emphasise the importance of a thorough diagnosis of primary and secondary lesions in oncology patients.
Also noteworthy is the paper Successful Use of Metronomic Chemotherapy with Irinotecan in a Patient with Glioblastoma Multiforme (GBM) – Case Report and Literature Review. The case report presents a 46-year-old patient diagnosed six years ago with glioblastoma multiforme. The therapeutic process included unsuccessful radiotherapy, temozolomide chemotherapy and a PCV regimen. It was only after customised metronomic therapy (MCT) with irinotecan that disease stabilisation was achieved based on the RECIST scale. The patient has remained consistently in good general condition since the start of treatment. The median overall survival time from diagnosis in treated patients with glioblastoma multiforme is approximately 8 months. In contrast, the time elapsed since the diagnosis of GBM in the described patient is already 6 years, which is far from the average in this patient group. This indicates the relevance of non-standard therapies in cases where standard therapies have failed to achieve stabilisation or regression of the disease and when there are no contraindications. Non-standard metronomic therapy is a relatively new and not very common treatment modality but also shows minimal toxicity. It should therefore be considered in patients with a diagnosis of GBM.
Yours sincerely
Editor-in-Chief
dr hab. n. med. Anna Wilmowska-Pietruszyńska, prof. UŁa
