Faculty of Medicine

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Radiation-induced rectal leiomyosarcoma in a cervical cancer survivor: a case report
(Oxford University Press (OUP), 2025-08)
Sulejmani, Haris
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Vasilevski, Filip
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Rectal leiomyosarcoma (LMS) is an exceptionally rare malignancy, representing ˂0.5% of all rectal cancers. Even more uncommon are the cases of radiation-induced LMS arising as an independent malignancy following pelvic radiotherapy. We report a case of a 56-year-old female patient with a history of high-grade large cell neuroendocrine cervical carcinoma treated 12 years earlier with radical hysterectomy and adjuvant chemoradiotherapy. The patient presented with rectal discomfort and altered bowel habits. A colonoscopy revealed a near-obstructing polypoid rectal mass, and a biopsy confirmed LMS. Surgical treatment via abdominoperineal resection with total mesorectal excision was performed. Adjuvant chemotherapy was conducted by an oncologist. Given the long latency period and absence of metastases, the tumor was stated as a radiation-induced primary malignancy. This case emphasizes the importance of awareness in cancer survivors previously treated with pelvic radiotherapy and highlights the critical role of surgery in the management of rectal LMS.
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Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival
(Research Square Platform LLC, 2023-02-13)
Morra, Anna
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Schreurs, Maartje A C
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Andrulis, Irene L
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Anton-Culver, Hoda
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Augustinsson, Annelie
Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers. We aimed to assess the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS. Analyses were based on 82,701 women diagnosed with invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations of treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death. There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR(95%CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR(95%CI) :1.30 (1.09-1.56)]. In conclusion, systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk. (Main MS: 3201 words).
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Availability of technology for managing cancer patients in the Southeast European (SEE) region
(Elsevier BV, 2022-03)
Dosanjh, Manjit
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Georgieva, Petya
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Balin Kovacevic, Marijana
Background: The Southeast European (SEE) region of 10 countries and about 43 million people differs from Western Europe in that most SEE countries lack active cancer registries and have fewer diagnostic imaging devices and radiotherapy (RT) units. The main objective of this research is to initiate a common platform for gathering SEE regional cancer data from the ground up to help these countries develop common cancer management strategies. Methods: To obtain detailed on-the-ground information, we developed separate questionnaires for two SEE groups: a) ONCO - oncologists regarding cancer treatment modalities and the availability of diagnostic imaging and radiotherapy equipment; and b) REG - national radiation protection and safety regulatory bodies regarding diagnostic imaging and radiotherapy equipment in SEE facilities. Results: Based on responses from 13/17 ONCO participants (at least one from each country) and from 9/10 REG participants (all countries but Albania), cancer incidence rates are higher in those SEE countries that have greater access to diagnostic imaging equipment while cancer mortality-to-incidence (MIR) ratios are higher in countries that lack radiotherapy equipment. Conclusion: By combining unique SEE region information with data available from major global databases, we demonstrated that the availability of diagnostic imaging and radiotherapy equipment in the SEE countries is related to their economic development. While immediate diagnostic imaging and radiation therapy capacity building is necessary, it is also essential to develop both national and SEE-regional cancer registries in order to understand the heterogeneity of each country’s needs and to establish regional collaborative strategies for combating cancer.
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A review of the International Early Recommendations for Departments Organization and Cancer Management Priorities during the Global COVID-19 Pandemic. Applicability in Low- and Middle-Income Countries
(Elsevier BV, 2020-06)
Belkacemi, Yazid
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Grellier, Noemie
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Ghith, Sahar
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Debbi, Kamel
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Coraggio, Gabriele
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus that has never been identified in humans before. COVID-19 caused at the time of writing of this article, 2.5 million cases of infections in 193 countries with 165,000 deaths, including two-third in Europe. In this context, Oncology Departments of the affected countries had to adapt quickly their health system care and establish new organizations and priorities. Thus, numerous recommendations and therapeutic options have been reported to optimize therapy delivery to patients with chronic disease and cancer. Obviously, while these cancer care recommendations are immediately applicable in Europe, they may not be applicable in certain emerging and low and middle income countries (LMICs). In this review we aimed to summarize these international guidelines according to cancer types, making a synthesis for daily practice to protect patients, staff and tailor anti-cancer therapy delivery taking into account patients/tumor criteria and tools availability. Thus, we will discuss their applicability in the LMICs with different organizations, limited means and different constraints

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