Mitreski, Nenad
Preferred name
Mitreski, Nenad
Official Name
Mitreski, Nenad
Main Affiliation
Email
nenad.mitreski@medf.ukim.edu.mk
11 results
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Item type:Publication, Radiation-induced rectal leiomyosarcoma in a cervical cancer survivor: a case report(Oxford University Press (OUP), 2025-08); ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Head and neck cancer in young adults treated with 3-D conformal radiotherapy(National Library of Serbia, 2010); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Determining the Efficiency of a Commercial Belly Board Device in Reducing Small Bowel Volume in Rectal Cancer Patients(Association for Medical Physics and Biomedical Engineering, 2010-11-06); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Molecular Basis of Inherited Colorectal Carcinomas in the Macedonian Population: An Update(Macedonian Academy of Sciences and Arts / De Gruyter, 2019) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A SINGLE INSTITUTIONAL EXPERIENCE WITH CETUXIMAB IN METASTATIC COLORECTAL CANCER(Sestre milosrdnice University Hospital Center University Hospital for Tumors, Zagreb, Croatia, 2022-05); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Serum chromogranin-A levels in neuroendocrine neoplasms as prognostic marker in correlation with the clinical course of the disease and the influence of octreotid therapy(Faculty of Medicine, University Ss. Cyril and Methodius in Skopje, 2021-05); ; ; ; Introduction. Neuroendocrine neplasms (NEN) arise from neuroedocrine cells in various tissues and organs, have diverse biological behavior and express neuroendocrine markers synaptophysin and chromogranin A (CgA). Aim of the study. The aim of this study was to correlate the serum CgA levels before and after surgical and/or oncological treatment with octreotide and to determine the prognostic value of CgA variations during the follow-up. Material and methods. We used ELISA to analyze 699 serum samples from 410 patients during 9 years, due to carcinoid syndrome, benign neuroendocrine tumor (NET), localized neuroendocrine carcinoma (NEC) and patients with metastatic NEC (MS). Data from hospital databases were used for follow-up of 60 patients, divided into responders and non-responders, regarding their response to therapy. Results. The mean serum CgA value in 410 analyzed patients was by 3.47-fold increase compared to the maximal reference values. The highest increase was measured in patients with NEC/MS, with mean 12.94-fold increase, followed by patients with localized NECs, with mean 4.57. During follow-up, CgA values were reduced, with a significant difference between the groups of responders and non-responders. Conclusions. Reduction of the CgA level for at least 49.5% during the first 12 months after therapy was correlated with stable disease course, and serum CgA elevation or decrease less than 34% during the first 12 months after the therapy was correlated to unfavorable clinical course. Serum CgA levels are useful for the diagnosis of NENs and during the follow-up for detection of recurrence, disease progression and evaluation of the oncologic therapy response. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Real-world data of cardiotoxicity during long-term therapy with trastuzumab in human epidermal growth factor receptor-2-positive metastatic breast cancer(National Library of Serbia, 2022-12-16); ; ; Introduction/Objective. This study aims to investigate the cardiotoxicity of long-term therapy with trastuzumab in patients with HER2 positive metastatic breast cancer. Methods. A total of 48 patients with metastatic HER2 positive breast cancer were analyzed. The patients received long-term trastuzumab (time of application was longer than 20 months). The analyzed characteristics of the patients were: age, initial stage of the disease, application of anti-HER2 therapy and anthracyclines in the adjuvant setting, the number and type of applied systemic therapies concomitant with trastuzumab in the metastatic setting. Cardiac toxicity was assessed using left ventricular ejection fraction (LVEF) values at three time points: at the beginning, in the middle, and at the end of treatment period for each patient separately. Results. In 17 (35.4%) patients the trastuzumab treatment was temporary discontinued. The average time of trastuzumab therapy interval was 52.2 ? 23.5 months. The mean LVEF values were 66.73 ? 7.02%, 64.62 ? 5.7% and 63.44 ? 6.1%, respectively. The mean values of LVEF differed significantly in the observed three time points (F=4.9 p=0.009). Post hoc pairwise comparison, using Bonferonni correction, confirmed significantly lower mean LVEF values at the end point (at the end of treatment) compared with the mean LVEF values at the beginning of anti-HER2 treatment (p = 0.019), but within the reference range of LVEF ?50%. Conclusion. The data confirm good safety profile of long-term trastuzumab therapy in HER2 positive metastatic breast cancer patients considering cardiotoxicity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Influence of MSI and 18q LOH markers on capecitabine adjuvant monotherapy in colon cancer patients(Dove Press Ltd., 2018); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, POSTOPERATIVE ADJUVANT INTENSITY-MODULATED RADIOTHERAPY FOR RADICALLY RESECTED RECTAL ADENOCARCINOMA: DATA FROM EVERYDAY PRACTICE(Faculty of Medicine, University Ss. Cyril and Methodius in Skopje, 2022-05-04); ; ; Introduction: Adjuvant radiochemotherapy is a standard treatment in patients with surgically treated stage II or III rectal adenocarcinoma who did not undergo neoadjuvant radiotherapy. Intensity-modulated radiation therapy (IMRT) was only marginally investigated in postoperative setting. Material and methods: A longitudinal observational analysis was conducted in patients with radically resected stage II or III rectal adenocarcinoma treated with IMRT at the University Clinic for Radiotherapy and Oncology as part of the adjuvant postoperative treatment. The dose-volume parameters of the radiotherapy plans, as well as acute side effects of 40 patients were analyzed. Results: The average dose received by the target volume was 49.95 Gy (range 27-54 Gy). The mean volume of peritoneal cavity receiving 45 Gy (V45) was 102.73 cm3 (±52.10), V30 for pelvic bones was 38.3% (±5.48), V40 for bladder 52.48% (±10.9). The most frequent acute side effects were diarrhea in 17 (42.5%), lymphopenia in 34 (85%) and thrombocytopenia in 26 patients (65%). Most of the side effects were self-limiting and caused disruption of the radiation treatment only in 3 patients (7.5%). Conclusion: Integrating IMRT in the adjuvant treatment of locally advanced rectal cancer provides a good dose distribution and organs at risk sparing. The treatment is well tolerated, the side effects are mainly of lesser degrees and easily managed. A prospective trial comparing IMRT with 3-dimensional conformal radiotherapy is needed to assess whether IMRT offers a better perspective for adjuvant treatment. Keywords: rectal adenocarcinoma, adjuvant treatment, remove adjuvant treatment, intensity-modulated radiotherapy, acute side effects - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DUAL HER2 BLOCKADE WITH TRASTUZUMAB AND PERTUZAMB IN HER2- POSITIVE BREAST CANCER: SINGLE CENTER REAL WORLD DATA(Macedonian Association of Anatomists, 2020-12-30); ; ; Agents targeting the human epidermal growth factor receptor 2 (HER2) have improved outcomes of advanced HER2-positive breast cancer with durable responses. We evaluated therapy with trastuzumab and pertuzumab in early and metastatic HER2-positive breast cancer patients. In this paper we discuss the practicalities of treating patients with this combination with a particular focus on treatment in the single center setting. We retrospectively identifed patients on adjuvant and frst-line anti-HER2 therapy at The University Clinic of Radiotherapy and Oncology Skopje for at least 1 year from 2019 to 2020. Demographics, treatments and adverse events were recorded. The combination of pertuzumab–trastuzumab has established efficacy in patients with HER2‐positive advanced/metastatic breast cancer. Management of treatment related side‐effects such as diarrhea, febrile neutropenia and neuropathy typically include dose reduction or switching taxane. Specific patients with poorer tolerance of chemotherapy such may require particular management strategies.The roles of trastuzumab and pertuzumab are now very well established in the frst-line setting; identifying predictors of long-term response to these would be important in selecting which patients might beneft from entry into future clinical trials assessing the long-term beneft of these newer agents in addition.