Wspolczesna Onkologia-Contemporary Oncology最新文献

{"title":"Host's immune response to primary tumours and concomitant brain metastases in the central nervous system.","authors":"Alexandra Papadaki, George Zarkavelis, Melina Yerolatsite, Nanteznta Torounidou, Anna-Lea Amylidi, Antonia V Charchanti, Davide Mauri, Anna Batistatou, Anna Gousia","doi":"10.5114/wo.2026.159847","DOIUrl":"10.5114/wo.2026.159847","url":null,"abstract":"<p><strong>Introduction: </strong>Brain metastases from solid tumours are the most common intracranial neoplasms and significantly impact patients' quality of life and overall survival (OS). Despite advances in oncological therapies, these patients have often been excluded from clinical trials, limiting our understanding of the efficacy of new treatments, such as immunotherapy, in this population. Investigating the tumour microenvironment (TME) of brain metastases is challenging, particularly in determining whether immunotherapy is effective for these lesions. The aim of this study is to investigate the host's immune response to primary tumours and concomitant brain metastases in the central nervous system from various malignancies.</p><p><strong>Material and methods: </strong>A retrospective study was conducted to examine tumour-infiltrating lymphocytes (TIL) and the expression of programmed cell death 1 and programmed death ligand 1 (PD-L1) in tissue samples from 72 patients with predominant solid tumours and synchronous or metachronous brain metastases. Correlations with different parameters were analysed to evaluate the prognosis of these patients.</p><p><strong>Results: </strong>All metastatic tumour samples exhibited decreased intraepithelial CD3 and CD8 levels compared to primary tumours, with variable FOXP3 levels and no consistent difference in PD-L1 levels in tumour cells. Programmed death ligand 1 expression in immune cells was generally lower in metastatic lesions compared to primary tumours. The median OS from diagnosis (OS1) was 19.1 months (95% CI: 13.6-35.1), and the median OS from the diagnosis of brain metastases (OS2) was 11.35 months.</p><p><strong>Conclusions: </strong>The brain TME demonstrates varying levels of TIL and immune checkpoint expression, highlighting the need for further research to develop effective therapies for intracranial metastases.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 1","pages":"23-32"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinicopathologic and survival analysis of mucoepidermoid carcinoma of the breast.","authors":"Omar Tluli, Mahd M Abujbara, Eman A Almaraghi, Dina Tluli, Giridhara Rathnaiah Babu, Semir Vranic","doi":"10.5114/wo.2026.163810","DOIUrl":"10.5114/wo.2026.163810","url":null,"abstract":"<p><strong>Introduction: </strong>Mucoepidermoid carcinoma (MEC) of the breast is an exceptionally rare salivary gland-type malignancy with uncertain prognostic behaviour. This study compared the clinicopathologic characteristics, treatment patterns, and survival outcomes of MEC and invasive ductal carcinoma not otherwise specified (IDC-NOS) using Surveillance, Epidemiology, and End Results (SEER) data.</p><p><strong>Material and methods: </strong>A retrospective cohort analysis of SEER data (1975-2022) identified cases with MEC (<i>n</i> = 42) and IDC-NOS (<i>n</i> = 50,881). Demographic, clinicopathologic, and treatment variables were compared using χ² and one-way analysis of variance tests. Overall survival (OS) and disease-specific survival (DSS) were analysed with Kaplan-Meier and Cox proportional hazards models.</p><p><strong>Results: </strong>Mucoepidermoid carcinoma cases were older (≥ 70 years: 91.0% vs. 31.1%; p < 0.001) and predominantly White. Compared with IDC-NOS, MEC exhibited lower HER2 positivity (0.0% vs. 31.4%), oestrogen receptor/progesterone receptor expression (31.0% and 0.0% vs. 60.1% and 52.3%), and distant metastasis (0.0% vs. 20.1%) (all <i>p</i> < 0.001). Mucoepidermoid carcinoma cases were less likely to undergo surgery (85.7%) or receive systemic therapy (40.5%, <i>p</i> < 0.05). Only five deaths (OS) and three (DSS) occurred among MEC cases. Kaplan-Meier curves showed similar early survival, but MEC survival plateaued after 120 months, whereas IDC-NOS declined steadily. Multivariable Cox analysis revealed higher all-cause mortality for IDC-NOS (adjusted hazard ratios [HR] = 3.80, 95% CI: 1.18-12.22), with no significant difference in cancer-specific mortality (HR = 2.32, 95% CI: 0.71-7.58).</p><p><strong>Conclusions: </strong>Mucoepidermoid carcinoma exhibits distinct clinicopathologic features, limited metastatic potential, and favourable long-term survival despite frequent triple negativity. Its indolent course supports conservative management for low-grade cases, warranting further molecular and prognostic studies.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 2","pages":"157-169"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myelodysplastic syndrome after maintenance treatment with metronomic cyclophosphamide: weighing prolonged stable disease against late toxicity.","authors":"Sara Neves Carvalho, Carolina Perez Duque, Susana Lisboa, Dulcineia Pereira, Miguel H Abreu","doi":"10.5114/wo.2026.159746","DOIUrl":"10.5114/wo.2026.159746","url":null,"abstract":"<p><p>Metronomic cyclophosphamide is occasionally used as maintenance therapy for patients with metastatic triple-negative breast cancer (TNBC), although there is limited long-term safety data. In this case study, we present the patient with metastatic TNBC who achieved a durable complete response and subsequently received metronomic cyclophosphamide for seven years. Progressive cytopenias prompted an investigation, which revealed myelodysplastic syndrome with monosomy 7 once reversible causes had been addressed, including vitamin deficiencies, Helicobacter pylori infection and previous hepatitis C exposure. Following discontinuation of cyclophosphamide, gradual haematological recovery was observed, and the patient remains without radiological evidence of progression. This case highlights the potential for late haematological toxicity associated with prolonged exposure to low doses of alkylating agents, emphasises the need for periodic reassessment of maintenance therapy in long-term responders, and shows that persistent cytopenias require evaluation of alternative causes rather than being solely attributed to chemotherapy.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 1","pages":"88-94"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticancer effects of fangchinoline in 4T1 breast cancer cells: <i>in vitro</i> and <i>in silico</i> analysis of TGF-β1 and mTOR pathways.","authors":"Nicolas Kusady, Denny Satria, Poppy Anjelisa Zaitun Hasibuan, Dewi Pertiwi, Syukur Berkat Waruwu, Choo Yeun-Mun","doi":"10.5114/wo.2026.163119","DOIUrl":"10.5114/wo.2026.163119","url":null,"abstract":"<p><strong>Introduction: </strong>Triple-negative breast cancer (TNBC) is an aggressive subtype with poor prognosis and limited therapeutic options. Fangchinoline, a bisbenzylisoquinoline alkaloid, has demonstrated anticancer activity; however, its molecular mechanism in TNBC remains unclear. This study aimed to investigate the anticancer effects of fangchinoline and explore its potential molecular mechanisms in TNBC.</p><p><strong>Material and methods: </strong>An integrated <i>in vitro</i> and <i>in silico</i> approach was employed. Molecular docking and molecular dynamics simulations were conducted to evaluate the interaction of fangchinoline with TGF-β1 and mTOR proteins. Cytotoxicity was assessed in murine 4T1 TNBC-cells.Flow cytometry was used to analyse cell cycle distribution, apoptosis, and protein expression related to the PI3K/Akt/mTOR pathway and p53.</p><p><strong>Results: </strong>Fangchinoline demonstrated strong binding affinity toward TGF-β1 and exhibited selective cytotoxicity against 4T1 cells (IC₅₀ = 25.95 µM). Treatment induced apoptosis and mild G2/M phase arrest. In addition, changes in the expression of PI3K, Akt, mTOR, and p53 proteins were observed. These findings suggest that fangchinoline may suppress cell proliferation and promote apoptosis, possibly through modulation of the PI3K/Akt/mTOR signalling pathway; however, this interpretation is based on protein expression data without phosphorylation analysis or functional validation.</p><p><strong>Conclusions: </strong>Fangchinoline exhibits potential anticancer activity against TNBC-cells by inducing apoptosis and affecting key survival-related pathways. Further studies are required to confirm its molecular mechanisms and therapeutic potential.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 2","pages":"134-144"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-grade appendiceal mucinous neoplasm vs. high-grade appendiceal mucinous neoplasm: similarities, differences, and current management challenges.","authors":"Paweł Lesiak, Bartosz Kapturkiewicz, Tomasz Jastrzębski, Marek Bębenek, Michał Kazanowski","doi":"10.5114/wo.2026.163813","DOIUrl":"10.5114/wo.2026.163813","url":null,"abstract":"<p><p>Appendiceal mucinous neoplasms are rare tumours whose terminology, staging and management remain difficult to align with conventional colorectal cancer paradigms. Low-grade appendiceal mucinous neoplasm (LAMN) is well established, whereas high-grade appendiceal mucinous neoplasm (HAMN) remains less clearly defined in clinical practice. This review summarises current evidence on the classification, pathological distinction, clinical behaviour, prognosis and management of LAMN and HAMN. Both entities share a non-infiltrative growth pattern, but HAMN is distinguished by high-grade cytologic atypia and a greater association with high-grade peritoneal disease once dissemination occurs. In appendix-confined, non- perforated disease, HAMN seems to behave more like LAMN than invasive adenocarcinoma, so high-grade cytology alone should not be taken as an indication for routine right hemicolectomy. When perforation, extra-appendiceal mucin or peritoneal involvement is present, management should be escalated to specialist multidisciplinary assessment, with surveillance and consideration of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy tailored to disease extent. Management should therefore integrate histology with disease extent, perforation status, peritoneal cellularity and dissemination pattern rather than rely on the cytologic grade alone.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 2","pages":"110-116"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In silico approach and <i>in vitro</i> study of fangchinoline-induced apoptosis and reactive oxygen species production in HER2-overexpressing breast cancer cells.","authors":"Denny Satria, Poppy Anjelisa Zaitun Hasibuan, Masfria Masfria, Syukur Berkat Waruwu, Choo Yeun-Mun, Feri Eko Hermanto, Nashi Widodo","doi":"10.5114/wo.2026.159783","DOIUrl":"10.5114/wo.2026.159783","url":null,"abstract":"<p><strong>Introduction: </strong>Fangchinoline, a bisbenzylisoquinoline alkaloid derived from Stephaniae tetrandrine, is known for its antioxidant and anticancer potential. This study aimed to explore fangchinoline's anticancer targets in silico and evaluate its effects on human epidermal growth receptor-2 (<i>HER-2</i>) overexpressing <i>MCF-7</i> breast cancer cells.</p><p><strong>Material and methods: </strong>Potential molecular targets were identified using GeneCards and DisGeNET, with intersecting genes analysed via DAVID and Cytoscape. Molecular docking and 50-nanosecond molecular dynamics simulations were conducted against <i>ERBB2, IGF1R</i>, and <i>ADRB2</i> proteins. Cytotoxicity was evaluated through 3-(4,5-dimethylthiazole-2-yl)-2,5- diphenyl tetrazolium bromide assay, while flow cytometry assessed cell cycle distribution, apoptosis, expression of <i>PI3K, Akt, mTOR, p53, HER-2</i>, and reactive oxygen species (ROS) levels.</p><p><strong>Results: </strong>A total of 256 overlapping genes were identified, and <i>ERBB2</i> emerged as the most promising target with a binding affinity of -8.57 kcal/mol. Fangchinoline exhibited cytotoxicity against <i>MCF-7</i>/<i>HER-2</i> cells with an IC₅₀ of 9.67 ±0.14 µM. Fangchinoline induced G2-M arrest and significantly increased apoptosis. Flow cytometry revealed downregulation of <i>PI3K</i> (-42.1%), <i>Akt</i> (-38.6%), and <i>mTOR</i> (-45.3%), with a corresponding upregulation of <i>p53</i> (+59.8%) compared to controls. Reactive oxygen species production was elevated by +48.5% after treatment.</p><p><strong>Conclusions: </strong>Fangchinoline exhibits promising anticancer activity by targeting <i>ERBB2</i> and modulating critical oncogenic and apoptotic pathways. Its ability to upregulate <i>p53</i> and ROS while suppressing <i>PI3K</i>/<i>Akt</i>/<i>mTOR</i> signalling suggests its strong potential as a <i>HER-2</i>-targeted therapeutic agent.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 1","pages":"56-67"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marginal zone lymphoma of arytenoid cartilage: a rare malignancy of the larynx.","authors":"Julia Bernaciak, Piotr Nogal, Katarzyna Iwanik, Joanna Jackowska","doi":"10.5114/wo.2026.159893","DOIUrl":"10.5114/wo.2026.159893","url":null,"abstract":"<p><p>Extranodal marginal zone lymphoma (EMZL), which has an indolent course, rarely occurs in arytenoid cartilage. Diagnosis of the condition in such an infrequent location is challenging and demands the use of various methods, such as magnetic resonance imaging and histopathological examination of the tissue sections acquired during microlaryngoscopy. We present an infrequent case of a 61-year-old patient who was diagnosed with EMZL of arytenoid cartilage after a four-year period of surveillance and examinations. Chemoimmunotherapy was implemented in this case as a successful method of treatment, as it included bendamustine and rituximab. The disease was in remission after the treatment.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 1","pages":"95-97"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best supportive care in patients with brain metastases: impact of the primary tumour type on survival.","authors":"Carsten Nieder, Ellinor C Haukland, Bård Mannsåker, Luka Stanisavljevic, Astrid Dalhaug","doi":"10.5114/wo.2026.159586","DOIUrl":"10.5114/wo.2026.159586","url":null,"abstract":"<p><strong>Introduction: </strong>The study was aimed to analyse the impact of the tumour type and other patient- and disease-related baseline parameters in a consecutive cohort managed with best supportive care (BSC) in northern Norway.</p><p><strong>Material and methods: </strong>This is a retrospective analysis of 149 patients managed with BSC without any systemic cancer-directed therapy or local brain-directed measures (2007-2024). Eleven patients were originally supposed to start active treatment and 12 had received prior prophylactic whole-brain irradiation (WBRT). Uni- and multivariate analyses of prognostic factors for survival were performed.</p><p><strong>Results: </strong>Median survival after radiological diagnosis was 1.3 months (95% CI: 1.08-1.52) for all 149 patients combined. The 3- and 6-month survival rates were 20% and 1%, respectively. Neither prior WBRT nor upfront intention to treat were associated with survival. Steroid responders survived significantly longer than non-responders. The multivariate Cox model suggested that survival mainly depends on Karnofsky performance status (< 70 vs. ≥ 70), extracranial metastases (present/absent), and primary tumour type (better in renal cell cancer/malignant melanoma vs. all others combined), <i>p</i> ≤ 0.01 for all three predictors of survival.</p><p><strong>Conclusions: </strong>All prognostic strata in our study had median survival times < 2.5 months, indicating an inevitable poor outcome, despite presence of statistically significant differences, e.g. for the primary tumour type. The clinical impact of prognostic scores would thus be very limited. Median survival was similar in historical studies of BSC. Best supportive care is a reasonable choice in patients with brain metastases and very short life expectancy, as also evident from prospective research.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 1","pages":"40-46"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous adipose tissue radiodensity as a prognostic marker in metastatic non-small cell lung cancer treated with immune checkpoint inhibitors.","authors":"Yuliia Moskalenko, Viktor Kovchun, Anton Bohdanov, Vitalii Budko","doi":"10.5114/wo.2026.159311","DOIUrl":"10.5114/wo.2026.159311","url":null,"abstract":"<p><strong>Introduction: </strong>Radiodensity of subcutaneous adipose tissue (SAT), measurable on routine computed tomography (CT), may reflect metabolic status and cachexia, both of which influence cancer outcomes. However, its prognostic role in metastatic non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI) remains unclear. This study aimed to evaluate the prognostic value of SAT radiodensity in this patient population.</p><p><strong>Material and methods: </strong>The retrospective analysis included 92 patients with stage IV NSCLC receiving ICI. Subcutaneous adipose tissue radiodensity (Hounsfield units) was measured from pre-treatment CT at the L3 level and categorized into quartiles. Kaplan- Meier analysis, log-rank test, and Cox proportional hazards models were used. Nonlinear associations were assessed using restricted cubic splines. Cox models were? adjusted for demographic, clinical, and treatment factors. A <i>p</i>-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Median overall survival for Q1, Q2, Q3, and Q4 was 13.4, 26.3, 18.4, and 14.2 months, respectively (log-rank <i>p</i> = 0.0226). Compared with Q1, Q2 showed a significantly reduced mortality risk across all models (fully adjusted hazard ratios = 0.32, 95% CI: 0.15-0.64, <i>p</i> = 0.002). Q3 and Q4 were not significantly different from Q1. Restricted cubic spline analysis revealed a mild U-shaped relationship (<i>p</i> for nonlinearity = 0.0094), with intermediate SAT density linked to best outcomes. Programmed death ligand 1 expression significantly modified the SAT-survival association (<i>p</i> for interaction < 0.0001).</p><p><strong>Conclusions: </strong>Moderate SAT radiodensity was associated with improved survival in metastatic NSCLC patients on ICI, potentially reflecting an optimal metabolic-immune balance. Subcutaneous adipose tissue density, easily obtained from routine imaging, warrants further prospective validation as a scalable prognostic biomarker.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 1","pages":"47-55"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical guidelines for the management of cytostatic extravasation in children.","authors":"Patrycja Sosnowska-Sienkiewicz, Anna Łohynowicz, Danuta Januszkiewicz-Lewandowska","doi":"10.5114/wo.2026.163773","DOIUrl":"10.5114/wo.2026.163773","url":null,"abstract":"<p><p>Extravasation of cytostatic drugs is a rare but potentially devastating complication of chemotherapy in children, leading to severe pain, tissue necrosis, functional impairment, and cosmetic deformities. Despite its importance, management protocols remain inconsistent. This paper presents structured instructions to support rapid recognition, intervention, and prevention of cytostatic extravasation in paediatric patients, aiming to reduce morbidity and optimise outcomes. The guidance was developed from published recommendations, systematic reviews, and institutional experience, and it provides a stepwise algorithm for immediate management: stopping infusion, retaining intravenous access for aspiration, marking and documenting the affected site, and performing clinical assessment. Specific measures include aspiration techniques for peripheral and central lines, administration of antidotes such as dexrazoxane, dimethyl sulfoxide, or hyaluronidase, and application of cold or warm compresses depending on the cytostatic agent. Preventive strategies emphasise correct vessel selection, careful cannula monitoring, and strict adherence to administration procedures. For advanced necrosis or refractory injury, surgical approaches - such as early wash-out, liposuction, excision with negative- pressure wound therapy, skin grafting, and complex reconstructions - are outlined. The proposed framework integrates available evidence and expert consensus into a practical and user-friendly protocol. Its implementation may facilitate early detection, minimise the risk of severe complications, and promote standardised paediatric oncology care. In conclusion, cytostatic extravasation in children requires prompt, structured, interdisciplinary management. Early use of specific antidotes and supportive measures can prevent irreversible damage, while preventive strategies and vigilant monitoring remain crucial. Surgical interventions should be reserved for severe, non-responsive cases.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":"30 2","pages":"103-109"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}