Mogućnosti liječenja karcinoma pluća

master's thesis

• Title (english): Lung cancer treatment possibility
• Author: Nikola Lugović
• Mentor: Petra Turčić (mentor)
• Committee member: Petra Turčić
• Committee member: Branka Zorc
• Committee member: Erim Bešić
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2015-02-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Karcinom pluća je bolest koja se javlja kod ljudi starijih od 50 godina, najčešće pušača. Najčešći oblik karcinoma ovog tipa je ne-mikrocelularni karcinom pluća (NSCLC) koji čini do 90% svih tipova plućnog karcinoma, potom mikrostanični karcinom te, kao zadnji, plućni karcinoidni tumor. U Hrvatskoj je rak pluća vodeći uzrok obolijevanja raka kod muškraca a čak treći kod žena. Novim saznanjima o nasljednoj sklonosti prema karcinomu pluća, o mogućnostima samoprevencije što zdravijom prehranom, izbjegavanjem rizičnih uzročnika, još uvijek velik broj ljudi umire sa karcinomom pluća. S tom spoznajom specifični simptomi i biokemijski parametri nisu nađeni koji bi sa velikim udiom sigurnosti korelirali sa prisutnošću/odsutnošću bolesti i stadijem same bolesti. Vrsta karcinoma, zrelost njegovih stanica te njegova rasprostranjenost utječe na odabir terapije liječenja. Ako je karcinom ograničen na pluća, u slučaju kirurškog zahvata, preventivno se djeluje radioterapijom kako bi se tumor smanjio te potom kirurški odstranio dio pluća ili pak lobusa, ovisno o stanju bolesnika. U slučaju da je bolest metastazirala na druge organe, provodi se sustavno liječenje. Kontrolom bioloških parametara (pr. nuklearni ribonukleoprotein hnRNP A2/B1) te rentgenom, CT pregledom, PET Scanom ili biopsijom pluća prati se uspijeh terapije. Osnove liječenja ovise o stadiju tumora. Kemoterapija lijekovima koje nazivamo još citostaticima primjenjuje se kod in/operabilnih tumora ili u svrhu neoadjuvante (prije operacije) i adjuvantne (poslije operacije) terapije. Uobičajeno je da se daju kombinacije citostatika zbog sinergističkog djelovanja, pokrivanja šireg intervala heterogene populacije karcinoidnih stanica te maksimizacije liječenja i smanjenja rezistencije stanica. Najnovije metode liječenja su ciljana terapija djelovanjem na specifične receptore koji su jače eksprimirani na površinama tumorskih stanica. Ovakav tip terapija blokira rast i širenje karcinoidnih stanica dok je limitirano oštećenje zdravih. Primjeri takve terapije je tirozin kinazni inhibtor erlotinib koji se koristi kod EGFR-a te protutijela bevacizumab (koji djeluje na VEGF), krizotinib i Ipalimumab (usmjerene na CTLA-4 molekulue koje dovode do aktivacije T stanica i posljedične aktivacije T limfocita.).

Abstract (english)

Lung cancer is a disease that occurs in people older than 50 years old with a history of smoking. The most common form of this type of carcinoma is non-small cell lung cancer (NSCLC), which makes up about 90% of all types of lung cancer, then the micro-cellular carcinoma and, as the last, lung carcinoid tumors. In Croatia, lung cancer is the leading cause of illness of carcinoma in men and third in women. With new knowledge about hereditary tendency toward lung cancer, the possibilities in healthier diet as avoiding high-risk factors, there is still large number of people dying from lung cancer. There were not found specific symptoms or biochemical parameters that will share payroll safety correlated with the presence/absence of disease and stage of the disease itself. Type of cancer, the maturity of its cells and its distribution affects the choice of therapy treatment. If the cancer is confined to the lungs, in the case of surgery, radiotherapy might be used for preventive effect or to reduce the tumor. After that physician surgically remove part of the lung lobe, depending on the condition of the patient. If the disease has metastasized to other organs, it has to be treated systematically. Succes of therapy is monitored by controlling the biological parameters (eg. Nuclear ribonucleoprotein hnRNP A2/B1) and X-ray, CT scan, PET scan or biopsy of the lung. Basics of treatment depends on the stage of the tumor. Chemotherapy drugs called cytostatics are applied on in/operable tumors or/as neoadjuvant (before surgery) and adjuvant (post-surgery) treatment. It is usual to provide a combination of cytostatics for synergistic action, covering a wider interval of heterogeneous population carcinoid cells, maximization of treatment and reduce cancer cell resistance. The latest method of treating is targeted therapy with acting on specific receptors, which are heavily expressed on the surface of tumor cells. This type of therapy blocks the growth and spread of carcinoid cells while limiting damaging normal cells. Examples of such therapy is the tyrosine kinase inhibitor erlotinib (used on EGFR) and an antibody bevacizumab (acting on VEGF), Crizotinib ND Ipalimumab (directed to CTLA-4 molekulue leading to T cell activation and subsequent activation of T cells.).

• Keywords: karcinom pluća; epidemiologija; liječenje
• Keywords (english): lung cancer; epidemiology; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:163:223528
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2015-12-10 09:14:33