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Izhodišča: Imunoterapija z zaviralcem imunskih kontrolnih točk nivolumabom, zaviralnim protitelesom proti proteinu programirane celične smrti 1 (PD-1), predstavlja za bolnike z neozdravljivo ponovitvijo bolezni ali s sistemskimi zasevki ploščatoceličnega karcinoma glave in vratu (P/Z PKGV), pri katerih je bolezen neobčutljiva na preparate platine, pomembno novo možnost zdravljenja. V primerjavi s citostatiki pomembno podaljša njihovo preživetje. Metode: Retrospektivna analiza zdravljenja z nivolumabom pri slovenskih bolnikih s P/Z PKGV, ki so prejeli prvi odmerek nivolumaba do marca 2020. Zbiranje podatkov je bilo zaključeno v septembru 2020. Uporabljene so bile opisne statistične metode in log-rank test. Rezultati: V raziskavo je bilo vključenih 27 bolnikov. Srednji čas sledenja od prve aplikacije nivolumaba do konca opazovanja je bil 7,4 meseca, relativno šestmesečno celokupno preživetje pa 59% (95% interval zaupanja 41–78%). Odgovor na zdravljenje je bil pri 85% bolnikov ocenjen s kliničnim pregledom in rentgenskim slikanjem prsnega koša, pri čemer je bil pri 41% kot najboljši odgovor ugotovljen delen odgovor na zdravljenje. Imunsko pogojeni neželeni dogodki so se pojavili pri 30% bolnikov, pri čemer so bili vsi gradusa ≤2. En bolnik je bil sočasno z nivolumabom tudi obsevan. Zaključek: Glede na zbrane podatke se je tudi v slovenski populaciji bolnikov s P/Z PKGV zdravljenje z nivolumabom izkazalo za varno. Zaradi kratkega časa sledenja ugotovljene učinkovitosti ni mogoče primerjati z rezultati tujih raziskav. S pričakovano odobritvijo pembrolizumaba bodo zaviralci imunskih kontrolnih točk tudi v Sloveniji dobili mesto v prvem redu zdravljenja P/Z PKGV.

Priporočila za obravnavo rakov glave in vratu (RGV) v Sloveniji sledijo priporočilom in usmeritvam, povzetim v publikaciji neprofitne mreže 30 vodilnih severnoameriških inštitucij za obravnavo raka, National Comprehensive Cancer Network, in hkrati upoštevajo obstoječe zmožnosti slovenskega zdravstvenega sistema. Smernice predstavljajo poenoteno mnenje vseh štirih najpomembnejših deležnikov na področju obravnave rakov glave in vratu v državi: Klinike za otorinolaringologijo in cervikofacialno kirurgijo, Kliničnega oddelka za maksilofacialno in oralno kirurgijo ter Stomatološke klinike UKC Ljubljana, Klinike za otorinolaringologijo, cervikalno in maksilofacialno kirurgijo UKC Maribor ter Onkološkega inštituta Ljubljana.

Background Authors present the preliminary results of ambulatory treatment of vein thrombosis (VT) at the University Medical Centre Ljubljana Department of Vascular Diseases. In Slovenia ambulatory treatment of VT in form of a daily hospital has been carried out since 2005. Patients and From October 2005 to December 2006 we retrospectively reviewed 395 consecutive pati- methods ents, treated for VT of lower or upper limbs. Diagnosis of VT was confirmed by ultrasound imaging. The physician on duty decided whether the patient will be treated in hospital or as an outpatient, on the ground of his/her clinical condition and compliance in the treat- ment process. Results In the ambulatory treated group were 198 patients (108 men and 90 women), aged 58 (4272) years. In the hospital treated group there were 197 patients (91 men and 106 women), aged 73 (5780) years. Patients treated in the hospital were older than patients treated ambulatory, had more frequently associated pulmonary embolism (PE), malignan- cies and immobilization. In the latter group, the use of oral contraceptives and hormone replacement therapy was significantly more frequent. The time needed to achieve the the- rapeutic range of INR (2.03.0) was longer in the ambulatory treated group. More pati- ents were admitted to the ambulatory treatment during weekdays and more patients were admitted to the hospital on weekends and during holidays. More patients admitted to the ambulatory treatment were from Ljubljana and more patients admitted to the hospital were from more distant locations. In the ambulatory treated group none of the patients had complications during the acute phase of VT. Seven patients treated in hospital survi- ved complications: two massive PE, five major bleeding. Eight patients treated in hospital died: four had PE, two septic shock, one heart failure and one terminal malignancy. Conclusions The decision of the physician on duty for ambulatory treatment of patients with VT de- pends not only on the patient clinical condition, but also on their home location and on the schedule of the daily hospital.