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  1. Article ; Online: A sugárkezelés okozta cardiotoxicitas kockázatának csökkentése bal oldali emlőtumoros betegek kezelése során.

    Dankovics, Zsófia / Ungvári, Tamás / Szabó, Döme / Heim, András / Farkas, Béla / Kiss, Balázs / Csejtei, András / Olajos, Judit

    Orvosi hetilap

    2023  Volume 164, Issue 11, Page(s) 420–425

    Abstract: Introduction: Breast cancer is one of the most common malignancies affecting women. Treatment with drugs and radiotherapy increases the incidence of late cardiovascular disease. It is therefore particularly important to protect the heart from radiation ... ...

    Title translation Reducing the risk of radiation-induced cardiotoxicity in patients with left breast tumor.
    Abstract Introduction: Breast cancer is one of the most common malignancies affecting women. Treatment with drugs and radiotherapy increases the incidence of late cardiovascular disease. It is therefore particularly important to protect the heart from radiation exposure.
    Method: We prepared an irradiation plan for 45 patients with left breast cancer using deep breathing and normal breathing techniques. The plans were compared and analyzed. The irradiation plans were created in the Philips Pinnacle v. 16 planning system.
    Results: At the same target volume coverage, the use of the deep breathing technique leads to a reduction of the dose burden to the heart and to the left descending coronary branch, thus reducing the incidence of late cardiovascular complications.
    Discussion: The results obtained show that the use of the deep breathing technique during adjuvant radiotherapy of left-sided breast cancer patients has a beneficial effect on the radiation exposure of the heart. Our results are in good agreement with similar data from national centres. We were not only able to maintain planning target volume coverage, but also to achieve an improvement of 1%. There is a significant difference in dose to the heart and coronary artery. By using the deep breathing technique, we were able to reduce the average cardiac dose by almost half (deep breathing: 2.87 Gy, normal breathing: 5.4 Gy). The coronary exposure was reduced from 19.5 Gy to 10.98 Gy.
    Conclusion: The accuracy of treatment can be further improved by using a respiratory gating system with a surface-guided radiotherapy system. The successful use of deep breathing technique requires professionalism of the treatment staff and good patient cooperation. It is less equipment intensive than a respiration-guided system. The deep breathing technique is no longer considered state-of-the-art in the era of breath-holding, but the experience gained in our department is worth describing because of its relevance to oncocardiology. Orv Hetil. 2023; 164(11): 420-425.
    MeSH term(s) Humans ; Female ; Cardiotoxicity/etiology ; Cardiotoxicity/prevention & control ; Radiotherapy Dosage ; Heart ; Breast Neoplasms/pathology ; Unilateral Breast Neoplasms/radiotherapy ; Unilateral Breast Neoplasms/pathology ; Radiotherapy Planning, Computer-Assisted/methods ; Organs at Risk/pathology ; Organs at Risk/radiation effects
    Language Hungarian
    Publishing date 2023-03-19
    Publishing country Hungary
    Document type English Abstract ; Journal Article
    ZDB-ID 123879-6
    ISSN 1788-6120 ; 0030-6002
    ISSN (online) 1788-6120
    ISSN 0030-6002
    DOI 10.1556/650.2023.32740
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Thoracic irradiation as consolidation therapy in patients with extensive-stage small cell lung cancer.

    Berta, Judit / Rózsás, Anita / Megyesfalvi, Zsolt / Ostoros, Gyula / Döme, Balázs

    Current opinion in oncology

    2022  Volume 35, Issue 1, Page(s) 54–60

    Abstract: Purpose of review: Small cell lung cancer (SCLC) is marked by an exceptionally high proliferative rate and poor prognosis. Given its high propensity to metastasize, nearly two-thirds of SCLC patients are diagnosed with extensive-stage (ES) disease when ... ...

    Abstract Purpose of review: Small cell lung cancer (SCLC) is marked by an exceptionally high proliferative rate and poor prognosis. Given its high propensity to metastasize, nearly two-thirds of SCLC patients are diagnosed with extensive-stage (ES) disease when surgery is not a treatment option anymore. Over several decades, only minimal changes have been made in the therapeutic armamentarium of ES-SCLC. Recently, however, several new therapeutic avenues were defined, thus renewing the hope for patients with this recalcitrant cancer. Here, we present an overview of the most current therapeutic advances in ES-SCLC focusing in particular on consolidative thoracic radiation therapy (cTRT) and chemo-immunotherapy.
    Recent findings: The incorporation of immunotherapy in the standard-of-care of ES-SCLC patients and the resulting outcomes are both a remarkable hallmark of progress and a disappointment. Indeed, chemo-immunotherapy with or without cTRT and prophylactic cranial irradiation contributes to longer survival outcomes with minimal toxicity rates in well selected and properly monitored patients. Nevertheless, the gain in overall survival is still modest relative to that seen in many other solid tumors.
    Summary: Despite the encouraging results, further clinical trials are needed to determine the efficacy and safety of these therapeutic approaches, and moreover, to identify new predictive biomarkers of response.
    MeSH term(s) Humans ; Small Cell Lung Carcinoma/radiotherapy ; Consolidation Chemotherapy ; Lung Neoplasms/radiotherapy
    Language English
    Publishing date 2022-11-16
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1049384-0
    ISSN 1531-703X ; 1040-8746
    ISSN (online) 1531-703X
    ISSN 1040-8746
    DOI 10.1097/CCO.0000000000000911
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  3. Article ; Online: Öngyilkossági halálozás Magyarországon a COVID–19-pandémia idején.

    Bálint, Lajos / Osváth, Péter / Németh, Attila / Kapitány, Balázs / Rihmer, Zoltán / Döme, Péter

    Orvosi hetilap

    2022  Volume 163, Issue 48, Page(s) 1895–1901

    Abstract: Introduction: While suicide rates did not change (or decreased) in the first pandemic year (i.e., 2020) in the majority of countries, in Hungary the number of completed suicides rose significantly.: Objective: In our study, we investigated whether ... ...

    Title translation Suicide mortality in Hungary during the COVID-19 pandemic.
    Abstract Introduction: While suicide rates did not change (or decreased) in the first pandemic year (i.e., 2020) in the majority of countries, in Hungary the number of completed suicides rose significantly.
    Objective: In our study, we investigated whether the unfavourable trend reversal of the Hungarian suicide rate following the outbreak of COVID-19 pandemic persisted in the second pandemic year.
    Method: We used an interrupted time-series analysis with Prais-Winsten regression, controlling for time and seasonal effects as well as autoregressive effects, to estimate the effect of the pandemic on the suicide rates of the Hungarian male, female and total populations in 2020 and 2021.
    Results: In the first pandemic year, we observed a significant increase in suicide rates in males and the total population. Although the case numbers for males and the total population in 2021 exceeded the case numbers of the pre-pandemic year, regression estimates suggest that the increase in rates did not differ significantly from the pre-pandemic years in males and it was only found to be significant at the 10% level in the total population.
    Discussion and conclusion: Based on the examination of data from the first two pandemic years, we may conclude that by 2021 the adverse effect of the pandemic on suicidality reduced in the total population and disappeared in males. The question remains open whether this favourable development will continue. Orv Hetil. 2022; 163(48): 1895-1901.
    MeSH term(s) Humans ; Male ; Female ; Pandemics ; COVID-19 ; Hungary/epidemiology ; Suicide ; Suicidal Ideation
    Language Hungarian
    Publishing date 2022-11-27
    Publishing country Hungary
    Document type English Abstract ; Journal Article
    ZDB-ID 123879-6
    ISSN 1788-6120 ; 0030-6002
    ISSN (online) 1788-6120
    ISSN 0030-6002
    DOI 10.1556/650.2022.32642
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  4. Article ; Online: A molekuláris altípusok szerinti heterogenitás biológiai és klinikai jelentősége kissejtes tüdőrákban.

    Berta, Judit / Ferencz, Bence / Horváth, Lilla / Fillinger, János / Lantos, András / Bogos, Krisztina / Rényi-Vámos, Ferenc / Megyesfalvi, Zsolt / Döme, Balázs

    Magyar onkologia

    2023  Volume 67, Issue 3, Page(s) 181–192

    Abstract: Small-cell lung cancer (SCLC) is a highly aggressive malignancy characterised by genomic instability and early metastatic spread. Patients are typically diagnosed at advanced disease stage, when platinum-based chemotherapy with immunotherapy represents ... ...

    Title translation Small cell lung cancer heterogeneity and molecular subtypes: biological and clinical relevance.
    Abstract Small-cell lung cancer (SCLC) is a highly aggressive malignancy characterised by genomic instability and early metastatic spread. Patients are typically diagnosed at advanced disease stage, when platinum-based chemotherapy with immunotherapy represents the standard therapeutic approach. The role of radiotherapy with concomitant systemic therapy is also well established in the management of SCLC patients. Although these therapeutic approaches are initially effective, most patients rapidly develop resistance. This clearly highlights the need to improve therapeutic efficacy and broaden the scope of current therapeutic strategies. Recent advances in the study of this disease, once considered homogeneous, have led to a new model of the SCLC classification scheme based on the relative expression of certain transcriptional regulators and inflammatory characteristics. New biological insights into the molecular subtypes of SCLC could lead to the implementation of subtype-specific therapeutic approaches. Here, we summarise our key findings concerning the biological and clinical relevance of SCLC molecular subtypes.
    MeSH term(s) Humans ; Clinical Relevance ; Small Cell Lung Carcinoma/genetics ; Small Cell Lung Carcinoma/therapy ; Immunotherapy ; Platinum ; Lung Neoplasms/drug therapy ; Lung Neoplasms/genetics
    Chemical Substances Platinum (49DFR088MY)
    Language Hungarian
    Publishing date 2023-08-25
    Publishing country Hungary
    Document type English Abstract ; Journal Article
    ZDB-ID 414033-3
    ISSN 2060-0399 ; 0025-0244
    ISSN (online) 2060-0399
    ISSN 0025-0244
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  5. Article ; Online: Small cells - big issues: biological implications and preclinical advancements in small cell lung cancer.

    Solta, Anna / Ernhofer, Büsra / Boettiger, Kristiina / Megyesfalvi, Zsolt / Heeke, Simon / Hoda, Mir Alireza / Lang, Christian / Aigner, Clemens / Hirsch, Fred R / Schelch, Karin / Döme, Balazs

    Molecular cancer

    2024  Volume 23, Issue 1, Page(s) 41

    Abstract: Current treatment guidelines refer to small cell lung cancer (SCLC), one of the deadliest human malignancies, as a homogeneous disease. Accordingly, SCLC therapy comprises chemoradiation with or without immunotherapy. Meanwhile, recent studies have made ... ...

    Abstract Current treatment guidelines refer to small cell lung cancer (SCLC), one of the deadliest human malignancies, as a homogeneous disease. Accordingly, SCLC therapy comprises chemoradiation with or without immunotherapy. Meanwhile, recent studies have made significant advances in subclassifying SCLC based on the elevated expression of the transcription factors ASCL1, NEUROD1, and POU2F3, as well as on certain inflammatory characteristics. The role of the transcription regulator YAP1 in defining a unique SCLC subset remains to be established. Although preclinical analyses have described numerous subtype-specific characteristics and vulnerabilities, the so far non-existing clinical subtype distinction may be a contributor to negative clinical trial outcomes. This comprehensive review aims to provide a framework for the development of novel personalized therapeutic approaches by compiling the most recent discoveries achieved by preclinical SCLC research. We highlight the challenges faced due to limited access to patient material as well as the advances accomplished by implementing state-of-the-art models and methodologies.
    MeSH term(s) Humans ; Small Cell Lung Carcinoma/genetics ; Small Cell Lung Carcinoma/therapy ; Lung Neoplasms/genetics ; Lung Neoplasms/therapy ; Immunotherapy ; Transcription Factors
    Chemical Substances Transcription Factors
    Language English
    Publishing date 2024-02-24
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2091373-4
    ISSN 1476-4598 ; 1476-4598
    ISSN (online) 1476-4598
    ISSN 1476-4598
    DOI 10.1186/s12943-024-01953-9
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  6. Article ; Online: Suicide in Hungary during the first year of the COVID-19 pandemic: Subgroup investigations.

    Balint, Lajos / Osvath, Peter / Kapitany, Balazs / Rihmer, Zoltan / Nemeth, Attila / Dome, Peter

    Journal of affective disorders

    2023  Volume 325, Page(s) 453–458

    Abstract: Background: COVID-19 may unfavourably affect the mental health of individuals in various ways. Accordingly, the concern has been raised that national suicide rates will increase in the wake of the outbreak of the pandemic.: Methods: In the current ... ...

    Abstract Background: COVID-19 may unfavourably affect the mental health of individuals in various ways. Accordingly, the concern has been raised that national suicide rates will increase in the wake of the outbreak of the pandemic.
    Methods: In the current study, we tested this conjecture in three age groups (<25; 25-64; ≥65) of the Hungarian total population and the male and female populations. In addition, we assessed whether the pandemic had different effects on counts of suicides committed by violent or non-violent methods. Finally, by comparing the monthly suicide rates in 2020 and the corresponding monthly rates in 2019, we also investigated the "pulling together" hypothesis that postulates that a temporary decrease in suicides may occur after large-scale catastrophic events.
    Results: With regard to the total population only the suicide counts of individuals aged 25-64 rose significantly (p < 0.05) during the COVID months of 2020. Similar patterns, but at lower levels of significance (0.05 < p < 0.1), were found in those members of the total population aged 65 or older and among males aged between 25 and 64. Furthermore, we found that the number of violent suicides increased significantly (p < 0.05) during the COVID months. Finally, our results have not confirmed the existence of a "pulling together" phenomenon in association with the COVID-19 pandemic in Hungary.
    Limitations: We used non-individual level data and were therefore unable to control suicide risk factors at the level of individuals.
    Discussion: The number of suicides rose significantly in some subgroups of the Hungarian population during the COVID months of 2020.
    MeSH term(s) Humans ; Male ; Female ; Adult ; Middle Aged ; Suicide ; Hungary/epidemiology ; Pandemics ; Sex Distribution ; Age Distribution ; COVID-19/epidemiology
    Language English
    Publishing date 2023-01-13
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2023.01.046
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  7. Article ; Online: Changes in suicide mortality of Hungary during the first year of the COVID-19 pandemic

    Osváth, Péter / Bálint, Lajos / Németh, Attila / Kapitány, Balázs / Rihmer, Zoltán / Döme, Péter

    Orvosi hetilap

    2021  Volume 162, Issue 41, Page(s) 1631–1636

    Title translation A magyarországi öngyilkossági halálozás változásai a COVID-19-járvány első évében.
    MeSH term(s) COVID-19 ; Female ; Humans ; Hungary/epidemiology ; Male ; Pandemics ; SARS-CoV-2 ; Suicide/prevention & control
    Language Hungarian
    Publishing date 2021-10-10
    Publishing country Hungary
    Document type Journal Article
    ZDB-ID 123879-6
    ISSN 1788-6120 ; 0030-6002
    ISSN (online) 1788-6120
    ISSN 0030-6002
    DOI 10.1556/650.2021.32346
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Clinical characteristics of treatment-resistant depression in adults in Hungary: Real-world evidence from a 7-year-long retrospective data analysis.

    Döme, Péter / Kunovszki, Péter / Takács, Péter / Fehér, László / Balázs, Tamás / Dede, Károly / Mulhern-Haughey, Siobhán / Barbreau, Sébastien / Rihmer, Zoltán

    PloS one

    2021  Volume 16, Issue 1, Page(s) e0245510

    Abstract: Purpose: Treatment-resistant depression (TRD) is associated with a poor quality of life and high economic burden. This observational retrospective epidemiological study aimed to estimate the proportion of patients with TRD within a cohort of patients ... ...

    Abstract Purpose: Treatment-resistant depression (TRD) is associated with a poor quality of life and high economic burden. This observational retrospective epidemiological study aimed to estimate the proportion of patients with TRD within a cohort of patients with major depressive disorder (MDD) in Hungary and examine the mortality and comorbidities of patients with and without TRD.
    Patients and methods: This study included patients with MDD who experienced onset of a new depressive episode between 01 January 2009 and 31 August 2015, using data from a nationwide, longitudinal database.
    Results: Overall, 99,531 patients were included in the MDD cohort, of which 8,268 (8.3%) also met the criteria for TRD. The overall survival of non-TRD patients was longer than in TRD patients; the risk of mortality for TRD patients was significantly higher than of non-TRD patients (HR [CI] 1.381 [1.212-1.571]; p<0.001). Patients with TRD had a significantly higher probability of having "Neurotic, stress-related and somatoform disordersˮ, autoimmune conditions, cardio- or cerebrovascular diseases, thyroid gland diseases and self-harming behaviour not resulting in death than non-TRD patients (for all comparisons, p values were less than 0.005).
    Discussion: To our best knowledge, this is the first study to assess the frequency of TRD in Hungary. In a cohort of Hungarian MDD patients, we have found that the proportion of TRD (~8.3%) is comparable to those reported in previous studies with similar methodology from other countries. The majority of our other main findings (e.g. more frequent self-harming behaviour, increased risk of "Neurotic, stress-related and somatoform disordersˮ and higher overall mortality in TRD subjects) are also in line with previous results from other countries. Taking the substantial proportion of patients with TRD into consideration, a more comprehensive and targeted treatment strategy would be required for these individuals.
    MeSH term(s) Adolescent ; Adult ; Aged ; Cohort Studies ; Depression/therapy ; Female ; Humans ; Hungary ; Male ; Middle Aged ; Retrospective Studies ; Treatment Failure ; Young Adult
    Language English
    Publishing date 2021-01-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0245510
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  9. Article ; Online: Potential subtype-specific therapeutic approaches in small cell lung cancer.

    Horvath, Lilla / Lang, Christian / Boettiger, Kristiina / Aigner, Clemens / Dome, Balazs / Megyesfalvi, Zsolt

    Current opinion in oncology

    2023  Volume 36, Issue 1, Page(s) 51–56

    Abstract: Purpose of review: Small cell lung cancer (SCLC) remains one of the most aggressive thoracic malignancies with an especially dismal prognosis. While the detection of various targetable driver mutations and immune checkpoints have revolutionized the ... ...

    Abstract Purpose of review: Small cell lung cancer (SCLC) remains one of the most aggressive thoracic malignancies with an especially dismal prognosis. While the detection of various targetable driver mutations and immune checkpoints have revolutionized the treatment of non-small cell lung cancer (NSCLC), there has been only modest therapeutic innovation over the past decades in SCLC. In this review, we aim to provide a brief summary on the clinical relevance of recent research findings, which could soon pave the way towards a more personalized and targeted management of SCLC patients.
    Recent findings: Substantial research on the biological and molecular heterogeneity of SCLC has been conducted in the last years. Recent results from comprehensive profiling studies have shown that unique major SCLC subtypes can be distinguished based on the relative expression of key transcription regulators (ASCL1, NEUROD1, POU2F3) or distinct inflammatory features. Understanding the differing molecular characteristics of these distinct subtypes has resulted in the identification of specific therapeutic vulnerabilities.
    Summary: The recently introduced molecular SCLC subtype classification represents a substantial progress towards a personalized and more efficacious approach in SCLC. The consequences of this paradigm shift provide hope for improved patient care and clinical outcomes in this exceptionally lethal thoracic malignancy.
    MeSH term(s) Humans ; Small Cell Lung Carcinoma/genetics ; Small Cell Lung Carcinoma/therapy ; Carcinoma, Non-Small-Cell Lung ; Lung Neoplasms/genetics ; Lung Neoplasms/therapy
    Language English
    Publishing date 2023-10-18
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1049384-0
    ISSN 1531-703X ; 1040-8746
    ISSN (online) 1531-703X
    ISSN 1040-8746
    DOI 10.1097/CCO.0000000000001005
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  10. Article ; Online: [No title information]

    Bogos, Krisztina / Török, Szilvia / Pucsok, Mariann / Cselko, Zsuzsanna / Rényi-Vámos, Ferenc / Ostoros, Gyula / Döme, Balázs / Megyesfalvi, Zsolt

    Magyar onkologia

    2022  Volume 66, Issue 1, Page(s) 43–49

    Abstract: The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide. Patients with cancer, and particularly those with lung malignancies, represent a highrisk group for COVID-19 since they are more susceptible to infection and have a ... ...

    Title translation Covid-19-fertőzés klinikai jelentősége tüdőrák és egyéb malignus mellkasi daganatok esetén.
    Abstract The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide. Patients with cancer, and particularly those with lung malignancies, represent a highrisk group for COVID-19 since they are more susceptible to infection and have a higher risk of severe outcomes. However, the restructuration of the healthcare environment, the development of guidelines for treatment and surveillance, and the improvement of vaccination coverage allowed adequate patient shielding and continuity of oncological care of cancer patients. By shedding light on the characteristics of COVID-19 patients with thoracic malignancies, recent studies also contributed to the development of personalized therapeutic strategies. Accordingly, several determinants were identified to predict disease outcomes. These include the ECOG performance status, the levels of C-reactive protein, neutrophils and procalcitonin, the disease stage, and the presence of pneumonia. COVID-19 vaccines are safe in patients with lung cancer. In order to obtain adequate immunization, the booster dose is recommended in these patients.
    MeSH term(s) Breast Neoplasms ; COVID-19/prevention & control ; COVID-19 Vaccines ; Female ; Humans ; Immunization Programs ; Lung Neoplasms/therapy ; Pandemics/prevention & control
    Chemical Substances COVID-19 Vaccines
    Language Hungarian
    Publishing date 2022-02-17
    Publishing country Hungary
    Document type Journal Article
    ZDB-ID 414033-3
    ISSN 2060-0399 ; 0025-0244
    ISSN (online) 2060-0399
    ISSN 0025-0244
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