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Samenvatting oncologie
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Dit is een samenvatting van het deel 'oncologie' van het vak 'hemato-oncologie Het bevat alle leerstof van de powerpoints van oa prof Schöffski, prof Haustermans...
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INHOUDHoofdstuk 1: inleiding kanker ...............................................................................................................3
Epidemiologie (wereldwijd) ...............................................................................................................3
Trends ..........................................................................................................................................3
Risico op kanker (België) ...................................................................................................................3
Etiologie...........................................................................................................................................4
Preventie .........................................................................................................................................6
Primair .........................................................................................................................................6
Secundair .....................................................................................................................................6
Symptomatologie .............................................................................................................................6
Hoofdstuk 2: systemische, antineoplastische therapie ..........................................................................8
Inleding: systemsische kankertherapie ..............................................................................................8
Principes .........................................................................................................................................9
Praktijk ............................................................................................................................................9
Procedures ................................................................................................................................. 10
Evaluatie .................................................................................................................................... 10
Behandelingsintervallen en therapiefasen .................................................................................... 11
Producten ...................................................................................................................................... 11
Chemotherapie .......................................................................................................................... 11
Hormoontherapie ....................................................................................................................... 12
Target therapie ........................................................................................................................... 12
Immuuntherapie ......................................................................................................................... 13
Multimodale therapie .................................................................................................................. 13
Nevenwerkingen............................................................................................................................. 13
Chemotherapie .......................................................................................................................... 13
Hormoontherapie ....................................................................................................................... 14
Target therapie ........................................................................................................................... 14
Immuuntherapie ......................................................................................................................... 14
Worst case ................................................................................................................................. 14
Supportieve behandeling ................................................................................................................ 14
Hoofdstuk 3: erfelijke voorbeschiktheid tot kanker ............................................................................... 15
Ontstaan van kanker ....................................................................................................................... 15
Familiaal voorkomen ...................................................................................................................... 16
Familiaal kankersyndroom .......................................................................................................... 16
Erfelijke borst- en ovariumkanker (HBOC) ........................................................................................ 17
Borstkanker ................................................................................................................................ 17
Inhoud 1
, Diagnostisch genetisch onderzoek HBOC .................................................................................... 18
Predictief genetisch onderzoek HBOC .......................................................................................... 18
Familiaal colorectaal kanker (CRC) ................................................................................................. 19
Lynch syndroom ......................................................................................................................... 19
Familiaal adenomateuze polyposis (FAP) ..................................................................................... 20
MUTYH-associated polyposis (MAP)............................................................................................. 20
Zeldzame familiale kankersyndromen ............................................................................................. 20
Li Fraumeni syndroom ................................................................................................................. 20
Andere ....................................................................................................................................... 20
Hoofdstuk 4: radiotherapie ................................................................................................................. 23
Inleiding ......................................................................................................................................... 23
Straling .......................................................................................................................................... 23
Proces ........................................................................................................................................... 24
Types ............................................................................................................................................. 26
Protontherapie ........................................................................................................................... 26
R’en van radiologie ......................................................................................................................... 27
Radiosensitiviteit ........................................................................................................................ 27
Repair ........................................................................................................................................ 27
Repopulatie ................................................................................................................................ 28
Redistributie ............................................................................................................................... 29
Reoxygenatie .............................................................................................................................. 29
Fractionatie ................................................................................................................................... 29
Target therapie ............................................................................................................................... 30
Inhoud 2
, ONCOLOGIE
HOOFDSTUK 1: INLEIDING KANKER
EPIDEMIOLOGIE (WERELDWIJD)
Incidentie = aantal nieuwe diagnosen per 100000/jaar (heel zeldzaam: 1/1000000)
- Duidelijke verschillen tussen ontwikkelde landen onderling -> ander type primeert
- Duidelijke verschillen tussen ontwikkelde en ontwikkelingslanden
- Mannen: - Vrouwen:
1. Longkanker 1. Borstkanker
2. Prostaatkanker 2. Darmkanker
3. Darmkanker 3. Longkanker
Prevalentie = aantal patiënten met een bepaalde aandoening op een gegeven moment
Mortaliteit = aantal overlijdens per 100000/jaar => elk jaar 8 miljoen
- Mannen: - Vrouwen:
1. Longkanker 1. Borstkanker (door heel hoge incidentie!)
2. Leverkanker 2. Longkanker
3. Maagkanker 3. Darmkanker
TRENDS
- Grote piek prostaatkanker → door invoeren screening PSA
o Vaak overbehandeling, want PSA kan door heel veel zaken gestegen zijn
o Biopsie bij pos PSA test voor bevestiging
- Grote piek longkanker bij mannen met momenteel daling mortaliteit
o Plateau bij vrouwen door nog moeten komen -> vrouwen later beginnen met roken
- Daling maagkanker → door eradicatie H pylori + betere bewaring van voedsel
o Minder conservering door roken of pekelen
o Minder opname carcinogenen (nitraat, nitriet)
o Minder opname bacteriën en schimmels (aflatoxine)
RISICO OP KANKER (BELGIË)
Incidentie
- 1/3 bij mannen 1/4 bij vrouwen ➔ correlatie tussen incidentie en leeftijd
o Meeste patiënten > 60 jaar; uitzonderlijk bij kinderen (0,6%)
o Kinderen: leukemie, hersenen, nieren paradox: veel mensen denken veel voorkomen
o Adolescenten: hematologisch, hersenen, huid (melanoom), testis, baarmoederhals
o Ouderen: major killers (zie wereldwijd)
- Hogere incidentie tov andere Europese landen voor: prostaatkanker, borstkanker, hoofd- en
halskanker
- Meest voorkomende kankers zijn die van wereldwijd
Hoofdstuk 1: inleiding kanker 3
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