@article{MTMT:34825012,
	title = {The Real-Life Impact of Primary Tumor Resection of Synchronous Metastatic Colorectal Cancer-From a Clinical Oncologic Point of View},
	url = {https://m2.mtmt.hu/api/publication/34825012},
	author = {Pécsi, Balázs and Mangel, László Csaba},
	doi = {10.3390/cancers16081460},
	journal-iso = {CANCERS},
	journal = {CANCERS},
	volume = {16},
	unique-id = {34825012},
	abstract = {The complex medical care of synchronous metastatic colorectal (smCRC) patients requires prudent multidisciplinary planning and treatments due to various challenges caused by the primary tumor and its metastases. The role of primary tumor resection (PTR) is currently uncertain; strong arguments exist for and against it. We aimed to define its effect and find its best place in our therapeutic methodology.We performed retrospective data analysis to investigate the clinical course of 449 smCRC patients, considering treatment modalities and the location of the primary tumor and comparing the clinical results of the patients with or without PTR between 1 January 2013 and 31 December 2018 at the Institute of Oncotherapy of the University of Pécs.A total of 63.5% of the 449 smCRC patients had PTR. Comparing their data to those whose primary tumor remained intact (IPT), we observed significant differences in median progression-free survival with first-line chemotherapy (mPFS1) (301 vs. 259 days; p < 0.0001; 1 y PFS 39.2% vs. 26.6%; OR 0.56 (95% CI 0.36-0.87)) and median overall survival (mOS) (760 vs. 495 days; p < 0.0001; 2 y OS 52.4 vs. 26.9%; OR 0.33 (95% CI 0.33-0.53)), respectively. However, in the PTR group, the average ECOG performance status was significantly better (0.98 vs. 1.1; p = 0.0456), and the use of molecularly targeted agents (MTA) (45.3 vs. 28.7%; p = 0.0005) and rate of metastasis ablation (MA) (21.8 vs. 1.2%; p < 0.0001) were also higher, which might explain the difference partially. Excluding the patients receiving MTA and MA from the comparison, the effect of PTR remained evident, as the mOS differences in the reduced PTR subgroup compared to the reduced IPT subgroup were still strongly significant (675 vs. 459 days; p = 0.0009; 2 y OS 45.9 vs. 24.1%; OR 0.37 (95% CI 0.18-0.79). Further subgroup analysis revealed that the site of the primary tumor also had a major impact on the outcome considering only the IPT patients; shorter mOS was observed in the extrapelvic IPT subgroup in contrast with the intrapelvic IPT group (422 vs. 584 days; p = 0.0026; 2 y OS 18.2 vs. 35.9%; OR 0.39 (95% CI 0.18-0.89)). Finally, as a remarkable finding, it should be emphasized that there were no differences in OS between the smCRC PTR subgroup and metachronous mCRC patients (mOS 760 vs. 710 days, p = 0.7504, 2 y OS OR 0.85 (95% CI 0.58-1.26)).The role of PTR in smCRC is still not professionally justified. Our survey found that most patients had benefited from PTR. Nevertheless, further prospective trials are needed to clarify the optimal treatment sequence of smCRC patients and understand this cancer disease's inherent biology.},
	keywords = {overall survival; Metastatic colorectal carcinoma; Primary tumor resection},
	year = {2024},
	eissn = {2072-6694}
}

@article{MTMT:34742430,
	title = {A felnőttkori gliómák gyógyszeres kezelése},
	url = {https://m2.mtmt.hu/api/publication/34742430},
	author = {Mangel, László Csaba},
	journal-iso = {MAGYAR ONKOLÓGIA},
	journal = {MAGYAR ONKOLÓGIA},
	volume = {68},
	unique-id = {34742430},
	issn = {0025-0244},
	abstract = {Gliomas are considered as locally aggressive diseases, consequently, surgery and radiotherapy are the basic therapies of the glial tumors. Nevertheless, the long-term ineffectiveness of the local treatment modalities and the frequently observed relapses explain the unmet medical need for the elaboration of effective systemic treatment regimes. In the last few decades of the 20th century, the use of different chemotherapeutic agents and their combinations, and the alternative administration of drugs have been in the therapeutic forefront of gliomas, whereas, later, in the first years of this century temozolomide was introduced to the everyday clinical practice as the most effective "anti-glioma" medicine, and it is still widely used both in monotherapy and in different combinations. Nevertheless, in the last two decades, considering the recognition of different predictive molecular markers, different targeted therapies, e.g. VEGFR inhibitor agents were also introduced into the routine clinical practice, and there have been promising results published in immunotherapy trials in the recent years, as well. Besides the promising results with the novel systemic therapies, it should be emphasized that both in the primary and the salvage care of the glial tumors the most effective treatment options are the individualized combinations of local and systemic treatment modalities, with the proper interpretation of brain imaging data and patient-centered clinical management.},
	year = {2024},
	eissn = {2060-0399},
	pages = {67-75}
}

@article{MTMT:34723989,
	title = {Szorongás, depresszió, valamint fizikai tüneti terhek felmérése és összefüggéseik megismerése daganatos betegek körében},
	url = {https://m2.mtmt.hu/api/publication/34723989},
	author = {Varga, Gergely and Horváth, Rita and Busa, Csilla and Virág, Edit and Mangel, László Csaba and Csikós, Ágnes},
	doi = {10.1556/650.2024.32984},
	journal-iso = {ORV HETIL},
	journal = {ORVOSI HETILAP},
	volume = {165},
	unique-id = {34723989},
	issn = {0030-6002},
	abstract = {Bevezetés: A daganatos megbetegedésekre jellemzőek a megnövekedett pszichés terhek. A jelentős fizikai tüneti terhek, a multimorbiditás, a szorongás és a depresszió kialakulásának kockázati tényezői lehetnek daganatos betegekben, mely összefüggések vizsgálatára tudomásunk szerint eddig még nem került sor Magyarországon. Célkitűzés: Célunk volt (1) felmérni a szorongás és (2) a depresszió szintjét daganatos betegek körében, (3) megvizsgálni, hogy milyen fizikai tüneti terhek jelennek meg leginkább az onkológiai betegek között, (4) megismerni a szorongás, a depresszió és a fizikai tüneti terhek és (5) a multimorbiditás összefüggéseit. Módszer: Keresztmetszeti vizsgálatunkba 18. életévüket betöltött, daganatos megbetegedés diagnózisával rendelkező betegeket vontunk be. A kvantitatív adatok feldolgozása során az eredményeket 0,05 alatti p-érték esetén tekintettük szignifikánsnak. Eredmények: A vizsgálatban 113 beteg vett részt. A válaszadók 29,2%-ában a normális határértéknél magasabb szintű szorongást mértünk, a depresszió pedig 36,2%-ban volt jelen különböző súlyosságban. Alvási nehézségekről a megkérdezettek 69,5%-a, fáradtságról 66,3%, fájdalomról 52,2% számolt be. A normálérték feletti szorongást és depressziót mutatók átlagosan több fizikai tüneti terhet említettek. Szignifikáns összefüggés volt kimutatható a normálérték feletti depressziót mutatók és a fáradtság, valamint a fájdalom között. A multimorbiditást tekintve a normálérték feletti szorongást mutatók átlagosan több krónikus betegséggel rendelkeztek. Megbeszélés: Vizsgálatunkban a szorongás szintje magasabb, a depresszió szintje azonban egyezik a nemzetközi adatokkal. Az alvási nehézségek nagyobb arányban fordulnak elő vizsgálatunkban, a fáradtság és a fájdalom előfordulása azonban összhangban áll a nemzetközi kutatások eredményeivel. Az eddig publikált nemzetközi vizsgálatokhoz hasonlóan vizsgálatunk is a multimorbiditás, a megnövekedett fizikai tüneti terhek, továbbá a szorongás és a depresszió közötti jelentős összefüggésre utal. Következtetés: A szorongás és a depresszió nagy arányban van jelen onkológiai betegekben. A legnagyobb arányban az alvási nehézségek fordulnak elő, ezt követi a fáradtság és a fájdalom. A szorongás és depresszió mértéke összefüggést mutat a fizikai tüneti terhekkel, valamint a multimorbiditás is fokozza a betegek szorongásszintjét. Orv Hetil. 2024; 165(8): 309–317.},
	year = {2024},
	eissn = {1788-6120},
	pages = {309-317},
	orcid-numbers = {Busa, Csilla/0000-0001-6916-1118}
}

@article{MTMT:34486698,
	title = {Effect of radiotherapy in deep inspiration in patients with left breast cancer: Does the size of the target area affect the dose for the most crucial organs at risk?},
	url = {https://m2.mtmt.hu/api/publication/34486698},
	author = {Locsei, Z. and Nagy, B. and Brunner, T. and Mangel, László Csaba},
	doi = {10.1016/j.annonc.2023.09.526},
	journal-iso = {ANN ONCOL},
	journal = {ANNALS OF ONCOLOGY},
	volume = {34},
	unique-id = {34486698},
	issn = {0923-7534},
	year = {2023},
	eissn = {1569-8041},
	pages = {S315-S315}
}

@article{MTMT:34377797,
	title = {The Real-Life Impact of mFOLFIRI-Based Chemotherapies on Elderly Patients-Should We Let It or Leave It?},
	url = {https://m2.mtmt.hu/api/publication/34377797},
	author = {Pécsi, Balázs and Mangel, László Csaba},
	doi = {10.3390/cancers15215146},
	journal-iso = {CANCERS},
	journal = {CANCERS},
	volume = {15},
	unique-id = {34377797},
	abstract = {The oncologic treatment of elderly patients is going on with a lack of evidence due to their underrepresentation in clinical trials. Many data suggest that certain groups of elderly patients, like their younger counterparts, may benefit from the systemic treatment of their metastatic colorectal tumors (mCRC).We performed retrospective data analysis to investigate the clinical course of care and clinical outcomes of 515 patients who received first-line mFOLFIRI-based chemotherapy for mCRC between 1 January 2013 and 31 December 2018 at the Institute of Oncotherapy of the University of Pécs, focusing on a comparison of patients over and under 70 years of age, defined as the cut-off value.28.7% of the 515 patients were 70 years old and older (median age 73.5 years). Compared to the data of the elderly patients, the younger group (median age 61.1 years) had a performance status that was significantly better (average ECOG 1.07 vs. 0.83, p < 0.0001), and significantly more patients received molecularly targeted agents (MTA) (21.6% vs. 51.8%, p < 0.0001); nevertheless, mPFS (241 vs. 285 days, p = 0.3960) and mOS (610 vs. 698 days, p = 0.6305) results did not differ significantly. Considering the 1y PFS OR and the 2ys OS OR values (0.94 [95%CI 0.63-1.41] and 0.72 [95%CI 0.47-1.09], respectively), only a non-significant trend was observed in OS favouring the younger population. Additional analysis of our data proved that the survival in patients over 70 years was positively affected by the addition of MTAs to the doublet chemotherapies, and the reasonable modifications/reductions in dose intensity and the addition of local interventions had similar positive effects as observed in the younger patients' group.Age stratification of mCRC patients is not professionally justified. Patients over 70 years of age with good performance status and controlled co-morbidities benefit from systemic therapy, its modifications and local treatment to the same extent as younger patients. With the increasing incidence of age-related cancers due to the rising average lifespan, prospective randomised clinical trials are needed to determine the real value of systemic therapy in the elderly and the rational, objective methods of patient selection.},
	keywords = {Metastatic colorectal carcinoma; Cancer in the elderly; mFOLFIRI-based treatments},
	year = {2023},
	eissn = {2072-6694}
}

@misc{MTMT:34229573,
	title = {THE USE OF ORAL KETAMINE IN PATIENTS WITH CHRONIC PAIN CAN PREVENT OPIOID ESCALATION – A RETROSPECTIVE STUDY},
	url = {https://m2.mtmt.hu/api/publication/34229573},
	author = {Kovács-Ábrahám, Zoltán and Rézmán, Barbara and Fenyvesi, Nikolett and Bartos, Barbara and Boda, Kamilla and Aczél, Timea and Mangel, László Csaba and Almási, Róbert Gyula},
	unique-id = {34229573},
	year = {2023},
	orcid-numbers = {Kovács-Ábrahám, Zoltán/0009-0005-2516-8349; Almási, Róbert Gyula/0000-0002-1134-9932}
}

@article{MTMT:34167217,
	title = {Májáttétes pancreasrák: meghosszabbítható-e a túlélés az oligoperzisztens primer daganat neoadjuváns kemoterápiát követő reszekciójával?},
	url = {https://m2.mtmt.hu/api/publication/34167217},
	author = {Kelemen, Dezső and Mangel, László Csaba and Szabó, Zsolt and Varga, Ádám and Palkovics, András and Vereczkei, András},
	doi = {10.1556/650.2023.32900},
	journal-iso = {ORV HETIL},
	journal = {ORVOSI HETILAP},
	volume = {164},
	unique-id = {34167217},
	issn = {0030-6002},
	year = {2023},
	eissn = {1788-6120},
	pages = {1712-1718}
}

@article{MTMT:33791187,
	title = {Áttétes vesedaganatos betegek kabozantinibterápiájának multicentrikus magyarországi eredményei},
	url = {https://m2.mtmt.hu/api/publication/33791187},
	author = {Maráz, Anikó and Nagyiványi, Krisztián András and Balogh, Ingrid and Bodoky, György and Mangel, László Csaba and Küronya, Zsófia and Géczi, Lajos and Torday, László and Dudás, Szilvia and Szűcs, Miklós and Nagy, Zsófia and Hornyák, Lajos and Zolcsák, Zita and Bassam, Ali and Kocsis, Judit and Keresztes, Tamás and Kullmann, Tamás and Máhr, Károly and Solymosi, Tibor and Rozsvai, Tímea and Szabó, Imre and Varga, Zoltán and Bíró, Krisztina},
	journal-iso = {MAGYAR ONKOLÓGIA},
	journal = {MAGYAR ONKOLÓGIA},
	volume = {67},
	unique-id = {33791187},
	issn = {0025-0244},
	abstract = {The aim of our analysis was to evaluate the efficacy of cabozantinib in patients with metastatic renal cell carcinoma. Cabozantinib therapy initiated between 01/01/2019 and 31/12/2022 was evaluated based on a retrospective review of data from 14 renal centers in Hungary. The starting dose was 60 or 40 mg. Physical examinations and laboratory tests were performed every 4 weeks and imaging studies 3-monthly. Tumor response was assessed according to RECIST 1.1, and toxicity according to NCI CTCAE 4.0. A total of 230 patient records were evaluated, 201 (87.4%) of them had clear cell RCC. Cabozantinib was administered as third, second and first-line treatment in 48.7%, 38.3% and <5% of cases, respectively. Dose reductions occurred in 62.6% and treatment interruption in 6.5%. Duration of therapy was 10.03 months, which was independent of dose reduction. Overall tumor response rate was 39.2% and clinical benefit was 82.8%. The duration of first-, second-, third- and fourth-line treatment was 11.47, 8.03, 11.57 and 10.13 months, respectively. Overall survival from the start of therapy was 22.0 months. Cabozantinib therapy in daily practice was more beneficial than according to registry study results. Dose reduction did not affect efficacy.},
	year = {2023},
	eissn = {2060-0399},
	pages = {73-83},
	orcid-numbers = {Maráz, Anikó/0000-0002-2018-8413; Bodoky, György/0000-0002-5659-2020; Küronya, Zsófia/0000-0001-8500-5924; Géczi, Lajos/0000-0001-7432-2043; Torday, László/0000-0002-2911-5499; Szűcs, Miklós/0000-0003-3576-8637; Varga, Zoltán/0000-0001-8537-6282; Bíró, Krisztina/0000-0002-2070-0608}
}

@article{MTMT:33770173,
	title = {A vesedaganatok sugárkezelése: a megváltozott sugárterápiás szemlélet és klinikai gyakorlat példázata},
	url = {https://m2.mtmt.hu/api/publication/33770173},
	author = {Mangel, László Csaba},
	journal-iso = {MAGYAR ONKOLÓGIA},
	journal = {MAGYAR ONKOLÓGIA},
	volume = {67},
	unique-id = {33770173},
	issn = {0025-0244},
	abstract = {The evolution of radiotherapy (RT) technologies in the last two decades has changed the RT treatment attitude, and the routine application of novel stereotactic methods has opened new avenues in the complex cancer care. To prove the clinical consequences of this paradigm shift, a good example is the transformation of the renal cell carcinoma (RCC) treatment strategy. RCC was originally considered as a radioresistant disease, however, the introduction of new RT technologies has provided a risk-free focal dose escalation, so RT in primary or metastatic RCCs has become a more efficient method. Meanwhile, there has also been a spectacular development in the medical treatment of advanced RCC, thus the treatment strategy has radically changed in this field of oncology, resulting in a remarkably increased effectiveness. In the present communication, we summarize the steps of recent RT evolution, the new fields of indications and possibilities of combination therapies in RCC.},
	year = {2023},
	eissn = {2060-0399},
	pages = {43-51}
}

@article{MTMT:33560488,
	title = {Real-Life Effectivity of Dose Intensity Reduction of First-Line mFOLFIRI-Based Treatment of Metastatic Colorectal Cancers: Sometimes Less Is More},
	url = {https://m2.mtmt.hu/api/publication/33560488},
	author = {Pécsi, Balázs and Mangel, László Csaba},
	doi = {10.3390/curroncol30010069},
	journal-iso = {CURR ONCOL},
	journal = {CURRENT ONCOLOGY (TORONTO)},
	volume = {30},
	unique-id = {33560488},
	issn = {1198-0052},
	abstract = {Aim: The key purposes of the treatment of metastatic malignancies are to extend survival and maintain the quality of life. Recently it has been emphasized in the scientific literature that the maintenance of maximal dose intensity is not always beneficial. Method: We examined the effectiveness of first-line mFOLFIRI-based treatments used in mCRC indication in 515 patients, treated between 1 January 2013 and 31 December 2018 at the Department of Oncotherapy of the University of Pécs, on a basis of real-world retrospective data analysis. We studied the effect of decreased dose intensity treatment modifications on patient survival. Results: 45% of all patients achieved the optimal relative dose intensity (RDI) of 85%, and the median progression-free and overall survival (mPFS, mOS) were 199 and 578 days, compared to 322 and 743 days, (mPFS p < 0.0002, 1 y (year) PFS OR (odds ratio) 0.39 (95% CI: 0.26–0.56) and mOS p = 0.0781, 2 yrs OS OR 0.58 (95% CI: 0.39–0.85), respectively) in the group of patients not achieving the RDI of 85%. Conclusions: Decreased dose intensity did not reduce the effectiveness of treatment; in fact, there was a significant improvement in most of the analyzed parameters. The option of reduced dose intensity, which shows the same or even better results with less toxicity, should definitely be considered in the future palliative treatment of mCRC patients.},
	keywords = {DRUG HOLIDAY; Metastatic colorectal carcinoma; dose intensity reduction; first-line mFOLFIRI-based chemotherapy; chemotherapy cycle-time},
	year = {2023},
	eissn = {1718-7729},
	pages = {908-922}
}