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Blanco López AM, Rodríguez Enríquez M. Ocular neuromyotonia: an unusual case after radiotheraphy for nasopharyngeal carcinoma. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99:209-212. [PMID: 38401598 DOI: 10.1016/j.oftale.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
Ocular neuromyotonia (ONM) is an infrequent disorder characterised by recurrent episodes of binocular diplopia caused by paroxysmal contraction of one or several extraocular muscles innervated by the same cranial nerve. It can be triggered spontaneously or caused by prolonged contraction of specific eye muscle(s) and is usually related to a local intracranial radiotherapy antecedent. We report the case of a 46-year-old woman who developed intermittent episodes of binocular diplopia eight years after radiotherapy for a nasopharyngeal carcinoma. After a complete neuro-ophthalmic assessment we diagnosed the case as an abducens nerve neuromyotonia. Although it is infrequent, radiotherapy to the nasopharynx is a possible cause of ONM, due to the proximity to the base of the skull and extraocular motor nerve pathways, especially that of the VI cranial nerve, as is the case presented in this article, about a patient whose history is a nasopharyngeal carcinoma treated with local radiotherapy.
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Affiliation(s)
- A M Blanco López
- Departamento de Oftalmología, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - M Rodríguez Enríquez
- Departamento de Estrabismo y Oftalmología Pediátrica, Hospital Universitario Lucus Augusti, Lugo, Spain
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2
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Garcés-Visier C, Conejero-Gonzalez P, Andión-Catalán M, Martín-Vega A, Muñoz-Hernández D, Espinoza-Vega ML, Luis-Huertas AL, Alonso-Calderón JL. Thyroid abnormalities in patients with Hodgkin lymphoma: The importance of close surveillance. An Pediatr (Barc) 2024:S2341-2879(24)00122-4. [PMID: 38644086 DOI: 10.1016/j.anpede.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/21/2024] [Indexed: 04/23/2024] Open
Abstract
INTRODUCTION Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents. METHODS We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves. RESULTS Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of follow-up was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (P= .026), thyroid nodules (P= .01) and thyroid disease overall (P= .003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; P= .017). CONCLUSION Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the follow-up. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.
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Affiliation(s)
- Cristina Garcés-Visier
- Servicio de Cirugía Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
| | | | | | - Alberto Martín-Vega
- Medicina Preventiva, Centros, Servicios y Unidades de Referencia (CSUR), Spain
| | - Diego Muñoz-Hernández
- Servicio de Cirugía Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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López Valcárcel M, Barrado Los Arcos M, Ferri Molina M, Cienfuegos Belmonte I, Duque Santana V, Gajate Borau P, Fernández Ibiza J, Álvarez Maestro M, Sargos P, López Campos F, Couñago F. Is trimodal therapy the current standard for muscle-invasive bladder cancer? Actas Urol Esp 2024:S2173-5786(24)00028-3. [PMID: 38575067 DOI: 10.1016/j.acuroe.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE The aim of this review is to summarize the current evidence and future perspectives of bladder-sparing treatment for MIBC. METHODS A non-systematic literature search in Medline/Pubmed was performed in October 2023 with the following keywords "bladder cancer", "bladder-sparing", "trimodal therapy", "chemoradiation", "biomarkers", "immunotherapy", "neoadjuvant chemotherapy", "radiotherapy". RESULTS Urology guidelines recommend radical cystectomy as the standard curative treatment for muscle-invasive urothelial bladder cancer, reserving radiotherapy for patients who are unfit or who want to preserve their bladder. Given the morbidity and mortality of cystectomy and its impact on quality of life and bladder function, modern oncologic therapies are increasingly oriented toward organ preservation and maximizing functional outcomes while maintaining treatment efficacy. Trimodal therapy, which incorporates maximal transurethral resection followed by radiotherapy with concurrent radiosensitizing chemotherapy, is an effective regimen for bladder function preservation in well-selected patients. Despite the absence of comparative data from randomized trials, the two approaches seem to provide comparable oncologic outcomes. Studies are evaluating the expansion of eligibility criteria for trimodal therapy, the optimization of radiotherapy and immunotherapy delivery to further improve outcomes, and the validation of biomarkers to guide bladder preservation. CONCLUSIONS Trimodal therapy has shown acceptable outcomes for bladder preservation; therefore, it provides a valid treatment option in well-selected patients.
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Affiliation(s)
- M López Valcárcel
- Servicio de Oncología Radioterápica, Hospital Universitario Puerta de Hierro, Madrid, Spain, Miembro del GUARD Consortium.
| | - M Barrado Los Arcos
- Servicio de Oncología Radioterápica, Hospital Universitario de Navarra, Instituto de Investigación Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - M Ferri Molina
- Servicio de Oncología Radioterápica, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Universidad de Cantabria, Spain
| | - I Cienfuegos Belmonte
- Servicio de Urología, Hospital Virgen del Puerto, Plasencia, Cáceres, Extremadura, Spain
| | - V Duque Santana
- Servicio de Oncología Radioterápica, Hospital Universitario Quironsalud y Hospital Universitario La Luz, Universidad Europea de Madrid, Spain
| | - P Gajate Borau
- Servicio de Oncología Médica, Hospital Universitario Ramon y Cajal, Instituto Ramon y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - J Fernández Ibiza
- Servicio de Oncología Radioterápica, GenesisCare Clínica Corachan, Barcelona, Spain
| | | | - P Sargos
- Servicio de Oncología Radioterápica, Institut Bergonié, Burdeos, France
| | - F López Campos
- Servicio de Oncología Radioterápica, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - F Couñago
- Servicio de Oncología Radioterápica, GenesisCare Madrid, Hospital Universitario San Francisco de Asis y Hospital Universitario La Milagrosa, Madrid, Spain
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Lassaletta L, Acle Cervera L, Altuna X, Amilibia Cabeza E, Arístegui Ruiz M, Batuecas Caletrio Á, Benítez Del Rosario J, Cabanillas Farpón R, Costales Marcos M, Escada P, Espinosa-Sánchez JM, García Leal R, Gavilán J, Gómez Martínez J, González-Aguado R, Martinez-Glez V, Guerra Jiménez G, Harguindey Antolí-Candela A, Hernández García BJ, Orús Dotú C, Polo López R, Manrique M, Martín Sanz E, Martínez Álvarez R, Martínez H, Martínez-Martínez M, Rey-Martinez J, Ropero Romero F, Santa Cruz Ruiz S, Vallejo LÁ, Soto Varela A, Varela-Nieto I, Morales Puebla JM. Clinical practice guideline on the management of vestibular schwannoma. Acta Otorrinolaringol Esp (Engl Ed) 2024; 75:108-128. [PMID: 38346489 DOI: 10.1016/j.otoeng.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Vestibular schwannoma (VS) is the most common tumour of the cerebellopontine angle. The greater accessibility to radiological tests has increased its diagnosis. Taking into account the characteristics of the tumour, the symptoms and the age of the patient, three therapeutic strategies have been proposed: observation, surgery or radiotherapy. Choosing the most appropriate for each patient is a frequent source of controversy. MATERIAL AND METHODS This paper includes an exhaustive literature review of issues related to VS that can serve as a clinical guide in the management of patients with these lesions. The presentation has been oriented in the form of questions that the clinician usually asks himself and the answers have been written and/or reviewed by a panel of national and international experts consulted by the Otology Commission of the SEORL-CCC. RESULTS A list has been compiled containing the 13 most controversial thematic blocks on the management of VS in the form of 50 questions, and answers to all of them have been sought through a systematic literature review (articles published on PubMed and Cochrane Library between 1992 and 2023 related to each thematic area). Thirty-three experts, led by the Otology Committee of SEORL-CCC, have analyzed and discussed all the answers. In Annex 1, 14 additional questions divided into 4 thematic areas can be found. CONCLUSIONS This clinical practice guideline on the management of VS offers agreed answers to the most common questions that are asked about this tumour. The absence of sufficient prospective studies means that the levels of evidence on the subject are generally medium or low. This fact increases the interest of this type of clinical practice guidelines prepared by experts.
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Affiliation(s)
- Luis Lassaletta
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain.
| | | | - Xabier Altuna
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | - Emilio Amilibia Cabeza
- Servicio de Otorrinolaringología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Miguel Arístegui Ruiz
- Servicio de Otorrinolaringología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Ángel Batuecas Caletrio
- Servicio de Otorrinolaringología, Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Jesús Benítez Del Rosario
- Servicio de Otorrinolaringología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | - María Costales Marcos
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Pedro Escada
- Servicio de Otorrinolaringología, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Juan Manuel Espinosa-Sánchez
- Servicio de Otorrinolaringología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
| | - Roberto García Leal
- Servicio de Neurocirugía, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Gavilán
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Justo Gómez Martínez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Rocío González-Aguado
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Victor Martinez-Glez
- Center for Genomic Medicine, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autónoma de Barcelona, Sabadell, Barcelona, Spain
| | - Gloria Guerra Jiménez
- Servicio de Otorrinolaringología, Complejo Hospitalario Universitario Insular Materno Infantil de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | | | - Cesar Orús Dotú
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Rubén Polo López
- Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Manuel Manrique
- Servicio de Otorrinolaringología, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Eduardo Martín Sanz
- Servicio de Otorrinolaringología, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | | | - Henry Martínez
- Servicio de Otorrinolaringología, Hospital Universitario Clínica San Rafael, Sur Bogotá D. C., Colombia; Servicio de Otorrinolaringología, Hospital San José, Bogotá, Colombia
| | | | - Jorge Rey-Martinez
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | | | - Santiago Santa Cruz Ruiz
- Servicio de Otorrinolaringología, Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Luis Ángel Vallejo
- Servicio de Otorrinolaringología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Andrés Soto Varela
- Servicio de Otorrinolaringología, Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Complexo Hospitalario Universitario de Santiago, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Isabel Varela-Nieto
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain; Grupo de Audición y Mielinopatías, Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, CIBERER-ISCIII, Madrid, Spain
| | - José Manuel Morales Puebla
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
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León X, Neumann E, Holgado A, Vásquez R, Pujol A, Quer M. Oncological results of salvage treatment in patients with oropharynx carcinoma treated with radiotherapy. Acta Otorrinolaringol Esp (Engl Ed) 2024; 75:8-16. [PMID: 37393035 DOI: 10.1016/j.otoeng.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE To evaluate the possibilities of salvage after local recurrence in patients with oropharyngeal carcinomas treated with radiotherapy, and to analyse the prognostic factors related to the final control of the disease. METHODS Retrospective study of 596 patients with oropharyngeal carcinoma treated with radiotherapy during the period 1991-2018. RESULTS One hundred and eighty-one patients (30.4%) had a local recurrence. Of the patients with a local recurrence, 51 (28.2%) were treated with salvage surgery. Variables that were associated with the patient not receiving salvage surgery were age greater than 75 years, tumour location in the posterior hypopharyngeal wall, an initial tumour extent cT4, and a recurrence-free interval of less than 6 months. Five-year specific survival of patients treated with salvage surgery was 19.1% (95% CI: 7.3%-30.9%). Variables that were related to specific survival were extent of recurrence and status of resection margins. Final tumour control was not achieved in any of the patients with extensive recurrence (rpT3-4, n = 25) or positive resection margins (n = 22). CONCLUSION Patients with oropharyngeal carcinomas treated with radiotherapy with local tumour recurrence have a limited prognosis. Most patients (71.8%) were not considered candidates for salvage surgery. The 5-year specific survival of patients treated with salvage surgery was 19.1%.
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Affiliation(s)
- Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; UVIC. Universitat Central de Catalunya, Vic, Spain
| | - Eduard Neumann
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Holgado
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosselin Vásquez
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Pujol
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
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Díaz Silvera CM, Azinovic I, Bolle SLE, Pérez Cobos M, Matute R. Role of radiotherapy in the management of spine metastases. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:542-551. [PMID: 37245636 DOI: 10.1016/j.recot.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023] Open
Abstract
Spine metastases are a common cause of pain in the oncologic patient which can generate functional limitation, in addition to complications derived from spinal cord compression, radicular compression and fractures. A complex approach to these metastases is required due to the risk of permanent sequelae. With the increase in survival rates due to new emerging treatments, the possibilities of presenting vertebral metastases are increasing, therefore, the management of these lesions should be aimed at pain relief and maintenance of ambulation. Radiotherapy has a fundamental role in the management of these lesions, and technological advances in recent years have made it possible to improve the quality and intentionality of the treatments, going from having a palliative intent to proposing treatments that improve local control. In this article we describe how the stereotactic body radiotherapy (SBRT) technique, in selected patients, can improve local control and its value in oligometastatic patients and after surgery.
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Affiliation(s)
- C M Díaz Silvera
- Oncología Radioterápica. Fundación Jiménez Díaz. Madrid, España.
| | - I Azinovic
- Oncología Radioterápica. Fundación Jiménez Díaz. Madrid, España
| | - S L E Bolle
- Oncología radioterápica. Centro de Protonterapia. Quironsalud. Madrid, España
| | - M Pérez Cobos
- Oncología Radioterápica. Fundación Jiménez Díaz. Madrid, España
| | - R Matute
- Oncología radioterápica. Centro de Protonterapia. Quironsalud. Madrid, España
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Díaz Silvera CM, Azinovic I, Bolle SLE, Pérez Cobos M, Matute R. [Translated article] Role of radiotherapy in the management of spine metastases. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:S542-S551. [PMID: 37541346 DOI: 10.1016/j.recot.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/23/2023] [Indexed: 08/06/2023] Open
Abstract
Spine metastases are a common cause of pain in the oncologic patient which can generate functional limitation, in addition to complications derived from spinal cord compression, radicular compression and fractures. A complex approach to these metastases is required due to the risk of permanent sequelae. With the increase in survival rates due to new emerging treatments, the possibilities of presenting vertebral metastases are increasing, therefore, the management of these lesions should be aimed at pain relief and maintenance of ambulation. Radiotherapy has a fundamental role in the management of these lesions, and technological advances in recent years have made it possible to improve the quality and intentionality of the treatments, going from having a palliative intent to proposing treatments that improve local control. In this article, we describe how the stereotactic body radiotherapy (SBRT) technique, in selected patients, can improve local control and its value in oligometastatic patients and after surgery.
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Affiliation(s)
| | - I Azinovic
- Oncología Radioterápica, Fundación Jiménez Díaz, Madrid, Spain
| | - S L E Bolle
- Oncología Radioterápica, Centro de Protonterapia, Quironsalud, Madrid, Spain
| | - M Pérez Cobos
- Oncología Radioterápica, Fundación Jiménez Díaz, Madrid, Spain
| | - R Matute
- Oncología Radioterápica, Centro de Protonterapia, Quironsalud, Madrid, Spain
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León X, Llansana A, Pérez-Ugarte L, García J, Valero C, Quer M, Camacho M. Predictive capacity of FAT1 transcriptional expression in patients with head and neck squamous cell carcinomas treated with radiotherapy. Acta Otorrinolaringol Esp (Engl Ed) 2023; 74:359-364. [PMID: 37931687 DOI: 10.1016/j.otoeng.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/11/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE To analyze the predictive capacity at the primary location of the tumor of the FAT1 transcriptional expression in patients with head and neck squamous cell carcinoma treated with radiotherapy. MATERIAL AND METHODS We conducted a retrospective study from biopsies of the primary location of the tumor in 82 patients with head and neck squamous cell carcinoma treated with radiotherapy. The transcriptional expression of FAT1 was determined by RT-PCR. The level of FAT1 transcriptional expression was categorized according to the local control after radiotherapy using a recursive partitioning analysis. RESULTS Elevated FAT1 transcriptional expression was associated with an increased risk of local recurrence after radiotherapy. Patients with a high expression level of FAT1 (n=18; 22.0%) had a 5-year local recurrence-free survival of 42.1% (95% CI: 18.6%-65.6%), whereas for patients with a low expression (n=64; 78.0%) it was 72.4% (95% CI: 61.5%-83.3%) (p=0.002). According to the result of a multivariate analysis, patients with a high FAT1 expression category had a 2.3-fold increased risk of local recurrence (95% CI: 1.0-5.2; p=0.043). CONCLUSIONS Elevated FAT1 transcriptional expression was associated with a significantly increased risk of local recurrence in patients with head and neck squamous cell carcinoma treated with radiotherapy.
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Affiliation(s)
- Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; Universitat de Vic (UVic) - Universitat Central de Catalunya, Vic, Barcelona, Spain
| | - Albert Llansana
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Leyre Pérez-Ugarte
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Jacinto García
- Servicio de Otorrinolaringología, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Cristina Valero
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Mercedes Camacho
- Genomics of Complex Diseases, Research Institute Hospital Sant Pau, IIB Sant Pau, Barcelona, Spain
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Holgado A, León X, Quer M, Camacho V, Fernández A. Association between maximum standarised uptake value (SUV) and local control in patients with oropharyngeal carcinoma treated with radiotherapy. Acta Otorrinolaringol Esp (Engl Ed) 2023; 74:211-218. [PMID: 37149130 DOI: 10.1016/j.otoeng.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/19/2022] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To analyse the prognostic ability of the maximum standardised uptake value (SUVmax) on local disease control in patients with oropharyngeal carcinoma treated with radiotherapy. MATERIAL AND METHODS Retrospective study of 105 patients with oropharyngeal carcinomas treated with radiotherapy, including chemo- and bio-radiotherapy, and who had a PET-CT scan prior to the start of treatment. RESULT Patients with a SUVmax value higher than 17.2 at the primary tumour site had a significantly higher risk of local recurrence. The 5-year local recurrence-free survival for patients with SUVmax less than or equal to 17.2 (n = 71) was 86.5% (95% CI 78.2-94.7 %), and for patients with SUVmax greater than 17.2 (n = 34) it was 55.8% (95% CI 36.0-75.6 %) (P = 0.0001). This difference in local control was maintained regardless of patients' HPV status. Specific survival was similarly lower for patients with a SUV greater than 17.2. The 5-year specific survival for patients with SUVmax greater than 17.2 was 39.5% (95% CI: 20.6-58.3 %), significantly shorter than that of patients with SUVmax equal to or less than 17.2, which was 77.3% (95% CI: 66.9-87.6 %) (P = 0.0001). CONCLUSIONS Patients with oropharyngeal carcinomas treated with radiotherapy with a SUVmax greater than 17.2 at the level of the primary tumour site had a significantly higher risk of local recurrence.
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Affiliation(s)
- Anna Holgado
- Servicio de Otorrinolaringología-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier León
- Servicio de Otorrinolaringología-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; UVIC-->, Universitat Central de Catalunya, Vic, Spain.
| | - Miquel Quer
- Servicio de Otorrinolaringología-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Valle Camacho
- Servicio de Medicina Nuclear-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alejando Fernández
- Servicio de Medicina Nuclear-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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10
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León X, Farré N, Montezuma L, Holgado A, Vásquez R, Neumann E, Quer M. Results of radiotherapy in oropharyngeal carcinomas. Acta Otorrinolaringol Esp (Engl Ed) 2023; 74:137-147. [PMID: 37149134 DOI: 10.1016/j.otoeng.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/18/2022] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas. MATERIAL AND METHODS Retrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive. RESULTS Five-year local recurrence-free survival was 73.5% (95% CI: 68.8-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status. CONCLUSIONS Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status.
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Affiliation(s)
- Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; UVIC. Universitat Central de Catalunya, Vic, Spain
| | - Núria Farré
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Montezuma
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Holgado
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosselin Vásquez
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Eduard Neumann
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
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11
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López-Morales P, Candel-Arenas MF, Martínez-Sanz N, Medina-Manuel E, Giménez-Francés C, Albarracín-Marín-Blázquez A. Perforación traqueal diferida tras cirugía tiroidea en un paciente con radioterapia cervical. CIR CIR 2023; 91:113-116. [PMID: 36787618 DOI: 10.24875/ciru.21000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Tracheal perforation is a rare complication of thyroid surgery. A 36-year-old man with previous neck radiotherapy due to a nasopharyngeal cancer. After right hemithyoidectomy and isthmusectomy, the patient presented a tracheal perforation. The diagnosis was confirmed with computed tomography and bronchoscopy. A conservative management was performed with drainage and antibiotic therapy, and the evolution was satisfactory. If recognized at the time of the surgery, perforations should be closed primarily. Delayed perforations will be treated with an emergency surgery or conservatively depending on the clinical situation of the patient.
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Affiliation(s)
- Pedro López-Morales
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, España
| | - M Fe Candel-Arenas
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, España
| | - Nuria Martínez-Sanz
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, España
| | - Esther Medina-Manuel
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, España
| | - Clara Giménez-Francés
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, España
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12
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Collado Chazarra P, Santiñá Vila M. [Influence of physical activity on radiotherapy-treated breast cancer patients: A systematic review]. J Healthc Qual Res 2023; 38:50-58. [PMID: 35792048 DOI: 10.1016/j.jhqr.2022.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/22/2022] [Accepted: 05/23/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The number of survivors with cancer is growing worldwide, but the adverse effects of the radiotherapy are still frequent, affecting effort capacity, respiratory function and quality of life. The objective is to know how the physical exercise influences the respiratory function and tolerance to effort, in pacients with breast cancer after the radiotherapy treatment. MATERIALS AND METHODS The searches were carried out in the databases of Pubmed, PEDro, Web Of Science, Cochrane, EMBASE, UptoDate and Tripdatabase. Were included studies with patients with breast cancer treated with radiotherapy and included in an exercise program. The main results were: maximum oxygen consumption, 6 minutes walking test, forced vital capacity, vital capacity, forced expiratory volume in 1 second, total lounge capacity, inspiratory capacity, and the diffusion capacity of the lungs for carbon monoxide. RESULTS The results show an increase of the effort capacity with 15% improvements in the maximum oxygen consumption and 6.675% in the 6 minutes walking test, while they are limited for the respiratory function. CONCLUSIONS The physical exercise is effective for improve the effort capacity in pacients with breast cancer treated with radiotherapy, without changes in the respiratory function. Nevertheless, new studies are necessary to investigate deeply how the physical exercise influences in those pacients, and the ideal design of the programs.
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Affiliation(s)
- P Collado Chazarra
- Máster Universitario en Fisioterapia del Tórax, Escuelas Universitarias Gimbernat, Barcelona, España.
| | - M Santiñá Vila
- Dirección de Calidad y Seguridad Clínica, Hospital Clínic, Barcelona, España
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13
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Faiella E, Santucci D, Vertulli D, Esperto F, Messina L, Castiello G, Papalia R, Flammia G, Scarpa RM, Fiore M, Trodella LE, Ramella S, Grasso RF, Beomonte Zobel B. The role of multiparametric mri in the diagnosis of local recurrence after radical prostatectomy and before salvage radiotherapy. Actas Urol Esp 2022; 46:397-406. [PMID: 35778338 DOI: 10.1016/j.acuroe.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/11/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Assess multiparametric-MRI (mp-MRI) diagnostic accuracy in the detection of local recurrence of Prostate Cancer (PCa) after Radical Prostatectomy (PR) and before Radiation Therapy (RT). MATERIALS AND METHODS A total of 188 patients underwent 1.5-T mp-MRI after RP before RT. Patients were divided into two groups: with biochemical recurrence (group A) and without but with high risk of local recurrence (group B). Continuous variables were compared between two groups using T-Student; categoric variables were analyzed using Pearson chi-square. ROC analysis was performed considering PSA before RT, ISUP, pT and pN as grouping variables. RESULTS PCa recurrence (reduction of PSA levels after RT) was 89.8% in the group A and 80.3% in the group B. Comparing patients with and without PCa recurrence, there was a significant difference in PSA values before RT for group A and for PSA values before RT and after RT for group B. In group A, there was a significant correlation between PSA before RT and diameter of recurrence and between PSA before RT and time spent before recurrence. The mp-MRI diagnostic accuracy in detecting PCa local recurrence after RP is of 62.2% in group A and 38% in group B. DWI is the most specific MRI-sequence and DCE the most sensitive. For PSA = 0.5 ng/ml, the AUC decreases while sensitivity and accuracy increase for each MRI-sequence. For PSA = 0.9 ng/ml, DCE-AUC increases significantly. CONCLUSION mp-MRI should always be performed before RT when a recurrence is suspected. New scenarios can be opened considering the role of DWI for PSA ≤ 0.5 ng/ml.
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Affiliation(s)
- E Faiella
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy.
| | - D Santucci
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy
| | - D Vertulli
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy
| | - F Esperto
- Department of Urology, University of Rome Campus Bio-medico, Rome, Italy
| | - L Messina
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy
| | - G Castiello
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy
| | - R Papalia
- Department of Urology, University of Rome Campus Bio-medico, Rome, Italy
| | - G Flammia
- Department of Urology, University of Rome Campus Bio-medico, Rome, Italy
| | - R M Scarpa
- Department of Urology, University of Rome Campus Bio-medico, Rome, Italy
| | - M Fiore
- Department of Radiotherapy, University of Rome Campus Bio-medico, Rome, Italy
| | - L Eolo Trodella
- Department of Radiotherapy, University of Rome Campus Bio-medico, Rome, Italy
| | - S Ramella
- Department of Radiotherapy, University of Rome Campus Bio-medico, Rome, Italy
| | - R F Grasso
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy
| | - B Beomonte Zobel
- Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy
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14
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Casas-Nebra J, Blanco-Gomez B, Medina-González A, Formoso-Garcia I, Escaf-Barmadah S, Alvarez-Arenal A. Impact of a radical prostatectomy on the urodynamic results of prostate cancer patients treated with intensity modulated radiation therapy. Actas Urol Esp 2022; 46:431-441. [PMID: 35339398 DOI: 10.1016/j.acuroe.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND OBJECTIVES To evaluate the effect of radical prostatectomy and age on urodynamics before and after intensity-modulated radiation therapy administered to prostate cancer patients. MATERIALS AND METHODS The sample consisted of 40 prostate cancer patients, 22 of whom had undergone a radical prostatectomy. Urodynamic parameters before and after an average of 4.2 months of radiotherapy were measured and compared. External radiotherapy was administered via Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) techniques. RESULTS Uroflowmetry presented no significant parameters. In the case of Cystomanometry, the data did not show an increase in secondary stress urinary incontinence, although there is 7 percent increase in urge urinary incontinence. There were statistically significant changes in reduced bladder capacity with a strong desire to void, with an urge to void and also in the detrusor pressure with a normal desire to void. Furthermore, pressure/flow analysis revealed a statistically significant reduction of residual urine volume. CONCLUSIONS The effect of prostatectomy and age varies according to the evolution of urodynamics. There was a significant reduction in terms of residual urine volume and detrusor pressure with a normal desire to void in patients without a prostatectomy and in those under 75 years old. In addition to an increase in urge incontinence, there was also a significant worsening of the bladder filling urodynamics and a decrease in the cystomanometric bladder capacity with a strong desire and an urge to void. None of these were modified by age or prostatectomy.
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Affiliation(s)
- J Casas-Nebra
- Servicio de Urología, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - B Blanco-Gomez
- Servicio de Urología, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - A Medina-González
- Servicio de Urología, Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - I Formoso-Garcia
- Service de Oncología Radioterápica, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - S Escaf-Barmadah
- Servicio de Urología, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Cirugía y Especialidades Medicoquirúrgicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | - A Alvarez-Arenal
- Departamento de Cirugía y Especialidades Medicoquirúrgicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
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15
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Barranco-Lampón G, Martínez-Castro R, Arana-Luna L, Álvarez-Vera JL, Rojas-Castillejos F, Peñaloza-Ramírez R, Carballo-Zarate AA, Olarte-Carrillo I, Minamy JIG, López-Salazar J, Navarrete JJ, Espinosa-Partida A, Ventura-Enríquez Y, Ruiz-Contreras JI, Aguirre-Reyes OG, Anaya-Cuéllar I, Aguilar-Luévano J, Díaz-Ramírez HF, Herrera-Olivares W, Aguilar-Hidalgo JA, Alcívar-Cedeño LM, Hernández-Caballero Á, Galaz-Cordero LE, Peña-Celaya JADL, Báez-Islas PE, Bates-Martín RA, Cano-León AMDLL, Espitia-Ríos ME, Barbosa D, Morales-Adrián J, Pacheco MJ, Delgado-López N, Neme-Yunes Y, Moralws-Hernández AE, Mújica-Martínez A, Pérez-Lizardi AB, Pérez-Gómez KD, Barragán-Ibáñez G, Martínez A, Flores-Ordúñez K, Ramírez-Hoyos P, Rosales-López MDLÁ, Acosta-Maldonado BL, Jiménez-Ochoa MA, Garzón-Velásquez KB, Hernández-Ruiz E, McNally-Guillén BM, Saucedo-Montes EE, Aguilar-Andrade C, Vivas-Arteaga CL, Guerra-Alarcón LV, Milán-Salvatierra AI, Campa-Monroy DI, Cota-Rangel X, Estrada-Domínguez P, García-Camacho AS, García-Castillo C, Banda-García LI, Rodríguez-Sánchez V, Meillón-García LA, Urbina-Escalante E, Martínez-Ramírez MA, Loera-Fragoso SJ, Martínez-Coronel J, Zapata-Canto N, Gómez-Cortés SC, Medina-Coral JE, Mójica-Balderas L, Pérez-Zúñiga JM, Pérez FJ, López-Arroyo JL, Zazueta-Pozos JF, Romero-Martínez E, Romero-Rodelo H, Tapia-Enríquez AL, Soriano-Mercedes EJ, Salazar-Ramírez Ó, Vilchis-González SP, Tepepa-Flores F, Alvarado-Ibarra M. Myelofibrosis: diagnosis and treatment. GAC MED MEX 2022; 158:26-37. [PMID: 37734057 DOI: 10.24875/gmm.m22000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 09/23/2023] Open
Abstract
Myelofibrosis (MF) is a BCR-ABL1-negative myeloproliferative neoplasm characterized by clonal myeloproliferation, dysregulated kinase signaling, and release of abnormal cytokines. In recent years, important progress has been made in the knowledge of the molecular biology and the prognostic assessment of MF. Conventional treatment has limited impact on the patients' survival; it includes a wait-and-see approach for asymptomatic patients, erythropoiesis-stimulating agents, androgens, or immunomodulatory agents for anemia, cytoreductive drugs such as hydroxyurea for the splenomegaly and constitutional symptoms, and splenectomy or radiotherapy in selected patients. The discovery of the Janus kinase (JAK) 2 mutation triggered the development of molecular targeted therapy of MF. The JAK inhibitors are effective in both JAK2-positive and JAK2-negative MF; one of them, ruxolitinib, is the current best available therapy for MF splenomegaly and constitutional symptoms. Although ruxolitinib has changed the therapeutic scenario of MF, there is no clear indication of a disease-modifying effect. Allogeneic stem cell transplantation remains the only curative therapy of MF, but due to its associated morbidity and mortality, it is usually restricted to eligible high- and intermediate-2-risk MF patients. To improve current therapeutic results, the combination of JAK inhibitors with other agents is currently being tested, and newer drugs are being investigated.
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Affiliation(s)
- Gilberto Barranco-Lampón
- Servicio de Hematología, Hospital General de México, Ciudad de México, México
- Servicio de Hematología, Instituto Nacional de Cancerología, Ciudad de México, México
| | - Raúl Martínez-Castro
- Servicio de Hematología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Luara Arana-Luna
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - José Luis Álvarez-Vera
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Flavio Rojas-Castillejos
- Servicio de Hematología, Hospital General de Zona No. 2, Instituto Mexicano del Seguro Social, Salina Cruz, Oax., México
| | | | | | - Irma Olarte-Carrillo
- Servicio de Hematología, Hospital General de México, Ciudad de México, México
- Biología molecular, Hospital General de México,Ciudad de México, México
| | - Jaime Israel-García Minamy
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Javier López-Salazar
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Juan José Navarrete
- Servicio de Hematología, Hospital General de México, Ciudad de México, México
| | - Arturo Espinosa-Partida
- Servicio de Hematología, Hospital General Belisario Domínguez, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tuxtla Gutiérrez, Chis., México
| | - Yanet Ventura-Enríquez
- Banco de Sangre, Hospital Centro Médico Naval, Ciudad de México, México
- Servicio de Hematología, Hospital Centro Médico Naval, Ciudad de México, México
| | - Josué Isel Ruiz-Contreras
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Irene Anaya-Cuéllar
- Servicio de Hematología, Hospital General Presidente Lázaro Cárdenas del Río, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Chihuahua, Chih., México
| | | | - Hugo Francisco Díaz-Ramírez
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Wilfrido Herrera-Olivares
- Servicio de Hematología, Hospital Regional de Puebla, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Puebla, Pue., México
| | - José Antonio Aguilar-Hidalgo
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Álvaro Hernández-Caballero
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional La Raza, Ciudad de México, México
| | - Lourdes Elena Galaz-Cordero
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - José Antonio de la Peña-Celaya
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Pamela Elena Báez-Islas
- Servicio de Hematología, Instituto Mexicano del Seguro Social, Hospital de Zona No. 14, Hermosillo, Son., México
| | | | - Ana Ma de la Luz Cano-León
- Servicio de Hematología, Instituto Mexicano del Seguro Social, Hospital General Regional No. 1, Querétaro, Qro., México
| | - Ma Eugenia Espitia-Ríos
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Diego Barbosa
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Javier Morales-Adrián
- Servicio de Hematología, Hospital Regional de Mérida, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mérida, Yuc., México
| | - Martín Jacobo Pacheco
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Nancy Delgado-López
- Servicio de Hematología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Yvette Neme-Yunes
- Servicio de Hematología, Centro Médico ABC, Ciudad de México, México
| | - Alba Edna Moralws-Hernández
- Servicio de Hematología, Hospital General de Zona No. 27, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - Alejandra Betsabé Pérez-Lizardi
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional La Raza, Ciudad de México, México
| | - Karen Daniela Pérez-Gómez
- Servicio de Hematología, Hospital Instituto Mexicano del Seguro Social Chihuahua, Hospital General de Zona No. 1, Chihuahua, Chih., México
| | - Gabriel Barragán-Ibáñez
- Servicio de Hematología, Hospital Regional Presidente Juárez, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Adolfo Martínez
- Laboratorio de Hematología, Hospital General de México, Ciudad de México, México
| | - Karen Flores-Ordúñez
- Servicio de Hematología, Hospital General de Zona No. 24, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - Ma de Los Ángeles Rosales-López
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Marco Alejandro Jiménez-Ochoa
- Unidad de trasplante de médula ósea, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | | | - Eleazar Hernández-Ruiz
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Bosco Martín McNally-Guillén
- Servicio de Hematología, Trasplante de médula ósea, Centro Médico de Especialidades, Ciudad Juárez, Chih., México
| | - Erick Eduardo Saucedo-Montes
- Banco de Sangre, Hospital General Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Tampico, Tampico, Tamps., México
| | - Carolina Aguilar-Andrade
- Banco de Sangre, Hospitalización, Instituto Nacional de Cardiología, Ciudad de México, México
- Banco de Sangre, Hospitalización, Instituto Mexicano del Seguro Social Carlos MacGregor, Ciudad de México, México
| | - Cindy Lissette Vivas-Arteaga
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Andrea Iracema Milán-Salvatierra
- Servicio de Hematología, Hospital Regional Presidente Juárez, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Dafne Itzel Campa-Monroy
- Servicio de Hematología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Xóchitl Cota-Rangel
- Servicio de Hematología, San Telmo Medical Center, Aguascalientes, Aguascalientes, Ags., México
| | - Patricia Estrada-Domínguez
- Servicio de Hematología, Hospital Instituto Mexicano del Seguro Social Chihuahua, Hospital General de Zona No. 1, Chihuahua, Chih., México
| | - Alinka Socorro García-Camacho
- Servicio de Hematología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
- Servicio de Hematología, Oncología integral satélite, Ciudad de México, México
| | - Carolina García-Castillo
- Servicio de Hematología, Oncología integral satélite, Ciudad de México, México
- Servicio de Hematología, Hospital Central Militar, SEDENA, Ciudad de México, México
| | | | - Vania Rodríguez-Sánchez
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Elizabeth Urbina-Escalante
- Servicio de Hematología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Mario Alberto Martínez-Ramírez
- Servicio de Hematología, Hospital Regional B, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Veracruz, Veracruz, Ver., México
| | | | - Jorge Martínez-Coronel
- Servicio de Hematología, Hospital Regional Valentín Gómez Farias, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Guadalajara, Jal., México
| | - Nidia Zapata-Canto
- Servicio de Hematología, Instituto Nacional de Cancerología, Ciudad de México, México
- Servicio de Hematología, Médica Sur, Ciudad de México, México
| | - Sue Cynthia Gómez-Cortés
- Servicio de Hematología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Jesús Emanuel Medina-Coral
- Servicio de Hematología, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Dr. Manuel Cárdenas de la Vega, Culiacán, Sin., México
| | | | - Juan Manuel Pérez-Zúñiga
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | | | | | | | - Hilda Romero-Rodelo
- Servicio de Hematología, Hospital Fray Junípero Serra, Tijuana, B.C., México
| | - Ana Laura Tapia-Enríquez
- Servicio de Hematología, Hospital General Presidente Lázaro Cárdenas del Río, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Chihuahua, Chih., México
| | - Emely Johanny Soriano-Mercedes
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Óscar Salazar-Ramírez
- Servicio de Hematología, Hospital General Dr. Darío Fernández Fierro, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Fredy Tepepa-Flores
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Martha Alvarado-Ibarra
- Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
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León X, García J, Farré N, Majercakova K, Avilés-Jurado FX, Quer M, Camacho M. Predictive capacity of IL-8 expression in head and neck squamous carcinoma patients treated with radiotherapy or chemoradiotherapy. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:337-343. [PMID: 34844671 DOI: 10.1016/j.otoeng.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To analyse the relationship between the transcriptional expression of interleukin-8 (IL-8) and response to treatment with radiotherapy or chemo-radiotherapy in patients with squamous cell carcinoma of the head and neck (SCCHN). MATERIAL AND METHODS Retrospective study from tumour biopsies obtained before a treatment with radiotherapy or chemo-radiotherapy in 87 patients with SCCHN. We had a sample of healthy mucosa in 35 cases. We determined the transcriptional expression of IL-8 with RT-PCR. The transcriptional expression of IL-8 was categorized according to the local control of the disease with a recursive partitioning analysis. RESULTS The transcriptional expression of IL-8 in tumour tissue was about 50 times higher than that in the samples of healthy mucosa. Patients with a high transcriptional expression of IL-8 (n = 56) had a 5-year local recurrence-free survival of 65.6%, and for patients with low expression (n = 31) it was 90.2% (P = 0.017). According to the results of a multivariate analysis, patients with high expression of IL-8 had a 4.1 higher risk of local recurrence of the tumour. CONCLUSIONS SCCHN have a significant increase in transcriptional expression of IL-8 in relation to non-tumour tissue. Tumours with high IL-8 expression have an increased risk of local recurrence after treatment with radiotherapy or chemo-radiotherapy.
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Affiliation(s)
- Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
| | - Jacinto García
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuria Farré
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Katarina Majercakova
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc-Xavier Avilés-Jurado
- Servicio de Otorrinolaringología, Hospital Clínic, IDIBAPS Universitat de Barcelona, Barcelona, Spain; Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya. 2017-SGR-01581, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (CIBERDEM), Madrid, Spain
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Mercedes Camacho
- Genomics of Complex Diseases, Research Institute Hospital Sant Pau, IIB Sant Pau, Barcelona, Spain
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Beato Tortajada I, Ferrer Albiach C, Morillo Macias V. Nomogram for the personalisation of radiotherapy treatments in breast cancer patients. Breast 2021; 60:255-262. [PMID: 34808437 PMCID: PMC8609093 DOI: 10.1016/j.breast.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Numerous prospective studies have shown that the incorporation of genomic assays into clinical practice significantly impacts the choice of adjuvant treatments for patients with early-stage breast cancer. However, the same evidence does not exist for the treatment of locoregional recurrences. Hypothesis and objectives The main objective of this work was to identify the clinicopathological, molecular, and genetic parameters that allow patients to be more precisely categorised into risk groups, in order to create a locoregional recurrence riskclassification tool, the PersonalRT27. Material and methods To create PersonalRT27, we retrospective assessed the variables of patients with early breast cancer (stages I or II) who had undergone the OncotypeDx ® and MammaPrint ® genetic tests. These variables and factors included in the tests were categorised and weighted to obtain scores between 1 and 5 pointsto represent a lower or higher risk of relapse, respectively, based on these factors and as determined by the researchers. Results The mean follow-up time was 60.5 months (range 25–96 months); locoregional progression-free survival at the time of the analysis was 98.4%, and overall survival was 97.5%, of which 0.6% of the deaths had been cancer specific. The area under the curve for the PersonalRT27 was 0.76 (95% CI [0.70, 0.81]), sensitivity was 78%, and the specificity was 58.9%. We used these factors to create an inhospital web-based nomogram. Conclusions The PersonalRT27 is a novel tool that integrates clinical-pathological, molecular, and genetic parameters. External and independent validation will be required to implement its clinical use. Genomic assays impact the choice of adjuvant systemic treatment for patients with early-stage breast cancer. However, the same evidence does not exist for decision making regarding adjuvant locoregional therapy. In other words, can the clinically approved genomic assays predict the risk of locoregional recurrende as a primary event. The main objective of this work was to identify the clinicopathological, molecular, and genetic parameters that allow patients to be more precisely categorised into risk groups, in order to create a locoregional recurrence risk-classification tool, the PersonalRT27.
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Francés-Monasterio M, García-Minarro Á, Paredes-Pérez AB, García-Duque O. Merkel cell carcinoma: Clinical and anatomopathological features, management and survival in our centre. CIR CIR 2021; 88:448-452. [PMID: 32567591 DOI: 10.24875/ciru.20001596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To summarize the features of the Merkel cell carcinoma (MCC) and to sistematyze its diagnosis and therapeutic management. Method We performed a literature review in PubMed, obtaining a total of 3,308 articles, selecting 10 for its complete reading and 22 for the reading of the summary according to the content. Results In none of our patients, the MCC was the first suspected diagnosis. The treatment consisted in surgical excision with tumor free margins and lymphadenectomy. We offered ad-juvant RT which they rejected. They remain disease-free at the present time. Conclusions MCC is a rare and aggressive disease which presents as a fast-growing solitary asymptomatic erythematous nodule in those areas of skin which are exposed to sunlight in elderly patients. The main risk factors include radiative ultraviolet, immunosuppression and merkel cell polyomavirus. Surgery is the main loco-regional treatment. Lymph node metastases in the course of the disease is one of the main prognostic factors. If there are no adenopaties, sentinel lymph node biopsy must be done; if there are adenopaties or a positive biopsy, lymphadenectomy is indicated. Radiotherapy is indicated in all stages of disease since it has shown to improve loco-regional control. In distant metastatic disease, immunotherapy and participating in clinical trials are the first choice.
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Affiliation(s)
- Mónica Francés-Monasterio
- Servicio de Cirugía Plástica y Reparadora. Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | - Ángela García-Minarro
- Servicio de Dermatología. Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | - Ana B Paredes-Pérez
- Servicio de Anatomía Patológica. Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | - Orlando García-Duque
- Servicio de Cirugía Plástica y Reparadora. Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
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Ponce Blasco P, Sánchez Llopis A, Barrios Arnau L, Salvador Marín M, Di Capua Sacoto C, Rodrigo Aliaga M. [Hyperbaric oxygen therapy efficacy in the treatment of hematuria due to radiation cystitis. Experience in a reference center.]. ARCH ESP UROL 2021; 74:215-223. [PMID: 33650536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in the treatment of hemorrhagic radiation cystitis (HRC). MATERIAL AND METHOD Retrospective study of patients diagnosed with hematuria secondary to HRC after pelvic radiation from January 2005 to January 2017 who were treated with HBOT. Demographic and clinical variables were collected. A descriptive univariate and multivariate statistical analysis using Cox regression was carried out. The treatment was considered effective when there was a total or partial remission of the hematuria based on the Radiation Therapy Oncology Group (RTOG) scoring schema. Partial remission was defined as the presence of hematuria grade 2 or less. RESULTS A total of 67 patients with a mean age of 68,6 years (39-87) were included. 65,7% men and 34,3% women. The RT was administered in 64,2% of the cases by urological cause, prostate cancer. The av-erage dose of RT was 75,24 Gy (45-180). The mean from the RT to the HBOT treatment was 55,97 months (4-300) and from the beginning of the hematuria until the treatment was 11,3 months (1-48). Response was observed in 51 (76,1%) patients, total in 50,7% and partial in 25,4% of cases. Patients with a degree of hematuria less than 3, those who were administered more than 30 sessions and those who did not require transfusion or hospital admission, responded significantly bet-ter to treatment with HBOT (p<0.05) according to the univariate and multivariate analysis. No adverse effects related to treatment were reported, only one patient was excluded due to claustrophobia. CONCLUSIONS Hyperbaric oxygen therapy is an effective and safe treatment for the management of hematuria due to radiological cystitis secondary to radiotherapy. A better response was observed in patients with a lower degree of hematuria and those who could be administered a greater number of sessions.
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Affiliation(s)
- Paula Ponce Blasco
- Servicio de Urología. Hospital General Universitario de Castellón. Castellón de la Plana. España
| | - Anna Sánchez Llopis
- Servicio de Urología. Hospital General Universitario de Castellón. Castellón de la Plana. España
| | - Laura Barrios Arnau
- Servicio de Urología. Hospital General Universitario de Castellón. Castellón de la Plana. España
| | - Manuel Salvador Marín
- Servicio de Medicina Hiperbárica. Hospital General Universitario de Castellón. Castellón de la Plana. España
| | | | - Miguel Rodrigo Aliaga
- Servicio de Urología. Hospital General Universitario de Castellón. Castellón de la Plana. España
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Ibarrondo O, Lizeaga G, Martínez-Llorente JM, Larrañaga I, Soto-Gordoa M, Álvarez-López I. Health care costs of breast, prostate, colorectal and lung cancer care by clinical stage and cost component. Gac Sanit 2021; 36:246-252. [PMID: 33612313 DOI: 10.1016/j.gaceta.2020.12.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To measure 3-year care costs of breast, prostate, colorectal and lung cancers disaggregated by site and clinical stage. METHOD A retrospective observational design was employed to investigate care costs of cases recorded in the Registry of the Basque Country between 2010 and 2015. Data gathered included TNM stage and demographic, clinical and resource use variables. Total costs per patient with stage IV disease were calculated by combining generalized linear models with parametric survival analysis. Unit costs were obtained from the analytical accounting system of the Basque Health Service. RESULTS The sample comprised 23,782 cancer cases (7801 colorectal, 5530 breast, 4802 prostate and 5649 lung cancer). The mean 3-year costs per patient with stage I to III disease were €11,323, €13,727, €8,651 and €12,023 for colorectal, breast, prostate and lung cancer, respectively. The most important cost components were surgery and chemotherapy. Total survival-adjusted costs until death for patients with stage IV disease (€27,568, €26,296, €16,151 and €15,931 for breast, colorectal, lung and prostate cancer, respectively) were higher than the 3-year costs for those with earlier-stage disease. CONCLUSIONS This study quantitatively shows the pattern of changes in the economic burden of cancer throughout its natural history and the great magnitude of this burden for the health system. The use of indicators based on real-world data from each regional health service would allow cancer care in each region to be tailored to local population needs.
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Affiliation(s)
- Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Spain; RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain.
| | - Garbiñe Lizeaga
- Basque Health Service (Osakidetza), Donostia University Hospital, Pharmacy Services, Donostia-San Sebastián, Spain
| | - José Miguel Martínez-Llorente
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Accounting Department, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Igor Larrañaga
- Kronikgune Institute for Health Service Research, Barakaldo, Bizkaia, Spain
| | - Myriam Soto-Gordoa
- Mondragon Unibertsitatea, Faculty of Engineering, Arrasate-Mondragón, Gipuzkoa, Spain
| | - Isabel Álvarez-López
- Biodonostia Health Research Institute, Donostia-San Sebastián, Spain; RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain; Basque Health Service (Osakidetza), Donostia University Hospital, Medical Oncology Service, Donostia-San Sebastián, Spain
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21
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Pérez-López C, Álvarez-Escolá C, Isla Guerrero A. Therapeutic approach to non-functioning pituitary adenomas. Med Clin (Barc) 2021; 156:284-289. [PMID: 33454125 DOI: 10.1016/j.medcli.2020.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 10/22/2022]
Abstract
The treatment of non-functioning pituitary adenomas raises two questions: when should they be treated and what role does each available treatment play. We review the usefulness of the different treatments and propose a therapeutic scheme based on the existing literature. Active treatment of pituitary adenomas should be performed when they produce symptoms, have contact with the optic tract, or have grown on imaging tests. The treatment is surgical, using radiotherapy for cases with significant non-removable postsurgical tumour remnants and for those in which histopathology studies show aggressive features. Medical treatment is reserved for situations in which surgical and radiotherapy treatments have been exhausted. The most advisable surgical treatment is endoscopic, although experienced neurosurgeons achieve results with microsurgery that are only slightly inferior.
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Affiliation(s)
- Carlos Pérez-López
- Servicio de Neurocirugía. Hospital Universitario La Paz, Madrid, España.
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22
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Reyes-Arroyo J, Mejía-Ríos LC, Fernández-Vivar E, Gutiérrez-Quiroz CT, Priego-Niño A, Montiel-Jarquín ÁJ. Urachal adenocarcinoma. Analysis of 8 years in a third level medical facility. CIR CIR 2021; 89:71-76. [PMID: 33498072 DOI: 10.24875/ciru.19001597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Urachal cancer is one of the rarest and aggressive malignant diseases of the bladder; its incidence was 0.2% of all bladder cancers in 2012. It occurs in advanced stages, among stage IV tumors 58% die at 22 months. It is originated from urachal, an embryological structure that is present in 32% of the adult population. Objective To present a case series of urachal cancer in a third level medical facility. Method Case series. Clinical data from patients with of urachal cancer during 2011 to 2019 were analyzed. The variables included were age, gender, smoking, clinical stage, treatment and evolution. Descriptive statistics, measures of central tendency and dispersion were used. Results There were seven patients; three men and four women; the mean age was 54.4 years. The most frequent histological type was mucinous adenocarcinoma. Partial cystectomy was performed with bilateral pelvic lymphadenectomy in three (42.8%) patients, radical cystectomy plus bilateral pelvic lymphadenectomy in the remaining four (57.2% patients). Conclusions Urachal cancer is rare, clinical manifestations occur late. Hematuria is the most frequent clinical sign. The medium term prognosis is bad.
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Affiliation(s)
- Jorge Reyes-Arroyo
- Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México
| | - Laura C Mejía-Ríos
- Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México
| | - Elieser Fernández-Vivar
- Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México
| | - Claudia T Gutiérrez-Quiroz
- Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México
| | - Alejandro Priego-Niño
- Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México
| | - Álvaro J Montiel-Jarquín
- Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México
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Ramos-Martínez E, Lagunas-Rangel FA. Anaplastic extraosseous (extramedullary) plasmacytoma in the right nostril. Rev Esp Patol 2020; 53:257-263. [PMID: 33012497 DOI: 10.1016/j.patol.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
Extraosseous (extramedullary) plasmacytomas are rare plasma cell neoplasms that can result in an erroneous and/or delayed diagnosis as often they are not considered in the differential diagnosis due to their rarity. Furthermore, the anaplastic type is one of the most difficult to recognize in biopsies. We report the case of a patient with an extraosseous plasmacytoma occluded in the right nostril. Its prompt and accurate diagnosis resulted in early treatment and a good outcome, despite the tumour being anaplastic with the risk of progressing into a plasma cell myeloma. The patient shows no recurrence or disease progression after 10 years of follow-up. Our case highlights the clinical and pathological characteristics of this rare disorder that should be considered in order to improve diagnostic criteria and thus early treatment. We also reviewed the pertinent literature.
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Affiliation(s)
| | - Francisco Alejandro Lagunas-Rangel
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV), Mexico City, Mexico.
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Echazarreta-Gallego E, Elía-Guedea M, de Laspra ECD, Gonzales-Sejas AG, Hernáez-Arzoz A, Ramírez-Rodríguez JM. Colostomy stenosis due to chronic radiation enteritis. Report of clinical case. CIR CIR 2020; 88:48-50. [PMID: 32963377 DOI: 10.24875/ciru.20001418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Antecedentes La colitis actínica es una endarteritis obliterante ocasionada por exposición a radiación ionizante. Se manifiesta de manera aguda (primeras semanas) o crónica (hasta 30 años después). Caso clínico Paciente tratado por neoplasia rectal mediante quimiorradioterapia y amputación abdominoperineal. En su estudio por cuadros oclusivos se objetiva una estenosis colónica desde la colostomía hasta el ángulo hepático. Se lleva a cabo cirugía resectiva, con resultado favorable. Conclusiones En los próximos años es previsible un aumento en la incidencia de esta patología. Resultará fundamental establecer un nivel de sospecha que nos permita detectar los casos, así como establecer medidas que prevengan su aparición. Background Radiation colitis is a obliterans endarteritis caused by exposure to ionizing radiation. It manifests early or late in time. Case report We present a case of rectal cancer treated with chemoradiotherapy and abdominoperineal resection ten years before. Patient suffered occlusive periods and colonoscopy showed stenotic colon extending from the colostomy up hepatic flexure. Colonic resection surgery was performed. Conclusions It will be essential to establish a high level of suspicion that allows us to detect cases and it also will be essential to establish measures to prevent its occurrence.
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Affiliation(s)
- Estíbaliz Echazarreta-Gallego
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza, España
| | - Manuela Elía-Guedea
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza, España
| | - Elena Córdoba-Díaz de Laspra
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza, España
| | - Ariel G Gonzales-Sejas
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Zaragoza. Zaragoza, España
| | - Alba Hernáez-Arzoz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza, España
| | - José M Ramírez-Rodríguez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza, España
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León X, García J, Farré N, Majercakova K, Avilés-Jurado FX, Quer M, Camacho M. Predictive capacity of IL-8 expression in head and neck squamous carcinoma patients treated with radiotherapy or chemoradiotherapy. Acta Otorrinolaringol Esp (Engl Ed) 2020; 72:S0001-6519(20)30146-1. [PMID: 32972719 DOI: 10.1016/j.otorri.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/01/2020] [Accepted: 05/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To analyse the relationship between the transcriptional expression of interleukin-8 (IL-8) and response to treatment with radiotherapy or chemo-radiotherapy in patients with squamous cell carcinoma of the head and neck (SCCHN). MATERIAL AND METHODS Retrospective study from tumour biopsies obtained before a treatment with radiotherapy or chemo-radiotherapy in 87 patients with SCCHN. We had a sample of healthy mucosa in 35 cases. We determined the transcriptional expression of IL-8 with RT-PCR. The transcriptional expression of IL-8 was categorized according to the local control of the disease with a recursive partitioning analysis. RESULTS The transcriptional expression of IL-8 in tumour tissue was about 50 times higher than that in the samples of healthy mucosa. Patients with a high transcriptional expression of IL-8 (n=56) had a 5-year local recurrence-free survival of 65.6%, and for patients with low expression (n=31) it was 90.2% (P=.017). According to the results of a multivariate analysis, patients with high expression of IL-8 had a 4.1 higher risk of local recurrence of the tumour. CONCLUSIONS SCCHN have a significant increase in transcriptional expression of IL-8 in relation to non-tumour tissue. Tumours with high IL-8 expression have an increased risk of local recurrence after treatment with radiotherapy or chemo-radiotherapy.
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Affiliation(s)
- Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España.
| | - Jacinto García
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - Nuria Farré
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - Katarina Majercakova
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - Francesc-Xavier Avilés-Jurado
- Servicio de Otorrinolaringología, Hospital Clínic, IDIBAPS Universitat de Barcelona, Barcelona, España; Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya. 2017-SGR-01581, Barcelona, España; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (CIBERDEM), Madrid, España
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España
| | - Mercedes Camacho
- Genomics of Complex Diseases, Research Institute Hospital Sant Pau, IIB Sant Pau, Barcelona, España
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Wang G, Li G, Wu J, Song P. Analysis of prognostic factors for Tis-2N0M0 early glottic cancer with different treatment methods. Braz J Otorhinolaryngol 2020; 88:375-380. [PMID: 32830100 PMCID: PMC9422441 DOI: 10.1016/j.bjorl.2020.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION In many regions, laryngeal carcinoma is a common upper respiratory tract cancer, most commonly involving the glottic region. The treatment of early glottic cancer includes radiotherapy, open surgery and laryngeal laser microsurgery. However, the preferred treatment for early glottic cancer is still controversial. OBJECTIVES To study the factors affecting the 5-year survival rate of Tis-2N0M0 early glottis cancer and to demonstrate the oncological safety of different treatments. METHODS 144 patients with early glottic cancer were analyzed retrospectively. All patients were clinically node negative. 53 patients underwent open surgery, transoral CO2 laser microsurgery in 46 cases and radiotherapy in 45 cases. The patients were followed up for 26 - 84 months, with an average follow-up period of 62.9 months. RESULTS The 5-year overall survival was 82.6%. The 5 year survival rates of open surgery, laser microsurgery and radiotherapy were 83.0%, 82.6% and 82.2%, respectively. There was no significant difference in 5-year survival rate among the three treatments (p = 0.987). In multivariate analysis, age, T-stage, pathological grading, and anterior commissure involvement were important prognostic factors for early glottic cancer. CONCLUSIONS There was no significant difference in 5 year survival rate among patients treated by either radiotherapy, laser microsurgery or open surgery for early glottic cancer. We urge more attention to the age, T-stage, pathological grade, and anterior commissure involvement of the patients.
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Affiliation(s)
- Guanyu Wang
- Heping Hospital Affiliated to Changzhi Medical College, Department of Radiotherapy, Changzhi, PR China
| | - Guodong Li
- Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Department of Otolaryngology, Taiyuan, PR China
| | - Jianjun Wu
- Heping Hospital Affiliated to Changzhi Medical College, Department of Radiotherapy, Changzhi, PR China
| | - Penghui Song
- Heping Hospital Affiliated to Changzhi Medical College, Department of Radiotherapy, Changzhi, PR China.
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Carvalho GBD, Kohler HF, Lira RB, Vartanian JG, Kowalski LP. Survival results of 3786 patients with stage I or II laryngeal squamous cell carcinoma: a study based on a propensity score. Braz J Otorhinolaryngol 2020; 88:337-344. [PMID: 32771434 PMCID: PMC9422720 DOI: 10.1016/j.bjorl.2020.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/08/2020] [Accepted: 06/20/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Laryngeal squamous cell carcinoma is the second most prevalent malignancy among head and neck tumors, and the treatment of patients with stage I or II disease can be performed with surgery or radiation therapy. National population studies describing therapeutic results comparing these modalities are unusual, but they can be very important to direct treatment guidelines. Objective To evaluate the survival results of patients with laryngeal squamous cell carcinoma at clinical stages I or II, according to the main therapeutic modalities used. Methods Cross-sectional, population-based study using the database of Fundação Oncocentro de São Paulo from January 2000 to March 2019. Inclusion criteria were patients with laryngeal squamous cell carcinoma in clinical stages cT1-2N0. To compensate for the non-random allocation of patients and the imbalance between confounding variables between groups, we used the propensity score methodology. Results A total of 3786 patients met the inclusion criteria. Regarding the cT stage, there were 2171 patients (57.3%) with cT1 tumors. Patients in the public health system had a longer time between diagnosis and treatment (p < 0.001). The analysis by propensity score showed that patients treated with surgery had a tendency towards better disease-specific survival (p = 0.012). Comparing radiotherapy alone versus its combination with radiochemotherapy, radiotherapy alone showed a tendency towards a better survival rate (p < 0.001). Conclusion Analysis by propensity score identified better results for disease-specific survival in patients with laryngeal squamous cell carcinoma at clinical stages I and II treated by surgery when compared to radiotherapy.
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Affiliation(s)
- Genival Barbosa de Carvalho
- A C Camargo Cancer Center, Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, São Paulo, SP, Brazil.
| | - Hugo Fontan Kohler
- A C Camargo Cancer Center, Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, São Paulo, SP, Brazil
| | - Renan Bezerra Lira
- A C Camargo Cancer Center, Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, São Paulo, SP, Brazil
| | - José Guilherme Vartanian
- A C Camargo Cancer Center, Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, São Paulo, SP, Brazil
| | - Luiz Paulo Kowalski
- A.C. Camargo Cancer, Centro de Referência de Tratamento dos Pacientes com Tumores de Cabeça e Pescoço, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia de Cabeça e Pescoço e LIM 28, São Paulo, SP, Brazil
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Oliver Guillén JR, Hernando Almudi E, Molina Osorio G, Ibañez Carreras R, Font Gómez JA, Vicente Gómez I, García Mur C, Casamayor Franco MC. Intraoperative radiotherapy in early breast cancer: observational comparison with whole breast radiotherapy. Cir Esp 2020; 99:132-139. [PMID: 32493607 DOI: 10.1016/j.ciresp.2020.04.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In early breast cancer (EBC), a single dose of intraoperative radiotherapy (IORT) might be an option to standard whole breast radiotherapy (WBRT). However, there is no consensus about its use and clinical results. AIM to analyse the morbidity and oncological outcomes of IORT as monotherapy in EBC. METHODS A single centre observational analytic study was performed. A prospective IORT cohort (2015-17) and a retrospective WBRT cohort (2012-17) were selected following the same criteria: ≥ 45 y.o., invasive ductal carcinoma or variants, radiological tumour size ≤ 3 cm, positive oestrogenic receptors, negative HER2, cN0; exclusion criteria: lymphovascular invasion, multicentricity/multifocality, BRCA mutation and neoadjuvant therapy. Clinical, histological, surgical, oncological characteristics and complications were collected. RESULTS A total of 425 cases were selected: 217 in IORT cohort and 208 in WBRT cohort. Average age in IORT and WBRT groups was 67±9.5 and 64.8 ± 9.9 y.o. respectively (p = 0.01). ASA 3 risk score patients were 17.7% in IORT and 24 cases in WBRT (p = 0.027). There were no differences in histological results or tumoral stage. Average follow up was 24.4 ± 8 months in IORT and 50.5 ± 18 months in WBRT (p < 0.001). No differences were detected in local recurrence, metastases or mortality. Complications that required reintervention or hospitalization were similar in both groups. A total of 3 and 14 cases developed early severe dermatitis in IORT and WBRT groups respectively (p = 0.01). CONCLUSION IORT as monotherapy in selected patients with EBC stands for an alternative option versus WBRT. It seems especially useful in advanced-age patients with severe comorbidities. IORT associates lesser early severe dermatitis.
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Affiliation(s)
- José Ramón Oliver Guillén
- IIS Aragón. S. de Cirugía General y del Ap. Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Ernesto Hernando Almudi
- S. de Cirugía General y del Ap. Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | - Reyes Ibañez Carreras
- S. de Oncología Radioterápica, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | | | - Carmen García Mur
- S. de Radiología, Hospital Universitario Miguel Servet, Zaragoza, España
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Tabuenca Del Barrio L, Gasparini C, Devoto MH. Intramuscular cavernous venous malformation of extraocular muscles. Fractionated stereotactic radiotherapy as a therapeutic alternative. ACTA ACUST UNITED AC 2020; 95:293-296. [PMID: 32409245 DOI: 10.1016/j.oftal.2020.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 10/24/2022]
Abstract
Intramuscular cavernous venous malformations affecting extraocular muscles are extremely uncommon. Due to their location, complete resection could be difficult. A clinical case is presented of an inferior rectus muscle orbital cavernous malformation treated with fractionated stereotactic radiotherapy after post-surgical excision recurrence. The malformation responded to radiotherapy with a reduction in size and symptoms. Fractionated stereotactic radiotherapy is an alternative and effective treatment for cavernous venous malformations that are surgically challenging due to their radiotherapy sensitivity.
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Affiliation(s)
- L Tabuenca Del Barrio
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - C Gasparini
- Consultores Oftalmológicos, Buenos Aires, Argentina
| | - M H Devoto
- Consultores Oftalmológicos, Buenos Aires, Argentina
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Beltran Vilagrasa M, Varó Curbelo A, Fa Asensio X, García Relancio D, Giralt López de Sagredo J. [Safety in radiationtherapy. Results after 9 years implementation of incidents reporting system]. J Healthc Qual Res 2020; 35:173-181. [PMID: 32467079 DOI: 10.1016/j.jhqr.2020.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Radiation therapy (RT) is a complex process that employs high-dose radiation for therapeutic purposes. Incident reporting and analysis, in addition to being a legal requirement in RT, provides information that helps to improve patient safety. This paper describes our experiences over a 9 year period in which a local incident reporting and learning system (SNAI) specific to RT was employed. MATERIALS AND METHODS The center has 4 lineal accelerators that treat a total of 1900 patients annually. The first action taken with a view to improving patient safety was the implementation of a multidisciplinary RT safety group (GSRT), who decided to employing a methodology based on incident reporting. For this purpose, a local SNAI was implemented, adapting the ROSEIS incident reporting system used and consolidated by the European Society of Radiation Oncology Therapy (ESTRO). All incidents in which patients received an incorrect RT session were considered adverse events (AE) and were thus analyzed. Finally, the opinion of the professionals involved in relation to the SNAI and the functioning of the safety group was evaluated by means of a survey. RESULTS From June 2009 to October 2018, 1708 incidents were recorded, with an increasing incidence observed over time. Approximately 2.5% of the incidents reported were AE. The remainders were events that did not affect the patient. As many as 55% of incidents were detected in the treatment administration phase. Radiotherapy technicians were the professionals who reported more incidents. The majority of recorded cases originated from procedural shortcomings relating to communication or work protocols. Implemented remedial actions were aimed at reducing the frequency of AE and facilitating its early detection. Actions employed were essentially: drafting and revision of protocols and circuits, implementation of checklists, and training actions. Of the workers surveyed, 85% positively valued the incorporation of the SNAI and the existence of a safety group. However, 15% of the professionals considered that the methodology used in the analysis of incidents was not totally objective i.e punitive in nature. CONCLUSIONS The safety of the patient receiving RT has been approached from a methodology based on a local SNAI. The analysis of reported incidents has promoted various actions aimed at improving the safety of patients receiving RT. The methodology used has been well received by the workers and has helped to introduce a culture of patient safety for the majority of professionals involved. Furthermore, the local SNAI facilitates compliance with European regulations regarding the obligation to record incidents in RT.
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Affiliation(s)
- M Beltran Vilagrasa
- Servicio de Física y Protección Radiológica, Hospital Universitario Vall d'Hebron, Barcelona, España.
| | - A Varó Curbelo
- Servicio de Física y Protección Radiológica, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - X Fa Asensio
- Servicio de Física y Protección Radiológica, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - D García Relancio
- Servicio de Oncología Radioterápica, Hospital Universitario Vall d'Hebron, Barcelona, España
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Özaydın Ş, Ataş E, Karadurmuş N, Emirzeoğlu L, Arpacı F. Outcomes of bladder preservation therapy on survival in patients with muscle-invasive bladder cancer. ARCH ESP UROL 2020; 73:41-46. [PMID: 31950922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The standard of care in muscle invasive bladder cancer is radical cystectomy; however; transurethral resection (TUR) followed by external radiotherapy and systemic chemotherapy demonstrates comparable results with radical cystectomy in terms of local control and survival rates. OBJECTIVES To evaluate our results of multimodality bladder preservation therapy (BPT) in patients who had muscle-invasive bladder cancer and were reluctant to radical cystectomy. METHODS: The retrospective analysis of twenty-three patients with stage T2 transitional cell bladder cancer that were consecutively treated with BPT was performed. Treatment strategy included radical TUR followed by 3 cycles of cisplatin, gemcitabine combination, and radiotherapy of 64 Gy as adjuvant treatment. The Kaplan-Meier survival estimates and log rank were calculated. RESULTS Median follow-up time was 58 (15-158) months. Disease-free survival (DFS) and five year overall survival (OS) rates for 23 patients were 55.9% and 63.9%, respectively. Cancer-specific OS was 67%. There were no grade 3 or higher complications. CONCLUSIONS Our small patient group suggests that BPT can be safely applied in selected cases with bladder cancer or in patients that refused radical cystectomy.
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Affiliation(s)
- Şükrü Özaydın
- Department of Medical Oncology. Gülhane Training and Research Hospital. Ankara. Turkey
| | - Erman Ataş
- Department of Paediatric Oncology. Gülhane Training and Research Hospital. Ankara. Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology. Gülhane Training and Research Hospital. Ankara. Turkey
| | - Levent Emirzeoğlu
- Department of Medical Oncology. Sultan Abdülhamid Han Training and Research Hospital. İstanbul. Turkey
| | - Fikret Arpacı
- Department of Medical Oncology. Gülhane Training and Research Hospital. Ankara. Turkey
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Iglesias P, Magallón R, Mitjavila M, Rodríguez Berrocal V, Pian H, Díez JJ. Multimodal therapy in aggressive pituitary tumors. ACTA ACUST UNITED AC 2019; 67:469-485. [PMID: 31740190 DOI: 10.1016/j.endinu.2019.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/19/2019] [Accepted: 08/01/2019] [Indexed: 01/09/2023]
Abstract
The concept of aggressive pituitary tumor (APT) has been precisely defined in recent years. These tumors are characterized by morphological (radiological or histopathological) data of invasion, proliferative activity superior to that of typical adenomas and a clinical behavior characterized by resistance to standard therapies and frequent recurrences. The absence of cerebrospinal or distant metastases differentiates them from the pituitary carcinoma. APTs account for about 10% of all pituitary neoplasm. Proper diagnostic implies participation not only of radiological and hormonal investigation but also a thorough pathological assessment including proliferation markers and immunohistochemistry for hormones and transcription factors. Surgical resection, aiming gross total resection or tumor debulking, is the mainstay initial therapy in most patients. Most patients with APTs need more than one surgical intervention, pituitary radiation, sometimes on more than one occasion, and multiple sequential or combined medical treatments, to finally be doomed to unusual treatments, such as alkylating agents (temozolomide alone or in combination), molecular targeted therapies, or peptide receptor radionuclide therapy. Multimodal therapy, implemented by experts, preferably in specialized centers with high volume caseload, is the only way to improve the prognosis of patients with these uncommon tumors. The research needs in this area are multiple and include a greater knowledge of the molecular biology of these tumors, establishment of protocols for monitoring and sequencing of treatments, development of multicenter studies and international registries.
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Affiliation(s)
- Pedro Iglesias
- Department of Endocrinology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.
| | - Rosa Magallón
- Department of Radiation Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mercedes Mitjavila
- Department of Nuclear Medicine, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Héctor Pian
- Department of Pathology, Hospital Universitario, Ramón y Cajal, Madrid, Spain
| | - Juan J Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Asencio Pascual JM, Fernandez Hernandez JA, Blanco Fernandez G, Muñoz Casares C, Álvarez Álvarez R, Fox Anzorena B, Lozano Borbalas A, Rodriguez Blanco M, Cantin Blázquez S, Artigas Raventós V. Update in pelvic and retroperitoneal sarcoma management: The role of compartment surgery. Cir Esp 2019; 97:480-488. [PMID: 31521244 DOI: 10.1016/j.ciresp.2019.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/22/2019] [Accepted: 06/21/2019] [Indexed: 12/31/2022]
Abstract
Surgery for retroperitoneal sarcomas should be "en bloc" compartmental, which involves resection of unaffected organs. Its upfront use is key, providing a high percentage of resections with negative margins, resulting in a better local control and increased survival in many patients. Preservation of organs should be done in an individualized manner, especially in the pelvic location, and adapted to the histological aggressiveness of the tumor. Preoperative biopsy is able to establish the diagnosis of sarcoma subtype and consequently an adequate perioperative strategy. These patients should be managed by expert surgeons at referral centers with multidisciplinary units and oncology committees. The use of chemotherapy and radiotherapy is not yet well defined, so it is only recommended at referral centers with clinical trials. Currently, this is the only option to offer the best morbidity and mortality rates, as well as possible improvements in the survival of these patients.
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Affiliation(s)
| | | | | | | | | | | | - Alicia Lozano Borbalas
- Oncología Radioterápica, Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, España
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González-Vargas PM, Thenier-Villa JL, Sanromán Álvarez P, Serantes Combo A, Calero Félix L, Galárraga Campoverde RA, Azevedo González E, Martín-Gallego Á, Martínez-Rolan R, de la Lama Zaragoza A, Conde Alonso C. Hemangiopericytoma/Solitary Fibrous Tumor in the central nervous system. Experience with surgery and radiotherapy as a complementary treatment: A 10-year analysis of a heterogeneous series in a single tertiary center. Neurocirugia (Astur) 2019; 31:14-23. [PMID: 31351895 DOI: 10.1016/j.neucir.2019.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/29/2019] [Accepted: 06/09/2019] [Indexed: 11/19/2022]
Abstract
Hemangiopericytoma and Solitary Fibrous Tumor are tumors with low incidence. They have a tendency to recur locally and to metastasize. The WHO integrated both tumors into a new entity but one of the pending issues is to demonstrate the effectiveness of surgery plus complementary radiotherapy (RT) and standardize the use of it. We reviewed the data from 10 years. We assessed pathologic and radiologic characteristics. The operation records were evaluated to determine the features and extent of tumor resection. We compared the outcomes in patients using or not RT. The mean follow-up was 74.8 months, with a range of 12 and 210 months. The population included 3 males (30%) and 7 females (70%). The most common location was brain convexity (30%), the remaining were cervical and lumbar spine, sacrum, intraventricular, torcular, sphenoid ridge and intraorbital. Postoperative external beam radiotherapy was delivered in 7 patients (70%), the criteria were a partial resection or WHO II and III histological grades. 2 patients developed local recurrences at 12 and 19 months after initial surgery. 1 patient underwent 2 surgeries, and the other, 4 surgeries. The mean recurrence free survival rate was 15.5 months. Distant metastases were found in 4 patients. 3 of the 10 patients died. Five-year overall survival rate was 66% and mean overall survival was 76 months. A safe and complete resection in the first surgery is the most important prognostic factor. Complementary RT can be helpful, even in cases of complete resection in WHO low-grade.
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Affiliation(s)
| | - José Luis Thenier-Villa
- Department of Neurosurgery, Hospital Universitari Arnau de Vilanova, Lleida, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | - Pablo Sanromán Álvarez
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | | | - Lourdes Calero Félix
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain
| | - Raúl Alejandro Galárraga Campoverde
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | - Eva Azevedo González
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | - Álvaro Martín-Gallego
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | - Rosa Martínez-Rolan
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | - Adolfo de la Lama Zaragoza
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
| | - Cesáreo Conde Alonso
- Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain; Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain
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Caño-Velasco J, Herranz-Amo F, Barbas-Bernardos G, Polanco-Pujol L, Verdú-Tartajo F, Lledó-García E, Hernández-Fernández C. Oncological control in high-risk prostate cancer after radical prostatectomy and salvage radiotherapy compared to radiotherapy plus primary hormone therapy. Actas Urol Esp 2019; 43:190-197. [PMID: 30878158 DOI: 10.1016/j.acuro.2018.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/28/2018] [Accepted: 07/30/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION In patients with high-risk localized prostate cancer (HRPCa), multimodal treatment plays a fundamental role. OBJECTIVE To compare relapse-free survival (RFS) in patients with HRPCa, treated primarily with radiotherapy (RT)+hormone therapy (HT) versus radical prostatectomy (RP) and salvage RT (sRT)±HT when biochemical recurrence (BCR) appears. MATERIAL AND METHODS Retrospective analysis of 226 patients with HRPCa (1996-2008), treated primarily with RT+HT (n=137) or RP (n=89). The Kaplan-Meier method has been used to evaluate survival and the log-rank test has been used to evaluate the contrast between the different categories of the variables. Multivariate analysis has been performed using Cox regression to determine variables with an impact on RFS with statistical significance (P<0.05). RESULTS The median follow-up of the series was 111 (IQR 85-137.5) months. After RT+HT, 32 (23.4%) patients relapsed, and after RP (P=0.0001), 41 (46.1%) cases. When comparing the primary treatments, the RFS at 5 and 10 years was higher after RT+HT versus RP in monotherapy (P=0.001). The primary treatment with RT+HT reduced the risk of BCR when compared to the RP (HR=0.41, P=0.002). The estimation of the RFS at 5 and 10 years after RP+sRT±HT was 89.7 and 87.1%, while after primary RT+HT was 91.6 and 71.1%, respectively (P=0.01). The only factor that behaved as an independent predictor of RFS was the multimodal treatment with RP+sRT±HT when BCR showed up (HR=2.39, P=0.01). CONCLUSION In HRPCa, multimodal treatment with RP+sRT±HT if BCR, significantly improves RFS with respect to treatment with RT+HT.
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Linares Espinós E, Ogaya-Piniés G, Martínez-Salamanca JI. Salvage robot-assisted radical prostatectomy following failed local treatments. ARCH ESP UROL 2019; 72:277-282. [PMID: 30945654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prostate cancer represents the most commonly diagnosed cancer in men and is the second-leading cause of cancer related death in the United States. Primary treatment for prostate cancer includes radiotherapy or ablative procedures such as cryotherapy, and high-intensity focused ultrasound (HIFU). Unfortunately, a large proportion of these patients, especially with high risk features, may experience disease recurrence within 10 years. Management of recurrent localized prostate cancer is heterogeneous, and radical surgery remains as a salvage option in these patients. The purpose of this article is to offer oncological arguments in favor of salvage robotic radical prostatectomy (sRARP), which could benefit a certain group of patients. Tips and tricks in order to perform a challenging salvage surgery are summarized, as evidence of modern series with acceptable morbidity rates.
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Affiliation(s)
| | - Gabriel Ogaya-Piniés
- Lyx Institute of Urology. Madrid. Spain. Rey Juan Carlos Hospital. Madrid. Spain
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Allué Cabañuz M, Arribas Del Amo MD, Navarro Barlés A, Guemes Sanchez AT. Influence of radiotherapy on immediate breast reconstruction after skin-sparing mastectomy. Before or after: Does it matter? Cir Esp 2018; 97:156-161. [PMID: 30545644 DOI: 10.1016/j.ciresp.2018.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The use of bilateral mastectomy with immediate reconstruction is increasing. Radiotherapy increases complications; however, its uses have been extended. We evaluate the profile of the complications and long-term failure of reconstruction through a comparative analysis with a cohort without radiotherapy. METHODS Retrospective analysis of patients with breast cancer who underwent mastectomy with immediate reconstruction during 2000-2016. Three groups were evaluated: 1) patients who received radiotherapy and posterior breast reconstruction; 2) patients with bilateral mastectomy and immediate reconstruction following adjuvant radiotherapy; 3) patients who did not receive radiotherapy at all. Demographic variables, surgical techniques and postoperative morbidity were assessed. Outcomes and complications were compared between cohorts. Analysis was done with SPSS Statistics. RESULTS 296 bilateral mastectomies with immediate reconstruction. Mean age 48.4 ± 9. No differences in comorbidity in the different groups. Group 1: 125 patients. Radiotherapy given 21.69 months before, on average. Complication rate: 20%. Failure of reconstruction rate: 20%. Reoperation rate: 33.6%. Group 2: 71 patients. Radiotherapy after reconstruction: mean 134.2 days. Complication rate: 36.7%. Failure of reconstruction rate: 21.1%. Reoperation rate: 16.9%. Group 3: 100 patients. Complication rate: 25%. Failure of reconstruction rate: 21%. Reoperation rate: 20%. Morbidity published in patients after radiotherapy before or after reconstruction is higher than complications in patients who did not receive radiotherapy. Even so, in our series they were similar. We found a higher sequelae rate in group 1, with almost double the rate of reoperation. CONCLUSIONS Patients who underwent radiotherapy before reconstruction had a higher risk of developing failure of reconstruction and needing reoperation than those patients who received radiotherapy after breast reconstruction or did not receive radiotherapy at all.
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Affiliation(s)
- Marta Allué Cabañuz
- Unidad de Mama, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | | | - Ana Navarro Barlés
- Unidad de Mama, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Antonio Tomás Guemes Sanchez
- Profesor titular, Universidad de Zaragoza, jefe Unidad de Mama, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Angulo JC, Fonseca J, Esquinas C, Ojea A, Rodríguez A, Rabassa M, Teba F, Escribano G, Cruz F. Adjustable transobturator male system (ATOMS ®) as treatment of stress urinary incontinence secondary to transurethral resection of the prostate. Actas Urol Esp 2018; 42:567-573. [PMID: 29929737 DOI: 10.1016/j.acuro.2018.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/02/2018] [Accepted: 05/04/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Feasibility study to evaluate efficacy and safety of Adjustable Transobturator Male System (ATOMS®) for male stress urinary incontinence (SUI) after transurethral resection of the prostate. MATERIALS AND METHODS Twenty patients were implanted ATOMS® for SUI caused by transurethral resection of the prostate with or without radiotherapy. Incontinence severity was evaluated as mild (2 pads/day), moderate (3-5 pads/day) or severe (≥6pads/day), and dryness as none or one security pad/day. Changes in pad-test and pad-count after adjustment were investigated, together with operative parameters, patient satisfaction with the procedure, and number and grade of complications (Clavien-Dindo). RESULTS Median age was 76.5years. Five patients received previous pelvic radiation (3 prostate, 2 rectal cancer) and 2 (10%) previous failed artificial urinary sphincter with urethral erosion and mechanical failure, respectively. Preoperative SUI was mild in 4 (20%), moderate in 7 (35%) and severe in 9 (45%). Median filling of the system was 13.5ml. Median pad-test decreased from 375±855ml baseline to 10±31.5ml and pad-count from 4±3 to 0±1.5 after adjustment (1±3fillings). Postoperative SUI distribution was mild in 2 (10%), moderate in one (5%) and severe in 2 (10%). Satisfaction rate was 80%, equal for transurethral resection of the prostate with/without previous radiotherapy. No patient had urinary retention after catheter removal. Complications presented in 3 (15%) patients, all minor. After median 38.5mo follow-up no system has been removed, 19 (95%) self-considered better than before and 11 (55%) very much better. CONCLUSION Based on short-term efficacy and patient satisfaction ATOMS® can be considered a realistic alternative for SUI after transurethral resection of the prostate, even after irradiation. Absence of urethral erosion and very limited problems make this alternative especially attractive for cases with diminished dexterity, advanced age and previous failed treatments.
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Affiliation(s)
- J C Angulo
- Hospital Universitario de Getafe, Universidad Europea de Madrid, Getafe, Madrid, España; Fundação Champalimaud, Lisboa, Portugal.
| | - J Fonseca
- Fundação Champalimaud, Lisboa, Portugal
| | - C Esquinas
- Hospital Universitario de Getafe, Universidad Europea de Madrid, Getafe, Madrid, España
| | - A Ojea
- Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - A Rodríguez
- Hospital Arquitecto Marcide, Ferrol, La Coruña, España
| | | | - F Teba
- Hospital Universitario de La Princesa, Madrid, España
| | | | - F Cruz
- Centro Hospitalar São João, Oporto, Portugal
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Diago A, Llombart B, Requena C, Sanmartín O, Guillén C. Postirradiation Morphea in Patients With Breast Cancer: Possible Association With Other Autoimmune Diseases. Actas Dermosifiliogr (Engl Ed) 2018; 110:153-159. [PMID: 30389122 DOI: 10.1016/j.ad.2017.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/01/2017] [Accepted: 10/04/2017] [Indexed: 10/28/2022] Open
Abstract
Postirradiation morphea is an uncommon entity that has been mostly described in women with breast cancer. The increasing use of radiotherapy to treat breast cancer and the clinical similarities between morphea and other conditions, such as radiodermatitis, postirradiation fibrosis, and tumor recurrence, highlights the need for dermatologists to be familiar with this entity. We present a series of 6 women with a mean age of 64.2 years and a mean latency of 9.5 years between radiotherapy for breast cancer and onset of morphea. Four of the patients had a history of autoimmune disease: rheumatoid arthritis, Sjögren syndrome, vitiligo, and Crohn disease. No specific risk factors for postirradiation morphea have been identified to date, although it would appear that a history of autoimmune disease could be associated with an increased risk of morphea in patients treated with radiation therapy.
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Affiliation(s)
- A Diago
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
| | - B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Guillén
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
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Sisinni L, Gich I, Torrent M, Badell I. [Subsequent malignancies after long-term follow-up of pediatric hematopoietic stem cell transplantation]. An Pediatr (Barc) 2018; 90:157-164. [PMID: 30195711 DOI: 10.1016/j.anpedi.2018.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/14/2018] [Accepted: 05/17/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Survival after hematopoietic stem cell transplantation has improved dramatically in recent years. Unfortunately, there is an increased risk of subsequent malignant neoplasms (SMN) in this population and this represents a significant cause of late mortality. PATIENTS AND METHODS In this study, we analyzed the incidence of SMN and the associated risk factors in patients referred at a pediatric age for hematopoietic stem cell transplantation (allogeneic or autologous) in our center. RESULTS We observed 19 cases of SMN in a cohort of 371 patients, with a cumulative incidence of 6, 12, and 36% at 15, 20, and 30 years of follow-up, respectively. The solid tumors were the most prevalent malignancies. The risk was significantly higher than expected in the general population for each tumor type and in the different age ranges (p<.0001). Radiotherapy and chronic GvHD were the main risk factors for the development of SMN in our series. CONCLUSIONS We observed a high incidence of SMN among hematopoietic stem cell transplantation survivors highlighting the need for life-long surveillance.
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Affiliation(s)
- Luisa Sisinni
- Pediatric Hematology, Oncology and HSCT Unit, Santa Creu i Sant Pau University Hospital, Barcelona, España.
| | - Ignasi Gich
- Clinical Epidemiology Department, Santa Creu i Sant Pau University Hospital, Barcelona, España
| | - Monserrat Torrent
- Pediatric Hematology, Oncology and HSCT Unit, Santa Creu i Sant Pau University Hospital, Barcelona, España
| | - Isabel Badell
- Pediatric Hematology, Oncology and HSCT Unit, Santa Creu i Sant Pau University Hospital, Barcelona, España
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Couñago F, Artigas C, Sancho G, Gómez-Iturriaga A, Gómez-Caamaño A, Maldonado A, Caballero B, López-Campos F, Recio M, Del Cerro E, Henríquez I. Importance of 68Ga-PSMA PET/CT in hospital practice. View of the radiation oncologist. Rev Esp Med Nucl Imagen Mol 2018; 37:302-314. [PMID: 30139594 DOI: 10.1016/j.remn.2018.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022]
Abstract
Radiotherapy is a treatment with curative intent, both in patients with primary diagnosis of prostate cancer (PCa) and in patients presenting with biochemical recurrence after radical prostatectomy (RP). Moreover, the use of stereotactic body radiotherapy as a metastasis directed therapy in patients with oligometastatic PCa has significantly increased in the recent years. Conventional imaging techniques, including transrectal ultrasound, computed tomography (CT), morphologic magnetic resonance and bone scintigraphy have traditionally played a minor role in all those clinical scenarios due to its low diagnostic accuracy. The recent development of the positron emission tomography (PET) radiotracer 68Ga-PSMA binding to the prostate specific membrane antigen (PSMA), a transmembrane glycoprotein overexpressed in PCa cells, has shown promising results. Detection rates for PCa lesions are higher than CT and higher than the best technique available, the PET/CT with choline. Its superiority has been demonstrated even at very low PSA levels (<1 ng/ml). This increase in diagnostic accuracy represents a potential impact on patient management, especially in radiotherapy. Even if this imaging technique is already available for routine clinical practice in some European countries, in Spain, unfortunately, there is very limited access. In this review, we analyze the main studies that investigate the usefulness of 68Ga-PSMA PET/CT in patients with PCa and its potential impact on radiotherapy treatments. In addition, we compared the 68Ga-PSMA PET/CT, with the multiparametric magnetic resonance imaging and the PET/CT with choline, in the different clinical scenarios.
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Affiliation(s)
- F Couñago
- Departamento de Oncología Radioterápica, Hospital Universitario Quirónsalud Madrid, Hospital La Luz, Universidad Europea de Madrid, Madrid, España.
| | - C Artigas
- Departamento de Medicina Nuclear y Terapias Metabólicas, Jules Bordet Institute, Bruselas, Bélgica
| | - G Sancho
- Departamento de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - A Gómez-Iturriaga
- Departamento de Oncología Radioterápica, Hospital Universitario Cruces, Biocruces Health Research Institute, Barakaldo, España
| | - A Gómez-Caamaño
- Departamento de Oncología Radioterápica, Complexo Hospitalario Universitario Santiago de Compostela, La Coruña, España
| | - A Maldonado
- Departamento de Medicina Nuclear, Hospital Universitario Quirónsalud, Madrid, España
| | - B Caballero
- Departamento de Oncología Radioterápica, Hospital Universitario de Fuenlabrada, Madrid, España
| | - F López-Campos
- Departamento de Oncología Radioterápica, Hospital Universitario Ramón y Cajal, Madrid, España
| | - M Recio
- Departamento de Radiología, Hospital Universitario Quirónsalud, Madrid, España
| | - E Del Cerro
- Departamento de Oncología Radioterápica, Hospital Universitario Quirónsalud Madrid, Hospital La Luz, Universidad Europea de Madrid, Madrid, España
| | - I Henríquez
- Departamento de Oncología Radioterápica, Hospital Universitario de Sant Joan, Institute d'Investigació Sanitària Pere Virgili (IISPV), Reus, España
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Cañueto J, Jaka A, Toll A. The Value of Adjuvant Radiotherapy in Cutaneous Squamous Cell Carcinoma: A Review. Actas Dermosifiliogr (Engl Ed) 2018; 109:476-484. [PMID: 29759308 DOI: 10.1016/j.ad.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/05/2018] [Accepted: 03/19/2018] [Indexed: 12/24/2022] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in humans and its incidence is rising. Although surgery is the treatment of choice for cSCC, postoperative adjuvant radiotherapy has an important role in local and locorregional disease control. In this review, we analyze the value of postoperative radiotherapy in the management of high-risk cSCC (in particular, cases with perineural invasion), cSCC with positive surgical margins, and locally advanced cSCC (with parotid gland and/or lymph node metastasis).
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Affiliation(s)
- J Cañueto
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, IBSAL Instituto de Investigación Biomédica de Salamanca, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - A Jaka
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - A Toll
- Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, España.
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Afonso-João D, Pacheco-Figueiredo L, Antunes-Lopes T, Morgado LA, Azevedo V, Vendeira L, Silva J, Martins-Silva C. Cumulative incidence and predictive factors of radiation cystitis in patients with localized prostate cancer. Actas Urol Esp 2018; 42:256-61. [PMID: 29169704 DOI: 10.1016/j.acuro.2017.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/15/2017] [Accepted: 06/16/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the cumulative incidence of overall and severe radiation cystitis in a high volume cohort of patients and to investigate its potential predictive factors. METHODS We have performed a retrospective analysis of clinical data from patients diagnosed with localized prostate cancer and treated with radiotherapy at our institution (June 2005-January 2013), and quantified the cumulative incidence of radiation cystitis. Cox regression analysis and Kaplan-Meier curves were computed to evaluate the determinants of radiation cystitis. RESULTS Data from 783 patients was retrieved (557 treated with primary radiotherapy, 188 with adjuvant and 38 with salvage). Median follow-up time was 49 months (P25-P75: 31.8-69.3). At 5 years of follow-up, cumulative incidence of overall and severe radiation cystitis was 9.1 and 1.6%, respectively. No association was found between the incidence of radiation cystitis and age, tumor T stage, baseline PSA level, Gleason score, D'Amico risk classification, radiotherapy setting (primary versus adjuvant versus salvage) or radiation dose applied. CONCLUSIONS Within our cohort, radiation cystitis is an uncommon complication of prostatic radiotherapy treatment, and severe cases requiring hospitalization are even more infrequent. We found no association between tumor characteristics, radiotherapy setting or radiation dose and the cumulative incidence of radiation cystitis.
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Martínez-Arribas CM, González-San Segundo C, Cuesta-Álvaro P, Calvo-Manuel FA. Predictors of urinary and rectal toxicity after external conformed radiation therapy in prostate cancer: Correlation between clinical, tumour and dosimetric parameters and radical and postoperative radiation therapy. Actas Urol Esp 2017. [PMID: 28625534 DOI: 10.1016/j.acuro.2017.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine rectal and urinary toxicity after external beam radiation therapy (EBRT), assessing the results of patients who undergo radical or postoperative therapy for prostate cancer (pancreatic cancer) and their correlation with potential risk factors. METHOD A total of 333 patients were treated with EBRT. Of these, 285 underwent radical therapy and 48 underwent postoperative therapy (39 cases of rescue and 9 of adjuvant therapy). We collected clinical, tumour and dosimetric variable to correlate with toxicity parameters. We developed decision trees based on the degree of statistical significance. RESULTS The rate of severe acute toxicity, both urinary and rectal, was 5.4% and 1.5%, respectively. The rate of chronic toxicity was 4.5% and 2.7%, respectively. Twenty-seven patients presented haematuria, and 9 presented haemorrhagic rectitis. Twenty-five patients (7.5%) presented permanent limiting sequela. The patients with lower urinary tract symptoms prior to the radiation therapy presented poorer tolerance, with greater acute bladder toxicity (P=0.041). In terms of acute rectal toxicity, 63% of the patients with mean rectal doses >45Gy and anticoagulant/antiplatelet therapy developed mild toxicity compared with 37% of the patients with mean rectal doses <45 Gy and without anticoagulant therapy. We were unable to establish predictors of chronic toxicity in the multivariate analysis. The long-term sequelae were greater in the patients who underwent urological operations prior to the radiation therapy and who were undergoing anticoagulant therapy. CONCLUSIONS The tolerance to EBRT was good, and severe toxicity was uncommon. Baseline urinary symptoms constitute the predictor that most influenced the acute urinary toxicity. Rectal toxicity is related to the mean rectal dose and with anticoagulant/antiplatelet therapy. There were no significant differences in severe toxicity between radical versus postoperative radiation therapy.
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Affiliation(s)
- C M Martínez-Arribas
- Servicio de Oncología Radioterápica, Fundación Centro Oncológico de Galicia, A Coruña, España.
| | - C González-San Segundo
- Servicio de Oncología Radioterápica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - P Cuesta-Álvaro
- Servicios Informáticos, Departamento de Estadística, Universidad Complutense de Madrid, Madrid, España
| | - F A Calvo-Manuel
- Servicio de Oncología Radioterápica, Hospital General Universitario Gregorio Marañón, Madrid, España
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Jiménez Gómez M, Navarro-Sánchez A, Lima Sánchez J, Hernández Hernández JR. [Perineal reconstruction: Salvage surgery with 2flaps technique]. CIR CIR 2017; 85 Suppl 1:1-5. [PMID: 28279398 DOI: 10.1016/j.circir.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The principles of perineal reconstructive surgery comprise adequate filling of the defect along with stable and durable skin coverage, with a low morbidity rate. Two-flap perineal reconstruction is a simple, fast and reliable technique that uses a single donor site. This improves scar position with low morbidity. It is based in the use of 2flaps; one flap fills the defect with a «turn over» technique and the other is a rotation - advancement flap for skin coverage. CLINICAL CASE A 52-year-old male diagnosed with Lynch syndrome who underwent laparoscopic abdominoperineal amputation for adenocarcinoma of the lower rectum and developed recurrence 2years later over the perineal scar that required radical resection and perineal reconstruction. CONCLUSION The use of this approach facilitates perineal reconstruction and enables treatment of patients with large and complex defects in frequently irradiated tissues where wound dehiscence and infection are common.
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Affiliation(s)
- Marta Jiménez Gómez
- Departamento de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Antonio Navarro-Sánchez
- Departamento de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Jaime Lima Sánchez
- Departamento de Cirugía Plástica, Estética y Reparadora, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
| | - Juan Ramón Hernández Hernández
- Departamento de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
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Sánchez-Gómez LM, Polo-deSantos M, Rodríguez-Melcón JI, Angulo JC, Luengo-Matos S. High-dose rate brachytherapy as monotherapy in prostate cancer: A systematic review of its safety and efficacy. Actas Urol Esp 2017; 41:71-81. [PMID: 27496770 DOI: 10.1016/j.acuro.2016.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/23/2016] [Accepted: 06/09/2016] [Indexed: 11/15/2022]
Abstract
CONTEXT High-dose rate brachytherapy (HDR-BT) is an increasingly popular treatment for patients with localised prostate cancer (PC). OBJECTIVE To assess the safety and efficacy of HDR-BT as monotherapy in PC. ACQUISITION OF EVIDENCE A systematic literature review was conducted through searches on MEDLINE (PubMed), Cochrane Library, CDR, ClinicalTrials and EuroScan. We assessed safety and efficacy indicators. SUMMARY OF THE EVIDENCE We selected 2 reviews and 12 uncontrolled studies, included in these 2 reviews. In terms of efficacy, local control in 6 studies was 97-100%. The biochemical progression-free survival varied as follows: 85-100% for low risk and 79-92% for high risk. Survival free of metastases was >95% at 8 years, except in one study where the survival rate was 87% at 5 years. The overall survival was ≥95% in 8 studies. In terms of safety, most of the studies recorded acute and long-term genitourinary and gastrointestinal complications, especially grade ≥2. Only 3 studies found grade 4 complications. All studies, except for one without complications, observed genitourinary complications that were more frequent and severe than the gastrointestinal complications. Two studies assessed the quality of life and showed an initial reduction in various domains and subsequent partial or total recovery, except in the sexual domain. CONCLUSIONS HDR-BT is effective as monotherapy, especially in cases of low to intermediate risk. There is insufficient information on high-risk patients. The short to medium-term toxicity was acceptable. Further research needs to be funded to provide more information on the long-term safety and efficacy of this treatment.
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Affiliation(s)
- L M Sánchez-Gómez
- Agencia de Evaluación de Tecnologías Sanitarias (AETS), Instituto de Salud Carlos III (ISCIII), Ministerio de Economía y Competitividad, Madrid, España; Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa (IP), Madrid, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España.
| | - M Polo-deSantos
- Agencia de Evaluación de Tecnologías Sanitarias (AETS), Instituto de Salud Carlos III (ISCIII), Ministerio de Economía y Competitividad, Madrid, España
| | - J I Rodríguez-Melcón
- Servicio de Oncología Radioterápica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | - J C Angulo
- Servicio de Urología, Hospital Universitario de Getafe, Universidad Europea de Madrid, Madrid, España
| | - S Luengo-Matos
- Agencia de Evaluación de Tecnologías Sanitarias (AETS), Instituto de Salud Carlos III (ISCIII), Ministerio de Economía y Competitividad, Madrid, España
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47
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Galindo-Bocero J, Macías-Franco S, Sánchez-García S, Fonollá-Gil M, García-Alonso A. Radiation retinopathy secondary to treatment of maxillary sinus carcinoma: a dramatic case. ACTA ACUST UNITED AC 2017; 92:486-489. [PMID: 28185695 DOI: 10.1016/j.oftal.2016.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 11/22/2016] [Accepted: 11/27/2016] [Indexed: 11/26/2022]
Abstract
CLINICAL CASE A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: haemorrhages, exudates, macular oedema, and peripheral retinal ischaemia. A poor outcome was achieved despite laser treatment and intravitreal injections of bevacizumab, resulting in evisceration of the affected eye. DISCUSSION Radiation retinopathy must be considered in any loss of vision after head and neck irradiation. Ophthalmological long-term follow-up of these patients is essential for an early diagnosis.
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Affiliation(s)
- J Galindo-Bocero
- Servicio de Oftalmología, Fundación Hospital de Jove, Gijón, Asturias, España.
| | - S Macías-Franco
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - S Sánchez-García
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - M Fonollá-Gil
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - A García-Alonso
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
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García-Cabo Herrero P, Fernández-Vañes L, López Álvarez F, Álvarez Marcos C, Llorente JL, Rodrigo JP. Results of total laryngectomy as treatment for locally advanced hypopharyngeal cancer. Acta Otorrinolaringol Esp (Engl Ed) 2017; 68:328-335. [PMID: 28110860 DOI: 10.1016/j.otorri.2016.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 11/13/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES Total laryngectomy (TL), with eventual postoperative radiotherapy, has proven to be effective in treating cases of locally advanced hypopharyngeal cancer. The aim of this study was to analyse the oncological outcomes of this procedure in patients with hypopharyngeal cancer classified T3 and T4. METHODS We studied 59 patients (33 T3 and 26 T4a) with primary squamous cell carcinoma of the hypopharynx treated with TL from 1998 to 2012. RESULTS Mean age was 61 years with a male predominance (96.6%). All the patients were smokers and 96% consumed alcohol. Unilateral selective neck dissection (ND) was performed in 12 patients, unilateral radical ND in 11 patients, bilateral selective ND in 20 patients and radical ND plus selective ND in 14 patients. 66% of the patients received postoperative radiotherapy. Lymph node metastases occurred in 81% of the patients and extranodal invasion in 56% of them. 29% of the patients had loco-regional recurrence, 17% developed distant metastases, and 25% a second primary tumour. The 5-year disease-specific survival was 46%. CONCLUSIONS TL extended to pharynx (with eventual postoperative radiotherapy) offers good oncological results in terms of loco-regional control and survival in locally advanced hypopharyngeal cancer, so organ preservation protocols should achieve similar oncological results to those shown by TL.
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Affiliation(s)
| | - Laura Fernández-Vañes
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Fernando López Álvarez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España
| | - César Álvarez Marcos
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España
| | - José Luis Llorente
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España
| | - Juan Pablo Rodrigo
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España.
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49
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Hernández Aragüés I, Pulido Pérez A, Suárez Fernández R. Inflammatory Skin Conditions Associated With Radiotherapy. Actas Dermosifiliogr 2016; 108:209-220. [PMID: 28010872 DOI: 10.1016/j.ad.2016.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 09/01/2016] [Accepted: 09/11/2016] [Indexed: 10/20/2022] Open
Abstract
Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized.
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Affiliation(s)
- I Hernández Aragüés
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - A Pulido Pérez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R Suárez Fernández
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
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50
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Llombart B, Kindem S, Chust M. Merkel Cell Carcinoma: An Update of Key Imaging Techniques, Prognostic Factors, Treatment, and Follow-up. Actas Dermosifiliogr 2016; 108:98-107. [PMID: 27919405 DOI: 10.1016/j.ad.2016.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/01/2016] [Accepted: 07/29/2016] [Indexed: 02/06/2023] Open
Abstract
Merkel cell carcinoma, though rare, is one of the most aggressive tumors a dermatologist faces. More than a third of patients with this diagnosis die from the disease. Numerous researchers have attempted to identify clinical and pathologic predictors to guide prognosis, but their studies have produced inconsistent results. Because the incidence of Merkel cell carcinoma is low and it appears in patients of advanced age, prospective studies have not been done and no clear treatment algorithm has been developed. This review aims to provide an exhaustive, up-to-date account of Merkel cell carcinoma for the dermatologist. We describe prognostic factors and the imaging techniques that are most appropriate for evaluating disease spread. We also discuss current debates on treating Merkel cell carcinoma.
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Affiliation(s)
- B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
| | - S Kindem
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - M Chust
- Servicio de Radioterapia, Instituto Valenciano de Oncología, Valencia, España
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