EPID-05. EVALUATION OF THE INCIDENCE OF CENTRAL NERVOUS SYSTEM TUMORS IN A CHILDHOOD CANCER TREATMENT CENTER AND THE CREATION OF A SPECIFIC GROUP

Central Nervous System Tumors (CNST) are the main solid neoplasm of childhood, representing 20% diagnosis. Based on this information, a search was carried out at a reference treatment center for childhood cancer in the state of Sao Paulo, belonging to University of Sao Paulo- ITACI/HCFMUSP, and at between 2017 and 2019, 352 new patients, 116 of which were neoplasm of CNS (32.9%). Aiming at an incidence of new cases, in 2019, an institutional group was created, with a team composed of Pediatric Oncologists, Neurosurgeons, Radiologists, Radiotherapists and Pathologists. In this first year, 31,8% of the 132 new patients were diagnosed with CNS tumor. According to WHO 2016, 15 patients were classified as a group that includes Diffuse Astrocytomas, Oligodendrioglial Tumors and Other Astrocytic Tumors. Among the other patients, 14.2% were Medulloblastomas, 4.7% Embryonic Tumors and 2.3% ART / RT. Patients diagnosed with diffuse brainstem glioma accounted for 11.9% of the total. The institution had a diagnosis of Angiocentric Glioma, Craniopharyngioma, Plexiform Neurofibroma and Anaplastic Ependymoma. Neuronal-glial tumors accounted for 9.5% of cases. Choroid plexus tumors represents 5%. Among them, 4.72% had metastatic tumors: Neuroblastoma and Ewing’s Sarcoma. Of the total of 42 patients, there were 5 deaths, 4 due to disease progression and one due to clinical complications. With the group, the discussions were carried out, allowing us to analyze that the presence of the Radiotherapy, Neurosurgery and Pathology team from the first moment, optimized the beginning of treatment and increased the patients’ survival.

Morbidity of adjuvant high-dose-rate brachytherapy for low to intermediate risk endometrial adenocarcinoma completely resected

The aim of this retrospective analysis was to evaluate bowel and urinary acute and late morbidity in patients with low to intermediate risk endometrial carcinoma, submitted to total abdominal hysterectomy and bilateral salpingo-oophorectomy, without lymphadenectomy, and postoperative high-dose-rate brachytherapy (HDR-B) as the sole treatment. From March 1996 to June 1998, 70 patients were treated on an outpatient basis, to a total dose of 30-50 Gy, given in two fractions per week. A total of 4-5 fractions of 6-10 GY was delivered. Three patients (4.2%) developed severe bowel complications, with one patient experiencing severe rectal bleeding. Local control was observed in 68 (97.1%) patients. Five-year actuarial disease and complication-free survival were 94.3% and 96.8%, respectively. In conclusion, it seems that a modest dose fraction schedule of HDR-B yields very high local control rates and low morbidity rates.