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Introduction. Squamous cell carcinoma is a relatively common pathology in Paraguay, which must be diagnosed and treated on time. The sarcomatoid variety is a rare subtype, but much more aggressive than the conventional presentation, with high rates of recurrence and lymphatic metastasis. Previous exposure to radiation is one of the main triggering factors. Clinical case. An 83-year-old patient with a history of radiotherapy for squamous cell carcinoma of the soft palate, who consulted for a mass on the lateral edge of the tongue that corresponded to a squamous cell carcinoma of the sarcomatoid subtype. Results. The patient underwent surgery and chemotherapy, but had tumor relapse after four months, without accepting salvage surgery, opting for palliative treatment and dying a few months later. Conclusion. Exhaustive examination of the oral cavity in a first consultation allows lesions to be identified in early stages and early multidisciplinary treatment can improve overall survival. The prognosis of these patients in advanced stages is discouraging. Currently, microvascular surgery is the best therapeutic option, but hemiglossectomy without reconstruction continues to be an acceptable option in our environment, knowing the high costs of the former and the requirement for a larger group of specialists, long surgical times and hospital stays. [ABSTRACT FROM AUTHOR]

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Copyright of Folia Pharmaceutica Cassoviensia is the property of University of Veterinary Medicine & Pharmacy in Kosice and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

O documento "RT-2030", elaborado pela Sociedade Brasileira de Radioterapia, delineia um plano estratégico para o desenvolvimento da radioterapia no Brasil ao longo da próxima década. Esta resenha oferece uma análise crítica das principais diretrizes e metas propostas pelo plano, abordando tópicos de importância para o setor, bem como seus impactos esperados na prática clínica, na inovação tecnológica e na formação profissional na área, além de discutir a viabilidade e os desafios associados à execução das estratégias delineadas no plano, oferecendo uma visão crítica sobre as suas implicações para o avanço da radioterapia no Brasil.

Diante do cenário da rotina de verificação de fator output para blocos de elétrons manufaturados para pacientes e fora do padrão das medidas quadradas, o presente trabalho propõe uma metodologia de medida do fator output no EPID, validando com medida em água usando diodo e utilizando programação em Python para analisar as imagens pré-processadas do detector. O trabalho utilizou blocos quadrados e retangulares para validar o código e avaliar as limitações do EPID e encontrou concordância de até ±3,0% para campos maiores que 6,0 cm² e ±5,0% para campos entre 3,0 cm² e 5,0 cm². A última avaliação realizada teve o intuito de confrontar as medidas do campo quadrado com campos assimétricos retangulares e os resultados obtiveram desvios menores que ±1,0%, indicando assim a viabilidade do EPID para tal metodologia.

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. Resumen: Introducción: La supervivencia de pacientes con linfoma de Hodgkin (LH) se ha incrementado en las últimas décadas. Sin embargo, el tratamiento con radioterapia (RT) y alquilantes aumenta el riesgo de desarrollo de patología tiroidea a largo plazo. Métodos: Se realizó un estudio observacional y retrospectivo en un hospital de referencia para oncología pediátrica, de pacientes diagnosticados de LH desde 2007-2022 mediante revisión de historias clínicas del sistema “Historia Clínica Electrónica” (HCIS). Se recogieron en Microsoft Excel datos demográficos (edad, sexo), clínicos, radiológicos y anatomopatológicos, así como dosis de RT y alquilantes recibidas, y alteraciones tiroideas encontradas. Estos datos fueron analizados mediante el sistema estadístico SPSS17, utilizando test de Fisher para análisis cualitativo y pruebas no paramétricas para las variables cuantitativas, así como curvas de Kaplan-Meier. Resultados: Se diagnosticaron 60 pacientes con LH, con una mediana de seguimiento de 78,5 meses. Se detectaron 4 casos de hipotiroidismo, 5 nódulos y un caso de hipertiroidismo subclínico. El tratamiento con RT resultó estadísticamente significativo para el desarrollo de hipotiroidismo (p=0,026), nódulos tiroideos (p=0,01) y patología tiroidea total (p=0,003). Este riesgo aumenta a razón de un 8% por cada grey administrado (p = 0,017, HR = 1,081, IC95% = 1,014–1,152). Conclusiones: Los pacientes con LH tratados con RT presentan un mayor riesgo de desarrollo de patología tiroidea a largo plazo, principalmente hipotiroidismo y neoplasias. Este riesgo aumenta cuanto mayor es la dosis recibida y mayor el tiempo de seguimiento. No se ha podido demostrar que los agentes alquilantes aumenten el riesgo de desarrollo de patología tiroidea.

Rates of childhood cancer survival in developed countries have risen to over 80–85 %. In consequence, the population of childhood cancer survivors (CCS) has grown considerably. Nevertheless, CCS present a high morbidity and mortality due to cancer or its treatment, with an increased risk of premature mortality, second primary tumors and late side effects, both physical and psychosocial, all of which decrease the quality of life. Long-term follow-up (LTFU) of CCS is recommended to prevent, detect and treat those health problems. Despite the advances achieved, the management of CCS is still not optimal. Among the areas for improvement discussed in this manuscript are: (1) Quantifying the real burden of morbimortality, by implementing new frequency measures (mean cumulative count and cumulative burden), to obtain more accurate assessments, and using simulation models, to determine individual risks; (2) Assessing the impact of risk factors for late side effects, related to the patient, tumor type, treatments, lifestyle, comorbidities, genetics and ageing; (3) Considering the impact of the international harmonisation of long-term follow-up guidelines, to generate homogeneous, evidence-based recommendations and an individualized LTFU and, (4) Challenges to LTFU implementation, considering models of care adapted to patient risk and needs, with special attention to the transition to adult-care follow-up. Finally, we comment on the situation of CCS in Spain and consider future prospects for improving the health and quality of life of this population. Resumen: La supervivencia del cáncer infantil supera en la actualidad el 80–85 % en países desarrollados. La población superviviente ha crecido considerablemente, presentando una elevada morbimortalidad secundaria al cáncer o su tratamiento, representada por un riesgo incrementado de mortalidad prematura, segundos tumores y efectos tardíos (ET), en la esfera física y psicosocial, afectando la calidad de vida. El seguimiento a largo plazo y de por vida en supervivientes de cáncer infantil (SCI), está recomendado para prevenir, detectar y tratar sus problemas de salud. A pesar de los avances producidos, el manejo de los SCI no es adecuado. En este artículo se plantean los retos pendientes como: (1) Cuantificar la carga real de morbimortalidad, proponiendo nuevas medidas de frecuencia (recuento acumulado medio y carga acumulada), que ofrecen resultados más exactos de la multimorbilidad que presentan, y la utilización de modelos de simulación, para conocer el riesgo individual de eventos; (2) Impacto de factores que determinan el riesgo de presentar ET relacionados con el paciente, tumor, tratamientos, estilo de vida, comorbilidades, genética y envejecimiento; (3) Importancia de la armonización de las guías de seguimiento a largo plazo a nivel mundial, para ofrecer recomendaciones homogéneas, basadas en la evidencia y un plan individualizado de seguimiento y (4) Problemas en la implementación del seguimiento, con diferentes modelos de atención, adaptados al riesgo y necesidades del paciente, con especial atención a la transición. Finalmente, se comenta la situación actual de los SCI en España y consideramos las perspectivas futuras que contribuyan a mejorar la salud y calidad de vida de esta población.

Resumen: Las metástasis óseas son frecuentes en pacientes oncológicos y una causa frecuente de complicaciones debido al daño estructural que causan a nivel del hueso. Generan complicaciones denominadas “eventos relacionados con el esqueleto” (SRE, por sus siglas en inglés), lo que conlleva un deterioro importante en la calidad de vida en los pacientes.En el manejo de las metástasis óseas, uno de los objetivos es la disminución del dolor y el manejo de las complicaciones cuando ya se han producido, pero otro objetivo, no menos importante, es la prevención de los SRE.Con respecto a la prevención de SRE, existe amplio conocimiento y bibliografía que avala el uso de cirugía y tratamientos sistémicos como la hormonoterapia, bifosfonatos, radiofármacos y otros agentes. Sin embargo, la radioterapia también tiene un rol en la prevención de SRE en pacientes oncológicos con metástasis óseas, ya que ha demostrado que genera mayor latencia para la ocurrencia de SRE y menor tasa de hospitalización, traduciéndose en un menor costo de tratamiento y mejor calidad de vida para los pacientes. Por este motivo, el objetivo del presente trabajo es comentar cuáles son las indicaciones y el beneficio de la radioterapia profiláctica en el contexto de prevención de SRE. Abstract: Bone metastases are frequent in cancer patients and are a frequent cause of complications due to the structural damage they cause at bone level, generating complications called “skeletal-related events” (SREs), which lead to significant deterioration in patient quality of life.In the management of bone metastases, one of the objectives is to reduce pain and manage complications when they have already occurred, but another objective, no less important, is the prevention of SREs. Regarding the prevention of SRE, there is extensive knowledge and literature that supports the use of surgery and systemic treatments such as hormone therapy, bisphosphonates, radiopharmaceuticals and other agents. However, radiotherapy also has a role in the prevention of SRE in cancer patients with bone metastases since it has been shown to produce a greater latency for the occurrence of an SRE and a lower hospitalization rate, which translates into lower treatment costs and better. quality of life for patients. For this reason, the objective of the present work is to comment on the indications and benefits of prophylactic radiotherapy in the context of SRE prevention.

What does the humanization of medicine and care mean? What type of education can be considered integral for building the identity of the medical professional and for the expert exercise of their skills in daily team work? The pedagogical reflection on the humanization of medicine calls for an interdisciplinary and transdisciplinary collaboration perspective, bridging knowledge and action, scientific knowledge and the desire to care for others. This is especially relevant in healthcare contexts characterized by a multi-professional approach, as exemplified by the School of Specialization in Radiotherapy at the Faculty of Medicine and Surgery of the Catholic University of the Sacred Heart in Rome. This contribution interprets several key conceptual frameworks to identify their educational potential, effective operational practices, and theoretical concepts that can enhance the pedagogical development of medical education. [ABSTRACT FROM AUTHOR]

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Los hemangiomas del seno cavernoso son considerados como malformaciones vasculares o tumores vasculares, se desarrollan extraaxiales, pero son histológicamente distintos a la malformación cavernomatosa cerebral. Su clínica puede ser cefalea, alteraciones visuales o paresia de pares craneales. Los métodos diagnósticos son la tomografía, pero principalmente la resonancia contrastada. El tratamiento puede ser mediante microcirugía o radioterapia. Se presenta el caso de un varón de 30 años, sin antecedentes, con 3 años de evolución de cefalea, y 7 meses de diplopía por paresia del VI par craneal. La resonancia contrastada evidencia un proceso expansivo en el seno cavernoso derecho, bordes regulares, hipointensa en T1, hipercaptador de contraste, hiperintensa en T2 y FLAIR, que no restringe en difusión. Se le realizó una craneotomía más resección total de la tumoración con apoyo de matriz hemostática para el control del sangrado. En el posoperatorio presento oftalmoparesia completa que fue mejorando en el tiempo. Se concluye que el hemangioma del seno cavernoso es una patología rara, con alta morbimortalidad asociada, pero con una adecuada técnica quirúrgica se pueden obtener buenos resultados.

Foundation: prostate cancer is a common oncological condition in men. The study of treatments, effectiveness and survival is a necessity. Objective: to compare survival in ecuadorian patients with prostate cancer treated clinically with radiotherapy and chemotherapy in a hospital in the Amazon region. Method: an observational, analytical prospective cohort study was carried out in 74 patients with prostate cancer. The variables were analyzed: survival time, treatment, survival function, risk function. It was developed in two phases, in the first the average survival time of the patients was calculated, while in the second the comparison of survival between patients treated with radiotherapy and chemotherapy was carried out. The Chi-square test and the Log Rank (Mantel-Cox) statistic were used to evaluate significant differences in survival distributions between the groups. Results: the mean overall survival was 46.2 months; higher in the group that received radiotherapy (50.3 months) compared to the chemotherapy group (39.4 months). Greater cumulative survival was observed in patients who received radiotherapy. In the chemotherapy group, the cumulative risk curve tended to increase more steeply as the months passed compared to the radiotherapy group; however, no statistically significant difference in survival was identified between groups (p > 0 .05) Conclusions: greater survival was found in the group that received radiotherapy, however, no significant difference in survival was found between groups.

The case report of a 37-year-old patient with history of having received radiotherapy due to a tumor lesion in the right frontal region is presented, who attended to the Institute of Neurology and Neurosurgery in Cuba because of intense headache and left hemiparesis. After carrying out the necessary examinations, the clinical-imaging diagnosis of a radionecrosis lesion in the contralateral hemisphere was established, which was corroborated in the pathological examination once the tumor was removed; then, immunotherapy was indicated. The patient had a favorable clinical course because the control of the disease was achieved as well as the resolution of symptoms. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: A radioterapia, apesar de ser um tratamento eficaz para o câncer, pode ocasionar a radiodermite, efeito colateral que repercute em sintomas físicos e emocionais no paciente. No intuito de minimizar as chances de desenvolvê-las, é possível aplicar medidas preventivas, por meio da educação em saúde e, destaca-se na enfermagem, as tecnologias educativas nesse processo. Objetivo: relatar a experiência de ações de educação em saúde como estratégia para a enfermagem na prevenção da radiodermite. Método: relato de experiência realizado por meio de sete atividades educativas com duração média de 30 minutos cada, de setembro a novembro de 2023, na sala de espera do setor de radioterapia de um hospital na fronteira-oeste do Rio Grande do Sul, com os pacientes e seus familiares ou acompanhantes que aguardavam para a realização da sessão de radioterapia. Resultados: foram sete ações com diferentes participantes, totalizando 55 pessoas. Foi produzido e entregue aos participantes, uma tecnologia educativa, do tipo cartilha contendo orientações sobre os principais cuidados com a região da pele irradiada e como produto final, um banner embasado no modelo da cartilha, para ser deixado permanentemente no serviço. A maioria dos participantes avaliou positivamente as ações, tendo suas dúvidas sanadas e seu conhecimento ampliado, principalmente, para aqueles que estavam iniciando o tratamento. Conclusão: esse tipo de ação desenvolvida contribuiu para o cuidado de enfermagem sobre o manejo e a prevenção da radiodermite.

Introducción: El cáncer de laringe es el tumor maligno de mayor prevalencia en la Otorrinolaringología. La topografía glótica es la más frecuente en Uruguay y suele detectarse en estadios tempranos dada la manifestación precoz y sostenida de disfonía. El objetivo de este estudio es describir la sobrevida libre de enfermedad (SLE) y la sobrevida global (SG) de los pacientes con cáncer de laringe glótico en estadio T1N0M0 en 4 instituciones de Montevideo. Metodología: Se analizó de forma retrospectiva la SG y SLE de 55 pacientes diagnosticados con cáncer de glotis T1 entre los años 2009 y 2019. Para el cálculo de la sobrevida se utilizó el método de Kaplan-Meier. Se estudió además el efecto de variables pronósticas de interés sobre la SG mediante análisis univariado y multivariado. Resultados: En la muestra analizada la SG de los pacientes con cáncer glótico T1N0M0 fue como media de 7.706 años (IC 95% 6.63 - 8.78). A los 5 años, la SG fue de 77.5% (± 7%) y de 62% (± 9.8%) a los 10 años. La SLE para todos los pacientes correspondió al 74.6% (± 7.5%) y 63.1% (± 9.8%), a 5 y 10 años respectivamente. No se alcanzaron las medianas de SG ni de SLE para los grupos. Conclusiones: Los valores de SG y SLE medios obtenidos en nuestro medio son comparables a los valores reportados en la bibliografía internacional. No se alcanzó la mediana de SG ni de SLE, por lo que se puede afirmar que ésta enfermedad tiene, cuandose realiza el tratamiento adecuado, un buen pronóstico vital a los 10 años. Se requiere un seguimiento más largo para determinar las medianas de SG y SLE de los grupos en estudio.

Se presenta el caso clínico de un paciente de 37 años de edad con el antecedente de haber recibido radioterapia por una lesión tumoral en la región frontal derecha, el cual acudió a consulta en el Instituto de Neurología y Neurocirugía de Cuba por presentar cefalea intensa y hemiparesia izquierda. Luego de realizados los exámenes necesarios, se estableció el diagnóstico clínico-imagenológico de lesión por radionecrosis en el hemisferio contralateral, que fue corroborado en el estudio anatomopatológico una vez que se extirpó el tumor; seguidamente, se indicó inmunoterapia. La evolución del paciente fue satisfactoria, pues se logró el control de la enfermedad y la resolución de los síntomas.

El cáncer de páncreas es una enfermedad donde la mayoría de los pacientes se encuentran en estadios irresecables desde su diagnóstico. La radioterapia y la quimioterapia han demostrado ser parte importante en el tratamiento de los pacientes con cáncer de páncreas. Con el advenimiento de las nuevas técnicas de radioterapia ha sido posible aumentar la dosis dirigida a la lesión, respetando las tolerancias de los órganos adyacentes a la misma. Está descrito que el aumento la dosis de radiación por fracción aumenta a su vez la dosis biológicamente efectiva (BED) permitiendo que se realice el tratamiento en menos tiempo y a su vez escalando la dosis total que recibe el paciente. Ésta es la base del hipofraccionamiento y de la radioterapia estereotáxica las cuales poseen un papel cada vez mayor en el tratamiento de este grupo de pacientes debido a la mejor respuesta que presenta este tipo de tumores al aumentar la dosis de radiación. El desarrollo de una revisión narrativa sobre el escalamiento de dosis con radioterapia externa en cáncer de páncreas, nos permite conocer las técnicas y fraccionamientos que se están utilizando, motivando al desarrollo y uso de dichas herramientas en beneficio del paciente en nuestro país.

Las metástasis cerebrales son las neoplasias más frecuentes del sistema nervioso central en la edad adulta, representando el 50% de las neoplasias intracraneales. El enfoque primario de tratamiento incluye cirugía, radioterapia estereotáxica intracraneal y radioterapia holocraneal. En la actualidad la radioterapia holocraneal adyuvante y definitiva, consiste en la irradiación a todo el encéfalo y la radioterapia estereotáxica intracraneal postoperatoria y definitiva, permite la administración de alta dosis de radiación a la lesión tumoral, utilizando técnicas avanzadas de planificación, en 1 – 5 fracciones, reduciendo significativamente el riesgo de recurrencia local. Aunque está indicada en pacientes con un número limitado de metástasis cerebrales, es una modalidad utilizada en los últimos años, como medida de rescate para pacientes con esta entidad, sin embargo, no existe suficiente evidencia que lo sustente, es por ello que el enfoque de esta revisión va dirigido a recopilar más información sobre el beneficio clínico, así como algunas de las variables que pueden incidir en la supervivencia de los pacientes con reirradiación del SNC para el control de metástasis cerebrales recurrentes. En la radioterapia estereotáxica intracraneal de rescate, una de las complicaciones más temidas en los pacientes que ameritan reirradiación es la radionecrosis, sobre todo en aquellas lesiones que se presentan en el lugar del tratamiento previo, por los múltiples efectos adversos que esto puede generar. Darle sustento a esta modalidad de tratamiento permite justificar su aplicación en nuestro centro de desarrollo profesional y darle un aporte a su uso en otras instituciones nacionales e internacionales.

Introduction: energy metabolism in cancer patients is influenced by different factors. However, the effect of antineoplastic treatment is not clear, especially in women. Objective: to evaluate resting energy expenditure (REE) by indirect calorimetry (IC) before (T0) and after (T1) first cycle period of antineoplastic therapy: radiotherapy (RT), chemotherapy (CT), and concomitant chemoradiation therapy (CRT), quality of life (QoL) and accuracy of REE were compared with international guidelines recommendations per kilogram (European Society for Clinical Nutrition and Metabolism [ESPEN]). Methods: an observational, longitudinal study was conducted in women with gynecological cancer diagnosis undergoing antineoplastic treatment: RT, CT and CRT. Weight loss, actual body weight and height were measured. REE was evaluated in T0-T1 and compared with ESPEN recommendations. Kruskal-Wallis test and Bland-Alman analysis were used to determine the agreement (± 10 % of energy predicted) of REE adjusted by physical activity (TEE) compared with ESPEN recommendations, respectively. Results: fifty-four women with cancer were included: 31.5 % (n = 17) for RT group, 31.5 % (n = 17) for CT group and 37 % (n = 20) for CRT group. REE showed statistical differences between T0 and T1 in the total population (p = 0.018), but these were not associated with anticancer therapy groups (p > 0.05). QoL had no significant changes after treatment (p > 0.05). Accuracy of 25 and 30 kcal/kg compared to TEE was less than 30 %. Conclusion: REE in women with gynecological cancer decreased after antineoplastic treatments but this is not associated with a particular antineoplastic therapy. It is needed to develop research to determine the accuracy of ESPEN recommendations with TEE estimated by IC and clinical factors in women with cancer. [ABSTRACT FROM AUTHOR]

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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. Resumen: Las metástasis vertebrales son una causa común de dolor en el paciente oncológico lo cual puede generar limitación funcional, además de complicaciones derivadas de una posible compresión medular, radicular y fracturas. Se requiere de un abordaje complejo de estas metástasis por el riesgo de secuelas permanentes. Con el aumento de la supervivencia gracias a los nuevos tratamientos emergentes, las posibilidades de presentar metástasis vertebrales son cada vez mayores, por ende, el manejo de estas lesiones debe ir encaminado al alivio del dolor y el mantenimiento de la deambulación. La radioterapia juega un papel fundamental en el manejo de estas lesiones; disponemos de avances tecnológicos en los últimos años que han permitido mejorar la calidad e intencionalidad de los tratamientos, pasando de ser meramente paliativos a proponer tratamientos que mejoren el control local. En este articulo hacemos una descripción de cómo la técnica de stereotactic body radiotherapy (SBRT) en pacientes seleccionados puede mejorar el control local de forma más duradera, y el valor que tiene en el paciente oligometastásico y tras cirugía.

Introducción: el linfoma nasal de células T/natural killer (LNT/NK) forma parte de un espectro de lesiones inmunoproliferativas de las células T postímicas. Consiste en un proceso necrótico que destruye en forma progresiva la nariz, senos paranasales, paladar y otras estructuras faciales. Dentro de su etiología se han descrito factores genéticos. El diagnóstico se basa en las características clínicas apoyadas en el estudio histopatológico con tinción de hematoxilina-eosina e inmunohistoquímica. Es conveniente la búsqueda de EBER (Epstein-Barr virus-encoded small RNAs) teniendo en cuenta la asociación entre estas dos patologías. Existen diferentes opciones de tratamiento que van a depender de la clasificación de la neoplasia en el paciente. Caso clínico: hombre de 58 años que presentó la aparición de una placa eritematoviólacea con posterior ulceración sobre el dorso nasal, de rápido crecimiento y destrucción de tejidos blandos adyacentes. Consultó al servicio de dermatología, donde consideró la toma de biopsia de piel con diagnóstico presuntivo de linfoma extranodal de células NK-T tipo nasal. Conclusión: el LNT/NK de tipo nasal es una entidad de rápida progresión que involucra un importante compromiso de órganos, por lo cual es de suma importancia hacer una identificación temprana para mejorar su pronóstico.

Introdução: As neoplasias de sistema nervoso central representam 21% do câncer infantojuvenil, sendo a principal causa de morte nessa população em países desenvolvidos. Avanços na neuroimagem têm melhorado seu diagnóstico, e a combinação de terapias tem permitido a cura, com maior preservação neurológica. A cirurgia é o principal tratamento, frequentemente combinada com radioterapia e quimioterapia. Objetivo: Descrever achados socioeconômicos, sinais e sintomas, e aspectos histológicos dos tumores cerebrais pediátricos, tratados com radioterapia. Método: Estudo transversal e descritivo, utilizando prontuários de 257 crianças e adolescentes portadores de neoplasias de sistema nervoso central, tratados com radioterapia no Instituto Nacional de Câncer, no Rio de Janeiro, de 2012 a 2020. As variáveis foram divididas em sociodemográficas, clínicas e patológicas. Resultados: Crianças brancas do sexo masculino foram as mais prevalentes, com mediana de idade de 7,5 anos no diagnóstico e de 8,0 anos na radioterapia. A maioria possuía casa própria com infraestrutura básica e renda familiar de até um salário-mínimo. Os sintomas mais comuns foram cefaleia, vômitos e alterações na marcha, variando de acordo com a localização do tumor e a idade da criança. A radioterapia foi utilizada em 64% dos pacientes, principalmente para meduloblastoma, tumores de tronco cerebral e ependimoma anaplásico. Conclusão: Estudos específicos sobre crianças e adolescentes com neoplasias cerebrais tratados com radioterapia são raros na literatura. Quando comparados com a população em geral, apresentam perfis sociodemográficos e clínicos semelhantes, com diferenças notáveis apenas na frequência dos tipos tumorais.

O autor, radioterapeuta do S.N.C., foi incumbido por seu Diretor, Dr. Mário Kroeff, de estudar o "radon'', importante agente radioterópico. Após ter conseguido bolsa de estudos por intermédio do "Institute of Interamerican Affairs'' permaneceu nos EE UU. da América durante um ano e dois mêses. Durante essa estada, frequentou o "Memorial Hospital" onde ao lado dos físicos L. Marinelli e G. Failla, familiarizou-se no manejo da aparelhagem, no modo de captação, acondicionamento e dosagem das células de "radon". Na Universidade de Colúmbia, seguiu o curso sôbre "física das irradiações" ministrado pela Dra. E. Quimby. Acompanhou durante três mêses o Serviço de Radioterapia do "Billings Hospital" e do "Hines Hospital'', respectivamente sob a orientação dos Drs. Anna Hamann e Harry Slobodin. Visitou em Chicago o "Tumor Institute'' do Dr. Max Cutler e a fábrica de aparêlhos de Raios X da General Electric. Em Nova lorque frequentou ainda, durante três mêses, o Serviço de Radioterapia do "Presbyterian Hospital'', chefiado pelo Dr. Maurice Lens.

Trabalho apresentado por ocasião da 1ª Jornada Brasileira de Radiologia. Nas três primeiras décadas, que se seguiram à descoberta dos raios X e do radium dezenas de pessoas pagaram com a vida o tributo, devido à super-exposição aqueles tipos de irradiações. Isto porque, não conhecendo bem os perigos a que se expunham, trabalhavam os pioneiros da radioterapia com meios insuficientes de proteção. Hoje em dia, graças aos notáveis trabalhos de Failla, Quimby, Taylor, Evans e Braestrup além de outros, onde são descritos os meios de proteção adequada para os raios X e radium, podem os médicos e técnicos trabalhar durante muito tempo com as irradiações sem sofrer os seus efeitos nocivos.

Palestra realizada na Sociedade Brasileira de Cancerologia sobre o tratamento médico do câncer.

O informe traz a exposição feita à Comissão de Saúde da Câmara dos Deputados sobre o câncer como um flagelo que já traz apreensiva a toda a humanidade.

Objetivos: Relatar uma manifestação clínica atípica de micose fungoide, com ênfase na importância do reconhecimento e diagnóstico dessa apresentação rara, bem como nas possibilidades terapêuticas. Metodologia: Relato de caso com informações obtidas através de revisão de prontuário, registro fotográfico e revisão de literatura. O presente relato foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Walter Cantídio da Universidade Federal do Ceará. Resultados: Relata-se o caso de um paciente de 74 anos, apresentando, há dez anos, uma placa verrucosa no primeiro quirodáctilo esquerdo, com crescimento progressivo. Foi realizada biópsia por punch com estudo histopatológico e imunohistoquímico, que confirmaram o diagnóstico de micose fungoide. Por se tratar de lesão isolada, foi optado por tratamento com radioterapia, com boa resposta terapêutica até o momento. Conclusões: A apresentação clínica de micose fungoide como placa verrucosa isolada é muito rara, com poucos casos relatados na literatura. Formas atípicas desse linfoma podem dificultar o diagnóstico e a abordagem terapêutica precoce, sendo, portanto, importante o seu reconhecimento em razão do seu potencial de morbimortalidade.

Trabalho com a única finalidade de difundir conhecimentos concernentes à Radioterapia, entre os médicos em geral, dividido em duas partes: a primeira visando conhecimentos básicos de ordem principalmente técnica e a segunda, as indicações do emprego desta arma no combate ao câncer.

Introdução: O câncer é uma doença genética que foge parcial ou totalmente da defesa imunológica e com seu avanço são utilizados tratamentos como a quimioterapia e a radioterapia. Entretanto, ambos os tratamentos promovem efeitos adversos. Desta forma, a fisioterapia vem com o intuito de tratar esses efeitos. Objetivo: Sistematizar as condutas fisioterapêuticas mais utilizadas para tratar os principais efeitos adversos oriundos da quimioterapia e radioterapia em pacientes oncológicos. Métodos: Realizou-se uma revisão sistemática nas bases de dados PubMed, LILACS, PEDro e SciELO no período de 2017 a 2022. Resultados: Dos 4.190 artigos, foram selecionados apenas 13 que preencheram os critérios de inclusão e nota superior 6/10 pela Escala PEDro. As condutas fisioterapêuticas relatadas nos estudos foram acupuntura, LASER, LED, massagem terapêutica, auriculoterapia, crioterapia e osteopatia ao qual promoveram diminuição e alivio dos efeitos adversos podendo atuar como atenuantes na ocorrência desses sintomas. Conclusão: Conclui-se que os efeitos adversos como náuseas e vômitos, mucosite e fadiga secundárias a quimioterapia e radioterapia poderão ser tratados com condutas fisioterapêuticas como acupuntura, LASER, LED, massagem terapêutica, auriculoterapia, crioterapia e osteopatia as quais são seguras e efetivas nesses perfis de pacientes, além de proporcionar alivio dos sintomas, prevenir e diminuir os processos inflamatórios, aumento do apetite, melhora da função gastrointestinal e do condicionamento físico. Palavra-chave: Neoplasia; Quimioterapia; Radioterapia; Fisioterapia.

Introduction: The qualitative elastography by endoscopic echography is a technique to examine the elastic properties of tissues that can distinguish the fibrosis of the tumor by means of color patterns. Objective: To determine the value of elastography by color patterns in the reestadification of the rectum cancer. Methods: An observational and descriptive study (serial cases) of 54 patients with rectum cancer was carried out, who were assisted in the National Center of Minimum Access Surgery, in Havana, between September, 2018 and December, 2022 to whom elastography by endoscopic echography were carried out for the reevaluation of the tumor. To determine the value of this technique the sensibility, specificity, the predictive positive and negative values, the positive and negative true ratio, as well as the index of Youden were calculated. The diagnostic consistency was established according to the kappa index and the histologic study of the sample was the reference standard. Results: The elastography consistency with the pathologic result was good (ĸ=0.84). The specificity and the index of validity were 91.7 and 94.4%, respectively; while the negative predictive value was 84.6%. The 16 patients with mixed elastographic pattern (ye3) had residual tumor located in some of the layers of the rectum wall. The Youden index reached values close to 1. Conclusions: The value of this technique resides in its diagnostic specificity and negative predictive value when differentiating fibrosis from the residual tumor in the rectal wall. [ABSTRACT FROM AUTHOR]

Copyright of Folia Cardiologica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Paediatrics & Family Medicine / Pediatria i Medycyna Rodzinna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Describir las características epidemiológicas y clínicas de los pacientes con leucemia linfocítica aguda atendidos en el Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, que recibieron radioterapia externa, durante el periodo de enero de 2009 a diciembre de 2017. Métodos: Estudio observacional, descriptivo. Se revisaron retrospectivamente los expedientes clínicos de pacientes pediátricos (0-13 años) con leucemia linfocítica aguda, que recibieron radioterapia externa en el periodo mencionado. Se aplicó un análisis estadístico descriptivo de las variables cualitativas y cuantitativas. Resultados: Se analizó un total de 58 pacientes, de estos el 79,3% fueron hombres. La edad promedio fue de 7,3 años. El 84,2% fueron clasificados como L1, 84,2% con inmunofenotipo B común y el 56,9% eran grupo de alto riesgo al diagnóstico. La principal indicación de radioterapia fue recaída (67,7%). Aproximadamente la mitad se irradió a sistema nervioso central y la otra mitad a testículos. Los principales efectos adversos fueron cutáneos. Conclusiones: Los resultados obtenidos fueron comparables con los reportados en la literatura. La radioterapia es importante en el tratamiento de leucemias, especialmente en pacientes de recaída y de alto riesgo.

A 22­year­old female patient, with no known morbid history, with a clinical picture of 1 year of evolution characterized by frontal headache, vomiting, lipotimia and bilateral blindness, was diagnosed with primary germinal tumor of the central nervous system, germinoma type. She underwent partial resection of the tumor and received adjuvant management with CDDP/VP16 based chemotherapy for 2 cycles and craniospinal radiotherapy, with complete response. [ABSTRACT FROM AUTHOR]

BACKGROUND: The appearance of malignant neoplasms is one of the most concerning long-term effects of ionizing radiation. Basal cell carcinoma is known to be the most frequent skin cancer associated with radiotherapy. CLINICAL CASE: A 79-year-old female patient with multiple basal cell carcinomas on the scalp; the largest of them on the temporoparietal area. She referred having a history of tinea capitis when she was 15 years old, for which she received therapeutic ionizing radiation on the scalp. Surgical treatment was performed with intraoperative study of margins and postoperative management. CONCLUSIONS: The correlation between the prevalence of basal cell carcinoma and therapeutic ionizing radiation is intriguing. Understanding the interactions between radiation and the signaling pathways that drive the development of basal cell carcinoma is essential to educate the medical community about the importance of long-term follow-up of patients who have previously received therapeutic ionizing radiation. Radiated skin areas should be evaluated as a follow-up in all patients who have received this type of therapy. [ABSTRACT FROM AUTHOR]

Radiation-induced secondary tumors constitute a rare complication of radiation therapy and typically occur in or near the irradiated area. Women who undergo thoracic radiotherapy before 30 years of age have a significantly greater lifetime risk of developing breast cancer than do those in the general population. It is recommended that a patient who has previously received thoracic radiotherapy with a radiation dose = 10 Gy subsequently undergo annual screening with mammography and magnetic resonance imaging, beginning eight years after the initial treatment or when the patient has reached 25 years of age (whichever comes later). The treatment of secondary breast cancer in this population should be individualized and should be discussed with a multidisciplinary team to avoid toxicity related to the treatment of the primary cancer. [ABSTRACT FROM AUTHOR]

Introduction – Surface guided radiotherapy (SGRT) is a technique that uses technology in the 3D detection of the patient’s surface, which helps the radiation therapists in the daily repositioning and monitoring of intra and interfraction movements of the patient. It is a non-invasive technique and does not use ionising radiation. Objectives – It is intended to study if the SGRT technique could replace the use of skin markers and the use of verification/Image- -guided radiation therapy (IGRT) imaging protocols, without compromising the reproducibility of the treatment. Methods – A systematic review was performed in the Scopus and MEDLINE databases, where articles published in the last five years were analysed. After combining the search terms and according to the inclusion and exclusion criteria, ten articles were included in this review. Results/Discussion – The SGRT technique reduced positioning deviations compared to positioning based on skin markers. On the other hand, it allows a dose reduction resulting from IGRT verification, due to the lower frequency of its use, when combined with SGRT. Conclusion – SGRT proved to be feasible in ensuring accurate positioning when compared to conventional repositioning based on the conjugation of skin markers and lasers. A significant reduction in intrafraction and interfraction errors was also observed. However, it was not considered sufficiently feasible to replace IGRT to its full extent. IGRT still has an important role in confirming anatomical positioning and in monitoring PTV and adjacent organs. [ABSTRACT FROM AUTHOR]

Angiosarcoma is a rare and aggressive tumor derived from endothelial cells of blood vessels, it has a poor prognosis, and its 5-year survival is very low; the most common location is the scalp or face of white men. It is characterized by the appearance of purpuric macules and plaques with poorly defined borders that bleed easily and can progress to nodules and ulcerated tumors. The only curative therapeutic modality is complete surgical resection, although radiotherapy and chemotherapy are also used. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Odontologica Latinoamericana: AOL is the property of Acta Odontologica Latinoamericana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Os AA. apresentam o critério de orientação no tratamento do carcinoma do colo do útero adotado no Departamento de Radioterapia do Instituto Central — Hospital A. C. Camargo da A.P.C.C. A antecipação da irradiação externa pelo Co60 em relação a aplicação do Ra intra-cervico-vaginal é apresentada como um dos elementos de importância clínica e de eficiência técnica na conduta atualmente adotada, em, serviços de grande experiência ginecológica. Além da aplicação do rádio e do cobalto, o Departamento prossegue a observação paralela de casos submetidos à cirurgia pelo Serviço de Ginecologia sendo a escolha feita por casualização entre os casos clínicos em que as duas terapêuticas são aplicáveis.