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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]

Copyright of Momento: Revista de Física is the property of Universidad Nacional de Colombia, Departamento de Fisica 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 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]

Copyright of Journal of the Argentine Society of Dermatology/Revista de la Journal Sociedad Argentina de Dermatología is the property of Editorial Biotecnologica S.R.L 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.)

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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.)

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo 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.)

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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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.

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.)

The standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC) is now a combination of androgen deprivation therapy plus an androgen receptor-targeted therapy (abiraterone, apalutamide, enzalutamide or darolutamide), with or without chemotherapy (docetaxel). The selection of suitable patients for each therapeutic approach has become a determining factor to ensure efficacy and minimize side effects. This article combines recent clinical evidence with the accumulated experience of experts in medical oncology, radiation oncology and urology, to provide a comprehensive view and therapeutic recommendations for mHSPC., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD., Objective: Our main objective was to identify and quantify the effects of radiotherapy with a computational model using optical coherence tomography (OCT) skin scanning. Secondary objectives included determining the ARD impact of different radiotherapeutic schemes and adjuvant topical therapies., Methods: We conducted a prospective, single-center case series study in a tertiary referral center of patients with breast cancer who were eligible for whole breast radiotherapy (WBRT)., Results: A total of 39 women were included and distributed according to the radiotherapeutic schemes (15, 20, and 25 fractions). A computational model was designed to quantitatively analyze OCT findings. After radiotherapy, OCT scanning was more sensitive revealing vascularization changes in 84.6% of the patients (vs 69.2% of the patients with ARD by clinical examination). OCT quantified an increased vascularization at the end of WBRT (P<.05) and a decrease after 3 months (P=.032). Erythematous skin changes by OCT were more pronounced in the 25-fraction regime., Conclusion: An OCT computational model allowed for the identification and quantification of vascularization changes on irradiated skin, even in the absence of clinical ARD. This may allow the design of standardized protocols for ARD beyond the skin color of the patients involved., (Copyright © 2024 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

We present a case of diagnostic interest; we present the differential diagnosis and the complementary tests necessary to reach it, in addition to highlighting the importance of a correct collection of background and clinical history. A 54-year-old woman with a history of carcinoma of the floor of the mouth treated with radiotherapy and chemotherapy develops ischemic retinopathy. It was necessary to perform a systemic study and differential diagnosis with entities such as ocular ischemic syndrome and radiation retinopathy, due to the similarity in the clinical findings found. Radiation retinopathy should be ruled out in any patient with visual impairment and a history of radiotherapy treatment. A broad differential diagnosis and systemic study are required to rule out entities such as ocular ischemic syndrome and diabetic retinopathy, in addition to early treatment to avoid possible complications., (Copyright © 2024 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques (NGI). However, the evidence regarding the role of NGI and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference (APCCC), a multidisciplinary expert consensus was developed to address controversial questions concerning the use of NGI and clinical management in four priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians and provides useful recommendations for clinical practice., (Copyright © 2024 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

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., (Copyright © 2024 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Introducción: El Nasoangiofibroma Juvenil (NAJ) es una neoplasia benigna de comportamiento local agresivo en la región craneofacial en adolescentes. La radioterapia es una opción terapéutica en la enfermedad irresecable y no recurrente, pero los efectos secundarios aún son controversiales con las nuevas tecnologías. Objetivo: Analizar el beneficio clínico y toxicidad entre la técnica conformada tridimensional (3DC) y la terapia de arco volumétrico modulado (VMAT) en NAJ irresecable y no recurrente con extensión a base de cráneo. Métodos y materiales: Mediante cohorte retrospectivo, se evaluaron pacientes con nasoangiofibroma no recurrente e irresecable, tratados con radioterapia durante marzo 2010 hasta marzo 2021. Resultados: Se identificaron 9 pacientes (37.5%) sometidos a 3DC, y 15 (62.5%) a VMAT. La obstrucción nasal en 9 individuos (37.5%) de 3DC y en 15 (62.5%) de VMAT, posterior al tratamiento con ausencia en el primer grupo (0%) y a 3 pacientes (12.5%) de VMAT, con disminución a grado I y significancia estadística (p= 0.012). La epistaxis se presentó en 2 pacientes de VMAT (8.3%) y fue ausente en pacientes de 3DC (0%) (p=0.5). En toxicidad aguda, 5 pacientes de 3DC (20.8%) y 6 de VMAT (25%) presentaron radioepitelitis con diferencia estadística (p=0.03). En toxicidad crónica, 2 pacientes de VMAT (8.3%) presentaron xeroftalmia y 2 de 3DC (8.3%) hipoplasia craneofacial con significancia estadística (p=0.001). Conclusiones: La radioterapia mostró beneficio sobre los síntomas iniciales. En relación con la toxicidad, la modalidad VMAT tiende a la mejoría de la hipoplasia craneofacial. La rareza de la enfermedad supone una limitante. [ABSTRACT FROM AUTHOR]

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., (Copyright © 2024 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

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., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

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., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

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., (Copyright © 2023 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Published by Elsevier España, S.L.U. All rights reserved.)

Introducción: La mediana de sobrevida global en tumores del sistema nervioso central es de 14.6 meses, recientemente se ha modificado la clasificación OMS a histológica-molecular. En México, se ha estimado una prevalencia del 12%. La radiómica ha obtenido características asociadas al microambiente tumoral mediante segmentación y cálculos de primer-segundo orden. Objetivo: Analizar volumetría y compacidad de gliomas tratados por radioterapia mediante plataforma LIFEx 7.1. Metodología: Análisis retrospectivo de 71 pacientes con diagnóstico de gliomas del SNC, tratados por radioterapia en Hospital de Oncología CMNSXXI de enero 2016 a enero 2020. Se analizaron y revisaron para este proyecto 14 pacientes; segmentación por LIFEx de regiones de interés (ROI) en imágenes de RM (T1) pretratamiento y postratamiento para obtener perfiles radiómicos. Resultados: Se determinaron un total de 2,604 características radiómicas totales. Posteriormente, se analizaron 56 características radiómicas para la caracterización análisis de volumetría y compacidad (SHAPE: volumen_mL, volumen_ vx y compacity). Análisis volumétrico en mililitros (mL), promedio diagnóstico de 20.47 mL (+/- 15.66 D. E) y una mediana de 12.69 mL (+/- 19.49 D. E) al seguimiento. Análisis volumétrico por voxeles (vx), un promedio de 10,587.43 vx (+/- 9,921.33 D.E) y una mediana de 4,624 vx (+/- 18,385.77 D. E) al seguimiento. Análisis de compacidad, al diagnóstico una relación promedio de 1.82 (+/- 0.67 D. E), y mediana de relación de 1.39 (+/- 0.62 D. E) al seguimiento. Conclusiones: En este trabajo encontramos características de volumen y compacidad que podrían estar asociadas a la heterogeneidad tumoral y pudiesen apoyar en la valoración con fines diagnósticos, planeación de manejos multimodales, y estudios de seguimiento. [ABSTRACT FROM AUTHOR]

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%., (Copyright © 2023 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Published by Elsevier España, S.L.U. All rights reserved.)