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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.)

Introduction: Vertebral hemangiomas are benign vascular tumors composed of capillary and venous structures with little malignant metaplasia. They represent 3% of all spinal tumors, are generally asymptomatic, with estimated incidence of 1.9- 27% in the general population. Objective: To report a case of vertebral hemangioma with aggressive behavior, clinical presentation and therapeutic possibilities. Clinical case report: A 43-year-old female patient, hospitalized for moderate axial and radicular pain in the right lower limb caused by a pathological fracture, was diagnosed to suffer from an aggressive vertebral hemangioma. Conclusions: It is important to know the radiographic characteristics of vertebral hemangiomas for their correct diagnosis and treatment. The use of bisphosphonates is an adequate therapeutic option in osteolytic tumor lesions. [ABSTRACT FROM AUTHOR]

A basic element to achieve the measurement traceability is the correct implementation and dissemination of the measurement standards. In the case of dosimetry, there are internationally harmonized calibration methods; however difficulties may arise in their introduction related to the technical characteristics of the standards and the methods described in the technical documents. The use of commercially available dosimetry systems as secondary standards requires the personalized studies of their technical characteristics. The recommended methods do not always compatible with the available infrastructure and modifications are needed. The article makes a critical analysis of the implementation of the dosimetry secondary standards in the international arena based on the identified difficulties. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura 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.)

Introdução: O câncer está atualmente entre as cinco causas mais frequentes de mortes no planeta, tudo isso devido a hábitos deletérios ou predisposição genética. O câncer de boca ocupa uma posição de destaque nesse panorama e necessita de uma atenção odontológica especial, devido à associação da perda dentária com o tratamento oncológico. Objetivo: O objetivo deste trabalho foi fazer uma análise biológica dos processos desencadeados pelo tratamento radioterápico e apresentar um método alternativo de exodontia seguro para os pacientes oncológicos. Revisão da literatura: O tratamento oncológico radioterápico desencadeia uma série de complicações bucais que eventualmente exigirão a exodontia, entre eles: osteorradionecrose, hipossalivação, cáries, doença periodontal, entre outros. Discussão: A exodontia com elásticos ortodônticos consiste no envolvimento dentário na altura cervical com os elásticos causando uma esfoliação lenta, gradual e mais atraumática possível da raiz, esse processo leva em torno de 5 a 8 semanas. Esta técnica associada a um bom pós-operatório garantirá uma cicatrização adequada aumentando significativamente as chances de um prognóstico positivo. Conclusão: Os resultados dessa associação de técnicas são seguros e diminuem os riscos de complicações pós-operatória, garantindo assim, uma recuperação sem maiores problemas ao paciente.

Introducción. El angiosarcoma primario de la mama es una neoplasia maligna derivada de las células endoteliales de los vasos sanguíneos, potencialmente agresiva independientemente de su grado histológico, por lo que su pronóstico es malo. Su diagnóstico prequirúrgico es difícil, ya que las características clínicas e imagenológicas son inespecíficas, y el diagnóstico definitivo únicamente se realiza por estudios de patología. Para su tratamiento generalmente se requiere de resección quirúrgica, radioterapia y, ocasionalmente, quimioterapia. Caso clínico. Paciente de 49 años sin antecedentes, que consultó por cuadro clínico de 5 meses de evolución de aparición y rápido crecimiento de masa en mama izquierda. Se realizaron estudios imagenológicos que reportaron lesión BIRADS 4a y diagnóstico histológico de lesión vascular con atipía, por lo cual fue llevada a mastectomía simple, con informe final de patología de angiosarcoma primario de mama; tuvo que ser reintervenida por márgenes positivos. Completó 33 ciclos de radioterapia y dos años después de la cirugía presentó cambios inflamatorios en la cicatriz quirúrgica, de la cual se tomó biopsia con reporte de lesión vascular atípica, por lo que fue operada nuevamente, con reporte histológico negativo para angiosarcoma residual. Actualmente la paciente está en seguimiento imagenológico, sin evidencia de recaída tumoral. Conclusión. Los angiosarcomas primarios de la mama son neoplasias raras y muy agresivas, independientemente de su grado histológico, por lo cual es importante hacer un diagnóstico histológico y tratamiento oncológico oportunos

Um estudo realizado no Instituto Mineiro de Oncologia, no período de 1986 a 1992, envolveu 158 pacientes com câncer de esôfago. Destes, 47 (29,74%) foram submetidos a radioterapia (4400 cGy) e, um mês após, à esofagectomia. A histopatologia das peças ressecadas revelou a presença de tumor residual em 34 (72,34%) delas.

Os autores mostram a importância da participação multidisciplinar no tratamento do paciente oncológico no que diz respeito à prevenção e tratamento das sequelas orais decorrentes da irradiação de cabeça e pescoço. Os principais efeitos secundários são: xerostomia, mucosite, cárie de radiação e osteorradionecrose; cabendo ao cirurgião-dentista agir preventivamente no sentido de evitar o aparecimento dessas seqüelas ou amenizar seus efeitos.

Introdução – A escolha do tratamento depende de vários fatores, incluindo o estado clínico e prognóstico de cada doente. Estes fatores desempenham um papel importante na escolha da intervenção terapêutica em metástases ósseas. A deteção precoce e o tratamento adequado podem melhorar a qualidade de vida e independência funcional dos doentes. Metodologia – Este artigo pretende realizar uma revisão sistemática da literatura dos últimos 15 anos, identificando os diferentes tipos de fracionamentos (fração única versus múltiplas frações) e técnicas utilizadas em radioterapia no tratamento de metástases ósseas. Resultados – Os recentes avanços na tecnologia e nas técnicas de tratamento de radioterapia ajudam na distribuição de doses altamente conformacionais e com orientação por imagem para uma entrega mais precisa do tratamento. A radioterapia estereotáxica corporal (SBRT, do acrónimo inglês stereotactic body radiotherapy) permite delimitar e aumentar a dose nos tumores a irradiar. No caso das metástases ósseas, os resultados de controlo local do tumor e da dor têm-se revelado promissores. A radioterapia convencional de 8Gyx1, no entanto, continua a ser o tratamento mais indicado nos doentes paliativos. Conclusão – O tratamento de metástases ósseas é complexo e uma abordagem multidisciplinar é sempre necessária. O tratamento deve ser individualizado para se adequar aos sintomas e estado clínico de cada doente.

A incidência mediana de câncer endometrial no Brasil é de 6 casos novos/cem mil mulheres/ ano. A radioterapia tem sido usada como tratamento adjuvante pré ou pós cirurgia, com ou sem braquiterapia. Há consenso de que os casos estadiados como II e III pela FIGO recebam irradiação pélvica, com ou sem braquiterapia. Entretanto, 75% dos casos são estádios I. Por isso há subgrupos prognósticos que dependem da profundidade de invasão do miométrio e do grau histológico do tumor. Tumores em estádio I com invasão profunda do miométrio e/ou alto grau têm também sido tratados com irradiação. A adição de braquiterapia vaginal após a radioterapia externa resulta em melhor controle de falha pélvica? Esta é uma pergunta não resolvida. Desde 1990 temos feito apenas radioterapia externa nos casos de câncer do endométrio que têm indicação de irradiação adjuvante, sem braquiterapia. A cirurgia básica destes casos têm sido histerectomia abdominal total + salpingo-ooforectomia bilateral sem dissecção de rotina dos linfonodos pélvicos. Foram revistas retrospectivamente 61 destes casos tratados no nosso serviço, com 4 campos pélvicos. Cobalto, dose total entre 45Gy-50,4Gy em 25 a 28 frações. Seguimento mediano de 33 meses mostrou um único caso de falha em vagina, 6/61 casos de pacientes que morreram e apenas um caso de complicação intestinal moderada. Estes resultados se assemelham com outros da literatura que não usam a braquiterapia de rotina após a irradiação externa na pelve.

O câncer do colo do útero tem expressiva significação no Brasil; como é uma patologia cuja radioterapia constitui um dos tratamentos mais importantes, é possível fazer uma análise da radioterapia e dos métodos usados para o seu tratamento utilizando este tumor como instrumento de análise. Os objetivos deste estudo são levantar o número e a forma como os tumores de colo uterino vêm sendo tratados no Brasil e, através desta análise, estudar a possibilidade de um protocolo nacional de tratamento. Foi elaborado um formulário com dados cadastrais e detalhes sobre o número, a maneira e o equipamento usado no tratamento dos tumores ginecológicos, que foi enviado a 117 instituições para serem respondidos, espontaneamente. Foram obtidos 80% de retorno, e a análise mostrou que 89% eram tumores do colo e 1 1 % do corpo do útero. Setenta e cinco por cento das instituições são privadas e apenas 5% são em hospitais-escola. Cinqüenta e oito por cento dos serviços ainda utilizam cálculo manual na braquiterapia e 70% das pacientes receberam tratamento combina do de tele-braquiterapia. Dos 22.750 casos de tumor do colo do útero estimados pelo Instituto Nacional de Câncer (INCA), para o ano de 1995, apenas 49% receberam radioterapia a despeito de se esperar uma taxa de 80%. Os autores fazem um ensaio sobre as possíveis causas que levam a discrepância entre estes dados e sugerem um protocolo nacional multi-institucional, coordenado pelo INCA e pelo Colégio Brasileiro de Radioloia (CBR), para o tratamento dos tumores de colo do útero, levando em consideração a realidade nacional.

Este trabalho tem como objetivo mostrar a importância do enfermeiro no setor de radioterapia dando ênfase a três níveis de atuação: administrativo, assistencial e educacional. Em decorrência dos avanços técnico-científico da área da saúde, foi necessário a criação de novos serviços impondo os profissionais de saúde - entre os quais o enfermeiro - a necessidade de se atualizar e se adaptar a esse processo de desenvolvimento. Atualmente se tem reconhecido a importância do atendimento do enfermeiro aos pacientes que se submetem à quimioterapia, na radioterapia, entretanto ainda são poucos os serviços que valorizam e dispõem de um enfermeiro especializado. Os autores relatam suas experiências administrativas no que se refere ao processo de gerenciamento do serviço e a sua competência quanto à elaboração de relatórios administrativos, supervisão da equipe, coordenação do agendamento dos pacientes em tratamento, entre outras atividades. Quanto à área assistencial o enfermeiro é visto como um profissional diferenciado que necessita de conhecimento especializado e habilidades específicas para desenvolver as suas atividades na área de radioterapia. Enfatiza-se a importância da Consulta de Enfermagem e todas as suas implicações. Quanto ao aspecto educacional mostram os autores que esta ação se encontra presente nas áreas relatadas. Eles destacam o treinamento dos funcionários, o acompanhamento dos estagiários de enfermagem, reciclagem para a enfermagem e atividades extra-hospitalares. Esta conquista de novos espaços vem demonstrar o interesse pela aquisição de conhecimentos técnicos científicos do enfermeiro e, nas instituições de saúde, este profissional vem se destacando como elemento imprescindível e insubstituível em relação à qualidade da assistência prestada, desenvolvendo uma atenção individualizada e buscando formas de integração entre o conhecimento e a ação.

Este trabalho descreve uma nova técnica radioterapêutica baseada no acoplamento de dois métodos distintos: a braquiterapia, proporcionada pela emissão de nêutrons e raios gama de fontes mistas discretas colocadas em regiões intracavitárias do paciente, e a captura neutrônica por boro (BNCT). Com o objetivo de estudar a “performance” do tratamento acoplado, avaliações computacionais são propostas para quantificar as doses absorvidas. Análises de possíveis fontes geradoras de nêutrons, a saber: fontes mistas discretas, reatores nucleares, aceleradores lineares tipo LINAC e dispositivos de nêutrons frios, são apresentadas com o intuito de verificar a viabilidade técnica de instalação e uso da terapia de nêutrons em hospitais.

Introduction: Breast cancer is a disease from which there is a high chance of recovery if it is detected early and proper therapeutic treatment is undertaken. Radiotherapy is one of the methods of local treatment of malignancies, using ionizing radiation. It is often the method of choice among women with breast cancer. Radiotherapy, like other methods of oncological treatment, can cause side effects that may reduce the patients' quality of life. Aim of the research: The assessment of influence of radiotherapy on the quality of life of patients with breast cancer. Material and methods: The research method was a diagnostic survey, while the technique was a survey. The research tool was the author's questionnaire. The EORTC QLQ-C30 questionnaire was used to measure the quality of life. The study included 88 women treated at the Oncology Department of the Centre of Oncology of the Lublin Region. The Fisher test and the c2 test were used in the statistical analysis. Results and conclusions: Patients treated with radiotherapy were satisfied with the effects of treatment. There were no differences in the assessment of the quality of life before and after radiotherapy treatment. In the studied group of patients, the overall severity of individual symptoms significantly affects the quality of life of women with breast cancer. [ABSTRACT FROM AUTHOR]

Copyright of Dental Forum is the property of Dental Forum 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 Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana 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 Zdravotnicke listy is the property of Alexander Dubcek University in Trencin, Faculty of Nursing 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.)

Introducción: Los hemangiomas agresivos constituyen el 1% del total de los hemangiomas vertebrales. Pueden producir dolor, fracturas, deformidad y compromiso neurológico, generalmente de larga evolución. Se han descrito diferentes opciones terapéuticas, pero el manejo óptimo sigue sin estar claro. Comunicamos dos casos de paraparesia aguda secundaria a un hemangioma torácico agresivo, describimos su tratamiento y evolución. Realizamos una revisión narrativa de la bibliografía. Conclusión: Mediante la descompresión y la artrodesis tempranas seguidas de radioterapia, se logró la recuperación neurológica completa y el control de la enfermedad en un seguimiento a mediano plazo.

Estudios científicos han demostrado que la etnicidad tiene un gran impacto en la incidencia del cáncer, la supervivencia y la respuesta a los medicamentos. Dentro de los tratamientos más comunes para el cáncer de mama se encuentra la extirpación tumoral, la cual va de la mano con la radioterapia por su eficacia en destruir células cancerosas residuales. Sin embargo, se ha observado que la respuesta a la radiación es heterogénea entre pacientes y subtipos de cáncer de mama, observándose diferentes efectos adversos que pudieran estar asociados a la etnicidad. Sin embargo, en investigación se utilizan líneas celulares de origen caucásico y afroamericano, por lo que se considera la necesidad de nuevas líneas celulares de origen latinas y/o asiáticas. En esta revisión se expone la necesidad de evaluar y comparar los efectos de la radiosensibilidad usando modelos con diferente origen étnico para potencialmente aplicar la radioterapia personalizada según la etnicidad.

Introducción: El tumor de Buschke – Lowenstein (TBL) es enfermedad de transmisión sexual causada por el virus del papiloma humano (VPH), descrita como una forma intermedia entre un condiloma acuminado y un carcinoma de células escamosas. Afecta principalmente al área genital y anorrectal, posee capacidad de transformación maligna y una alta tasa de recurrencia. La cirugía es el tratamiento de primera línea. Caso clínico: Presentamos el caso de un paciente masculino de 27 años con lesiones verrucosas de crecimiento progresivo en el área inguinal y genital. Mediante la correlación clínico-patológica se llegó al diagnóstico de TBL. Tras discusión en comité multidisciplinario se declaró irresecable y se resolvió tratamiento con radioterapia, además vacunación terapéutica contra el VPH, tanto sistémica como intralesional. Conclusión: El TBL es localmente agresivo y de difícil tratamiento, por lo que la prevención contra el VPH es fundamental. La vacunación terapéutica en conjunto con la radioterapia ofreció mejoría clínica.

Introdução: A doença de Hodgkin (DH) e uma patologia que se inicia nos linfonodos, desenvolve-se nos tecidos neoplásicos e manifesta-se, majoritariamente, em jovens adultos. Objetivo: Correlacionar os resultados da terapêutica cirúrgica e do protocolo DH-II-90 em jovens adultos acometidos pela DH, e associa-los ao perfil epidemiológico, aos dados de mortalidade pela doença e a distribuição de recursos físicos no Brasil. Método: Estudo ecológico exploratório, com informações coletadas do Departamento de Informática do Sistema Único de Saúde (DATASUS), do Instituto Nacional de Câncer Jose Alencar Gomes da Silva (INCA), do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), entre 2013 e 2021. O estudo, portanto, compara os resultados da terapêutica cirúrgica e do protocolo DH-II-90 associados a dados epidemiológicos, sendo o protocolo considerado o método mais eficiente, por apresentar melhores resultados quando comparado a métodos mais invasivos. Resultados: A Região Sudeste concentra maior número de leitos e procedimentos com números mais expressivos de pacientes diagnosticados de 0 a 29 anos. Em resumo, as taxas de mortalidade bruta por DH reduziram-se a partir de 1990, período no qual o protocolo DH-II-90 foi aplicado. Conclusão: O presente estudo fornece uma visão relevante sobre o perfil epidemiológico da DH e contribui para a comparação entre a terapêutica cirúrgica e o protocolo DH-II-90, sendo possível concluir que, apos a aplicação do protocolo, houve redução da taxa de mortalidade por DH no Brasil e no mundo.

Introdução – A radioterapia (RT) é uma abordagem terapêutica para tratamento do cancro da mama esquerda. Contudo, diferentes técnicas respiratórias Respiração Livre (FB) e Inspiração Forçada (DIBH) podem ser usadas. Objetivos – Identificar em qual das técnicas de respiração, DIBH ou FB, se consegue obter uma melhor irradiação do Planning Target Volume (PTV) e uma menor dose nos órgãos de risco (OR). Perceber se a técnica de DIBH permite uma diminuição de dose no ventrículo esquerdo. Metodologia – Foram selecionadas 20 doentes, do sexo feminino, com patologia na mama esquerda. Na tomografia computorizada foram feitos os contornos do PTV e dos OAR. Obtiveram-se os dados dosimétricos de cada uma das doentes, com cada um dos dois tipos de técnica respiratória, que foram comparados. Resultados – Em média, a técnica DIBH reduziu a dose média (Dmed) e V20% no pulmão esquerdo, apenas sendo superior em quatro doentes. No ventrículo esquerdo observou-se uma diminuição de Dmed e V30% em todos os doentes. A medula quer em DIBH quer em FB não atingiu o limite de referência; contudo, verificou-se uma melhoria quando usado o DIBH. Conclusões – A técnica respiratória DIBH apresenta menor dose nos órgãos de risco, melhoria na cobertura de dose no PTV, bem como nos índices de conformidade homogeneidade e qualidade comparativamente à técnica de FB.

Spinal cord compression syndrome is defined as the symptoms and signs produced by compression of the spinal cord or nerve roots that form the cauda equina due to any lesion related to underlying neoplastic disease. It is the second most frequent neurological complication in cancer patients after brain metastases. It is estimated that it affects approximately 5% of cancer patients. It occurs mainly as a complication in patients affected by lung, breast, prostate cancer and multiple myeloma. Spinal cord compression syndrome is an oncological emergency in which early diagnosis and treatment largely determine the patient's functional prognosis. Its symptoms generally develop gradually over hours, days, or weeks, which varies depending on the biological behavior of the primary tumor. Magnetic resonance imaging is considered the imaging study of choice for the diagnosis of spinal cord compression syndrome. Treatment includes corticosteroids, radiation therapy, surgery, and chemotherapy. A search for original articles, systematic and narrative reviews was performed in the PubMed and Scielo database. From the review of 45 selected articles, a description of the pathophysiology and clinical manifestations of this syndrome was made. Special attention was paid to the different available diagnostic means and the therapeutic options. [ABSTRACT FROM AUTHOR]

Given the lack of an internationally accepted code of practice for patient-specific quality control (PS-QA) of intensity-modulated radiation therapy (IMRT) treatments and the need to introduce this advanced modality into the clinical practice of the Radiation Therapy Service at the cedt-CIMEQ, the methodology recommended by the American Association of Physicists in Medicine Working Group 119 (AAPM TG-119) was assimilated and implemented. The procedures used for its habilitation and the results obtained are shown. It can be seen that the results obtained with the cedt-CIMEQ system for PS-QA, applied to all TG-119 test cases, fall within the confidence limits emanating from 10 reference centers. It could be concluded that, from the point of view of the reliability of the linear accelerator, the accuracy of the planning system and the precision of the PS-QA system, the cedt-CIMEQ is suitable for the introduction of IMRT in the clinic. [ABSTRACT FROM AUTHOR]

The main objective of the present investigation was to solve the interruptions in radiotherapy according to the scientific and technical conditions of our radiotherapy institution. We analyzed which of the possible management modes can be applied in our center, establishing the dose compensation methods in the presence of interruptions of radiotherapy treatments. It was determined which method and mode of management is adapted to our circumstances, an action protocol was developed for our clinic, in the face of interruptions. A computer tool was developed to carry out the compensation automatically, only by entering the start, interruption and restart dates; as well as the data corresponding to the tumor, with the respective treatment scheme prescribed by the radiotherapist, solving the challenge of interruptions in our clinic. To achieve this, interruptions must be minimized, which leads to taking preventive measures and the creation of an action protocol. Both the protocol and the computer tool can be adapted to clinics with conditions similar to ours. Interruptions in radiotherapy treatment must be treated rigorously and resolved in the best possible way. [ABSTRACT FROM AUTHOR]

Intensity-modulated radiation therapy (IMRT) represents one of the most significant technical advances in radiotherapy since the advent of the medical linear accelerator, as it enables the clinical application of highly conformal and non-convex dose distributions. However, these advances do not come without risk, as IMRT represents a new paradigm in the radiation therapy process, particularly in terms of treatment quality assurance. This work focuses on one of the quality assurance aspects of IMRT, related to quality controls of multileaf collimators. A set of tests is presented to routinely evaluate the performance of this component of the accelerator to ensure the reliability and safety of the treatments. The results obtained show that most of the parameters studied comply with internationally accepted tolerances, so it is concluded that this component is suitable for use in IMRT treatments. [ABSTRACT FROM AUTHOR]

Introduction - Radiotherapy (RT) is a therapeutic approach for the treatment of left breast cancer. However, different breathing techniques free breathing (FB) and deep inspiration breath-hold (DIBH) can be used. Objectives - To identify which of the breathing techniques, DIBH or FB, has obtained better irradiation of the planning target volume (PTV) and a lower dose at the organs at risk (OAR). Check if the DIBH technique allows a dose reduction in the left ventricle. Method - Twenty female patients with pathology in the left breast were selected. In computed tomography, the contours of PTV and OAR were made. We obtained dosimetric data for each patient, with each of the two types of breathing techniques. Dosimetric data for all patients were compared and for both respiratory techniques. Results - The DIBH technique reduced the mean dose (Dmean) and V20% in the left lung, only being higher in four patients. In the left ventricle, there was a decrease in Dmean and V30% in all patients. The spinal cord in either DIBH or FB did not reach the reference limit, however, there was an improvement when using DIBH. Conclusions - The DIBH technique presents lower doses in the organs at risk, improvements in PTV dose coverage, as well as conformity, homogeneity, and quality indexes when compared to the FB technique. [ABSTRACT FROM AUTHOR]

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Background: image processing is the key in planning external beam radiotherapy treatments. In its execution, human errors and equipment failures can occur, which lead, among other effects, to erroneous interpretations of diagnostic images, target contouring errors, overdose of healthy tissues or underdose of tumor tissues, which means putting patients at risk patients subjected to these practices. Objective: to characterize the risks associated with technological and human factors related to image processing that can affect patients undergoing radiotherapy treatments with external beams. Methods: intensity modulated radiotherapy was used as the basis of the study. To characterize the initiators and defense measures related to this processing, risk models were used based on analysis of failure modes and effects and the risk matrix of the reference practice, which were processed with the SECURE-MR-FMEA software. Results: the sensitivity analyzes on the intensity-modulated radiotherapy models showed the effects on the risk of failures associated with image processing. Conclusions: the importance of applying risk analysis in image processing to increase patient safety during external beam radiotherapy treatments was confirmed. [ABSTRACT FROM AUTHOR]

Background: there is still no optimal way to determine the dose absorbed by tumors; this lack of knowledge is the reason why the final dose of treatment is unpredictable. For this reason, patients may be receiving doses greater than the minimum required for their correct diagnosis. Objective: to create a source code for an application project of the GATE program in the simulation of absorbed dose in molecular radiotherapy, by Monte Carlo method, for a Giap phantom. Methods: the simulation was carried out by the Montecarlo method from modeling the Giap phantom, using the GATE simulation platform. The results obtained were compared with the information reflected in the bibliography on standardized best practices. Results: a source code implemented in GATE was prepared for the determination of the absorbed dose in molecular radiotherapy. Non-uniform distribution of doses was obtained in a medium with uniform activity and an approximate 2% uncertainty (in correspondence with the values reported in the literature), the results allow to affirm that the dose simulation through the GATE platform is reliable, of little computational expense and highly recommended. Conclusions: it is advisable to use the GATE platform for the simulation of the calculation of the absorbed dose because it is fast, of low computational cost and reliable. [ABSTRACT FROM AUTHOR]

El cáncer de recto es el tercer cáncer en frecuencia en Colombia, y constituye un reto diagnóstico y terapéutico para gastroenterólogos, cirujanos y oncólogos. La evaluación diagnóstica y el estudio de su extensión locorregional y sistémica se han modificado por nuevos métodos de imagen, que permiten una visualización precisa de estructuras anatómicas que antes no se podían evaluar fácilmente. La disponibilidad de estas nuevas herramientas en la estadificación de la enfermedad ha tenido un gran impacto en las decisiones terapéuticas y en la escogencia de una ruta de tratamiento específica para cada paciente, lo que ha racionalizado el uso de terapias neoadyuvantes y la realización de cirugía con criterios anatómicos correctos. Esto ha sido fundamental en el objetivo de lograr los mejores desenlaces con la menor morbilidad posoperatoria asociada. En este artículo se revisarán y explicarán en detalle cuáles han sido los cambios más recientes y las recomendaciones más actualizadas para el manejo del cáncer de recto.

Objetivo: Determinar si los óvulos vaginales artesanales de aloe vera barbadensis son efectivos en el tratamiento tópico de la vaginitis atrófica postradioterapia. Métodos: Estudio prospectivo, unicéntrico, longitudinal experimental, incluidos pacientes sometidos a Radioterapia pélvica de la Clínica de Ginecología Oncológica (n= 75), con sintomatología de vaginitis atrófica. Aplicado criterios de inclusión y exclusión fueron seleccionados 46 pacientes de manera aleatoria 23 fueron asignados al grupo control y 23 al grupo experimental. Se obtuvo seguimiento de 18 y 21 pacientes respectivamente. Resultados: Prurito basal, la mediana en grupo control y experimental fue de 8 previo al tratamiento, postratamiento grupo control obtuvo una mediana de 6 mientras que la del grupo experimental fue 0. Para dispareunia, la mediana de la escala cualitativa en el grupo control y experimental fue de 8 previo al tratamiento, y postratamiento el grupo control obtuvo una mediana de 6 mientras que la del grupo experimental fue 2. En cuanto al trofismo vaginal, el 85.7% del grupo experimental no presentó imágenes sugestivas de atrofia en la colposcopia postratamiento, Conclusiones: Para los síntomas de atrofia vaginal (prurito vaginal y dispareunia) el grupo que utilizo los óvulos de A.V. Barbadensis presentaron mejoría clínica estadísticamente significativa y para los signos de atrofia postratamiento como trofismo a la colposcopia y citología vaginal, el grupo que utilizo los óvulos de A.V.Barbadensis presentaron mejoría evidente en un 85.7% siendo estadísticamente significativo, resultados que aportan evidencia para respaldar el uso de hidratantes vaginales para la atrofia vaginal, en nuestro caso en pacientes irradiados.

El análisis citológico tiene un papel fundamental en el estudio de los nódulos tiroideos. Sin embargo, de un 20% a 30% de estos muestran citologías indeterminadas (BETHESDA III o IV). En estos casos, se realizan cirugías diagnósticas que únicamente demuestran malignidad en un 15-35% de los pacientes, en el siguiente reporte de casos, se presentaran dos casos diagnosticados, tratados y aun con seguimiento médico en el Centro Medico Docente La Trinidad, Caracas, Venezuela en los cuales la prueba de marcadores moleculares (Afirma®) se utilizó como estudio complementario para el diagnóstico y decidir la conducta terapéutica de ambos casos, el Primer caso es un paciente masculino de 38 años de edad, quien acude a consulta por presentar aumento de volumen en región anterior del cuello, el cual refiere antecedente de linfoma hodgkin tratado hace 20 años con radioterapia, actualmente se encuentra libre de enfermedad, se realiza ultrasonido tiroideo y se evidencia Nódulo único en lóbulo Izquierdo TIRADS 4 A. ATA (American Thyorid Association) 2015: Categoría de riesgo: Baja Sospecha. Se realiza PAAF la cual arroja descripción microscópica: Citología IV sospechosa de neoplasia folicular. Segundo caso Paciente femenina de 83 años de edad quien consulta al servicio de endocrinología por presentar bocio multinodular con antecedentes de Diabetes mellitus tipo 2 Se realiza Ultrasonido tiroideo en el cual se evidencia múltiples imagines nodulares de predominio mixto, múltiples calcificaciones gruesas sin descartarse microcalcificaciones, nódulo LTO TIRADS 3-4 de predominio quístico.

Rectal cancer is the third most frequent cancer in Colombia and constitutes a diagnostic and therapeutic challenge for gastroenterologists, surgeons, and oncologists. Diagnostic evaluation and the study of its locoregional and systemic extension have been modified by new imaging methods, enabling an accurate view of anatomical structures that could not be easily examined before. The availability of these new tools in disease staging has significantly impacted therapeutic decisions and the choice of a specific treatment path for each patient, rationalizing the use of neoadjuvant therapies and the performance of surgery with correct anatomical criteria. The preceding has been essential to achieving the best outcomes with the least associated postoperative morbidity. This article will review and explain in detail the most recent changes and up-to-date recommendations for managing rectal cancer. [ABSTRACT FROM AUTHOR]

Background: The most common primary brain neoplasm is meningioma. Dolichocephalic breeds are predisposed and there is no sexual predilection. Clinical signs depend on the location and size of the tumor and have a progressive course. Primary treatement includes surgery, radiotherapy or both. This study aimed to describe the treatment of a dog with suspected intracranial meningioma with definitive radiotherapy, which resulted in significant clinical improvement and prolonged survival. Case: A 9-year-old Shetland Shepherd bitch was diagnosed with a head tilt to the left side that progressed over a few weeks. She previously received corticosteroid therapy, which resulted a clinical improvement that worsened after treatment was discontinued. Computed tomography revealed an extra-axial brain mass in the caudal fossa, lateralized to the right, welldelimited, and measuring approximately 1.5 × 1.4 × 1.7 cm, suggestive of intracranial meningioma. The patient was treated with radiotherapy using Cobalt-60 equipment, with 18 daily fractions of 2.5 Gy at a total dose of 45 Gy using parallel and opposite technique fields. A new tomography performed 30 days after treatment showed a remission of 85% of the initial brain mass measuring approximately 0.9 × 1.0 × 0.5 cm, as well as complete resolution of the clinical signs initially presented. After 14 months, the patient presented with signs of lethargy and ataxia and was medicated with hydroxyurea at a dose of 50 mg/kg 3 times a week and corticosteroid therapy. However, the patient’s neurological condition deteriorated, and she was subjected to reirradiation using the same protocol used previously, which resulted in clinical improvement and a 54% reduction in tumor volume on magnetic resonance. As a late side effect, only permanent alopecia in the irradiated region was observed. The patient died of disease 330 days after the second course of radiotherapy, with a total survival time of 1087 days. Discussion: Meningiomas are extra-axial neoplasms of the central nervous system that grow inside the dura mater. The literature shows that meningiomas are more common in dolichocephalic races with a mean age of 9 years, which supports our findings. Meningiomas most commonly affect the cortical thalamus and cerebellopontine region in dogs, which are normally associated with vestibular symptoms, as seen in this case. Diencephalic damage can result in vestibular signals since the thalamus functions as a relay station for vestibular afferent stimuli that are relayed to the cerebral cortex. In addition to the vestibular syndrome, common clinical signs associated with meningiomas in dogs include seizures, behavioral changes, and walking in circles, which are frequently misinterpreted due to tumor-induced side effects, such as cerebral edema, obstructive hydrocephalus, and cerebral hernia. Advanced imaging techniques should be used to diagnose intracranial neoplasms. In this case, computed tomography was critical for diagnosis and treatment planning. Meningioma treatment may comprise palliative measures, surgery, and radiotherapy. Radiotherapy as a single treatment can improve the quality of life with a decrease in clinical signs and a median survival time of approximately 250-536 days, as reported in the literature. Hydroxyurea can be a therapeutic option in inoperable cases and for patients with clinical limitations to undergo successive anesthesia during radiotherapy. Its most serious side effect is progressive myelosuppression. It can cause temporary partial tumor remission and improvement in clinical signs. As previously stated, radiotherapy can be an effective primary treatment option for treating intracranial meningiomas in dogs, with significant improvement in neurological clinical signs and mild side effects. [ABSTRACT FROM AUTHOR]

Treatment with radiation therapy can be relatively inexpensive and highly effective, reducing the overall cost of healthcare, as well as saving lives of cancer patients. To face the posed challenges of laborious tasks and understaff in radiotherapy, the use of knowledge-based models (artificial Intelligence) to reduce the treatment planning times up to 95% might be a promising solution. One such tool, called RapidPlan (Varian Medical Systems, Palo Alto-CA), could be acquired with an investment of a small fraction of the treatment planning system cost. RapidPlan's support during treatment planning results in a considerable increase in plan quality while reducing plan variability and elaboration time. The goal of this dissertation was to estimate the break-even point from where the time saved during treatment time would pay the initial investment on RapidPlan. Published data demonstrates that RapidPlan can largely benefit radiation therapy institutions by streamlining the treatment planning process and the break-even point started to be achieved after treating 112 to 2668 patients, depending on the cancer types treated for each group. Therefore, it may be possible to realize a return on investment within a reasonable time frame, while benefiting from gains in efficiency, and possibly mitigating understaffing and lack of experience in treatment planning. [ABSTRACT FROM AUTHOR]

Lacrimal duct obstruction can be a side effect of systemic and/or local cancer treatments. Chronic epiphora has a great impact on the quality of life of oncological patients. Since terminal fibrosis of the lacrimal system may require complex procedures, it is important to be aware of this adverse effect in order to recognize and treat it, or even prevent it. A literature review was performed to identify all types of systemic cancer treatment associated with lacrimal obstruction and to describe the mechanisms, frequency, treatment, and prophylaxis. The oncological treatments associated with lacrimal obstruction were head and neck radiotherapy (dosage above 45-75 Gy), radioiodine therapy (dosage above 150 mCi), and chemotherapy with 5-FU, S-1, Capecitabine and Docetaxel. Depending on the dose, this complication may be irreversible. Prophylactic intubation of the lacrimal system is an option for prophylaxis in cases of radiotherapy, use of 5-FU, S-1, and Docetaxel. Final surgical treatment is dacryocystorhinostomy. [ABSTRACT FROM AUTHOR]