RESUMEN
AIM: To analyse the efficacy and toxicity of postprostatectomy SRT in patients with a BCR evaluated with mpMRI. BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) has the ability to detect the site of pelvic recurrence in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). However, we do not know the oncological outcomes of mpMRI-guided savage radiotherapy (SRT). RESULTS: Local, lymph node, and pelvic bone recurrence was observed in 13, 4 and 2 patients, respectively. PSA levels were significantly lower in patients with negative mpMRI (0.4 ng/mL [0.4]) vs. positive mpMRI (2.2 ng/mL [4.1], p = 0.003). Median planning target volume doses in patients with visible vs. non-visible recurrences were 76 Gy vs. 70 Gy. Overall, mean follow-up was 41 months (6-81). Biochemical relapse-free survival (bRFS) at 3 years was 82.3% and 82.5%, respectively, for the negative and positive mpMRI groups (p = 0.800). Three-year rates of late grade ≥2 urinary and rectal toxicity were 14.8% and 1.9%, respectively; all but one patient recovered without sequelae. CONCLUSION: SRT to the macroscopic recurrence identified by mpMRI is a feasible and well-tolerated option. In this study, there were no differences in bRFS between MRI-positive and MRI-negative patients, indicating effective targeting of MRI-positive lesions.
RESUMEN
En el Servicio de Obstetricia del Hospital de la Mujer de la ciudad de La Paz, se realiza cesária de paciente con 43 años de edad con diagnóstico de anemia aplasica, con anesntesia general. Nose presentaron complicaciones hemorrágicas como se esperaba en el trans-operatorio y la recuperación pos-operatoria fue buena en la madre y recien nacido. Concluimos que la anemia aplasica es una entidad clínica poco frecuente con peligrosa mortalidad asociada al embarazo. La técnica anestésica de elección debe ser cuidadosamente analizada considerando el estado general de la paciente y las posibles complicaciones que se puedan presentar.