Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial).

PURPOSE: To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: Inclusion criteria comprised patients with COVID-19-related moderate-severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. RESULTS: Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X­ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. CONCLUSIONS: LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.

Predictive factors for survival in neoadjuvant radiochemotherapy for advanced rectal cancer.

INTRODUCTION: Neoadjuvant radiochemotherapy followed by radical surgery is the standard approach in advanced rectal carcinoma. Tumor response is determined in histological specimen. OBJECTIVE: To assess predictive factors for survival in 115 patients. PATIENTS AND METHOD: 115 patients treated with neoadjuvant radiochemotherapy followed by radical surgery with total mesorectal excision, in our hospital from January 2007 to December 2014. All patients received pelvic radiotherapy with concomitant chemotherapy, followed by radical surgery and in some adjuvant chemotherapy. RESULTS: In univariate analysis, distance to anal verge, radial margin, perineural invasion, and good grade regression are predictive factors for both, specific and disease free survival; and in multivariant, only radial margin and perineural invasion were predictive factors for survival. We found distance to anal verge (<5 cm) as the only clinical factor to predict a positive margin in the histologic specimen. CONCLUSIONS: Perineural invasion and positive radial margin are predictive factors for both specific and disease free survival.

[Intravitreal bevacizumab for choroidal neovascularization associated with Best's disease]. / Bevacizumab intravítreo en neovascularización coroidea asociada a enfermedad de Best.

CASE REPORT: A 27-year old woman presented with loss of vision in the right eye (20/200). Ophthalmoscopic examination showed intrarretinal hemorrhage in the macular region with neurosensory detachment in the right eye, and viteliform deposit on the left eye. Fluorescein angiography and the electrooculogram confirmed the diagnosis of choroidal neovascularization associated with Best's disease. Four weeks after a single bevacizumab intravitreal injection, visual acuity was restored (20/25) and remained stable after a 12 month follow-up. DISCUSSION: Intravitreal bevacizumab appears to be an effective treatment for choroidal neovascularization associated to Best's disease.

Predictive factors for survival in neoadjuvant radiochemotherapy for advanced rectal cancer

Introduction. Neoadjuvant radiochemotherapy followed by radical surgery is the standard approach in advanced rectal carcinoma. Tumor response is determined in histological specimen. Objective. To assess predictive factors for survival in 115 patients. Patients and Method. 115 patients treated with neoadjuvant radiochemotherapy followed by radical surgery with total mesorectal excision, in our hospital from January 2007 to December 2014. All patients received pelvic radiotherapy with concomitant chemotherapy, followed by radical surgery and in some adjuvant chemotherapy. Results. In univariate analysis, distance to anal verge, radial margin, perineural invasion, and good grade regression are predictive factors for both, specific and disease free survival; and in multivariant, only radial margin and perineural invasion were predictive factors for survival. We found distance to anal verge (<5 cm) as the only clinical factor to predict a positive margin in the histologic specimen. Conclusions. Perineural invasion and positive radial margin are predictive factors for both specific and disease free survival (AU)

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Bevacizumab intravítreo en neovascularización coroidea asociada a enfermedad de Best / Intravitreal bevacizumab for choroidal neovascularization associated with Best's disease

CASO CLÍNICO: Mujer de 27 años que presentaba disminución de visión en ojo derecho (20/200). El examen funduscópico reveló una hemorragia intrarretiniana macular con desprendimiento neurosensorial en ojo derecho, y un depósito de material viteliforme en el ojo izquierdo. La angiografía fluoresceínica y el electrooculograma confirmaron el diagnóstico de neovascularización coroidea asociada a enfermedad de Best. Cuatro semanas después de una única inyección de bevacizumab intravítreo, la agudeza visual a la normalidad (20/25) y se mantuvo estable tras 12 meses de seguimiento. DISCUSIÓN: El bevacizumab intravítreo puede ser una opción terapéutica eficaz en la neovascularización coroidea secundaria a enfermedad de Best

CASE REPORT: A 27-year old woman presented with loss of vision in the right eye (20/200). Ophthalmoscopic examination showed intrarretinal hemorrhage in the macular region with neurosensory detachment in the right eye, and viteliform deposit on the left eye. Fluorescein angiography and the electrooculogram confirmed the diagnosis of choroidal neovascularization associated with Best's disease. Four weeks after a single bevacizumab intravitreal injection, visual acuity was restored (20/25) and remained stable after a 12 month follow-up. DISCUSSION: Intravitreal bevacizumab appears to be an effective treatment for choroidal neovascularization associated to Best's disease

Long-term results and prognostic factors of patients with cervical carcinoma treated with concurrent chemoradiotherapy

AIMS AND BACKGROUND: To evaluate the predictive factors of recurrence in cervical cancer treated with radical radiochemotherapy. METHODS: A retrospective analysis of 56 women was performed. Response was assessed using the RECIST response. Overall survival and disease-free survival curves were estimated by the Kaplan-Meier method and the Cox proportional hazards model was used to analyse predictors of recurrence. RESULTS: Local recurrence was documented in 16 patients and distant metastases in 15. The Kaplan-Meier survival probabilities were 95.1 ± 6.4% at 3 years and 80.4 ± 13.1% at 5 years and the Kaplan-Meier curve values for disease-free survival were 60.3 ± 14.3% at 3 years and 53.0 ± 15.7% at 5 years. Thirty-five patients were alive and 21 patients died, 19 from metastatic disease and 2 from other causes. Complete response after chemoradiation therapy, squamous cell carcinoma and tumour size ≤ 4 cm were significantly associated with outcome. In the Cox regression model, tumour size > 4 cm (hazard ratio 7.48; 95% CI 2.71-20.6; p < 0.001) and partial response (hazard ratio 7.09; 95% CI 2.82-17.8; p < 0.001) were predictive factors for disease-free survival and partial response (hazard ratio 3.7; 95% CI 1.3-10.1; p < 0.001) and non-squamous cell carcinoma (hazard ratio 3.5; 95% CI 1.2-9.7; p < 0.001) were predictive factors for overall survival. CONCLUSIONS: Non-squamous histology and partial response were independent prognostic factors for overall survival and tumour size and partial response were independent prognostic variables for 5-year disease survival (AU)

Variación en las indicaciones de irradiación externa en el cáncer de mama. Análisis de 4.545 casos (1990-2005) / No disponible

Introducción: Los cambios en el diagnóstico precoz, la cirugía,el tratamiento sistémico y los avances tecnológicos de laradioterapia han provocado un cambio, cualitativo y cuantitativo,en la utilización de las radiaciones en el tratamiento de laneoplasia de mama.Objetivo: Analizar los cambios en las indicaciones de irradiaciónexterna por neoplasia de mama desde el año 1990hasta la actualidad.Resultados: De enero 1990 a diciembre 2005 se realizaron4.545 irradiaciones por cáncer de mama, que representanel 29% del total. En el año 1990, el 43% de las indicacioneseran radicales y el 56% paliativas y actualmente el 82%son radicales y el 18% paliativas. También se constata un aumentodel tratamiento conservador, del 14 al 61%. Por elcontrario el resto de indicaciones, tras mastectomía, paliativosistémico o local disminuyen.Conclusiones: Actualmente el 29% de los tratamientos deun servicio de radioterapia son por cáncer de mama. Se detectaun aumento de la incidencia de la irradiación tras tratamientoconservador. Por el contrario, destaca una disminución dela irradiación tras mastectomía y de los tratamientos paliativos,tanto generales como locales, probablemente debido al aumentode la utilización de los tratamientos sistémicos(AU)

Introduction: Changes in early diagnosis, surgery, sistemictreatment and technological radiotherapy developments havemade a qualitative and quantitative changes, in the use of radiationin the treatment of breast cancer.Objective: Analyze the changes in the indication of radiationtherapy for breast cancer, since 1990 to nowadays.Results: From january 1990 to december 2005 we underwent4.545 irradiations for breast cancer (29% of total irradiations).In 1990, 43% of indications were radicals and 56% werepalliatives. Nowadays 82% are radicals and 18% are palliatives.Also, we can see an increase of the conservative treatment,from 14 to 61%. On the contrary, the rest of indications dicrease:after mastectomy, sistemic, palliative or local palliative.Conclusion: An increase in the incidence of breast canceris observed at the present time correspondig to 29% amountof treatments in a radiation in department. Also an increase ofincidence of the radiation after conservative treatment is confirmed.On the contrary, the incidence of the radiation aftermastectomy and palliative treatments decreases, probably dueto the use of the sistemic treatments(AU)

Presentación de un modelo de programa de optimización en la gestión interna de pacientes / Presentation of a model for an optimisation in the internal management of patients

La complejidad de los circuitos de los servicios de radioterapia, donde intervienen distintos departamentos, el carácter secuencial del tratamento con un elevado número de pacientes en cada una de las diferentes fases del proceso, y la obligada optimización en el uso de los aceleradores debido a la creciente presión asistencias, requieren un control de calidad exhaustivo en la gestión interna de los pacientes. Los programas comerciales presentes en mercado acostumbran a ser cerrados, inaccesibles y no adaptables a la realidad de cada centro. En el Institut d´Oncologia Radioteràpica (IOR) hemos desarrollado un modelo de programa informático que permite garantizar un riguroso control sobre estos aspectos y elimina el uso de las engorrosas listas en papel

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Certificación ISO del Institut d´Oncología Radioteràpica del Hospital de l`Esperança / ISO certification of the Radiotherapeutic Oncology Institute of the Hospital de l'Esperança

El IOR (Institut d´Oncología Radioterápica) nació con la misión de tratar de forma eficaz y segura a los pacientes. En este artículo nos detallan los pasos a seguir y el tiempo empleado para con seguir la certificación ISO para establecer un plan de calidad para el Servicio (AU)

The IOR (Radiotherapeutic Oncology Institute) was set up with the mission of treating patients in an effective and safe way. This article explain the steps followed and the time required for obtaining the ISO certification in order to establish a quality plan for the Service (AU)