RESUMEN
Background: Benign diseases include tumours or localized growths with low potential for progression. The use of radiotherapy (RT) at a low dose (LD) or intermediate dose for benign pathologies has been widely proposed and studied. Currently, the use of RT is limited mainly to hyperproliferative and inflammatory diseases as a first or second line of treatment. Materials and methods: This was a retrospective, observational and descriptive study conducted in the Radiotherapy Unit of the Oncology Service of the General Hospital of Mexico "Dr. Eduardo Liceaga" from January 2, 2016, to December 31, 2020. Patients diagnosed with benign pathology and treated with RT were included. The response to treatment was recorded based on the imaging study report and/or clinical review that determined control of the disease, and toxicity was recorded based on the RTOG evaluation for acute effects and CTCAE V. 4.0 for chronic effects. Results: The records of 222 patients were analysed. The mean follow-up duration was 31.53 months (range 6-61), and the median was 24 months. Of all of the analysed pathologies that were treated with RT, keloid scars predominated in 112 patients (50.5%), and paragangliomas predominated in 72 patients (32.4%); the other patients were treated for rare pathologies. The prescribed dose was dependent on the diagnosis, with the mean dose being 31.63 Gy (1500-6000 cGy) and the median being 2000 cGy. Most of the cases of acute and chronic toxicity were grades 1 and 2, and a disease response was achieved in 94.1% of the patients. Conclusion: Our series shows that for cases of benign pathology, RT offers acceptable toxicity, improves quality of life and yields a good response, achieving disease control. These results suggest the inclusion of inflammatory pathology among the indications for treatment.
RESUMEN
Background: Radiotherapy (RT) is an essential element in cancer treatment: 50-70% of cancer patients receive RT at some time of the course of their disease. Of these, almost 95% experience some grade of radiation dermatitis (RD). RD can affect patient's quality of life during and after treatment. Consequently, the management of RD is important. There are few randomized controlled clinical trials on interventions used to prevent and treat RD and no standardized consensus on RD management. A panel of opinion leaders of the Mexican Society of Radiotherapy (SOMERA) took part in a study of oncologic practice in Mexico. The following clinical guide is referenced both by the national practice reality and international evidence. Materials and methods: This RD management guide is based on input provided by 25 Mexican radiation oncologists, whose criteria were gathered using the Delphi Method and article review. Results: Twenty-one questions about experience in RD treatment were voted. More than 80% of the panel agreed with: the use of dermocosmetics/medical device in prevention and in treatment of RD grades 1-2. As for grade 3, they recommend individualizing each case and dermatologist evaluation. Topical steroids should be used when there is skin itching or pain. Consider the use of natural soaking elements. Skin care must be continued to avoid or reduce severity of late radiation skin lesions. Conclusion: This consensus was developed as a supportive educational tool that can be adapted to individual clinical needs, useful for professionals involved in the treatment of RT patients.