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BACKGROUND: The 'FAST-forward', study published in April 2020, demonstrated the effectiveness of an extremely hypofractionated radiotherapy schedule, delivering the total radiation dose in five sessions over the course of 1 week. We share our department's experience regarding patients treated with this regimen in real-world clinical settings, detailing outcomes related to short-term toxicity and efficacy. METHODS: A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions. RESULTS: The median age was 64 years (range: 43-83), with 82 patients (51.3%) treated for left-sided breast cancer, 77 patients (48.1%) for right-sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki-67 (Ki-67 < 20%; 51.9%) and were Her 2 negative (85%). The majority of surgical margins were negative (99.4%). Among the patients, 72.5% received hormonotherapy, and 23.8% received chemotherapy. Additionally, 26 patients (16.3%) received an additional tumour boost following whole breast irradiation (WHBI) of 10 Gy administered in five sessions of 2 Gy over a week. The median planning target volume (PTV) was 899 cm3 (range: 110-2509 cm3). Early toxicity was primarily grade I radiodermatitis, affecting 117 patients (73.1%). During a median follow-up of 15 months (range: 3.9-28.77), only one patient experienced a local relapse, which required mastectomy. CONCLUSIONS: The implementation of this highly hypofractionated regimen in early-stage breast cancer appears feasible and demonstrates minimal early toxicity. However, a more extended follow-up duration would be required to evaluate long-term toxicity and efficacy accurately.
Assuntos
Neoplasias da Mama , Hipofracionamento da Dose de Radiação , Humanos , Feminino , Idoso , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Adulto , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Radioterapia Adjuvante/efeitos adversos , Radioterapia Adjuvante/métodos , Resultado do TratamentoRESUMO
Emerging adulthood is an important developmental period, associated to mental health risk. Resilience research points to both social and personal protective factors against development of psychopathology, but there is paucity with their comprehensive study in young adults. This study provides and initial integrative approach to model multiple dimensions of perceived social support (i.e., from family, friends, significant others) and personal factor of trait resilience (i.e., coping and persistence during stress, tolerance to negative affect, positive appraisals, trust) and their hypothesized contributions to reducing depression and anxiety rates. The study was conducted with a sample of 500 Spanish emerging adults (18 to 29 years old). Regression analyses and multiple mediation models were performed to test our hypotheses. Results showed that social support from family was the dimension with the highest strength relating individual differences in resilience. Furthermore, analyses supported a differential mediating role of specific resilience factors (coping and persistence during stress, tolerance to negative affect, positive appraisals, trust) in partially accounting for the association between higher social support from family and lower depression and anxiety levels in young adults. These results may inform new programs of mental health during emerging adulthood via the promotion of different sources of social support and their related resilience pathways contributing to low emotional symptomatology at this stage of development.
Assuntos
Depressão , Resiliência Psicológica , Humanos , Adulto Jovem , Adulto , Adolescente , Depressão/psicologia , Fatores de Proteção , Ansiedade/psicologia , Apoio SocialRESUMO
Negative interpretation biases are thought to be clinical markers of depression and risk factors for its recurrence that would remain active after remission. Evidence on the conditions under which negative interpretation biases are active after remission is still unclear, and further studies are required to clarify whether negative interpretation biases are equivalent in magnitude at different depression conditions. A large-scale study of the Scrambled Sentence Task (SST) was conducted (639 participants), where different depression and never-depressed samples were compared in their performance in the SST through three experiments (i.e., formerly - Studies 1 and 2 -, subclinically - Study 2 - and clinically depressed individuals - Study 3 -). Cognitive load manipulations were used while completing the task. Formerly compared to never-depressed individuals showed higher negative interpretation biases at conditions of cognitive load only (Study 1). Formerly and subclinically depressed showed equivalent biases compared to never-depressed individuals (Study 2). Negative interpretation biases were further supported for clinically depressed (Study 3). Comparative analyses showed that both formerly and subclinically differed from clinically depressed individuals in their negative bias magnitude. These results prove the utility of the SST to detect negative interpretation biases in different depression conditions, including those recovered from depression. Results further show that negative bias magnitudes tend to decrease after remission but remain at subclinical levels, potentially conferring risk for depression recurrence.
Assuntos
Cognição , Depressão , Humanos , Depressão/psicologia , Cicatriz , Viés , BiomarcadoresRESUMO
Rumination and worry are vulnerability factors involved in the early development of depression and anxiety during adolescence, particularly in girls. Current views conceptualize rumination and worry as transdiagnostic forms of repetitive negative thinking (RNT). However, most of research has analyzed them separately, without considering gender differences. We analyzed common and specific roles of rumination and worry in accounting for depressive and anxiety symptom levels overall and as a function of gender in adolescents (N = 159). Rumination and worry items were loaded into separate RNT factors. Girls showed a higher use of rumination and worry and higher levels of depression and anxiety than boys. Structural equation modeling supported that both RNT factors accounted for gender differences in symptom levels: rumination was the strongest mediator for depression and worry the strongest mediator for anxiety. Our findings support both general and specific contributions of RNT to account for affective symptomatology during adolescence, particularly in girls. Supplementary Information: The online version contains supplementary material available at 10.1007/s41811-022-00133-1.
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School satisfaction is conceptualized as a crucial factor influencing children´s happiness and consequent healthy functioning in multiple developmental areas. Research to date has mainly evaluated how contextual factors related to the interactions between the student, teachers and classmates influence children's happiness, not considering other important factors more related to their own student experiences. The aim of the present study was to examine the effect of school satisfaction on happiness in 10-year-old children from Europe. Children's global school satisfaction levels, as well as different separate indicators of school satisfaction (i.e., satisfaction with other children in class; school marks; school life experience as a student; things they have learned; and relationships with teachers) were considered. The study comprised a sample of 7.445 10-year-old children from seven European countries. First, correlation analysis showed that the overall school satisfaction measure, as well as its different indicators, had positive associations with happiness levels. Second, regression analyses confirmed the effect by indicators of global school satisfaction on happiness. The indicators with the strongest effects were the satisfaction with their life as a student and the satisfaction with other children in the class, while the smallest effects were found regarding the satisfaction with the relationships with teachers and the things learned. These results point out the need to consider personal and contextual indicators of school satisfaction in a program design to foster happiness in 10-year-old children.