BNCT research activities at the Granada group and the project NeMeSis: Neutrons for medicine and sciences, towards an accelerator-based facility for new BNCT therapies, medical isotope production and other scientific neutron applications.

The Granada group in BNCT research is currently performing studies on: nuclear and radiobiological data for BNCT, new boron compounds and a new design for a neutron source for BNCT and other applications, including the production of medical radioisotopes. All these activities are described in this report.

Spanish Society of Radiation Oncology clinical guidelines for stereotactic body radiation therapy in lymph node oligometastases.

Data in the literature support the existence of a state of limited metastases or oligometastases. Favorable outcomes have been observed in selected patients with such oligometastases that are treated with local ablative therapies, which include surgical extirpation, stereotactic body radiation therapy (SBRT), and radiofrequency ablation. The role of SBRT in the setting of lymph node oligometastases is still emerging but the early results for local control are promising. However, the biggest challenge is to identify patients who will benefit from treatment of their oligometastatic disease with local aggressive therapy. Patients are initially categorized based upon examination of the initial biopsy, location, stage, and previous treatments received. Appropriate patient management with SBRT requires an understanding of several clinicopathological features that help to identify several subsets of patients with more responsive tumors and a good tolerance to SBRT. In an effort to incorporate the most recent evidence, here the Spanish Society of Radiation Oncology presents guidelines for using SBRT in lymph node oligometastases.

Evidence-based estimation and radiotherapy utilisation rate in Andalusia.

INTRODUCTION: The objective of this study was to estimate the theoretical needs -based on evidence- of radiotherapy treatments (RDT) in Andalusia, compare these needs with actual use of RDT in 2006 and analyse their evolution from 2003. MATERIALS AND METHODS: Correlation between quantitative variables was analysed with Pearson's correlation coefficient. This dealt with differences between administered/estimated treatments and treatments carried out in years with the Student's t-distribution, and the Xi2 test among qualitative variables. RESULTS: In Andalusia, the evidence-based rate of cancer irradiation is 55%. Eighty-five percent of theoretical treatments were administered in 2006. From this group, 107% were in gynaecological tumours, 100% in breast cancer cases, 71% in head and neck cancer and 48% in lung cancers; differences in the last two conditions were significant (p<0.01). As for regional distribution, differences were reported with reference to irradiation rates (p<0.0002) and resource distribution. In the last three years, an increment of 17% was observed in treatments conducted in public hospitals. The rate increased from 61% (with regard to optimal values) to 85% in 2006; in a parallel way, an increment was seen in therapy units (from 22 to 26) and radiation oncologists (from 57 to 69). CONCLUSIONS: Despite the increment of irradiation rates seen in the last years, there is still a serious underutilisation of RDT for some cancer types (lung, head and neck cancer), as well as a great variability in the use of RDT between hospitals.

[Physiopathologic knowledge and clinical practice. A case of high dose chemotherapy in breast cancer]. / Conocimiento fisiopatológico y práctica clínica: quimioterapia a altas dosis en el cáncer de mama.

Breast cancer is the major cause of death from cancer in women. This causes a great activity in oncological investigation in this field. During the 80s preclinical data and retrospective analysis suggested a dose-response relationship both for adjuvant treatment and metastatic disease. Technical advances in collection and administration of peripheral stem cells and the development of hematological growth factors permitted the use, in this and other diseases, of high dose chemotherapy, usually with hematological support. All these things produced the widespread use of this technique with the only scientific support of phase II studies usually performed in only one center and with highly selected patients. Most of the randomized trials performed afterwards did not show a clinically important relationship between dose and response. This makes us think that this technique should not be used as routinary treatment. From a methodological point of view it would be interesting to investigate the evolution of this modality of treatment and why, its use has been so generalized without good quality scientifically support. This could be due to predetermined ideas in relation to what is the evolution and treatment of this disease, the neglect in the use of scientific methodology and the pressures coming from different directions trying to adopt new (and presumably better, treatments). It is evident that if most of the patients who have received high dose treatment for breast cancer had participated in randomized trials the question would probably have already been answered.

[The clinical usefulness of the serological study of IgG antibodies and IgA against the antigens associated with the Epstein-Barr virus in patients with nasopharyngeal carcinoma]. / Utilidad clínica del estudio serológico de anticuerpos IgG e IgA antiantígenos asociados al virus de Epstein-Barr en pacientes con carcinoma de nasofaringe.

The relationship between nasopharyngeal carcinoma (NPC) and Epstein-Barr virus (EBV) has been already well established. Titulation of the antibodies IgG and IgA against EBV-related antigens has been proved reliable but always suitable having tested and age-matched control population. We present here the preliminary results from the 14 patients bearing NPC and 12 patients with other carcinoma of the head and neck and healthy donors.