ABSTRACT
Introduction Hypofractionated whole breast irradiation (hWBI) and intraoperative radiotherapy (IORT) could be associated in breast cancer patients showing high-risk factors of local recurrence after breast conserving therapy (BSC). The aim of this trial was to evaluate, for the first time, the toxicity and cosmesis of hWBI after photon-IORT in high-risk patients treated by adjuvant chemotherapy. Materials and methods Thirty-one high-risk localized breast cancer patients treated by BCS, IORT (20 Gy), and adjuvant chemotherapy were included from February 2019 to August 2020 in this prospective trial, of hWBI (40.5 Gy/2.67 Gy/15 fractions). Acute and late toxicity (CTCAEv5.0) and cosmesis (Harvard scale), were assessed after treatment. Results All patients completed their treatment and were evaluable after treatment. No patients showed severe (G3) acute/late toxicity. Excellent/good cosmesis at least 6 months after completing the treatment, was present in 93.6% of the patients. Conclusion hWBI in high-risk localized breast cancer patients treated by chemotherapy seems to have similar toxicity and cosmetic results than conventionally fractionated WBI in combination to photon-IORT after BCS (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Chemotherapy, Adjuvant/methods , Mastectomy, Segmental/methods , Follow-Up Studies , Prospective Studies , PrognosisABSTRACT
INTRODUCTION: Hypofractionated whole breast irradiation (hWBI) and intraoperative radiotherapy (IORT) could be associated in breast cancer patients showing high-risk factors of local recurrence after breast conserving therapy (BSC). The aim of this trial was to evaluate, for the first time, the toxicity and cosmesis of hWBI after photon-IORT in high-risk patients treated by adjuvant chemotherapy. MATERIALS AND METHODS: Thirty-one high-risk localized breast cancer patients treated by BCS, IORT (20 Gy), and adjuvant chemotherapy were included from February 2019 to August 2020 in this prospective trial, of hWBI (40.5 Gy/2.67 Gy/15 fractions). Acute and late toxicity (CTCAEv5.0) and cosmesis (Harvard scale), were assessed after treatment. RESULTS: All patients completed their treatment and were evaluable after treatment. No patients showed severe (G3) acute/late toxicity. Excellent/good cosmesis at least 6 months after completing the treatment, was present in 93.6% of the patients. CONCLUSION: hWBI in high-risk localized breast cancer patients treated by chemotherapy seems to have similar toxicity and cosmetic results than conventionally fractionated WBI in combination to photon-IORT after BCS.
Subject(s)
Breast Neoplasms/radiotherapy , Chemotherapy, Adjuvant/methods , Mastectomy, Segmental/methods , Postoperative Care , Radiotherapy, Adjuvant/methods , Adult , Aged , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Middle Aged , Prognosis , Prospective Studies , Radiation Dose HypofractionationABSTRACT
INTRODUCTION: The cognitive effects of long-term exposure to organic solvents could be similar to those triggered by certain neurodegenerative diseases. AIMS: The purpose of this study was to evaluate the effects exerted by accumulated exposure on the cognitive functions. PATIENTS AND METHODS: 105 subjects with an average history of exposure of 19.3 years were evaluated using seven computerised cognitive tasks (CPT, digit-symbol substitution, Stroop, memory span, word learning and recognition, and TRD) and results were later compared with the performance of a non-exposure group and with a normative reference. A study was made of the association between the length of exposure and performance in the variables in which the exposed subjects displayed significantly lower values than control subjects. In order to evaluate the effect exerted by age, regression functions between performance and age were calculated for each group. RESULTS: Only the indicators from the Stroop and digit-symbol tasks correlated with the length of exposure. The regression functions between performance and age for each group showed that the former decreased significantly faster among exposed subjects than among controls. CONCLUSIONS: Findings suggest that, while recent exposure seems to have an effect on a wide range of functions, chronic exposure exerts a selective influence on a smaller group. In this case, only selective attention appears to deteriorate. Similar deficits have been observed in the early stages of patients with Alzheimer's and Parkinson's.
Subject(s)
Attention Deficit Disorder with Hyperactivity/chemically induced , Occupational Exposure/adverse effects , Solvents/toxicity , Adult , Humans , Middle Aged , Time FactorsABSTRACT
Introducción. Los efectos cognitivos de la exposición a largo plazo a solventes orgánicos podrían ser similares a los provocados por ciertas enfermedades neurodegenerativas. Objetivo. Evaluar los efectos de la exposición acumulada en las funciones cognitivas. Pacientes y métodos. Se evaluaron 105 sujetos con historia de exposición, con un promedio de 19,3 años, mediante siete tareas cognitivas computarizadas (CPT, dígito-símbolo, Stroop, amplitud de memoria, aprendizaje y reconocimiento de palabras, y TRD) y se comparó su desempeño con el de un grupo no expuesto y con una referencia normativa. Se evaluó la asociación entre la duración de la exposición y el desempeño en aquellas variables en las que los expuestos mostraron valores significativamente inferiores a los controles. Para evaluar el efecto de la edad, se calcularon funciones de regresión entre el desempeño y la edad en cada grupo. Resultados. Sólo los indicadores de las tareas de Stroop y de dígito-símbolo mostraron correlación con la duración de la exposición. Las funciones de regresión entre la edad y el desempeño para cada grupo mostraron que éste declinó significativamente más rápido entre los expuestos que entre los controles. Conclusiones. Los resultados sugieren que, mientras que la exposición reciente parece influir sobre un amplio conjunto de funciones, la exposición crónica ejerce una influencia selectiva sobre un grupo más reducido. En este caso, sólo parece deteriorarse la atención selectiva. Déficit similares se han observado en los estadios tempranos de enfermos de Alzheimer y Parkinson (AU)
Introduction. The cognitive effects of long-term exposure to organic solvents could be similar to those triggered by certain neurodegenerative diseases. Aims. The purpose of this study was to evaluate the effects exerted by accumulated exposure on the cognitive functions. Patients and methods. 105 subjects with an average history of exposure of 19.3 years were evaluated using seven computerized cognitive tasks (CPT, digit-symbol substitution, Stroop, memory span, word learning and recognition, and TRD) and results were later compared with the performance of a non-exposure group and with a normative reference. A study was made of the association between the length of exposure and performance in the variables in which the exposed subjects displayed significantly lower values than control subjects. In order to evaluate the effect exerted by age, regression functions between performance and age were calculated for each group. Results. Only the indicators from the Stroop and digit-symbol tasks correlated with the length of exposure. The regression functions between performance and age for each group showed that the former decreased significantly faster among exposed subjects than among controls. Conclusions. Findings suggest that, while recent exposure seems to have an effect on a wide range of functions, chronic exposure exerts a selective influence on a smaller group. In this case, only selective attention appears to deteriorate. Similar deficits have been observed in the early stages of patients with Alzheimer and Parkinson (AU)