Evaluation of toxicity of surgery and/or chemoirradiation treatment of uterine cervix cancer.

OBJECTIVE: To evaluate acute and chronic toxicity of chemoirradiation treatment (neoadjuvant, adjuvant and radical treatment) in patients diagnosed with cervix cancer. METHODS: From December 1999 to August 2007, 53 patients diagnosed with adenocarcinoma or squamous cell carcinoma of the uterine cervix received neoadjuvant, adjuvant or radical chemoirradiation. RESULTS: Acute gastrointestinal toxicity of grade 3 or more in 9 patients (17%) and haematological toxicity of grade 3 or more in 9 patients (17%). Chronic toxicity of grade 3 or more was shown in only 2 patients (4%). The most frequent toxicities were gastrointestinal toxicity and haematological toxicity. The most frequent chronic toxicities were gastrointestinal toxicity and vaginal toxicity. CONCLUSIONS: We report that the combined neoadjuvant, adjuvant or radical chemoirradiation treatment with weekly cisplatin chemotherapy (40 mg/m(2)/week) in patients diagnosed with cervix cancer is a well tolerated treatment and chronic and acute toxicity is low-grade. This treatment scheme has easy compliance.

Evaluation of toxicity of surgery and/or chemoirradiation treatment of uterine cervix cancer

OBJECTIVE: To evaluate acute and chronic toxicity of chemoirradiation treatment (neoadjuvant, adjuvant and radical treatment) in patients diagnosed with cervix cancer. METHODS: From December 1999 to August 2007, 53 patients diagnosed with adenocarcinoma or squamous cell carcinoma of the uterine cervix received neoadjuvant, adjuvant or radical chemoirradiation. RESULTS: Acute gastrointestinal toxicity of grade 3 or more in 9 patients (17%) and haematological toxicity of grade 3 or more in 9 patients (17%). Chronic toxicity of grade 3 or more was shown in only 2 patients (4%). The most frequent toxicities were gastrointestinal toxicity and haematological toxicity. The most frequent chronic toxicities were gastrointestinal toxicity and vaginal toxicity. CONCLUSIONS: We report that the combined neoadjuvant, adjuvant or radical chemoirradiation treatment with weekly cisplatin chemotherapy (40 mg/m(2)/week) in patients diagnosed with cervix cancer is a well tolerated treatment and chronic and acute toxicity is low-grade. This treatment scheme has easy compliance (AU)

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Re-irradiation to prevent ectopic bone formation after major hip surgery.

Ectopic bone formation may occur after total hip arthroplasty, but fortunately most patients are asymptomatic. Both pre-operative and post-operative radiotherapy are effective in prevention of ectopic bone formation. In the few patients who needed re-operation, we found that re-irradiation is possible and safe. This case report presents our experience with single dose reirradiation of the hip in an attempt to prevent post-operative ectopic bone formation.

Re-irradiation to prevent ectopic bone formation after major hip surgery

Ectopic bone formation may occur after total hip arthroplasty, but fortunately most patients are asymptomatic. Both pre-operative and post-operative radiotherapy are effective in prevention of ectopic bone formation. In the few patients who needed re-operation, we found that re-irradiation is possible and safe. This case report presents our experience with single dose reirradiation of the hip in an attempt to prevent post-operative ectopic bone formation (AU)

The role of radiotherapy for prevention of heterotopic ossification after major hip surgery

Heterotopic ossification or ectopic bone formation represents a widely known complication after surgery involving joint spaces. Posttraumatic heterotopic ossification can be found at any site. The most common postsurgical site is the hip following total hip arthroplasty. This review explores the treatment options to prevent ectopic bone formation after major surgery of hip, especially, the role of radiotherapy (AU)

Intracranial germ cell tumor mimicking anorexia nervosa.

We report on a case of a 23 year-old female diagnosed as having a germ-cell tumour located in the sellar region. The patient referred anorexia, psychic disorders, weight loss of 15 kilograms and secondary amenorrhea during the previous three years. This is the reason why the patient was diagnosed as having anorexia nervosa. Subsequently, the patient presented some endocrine dysfunction. MRI revealed the existence of a lesion located in suprasellar and hypothalamic regions. This case shows that the presence of intracranial tumours next to the hypothalamus must be borne in mind as a rare but real possibility in cases of anorexia nervosa, specially in those non-typical cases.

Intracranial germ cell tumor mimicking anorexia nervosa

We report on a case of a 23 year-old female diagnosed as having a germ-cell tumour located in the sellar region. The patient referred anorexia, psychic disorders, weight loss of 15 kilograms and secondary amenorrhea during the previous three years. This is the reason why the patient was diagnosed as having anorexia nervosa. Subsequently, the patient presented some endocrine dysfunction. MRI revealed the existence of a lesion located in suprasellar and hypothalamic regions. This case shows that the presence of intracranial tumours next to the hypothalamus must be borne in mind as a rare but real possibility in cases of anorexia nervosa, specially in those non-typical cases (AU)

The usefulness of reirradiation in the treatment of pelvic recurrence of rectal and gynaecological tumours

La recidiva local de tumores pélvicos tras irradiación, aunque ha disminuido su incidencia gracias alas modernas técnicas de radioterapia, sigue produciéndose acompañada o no de metástasis a distancia.Además dicha recidiva ocasiona una gran morbilidad e incluso puede ser la causa de la muerte deestos pacientes. La selección del método de retratamiento a emplear representa un importante desafíoclínico. De todos los métodos de retratamiento posibles a utilizar, la reirradiación es uno de ellos.En esta revisión intentamos poner de manifiesto la complejidad del tratamiento en el caso de tumoresginecológicos y rectales recidivados y lo importante de considerar minuciosamente todas las alternativasterapéuticas que existen, para poder tomar una decisión final adecuada, sobre todo, si los pacientesya han sido previamente irradiados como tratamiento único o combinado de su tumor primario

Pelvic tumors recurrences have diminished with the modern radiation therapy techniques. However,they are still observed, with or without distant metastases, leading to a serious and even mortaldisease. The choice of an adequate therapy poses a clinical challenge. One of the procedures is therepetition of radiation therapy.In this review we manifest how complex is the treatment of gynecological and rectal tumorsrecidivations, and the importance of a detailed consideration of the available therapies in order tomake a decision, specially when the primary tumor has been previously irradiated, be it as onlytreatment or combined with other therapies (AU)

Papel de la radioterapia en el tratamiento del carcinoma in situ de mama / Role of radiotherapy for the treatment of breast in situ carcinoma

Como consecuencia de los programas de cribado o despistaje mamográficos, la incidencia de tumoresde mama no invasivos ha aumentado de forma sorprendente. Sin embargo, cual debe ser el tratamientode elección para este tipo de tumores no ha sido bien establecido y ha dejado la controversia dela mejor opción terapéutica a realizar, la mastectomía o el tratamiento conservador. Se ha realizadouna revisión de la literatura, así como, una discusión de las alternativas de tratamiento posibles en elabordaje terapéutico del carcinoma in situ de mama, en especial del papel de la radioterapia

As a result of mammographic screening programs, the incidence of diagnosed non-invasive breastcarcinomas has increased markedly. Nevertheless, the elective treatment for these kind of tumours hasnot yet been established, leading to controversies to decide about which is the best therapeutic option,whether mastectomy or conserving therapy. We make a review of the literature, and discuss thedifferent treatment options for breast carcinoma in situ, especially the role of radiation therapy

Radioterapia en la prevención de las metástasis cutáneas, en pacientes con mesotelioma pleural, sometidos a procesos diagnósticos y terapéuticos invasivos / Radiotherapy in the prevention of skin metastases in patients with pleural mesothelioma underwent invasive diagnostic and therapeutic processes

Las metástasis cutáneas, por difusión de líquidopleural a lo largo de los trayectos de los diferentesprocesos diagnósticos y terapéuticos, es una complicaciónque suele presentarse con cierta frecuenciaen pacientes con mesotelioma pleural maligno.La radioterapia profiláctica parece prevenir laaparición de estas metástasis cutáneas. Sin embargo,no queda bien establecido su utilidad o eficacia paratodos los especialistas.El objetivo de presentar este caso clínico es valorarel papel preventivo o profiláctico que juega laradioterapia en la aparición de los nódulos cutáneostras técnicas invasivas sobre la pared costal de pacientescon mesotelioma, haciendo una revisión dela literatura

Malignant seeding of cancer cells by pleuralliquid spreading through the pathway of perforatingdiagnostic and therapeutic procedures is a commoncomplication appearing in patients with malignantpleural mesothelioma.Prophylactic radiotherapy seems to reduce theincidence of chest wall metastases at the incisionsites. However, no agreement has been reachedamong the specialists about its usefulness orefficacy.The purpose of the case we report is to review therole of radiotherapy in preventing the metastaticskin nodules appearing at the sites of invasivediagnostic or therapeutic procedures in patients withmalignant pleural mesothelioma

PONTO. Un sistema de información para la gestión de los servicios de oncología radioterápica / PONTO. An information system for the management of the departments of Radiation Therapy Oncology

Introducción: La gestión clínica se comenzó a generalizar en nuestro país a finales del siglo pasadocon la intención de conseguir un sistema sanitario más eficiente. La información, que ha sidofundamental en el avance de la ciencia y en el desarrollo económico social, es ahora decisiva en lastransformaciones que se están produciendo en el sistema sanitario.Material y métodos: El objetivo del presente trabajo es mostrar un sistema de obtención de información,que sirve para la gestión clínica de los servicios de Oncología Radioterápica, con el fin deoptimizar los tratamientos de los pacientes, complementar la información facilitada por el servicio decontrol de gestión de nuestro centro y por otra suministrar los datos por éste requeridos. Este sistemade información contempla la descripción del proceso radioterápico publicado en el Real Decreto,1566/1998 de 17 de julio, por el que se establecen los criterios de calidad en radioterapia. La metodologíade desarrollo utilizada ha sido Métrica 3 adecuada a las características del proyecto, siendo losprocesos de Análisis y Diseño del sistema desarrollados de forma completa. Se ha conseguido la totalimplicación en el proyecto, tanto de la dirección del centro, como del jefe del servicio y de todo el personalperteneciente al servicio de Oncología Radioterápica.Resultados: El proceso de funcionamiento de la aplicación PONTO se basa en la gestión integralde la propuesta que se abre a los pacientes en el momento de su llegada al servicio de Oncología Radioterápica.PONTO se ha estructurado en los siguientes módulos o bloques: Propuestas; Citación;Primeras Consultas; Comités; Sesión Clínica; Simulación-TAC; Planificación; Moldes; Sesión Dosimétrica;Tratamientos; Consulta de Tratamiento; Alta y Consultas Sucesivas.Conclusión: PONTO es un sistema de información propio para un Servicio de Oncología Radioterápicaque permite su gestión clínica. Está cuidadosamente diseñado y organizado con una finalidadclaramente especificada y útil

Introduction: The clinical management began to spread in our country at the end of the lastcentury, aiming to obtain a more efficient health system. Information has been fundamental for theadvancement of science and the socio-economic development, becoming decisive nowadays due to thechanges taking place in the health system.Material and methods: The objective of the present work is to describe an information systemuseful for the clinical management of the departments of Radiation Therapy Oncology, whose purposeis the patients' treatment optimization, complementing the information given by the managementcontrol service of our centre, providing at the same time some data that this could require. Thisinformation system considers the description of the radiotherapy process published in the “RoyalDecree”, 1566/1998 of July 17, setting up the quality criteria in radiotherapy. The methodology usedwas Metric 3, adapted to the characteristics of the project, with a complete development of theAnalysis and Design processes of the system.Results: The PONTO process application is based on the integral management proposals openedto the patients when they arrive at the Radiation Therapy Oncology service. PONTO was structured inthe following modules or blocks: Proposals, Appointments, First Consultation, Committees, ClinicalSession, CT-scanning Simulation, Planning, Moulds, Dosimetric Session, Treatments, TreatmentConsultation, Hospital Discharge, and Successive Consultations.Conclusions: PONTO is an information system suitable for the departments of RadiationTherapy Oncology allowing the clinical management. It is carefully designed and organized with aclear, useful and specific purpose

Información de los Sistemas de Información en la Gestión Clínica de los Servicios / Importance of Information Systems in Clinical Management of the Services

Nuestros hospitales han experimentado un enorme cambio, que podríamos clasificar en diferentes fases. La gestión clínica es, sin duda, el instrumento innovador con más fuerza de los que se hayan podido manejar para la transformación de los sistemas sanitarios. La información, que sido fundamental en el avance de la ciencia y en el desarrollo económico social, es ahora decisiva en las transformaciones que se están produciendo en la atención sanitaria. La importancia de la información en la atención sanitaria radica en que se trata de un entorno cambiante, donde la innovación es continua, con tecnologías y tareas cada vez más complejas. Por eso el sistema de información y recogida de datos de un Servicio es de una gran importancia. El presente trabajo intenta ser una puesta al día de la importancia que los sistsemas de información tienen para la gestión clínica y para la supervivencia de las organizaciones sanitarias

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[The role of radiotherapy in the management of bucopharyngeal epidemic Kaposi's sarcoma]. / Radioterapia en el tratamiento del sarcoma de Kaposi epidémico bucofaríngeo.

PURPOSE: This study is presented to help define the role of radiotherapy in the management of buccopharyngeal epidemic Kaposi's sarcoma. MATERIAL AND METHODS: Between January 1999 and December 2004, we treated 17 patients who had acquired inmunodeficiency syndrome related to mucous Kaposi's sarcoma. Kaposi's sarcoma lesions were in the oral cavity in 12 patients (70%), oropharynx in 3 patients (18%) and larynx in 2 patients (12%). All the patients were treated by radiotherapy using a Cobalt Unit beam energy, the treatment doses ranged from 15 to 30 Gy. RESULTS: Tolerance was generally satisfactory, with an effective palliation of symptoms (88,4% overall rate of objective responses). Nevertheless an enhanced mucosal reaction was noted in patients receiving doses close to 30 Gy (mucositis grade 3). CONCLUSIONS: We conclude that radiotherapy is an efficient treatment for mucous epidemic Kaposi's sarcoma; a dose of 15 Gy may be enough to shrink the tumour and obtain a good palliation of symptoms. Prophylactic measures with antifungal treatment should be systematically associated with oropharyngeal irradiation in order to improve tolerance to the treatment.

Sarcoma de Kaposi epidémico mucoso: aportación de un caso y revisión de la literatura / Epidemic mucous Kaposi's sarcoma: contribution with a case and review of the literature

• Propósito: Presentamos un caso clínico de sarcoma de Kaposi epidémico de laringe, con revisión y discusiónde la literatura.• Material y métodos: Paciente varón de 37 años, con antecedentes de SIDA y con clínica de disfonía ydiagnosticado de Sarcoma de Kaposi epidémico laríngeo. Se realizó tratamiento con radioterapia.• Resultados y conclusiones: Tras 3 años del tratamiento, el paciente se encuentra con la lesión laringeacontrolada. La radioterapia es un tratamiento paliativo de elección en el sarcoma de Kaposi epidémico mucoso

• Purpose: We present a clinical case of epidemic Kaposi’s sarcoma of the larynx, make a review, anddiscuss the literature• Material and methods: A 37 year old male with AIDS and hoarseness diagnosed of epidemicKaposi’s sarcoma of the larynx. He was treated with radiotherapy.• Results and conclusions: Three years after radiotherapy, the patient is free of laryngeal disease.Radiation therapy is the paliative treatment of choice for AIDS-associated epidemic mucous Kaposi’s sarcoma