RÉSUMÉ
The purpose of this study was to evaluate rectum motion during 3-Dimensional conformal radiation therapy (3D-CRT) in prostate cancer patients, to derive a planning volume at risk (PRV) and to correlate the PRV dose-volume histograms (DVH) with treatment complications.This study was conducted in two phases. Initially, the PRV was defined prospectively in 50 consecutive prostate cancer patients (Group 1) who received a radical course of 3-D CRT. Then, the obtained PRV was used in the radiotherapy planning of these same 50 patients plus another 59 prostate cancer patients (Group 2) previously treated between 2004 and 2008. All these patients' data, including the rectum and PRV DVHs, were correlated to acute and late complications, according to the Common Toxicity Criteria (CTC) v4.0.The largest displacement occurred in the anterior axis. Long-term gastrointestinal (GI) complications grade ≥ 2 were seen in 9.2% of the cases. Factors that influenced acute GI reactions were: doses at 25% (p 5 0.011) and 40% (p 5 0.005) of the rectum volume and at 40% of the PRV (p 5 0.012). The dose at 25% of the rectum volume (p 5 0.033) and acute complications ≥ grade 2 (p 5 0.018) were prognostic factors for long-term complications. The PRV DVH did not correlate with late toxicity. The rectum showed a significant inter-fraction motion during 3D-CRT for prostate cancer. PRV dose correlated with acute gastrointestinal complications and may be a useful tool to predict and reduce their occurrence.
Sujet(s)
Maladies gastro-intestinales/étiologie , Imagerie tridimensionnelle , Tumeurs de la prostate/anatomopathologie , Tumeurs de la prostate/radiothérapie , Lésions radiques/étiologie , Planification de radiothérapie assistée par ordinateur , Radiothérapie conformationnelle/effets indésirables , Sujet âgé , Sujet âgé de 80 ans ou plus , Humains , Mâle , Adulte d'âge moyen , Pronostic , Tumeurs de la prostate/complicationsRÉSUMÉ
The purpose of the present study was to evaluate breast carcinoma samples before and two days after treatment with tamoxifen in order to analyse early histopathological alterations--particularlynuclear alterations-- as well as immunohistochemical expression of Ki-67, Erb-B2, VEGF, TGF-beta1 and ILK proteins. Twenty one cases of invasive ductal and lobular breast carcinoma were studied. Patients were submitted to biopsy of the lesion and, after confirmation of the diagnosis, they received 20 mg of tamoxifen a day, beginning two days before surgery. The samples obtained during biopsy and after surgery were stained with HE for histopathological diagnosis. Estrogen receptor was positive in 18 cases and negative in 3. The immunohistochemical method was applied for the detection of Ki-67, Erb-B2, protein, vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-beta1) and integrin linked kinase (ILK). Two days after tamoxifen treatment, the following results were observed: 1) decrease in the cell volume, chomatine condensation, nucleoli less evident and clearly defined nuclear limits; 2) significant reduction in the expression of Erb-B2 protein and significant increase in the expression of TGF-beta1 protein; 3) expression of others proteins (Ki-67, VEGF and ILK) was not altered during the indicated time frame. Our results suggest that analyzing nuclear alterations and expression of Erb-B2 and TGF-beta1 proteins would be useful to assess the initial response to tamoxifen.
Sujet(s)
Tumeurs du sein/métabolisme , Noyau de la cellule/anatomopathologie , Antigène KI-67/métabolisme , Protein-Serine-Threonine Kinases/métabolisme , Récepteur ErbB-2/métabolisme , Tamoxifène/usage thérapeutique , Facteur de croissance transformant bêta/métabolisme , Facteurs de croissance endothéliale vasculaire/métabolisme , Tumeurs du sein/ultrastructure , Carcinome canalaire du sein/traitement médicamenteux , Carcinome canalaire du sein/métabolisme , Carcinome lobulaire/traitement médicamenteux , Carcinome lobulaire/métabolisme , Humains , Immunohistochimie , Facteur de croissance transformant bêta-1RÉSUMÉ
Primary bone lymphoma (PBL) is a rare entity and comprises about 5% of all extranodal non-Hodgkin's lymphomas (NHL) and 7% of all primary bone tumors. To date there is no consensus about the optimal treatment for PBL. We retrospectively reviewed all cases of PBL treated at Hospital São Paulo, Brazil, over a 10-year-period (January 1992-January 2002). Medical records of 7 patients with PBL were reviewed and information on age at diagnosis, sex, NHL clinical staging (CS), treatment and response to treatment were retrieved. Five patients (72%) received combined-modality therapy (CMT) and all of them are in complete remission (CR) with a median follow up of 19 months (ranging from 12 to 144 months). We conclude that PBL is a potentially curable malignancy and treatment should be undertaken in a multiprofessional approach, in order to provide the best support which probably has to include chemotherapy, radiotherapy and, for patients with IPI higher than 2, consolidation with stem-cell transplantation.
Sujet(s)
Tumeurs osseuses/thérapie , Lymphome malin non hodgkinien/thérapie , Adulte , Sujet âgé , Tumeurs osseuses/complications , Association thérapeutique , Femelle , Humains , Lymphome malin non hodgkinien/complications , Adulte d'âge moyen , Induction de rémission , Études rétrospectivesRÉSUMÉ
CONTEXT: There have been many reports that favor aggressive systemic treatment with chemotherapy and radiotherapy, even for well-localized lymphomas, avoiding the need for tonsillectomy of the normal tonsil. CASE REPORT: We report six cases of primary tonsillar lymphoma with a median patient age of 42 years. There were two lymphoma cases with diffuse large cells, two cases with mixed small and large cells, one with small cells and one indeterminate. They were treated with six cycles of chemotherapy and cervical radiotherapy. All patients achieved durable complete remission. Our data agree with previous reports that suggested that primary tonsillar high-grade B-cell NHL has a good prognosis if aggressively treated.
Sujet(s)
Lymphome malin non hodgkinien/traitement médicamenteux , Lymphome malin non hodgkinien/radiothérapie , Tumeurs de l'amygdale/traitement médicamenteux , Tumeurs de l'amygdale/radiothérapie , Adulte , Protocoles de polychimiothérapie antinéoplasique/usage thérapeutique , Association thérapeutique , Femelle , Humains , Mâle , Adulte d'âge moyen , PronosticRÉSUMÉ
Objetivo. Relato de três casos do GLLM acompanhados pela Disciplina de Hematologia e Hemoterapia da Unifesp-EPM que tiveram boa resposta à terapêutica e evoluçao favorável. Métodos. Após confirmaçao histológica e histoquímica, os pacientes foram submetidos à tratamento quimio e radioterápico com boa resposta terapêutica. Resultados. Atualmente estes pacientes encontram-se em remissao total da doença, com sobrevida média de 45 meses. Conclusao. Levando-se em consideraçao nossa pequena experiência, acreditamos que o tratamento radioterápico e a abordagem quimioterápica inicial agressiva sao fundamentais para uma boa evoluçao deste tipo de linfoma.
Sujet(s)
Femelle , Humains , Adulte , Adulte d'âge moyen , Granulome centrofacial/diagnostic , Granulome centrofacial/thérapie , Granulome centrofacial , Stadification tumoraleRÉSUMÉ
The effects of exposure to a single, whole body X-ray dose of 154.8 mC/Kg (600 R) on mouse (Mus musculus) hemocytopoietic tissue were analyzed by means of reticulocyte counts in peripheral blood, evaluating indirectly variations of the erythrocyte sector of bone marrow. The efficiency of the method for the evaluation of this tissue was demonstrated, constituting one more radiobiologic parameter to corroborate those existing already
Sujet(s)
Souris , Animaux , Mâle , Moelle osseuse/effets des radiations , Moelle osseuse/cytologie , Rayonnement ionisant , Numération des réticulocytes , Facteurs tempsRÉSUMÉ
An electron microscopic study of initial X-ray changes in ultrastructures of bone marrow cells was performed. Such changes reached nucleous and cytoplasm organellas early (1 hour) after radiation, but were more proeminent later on. Subsequent readings (2, 6 hours) showed them more proeminent in cytoplasm structures, and the morphologic appearance was close to normal within 12, 14 days. Quantitative analyses were performed using the marrow recovery coefficient (MRC).
Sujet(s)
Moelle osseuse/effets des radiations , Animaux , Moelle osseuse/ultrastructure , Myélogramme , Mâle , Souris , Microscopie électronique , Index mitotique , Dose de rayonnement , Irradiation corporelle totaleRÉSUMÉ
Bone marrow injury after exposure to ionizing radiation and cyclophosphamide was evaluated by morphologic analysis and by the ratio erythrocytes/nucleated cells (NN/N). The authors show the efficiency of the method proposed, which can be determined in bone marrow samples of variable and unpredictable size.