SEOR SBRT-SG survey on SRS/SBRT dose prescription criteria in Spain.

AIM: Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) are essential tools in radiation oncology. In Spain, the use of these techniques continues to grow as older linear accelerators (linacs) are replaced with modern equipment. However, little is known about inter-centre variability in prescription and dose heterogeneity limits. Consequently, the SBRT-Spanish Task Group (SBRT-SG) of the Spanish Society of Radiation Oncology (SEOR) has undertaken an initiative to assess prescription and homogeneity in SRS/SBRT treatment. In the present study, we surveyed radiation oncology (RO) departments to obtain a realistic overview of prescription methods used for SBRT and SRS treatment in Spain. METHODS: A brief survey was developed and sent to 34 RO departments in Spain, mostly those who are members of the SEOR SBRT-SG. The survey contained seven questions about the specific prescription mode, dose distribution heterogeneity limits, prescription strategies according to SRS/SBRT type, and the use of IMRT-VMAT (Intensity Modulated Radiation Therapy-Volumetric Modulated Arc Therapy). RESULTS: Responses were received from 29 centres. Most centres (59%) used the prescription criteria D95% ≥ 100%. Accepted dose heterogeneity was wide, ranging from 107 to 200%. Most centres used IMRT-VMAT (93%). CONCLUSIONS: This survey about SRS/SBRT prescription and dose heterogeneity has evidenced substantial inter-centre variability in prescription criteria, particularly for intended and accepted dose heterogeneity. These differences could potentially influence the mean planning target volume dose and its correlation with treatment outcomes. The findings presented here will be used by the SEOR SBRT-SG to develop recommendations for SRS/SBRT dose prescription and heterogeneity.

Secondary effects and biochemical control in patients with early prostate cancer treated with (125)-I seeds.

OBJECTIVE: To retrospectively evaluate the toxicity of low-dose-rate brachytherapy and to relate it to the dose-volume to organs at risk. MATERIAL AND METHODS: We study 160 patients with early prostate cancer, treated with (125)-I implants. Most of them were T1c (63.1%), T2a (35.6%) and Gleason < or =6 (96.2%). Median PSA was 7.2 ng/ml (2.3-13.5); 85.6% were lowrisk cases and 14.4% high-risk cases. Mean follow-up was 24 months (7-48). RESULTS: Acute urinary toxicity related to urological quality of life (UQL=CVU) was tolerable in 75% and unsatisfactory in 25%. Urinary retention was present in 6.9%. IPSS, V100 and D90 were related to the urinary toxicity grade. Rectal toxicity (RTOG) G2 was 0.6%. Sexual potency showed no changes with regard to the basal in 69%. Actuarial biochemical control was 89.8% at four years. CONCLUSIONS: Brachytherapy with (125)-I seeds yields acceptable toxicity and excellent biochemical control.

[Effectiveness of anti-flu vaccine in the elderly]. / Efectividad de la vacunación antigripal en ancianos.

OBJECTIVE: To evaluate the effectiveness of anti-flu vaccination on elderly people not in institutions, by measuring its effect on the reduction of deaths and hospital admissions due to Cardio-respiratory failure. DESIGN: A retrospective cohort. SETTING: La Chana Health Centre, Granada. PATIENTS AND OTHER PARTICIPANTS: 1,965 elderly people who were seen at the Health Centre over the previous three years. MEASUREMENTS AND MAIN RESULTS: 779 elderly people (39.6%) were vaccinated. 35 were admitted to hospital with Cardio-respiratory failure and 59 died. Of these two groups, 13 and 23 respectively had been given the anti-flu vaccination that year. After checking for variables which could lead to confusion, the vaccine was shown to be effective both in reducing admissions (advantage ratio 1,330) and deaths (advantage ratio 1,221). CONCLUSIONS: Given the effectiveness of anti-flu vaccinations, active efforts to encourage non-institutionalised elderly people to be vaccinated should be increased.