Age, Gleason Score, and PSA are important prognostic factors for survival in metastatic castration-resistant prostate cancer. Results of The Uroncor Group (Uro-Oncological Tumors) of the Spanish Society of Radiation Oncology (SEOR).

INTRODUCTION: The treatment of metastatic castration-resistant prostate cancer (mCRPC) has changed significantly in recent years. Inhibitors of androgen receptors have shown especially significant benefits in overall (OS) and progression-free survival (PFS), with a good toxicity profile. Treatment selection depends on the patient's individual clinical, radiological, and biological characteristics. OBJECTIVE: To describe treatment outcomes (efficacy, toxicity) in a cohort of patients with mCRPC in Spain. MATERIALS AND METHODS: Multicenter, retrospective study of patients with mCRPC included in a database of the Urological Tumour Working Group (URONCOR) of the Spanish Society of Radiation Oncology (SEOR). Metastatic CRPC was defined according to the prostate cancer working group 3 (PCWG3) criteria. The Kaplan-Meier technique was used to evaluate OS and the Common Terminology Criteria for Adverse Events (CTCAE, v.4.0) were used to assess toxicity. Univariate and multivariate Cox regression analyses were performed to identify the factors significantly associated with OS. RESULTS: A total of 314 patients from 17 hospitals in Spain diagnosed with mCRPC between June 2010 and September 2017 were included in this study. Mean age at diagnosis was 68 years (range 45-89). At a median follow-up of 35 months, OS at 1, 3, and 5 years were 92%, 38%, and 28%, respectively. Grades 1-2 and grade 3 toxicity rates were, respectively, 68% and 19%. No grade 4 toxicities were observed. On the multivariate analysis, the following factors were significantly associated with OS: age (hazard ratio [HR] 0.42, p = 0.010), PSA value at diagnosis of mCRPC (HR 0.55, p = 0.008), and Gleason score (HR 0.61, p = 0.009). CONCLUSIONS: Age, Gleason score, and PSA at diagnosis of mCRPC are independently associated with overall survival in patients with mCRPC. The efficacy and toxicity outcomes in this patient cohort treated in radiation oncology departments in Spain are consistent with previous reports.

Malrotación intestinal como causa de dolor abdominal crónico recurrente / Malrotación intestinal como causa de dolor abdominal

La malrotación intestinal como causa de dolor abdominal en adultos es una entidad poco frecuente. Presentamos el caso de un varón de 17 años con antecedentes de dolor abdominal crónico de 10 años de evolución, que ingresó por urgencias como consecuencia de la agudización de su dolor y al que se le practicó una laparotomía exploradora de forma urgente, encontrando una malrotación intestinal con enroscamiento en espiral del meso del intestino delgado y presencia de bandas de Ladd (AU)

The intestinal malrotation as cause of abdominal pain in adults is a not very frequent entity. We present the case of a 17 year-old male with antecedents of chronic abdominal pain of 10 years of evolution who went to the emergency room as a consequence of an increasing pain and who underwent an emergency exploratory laparotomy, thus finding an intestinal malrotation with spiral swinging of the meso of the midgut and presence of Ladd's bands (AU)

Obstrucción intestinal producida por la larva de Anisakis / Intestinal obstruction produced by Anisakis larvae

Introducción. Se presentan 8 casos de obstrucción intestinal mecánica simple producidos por Anisakis, diagnosticados en nuestro hospital durante los últimos 2 años. Pacientes y método. Los enfermos fueron diagnosticados, en el servicio de urgencias, de obstrucción intestinal mecánica simple; todos ellos referían ingestión de pescado crudo 36-48 h antes del comienzo del cuadro clínico. En un enfermo era el tercer cuadro de obstrucción intestinal que padecía durante los últimos 6 meses. El diagnóstico se realizó por la clínica, antecedentes de ingesta de pescado crudo y presencia en el hemograma de una leucocitosis moderada (12.000- 14.500). En 4 casos destacaba una eosinofilia superior al 8 por ciento. Las pruebas inmunológicas realizadas fueron: in vivo, la prueba cutánea llevada a cabo mediante el test de Prick, y la prueba in vitro, mediante la determinación de IgE específica e IgE total. Todas fueron positivas. Las pruebas de imagen realizadas fueron: radiología simple de abdomen en la que se apreciaban niveles hidroaéreos dependientes de asas de intestino delgado dilatadas y ecografía abdominal, que se realizó en 6 pacientes en los que se observaron signos de enfermedad inflamatoria en el íleon terminal. Resultados. El tratamiento de la obstrucción intestinal fue en todos los casos conservador. Una vez pasado el cuadro agudo se instauró tratamiento preventivo para la larva del Ani sakis. Conclusiones. La larva de Anisakis, que era rara en España, comienza a ser más frecuente como se demuestra en el número de trabajos que se han publicado en los últimos 2 años. Se puede concluir que Anisakis simple es un factor etiológico de la obstrucción intestinal mecánica simple y sugerimos tenerlo en consideración en los servicios de cirugía de urgencia ante la presencia de enfermos con cuadros de obstrucción intestinal, especialmente después de la ingestión de pescado (AU)

[Complications of radiotherapy for invasive bladder cancer: acute and chronic effects. Method of evaluation: measurement by RTOG/EORTC, SOMA/LENT]. / Complicaciones de la radioterapia del cáncer vesical invasor: efectos agudos y tardíos. Evaluación del daño: escalas de la RTOG/EORTC, SOMA/LENT.

OBJECTIVE: Irradiation of urinary bladder tumors produce early and late complications. The former is characterized by acute cystitis and the latter by fibrosis with loss of volume and more or less persistent hematuria. The present study was conducted to analyze the incidence of complications of radiotherapy in patients with invasive bladder cancer. METHODS: Toxicity was evaluated by the RTOG/ EORTC and SOMA LENT scales. RESULTS: The Spanish Toxicity Register showed 4.7% toxicity in a total of 782 patients. CONCLUSIONS: Although the microscopic and clinical changes caused by radiotherapy are well described, there are no reliable percentages in the studies on large series that evaluated the toxicity caused by radiotherapy for invasive bladder tumors.

Lymphangiosarcoma in a chronic lymphedematous limb: a case report.

A 69-year-old-woman developed a lymphangiosarcoma of the limb on chronic lymphedema after radical mastectomy and radiotherapy for primary breast cancer 12 years before. Since 1948, when Stewart and Treves described this entity, 200 cases have been described. We report this case because of its extremely rare frequency. Concepts of etiology, treatment and prognosis are reviewed.

Accidental overirradiation syndrome.

Between the 10th and 20th December 1990, there was a malfunction in the operation of the Electron Linear Accelerator (ELA) at the Hospital Clínico Universitario in Zaragoza (Spain), which led to irradiation with the highest beam energy. This situation shows the existence of a latent period between the irradiation and the appearance of the symptoms, even in situations involving much higher than normal doses in cases of localized irradiation.