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AIM: To establish consensus guidelines for a safe clinical practice of accelerated partial breast irradiation (APBI) interstitial multicatheter brachytherapy (BT). BACKGROUND: APBI with interstitial multicatheter BT has proved to be effective in the treatment of early stage breast cancer. This paradigm shift in the approach to early breast cancer conservative treatment, along with the existing controversies on the clinical practice of APBI, prompted the Spanish Brachytherapy Group (GEB) of the Spanish Societies of Radiation Oncology (SEOR) and Medical Physics (SEFM) to address BT APBI in a consensus meeting. MATERIALS AND METHODS: Prior to the meeting, a survey with 27 questions on indication, inclusion criteria, BT modality, implant technique, image guidance and simulation, CTV and OAR definition, dose prescription and fractionation, dose calculation, implant quality metrics and OAR dose constrains was distributed. Items not reaching a level of agreement of 70% were discussed and voted during the meeting. RESULTS: 26 Institutions completed the survey, 60% of them perform APBI procedures. The analysis of the survey showed consensus reached on approximately half the questions. An expert panel discussed the remaining items; thereafter, a voting established the definite consensus. CONCLUSIONS: This document summarizes the consensus guidelines agreed during the meeting of the Spanish Brachytherapy Group SEOR-SEFM. Institutions with BT facilities available should offer interstitial BT APBI as a treatment option to patients fulfilling the inclusion criteria. Institutions willing to implement interstitial BT APBI are encouraged to follow the consensus guidelines established herein.
RESUMO
Objetivo: Comprobar las diferencias en la calidad de vida y la información de los pacientes con cáncer de próstata según el tratamiento y grupo de riesgo, y valorar su asociación con las variables sociodemográficas y clínicas. Metodo: entre 2015-2016, 176 hombres con cáncer de próstata seleccionados aleatoriamente, que habían recibido tratamientos locales, hormonales o combinados fueron evaluados mediante entrevista y los cuestionarios EORTC QLQ-C30, EORTC QLQ-PR25 y EORTC QLQ-INFO25. Resultados: La calidad de vida estaba más deteriorada en las escalas física, de rol, social y sexual en el grupo de riesgo avanzado y los tratados con hormonoterapia. La prostatectomía era la que producía más problemas urinarios, y los tratamientos combinados mayor sintomatología hormonal. Los tratados con radioterapia consideraban la información más útil y se sentían más informados sobre la enfermedad, pruebas médicas y tratamientos que los que recibían tratamiento hormonal y estaban más satisfechos que los intervenidos con prostatectomía. Los mayores o con estudios básicos recibieron menos información y la consideraron menos útil. Conclusiones: La calidad de vida es satisfactoria y la sintomatología baja. Los hombres en riesgo avanzado y/o los que reciben hormonoterapia presentan mayor déficit en la calidad de vida. La información es deficitaria, sobre todo en los hombres con problemas urinarios y con peor calidad de vida. Hay poca o ninguna información en las áreas "otros servicios", "lugares de cuidado" y "pautas de autocuidado". Es necesario evaluar y tratar a los hombres más vulnerables. Además de formar en información al personal sanitario (AU)
Objective: to determine the differences in the quality of life and the information of the patients with prostate cancer according to the treatment and the risk group, and assess its association with sociodemographic and clinical variables. Method: Between 2015-2016, 176 men with prostate cancer, selected at random, who had received local treatments, hormonal or combined, were evaluated through interviews and the questionnaires EORTC QLQ-C30, EORTC QLQ-PR25 and EORTC QLQ-INFO25. Results: The quality of life was more damaged on the physical, role, social and sexual scales in the advanced risk group and those treated with hormone therapy. The prostatectomy was producing more urinary problems, and the combined treatments, more hormonal symptoms. Those treated with radiation therapy considered the information more useful and felt more informed about the disease, medical tests and treatments than those receiving hormonal treatment, and they were more satisfied than those treated with prostatectomy. The elderly or those with basic studies received less information and considered it was less useful. Conclusions: The quality of life is satisfactory and the symptomatology is low. Men at advanced risk and/or those who receive hormone therapy have a higher deficit in their quality of life. The information is deficient, especially in men with urinary problems and those with worse quality of life. There is little or no information in the "other services", "places of care" and "self-care guide". It is necessary to evaluate and treat the most vulnerable men. In addition, it would be desirable to introduce a system of training on information for medical professionals (AU)
Assuntos
Humanos , Masculino , Prostatectomia/psicologia , Neoplasias da Próstata/psicologia , Antineoplásicos Hormonais/efeitos adversos , Complicações Pós-Operatórias/psicologia , Qualidade de Vida , Perfil de Impacto da Doença , Fatores de Risco , Antígeno Prostático Específico/análise , Radioterapia/psicologia , Análise de SobrevidaRESUMO
Con el presente artículo, se pretende dar a conocer los tratamientos psicológicos eficaces en el cáncer de próstata que se han llevado a cabo hasta la actualidad. Para entender los tratamientos psicológicos, es importante conocer, aunque sea de manera general, qué medios médicos se llevan a cabo para curar o paliar la enfermedad y sus efectos (reversibles o irreversibles), ya que el bienestar biopsicológico influye en la calidad de vida del individuo y, en su salud física y psicológica. A pesar de que el cáncer de próstata es el cáncer más común en los hombres de nuestro país y que actualmente muchos se diagnostican en estadios iniciales, lo que aumenta la posibilidad de curación, existen pocos estudios sobre tratamientos psicológicos para afrontar este tumor, tanto a nivel nacional como internacional. Es importante seguir avanzando en la investigación, principalmente en aquella que vaya dirigida a evaluar la eficacia de los tratamientos psicológicos
The aim of this paper is to show the effective psychological treatments in prostate cancer performed to date. To understand these treatments is important to know the medical facilities carried out in order to treat or palliate the disease and its effects, both, reversible and irreversible ones, since the biopsychological state play an important role in the quality of life of individuals, as well as in their physical and psychological health. Even though prostate cancer is the most common in men in our country and is diagnosed at early stages in many cases, increasing the percentage of cure, there are only a few studies about psychological treatments to face with this tumor, both national and international ones. It is important to improve the research in this field, mainly in which is focused in evaluate psychological treatments effectiveness (AU)
