Phototherapy 660 nm for the prevention of radiodermatitis in breast cancer patients receiving radiation therapy: study protocol for a randomized controlled trial.

BACKGROUND: Breast neoplasms are the second most common type of cancer worldwide, and radiation therapy is a key component of their treatment. Acute skin reactions are one of the most common side effects of radiation therapy, and prevention of this adverse event has been investigated in several studies. However, a clinically applicable, preventative treatment remains unavailable. It has been demonstrated that application of a low-power laser can promote tissue repair. Therefore, the aim of this trial is to evaluate the effectiveness of an indium gallium aluminum phosphorus (InGaAIP) laser operated at 660 nm in preventing radiodermatitis in women undergoing adjuvant radiotherapy for breast cancer. METHODS/DESIGN: This is a two-arm, randomized controlled trial. A total of 52 patients undergoing radiotherapy for breast cancer (stages I to III) will be enrolled. Patients will be randomly assigned to an intervention group to receive laser therapy (n = 26) or a control group to receive a placebo (n = 26). The laser or placebo will be applied five days a week, immediately before each radiotherapy session. Skin reactions will then be graded weekly by a nurse, a radiotherapist, and an oncologist (all of whom will be blinded) using the Common Toxicity Criteria (CTC) developed by the National Cancer Institute and the Acute Radiation Morbidity Scoring Criteria developed by the Radiation Therapy Oncology Group. Patients will also answer a modified visual analogue scale for pain (a self-evaluation questionnaire). Primary and secondary outcomes will be the prevention of radiodermatitis and pain secondary to radiodermatitis, respectively. DISCUSSION: The ideal tool for preventing radiodermatitis is an agent that mediates DNA repair or promotes cell proliferation. Application of a low-power laser has been shown to promote tissue repair by reducing inflammation and inducing collagen synthesis. Moreover, this treatment approach has not been associated with adverse events and is cost-effective. Thus, the results of this ongoing trial may establish whether use of a low-power laser represents an ideal treatment option for the prevention of radiodermatitis. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02003599. Registered on 2 December 2013.

Effect of adjuvant chemoradiotherapy on overall survival of gastric cancer patients submitted to D2 lymphadenectomy.

BACKGROUND: Adjuvant chemoradiotherapy (CRT) is the standard treatment in Western countries for gastric cancer patients submitted to curative resection. However, the role of adjuvant CRT in gastric cancer treated with D2 lymphadenectomy has not been well defined. METHODS: We conducted a retrospective study in patients with stage II to IV gastric adenocarcinoma with no distant metastases, who underwent curative resection with D2 lymphadenectomy between January 2002 and December 2007. The present study compared the 3-year overall survival of two treatments (adjuvant CRT according to the INT 0116 trial versus resection alone). Survival curves were estimated by the Kaplan-Meier method and compared with a log-rank test. Multivariate analysis of prognostic factors was performed by the Cox proportional hazards model. RESULTS: A total of 185 patients were included, 104 patients (56 %) received adjuvant CRT and 81 received resection alone. The 3-year overall survival was 64.4 % in the CRT group and 61.7 % in the resection-alone group (p: 0.415). However, according to the Cox proportional hazards model, adjuvant CRT was a prognostic factor for 3-year overall survival (hazard ratio [HR] 0.46, 95 % confidence interval [CI] 0.26-0.82, p: 0.008). CONCLUSIONS: In the present study, adjuvant CRT was associated with a lower risk of death over a 3-year period in gastric cancer patients treated with D2 lymphadenectomy.

Câncer de glândulas salivares maiores - análise de sobrevida e resultados do tratamento em uma instituição hospitalar / Major salivary glands cancer - survival analysis and results of the treatment in one hospitalar institution

Introdução: Este estudo foi desenhado para demonstrar aexperiência e os resultados de uma única instituição de umtumor relativamente incomum. Objetivos: Relatar os resultadosdo tratamento dos tumores de glândulas salivares maiores doHospital do Câncer de Barretos e compará-los com os dadosda literatura. Método: Realizou-se a análise retrospectiva deregistros hospitalares de 38 pacientes tratados com cirurgia,radioterapia exclusiva ou adjuvante à cirurgia no Hospital doCâncer de Barretos entre Janeiro de 2002 e Dezembro de2006. Foi realizada análise descritiva dos dados demográficose epidemiológicos. O cálculo de sobrevida global foi feitoutilizando-se o método de Kaplan-Meier. Resultados: Dos 38pacientes avaliados no estudo, 6 (15,8%) apresentavam estádioI, 13 (34,2%) estádio II, 3 (7,9%) estádio III e 16 (42,1%) estádioIVa-b. Destes, 4 pacientes (10,5%) foram tratados com cirurgiaexclusiva; 27 pacientes (71%) com cirurgia e radioterapiaadjuvante; e 7 pacientes (18,5%) com radioterapia exclusiva. Asobrevida global em 5 anos dos pacientes tratados foi de 56,2%.Os pacientes que realizaram cirurgia exclusiva tiveram 75,0%de sobrevida global em 5 anos; os que realizaram cirurgia eradioterapia adjuvante 61,8% e os que fizeram radioterapiaexclusiva 28,6%. Conclusão: A radioterapia como tratamentoexclusivo ou adjuvante foi realizada em 89,5% dos pacientestratados no presente estudo. Os resultados de sobrevida globalem 5 anos da radioterapia adjuvante à cirurgia são semelhantesaos descritos na literatura.