Demand for radiotherapy in Spain

Aim. Assessing the demand for radiotherapy in Spain based on existing evidence to estimate the human resources and equipment needed so that every person in Spain has access to high-quality radiotherapy when they need it. Material and methods. We used data from the European Cancer Observatory on the estimated incidence of cancer in Spain in 2012, along with the evidence-based indications for radiotherapy developed by the Australian CCORE project, to obtain an optimal radiotherapy utilisation proportion (OUP) for each tumour. Results. About 50.5 % of new cancers in Spain require radiotherapy at least once over the course of the disease. Additional demand for these services comes from reradiation therapy and non-melanoma skin cancer. Approximately, 25-30 % of cancer patients with an indication for radiotherapy do not receive it due to factors that include access, patient preference, familiarity with the treatment among physicians, and especially resource shortages, all of which contribute to its underutilisation. Conclusions. Radiotherapy is underused in Spain. The increasing incidence of cancer expected over the next decade and the greater frequency of reradiations necessitate the incorporation of radiotherapy demand into need-based calculations for cancer services planning (AU)

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Demand for radiotherapy in Spain.

AIM: Assessing the demand for radiotherapy in Spain based on existing evidence to estimate the human resources and equipment needed so that every person in Spain has access to high-quality radiotherapy when they need it. MATERIAL AND METHODS: We used data from the European Cancer Observatory on the estimated incidence of cancer in Spain in 2012, along with the evidence-based indications for radiotherapy developed by the Australian CCORE project, to obtain an optimal radiotherapy utilisation proportion (OUP) for each tumour. RESULTS: About 50.5 % of new cancers in Spain require radiotherapy at least once over the course of the disease. Additional demand for these services comes from reradiation therapy and non-melanoma skin cancer. Approximately, 25-30 % of cancer patients with an indication for radiotherapy do not receive it due to factors that include access, patient preference, familiarity with the treatment among physicians, and especially resource shortages, all of which contribute to its underutilisation. CONCLUSIONS: Radiotherapy is underused in Spain. The increasing incidence of cancer expected over the next decade and the greater frequency of reradiations necessitate the incorporation of radiotherapy demand into need-based calculations for cancer services planning.

Análisis retrospectivo multicéntrico del tratamiento adyuvante con quimioradioterapia en pacientes con cáncer gástrico resecado. Resultados preliminares. Grupo Oncológico del Norte (G.O.N) / No disponible

INTRODUCCIÓN. En el carcinoma gástrico (CG), los resultados del estudio IT-0116 pusieron de manifiesto el beneficio del tratamiento con quimioterapia más radioterapia adyuvante después de cirugía radical R0, en un grupo de pacientes en los que la linfadenectomía D0 (inferior a D1) se había realizado en el 53% de los casos. Si los resultados de este estudio son trasladables a nuestros pacientes ha sido un punto de controversia. MATERIAL Y MÉTODOS. Hemos iniciado un análisis retrospectivo multicéntrico de los pacientes con CG que han recibido tratamiento adyuvante según la pauta de IT-0116. Analizamos las características de los pacientes, el tipo de linfadenectomía realizada, el número de ganglios analizados, el tratamiento recibido y la toxicidad. RESULTADOS. Analizamos 31pacientes. Se realizó una linfadenectomía D0 en 8(26%), D1 y entre D1-D2 en 12 (39%) y D2 en 9 (29%). Esplenectomía en 2 (6.5%). La mediana de ganglios analizados fue de 12 (2-38). El 90% presentaba ganglios positivos. De los 23 pacientes evaluables para la tolerancia al tratamiento, 17 pacientes (74%) completaron el tratamiento, 7 (32%) desarrollaron toxicidad hematológica grado 3-4 y 5 (20 %) toxicidad digestiva grado 3. La intensidad de dosis del 5FU fue del 86% (64-108%). CONCLUSIONES. En nuestros hospitales el número de pacientes con linfadenectomías D0 es inferior al del estudio IT-0116. Realizaremos análisis de supervivencia tras mayor tiempo de seguimiento (AU)

BACKGROUND. In gastric cancer, the results of Intergroup 0116 trial showed a benefit for adyuvant chemoradiotherapy after radical surgery. However, in 53% of this group of patients the lymphadenectomy had been D0 (less than D1). Controversy exists as to whether the results of this study can be applied to our patients. MATERIAL AND METHODS. We have conducted a retrospective multicentric analysis including patients with gastric cancer who have received adyuvant treatment with the IT-0116 regimen after complete resection. We analyze patients characteristics, the extent of lymph-node dissection, the number of cycles administered and toxicity. RESULTS. Thirty one patients were analyzed. 26% of the patients underwent a D0 dissection. A D1 lymphadenectomy or a lymphadenectomy between D1 and D2 were performed in 12 patients (39%) and a D2 in 9 patients (29%). 2 patients were splenectomized. The median number of nodes analyzed were 12 (2-38). 90% of the patients had positive-nodes. There were 23 patients evaluables for treatment toxicity. 17 patients (74%) completed treatment as planned. 7 patients (32%) developed hematologic toxicity grade 3-4 and 20% grade 3 diarrhea. The dose-intensity of fluorouracil was 83%(64-100%). CONCLUSIONS. We have less patients with a D0 lymphadenectomy in our hospitals than in the Intergroup trial. We will make a survival analysis after a longer follow-up (AU)

[Brachytherapy results in prostatic cancer]. / Resultados de la braquiterapia en el cáncer de próstata.

OBJECTIVE: To analyze the 15-year results of external irradiation combined with radioactive gold grain implantation (Au198) in the treatment of adenocarcinoma of the prostate and to discuss the therapeutic perspectives. METHODS: The present study was conducted on 23 patients with localized prostate carcinoma (17 stage B; 6 stage C) that had been diagnosed and treated at our department from February 1981 to October 1986. The mean patient follow-up was 90.96 months. Au198 implantation (mean dose 3347.6 cGy) was performed through the abdominal approach prior to external irradiation (mean dose 39 Gy) with Co-60 (19 patients) or the 18-MV photon linear accelerator (4 patients). The mean fractionated dose was 180.43 cGy/day. RESULTS: Overall the 15-year locoregional control rate was 61% and disease-free survival was 38%. The overall survival rate was 25%, regardless of the cause of death. The tumor control rate was 61% for stage B and 83% for stage C lesions at 15 years. The disease-free survival rate was 40% for stage B and 50% for stage C tumors. The local control and disease-free survival rates were worse for patients in whom the diagnosis had been made by TUR (p = not significant). CONCLUSIONS: The locoregional tumor control and disease-free survival rates for this group of 23 patients who received combined therapy with external irradiation and radioactive gold grain implantation (Au198) were slightly lower than those obtained in another group of 104 patients treated at our Service of Radiotherapeutic Oncology with radical external radiation therapy and can be ascribed mainly to poor patient selection and inadequate radiation dose.

Revised structure of phaeantharine.

Revised structure 8 is proposed for the quaternary bisbenzylisoquinoline alkaloid phaeantharine, based on spectrometric data. Phaeantharine, which occurs in Phaeanthus ebracteolatus (fam. Anonaceae), has current interest as a potential insecticide. Phaeantharine also exhibits moderate activity against gram-positive bacteria.