Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 29.478
Filtrar
1.
Int J Mol Sci ; 22(6)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33807089

RESUMO

Clinical, epidemiological, and experimental evidence demonstrate non-cancer, cardiovascular, and endocrine effects of ionizing radiation exposure including growth hormone deficiency, obesity, metabolic syndrome, diabetes, and hyperinsulinemia. Insulin-like growth factor-1 (IGF-1) signaling perturbations are implicated in development of cardiovascular disease and metabolic syndrome. The minipig is an emerging model for studying radiation effects given its high analogy to human anatomy and physiology. Here we use a minipig model to study late health effects of radiation by exposing male Göttingen minipigs to 1.9-2.0 Gy X-rays (lower limb tibias spared). Animals were monitored for 120 days following irradiation and blood counts, body weight, heart rate, clinical chemistry parameters, and circulating biomarkers were assessed longitudinally. Collagen deposition, histolopathology, IGF-1 signaling, and mRNA sequencing were evaluated in tissues. Our findings indicate a single exposure induced histopathological changes, attenuated circulating IGF-1, and disrupted cardiac IGF-1 signaling. Electrolytes, lipid profiles, liver and kidney markers, and heart rate and rhythm were also affected. In the heart, collagen deposition was significantly increased and transforming growth factor beta-1 (TGF-beta-1) was induced following irradiation; collagen deposition and fibrosis were also observed in the kidney of irradiated animals. Our findings show Göttingen minipigs are a suitable large animal model to study long-term effects of radiation exposure and radiation-induced inhibition of IGF-1 signaling may play a role in development of late organ injuries.


Assuntos
Biomarcadores , Fator de Crescimento Insulin-Like I/metabolismo , Miocárdio/metabolismo , Lesões por Radiação/metabolismo , Transdução de Sinais/efeitos da radiação , Animais , Células Sanguíneas/metabolismo , Células Sanguíneas/efeitos da radiação , Peso Corporal/efeitos da radiação , Colágeno/metabolismo , Modelos Animais de Doenças , Relação Dose-Resposta à Radiação , Fibrose/etiologia , Regulação da Expressão Gênica/efeitos da radiação , Frequência Cardíaca/efeitos da radiação , Hematopoese/efeitos da radiação , Metabolismo dos Lipídeos/efeitos da radiação , Especificidade de Órgãos/efeitos da radiação , Lesões por Radiação/genética , Suínos
2.
Radiol Clin North Am ; 59(3): 425-440, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33926687

RESUMO

Neurologic injury arises from treatment of central nervous system malignancies as result of direct toxic effects or indirect vascular, autoimmune, or infectious effects. Multimodality treatment may potentiate both therapeutic and toxic effects. Symptoms range from mild to severe and permanent. Injuries can be immediate or delayed. Many early complications are nonspecific. Other early and delayed neurologic injuries, such as posterior reversible encephalopathy syndrome, dural sinus thrombosis, infarctions, myelopathy, leukoencephalopathy, and hypophysitis, have unique imaging features. This article reviews treatment options for neurologic malignancies and common and uncommon neurologic injuries that can result from treatment, focusing on radiologic features.


Assuntos
Neoplasias Encefálicas/terapia , Diagnóstico por Imagem/métodos , Imunoterapia/efeitos adversos , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/etiologia , Lesões por Radiação/diagnóstico por imagem , Adulto , Encéfalo/diagnóstico por imagem , Criança , Terapia Combinada/efeitos adversos , Humanos
3.
Gan To Kagaku Ryoho ; 48(3): 449-451, 2021 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-33790184

RESUMO

Although radiation therapy for pelvic cancer leads to improved outcomes, it may cause radiation enteritis. Radiation enteritis is classified as early and late reaction. Late reaction indicate progressive and irreversible changes caused by ischemic changes of the intestinal mucosa. Severe cases require a surgical treatment, which is challenging because of severe adhesions and a high risk of suture failure. In addition, the postoperative course may be unfavorable in some cases. We performed surgery for 4 radiation enteritis cases; however, the postoperative course was unfavorable in 2 cases because of impaired absorption and ileus of the remaining short bowel. These patients could not eat adequately after discharge; therefore, we needed to explain and make them understand the benefits and disadvantages of radiation therapy.


Assuntos
Enterite , Obstrução Intestinal , Neoplasias Pélvicas , Lesões por Radiação , Enterite/etiologia , Humanos , Mucosa Intestinal , Lesões por Radiação/etiologia
4.
Medicine (Baltimore) ; 100(16): e25540, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879699

RESUMO

OBJECTIVES: The purpose of this study is to investigate the effect of the comprehensive oral care program on oral health status and symptoms in head and neck cancer (HNC) patients undergoing radiotherapy. METHODS: This was a quasi-experimental study using a non-equivalent control group in non-synchronized design. All participants including control and experimental group were asked for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 (EORTC QLQ-H&N35) and given an oral health education 4 times at baseline, immediate postradiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy. In each visit except for final, the experimental group was given fluoride varnish application and fluoride mouth rinsing solution for daily use. Oral health examination for dental caries, plaque score (PS), bleeding on probing (BOP), and salivary flow rate was performed in baseline and 6 months after radiotherapy. Statistical analyses were done by paired t-tests and mixed ANCOVA repeated-measures analysis. RESULTS: From November 1, 2013 to October 31, 2015, a total 61 patients undergoing radiotherapy for HNC cancer were enrolled (30 in control and 31 in experimental groups). Decrease in salivary flow rate was comparable between 2 groups. Dental caries increased in control group (P = .006); PS and BOP were decreased in experimental group (P < .001 and .004, respectively). Experimental group showed lower swallowing, speech problems, and less sexuality scores in EORTC QLQ-H&N35 than control group. CONCLUSION: We found improvement in oral health and the quality of life in HNC patients with comprehensive oral care intervention by dental professionals. Communicating and cooperating between the healthcare and dental professionals is needed to raise the quality of health care services for HNC patients receiving radiotherapy.


Assuntos
Assistência Odontológica Integral/métodos , Neoplasias de Cabeça e Pescoço/terapia , Saúde Bucal , Qualidade de Vida , Lesões por Radiação/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Cárie Dentária/etiologia , Cárie Dentária/prevenção & controle , Feminino , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/etiologia , Doenças da Boca/prevenção & controle , Ensaios Clínicos Controlados não Aleatórios como Assunto , Projetos de Pesquisa
5.
Medicine (Baltimore) ; 100(14): e24888, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832069

RESUMO

RATIONALE: The best treatment protocol for radiation maculopathy in children has not been determined. The purpose of this study was to determine the effect of photodynamic therapy (PDT) on radiation maculopathy. PATIENT CONCERNS: An 11-year-old boy who was originally diagnosed with orbital rhabdomyosarcoma when he was 1 year old, in October 2008. The lesion improved after peripheral blood stem cell transplantation, chemotherapy and radiation therapy. A cataract was detected in his right eye in May 2011, and he underwent cataract surgery in July 2011. Continuous amblyopia training maintained his visual acuity in his right eye. In January 2017, his visual acuity was reduced and macular edema was detected with optical coherence tomography. DIAGNOSES: We diagnosed radiation maculopathy, from the history of radiation therapy, macular edema by optical coherence tomography, and hyperfluorescent site by fluorescein angiography. INTERVENTIONS: We performed PDT in June 2017. OUTCOMES: Treatment with PDT improved macular edema and his visual acuity. LESSONS: Radiation retinopathy is progressive disorder with poor prognosis. PDT could be considered to treat radiation maculopathy.


Assuntos
Edema Macular/terapia , Fotoquimioterapia/métodos , Lesões por Radiação/complicações , Criança , Humanos , Edema Macular/diagnóstico por imagem , Edema Macular/etiologia , Edema Macular/patologia , Masculino , Lesões por Radiação/diagnóstico , Rabdomiossarcoma/radioterapia
6.
Anticancer Res ; 41(4): 2101-2110, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813420

RESUMO

BACKGROUND/AIM: To evaluate if topical support therapy during static-intensity modulated radiotherapy (sIMRT) course is able to equal the characteristic minimum risk for radiation proctitis of Image-guided volumetric modulated arc therapy (IG-VMAT) treatment among localized prostate cancer patients. PATIENTS AND METHODS: Rectal toxicity data of the above patients were retrospectively collected throughout three different clinical periods at our Radiotherapy Deparment: from October 2011 to December 2012, prostate cancer patients were treated with sIMRT and in advance supported by means of daily topical corticosteroids; from January 2013 to November 2016, topical corticosteroids were replaced by daily hyaluronic acid enemas; from December 2016 to May 2018 eligible patients were treated with newly introduced IG-VMAT supported by only on-demand topical corticosteroids. RESULTS: Among 359 eligible patients, IG-VMAT was proven generally more effective than sIMRT supported by topical medications in terms of proctitis reduction, although without clinical and practical relevance. CONCLUSION: Topical medications might have a role in radiation proctitis prevention.


Assuntos
Anti-Inflamatórios/administração & dosagem , Proctite/prevenção & controle , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Radioterapia de Intensidade Modulada , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Beclometasona/administração & dosagem , Enema/métodos , Humanos , Ácido Hialurônico/administração & dosagem , Itália , Masculino , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/métodos , Proctite/etiologia , Neoplasias da Próstata/patologia , Hipofracionamento da Dose de Radiação , Lesões por Radiação/prevenção & controle , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia Guiada por Imagem/efeitos adversos , Radioterapia Guiada por Imagem/métodos , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Estudos Retrospectivos
7.
Int J Mol Sci ; 22(6)2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33808935

RESUMO

Antioxidant agents are promising pharmaceuticals to prevent salivary gland (SG) epithelial injury from radiotherapy and their associated irreversible dry mouth symptoms. Epigallocatechin-3-gallate (EGCG) is a well-known antioxidant that can exert growth or inhibitory biological effects in normal or pathological tissues leading to disease prevention. The effects of EGCG in the various SG epithelial compartments are poorly understood during homeostasis and upon radiation (IR) injury. This study aims to: (1) determine whether EGCG can support epithelial proliferation during homeostasis; and (2) investigate what epithelial cells are protected by EGCG from IR injury. Ex vivo mouse SG were treated with EGCG from 7.5-30 µg/mL for up to 72 h. Next, SG epithelial branching morphogenesis was evaluated by bright-field microscopy, immunofluorescence, and gene expression arrays. To establish IR injury models, linear accelerator (LINAC) technologies were utilized, and radiation doses optimized. EGCG epithelial effects in these injury models were assessed using light, confocal and electron microscopy, the Griess assay, immunohistochemistry, and gene arrays. SG pretreated with EGCG 7.5 µg/mL promoted epithelial proliferation and the development of pro-acinar buds and ducts in regular homeostasis. Furthermore, EGCG increased the populations of epithelial progenitors in buds and ducts and pro-acinar cells, most probably due to its observed antioxidant activity after IR injury, which prevented epithelial apoptosis. Future studies will assess the potential for nanocarriers to increase the oral bioavailability of EGCG.


Assuntos
Células Acinares/efeitos dos fármacos , Células Acinares/efeitos da radiação , Catequina/análogos & derivados , Protetores contra Radiação/farmacologia , Glândulas Salivares/efeitos dos fármacos , Glândulas Salivares/efeitos da radiação , Animais , Apoptose/efeitos dos fármacos , Catequina/farmacologia , Linhagem Celular , Células Epiteliais/efeitos dos fármacos , Epitélio/efeitos dos fármacos , Epitélio/metabolismo , Humanos , Imuno-Histoquímica , Estresse Oxidativo , Lesões por Radiação/prevenção & controle
8.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(1): 99-104, 2021 Feb 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33723944

RESUMO

Oral squamous cell carcinoma (OSCC) is the most frequent tumour in head and neck malignant. The current treatment is mainly based on surgery therapy, radiation therapy and chemical therapy. Meanwhile, there are many a defect in the treatment. For example, there are many defects in radiotherapy. Radioactive salivatitis is the most common. In addition, there are a series of changes such as dry mouth, oral mucositis, rampant dental caries, and radioactive osteomyelitis of jaw, which cause swallowing, chewing problems, and taste dysfunction. Currently, the research on radioactive salivatitis is progressing rapidly, but its mechanism is more complication. This paper review aims to summarize the research progress in this field.


Assuntos
Carcinoma de Células Escamosas , Cárie Dentária , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Lesões por Radiação , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Glândulas Salivares , Xerostomia/etiologia
9.
Bull Cancer ; 108(4): 352-358, 2021 Apr.
Artigo em Francês | MEDLINE | ID: mdl-33678407

RESUMO

In a few situations, the consequences secondary to a carcinological pathology require an assessment of damages for compensatory purposes. This is particularly the case when liable parties have been found to be at cause of the disease: occupational pathologies in the case of inexcusable employer's fault, exposure to a radioactive risk, for example in the context of full compensation for damages suffered by the victims of nuclear experiments performed by France, or lastly, in the after-effects of late diagnosis. This article does not discuss the imputability of cancer pathologies to an event, but it proposes an adaptation of methods for assessing damages, in an attempt to provide full compensation for damages.


Assuntos
Compensação e Reparação/legislação & jurisprudência , Responsabilidade Legal , Neoplasias , Doenças Profissionais , Causalidade , Avaliação da Deficiência , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Estética , França , Experimentação Humana/legislação & jurisprudência , Humanos , Deficiências da Aprendizagem/etiologia , Responsabilidade Legal/economia , Neoplasias/economia , Neoplasias/etiologia , Neoplasias/psicologia , Neoplasias/terapia , Neoplasias Induzidas por Radiação/economia , Neoplasias Induzidas por Radiação/etiologia , Doenças Profissionais/economia , Doenças Profissionais/etiologia , Dor , Complicações Pós-Operatórias , Lesões por Radiação/economia , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Disfunções Sexuais Fisiológicas/etiologia , Responsabilidade Social
10.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 15-20, mar. 2021. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-1178270

RESUMO

Introducción: los estudios por imágenes (EPI) son de gran ayuda para el diagnóstico clínico, pero su uso irracional puede ocasionar daños. Objetivos: relevar las percepciones y expectativas sobre estudios por imágenes pediátricos en un grupo de padres de niños sanos. Evaluar los datos obtenidos en relación con el registro de EPI solicitados por Guardia durante el mismo período. Materiales y métodos: estudio exploratorio, descriptivo, cuali-cuantitativo mediante una encuesta en una muestra por conveniencia en un centro pediátrico ambulatorio, a lo largo de dos meses. Análisis retrospectivo de solicitud de EPI en el registro informatizado de historias clínicas de Guardia durante el mismo período. Resultados: respondieron 243 padres. El 93,4% refirió conocer métodos de EPI (la radiografía[Rx] fue el más conocido). Se había realizado al menos un EPI al 83,4% de los niños en los últimos doce meses. El estudio fue explicado en forma clara en el 96,4% de los casos. Un 47,7% de los padres refirieron conocer las consecuencias del uso repetitivo de EPI. El 81,6% acordó con que "ante cualquier traumatismo se debe realizar Rx para descartar fractura". Más del 60% consideró que debe realizarse Rx de tórax a todo niño con tos sin fiebre o con fiebre de más de dos días y 55% solicitarían Rx de senos paranasales si el niño elimina mocos verdes. El 49,8% opinó que los médicos piden EPI de menos (por falta de recursos, para trabajar menos o para ahorrar dinero). Durante el período estudiado se solicitó una radiografía al 5% de los pacientes que consultaron por Guardia; no se encontró justificación para solicitar el estudio en el 29% de los casos. Conclusión: un gran porcentaje de padres conoce los EPI; sin embargo, desconocen los riesgos asociados a su uso. Existen errores de concepto que generan expectativas desmedidas con respecto a la indicación de Rx. Se informó un exceso en las solicitudes de EPI por Guardia. Los padres consideran que los médicos solicitan EPI de menos. (AU)


Introduction: ediatric radiologic exams (PRE) are of great value for clinicians. It's over or misuse can lead to irreparable damage that can be prevented. Objective: to describe perceptions and expectations for the use of PRE among healthy children`s parents in an ambulatory center. To analyze these results in relation to the report of PRE performed in the emergency room during the same period. Methods: observational, cross sectional, quali- quantitative study using a survey on a convenience sample conducted in an outpatient pediatric center over a two months period. Retrospective analysis of medical records to evaluate PRE requested on the ER during the 2 months of the study. Results: 243 parents completed the survey. 93,4% were familiar with PRE (X-rays being the most popular among them). 83,4% of children in our sample had at least one PRE in the past 12 months. The need and utility of the study had been explained to the parents clearly in 96,4% of cases. 47,7% of parents knew about the side effects associated with repetitive use of PRE. 81,6% agreed with the statement "in the event that a child should suffer any trauma, an X-Ray should be performed to look for fractures". Over 60% think a chest X ray has to be obtained if the child has fever for over 48 hours and 55% would expect an X ray to be performed whenever a child has green nasal discharge. 49,8% respondents think that doctors order less than necessary (for lack of resources, unwillingness to work in or to save money). The analysis of clinical reports showed that X-Rays were performed to 5% of children at the emergency clinic. Among them, we found no reason for the study in 29% of the cases. Conclusion: we found that parents were very familiar with PRE, however less than half our sample knew of the potential risks related to their use. There are considerable misconceptions among parents regarding X-Ray use. Parents considered that doctors order too little PRE. (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Pediatria/estatística & dados numéricos , Diagnóstico por Imagem/estatística & dados numéricos , Argentina , Lesões por Radiação/etiologia , Radiação Ionizante , Raios X , Diagnóstico por Imagem/efeitos adversos , Radiografia/estatística & dados numéricos , Risco , Inquéritos e Questionários , Estudos Retrospectivos
11.
Cancer Treat Rev ; 95: 102176, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33743409

RESUMO

AIMS: The best therapeutic approach for local relapses of previously irradiated prostate cancer (PC) is still not defined. Re-irradiation (Re-I) could offer a chance of cure for highly selected patients, although high quality evidences are lacking. The aim of our study is to provide a literature review on efficacy and safety of Re-I. METHODS: Only studies where Re-I field overlaps with previous radiotherapy were considered. To determine 2 and 4 years overall mortality (OM), 2 and 4 years biochemical failure (BF) and pooled acute and late G ≥ 3 toxicities rate, a meta-analysis over single arm study was performed. RESULTS: Thirty-eight studies with 1194 patients were included. Median follow-up from Re-I was 30 months (10-94 months). Brachytherapy (BRT) was the most used Re-I technique (27 studies), followed by Stereotactic Body Radiotherapy (SBRT) (9) and External Beam Radiation Therapy (EBRT) (2). Re-I prescription doses ranged from 19 Gy in single HDR fraction to 145 Gy (interstitial BRT). The pooled 2 and 4 years OM rates were 2.1% (95%CI:1.1-3.7%, P < 0.001) and 12.5% (95%CI:8.1-19.5%; P < 0.001). The pooled 2 years BF rate was 24% (95% CI: 19.1-30.2%, P < 0.001). The pooled 4 years BF was 35.6% (95% CI: 28.7-44.3%, P < 0.001). The pooled result of G ≥ 3 acute toxicity was 1.4% (95%CI: 0.7-3%, P < 0.001). One hundred and three G ≥ 3 late adverse events were reported, with a pooled result of G ≥ 3 late toxicity of 8.7% (95%CI: 5.8-13%, P < 0.001). CONCLUSIONS: Re-I of local failures from PC showed promising OM and biochemical control rates with a safe toxicity profile.


Assuntos
Neoplasias da Próstata/radioterapia , Lesões por Radiação/etiologia , Lesões por Radiação/mortalidade , Reirradiação/efeitos adversos , Reirradiação/mortalidade , Humanos , Masculino , Neoplasias da Próstata/patologia , Lesões por Radiação/patologia , Dosagem Radioterapêutica
12.
Toxicol Appl Pharmacol ; 418: 115495, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33741346

RESUMO

In the present study, the effects of NLRP3 on radiation-induced tissue damage, including colon and skin damage in mice, and the possible mechanisms were explored in vivo and in vitro. The mice were subjected to whole abdomen radiation by timed exposure to X-ray at a cumulative dose of 14 Gy. The survival rate showed that NLRP3 deficiency increased the mortality rate in mice. Furthermore, colon damage, evaluated by H&E staining and barrier function analysis, were significantly aggravated by NLRP3 deficiency. Enhanced phosphorylation of p-TBK1 and p-IRF3 in colonic tissue as well as elevated IFN-ß levels in the serum indicated hyperactivation of cGAS-STING signaling. Moreover, radiation-induced expression of p-TBK1, p-IRF3, and IFN-ß in BMDMs increased in vitro after NLRP3 knockout. Thus, our study outcomes suggest that NLRP3 may protect mice from radiation-induced tissue damage via attenuating cGAS-STING signaling.


Assuntos
Colo/efeitos da radiação , Macrófagos/efeitos da radiação , Proteínas de Membrana/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Nucleotidiltransferases/metabolismo , Lesões por Radiação/prevenção & controle , Úlcera Cutânea/prevenção & controle , Pele/efeitos da radiação , Animais , Células Cultivadas , Colo/enzimologia , Colo/patologia , Fator Regulador 3 de Interferon/metabolismo , Interferon beta/metabolismo , Macrófagos/enzimologia , Macrófagos/patologia , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteína 3 que Contém Domínio de Pirina da Família NLR/deficiência , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Fosforilação , Proteínas Serina-Treonina Quinases/metabolismo , Lesões por Radiação/enzimologia , Lesões por Radiação/genética , Lesões por Radiação/patologia , Transdução de Sinais , Pele/enzimologia , Pele/patologia , Úlcera Cutânea/enzimologia , Úlcera Cutânea/genética , Úlcera Cutânea/patologia
13.
Mutat Res ; 863-864: 503313, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33678245

RESUMO

Biological dosimetry of ionizing radiation (IR) exposure relies on validated cytogenetic tests measuring the frequencies of micronuclei (MN) and dicentric chromosomes (DC). IR also causes oxidative damage of biomolecules, including DNA. We evaluated IR-induced genotoxic and oxidative damage in a carefully defined cohort of healthy donors, reducing confounding factors as much as possible. Frequencies of MN and DC (peripheral blood lymphocyte cultures) and oxidative stress parameters (plasma) were quantified. We observed dose dependence of both cytogenetic and biochemical endpoints, independent of age, sex, and smoking habits. Oxidative stress parameters, especially oxidative stress index, malondialdehyde, advanced oxidation protein products, and catalase, may be used confidently to assess IR-induced damage, if cytogenetic results are unavailable.


Assuntos
Aberrações Cromossômicas/efeitos da radiação , Linfócitos/metabolismo , Estresse Oxidativo/efeitos da radiação , Plasma/metabolismo , Lesões por Radiação/metabolismo , Radiação Ionizante , Adulto , Feminino , Humanos , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/patologia
14.
Am J Clin Oncol ; 44(4): 143-149, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33755031

RESUMO

OBJECTIVE: The objective of this study was to examine patterns of care and outcomes of female cancer patients treated for sexual and menopausal symptoms following pelvic radiotherapy (PRT) at our institution's multidisciplinary Sexuality, Intimacy, and Menopause (SIMS) Program. MATERIALS AND METHODS: We performed a retrospective review of 69 female patients who received PRT for gynecologic or gastrointestinal malignancies and were referred for SIMS Program intervention. Indications for referral and treatment patterns were summarized. Preintervention and postintervention, patients were screened at follow-up visits, and symptoms were recorded. Statistics were performed using Stata 13.1. RESULTS: Cancer types included cervical (53.6%), endometrial (31.9%), anorectal (5.8%), and vulvar/vaginal (8.7%). The median age was 48 years (interquartile range: 38 to 58 y). Patients were educated on vaginal lubricants, moisturizers, and dilator therapy both before and after PRT. Reasons for SIMS referral included persistent menopausal symptoms (50.7%), dyspareunia (40.6%), vaginal dryness (37.7%), decreased libido (17.4%), intimacy concerns (17.4%), and/or physical examination alterations (27.5%). SIMS interventions included vaginal estrogen (77.3%), nonhormonal climacteric interventions (53%), systemic hormone therapy (31.8%), dehydroepiandrosterone (4.6%), testosterone cream (4.6%), and/or psychological pharmacotherapy or counseling (13.6%). With a median follow-up of 36 months (interquartile range: 18 to 58 mo), sexual symptoms improved or were stable in 83.6%, while menopausal symptoms improved or were stable in 80.5%. CONCLUSIONS: This study highlights the importance of multidisciplinary care in improving the sexual and menopausal symptoms of women after PRT. Future work examining the impact of intervention timing with respect to PRT and measures of patient satisfaction is warranted.


Assuntos
Menopausa/efeitos da radiação , Pelve/efeitos da radiação , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Disfunções Sexuais Fisiológicas/terapia , Saúde Sexual , Serviços de Saúde da Mulher , Adulto , Braquiterapia/efeitos adversos , Terapia Combinada , Dispareunia/etiologia , Dispareunia/terapia , Feminino , Neoplasias dos Genitais Femininos/radioterapia , Humanos , Comunicação Interdisciplinar , Pessoa de Meia-Idade , Satisfação do Paciente , Neoplasias Retais/radioterapia , Estudos Retrospectivos , Disfunções Sexuais Fisiológicas/etiologia , Resultado do Tratamento , Doenças Vaginais/etiologia , Doenças Vaginais/terapia
15.
Arch Esp Urol ; 74(2): 215-223, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-33650536

RESUMO

OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in the treatment of hemorrhagic radiation cystitis (HRC). MATERIAL AND METHOD: Retrospective study of patients diagnosed with hematuria secondary to HRC after pelvic radiation from January 2005 to January 2017 who were treated with HBOT. Demographic and clinical variables were collected. A descriptive univariate and multivariate statistical analysis using Cox regression was carried out. The treatment was considered effective when there was a total or partial remission of the hematuria based on the Radiation Therapy Oncology Group (RTOG) scoring schema. Partial remission was defined as the presence of hematuria grade 2 or less. RESULTS: A total of 67 patients with a mean age of 68,6 years (39-87) were included. 65,7% men and 34,3% women. The RT was administered in 64,2% of the cases by urological cause, prostate cancer. The av-erage dose of RT was 75,24 Gy (45-180). The mean from the RT to the HBOT treatment was 55,97 months (4-300) and from the beginning of the hematuria until the treatment was 11,3 months (1-48). Response was observed in 51 (76,1%) patients, total in 50,7% and partial in 25,4% of cases. Patients with a degree of hematuria less than 3, those who were administered more than 30 sessions and those who did not require transfusion or hospital admission, responded significantly bet-ter to treatment with HBOT (p<0.05) according to the univariate and multivariate analysis. No adverse effects related to treatment were reported, only one patient was excluded due to claustrophobia. CONCLUSIONS: Hyperbaric oxygen therapy is an effective and safe treatment for the management of hematuria due to radiological cystitis secondary to radiotherapy. A better response was observed in patients with a lower degree of hematuria and those who could be administered a greater number of sessions.


Assuntos
Cistite , Oxigenação Hiperbárica , Lesões por Radiação , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistite/etiologia , Cistite/terapia , Feminino , Hematúria/etiologia , Hematúria/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/complicações , Lesões por Radiação/terapia , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 100(9): e24760, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655939

RESUMO

ABSTRACT: Radiation overexposure is common in chest X-ray (CXRs) of pediatric patients. However, overexposure may reveal incidental findings that can help to guide patient management or warrant quality improvement.To assess the prevalence of overexposure in CXRs in pediatric intensive care unit (PICU); and identify the incidental findings within overexposed areas, we conducted a retrospective cohort study of children who were admitted to PICU. Two independent evaluators reviewed patient's charts and digital CXRs according to the American College of Radiology standards; to evaluate overexposure of the anatomical parameters and incidental findings.A total of 400 CXRs of 85 patients were reviewed. The mean number of CXRs per patient was 4.7. Almost all (99.75%) CXRs met the criteria for overexposure, with the most common being upper abdomen (99.2%), upper limbs (97%) and neck (95.7%). In addition, 43% of these X-rays were cropped by the radiology technician to appear within the requested perimeter. There was a significant association between field cropping and overexposure (t-test: t = 9.8, P < .001). Incidental findings were seen in 41.5% of the radiographs; with the most common being gaseous abdominal distension (73.1%), low-positioned nasogastric tube (24.6%), and constipation (10.3%).Anatomical overexposure in routine CXRs remains high and raises a concern in PICU practice. Appropriate collimation of the X-ray beam, rather than electronically cropping the image, is highly recommended to minimize hiding incidental findings in the cropped-out areas. Redefining the anatomic boundaries of CXR in critically ill infants and children may need further studies and consideration. Quality improvement initiatives to minimize radiation overexposure in PICU are recommended, especially in younger children and those with more severe illness upon PICU admission.


Assuntos
Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Erros Médicos/estatística & dados numéricos , Exposição à Radiação/análise , Lesões por Radiação/epidemiologia , Radiografia Torácica/efeitos adversos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Achados Incidentais , Lactente , Recém-Nascido , Masculino , Prevalência , Melhoria de Qualidade , Estudos Retrospectivos , Tórax/diagnóstico por imagem
17.
Saudi Med J ; 42(3): 247-254, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33632902

RESUMO

This review summarizes the beginning of radiotherapy, techniques of modern radiation therapy with different types, toxicities induced by radiotherapy and their management. Head and neck radiation therapy is still improving for the better management and control of the cancer and induced radiotherapy toxicities.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/métodos , Radioterapia/tendências , Fracionamento da Dose de Radiação , Exantema/etiologia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/metabolismo , Humanos , Oxigenação Hiperbárica , Osteorradionecrose/etiologia , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Radioterapia/efeitos adversos , Espécies Reativas de Oxigênio/metabolismo
18.
Radiat Res ; 195(4): 355-365, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33544844

RESUMO

Radiation-induced brain injury (RBI) is a serious complication in patients who have received radiotherapy for head and neck tumors. Currently, there is a scarcity of information on early diagnostic and preventive methods of RBI. Accumulating evidence suggests that microRNAs are involved in the regulation of radiation injury, but the molecular biological mechanism of miRNAs in RBI is largely unknown. Therefore, in our study, microRNA sequencing was used to discover differential miRNAs in the hippocampus of RBI-modeled mice, which suggested that miR-741-3p was most significantly upregulated. To clarify the underlying mechanism of miR-741-3p in RBI-modeled mice, an inhibitor of miR-741-3p (antagomiR-741) was delivered into the brain via the nasal passage before irradiation. The delivery of antagomiR-741 significantly reduced miR-741-3p levels in the hippocampus of RBI-modeled mice, and the cognitive dysfunction and neuronal apoptosis induced by radiation were also alleviated at 6 weeks postirradiation. Downregulation of miR-741-3p was found to improve the protrusion and branching status of microglia after irradiation and reduced the number of GFAP-positive astrocytes. Additionally, antagomiR-741 suppressed the radiation-induced production of pro-inflammatory cytokines IL-6 and TNF-α in the hippocampus and S100B in the serum. Furthermore, Ddr2, PKCα and St8sia1 were revealed as target genes of miR-741-3p and as potential regulatory targets for RBI. Overall, our study provides identification and functional evaluation of miRNA in RBI and lays the foundation for improving the prevention strategy for RBI based on the delivery of miRNA via the nose-brain pathway.


Assuntos
Antagomirs/farmacologia , Lesões Encefálicas/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia , MicroRNAs/farmacologia , Lesões por Radiação/tratamento farmacológico , Animais , Apoptose/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Encéfalo/efeitos da radiação , Lesões Encefálicas/etiologia , Lesões Encefálicas/genética , Lesões Encefálicas/patologia , Modelos Animais de Doenças , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/patologia , Hipocampo/efeitos dos fármacos , Hipocampo/patologia , Humanos , Inflamação/tratamento farmacológico , Inflamação/genética , Inflamação/patologia , Camundongos , MicroRNAs/genética , Lesões por Radiação/genética , Lesões por Radiação/patologia , Transdução de Sinais/efeitos dos fármacos
19.
Radiother Oncol ; 157: 147-154, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33545258

RESUMO

BACKGROUND AND PURPOSE: A comprehensive individual toxicity risk profile is needed to improve radiation treatment optimisation, minimising toxicity burden, in head and neck cancer (HNC) patients. We aimed to develop and externally validate NTCP models for various toxicities at multiple time points. MATERIALS AND METHODS: Using logistic regression, we determined the relationship between normal tissue irradiation and the risk of 22 toxicities at ten time points during and after treatment in 750 HNC patients. The toxicities involved swallowing, salivary, mucosal, speech, pain and general complaints. Studied predictors included patient, tumour and treatment characteristics and dose parameters of 28 organs. The resulting NTCP models were externally validated in 395 HNC patients. RESULTS: The NTCP models involved 14 organs that were associated with at least one toxicity. The oral cavity was the predominant organ, associated with 12 toxicities. Other important organs included the parotid and submandibular glands, buccal mucosa and swallowing muscles. In addition, baseline toxicity, treatment modality, and tumour site were common predictors of toxicity. The median discrimination performance (AUC) of the models was 0.71 (interquartile range: 0.68-0.75) at internal validation and 0.67 (interquartile range: 0.62-0.71) at external validation. CONCLUSION: We established a comprehensive individual toxicity risk profile that provides essential insight into how radiation exposure of various organs translates into multiple acute and late toxicities. This comprehensive understanding of radiation-induced toxicities enables a new radiation treatment optimisation concept that balances multiple toxicity risks simultaneously and minimises the overall toxicity burden for an individual HNC patient who needs to undergo radiation treatment.


Assuntos
Neoplasias de Cabeça e Pescoço , Lesões por Radiação , Radioterapia de Intensidade Modulada , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador
20.
BMC Neurol ; 21(1): 59, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33557786

RESUMO

BACKGROUND: During medical imaging, cystic radiation encephalopathy and brain metastasis are difficult to differentiate, and hence they are easily misdiagnosed. To our knowledge, a nasopharyngeal carcinoma recurrence after more than seven years with cerebral metastasis that mimicked cystic radiation encephalopathy has not been reported. CASE PRESENTATION: A 52-year-old man was admitted to the hospital owing to weakness of the right limb for one month, which increased in intensity for three days. He had been diagnosed with nasopharyngeal carcinoma in 2011, which was treated by radiotherapy. The patient successively developed cystic radiation encephalopathy and brain metastasis from the nasopharyngeal carcinoma, which mimicked cystic radiation encephalopathy relapse. Left frontotemporal craniotomy, surgical resection of brain metastasis, and repair of the skull base and dura were performed. Postoperative computed tomography showed that midline deviation recovered, and brain edema was reduced. CONCLUSIONS: This report is significant because brain metastasis from nasopharyngeal carcinoma can masquerade as a benign entity and cause fatal consequences. In patients presenting with cystic radiation encephalopathy, brain metastasis should be considered as a differential diagnosis.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundário , Carcinoma Nasofaríngeo/secundário , Neoplasias Nasofaríngeas/patologia , Lesões por Radiação/patologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/radioterapia , Recidiva Local de Neoplasia/diagnóstico , Lesões por Radiação/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...