Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 16.513
Filtrar
1.
Rev Prat ; 70(6): 594-598, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-33058596

RESUMO

New in radiotherapy of solid tumors. The new irradiation techniques integrate the latest technological developments in medical imaging and computer science, dosimetry, and linacs into the treatment procedure. They raise new hopes for the treatment of solid tumor pathologies. Three techniques seem particularly promising: intensity modulated radiotherapy, respiratory gating radiotherapy, and stereotactic radiotherapy. The emergence of artificial intelligence, and particularly its applications in the field of imaging, opens up a new field of research. The purpose of these different innovations is to achieve very high precision radiotherapy, which makes it possible to better adapt the radiation fields to the tumor and thus protect the critical organs.


Assuntos
Neoplasias , Radiocirurgia , Radioterapia de Intensidade Modulada , Inteligência Artificial , Humanos , Neoplasias/radioterapia
2.
Int J Med Sci ; 17(16): 2561-2569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029098

RESUMO

Background: During the outbreak period of COVID-19 pneumonia, cancer patients have been neglected and in greater danger. Furthermore, the differential diagnosis between COVID-19 pneumonia and radiation pneumonitis in cancer patients remains a challenge. This study determined their clinical presentations and radiological features in order to early diagnose and separate COVID-19 pneumonia from radiation pneumonitis patients promptly. Methods and Findings: From January 21, 2020 to February 18, 2020, 112 patients diagnosed with suspected COVID-19 were selected consecutively. A retrospective analysis including all patients' presenting was performed. Four patients from 112 suspected individals were selected, including 2 males and 2 females with a median age of 54 years (range 39-64 years). After repeated pharyngeal swab nucleic acid tests, 1 case was confirmed and 3 cases were excluded from COVID-19 pneumonia. Despite the comparable morphologic characteristics of lung CT imaging, the location, extent, and distribution of lung lesions between COVID-19 pneumonia and radiation pneumonitis differed significantly. Conclusions: Lung CT imaging combined with clinical and laboratory findings can facilitate early diagnosis and appropriate management of COVID-19 pneumonia with a history of malignancy and radiation therapy.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Diagnóstico Diferencial , Neoplasias/radioterapia , Pneumonia Viral/diagnóstico por imagem , Pneumonite por Radiação/diagnóstico por imagem , Adulto , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/radioterapia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/radioterapia , Neoplasias/virologia , Pandemias , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
Radiat Oncol ; 15(1): 226, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993690

RESUMO

BACKGROUND: COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II. METHODS: The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily. RESULTS: By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed. CONCLUSION: During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Neoplasias/radioterapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Radioterapia (Especialidade)/estatística & dados numéricos , Betacoronavirus , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Hospitais , Humanos , Itália/epidemiologia , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/organização & administração , Carga de Trabalho/estatística & dados numéricos
5.
Medwave ; 20(8): e8012, 2020 Sep 07.
Artigo em Espanhol | MEDLINE | ID: mdl-32956343

RESUMO

Objective: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. Methods: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. Results: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. Conclusions: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.


Assuntos
Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/estatística & dados numéricos , Carga de Trabalho , Infecções por Coronavirus/prevenção & controle , Técnica Delfos , Desinfecção/métodos , Física Sanitária , Humanos , Higiene/normas , Neoplasias/radioterapia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/veterinária , Cuidados Paliativos/organização & administração , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Radioterapia (Especialidade)/organização & administração , Distância Social , Triagem/organização & administração
8.
Cancer Radiother ; 24(6-7): 762-767, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32873486

RESUMO

Health data financed by the French national solidarity system constitute a common heritage. Such data should be exploited to optimize care while complying with ethics and fundamental rights of citizens. The creation of the Health Data Hub (HDH) was allowed by the 24 July 2019 Law on the organization and transformation of the French health system. Its objective is to enable authorized innovative project leaders to access non-nominative data via a state-of-the-art secure technological platform. It appears to be one of the strong points of the French Artificial Intelligence strategy. This structure is a public interest group which associates 56 stakeholders, mostly from the public authorities. It implements, in partnership with the National Health Insurance Fund, the major strategic orientations relating to the National Health Data System set by the French State and the Ministry of Solidarity and Health. The Health Data Hub allows cross-reference of consolidated databases with SNDS data. Several use cases are under construction. The creation of relational databases in radiation oncology is also possible through specific strategies to get pseudonymized data from the various radiotherapy software programs upstream of the Health Data Hub.


Assuntos
Bases de Dados Factuais , Oncologia , Neoplasias/radioterapia , Radioterapia (Especialidade) , França , Humanos
9.
Radiat Oncol ; 15(1): 191, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778174

RESUMO

BACKGROUND: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy "red-zone". METHODS: Data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed. RESULTS: Dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. CONCLUSIONS: Although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Neoplasias/radioterapia , Pneumonia Viral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Itália/epidemiologia , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Radioterapia (Especialidade) , Estudos Retrospectivos
10.
Hell J Nucl Med ; 23 Suppl: 31-34, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32860394

RESUMO

The global COVID-19 health and economic crisis has forced people to adopt challenging rules of social distancing and self-isolation. Health care staff has been advised to change working routines to keep themselves and their patients safe. Radionuclide therapy has had an increasing role in clinical practice. Most therapeutic radionuclide procedures have applications in oncology. Cancer patients are an especially fragile and vulnerable population with higher risk due to co morbidities and immunosuppression. COVID-19 is another risk that must be considered in treatment planning. Therapeutic, prophylactic, and supportive interventions may require changes for these patients. The most common radionuclide therapies involve patients with differentiated thyroid cancer (DTC) who need radioiodine therapy (RAI), patients with neuroendocrine tumours (NETs) who need peptide receptor radionuclide therapy (PRRT), patients with hepatocellular carcinoma (HCC) who need therapy with radiolabelled microspheres, and patients with prostate cancer and bone metastasis who need radionuclide palliative therapy. If infected, cancer patients could be at a higher risk for serious COVID-19 disease. Treatment decisions for thyroid cancer and NETs are challenging in this environment. Any decision to postpone therapy must be carefully considered, balancing risks and benefits. A risk of worsened prognosis due to delayed or suboptimal cancer treatment must be weighed against the risk of severe COVID-19 illness.


Assuntos
Infecções por Coronavirus/transmissão , Controle de Infecções/normas , Serviço Hospitalar de Medicina Nuclear/normas , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Radioterapia/normas , Infecções por Coronavirus/epidemiologia , Humanos , Controle de Infecções/métodos , Neoplasias/radioterapia , Serviço Hospitalar de Medicina Nuclear/organização & administração , Serviço Hospitalar de Medicina Nuclear/provisão & distribução , Pandemias , Pneumonia Viral/epidemiologia , Radioterapia/métodos
11.
Hell J Nucl Med ; 23 Suppl: 35-40, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32860395

RESUMO

The coronavirus disease 2019 (COVID-19) global pandemic poses a significant challenge to the national health systems. Not only China, the first country that experienced the health crisis since last December, but the rest of the world, is facing an unprecedented global health crisis, the most serious crisis in a century, with social and economic impact. However, the most important impact of the new pandemic is the human impact. Till 4th of June 2020, coronavirus SARS-CoV-2, causing COVID-19 disease, has infected more than 65000.000 people and has been responsible for more than 386000 deaths globally. The first priority of public health authorities is to contain and mitigate the spread and infection rate of the coronavirus SARS-CoV-2, distributing the number of infections over time and, if possible, reduce the incidence of the disease (COVID-19) it causes. A critical task for health systems confronted with the spread of the coronavirus is to protect the health of all citizens, so this requires that both diagnosis/testing and appropriate care should be readily available, affordable, and provided in a safe environment. The health care systems of many developed countries failed to demonstrate a satisfactory response to the increased demand for acute care hospital beds, ventilators, emergency services, diagnostics tests, support equipment for their COVID-19 patients, availability of essential medicines, protective equipment for their staff etc. Nuclear Medicine (NM) departments and their staff, in spite of the fact that not being in the front line of the pandemic response, have experienced a dramatic alteration in their daily clinical activity, trying to adapt their clinical routine to the new environment. There are several issued guidance from national and international organizations, trying to help to cope with suspected or verified COVID-19 patients. Patients with cancer are thought to be more susceptible and have higher morbidity and mortality rates from COVID-19 than the general population. In the current article, our aim is to present measures, guidance and thoughts that should be considered for the cancer patients.


Assuntos
Infecções por Coronavirus/transmissão , Controle de Infecções/métodos , Neoplasias/radioterapia , Serviço Hospitalar de Medicina Nuclear/normas , Pneumonia Viral/transmissão , Radioterapia/métodos , Infecções por Coronavirus/epidemiologia , Prioridades em Saúde , Humanos , Controle de Infecções/normas , Serviço Hospitalar de Medicina Nuclear/economia , Serviço Hospitalar de Medicina Nuclear/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Radioterapia/normas
12.
Cancer Radiother ; 24(6-7): 751-754, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32753236

RESUMO

New concepts of medical consultations are currently disrupting the practice of medicine. The use of standardized questionnaires, or patient-reported outcome (PRO and ePRO) has already significantly changed the relationship between the physician and the patient. Telemedicine, or even automatic conversational agents, such as chatbots, are also providing more convenient access to care and medical information for many patients. These tools have a major impact in oncology, precisely because of the rising chronicity of the diseases the radiation oncologists treat. In this article, we provide a detailed analysis of these new concepts.


Assuntos
Neoplasias/radioterapia , Radioterapia (Especialidade)/métodos , Consulta Remota , Humanos , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários
13.
Cancer Radiother ; 24(6-7): 687-690, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32753239

RESUMO

Proton therapy is delivered to selected cancer patients presenting with rare tumours, for which a dose escalation paradigm and/or a reduced dose-bath to the organs at risk is pursued. It is a costly treatment with an additional cost factor of 2-3 when compared to photon radiotherapy. Notwithstanding the 180'000 patients treated with protons, scars robust clinical evidence is available to justify the administration of this treatment modality. The European Particle Therapy Network (EPTN) was created in 2015 to answer the critical European needs for cooperation among protons and carbon ions centres in the framework of clinical research networks. EPTN with other European groups will launch a number of prospective clinical trials that could be practice changing if positive. Alternative way to generate clinical data could be provided by alternative methodologies, such as the Dutch model-based approach, or could be provided by European infrastructure projects.


Assuntos
Neoplasias/radioterapia , Terapia com Prótons/tendências , Pesquisa Biomédica , Europa (Continente) , Previsões , Humanos
14.
PLoS One ; 15(8): e0238106, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32845905

RESUMO

PURPOSE: Real-time monitoring of physiological changes of tumor tissue during radiation therapy (RT) could improve therapeutic efficacy and predict therapeutic outcomes. Cherenkov radiation is a normal byproduct of radiation deposited in tissue. Previous studies in rat tumors have confirmed a correlation between Cherenkov emission spectra and optical measurements of blood-oxygen saturation based on the tissue absorption coefficients. The purpose of this study is to determine if it is feasible to image Cherenkov emissions during radiation therapy in larger human-sized tumors of pet dogs with cancer. We also wished to validate the prior work in rats, to determine if Cherenkov emissions have the potential to act an indicator of blood-oxygen saturation or water-content changes in the tumor tissue-both of which have been correlated with patient prognosis. METHODS: A DoseOptics camera, built to image the low-intensity emission of Cherenkov radiation, was used to measure Cherenkov intensities in a cohort of cancer-bearing pet dogs during clinical irradiation. Tumor type and location varied, as did the radiation fractionation scheme and beam arrangement, each planned according to institutional standard-of-care. Unmodulated radiation was delivered using multiple 6 MV X-ray beams from a clinical linear accelerator. Each dog was treated with a minimum of 16 Gy total, in ≥3 fractions. Each fraction was split into at least three subfractions per gantry angle. During each subfraction, Cherenkov emissions were imaged. RESULTS: We documented significant intra-subfraction differences between the Cherenkov intensities for normal tissue, whole-tumor tissue, tissue at the edge of the tumor and tissue at the center of the tumor (p<0.05). Additionally, intra-subfraction changes suggest that Cherenkov emissions may have captured fluctuating absorption properties within the tumor. CONCLUSION: Here we demonstrate that it is possible to obtain Cherenkov emissions from canine cancers within a fraction of radiotherapy. The entire optical spectrum was obtained which includes the window for imaging changes in water and hemoglobin saturation. This lends credence to the goal of using this method during radiotherapy in human patients and client-owned pets.


Assuntos
Neoplasias/radioterapia , Raios X , Animais , Cães , Processamento de Imagem Assistida por Computador , Neoplasias/diagnóstico por imagem , Aceleradores de Partículas , Projetos Piloto , Estudos Prospectivos , Dosagem Radioterapêutica , Tomografia Computadorizada por Raios X
16.
Cancer Radiother ; 24(6-7): 623-627, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32828668

RESUMO

Seeking a second medical advice as a medical practitioner is a frequent situation that should be facilitated to best suit patients' expectations, while maintaining medical confidentiality. The patient and his relatives need to be involved with diagnostic and therapeutic procedures. The radiation oncologist should accept and help a patient who seeks a second advice, and patients will always appreciate when the physician helps them to seek such an advice. Examples that each practitioner should know include tertiary centers tumor boards, centers with access to innovation or clinical research, or with special teams to take care of specific populations such as adolescents and young adults. In some situations, no treatment can also be the best treatment, and it takes time to explain and discuss such watchful waiting strategies to patients. In case of recurrent disease after radiotherapy, salvage reirradiation must be discussed at a tertiary tumor board and weighed against other options, especially for rare and complex cases. Radiation oncology has gained multiple options with technological advances, such as proton therapy, brachytherapy, stereotactic body radiotherapy with respiratory tracking or contact therapy. Radiation oncologists must know the benefits associated with each option in terms of survival, local control or organ preservation in order to address patients to the best practitioner.


Assuntos
Aconselhamento , Relações Interprofissionais , Neoplasias/radioterapia , Radioterapia (Especialidade) , Adolescente , Humanos , Adulto Jovem
17.
Cancer Radiother ; 24(6-7): 667-675, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32828670

RESUMO

The planning target volume is an essential notion in radiotherapy, that requires a new conceptualization. Indeed, the variability and diversity of the uncertainties involved or improved with the development of the new modern technologies and devices in radiotherapy suggest that random and systematic errors cannot be currently generalized. This article attempts to discuss these various uncertainties and tries to demonstrate that a redefinition of the concept of planning target volume toward its personalization for each patient and the robustness notion are likely an improvement basis to take into account the radiotherapy uncertainties.


Assuntos
Neoplasias/radioterapia , Carga Tumoral/efeitos da radiação , Humanos , Neoplasias/patologia , Planejamento de Assistência ao Paciente , Radioterapia/métodos , Dosagem Radioterapêutica , Incerteza
18.
Cancer Radiother ; 24(6-7): 714-721, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32839103

RESUMO

PURPOSE: External radiotherapy process is a chain of steps in which each of them is carried out only if the previous one has been completed. The development of hypofractionation practices in recent years tends to increase the workload of the stages of preparation for irradiation and to decrease the number of fractions per patient. The purpose of this retrospective study is to analyze the evolution of these practices in a single centre and to assess the organizational issues involved. MATERIAL AND METHODS: All radiation therapy records management data were extracted from the Radiation Therapy Information System. Radiotherapy sessions were identified by patient and by ICD (International Classification of Diseases) code. The filling rate of the treatment equipment was calculated using actual data from the radiotherapy department. RESULTS: From 2015 to 2019, there was an increase in the number of scans (+16%), the number of patients treated (+11.6%) and the volume of hours available for treatment (+12%). Also, there was a decrease in the total number of fractions (-5%), in the average number of fractions performed per treatment sequence (-19%), in the occupancy rate of the machines (-7%) and in the average number of fractions performed per patient treated for malignant tumours of the bronchi and lung (-38%), digestive organs (-37%), secondary (-19%) breast (-15%) and prostate (-15%). The number of fractions administered per treatment sequence between 2015 and 2019 decreased significantly for patients in age groups [20-69] (P<0.001) and [>70] (P<0.001). CONCLUSION: A paradox appears between the increase in the total number of patients treated and the decrease in the loading rate of linacs. This shift of workload has an impact on the quality and safety of care and on the organizational and investment strategies. It also has an economic impact where the model of reimbursement is based on per fraction pricing. A reorganization of radiotherapy services is inevitable.


Assuntos
Neoplasias/radioterapia , Hipofracionamento da Dose de Radiação/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Inovação Organizacional , Estudos Retrospectivos , Adulto Jovem
19.
Cancer Radiother ; 24(6-7): 612-622, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32839104

RESUMO

PURPOSE: This article aims to describe and list the clinical trials that have changed our practices in breast cancer, urological cancer, gynecological cancer, cancer of the upper aerodigestive tract and digestive cancer in the last ten years. MATERIAL AND METHODS: We listed and selected the studies published between 2010 and 2020. The articles were identified on the basis of a Medline search with PubMed and knowledge of the authors. RESULTS: Five to six trials were selected in breast cancer, urological cancers, gynecological cancers, cancers of the upper aerodigestive tract and digestive cancers asking the different fundamental questions in radiotherapy. CONCLUSION: Depending on the pathologies, the questions raised over the past 10 years remain fundamental questions such as the place of neoadjuvant treatment, the place of hypofractionation or the type of chemotherapy concomitant with radiotherapy.


Assuntos
Ensaios Clínicos como Assunto , Neoplasias/radioterapia , Padrões de Prática Médica/tendências , Neoplasias da Mama/radioterapia , Feminino , Neoplasias Gastrointestinais/radioterapia , Neoplasias dos Genitais Femininos/radioterapia , Humanos , Masculino , Neoplasias do Sistema Respiratório/radioterapia , Fatores de Tempo , Neoplasias Urológicas/radioterapia
20.
Cancer Radiother ; 24(6-7): 602-611, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32855027

RESUMO

Mechanisms of late radio-induced lesions are the result of multiple and complex phenomena, with many entangled cellular and tissue factors. The biological continuum between acute and late radio-induced effects will be described, with firstly a break in homeostasis that leads to cellular redistributions. New insights into late toxicity will finally be addressed. Individual radiosensitivity is a primary factor for the development of late toxicity, and clinicians urgently need predictive tests to offer truly personalized radiation therapy. An update will be made on the various functional and genetic tests currently being validated. The management of radio-induced side effects remains a frequent issue for radiation oncologists, and an update will be made for certain specific clinical situations. Finally, an innovative management for patients with significant side effects after pelvic radiotherapy will be developed, involved mesenchymal stem cell transplantation, with the presentation of the "PRISME" protocol currently open to patients recruitment.


Assuntos
Neoplasias/radioterapia , Lesões por Radiação/terapia , Terapia Combinada , Humanos , Neoplasias/cirurgia , Lesões por Radiação/etiologia , Tolerância a Radiação , Radioterapia/efeitos adversos , Transplante de Células-Tronco , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA