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1.
Anticancer Res ; 39(8): 4215-4218, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366508

RESUMO

BACKGROUND/AIM: Targeted intraoperative radiotherapy (TARGIT IORT) is an option during breast-conserving surgery (BCS). No data have yet been published regarding the safety of TARGIT IORT with implants in situ. TARGIT IORT is an attractive option in this context because of the risk of capsular fibrosis following external beam radiotherapy (EBRT) in such patients. PATIENTS AND METHODS: We are reporting a retrospective analysis of 16 patients who received TARGIT IORT during BCS for early breast cancer after previous implant-based breast augmentation. TARGIT IORT was performed using the Intrabeam™method. RESULTS: Follow-up varied from 98 to 5 months. There were no procedure-related complications. One patient developed local recurrence after 36 months of follow-up. Among the remaining patients (15/16), no breast-cancer-related events occurred. CONCLUSION: This series of patients with TARGIT IORT during BCS after implant-based breast augmentation revealed no safety concerns and gives some confidence in discussing this option with selected patients.


Assuntos
Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Mastectomia Segmentar/efeitos adversos , Radioterapia , Adulto , Idoso , Neoplasias da Mama/patologia , Feminino , Humanos , Cuidados Intraoperatórios , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Resultado do Tratamento
2.
Anticancer Res ; 39(8): 4227-4236, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366510

RESUMO

BACKGROUND/AIM: Chest radiotherapy (RT) doubles late cardiac mortality. This study aimed to evaluate the evolution of cardiac changes in speckle tracking echocardiography during a three-year follow-up. MATERIALS AND METHODS: This prospective study included 81 chemotherapy-naïve early-stage breast cancer patients who were evaluated at baseline, immediately after RT and three years after RT. Sixty-one patients had left-sided (LSBC) and 20 right-sided breast cancer (RSBC). RESULTS: Global longitudinal strain (GLS) declined from baseline -18.0±3.3% to -17.0±3.0% (p=0.015) at the three-year follow-up examination. A decline over 15% (GLS15) was observed in 19 (27%) patients. GLS15 was independently associated with aromatase inhibitor use (ß=-1.977, p=0.001). In regional analysis, patients with LSBC had apical strain decline by 3.2±5.5% (p<0.001) and patients with RSBC showed basal rotation decline by 1.8° (-0.2°, 3.8°) (p=0.030). CONCLUSION: Even contemporary RT induced progressive global and regional decline in speckle tracking analysis. The regional changes complied with RT fields.


Assuntos
Neoplasias da Mama/radioterapia , Ventrículos do Coração/fisiopatologia , Radioterapia/efeitos adversos , Disfunção Ventricular Esquerda/fisiopatologia , Idoso , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Ecocardiografia , Feminino , Coração/fisiopatologia , Coração/efeitos da radiação , Ventrículos do Coração/efeitos da radiação , Humanos , Pessoa de Meia-Idade
3.
Anticancer Res ; 39(8): 4237-4242, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366511

RESUMO

AIM: To define safety and efficacy of a palliative, short-course accelerated radiation therapy for symptomatic locally advanced primary pelvic cancer. MATERIALS AND METHODS: A phase II trial was planned based on the minimax Simon's two-stage design. A total of 18 Gy in 4.5 Gy/fraction administered twice a day was delivered (SHARON). Pain and quality of life were recorded according to the Visual Analogue self-assessment and the cancer linear analog scales (CLAS), respectively. RESULTS: Twenty-five patients were enrolled in the study. The most frequent baseline symptoms were pain (48%), bleeding (40%), bleeding/pain (8%), and intestinal sub-occlusion (4%). The overall palliative response rate was 96.0%, with a median palliative duration of 6 months. An improvement of quality-of-life indices (well-being, fatigue, and ability to perform daily activities) was noted in 64.0%, 36.0%, and 48.0% of patients, respectively. CONCLUSION: The SHARON regimen was well tolerated and effective in the palliative treatment of patients with locally advanced pelvic cancer. Based on these results, a multicentric prospective phase III trial is ongoing to compare this regimen with traditional 2-week radiotherapy treatment.


Assuntos
Cuidados Paliativos , Neoplasias Pélvicas/radioterapia , Lesões por Radiação/patologia , Radioterapia/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Fracionamento da Dose de Radiação , Feminino , Humanos , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pélvicas/patologia , Pelve/patologia , Pelve/efeitos da radiação , Qualidade de Vida , Dosagem Radioterapêutica
4.
Anticancer Res ; 39(8): 4467-4474, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366546

RESUMO

BACKGROUND/AIM: The aim of this study was to investigate the association between lymphopenia after breast conserving therapy (BCT) and ipsilateral breast tumor recurrence (IBTR) in early breast cancer (EBC). PATIENTS AND METHODS: We examined 216 EBC patients treated with partial mastectomy followed by radiotherapy (RT), none of whom received chemotherapy. Absolute lymphocyte counts (ALCs) during the two years after RT were collected from each patient: pretreatment ALC, ALC at 3-5 months (ALC1), ALC at 9-11 months, ALC at 15-17 months, and ALC at 21-23 months. RESULTS: The 102 patients with ALC1 ≤1,479 cells/µl (defined as lymphopenia) had significantly higher 10-year IBTR rate than the 102 patients with ALC1 >1,479 cells/µl (16.2% vs. 1%, p=0.0034). The multivariate analysis showed that age, resection margins, human epidermal growth factor receptor, and lymphopenia were significant predictors of IBTR. CONCLUSION: Lymphopenia is a potential predictor for IBTR in EBC patients treated with BCT.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Linfopenia/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Terapia Combinada/efeitos adversos , Intervalo Livre de Doença , Feminino , Humanos , Contagem de Linfócitos , Linfopenia/induzido quimicamente , Linfopenia/epidemiologia , Linfopenia/patologia , Mastectomia , Mastectomia Segmentar/efeitos adversos , Pessoa de Meia-Idade , Radioterapia/efeitos adversos , Radioterapia Adjuvante/efeitos adversos
5.
Surg Clin North Am ; 99(5): 899-919, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446917

RESUMO

Palliative wound care is a philosophy of wound management that prioritizes comfort over healing and attends to the emotional distress these wounds can cause. Intervention strategies focus on management of symptoms such as pain, odor, bleeding, and exudate. Historic treatments such as honey, chlorine, and vinegar have gained renewed interest, and although well suited to the palliative setting, there is an increasing amount of research exploring their efficacy in other contexts. The lived experience of patients and caregivers facing these wounds is often stressful and isolating, and any treatment plan must address these issues along with the physical aspects of care.


Assuntos
Cuidados Paliativos/métodos , Lesão por Pressão/terapia , Ferimentos e Lesões/terapia , Desbridamento , Humanos , Neoplasias/complicações , Radioterapia/efeitos adversos , Ferimentos e Lesões/etiologia
6.
Rev Lat Am Enfermagem ; 27: e3168, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432921

RESUMO

OBJECTIVE: to identify the frequency of fatigue and domains affected in patients with head and neck cancer undergoing radiation therapy, at the beginning, middle and end of treatment. METHOD: longitudinal and prospective study of quasi-experimental design, involving 60 patients with head and neck cancer. It should be highlighted that this article will address only the data of the Control Group. The dependent variables were collected through interview, using the revised Piper Fatigue Scale, which is a multidimensional instrument that assesses global, behavioral, affective and sensory/psychological domains. Data analysis was based on absolute and relative frequencies. RESULTS: there was a predominance of males, age group between 41-60 years, low level of education and in regular use of alcohol and cigarettes. All domains in the fatigue scale had their scores increased, presenting median values of greater magnitude in Time 2 and Time 3, when compared to the Time 1 values, indicating an increase in fatigue levels during radiation therapy. CONCLUSION: fatigue increased in the course of the radiation therapy, having all domains affected. Therefore, its evaluation throughout the treatment is important, as fatigue is a common and debilitating symptom on cancer patients.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Fadiga/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/efeitos adversos , Adulto , Brasil , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/psicologia , Fadiga/psicologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Radioterapia/psicologia , Fatores Socioeconômicos , Inquéritos e Questionários
9.
Medicine (Baltimore) ; 98(27): e16003, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277093

RESUMO

RATIONALE: Sarcomatoid carcinoma is a rare variant of squamous cell carcinoma (SCC) with poor prognosis. Previous radiation has been reported as one of the etiologic factors. PATIENT CONCERNS: We describe a case of a 57-year-old man presented with a painless mass in the left supraclavicular area. Five years before, he was diagnosed with SCC in floor of mouth (FOM) and underwent radiotherapy (RT). DIAGNOSES: Sonography-guided biopsy on the supraclavicular lymph node revealed diffuse spindle cell proliferation with a focus of squamous differentiation. Local recurrence on primary site or distant metastasis was not obvious on both computed tomography (CT) of the neck and F-fluorodeoxyglucose positron emission tomography CT. The final diagnosis was confirmed as sarcomatoid carcinoma via surgery. INTERVENTIONS: The patient underwent surgery including explorative resection of the mouth floor, excision of the submandibular gland, and modified radical neck dissection. Following surgery, the patient received adjuvant radiation therapy. OUTCOMES: There were no complications according to the surgery. Six months after adjuvant therapy, distant metastasis to liver was identified. The patient is currently undergoing palliative chemotherapy. LESSONS: This may be the first reported case of sarcomatoid carcinoma arising from early-stage SCC in FOM that was previously treated with RT alone. When RT is performed as a single modality for oral SCC, even in an early stage, rigorous follow-up should be performed.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Neoplasias de Cabeça e Pescoço/etiologia , Neoplasias Bucais/radioterapia , Recidiva Local de Neoplasia/etiologia , Radioterapia/efeitos adversos , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Linfonodos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Esvaziamento Cervical , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Complexas Mistas/etiologia , Neoplasias Complexas Mistas/patologia , Neoplasias Complexas Mistas/cirurgia
11.
Rev Assoc Med Bras (1992) ; 65(6): 902-908, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340323

RESUMO

OBJECTIVE: To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment. METHODS: Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation. RESULTS: The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation. CONCLUSION: There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.


Assuntos
Fraturas Ósseas/etiologia , Lesões por Radiação/complicações , Radioterapia/efeitos adversos , Fraturas Ósseas/fisiopatologia , Humanos , Fatores de Risco
12.
Cancer Radiother ; 23(4): 312-315, 2019 Jul.
Artigo em Francês | MEDLINE | ID: mdl-31147172

RESUMO

PURPOSE: To report the results of Botulinum Toxin A (BTA) for radiation-induced head and neck pain. MATERIALS AND METHODS: This single-center retrospective study included all the patients treated at our institution with botulinum toxin A injections for radiation-induced head and neck pain between 2006 and 2017. Pain was evaluated by each patient on a visual analogue scale (VAS) (between 0 and 10) before, and 1 month after the injection. RESULTS: Sixteen patients were included in this series. The mean value of the pain was 8.5 before and 8 after the first injection. The difference was statistically significant (p<0.01). Major response occurred in 15 patients (VAS≤3 after BTA) and complete response in 11 patients (VAS=0 after BTA). CONCLUSION: Botulinum toxin is an effective treatment for radiation-induced head and neck pain.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Cervicalgia/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Radioterapia/efeitos adversos , Adulto , Idoso , Eletromiografia , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Estudos Retrospectivos , Escala Visual Analógica
13.
Anticancer Res ; 39(6): 2699-2710, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177104

RESUMO

BACKGROUND/AIM: Adrenal glands are one of the most common sites of cancer metastasis. The treatment options include either surgery or chemotherapy and/or radiotherapy while certain diagnosis is made via percutaneous biopsy or fine needle aspiration (FNA), guided by CT scan. This review aimed to present the current practice regarding the diagnosis and treatment of adrenal cancer metastasis. MATERIALS AND METHODS: A PRISMA-compliant systematic search of the PubMed, Cochrane, EMBASE, AMED, CINAHL, WoS, BIOSIS, LILACS, ASSIA, SCEH, SCIRUS databases, and JIT medical feed sources was performed through November 5th, 2018. RESULTS: A total of 87 original studies including 660 patients with adrenal metastasis were analyzed. Most preferred treatment was excision of the gland in 76.58% of the cases, while most of adrenal metastases were found at autopsy (43.88%) followed by computed tomography guided biopsy (33.09%). CONCLUSION: Adrenalectomy following metastatic disease to the adrenals should be performed when the lesion is isolated in the gland and the site of primary cancer has or can be resected.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/secundário , Neoplasias das Glândulas Suprarrenais/terapia , Glândulas Suprarrenais/patologia , Adrenalectomia , Biópsia por Agulha Fina , Tratamento Farmacológico , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Radioterapia , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Resultado do Tratamento
14.
Anticancer Res ; 39(6): 2799-2804, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177116

RESUMO

BACKGROUND/AIM: Spatially fractionated radiotherapy (grid therapy) can control some bulky tumors which is challenging for conventional radiotherapy. This study aimed to investigate whether a novel tungsten contained rubber (TCR) grid collimator can be employed in electron grid therapy. MATERIALS AND METHODS: The TCR grid collimator placed on a solid water phantom, and percentage depth doses (PDDs) and lateral dose profiles were measured for 9 MeV electron beam with Gafchromic EBT3 films. At the lateral dose profile, the ratios of the dose in the areas with and without shielding (valley-to-peak ratios) were evaluated. RESULTS: The dmax values with the 1, 2 and 3 mm TCR grid collimators were 1.2, 1.1 and 0.7 cm, respectively, while the valley-to-peak ratios at each dmax were 0.566, 0.412 and 0.293, respectively. CONCLUSION: Only the 2 mm TCR grid collimator had adequate dosimetric features compared to the conventional grid collimator and could be substituted.


Assuntos
Neoplasias/radioterapia , Radiometria/métodos , Radioterapia/instrumentação , Tungstênio/química , Relação Dose-Resposta à Radiação , Elétrons , Estudos de Viabilidade , Humanos , Imagens de Fantasmas , Planejamento da Radioterapia Assistida por Computador , Borracha/química
15.
Anticancer Res ; 39(6): 2839-2843, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177121

RESUMO

BACKGROUND/AIM: The aim of the study was to investigate the dosimetric characteristics of electron beams with a tungsten functional paper (TFP) surface collimator. MATERIALS AND METHODS: The circular field of 6.0 cm diameter was created with the TFP collimator put on the phantom. Depth and lateral dose profiles for 4 and 6 MeV electron beams were obtained. The characteristics of lateral dose profile, treatment diameter as width over 90% of the dose, and penumbra as width of the off-axis positions from 80% to 20% dose levels were evaluated. RESULTS: Compared to the lead collimator, the TFP collimator generated higher surface doses, the treatment diameters were increased from 42.8 to 48.6 mm and from 40.0 to 41.4 mm, and the penumbras were reduced from 15.0 to 9.6 mm and from 16.4 to 13.0 mm for 4 and 6 MeV electron beams, respectively. CONCLUSION: The TFP surface collimator can provide an excellent dose distribution compared to the conventional lead collimator.


Assuntos
Radiometria/métodos , Radioterapia/instrumentação , Tungstênio/química , Humanos , Imagens de Fantasmas , Dosagem Radioterapêutica
17.
Vet Clin North Am Small Anim Pract ; 49(5): 933-947, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31253427

RESUMO

Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are needed, and a unique biological mechanism distinguishes SRT from other forms of external beam radiotherapy. Families find the convenient schedules and minimal acute toxicity of SRT appealing. Common indications in veterinary oncology include nasal, brain, and bone tumors. Many other solid tumors can also be treated, including spinal, oral, lung, heart-base, liver, adrenal, and prostatic malignancies. Accessibility of SRT is improving, and new data are constantly emerging to define parameters for appropriate case selection, radiation dose prescription, and long-term follow-up."


Assuntos
Doenças do Gato/radioterapia , Doenças do Cão/radioterapia , Neoplasias/veterinária , Animais , Gatos , Cães , Oncologia , Neoplasias/radioterapia , Radioterapia (Especialidade)/métodos , Radiocirurgia/métodos , Radiocirurgia/veterinária , Radioterapia/métodos , Radioterapia/veterinária , Dosagem Radioterapêutica/veterinária , Medicina Veterinária
18.
Vet Clin North Am Small Anim Pract ; 49(5): 903-915, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31153610

RESUMO

Lymphoma is a common disease in companion animals. Although conventional chemotherapy has the potential to induce remission and prolong life, relapse is common, and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, as well as cutting-edge immunotherapy and small-molecule-based approaches that are in varying stages of regulatory approval.


Assuntos
Doenças do Gato/terapia , Doenças do Cão/terapia , Linfoma/veterinária , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Vacinas Anticâncer/uso terapêutico , Gatos , Cães , Imunoterapia/métodos , Imunoterapia/veterinária , Linfoma/terapia , Recidiva Local de Neoplasia , Prognóstico , Radioterapia/métodos , Radioterapia/veterinária
19.
Vet Clin North Am Small Anim Pract ; 49(5): 855-879, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31186126

RESUMO

Histiocytic sarcoma (HS) and hemangiosarcoma (HSA) are uncommon and aggressive neoplasms that develop much more frequently in dogs than in cats. Breed-specific predispositions have been identified for both cancers. The development of novel diagnostics is underway and may aid in earlier diagnosis. Therapeutic approaches to HS and HSA depend on the stage of disease and may include surgery, radiation therapy, and chemotherapy. Such interventions improve outcome; however, aside from a small number of clinical circumstances, both diseases are considered largely incurable. Continued efforts toward the identification of driver mutations and subsequent druggable targets may lead to improvements in long-term prognosis.


Assuntos
Doenças do Gato/patologia , Doenças do Gato/terapia , Doenças do Cão/patologia , Doenças do Cão/terapia , Hemangiossarcoma/veterinária , Sarcoma Histiocítico/veterinária , Animais , Doenças do Gato/epidemiologia , Gatos , Quimiorradioterapia Adjuvante/métodos , Quimiorradioterapia Adjuvante/veterinária , Doenças do Cão/epidemiologia , Cães , Hemangiossarcoma/epidemiologia , Hemangiossarcoma/patologia , Hemangiossarcoma/terapia , Sarcoma Histiocítico/patologia , Sarcoma Histiocítico/terapia , Cuidados Paliativos , Prognóstico , Radioterapia/métodos , Radioterapia/veterinária , Sobrevida
20.
Medicine (Baltimore) ; 98(24): e16027, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192956

RESUMO

BACKGROUND: Assessing the effectiveness and safety of acupuncture therapy for treating patients with radiotherapy-induced nausea and vomiting (RINV) is the main purpose of this systematic review protocol. METHODS: The following electronic databases will be searched from inception to Sep 2019: Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, Traditional Chinese Medicine, Chinese Biomedical Literature Database, Wan-Fang Database, and Chinese Scientific Journal Database. All published randomized controlled trials in English or Chinese related to acupuncture for RINV will be included. The primary outcome is the severity and frequency of RINV during radiotherapy. The secondary outcomes is the physical condition and quality of life after radiotherapy. Two reviewers will conduct the study selection, data extraction, and assessment independently. The assessment of risk of bias and data synthesis will be conducted with Review Manager Software V.5.2. RESULTS: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION: The conclusion of our study will provide evidence to judge whether acupuncture is an effective intervention for patients suffered from RINV. PROSPERO REGISTRATION NUMBER: CRD42019130952.


Assuntos
Terapia por Acupuntura , Náusea/etiologia , Náusea/terapia , Radioterapia/efeitos adversos , Revisão Sistemática como Assunto , Vômito/etiologia , Vômito/terapia , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
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