RESUMO
INTRODUCTION: The clinical course in patients with prostate cancer (PCa) after biochemical failure (BF) has received limited attention. This study analyzes survival time from recurrence, patterns of progression, and the efficacy of salvage therapies in patients treated with radical or postoperative radiotherapy (RT). METHODS: This is a multicenter retrospective comparative study of 1135 patients diagnosed with BF and treated with either radical (882) or postoperative (253) RT. Data correspond to the RECAP database. Clinical, tumor, and therapeutic characteristics were collected. Descriptive statistics, survival estimates, and comparisons of survival rates were calculated. RESULTS: Time to BF from initial treatment (RT or surgery) was higher in irradiated patients (51 vs 37 months). At a median follow-up of 102 months (14-254), the 8-year cause-specific survival (CSS) was 80.5%, without significant differences between the radical (80.1%) and postoperative (83.4%) RT groups. The 8-year metastasis-free survival rate was 57%. 173 patients (15%) died of PCa and 29 (2.5%) of a second cancer. No salvage therapy was given in 15% of pts. Only 5.5% of pts who underwent radical RT had local salvage treatment and 71% received androgen deprivation (AD) ± chemotherapy. The worst outcomes were in patients who developed metastases after BF (302 pts; 26.5%) and in cases with a Gleason > 7. CONCLUSIONS: In PCa treated with radiotherapy, median survival after BF is relatively long. In this sample, no differences in survival rates at 8-years have been found, regardless of the time of radiotherapy administered. AD was the most common treatment after BF. Metastases and high Gleason score are adverse variables. To our knowledge, this is the first study to compare outcomes after BF among patients treated with primary RT vs. those treated with postoperative RT and to evaluate recurrence patterns, treatments administered, and causes of death. The results allow avoiding overtreatment, improving quality of life, without negatively affecting survival.
Assuntos
Braquiterapia/mortalidade , Bases de Dados Factuais , Recidiva Local de Neoplasia/mortalidade , Neoplasias da Próstata/mortalidade , Sistema de Registros/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Prognóstico , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
We report on the appearance of two new cases of radio-induced bullous pemphigoid (BP), a rare complication of radiotherapy. Both were elderly women, were treated for breast cancer and suffered (BP) during the irradiation, the evolution was favorable with steroid therapy (AU)
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Carcinoma Ductal de Mama/radioterapia , Penfigoide Bolhoso/etiologia , Lesões por Radiação/diagnóstico , Neoplasias da Mama/radioterapia , Penfigoide Bolhoso/diagnóstico , Lesões por Radiação/etiologia , Dosagem RadioterapêuticaRESUMO
Extrapulmonary small cell carcinoma in breast and prostate are uncommon neoplasms. In the literature most of the data come from case reports and these show that these tumours are highly aggressive. Histologically, they bear striking similarities to small cell carcinomas of the lung and usually show evidence of additional histologies. Treatment, which may include surgery, radiotherapy and chemotherapy, is based on the clinical stage. We present the evolution of two cases (AU)
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Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Carcinoma de Células Pequenas/patologia , Neoplasias da Mama/patologia , Neoplasias da Próstata/patologia , Carcinoma de Células Pequenas/terapia , Neoplasias da Mama/terapia , Terapia Combinada/métodos , Terapia Combinada , Neoplasias da Próstata/terapia , Resultado do TratamentoRESUMO
El síndrome de Stevens-Johnson es una enfermedad inflamatoria aguda originada por una hipersensibilidad que incluye la piel y las membranas mucosas.Puede ser inducida por muchos factores precipitantes, desde agentes farmacológicos hasta una infección. La incidencia de reacciones cutáneasseveras secundarias a amifostina es inferior al 1%, siendo el síndrome de Stevens-Johnson una de ellas. Nosotros comunicamos un caso de síndromede Stevens-Johnson en probable relación con la administración subcutánea de amifostina subcutánea durante radioterapia
The Stevens-Johnson syndrome is an acute inflammatory disease, caused by hipersensitivity of the skin and mucous membrane. It can be induced bymany precipitant factors, including pharmacological agents and infections. The incidence rate of severe secondary cutaneous reactions is less than1%, the Stevens-Johnson syndrome being one of them. We report a case of Stevens-Johnson syndrome probably related to subcutaneous amifostineadministration during radiotherapy procedure