Transitioning from conformal radiotherapy to intensity-modulated radiotherapy after radical prostatectomy: Clinical benefit, oncologic outcomes and incidence of gastrointestinal and urinary toxicities.

AIM: The purpose of this study was to review genitourinary (GU) and gastrointestinal (GI) toxicity associated with high-dose radiotherapy (RT) delivered with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) or volumetric arc therapy (VMAT) following radical prostatectomy (RP). BACKGROUND: RP is a therapeutic option for the management of prostate cancer (PrCa). When assessing postoperative RT techniques for PrCa, the published literature focuses on patients treated with 2-dimensional conventional methods without reflecting the implementation of 3D-CRT, IMRT, or VMAT. MATERIALS AND METHODS: A total of 83 patients were included in this analysis; 30 patients received 3D-CRT, and 53 patients received IMRT/VMAT. Acute and late symptoms of the GU and lower GI tract were retrospectively graded according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer radiation toxicity grading systems. The relapse failure-free rate and overall survival were also evaluated. RESULTS: The rate of acute GU toxicity was 9.4% vs. 13.3% for the IMRT/VMAT and 3D-CRT groups (p = 0.583). The 5-year actuarial rates of late GI toxicity for IMRT/VMAT and 3D-CRT treatments were 1.9% and 6.7%, respectively. The rate of late GU toxicity for the IMRT/VMAT and 3D-CRT treatment groups was 7.5% and 16.6%, respectively (p = 0.199). We found no association between acute or late toxicity and the RT technique in univariate and multivariate analyses. CONCLUSION: Postprostatectomy IMRT/VMAT and 3D-CRT achieved similar morbidity and cancer control outcomes. The clinical benefit of highly conformal techniques in this setting is unclear although formal analysis is needed.

[Radiofrequency ablation of renal lesions: initial experience in a center of reference in Mexico City (INNSZ)]. / Ablación por radiofrecuencia de lesiones renales: experiencia inicial en un centro de referencia en la ciudad de México (INNSZ).

INTRODUCTION AND OBJECTIVES: With the advances of technology, the incidence of renal cancer has increased, but the stage at the time of diagnosis has decreased. In selected patients nephron sparing surgery can be made but there are patients who have important comorbidities and therefore they are not candidates to surgical management. For them, there are new minimally invasive procedures that use different types of energy to perform ablation of the neoplastic tissue; one of which is radiofrequency ablation. This article reports the initial experience with this therapeutic modality in a reference center of Mexico City. METHODS: Four patients with 5 renal masses of 3 cm or less, and with significant comorbidities that exclude the possibility of surgery, underwent radiofrequency ablation under fluoroscopic guidance. RESULTS: Five renal tumors in four patients were treated with radiofrequency ablation in a period of 18 months. No major complication during the procedure was reported, mean follow- up was of 12 months and they keep a good oncologic control. CONCLUSIONS: Radiofrequency ablation is a safe and reproducible therapeutic option for patients with incidental renal masses below 3 cm. We need more follow up to compare oncologic control with the gold standard, surgery.

Spermatic cord liposarcoma: a diagnostic challenge.

Spermatic cord liposarcoma (SCL) is a rare medical condition; to our knowledge there have been fewer than 100 cases reported in the literature worldwide. As a group, para-testicular tumors are relatively uncommon, and they must be differentiated from tumors of testicular origin with extension to the spermatic cord and its elements. SCL should be suspected in patients experiencing recurrent hernias of the inguinal region. Herein we present two cases of SCL recently diagnosed at our hospital. In both instances, the preoperative diagnosis was inguinal hernia.