RESUMO
PURPOSE: RENORT is a novel data mining application developed to extract relevant clinical data from oncology information systems (OIS; ARIA and Mosaiq) used in radiation oncology (RO). METHODS/PATIENTS: We used RENORT to extract demographic and clinical data from the OIS of all patients treated at the RO Department at the General Hospital of Valencia during the year 2019. RESULTS: A total of 1158 treatments were performed. The female/male ratio was 39.3%/60.7%, with a mean age of 66 years. The mean waiting time between the treatment decision/proposal to the first visit was 10.1 days. Mean duration of the treatment preparation process was 21 days. Most patients (90.4%) completed treatment within the prescribed time ± 7 days. The most common sites/treatment types were: metastatic/palliative treatments (n = 300; 25.9%), breast (209; 18.0%), genitourinary (195; 16.8%), digestive (116; 10.0%), thoracic (104; 9.0%), head and neck (62; 5.4%), and skin cancer (51; 4.4%). The distribution according to treatment intent was as follows: palliative (n = 266; 23.0%), adjuvant curative (335; 28.9%), radical without adjuvant treatment (229; 19.8%), radical with concomitant treatment (188; 16.2%), curative neoadjuvant (70; 6.0%), salvage radiotherapy (61; 5.3%); and reirradiation (9; 0.8%). The most common treatment techniques were IMRT/VMAT with IGRT (n = 468; 40.4%), 3D-CRT with IGRT (421; 36.4%), SBRT (127; 11.0%), 2DRT (57; 4.9%), and SFRT (56; 4.8%). A mean of 15.9 fractions were administered per treatment. Hypofractionated schemes were used in 100% of radical intent breast and prostate cancer treatments. CONCLUSIONS: The RENORT application facilitates data retrieval from oncology information systems to allow for a comprehensive determination of the real role of radiotherapy in the treatment of cancer patients. This application is valuable to identify patterns of care and to assess treatment efficacy.
Assuntos
Mineração de Dados/métodos , Neoplasias/radioterapia , Radioterapia (Especialidade)/estatística & dados numéricos , Distribuição por Idade , Idoso , Fracionamento da Dose de Radiação , Feminino , Hospitais Universitários , Humanos , Masculino , Metástase Neoplásica/radioterapia , Cuidados Paliativos/estatística & dados numéricos , Radioterapia/métodos , Radioterapia/estatística & dados numéricos , Radioterapia Adjuvante/estatística & dados numéricos , Reirradiação/estatística & dados numéricos , Terapia de Salvação/estatística & dados numéricos , Distribuição por Sexo , Espanha , Tempo para o Tratamento/estatística & dados numéricosRESUMO
PURPOSE: To assess the pattern of treatment failure in patients with prostate cancer (PCa) treated with radiotherapy (76-80 Gy) ± hormone therapy (HT). We also evaluated the influence of treatment failure on survival outcomes. METHODS: Retrospective study of patients with PCa (n = 302) treated with radiotherapy (RT) ± HT at our centre between November 1999 and July 2007. The mean patient age was 70.2 years (range 51-87). Distribution by NCCN risk group was low (n = 80, 26.5%), intermediate (n = 86, 28.5%), high (n = 77, 25.5%), and very high (n = 49, 16.2%). Most patients (n = 273, 90.4%) received IMRT at a dose of 76-80 Gy. HT was administered in 237 patients (78.5%), in most cases (n = 167, 55.3%) for < 7 months RESULTS: Survival rates at 10 years were: overall survival (OS), 64.3%; biochemical disease-free survival, 83.9%; disease-free survival, 92.5%; and metastasis-free survival (MFS), 94.3%. Biochemical failure (BF) was observed in 55 cases (18.2%), 32 of whom subsequently developed clinical recurrence: metastasis (n = 17, 5.6%), local failure (n = 11, 3.6%), and regional failure (n = 4, 1.3%). The cause of death (n = 159) was intercurrent disease in 115 cases (72.3%), second cancer in 27 (17.0%), and PCa in 17 (10.7%). Biochemical failure-free survival ≤ 24 months was significantly associated with worse OS and MFS (p = 0.0001). Late genitourinary and gastrointestinal toxicity grade ≥ 3 (RTOG) was observed in 18 (6.0%) and 7 (2.3%) patients, respectively. CONCLUSIONS: The main type of treatment failure after 76-80 Gy of radiotherapy ± HT is local or metastatic. In all cases, biochemical failure occurred prior to treatment failure. BF within 24 months of treatment completion was significantly associated with worse OS and MFS.
Assuntos
Próstata/efeitos da radiação , Neoplasias da Próstata/radioterapia , Glândulas Seminais/efeitos da radiação , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Terapia Combinada , Intervalo Livre de Doença , Humanos , Calicreínas/sangue , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/mortalidade , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Estudos Retrospectivos , Taxa de Sobrevida , Falha de TratamentoRESUMO
INTRODUCTION: Radiotherapy (RT) is an essential part of the patient's treatment diagnosed with cancer. Determination of the most common RT secondary effect, the cutaneous toxicity, is usually based on visual rating scales, like Common Terminology Criteria for Adverse Events with an inherent subjectivity. The aim of this work is to perform an objective method to evaluate the radiodermatitis using a non-invasive imaging technique based on laser Doppler flowmetry (LDF). MATERIALS AND METHODS: A prospective study was performed analysing 1,824 measurements. A LDF was used to measure the cutaneous microcirculation in real time. A basal measurement was taken prior to radiotherapy treatment. To be able to observe the microcirculation changes related to the delivered dose, several sets of measurements were taken in the irradiated area along the RT treatment and in the contralateral non-irradiated area. RESULTS: A relative increase in blood flow at all measured points was found in the irradiated area. This relative increase in blood flow increases with the dose administered. In the non-irradiated contralateral area, the relative increase in blood flow is not significant and is independent of the dose administered. After treatment, a decrease in blood flow was detected with a trend towards returning to the baseline measurements. CONCLUSIONS: LDF is an objective technique that assesses early radiodermatitis. This method is useful to develop strategies to prevent onset of radiation dermatitis in patients irradiated, such as the modification and individualization of fractionation parameters of the RT. This allows the reduction of radiation morbidities and maintains patient quality of life.
Assuntos
Fluxometria por Laser-Doppler , Microcirculação , Neoplasias/radioterapia , Radiodermite/diagnóstico , Pele/irrigação sanguínea , Relação Dose-Resposta à Radiação , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
Las histiocitosis constituyen un grupo heterogéneo de enfermedades de causa desconocida y caracterizada por la presencia de histiocitos reactivos neoplásicos en varios tejidos y órganos. En su clasificación existe un grupo poco frecuente y conocido como histiocitocitosis de células de Langerhans cutánea pura autoinvolutiva. Se han descrito casos en todo el mundo y esta enfermedad se caracteriza por la proliferación de células de Langerhans con afección cutánea exclusiva y su tendencia a la curación espontánea. Presentamos dos casos clínicos
Assuntos
Lactente , Criança , Humanos , Feminino , Masculino , Histiocitose de Células de Langerhans/classificação , Histiocitose de Células de Langerhans/diagnóstico , Dermatopatias/diagnóstico , Dermatopatias/fisiopatologiaRESUMO
É apresentado o primeiro caso espanhol publicado de reticuloendoteliose com eosinofilia (doença de Omenn). Este quadro é considerado, atualmente, como uma imunodeficiência mista, grave e mortal, que dá lugar a uma proliferaçäo histiocitária reativa generalizada. No plano clínico, caracteriza-se por apresentar-se em lactentes, em forma de infecçöes diversas, diarréias, eritrodermia, alopécia, deterioraçäo do estado geral, hepatoesplenomegalia, adenopatias generalizadas e eosinofilia persistente. Em alguns casos, tem-se observado um déficit de 5-nucleotidase linfocitária e um aumento de IgE. O diagnóstico diferencial deve ser feito, fundamentalmente, com as histiocitoses malígnas (histiocitose X e histiocitoses que cursam com autocitofagia) e com outras histiocitoses reativas secundárias a déficits imunitários congênitos
Assuntos
Lactente , Humanos , Feminino , Eosinofilia/patologia , Doenças Linfáticas/patologia , Eosinofilia/complicações , Dermatopatias/etiologiaRESUMO
Se presentan dos casos congénitos y esporádicos de síndrome de los cabellos impeinables, en dos niños de 14 meses y dos años de edad. Clinicamente presentan cabelo seco, brilhante, rubio y aspecto desordenado, indomable al peinado. La ultraestructura con microscopia de barrido demuestra la presencia de canales longitudinales del tallo piloso y defsctos de estratificación de la cutícula. Se comentan los aspectos generales de esta nueva displasiapilar.
Assuntos
Doenças do Cabelo/diagnóstico , Folículo PilosoRESUMO
La dermatitis plantar juvenil (DPJ) esta caracterizada por la presencia de lesiones eritematosas, secas, brillantes, fisurarias, de bordes mal limitados. Se observan frecuentemente en caras plantar y laterales de los pies, en ninos de ambos sexos, de edad escolar. En nuestro estudio de quince pacientes, hemos hallado antecedentes de atopia en ocho casos y sensibilidad al dodecilmercaptano (componente habitual del calzado) en tres. Coincidimos con la mayoria de los autores en reconocer el terreno atopico de la mitad de los individuos que lo presentan, por lo menos. Otros factores responsables o desencadenantes serian la sensibilizacion alergica a componentes del calzado, factores mecanicos o irritativos. Se trata pues de un sindrome plurietiologico, cuya clinica esta condicionada por la peculiar localizacion donde asienta