ABSTRACT
Los departamentos de ginecología oncológica y educación al usuario encontró una incidencia de cáncer de cérvix en un período de un año de un 30.2% del total de las pacientes que acuden a la institución, de los cuales el 45% estaba entre los 30-49 años de edad al momento del diagnóstico. Como parte de su tratamiento los pacientes recibieron radioterapia externa y braquiterapia por encontrarse en un estadio avanzado y presentar estenosis vaginal como uno de los efectos secundarios más conocidos...
Subject(s)
Female , Brachytherapy/methods , Fibrosis/complications , Abdominal Neoplasms/diagnosis , Abdominal Neoplasms/radiotherapyABSTRACT
BACKGROUND: In upper abdominal malignancies (UAM), due to the presence of multiple inhomogeneous tissues, a wedge-based conformal treatment planning results in high-dose regions inside the target volume. AIM: This study was designed to explore the feasibility of using a field-in-field (FIF) technique in different UAM and its efficacy in reducing the high-dose regions. MATERIALS AND METHODS: Twelve patients of UAM (which included malignancies of the gastroesophageal junction, stomach, gall bladder, and pancreas) were selected for this study. Computed tomography (CT) scans were performed and three-dimensional conformal wedge plans were generated for all the cases. The same plan was copied with the wedges removed and a FIF plan was generated. The two plans were compared for mean, maximum, and median doses; dose received by 2% (D2) and 98% (D98) of the target volume; volume receiving> 107% (V > 107%) and < 95% (V Statistical Analysis: Statistical analysis was performed with SPSS, version 10.0. RESULTS: For all the cases, the FIF technique was better than wedge-based planning in terms of maximum dose, D2, V > 107%, and CI; there was a statistically significant reduction in monitor units. With regard to doses to critical structures, there was marginal dose reduction for the kidneys and spinal cord with FIF as compared to wedge-based planning. CONCLUSION: The FIF technique can be employed for UAM in place of wedge-based conformal treatment plans.
Subject(s)
Abdominal Neoplasms/radiotherapy , Dose-Response Relationship, Radiation , Humans , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted/instrumentation , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy, Conformal , Tomography, X-Ray ComputedABSTRACT
A enterite induzida pela radioterapia (RT) é uma desordem da função intestinal resultante do tratamento radioterápico de tumores pélvicos e abdominais. Tem sido demonstrado que a suplementação com glutamina durante o período pré e pós radioterapia abdominal, parece prevenir as complicações da enteropatia provocada pela radioterapia. A desnutrição é muito freqüente no paciente oncológico, tem sido considerada um fator de prognóstico ruim para a sobrevida e resposta ao tratamento. O objetivo deste estudo foi avaliar os efeitos profiláticos e terapêuticos da suplementação oral da glutamina sobre o conteúdo protéico e estrutura da mucosa intestinal em ratos adultos desnutridos submetidos à radiação. Ratos Wistar foram divididos em 3 grupos: C: dieta controle (23% proteína); restrição protéica (RP - 8% proteína); restrição calórica (RC - dieta controle restrita à 60% da ingestão). Após 21 dias, os animais foram subdivididos: CGlutA, RPGlutA ou RCGlutA: com suplementação oral de Glutamina (125 mg/100g/p.c) por 5 dias antes da RT; e CGlic, RPGlic ou RCGlic: com suplementação de Glicina. Os animais receberam dose única de 1000 cGy no abdômen. Após radioterapia os animais dos grupos GlutA foram subdivididos em: CGlutA+GlicP, RPGlutA+GlicP e RCGlutA+GlicP, que corresponde aos animais que receberam glutamina antes da RT e glicina após a RT e CGlutAP, RPGlutAP e RCGlutAP que corresponde aos animais que receberam glutamina antes e após RT. Os animais foram monitorizados diariamente quanto à ingestão e peso corporal. No 6° dia pós RT foram sacrificados e o jejuno retirado para análise estereológica, histopatológica e dosagem de proteínas. A suplementação com glutamina antes da radioterapia nos animais controles (CGlutA+GlicP) resultou em maiores concentrações de proteína na mucosa intestinal, aumento no número de mitoses por cripta e ausência de inflamação, porém não foram observadas alterações na área de superfície das vilosidades intestinais...
The enteritis induced by radiation therapy (XRT) is an intestinal disorder that occur as consequence of cancer abdominal irradiation. It has been demonstrated the protective role of glutamine supplemented diet before abdominal irradiation. Malnutrition is prevalent in oncologic pacients and has been considered a bad prognostic factor for treatment response. However, there are scanty data about the effects of the glutamine when the malnutrition is associated with the radiation injury. The aim of this study was to evaluate the prophylactic and therapeutic effects of glutamine, administered orally before and after wholeabdominal radiation, on gut mucosal structure and nutritional status of adult rats. The animals four- month old were assigned to one of the following groups: control (C), diet with 23% protein; protein-restricted (PR), diet with 8% protein; energy restriction (ER), control diet restricted to 60% of ingestion. After 21 days of diet treatment, the animals from C and PR groups were randomized to a glutamine or glicine treatment 5 days before XRT in: CGlutB; PRGlutB, CGlicB; PRGlicB; CGlutB; RCGlutB, RCGlicB; RCGlicB. The glutamine or glicine were oral administered (125mg/100g body weight). All animals were subjected to a single dose of 1000 cGy x-radiation (227 cGy per minute). After radiation the groups GlutB were randomized in CGlutB+GlicA, PRGlutB+GlicA and ERGlutB+GlicA, that correspond to animals which received glutamine before XRT and glicine after XRT, and CGlutBA, PRGlutBA, ERGlutBA that correspond to animals which received glutamine before and after XRT. Body weight and food intake will be monitored daily, from beginning treatment diet. Six days after radiation the animals will be sacrificed with a lethal dose of pentobarbital and blood was obtained by cardiac puncture. The jejunum was removed and processed for histologic, stereologic evaluation and protein concentration. The control animals (CGlutB+GlicA) had higher protein concentrations in gut mucosal, higher number of mitoses per crypt and inflamation absence, but no changes in jejunal vilous area. The CGlutBA had a higher jejunal vilous area, higher number of mitoses per crypt and inflamation absence. The groups PRGlic and ERGlic, which no received glutamine, had higher protein concentrations in gut mucosal and no changes in jejunal vilous area compared to control animals, while ER group had a lower number of mitoses per crypt and higher level of inflamation...
Subject(s)
Male , Female , Humans , Abdominal Neoplasms/radiotherapy , Enteritis , Glutamine/administration & dosage , Pelvic Neoplasms , Malnutrition , SurvivalABSTRACT
Se presenta una alternativa para la obtención de los campos de radiación necesarios para la aplicación de la técnica de bandas móviles en la irradiación del abdomen en el caso particular de emplearse irradiadores de C060 Chisobalt o Chisostat. Los campos obtenidos son de 3,6 y 9 cm de ancho por 18,20 y 22 cm de largo, a la distancia fuente (superficie de 80 cm). Se adjuntan los valores de calibración de las escalas de los colimadores y las curvas de isodosis en el plano principal del haz para su uso en la planificación del tratamiento