Research progress of irradiation injuries anti-agents / 中华劳动卫生职业病杂志

Irradiation injuries anti-agents refer to drugs that can inhibit the initial stage of radiation injuries, or reduce the development of radiation injuries and promote the recovery of injuries when used early after irradiation exposure. According to the mechanism of action and the time of intervention, the irradiation injuries anti-agents are divided into four categories: radioprotectors, radiomitigators, radiation therapeutics for external radiation exposure, and anti-agents for internalized radionuclides. In this paper, the research progress of irradiation injuries anti-agents in recent years is reviewed.

Hiposialia y Xerostomía Post Irradiación: Terapias Innovadoras en el Campo Biomolecular / Hyposialia and Xerostomy Post Irradiation: Innovative Therapies in the Biomolecular Field

Las glándulas salivales humanas pueden ser gravemente lesionadas por la radioterapia utilizada contra neoplasias de cabeza y cuello, produciendo hiposialia y xerostomía, las cuales afectan la salud oral y sistémica, mermando la calidad de vida de la persona. Los tratamientos convencionales actuales están diseñados para disminuir los síntomas, sin actuar sobre los cambios fisiopatológicos que se dan a nivel glandular. Esta revisión intenta analizar aquellas terapias preventivas y/o curativas que están desarrollándose en el campo biomolecular y que tienen un futuro prometedor por sus características innovadoras: terapia génica, terapia con células madre y terapia con factores de crecimiento. Se evidencia un aporte adicional de la nanotecnología, la cual está mejorando las vías de aplicación de los tratamientos.

Human salivary glands can be seriously injured by the radiotherapy used against head and neck neoplasms, producing hyposialia and xerostomy, which affect oral and systemic health, diminishing the person's quality of life. Current conventional treatments are designed to reduce symptoms, without acting on the pathophysiological changes that occur at the glandular level. This review attempts to analyze those preventive and /or curative therapies that are developing in the biomolecular field and that have a promising future due to their innovative features: Gene therapy, stem cell therapy and growth factor therapy. An additional contribution of nanotechnology is evident, which is improving the routes of treatment application.

Implantation of a biodegradable rectum balloon implant: Tips, Tricks and Pitfalls

ABSTRACT Introduction: A rectum balloon implant (RBI) is a new device to spare rectal structures during prostate cancer radiotherapy. The theoretical advantages of a RBI are to reduce the high radiation dose to the anterior rectum wall, the possibility of a post-implant correction, and their predetermined shape with consequent predictable position. Objective: To describe, step-by-step, our mini-invasive technique for hands-free transperineal implantation of a RBI before start of radiotherapy treatment. Materials and Methods: We provide step-by-step instructions for optimization of the transperineal implantation procedure performed by urologists and/or radiation oncologists experienced with prostate brachytherapy and the use of the real-time bi-plane transrectal ultrasonography (TRUS) probe. A RBI was performed in 15 patients with localised prostate cancer. Perioperative side-effects were reported. Results: We provide 'tips and tricks' for optimizing the procedure and proper positioning of the RBI. Please watch the animation, see video in https://vimeo.com/205852376/789df4fae4. The side-effects included mild discomfort to slight pain at the perineal region in 8 out of 15 patients. Seven patients (47%) had no complaints at all. Two patients developed redness of the skin, where prompt antibiotic regimen was started with no further sequelae. One patient revealed a temporary urine retention, which resolved in a few hours following conservative treatment. Further no perioperative complications occurred. Conclusion: This paper describes in detail the implantation procedure for an RBI. It is a feasible, safe and very well-tolerated procedure.

Potential radioprotective effect of AT1 receptor antagonists against morphological and ultrastructural changes in the testes induced by ionizing radiation / Potencial efecto radioprotector de antagonistas del receptor AT1 contra los daños morfológicos y ultraestructurales en los testículos inducido por la radiación ionizante

Radiotherapy is a source of human exposure to ionizing radiation. This pure energy causes deleterious effects on tissues, which result from oxidative stress, a phenomenon in which there is the participation of the Renin-Angiotensin System (RAS). The male genital organs are extremely radiosensitive and the action of radiation in the testes can significantly affect spermatogenesis. In search of potential radioprotective for male genital system, this study investigated whether the AT1 receptor antagonists minimize radiation-induced damage to reproductive tissues, by decreasing oxidative stress. Male Wistar rats were divided into six groups: 0 Gray (Gy) (control), 5 Gy (single dose in the scrotal area), telmisartan, losartan, 5Gy+telmisartan and 5Gy+losartan. The treatment started the day after irradiation with losartan 34 mg/kg (two times/day) and telmisartan 12 mg/kg (one time/day) during 60 days. For ultrastructural analysis, the testis fragments were fixed in 2 % glutaraldehyde and 4 % paraformaldehyde in 0.1 M phosphate buffer, pH 7.3. The material was postfixed for 2 h in 1 % osmium tetroxide. For collagen evaluation, the sections were stained with Picrosirius-red method. Serum testosterone was determined. The date showed the deleterious effects of gamma radiation on testicular ultrastructure. Rich accumulation of collagen fibers in the interstitium was observed in the irradiated groups, especially the irradiated and nontreated testes. No significant difference was detected in serum testosterone concentration among the studied experimental groups. Treatments with telmisartan and losartan influenced the onset of attenuation on ultrastructural damages arising from ionizing radiation. Although the data strongly suggest that AT1 receptor antagonists may promote radioprotection to the testes, further studies with a longer duration of treatment are required for these potentially positive effects to be maximized and, therefore, to better characterize radioprotection to reproductive parameters.

El tratamiento radioterápico es una fuente de exposición del ser humano a la radiación ionizante. Esta energía pura causa efectos deletéreos en los tejidos, debido al estrés oxidativo, fenómeno donde hay participación del Sistema Renina-Angiotensina. Los órganos genitales masculinos son extremadamente radiosensibles y la acción de la radiación en los testículos puede afectar significativamente la espermatogénesis. En la búsqueda de potenciales radioprotectores, este estudio ha investigado fármacos antagonistas del receptor AT1 que minimizan los daños radioinduzidos en los tejidos reproductivos, por medio de la disminución del estrés oxidativo. Ratones Wistar machos fueron distribuidos en seis grupos: grupo 0 Gray (Gy) (control), grupo 5 Gy (dosis única en el área escrotal), grupo telmisartán, grupo losartán, grupo 5Gy+telmisartán y grupo 5Gy+losartán. El tratamiento empezó en el día siguiente a la irradiación con losartán 34 mg/kg (2x/día) y telmisartán 12 mg/kg (1x/día), durante 60 días. Para el análisis ultraestructural, los testículos se fijaron en glutaraldehido (2 %) y paraformaldehido (4 %) con tampón de fosfato 0,1 M, pH 7,3. El material fue post-fijado en tetróxido de osmio (1 %). Para evaluar el colágeno fue utilizado el método Picrosirius Red. Fue determinada la concentración sérica de testosterona. Los datos mostraron los efectos deletéreos de los rayos gamma sobre la ultraestructura testicular. Fue observada una rica deposición de colágeno en el intersticio en los grupos irradiados, especialmente en el irradiado y no tratado. Entre los grupos, no se detectó ninguna diferencia significativa en la concentración sérica de testosterona. Los tratamientos con telmisartán y losartán influenciaron el comienzo de la atenuación de los cambios en la ultraestructura testicular de la radiación. A pesar de que los datos sugieren que los antagonistas del receptor AT1 pueden promover radioprotección a los testículos, estudios complementarios con una duración de tratamiento más extendida son necesarios para que los efectos potencialmente positivos sean maximizados y, por supuesto, puedan mejorar la caracterizacion de la radioprotección a los parámetros reproductivos.

Nutritional supplementation with arginine protects radiation-induced effects. An experimental study

ABSTRACT PURPOSE: To investigate the protective effect of L-arginine on the prostate (nonneoplasic) of rats with radiation-induced injury. METHODS: Twenty-nine Wistar rats, male adult, allocated into three groups: Control group (C) was not exposed to irradiation (n=10); Radiated group (R) had undergone pelvic irradiation (n=10); Supplemented and radiated group (R+S) had undergone pelvic irradiation plus L-arginine supplementation (n=9). The animals were observed for signs of toxicity. After euthanization, the prostate was dissected under magnification and stained by hematoxylin and eosin to study acinar structures and stained with Picrosirius red for collagen analysis. RESULTS: After radiation exposure, all animals presented diarrhea, but supplementation with L-arginine reduced this effect. The weight gain in the R+S group was significantly higher than in the C and R groups. In the R+S group the collagen density and the prostate acinar area was similar to the R and C groups. Epithelial height was significantly reduced in group R compared with group C (p<0.0001). When comparing the group R+S with R, a statistical difference was observed to be present (p<0.0001). CONCLUSIONS: Pelvic radiation promotes systemic effects and some structural modifications in the ventral prostate of rats. These modifications can be prevented by oral supplementation with L-arginine.

¿Es eficiente la protección anti-radiación otorgada por gorros de pabellón de tungsteno-bismuto en cardiología intervencionista? / Radiation protection provided by tungsten bismuth caps during interventional cardiology

Background: The effectiveness against radiation of tungsten bismuth caps, used in interventional cardiology is not well known. Aim: To determine the degree of radiation protection conferred by these caps in real work conditions. Material and Methods: We compared the gross electric charges received at brain lobe levels by three occupationally exposed professionals who participated in 22 consecutive procedures, inside and outside of the tungsten bismuth cap. Results: The median electric charges outside and inside the cap were 3.71 (range 1.46-5.62) and 2.2 (range 1.29-3.93) nC, which correspond to a 40% radiation attenuation. However, the protection was heterogeneous. Conclusions: Tungsten bismuth caps provide an adequate attenuation, but its degree is heterogeneous.

Are the urology operating room personnel aware about the ionizing radiation?

ABSTRACT Purpose: We assessed and evaluated attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Materials and Methods: A questionnaire was sent by e-mail to urology surgery room personnel in Turkey, between June and August 2013. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results: In total, 127 questionnaires were answered. Of them, 62 (48.8%) were nurses, 51 (40.2%) were other personnel, and 14 (11%) were radiological technicians. In total, 113 (89%) participants had some knowledge of radiation, but only 56 (44.1%) had received specific education or training regarding the harmful effects of radiation. In total, 92 (72.4%) participants indicated that they used a lead apron and a thyroid shield. In the subgroup that had received education about the harmful effects of radiation, the use ratio for all protective procedures was 21.4% (n=12); this ratio was only 2.8% (n=2) for those with no specific training; the difference was statistically significant (p=0.004). Regarding dosimeters, the use rates were 100% for radiology technicians, 46.8% for nurses, and 31.4% for other hospital personnel; these differences were statistically significant (p<0.001). No significant relationship between working period in the surgery room, number of daily fluoroscopy procedures, education, task, and use of radiation protection measures was found. Conclusions: It is clear that operating room-allied health personnel exposed to radiation do not have sufficient knowledge of ionizing radiation and they do not take sufficient protective measures.

Recomendaciones para mejorar la seguridad radiológica durante los procedimientos de intervencionismo cardiológico / Recommendations to improve radiation safety during invasive cardiovascular procedures

El objetivo de este articulo fue entregar una guia con recomendaciones para mejorar la Seguridad Radiológica durante los procedimientos de intervencionismo cardiológico. Se describe la clasificación de los efectos causados por las radiaciones ionizantes a los pacientes y personal médico. Se recomienda la aplicación de un programa de Garatia de Calidad, el cual implicará tantos gastos, como mayores beneficios. Como parte de este programa, se sugiere la implementación de un programa de Protección Radiológica, que incluya al personal, monitoreo de la radiación, blindajes y entrenamiento del personal. Se deben establecer acciones permanentes en cada laboratorio de hemodinamia para gestionar de la mejor forma posible las dosis de radiación antes, durante y después de la intervención. Finalmente, para avanzar en la implementación de estas recomendaciones, creemos que un paso fundamental es la revisión de nuestro marco juridico en el ámbito de la Seguridad Radiológica, donde resultan imprescindibles aspectos como la implementación de programas de Garantia de Calidad y Protección Radiológica, junto al establecimiento de Niveles Referenciales de dosis para pacientes.

In this paper we present guidelines aimed to improve radiation safety during invasive cardiovascular procedures. Unwanted effects upon patients and medical personnel are conventionally classified. A program of Quality Assurance is proposed, an aspect of which is a program for radiologic protection, including operator protection, radiation monitoring, shielding and personnel training. Permanent and specific actions should be taken at every cardiovascular lab, before, during and after interventions. In order to implement these guidelines and actions, a fundamental step is a review of current legislation. Specific programs for quality control and radiologic protection along with a definition of acceptable radiation exposure doses are required.

Radioprotective effect of Haberlea rhodopensis (Friv.) leaf extract on -radiation-induced DNA damage, lipid peroxidation and antioxidant levels in rabbit blood.

Different concentrations of H. rhodopensis total extract (HRE; 0.03, 0.06 and 0.12 g/kg body weight) were injected im, into rabbits 2 h before collecting the blood samples. The whole blood samples were exposed in vitro to 2.0 Gy 60Co -radiation. The radiation-induced changes were estimated by using the chromosome aberration test (CA) and cytokinesis blocked micronucleus assay (CBMN) in peripheral lymphocytes, and by determining the malondialdehyde levels (MDA) in blood plasma and the superoxide dismutase (SOD) and catalase (CAT) activity in erythrocytes. Radiation significantly increased the chromosome aberration and micronuclei frequencies as well as MDA levels and decreased the antioxidant enzyme activity. On the other hand, the HRE pretreatment significantly decreased the CA, MN frequencies and MDA levels and increased the SOD and CAT activity in a concentration dependent manner. The most effective was the highest concentration of HRE (0.12 g/kg body weight). The results suggest that HRE as a natural product with an antioxidant capacity could play a modulatory role against the cellular damage induced by -irradiation. The possible mechanism involved in the radioprotective potential of HRE is discussed.

¿Es suficiente la protección otorgada por gafas plomadas en cardiología intervencionista? / Protection against ionizing radiation by leaded glass googles during interventional cardiology

Background: It is not known whether leaded glass goggles with 0.25 mm Pb equivalency, used in interventional cardiology procedures, attenuate radiation below the levels established by the latest recommendation of the International Commission on Radiological Protection (ICRP). Aim: To assess ifthe degree of attenuation of the secondary ionizing radiation achieved by the use of 0.25 mm Pb leaded glass goggles, in occupationally exposed workers in interventional cardiology procedures, meets the latest ICRP recommendations. Material and Methods: A prospective investigation was carried out to compare the eye exposure to secondary ionizing radiation received by occupationally exposed personnel in a 9 months period. A set of two thermo luminescent dosimeters was arranged in the front and back of leaded glass goggles in a cohort ofseven members of an interventional cardiology service, exposed to 1057 consecutive procedures. Results: The monthly dose equivalent measurement performed in front ofthe goggles ranged between 1.1 and 6.5 mSv, for paramedics and interventional cardiologists. The radiation measured in the back of the glass varied between 0.66 and 2.75 mSv, respectively. The degree of attenuation of the dose at eye level ranged from 40% to 57.7%, respectively. The projected annual exposure would reach 33 mSvfor the interventional cardiologist. Conclusions: With a similar load ofwork and wearing 0.25 mm Pb equivalent glass goggles, interventional cardiologists will exceed the crystalline equivalent dose limit recommended by the ICRP (20 mSv/year averaged over the past 5 years).

effect of olive leaf extract in decreasing the expression of two pro-inflammatory cytokines in patients receiving chemotherapy for cancer. A randomized clinical trial

Oral mucositis is the most common side effects of chemotherapy of all cancer with intensive treatments regimen, and is the most common side effects of head and neck radiation therapy. For steam cell transplantation, its also regarded as the most debilitating side effects. The objectives of this study were to assess the effect of a mouth rinse containing olive leaf extract [OLE] in preventing severe oral mucositis in patients receiving chemotherapy, and to estimate its effect in decreasing pro-inflammatory cytokine production after chemotherapy. This study utilized a placebo-controlled, randomized, double-blind, and cross-over design. Twenty-five patients undergoing intensive chemotherapy were randomly assigned to receive a mouth wash containing OLE, benzydamine hydrochloride, or placebo in 3 different cycles of chemotherapy. Oral mucositis severity was assessed using the World Health Organization criteria and Oral Mycositis Assessment Scale. Patients were evaluated weekly until 15 days after chemotherapy for each cycle. Salivary levels of interleukin-1 beta [IL-1[beta] and tumor necrosis factor-alpha [TNF-alpha] were evaluated by enzyme-linked immunosorbant assay. Oral mucositis rates and severity after 2 weeks were significantly lower in the OLE and benzydamine groups compared to the placebo group. The IL-1beta and TNF-alpha levels were significantly decreased in the OLE group compared to the other groups. Preliminary findings indicate that OLE is effective in reducing IL-1 beta and TNF-alpha levels after chemotherapy and exert a therapeutic effect and prevent development of severe oral mucositis

Prevención y tratamiento de la enteritis actínica / Prevention and treatment of radiation enteritis

Chronic actinic enteritis is a severe complication that ocurrs in oncological patients under radiation therapy. It is associated with significant morbidity and mortality rates. This article is focused on the acute and chronic actinic enteritis and their predisposing factors. Due to the multifactorial etiology of the gastrointestinal symptoms in these patients, it is important to have a diagnostic approach based on clinical background information and tests, that will allow to establish one etiology and rule out differential diagnoses. As for the treatment, drugs with variable effectiveness and validity are mentioned. In more complex patients successful treatment with better results has been achieved, but these have a higher cost and are less available. In severe cases, parenteral nutrition and/or surgery have been used. From the point of view of prevention, the utility of the drugs has been documented for acute enteritis. However, in order to reduce the risk of chronic enteritis it is critical to take actions resulting in less toxicity during the radiation therapy. The participation of a multidisciplinary team is very important both in the management and prevention of actinic enteritis.

La enteritis actínica crónica es una complicación grave y creciente que se presenta en pacientes oncológicos sometidos a radioterapia. Se asocia a morbilidad y mortalidad significativas. El presente artículo está enfocado en las formas aguda y crónica de la enteritis actínica y sus factores predisponentes. Dada la etiología multifactorial de los síntomas gastrointestinales en estos pacientes, es importante una aproximación diagnóstica basada en los antecedentes clínicos y exámenes que permitan definir una etiología y excluir diagnósticos diferenciales. En cuanto al tratamiento, se mencionan fármacos con efectividad variable y validez limitada. En pacientes más complejos se han realizado tratamientos con resultados más exitosos, pero de mayor costo y de difícil disponibilidad. En casos graves se debe recurrir a la nutrición parenteral y/o cirugía. Desde el punto de vista de la prevención, se ha documentado la utilidad de fármacos en la enteritis aguda. Sin embargo, para reducir el riesgo de la enteritis crónica es fundamental adoptar medidas que conduzcan a una menor toxicidad durante la radioterapia. Tanto en el manejo como en la prevención de la enteritis actínica es importante el enfoque de un equipo multidisciplinario.

Impacto da radioterapia e da quimioterapia sobre o aparelho genital feminino: procedimentos terapêuticos / Radiotherapy and chemotherapy impact on female genital apparatus: therapeutic procedures

No presente estudo apresentamos os diversos procedimentos terapêuticos existentes com o intuito de obter-se proteção e melhoria dos danos induzidos por radioterapia e quimioterapia no aparelho genital feminino.

The aim of this study is obtain a convenient analysis of different therapeutic methods to improve better conditions before and after radiotherapy and chemotherapy in the female genital apparatus.

Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer

The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

Medical preparedness in radiation accidents: a matter of logistics and communication not treatment!

The currently reactor wreckage in Fukushima raised the following important questions: Is our knowledge of the possible dangers of ionizing radiation sufficient to warrant special action? What is the role of the medical community in technical radiation accidents from Windscale to Fukushima? What is the role of the medical community in terrorist radiation attacks? Are we prepared for those challenges? How can medical services communicate information in the media framework? What have we learned recently? And, what should be improved? In this review of the current literature on ionizing radiation, we try to answer these questions. Our conclusion is that medical services have to improve their communication skills and convince the public that the dangers of ionizing radiation can be quantitated within certain limits to support a qualified discussion about its risks and benefits

Efficacy of a Self-designed Protective Lead Shield in Reduction of Radiation Exposure Dose During Endoscopic Retrograde Cholangiopancreatography / 대한소화기학회지

BACKGROUND/AIMS: The increasing use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) calls for greater consideration of radiation exposure risk to endoscopists and assistants, and emphasizes the proper system of radiation protection. This study was designed to assess the effect of a newly developed, self-designed, protective lead shield. METHODS: A curtain-shaped protective shield composed of seven movable lead plates was developed, each with the following dimensions: depth, 0.1 cm; width, 15 cm; length, 70 cm. The curtain-shaped protective shield was designed to be located between the patient and the endoscopist. Twenty-nine patients (11 men and 18 women) undergoing ERCP between January 2010 and March 2010 were selected for this study. The dose of radiation exposure was recorded with or without the protective lead shield at the level of the head, chest, and pelvis. The measurement was made at 50 cm and 150 cm from the radiation source. RESULTS: The mean patient age was 64 years. The mean patient height and weight was 161.7+/-6.9 cm and 58.9+/-9.9 kg, respectively. The mean body mass index (BMI) was 22.5+/-3.0 kg/m2. Endoscopists received 1522.2+/-537.0 mR/hr without the protective lead shield. At the same distance, radiation exposure was significantly reduced to 68.8+/-88.0 mR/hr with the protective lead shield (p-value<0.0001). The radiation exposure to endoscopists and assistants was significantly reduced by the use of a protective lead shield (p value<0.0001). The amount of radiation exposure during ERCP was related to the patient's BMI (r=0.749, p=0.001). CONCLUSIONS: This self-designed, protective lead shield is effective in protecting endoscopists and assistants from radiation exposure.

Criterios de evaluación odontológica pre-radioterapia y necesidad de tratamiento de las enfermedades orales post-radioterapia en cabeza y cuello / Pre-radiotherapy dental evaluation criteria and treatment needs of oral side effects after head and neck radiotherapy

El objetivo de esta revisión es presentar criterios de evaluación odontológica pre-radioterapia y cuáles son las principales necesidades de tratamiento de estos pacientes después del tratamiento de radiación. Fueron revisados artículos en inglés, español y portugués entre 1995 y 2009 indexados en Pubmed y Scielo. Las palabras claves fueron: cáncer oral y radioterapia, complicaciones de la radioterapia en cabeza y cuello, evaluación oral pre-radioterapia. Los efectos colaterales de la radioterapia en la región de cabeza y cuello pueden ser temporales o tardíos. Aquellos que son tardíos, como la caries de radiación y la osteorradionecrosis pueden estar directamente relacionados con el hecho de no haber realizado una evaluación odontológica previa y pueden afectar severamente la calidad de vida del paciente.La participación del cirujano-dentista en el equipo multidisciplinario y la evaluación odontológica de los pacientes que serán sometidos a radioterapia en la región de cabeza y cuello son de vital importancia en mejorar la calidad de vida post-operatoria de estos pacientes.

The objective of this review is to present pre-radiotherapy evaluation criteria and the main needs for treatment of these patients after the radiation therapy. Were revised articles in English, Spanish and Portuguese language between 1995 and 2009 indexed in Pubmed and Scielo. The keywords were oral cancer and radiotherapy, complications in head and neck radiotherapy, oral pre-radiotherapy evaluation.The adverse complications of radiotherapy in head and neck area could be temporary or late. The late effects, such as radiation caries and osteorradionecrosis could be directly associated with the fact that previous dental evaluation was not performed and can severely affect the post-operatory quality of life. The participation of the dentist in the multidisciplinary team and dental evaluation of the patients that will receive radiotherapy in the head and neck area are of vital importance to improve the post-operatory quality of life of these patients.

From two-dimensional to three-dimensional conformal radiotherapy in prostate cancer: An Indian experience.

Background: Sparse data from India are available regarding the outcome of prostate cancer treatment. We report our experience in treating prostate cancer with radiotherapy (RT). Materials and Methods: This study included 159 men with locally advanced cancer treated with RT with or without hormone therapy between 1984 and 2004. The median RT dose was 70 Gy over 35 fractions. Eighty-five patients received whole pelvic RT and prostate boost, and 74 patients were treated with 3-dimensional conformal radiotherapy (3DCRT) to prostate and seminal vesicles alone. Results: The median follow-up was 25 months and the freedom from biochemical failure for all the patients at 5 years was 76%, disease-free survival (DFS) 59.1%, and overall survival (OAS) was 70.1%. The risk stratification (91% vs 52%, P < 0.03) and RT dose (72.8% for dose > 66 Gy vs 43.5% for dose < 66 Gy; P = 0.01) affected the DFS. DFS at 5 years was better in the group receiving 3DCRT to prostate and seminal vesicles (78% vs 51.5%; P = 0.001) and was reflected in OAS as well (P = 0.01). Conclusion: CRT technique with dose escalation results in significant benefit in DFS and OAS in locally advanced prostate cancer.

The role of intensity-modulated radiotherapy in head and neck cancer.

Intensity-modulated radiotherapy (IMRT) has been a significant technological advance in the field of radiotherapy in recent years. IMRT allows sparing of normal tissue while delivering radical radiation doses to the target volumes. The role of IMRT for parotid salivary gland sparing in head and neck cancer is well established. The utility of IMRT for pharyngeal constrictor muscle and cochlear sparing requires investigation in clinical trials. The current evidence supporting the use of IMRT in various head and neck subsites has been summarized. Sparing of organs at risk allows for dose-escalation to the target volumes, taking advantage of the steep dose-response relationship for squamous cell carcinomas to improve treatment outcomes in advanced head and neck cancers. However, dose-escalation could result in increased radiation toxicity (acute and late), which has to be studied in detail. The future of IMRT in head and neck cancers lies in exploring the use of biological imaging for dose-escalation using targeted dose painting.

Radiaciones electromagnéticas y salud en la investigación médica / Electromagnetic radiations and health in medical research

Se realizó una búsqueda informativa a través de la consultoría BIOMUNDI relacionada con radiaciones electromagnéticas y afectaciones al estado de salud. El resultado de la búsqueda refleja la actualidad del tema y la importancia que se presta por los sistemas de salud a este aspecto que muchos han llamado la epidemia del desarrollo científico-tecnológico. Se confirma en muchas investigaciones la fuerte relación entre radiaciones electromagnéticas y cáncer

A information search was carried out in BIOMUNDI consultancy firm related to electromagnetic radiations and the affections to health status. Findings showed the subject updating and significance that health systems offer on this feature called the the epidemic of scientific-technological development. In many researches it is verified the strong relation between the electromagnetic radiations and the cancer