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1.
Arq. bras. oftalmol ; 84(1): 22-30, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153093

ABSTRACT

ABSTRACT Purpose: The aim of this study was to present our own experience with the use of thermography as a complementary method for the initial diagnosis and differentiation of intraocular tumors, as well as for the evaluation of the efficacy of treatment of intraocular melanomas. Methods: The study group comprised 37 patients with intraocular tumors, including 9 with uveal melanoma, 8 with uveal melanoma after I125 brachytherapy, 12 with a focal metastasis to the uvea, and 8 with retinal capillary hemangioblastoma. A FLIR T640 camera was used to capture images in the central point of the cornea, eye area, and orbital cavity area. Results: Eyes with uveal melanoma had higher temperature compared with the fellow normal eye of the patient in the range of all measured parameters in the regions of interest. In the group of patients with melanoma after unsuccessful brachytherapy, higher temperature was observed at the central point of the cornea. In patients with tumor regression, all measured parameters were lower in the affected eye. We observed lower tempe­ratures in the range of all tested parameters and areas in eyes with choroidal metastases. Eyes with diagnosed intraocular hemangioblastoma were characterized by higher parameters for the regions of interest versus eyes without this pathology. Conclusions: A thermographic examination of the eye can be used as an additional first-line diagnostic tool for the differentiation of intraocular tumors. Thermography can be a helpful tool in monitoring the treatment outcome in patients with intraocular melanoma.


RESUMO Objetivo: O objetivo deste estudo foi de apresentar a nossa experiência no uso da termografia como método complementar para o diagnóstico inicial e a diferenciação de tumores intraoculares, bem como para a avaliação da eficácia do tratamento de melanomas intraoculares. Métodos: O grupo estudado compunha-se de 37 pacientes com tumores intraoculares, sendo 9 com melanoma uveal, 8 com melanoma uveal após braquiterapia com I125, 12 com metástases focais na úvea e 8 com hemangioblastoma capilar retiniano. As imagens do ponto central da córnea, da área do olho e da área da cavidade orbital foram obtidas com uma câmera FLIR T640. Resultados: Os olhos dos pacientes com melanoma uveal tinham temperaturas mais elevadas do que as dos olhos normais dos mesmos, em toda a faixa dos parâmetros medidos nas regiões de interesse. No grupo de pacientes com melanoma após braquiterapia mal sucedida, encontrámos temperaturas maiores no ponto central da córnea. Nos pacientes com regressão do tumor, todos os parâmetros medidos foram menores no olho acometido. Encontrámos temperaturas mais baixas em toda a faixa dos parâmetros testados e das áreas medidas nos olhos com metástases na coroide. Os olhos com hemangioblastoma intraocular diagnosticado caracterizaram-se por parâmetros mais elevados nas regiões de interesse, em comparação com olhos sem essa patologia. Conclusões: O exame termográfico do olho pode usar-se como ferramenta de diagnóstico adicional de triagem na diferenciação de tumores intraoculares. A termografia pode ser uma ferramenta útil no acompanhamento do des­fe­cho do tratamento em pacientes com melanoma intraocular.


Subject(s)
Humans , Uveal Neoplasms , Brachytherapy , Melanoma , Uvea , Uveal Neoplasms/diagnosis , Uveal Neoplasms/radiotherapy , Thermography , Melanoma/diagnosis
2.
Ciênc. cuid. saúde ; 20: e56295, 2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1339639

ABSTRACT

RESUMO Objetivo: conhecer o significado da braquiterapia em mulheres com câncer ginecológico. Métodos: pesquisa qualitativa, descritiva e exploratória realizada com 32 mulheres, submetidas à braquiterapia em instituição oncológica de Santa Catarina, Brasil. Na coleta de dados, entre setembro de 2017 e julho de 2018, aplicou-se entrevista semiestruturada. As comunicações foram submetidas à análise de conteúdo, incluindo regras de enumeração para análise dos dados sociodemográficos, clínicos e para quantificação dos relatos agrupados. Publicações relacionadas com o tema e a Teoria do Conforto sustentaram teoricamente a inferência dos dados. Emergiram cinco categorias temáticas, neste artigo apresentam-se três. Resultados: a categoria "O medo e as crenças pessoais no enfrentamento do câncer ginecológico e da braquiterapia" destaca o medo da morte, o desejo pela cura e o apego à família e à religiosidade; "Medo do tratamento e desconfortos relacionados" retrata as alterações relacionadas aos contextos físico, psicológico e ambiental; "Dor como significado" revela a percepção dolorosa sentida pelas mulheres em decorrência da doença ou da braquiterapia. Conclusão: conhecer o significado da braquiterapia permite que os enfermeiros possam repensar a coleta de dados e o planejamento de enfermagem para melhor educação em saúde e redução dos desconfortos.


RESUMEN Objetivo: conocer el significado de la braquiterapia en mujeres con cáncer ginecológico. Métodos: investigación cualitativa, descriptiva y exploratoria realizada con 32 mujeres, sometidas a la braquiterapia en institución oncológica de Santa Catarina, Brasil. En la recolección de datos, entre septiembre de 2017 y julio de 2018, se aplicó entrevista semiestructurada. Los relatos fueron sometidos al análisis de contenido, incluyendo reglas de enumeración para análisis de los datos sociodemográfico, clínicos y para cuantificación de los relatos agrupados. Publicaciones relacionadas con el tema yla Teoría del Confort basaron teóricamente la inferencia de los datos. Surgieron cinco categorías temáticas, en este artículo se presentan tres. Resultados: la categoría "El miedo y las creencias personales en el enfrentamiento del cáncer ginecológico y de la braquiterapia" destaca el temor a la muerte, el deseo por la cura y el apego a la familia y a la religiosidad; "Miedo al tratamiento y las molestias relacionadas" retrata las alteraciones relacionadas a los contextos físico, psicológico y ambiental; "Dolor como significado" revela la percepción dolorosa sentida por las mujeres debido a la enfermedad o la braquiterapia. Conclusión: conocer el significado de la braquiterapia permite que los enfermeros puedan repensar la recolección de datos y la planificación de enfermería para una mejor educación en salud y reducción de las molestias.


ABSTRACT Objective: to know the meaning of brachytherapy in women with gynecological cancer. Methods: qualitative, descriptive and exploratory research conducted with 32 women who underwent brachytherapy at an oncology institution in Santa Catarina, Brazil. Data collection took place between September 2017 and July 2018 through semi-structured interviews. Communications were submitted to content analysis, including enumeration rules for the analysis of sociodemographic and clinical data and for the quantification of grouped reports. Publications related to the theme and the Comfort Theory theoretically supported the inference of the data. Five thematic categories emerged; in this article three are presented. Results: the category "Fear and personal beliefs in coping with gynecological cancer and brachytherapy" highlights the fear of death, the desire for healing and attachment to family and religiosity; "Fear of treatment and related discomforts" depicts changes related to physical, psychological and environmental contexts; "Pain as meaning" reveals the painful perception felt by women as a result of illness or brachytherapy. Conclusion: knowing the meaning of brachytherapy allows nurses to rethink data collection and nursing planning for better health education and reduction of discomfort.


Subject(s)
Humans , Female , Genital Neoplasms, Female , Oncology Nursing , Pain , Therapeutics , Physicians' Offices , Brachytherapy , Adaptation, Psychological , Family , Health Education , Nursing , Death , Fear , Religious Personnel
3.
Rev. enferm. UFSM ; 11: e35, 2021.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1178124

ABSTRACT

Objetivo: revelar os efeitos colaterais imediatos e as práticas de autocuidado adotadas por mulheres com câncer ginecológico submetidas à braquiterapia. Método: pesquisa narrativa, realizada com 12 mulheres, no Sul do Brasil, entre dezembro/2018 e janeiro/2019, incluindo entrevista semiestruturada submetida à análise de conteúdo. Resultados: da análise emergiram três categorias temáticas: Cuidados orientados e adotados pelas mulheres em braquiterapia pélvica; Efeitos colaterais imediatos percebidos pelas mulheres em braquiterapia pélvica; Cuidados não orientados pelos profissionais da saúde. Os cuidados orientados pelas enfermeiras mais relatados pelas mulheres foram dilatação vaginal, uso de ducha e lubrificante vaginal, consumo de chá, higienização e guarda do dilatador vaginal. Os efeitos colaterais mais citados nas entrevistas foram alterações urinárias e intestinais na pele e mucosas. Conclusão: evidencia-se que a atenção de enfermagem em braquiterapia deve priorizar cuidados para prevenir e controlar as alterações geniturinárias e tegumentares, incluindo práticas de autocuidado.


Objective: to reveal the immediate side effects and self-care practices adopted by women with gynecological cancer submitted to brachytherapy. Method: narrative research, conducted with 12 women, in southern Brazil, between December/2018 and January/2019, including semi-structured interviews submitted to content analysis. Results: three thematic categories emerged from the analysis: Care oriented and adopted by women in pelvic brachytherapy; Immediate side effects perceived by women in pelvic brachytherapy; Care not guided by health professionals. The care provided by the nurses most reported by the women was vaginal dilation, use of a shower and vaginal lubricant, tea consumption, cleaning, and storage of the vaginal dilator. The side effects most frequently mentioned in the interviews were urinary and intestinal changes in the skin and mucous membranes. Conclusion: nursing care in brachytherapy must prioritize care to prevent and control genitourinary and cutaneous changes, including self-care practices.


Objetivo: revelar los efectos colaterales inmediatos y las prácticas de autocuidado adoptadas por mujeres con cáncer ginecológico sometidas a la braquiterapia. Método: investigación narrativa, realizada con 12 mujeres, en el Sur de Brasil, entre diciembre/2018 y enero/2019, incluyendo entrevista semiestructurada sometida al análisis de contenido. Resultados: del análisis surgieron tres categorías temáticas: Cuidados orientados y adoptados por las mujeres en braquiterapia pélvica; Efectos colaterales inmediatos percibidos por las mujeres en braquiterapia pélvica; Cuidados no orientados por los profesionales de la salud. Los cuidados orientados por las enfermeras más relatados por las mujeres fueron dilatación vaginal, uso de ducha y lubrificante vaginal, consumo de té, higienización y guarda del dilatador vaginal. Los efectos colaterales más citados en las entrevistas fueron alteraciones urinarias e intestinales en la piel y mucosas. Conclusión: se observa que la atención de enfermería en braquiterapia debe priorizar cuidados para prevenir y controlar las alteraciones genitourinarias y pigmentarias, incluyendo prácticas de autocuidado.


Subject(s)
Humans , Brachytherapy , Nursing , Personal Narrative , Genital Neoplasms, Female , Medical Oncology
4.
Rev. enferm. Cent.-Oeste Min ; 10(1): 3883, out. 2020.
Article in Portuguese | LILACS, BDENF | ID: biblio-1147473

ABSTRACT

Objetivo: Avaliar a adesão das mulheres com câncer cervical às orientações de autocuidado relacionadas à braquiterapia. Método: Estudo longitudinal, realizado em um ambulatório de radioterapia na região centro-oeste, com mulheres com câncer cervical submetidas à braquiterapia. As participantes responderam ao questionário sobre adesão às orientações de autocuidado durante o tratamento. Resultados: Trinta mulheres com idade entre 22 e 76 anos participaram do estudo. Das 12 orientações, as pacientes reportaram adesão boa em seis(50%), moderada em quatro (33%), e baixa em duas (17%). Apenas sete (23%) das pacientes aderiram ao uso de dilatadores vaginais pós-braquiterapia para prevenção da estenose vaginal. Em média, as pacientes aderiram à nove das doze orientações recebidas. Conclusão: As pacientes apresentaram boa e moderada adesão para a maioria das orientações fornecidas. Sugere-se que intervenções educativas sejam implementadas para melhorar a comunicação visual e consequentemente melhorar a adesão às orientações de autocuidado em braquiterapia(AU)


Objective: to evaluate the adherence of women with cervical cancer to self-care guidelines related to brachytherapy. Method: Longitudinal study, performed in an outpatient radiotherapy clinic in the center-west region, with women with cervical cancer submitted to brachytherapy. Participants answered the questionnaire on adherence to self-care guidelines during treatment. Results: Thirty women between 22 and 76 years of age participated in the study. Of the 12 guidelines, patients reported good adherence to six (50%), moderate adherence to four (33%), and low adherence to two (17%). Only seven (23%) patients adhered to the use of postbrachytherapy vaginal dilators for prevention of vaginal stenosis. On average, the patients adhered to nine of the twelve guidelines received. Conclusion: The patients showed good and moderate adherence to most of the orientations provided. Educational interventions should be implemented to improve visual communication and consequently improve adherence to self-care guidelines in brachytherapy.(AU)


Objetivo: Evaluar la adhesión de las mujeres con cáncer de cuello uterino a las pautas de autocuidado relacionadas con la braquiterapia. Método: Estudio longitudinal, realizado en una clínica de radioterapia ambulatoria en la región centro-oeste, con mujeres con cáncer de cuello de útero sometidas a braquiterapia. Las participantes respondieron al cuestionario sobre la adhesión a las directrices de autocuidado durante el tratamiento. Resultados: Treinta mujeres entre 22 y 76 años de edad participaron en el estudio. De las 12 directrices, las pacientes informaron de una buena adhesión en seis (50%), una adhesión moderada en cuatro (33%) y una baja adhesión en dos (17%). Sólo siete (23%) de las pacientes se adhirieron al uso de dilatadores vaginales después de la braquiterapia para la prevención de la estenosis vaginal. En promedio, las pacientes se adhirieron a nueve de las doce pautas recibidas. Conclusión: Las pacientes tuvieron una buena y moderada adhesión a la mayoría de las orientaciones proporcionadas. Se sugiere que se realicen intervenciones educativas para mejorar la comunicación visual y, por consiguiente, mejorar la adhesión a las directrices de autocuidado en la braquiterapia(AU)


Subject(s)
Self Care , Brachytherapy , Uterine Cervical Neoplasms , Office Nursing , Constriction, Pathologic
5.
Rev. cuba. anestesiol. reanim ; 19(2): e589, mayo.-ago. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126361

ABSTRACT

Introducción: El cáncer de labio es el tumor más frecuente de la cavidad oral que afecta, sobre todo, el labio inferior. La braquiterapia es un tratamiento único eficaz en estadios tempranos y como terapia adyuvante a la cirugía en estadios avanzados. Esta técnica es un proceso doloroso por lo que para su realización se han empleado sedaciones profundas, infiltraciones intramusculares de anestésico local y técnicas de anestesia regional, entre otras. Objetivo: Presentar una técnica anestésica diferente y poco descrita como alternativa para disminuir el dolor de la intervención. Presentación del caso: Paciente con carcinoma de labio programado para braquiterapia. Se realiza bloqueo del nervio mentoniano de manera bilateral para el tratamiento en labio inferior. Conclusiones: Este tipo de bloqueo, por su sencillez y eficacia, es una alternativa útil a la sedación profunda para la realización de braquiterapia en el labio inferior(AU)


Introduction: Lip cancer is the most frequent tumor of the oral cavity that affects, above all, the lower lip. Brachytherapy is a unique treatment which is effective in early stages and, as adjuvant therapy to surgery, it is also effective in advanced stages. This technique is a painful process, a reason why deep sedation, intramuscular infiltrations of local anesthetic, and regional anesthesia techniques, among others, have been used. Objective: To present a different and scarcely described anesthetic technique as an alternative to reduce the pain of this intervention. Case presentation: Patient with lip carcinoma scheduled for brachytherapy. Bilateral mental nerve block is performed in the lower lip. Conclusions: This type of block, due to its simplicity and effectiveness, is a useful alternative to deep sedation for brachytherapy in the lower lip(AU)


Subject(s)
Humans , Male , Aged , Lip Neoplasms/surgery , Anesthesia, Conduction/methods , Nerve Block/methods , Brachytherapy/methods
7.
Article in English | WPRIM | ID: wpr-876554

ABSTRACT

@#Background: Concurrent chemoradiotherapy composed of pelvic external beam radiotherapy (PEBRT) with weekly chemotherapy plus intracavitary brachytherapy (ICBT) remains to be the treatment of choice for locally advanced cervical cancer (LACC). However, some patients are not suitable to have ICBT right after pelvic radiation. Locally, active chemotherapy is being given to these patients until they can undergo the procedure. Objective: The aim of the study was to determine the impact of ICBT in the treatment and survival outcomes of cervical cancer and to compare it with active chemotherapy. Methodology: This was a retrospective study of patients with LACC treated with or without brachytherapy in a single institution from January 2002 to December 2017. Results: The 5-year over-all survival (OS) and 5-year recurrence free survival (RFS) of patients with ICBT were both significantly improved compared to those without ICBT (p=0.001 and p=0.038), respectively. Factors that were significantly correlated with adequate response for brachytherapy were non-squamous cell histology (OR 0.65, CI 0.46- 092, p=0.016), initial tumor size of > 5cm (OR 0.41, CI 0.26-0.65, p=0.001), > 50% decrease in the original tumor size at the middle part of PEBRT (OR 1.83, CI 1.2-2.8, p=0.005), > 3 cycles of chemotherapy as radiosensitizers (OR 2.66, CI 1.79- 3.9, p=0.001), > 45 days duration of PEBRT (OR 0.63, CI 0.41-0.97, p=0.04) and > 2 episodes of anemia during PEBRT (OR 0.67, CI 0.52-0.85, p=0.001). Conclusion: Brachytherapy offers significant improvement on tumor control and over-all survival for patients with LACC. Active chemotherapy may offer some benefit in terms of delaying tumor recurrence or progression. However, this did not translate to survival impact if the patient was not able to have brachytherapy at all.


Subject(s)
Brachytherapy
8.
Rev. méd. Chile ; 147(6): 808-812, jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1020731

ABSTRACT

Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.


Subject(s)
Humans , Male , Aged , Brachytherapy/methods , Carcinoma, Hepatocellular/radiotherapy , Ablation Techniques/methods , Radiotherapy, Image-Guided/methods , Liver Neoplasms/radiotherapy , Radiation Dosage , Iridium Radioisotopes , Tomography, X-Ray Computed , Treatment Outcome , Carcinoma, Hepatocellular/diagnostic imaging , Liver Neoplasms/diagnostic imaging
9.
Oncol. (Guayaquil) ; 29(1): 36-44, 30 de abril 2019.
Article in Spanish | LILACS | ID: biblio-1000445

ABSTRACT

Introducción: En el tratamiento del Cáncer Cervico Uterino la braquiterapia (BQT) con planificación tridimensional (3D) está altamente extendida, aunque por su costo otros centros utilizan BQT con planificación bidimensional (2D). Es importante establecer si el beneficio que se obtiene con BQT en 3 D, en la protección a los órganos de riesgo, es un factor determinante para el cambio hacia esta nueva tecnología. El objetivo del estudio es comparar las dosis en ambos tipos de BQT en los órganos adyacentes al útero como el colon y vejiga. Métodos: El presente estudio descriptivo, incluye pacientes con diagnóstico de cáncer de cuello uterino que recibieron BQT en el período comprendido de enero 2015 a diciembre 2018, en el servicio Radioterapia del Hospital Solón Espinosa Ayala, Quito-Ecuador. Las variables fueron la dosis recibida con planificaciones en 2D y 3D. Se obtuvo histogramas dosis volumen de los órganos de riesgo: recto y vejiga. Se comparan los promedios con T de Student. Resultados: Participaron 44 casos, de 50.6 ±13.8 años de edad. En estadío clínico IIB 24 casos (55 %). La dosis prescrita de BQT en el grupo fue de 683.6 ±27 cGY. El tipo de aplicador usado fue en la gran mayoría AyT de 5 mm en 34 casos (77 %). La mayoría de los tratamientos consistieron en terapias de 4 sesiones 32 casos (73 %), con 117 implantes para BQT. La dosis planificada en vejiga en 2D fue 5.5 Gy, versus 5.1 Gy en 3D, P= 0.01. La dosis planificada en recto en 2D fue 2.8 Gy; versus 3.0 Gy en 3D P= 0.06. Conclusión: La planificación en 3D reduce significativamente 0.4 Gy la dosis irradiada a vejiga. En el caso del recto la dosis la dosis no produce cambios estadísticos respecto a planificación en 2D.


Introduction: In the treatment of Uterine Cervical Cancer brachytherapy (BQT) with three-dimensional planning (3D) is highly widespread, although for its cost other centers use BQT with two-dimensional planning (2D). It is important to establish if the benefit obtained with BQT in 3 D, in the protection of risk organs, is a determining factor for the change towards this new technology. The aim of the study is to compare the doses in both types of BQT in the organs adjacent to the uterus such as the colon and bladder. Methods: The present descriptive study includes patients diagnosed with cervical cancer who received BQT in the period from January 2015 to December 2018, in the Radiotherapy service of the Hospital Solón Espinosa Ayala, Quito-Ecuador. The variables were the dose received with 2D and 3D plans. Histograms were obtained volume volume of the organs at risk: rectum and bladder. The averages are compared with Student's T. Results: There were 44 cases, of 50.6 ± 13.8 years of age. In clinical stage IIB 24 cases (55%). The prescribed dose of BQT in the group was 683.6 ± 27 cGY. The type of applicator used was in the great majority AyT of 5 mm in 34 cases (77%). The majority of treatments consisted of therapies of 4 sessions 32 cases (73%), with 117 implants for BQT. The planned dose in 2D bladder was 5.5 Gy, versus 5.1 Gy in 3D, P = 0.01. The planned dose in rectum in 2D was 2.8 Gy; versus 3.0 Gy in 3D P = 0.06). Conclusion: 3D planning significantly reduces 0.4 Gy the dose irradiated to the bladder. In the case of the rectum, the dose does not produce statistical changes with respect to 2D planning.


Subject(s)
Humans , Brachytherapy , Uterine Cervical Neoplasms , Cervix Uteri , Radiotherapy , Radiotherapy Planning, Computer-Assisted , Colon
10.
Int. braz. j. urol ; 45(2): 273-287, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002208

ABSTRACT

ABSTRACT Introduction: Several recent randomized clinical trials have evaluated hypofractionated regimens against conventionally fractionated EBRT and shown similar effectiveness with conflicting toxicity results. The current view regarding hypofractionation compared to conventional EBRT among North American genitourinary experts for management of prostate cancer has not been investigated. Materials and Methods: A survey was distributed to 88 practicing North American GU physicians serving on decision - making committees of cooperative group research organizations. Questions pertained to opinions regarding the default EBRT dose and fractionation for a hypothetical example of a favorable intermediate - risk prostate cancer (Gleason 3 + 4). Treatment recommendations were correlated with practice patterns using Fisher's exact test. Results: Forty - two respondents (48%) completed the survey. We excluded from analysis two respondents who selected radical hypofractionation with 5 - 12 fractions as a preferred treatment modality. Among the 40 analyzed respondents, 23 (57.5%) recommend conventional fractionation and 17 (42.5%) recommended moderate hypofractionation. No demographic factors were found to be associated with preference for a fractionation regimen. Support for brachytherapy as a first choice treatment modality for low - risk prostate cancer was borderline significantly associated with support for moderate hypofractionated EBRT treatment modality (p = 0.089). Conclusions: There is an almost equal split among North American GU expert radiation oncologists regarding the appropriateness to consider moderately hypofractionated EBRT as a new standard of care in management of patients with prostate cancer. Physicians who embrace brachytherapy may be more inclined to support moderate hypofractionated regimen for EBRT. It is unclear whether reports with longer follow-ups will impact this balance, or whether national care and reimbursement policies will drive the clinical decisions. In the day and age of patient - centered care delivery, patients should receive an objective recommendation based on available clinical evidence. The stark division among GU experts may influence the design of future clinical trials utilizing EBRT for patients with prostate cancer.


Subject(s)
Humans , Male , Prostatic Neoplasms/radiotherapy , Brachytherapy/methods , Radiation Oncology/standards , Radiation Dose Hypofractionation/standards , Prostatic Neoplasms/pathology , United States , Brachytherapy/standards , Randomized Controlled Trials as Topic , Risk Factors , Radiation Oncology/methods , Neoplasm Grading
11.
Int. braz. j. urol ; 45(2): 288-298, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002196

ABSTRACT

ABSTRACT Objectives: Brachytherapy (BT) with iodine-125 seeds placement is a consolidated treatment for prostate cancer. The objective of this study was to assess the clinical outcomes in patients with prostate cancer who underwent low-dose-rate (LDR) -BT alone in a single Brazilian institution. Materials and Methods: Patients treated with iodine-125 BT were retrospectively assessed after at least 5 years of follow-up. Patients who received combination therapy (External beam radiation therapy-EBRT and BT) and salvage BT were not included. Results: 406 men were included in the study (65.5% low-risk, 30% intermediate-risk, and 4.5% high-risk patients). After a median follow-up of 87.5 months, 61 (15.0%) patients developed biochemical recurrence. The actuarial biochemical failure-free survival (BFFS) at 5 and 10 years were 90.6% and 82.2%, respectively. A PSA nadir ≥ 1 ng / mL was associated with a higher risk of biochemical failure (HR = 5.81; 95% CI: 3.39 to 9.94; p ≤ 0.001). The actuarial metastasis-free survival (MFS) at 5 and 10 years were 98.3% and 94%, respectively. The actuarial overall survival (OS) at 5 and 10 years were 96.2% and 85.1%, respectively. Acute and late grade 2 and 3 gastrointestinal toxicities were observed in 5.6%, 0.5%, 4.6% and 0.5% of cases, respectively. For genitourinary the observed acute and late grade 2 and 3 toxicities rates were 57.3%, 3.6%, 28% and 3.1%, respectively. No grade 4 and 5 were observed. Conclusions: BT was effective as a definitive treatment modality for prostate cancer, and its endpoints and toxicities were comparable to those of the main series in the literature.


Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/radiotherapy , Brachytherapy/methods , Iodine Radioisotopes/therapeutic use , Prostatic Neoplasms/mortality , Prostatic Neoplasms/pathology , Brachytherapy/mortality , Brazil/epidemiology , Survival Rate , Retrospective Studies , Follow-Up Studies , Prostate-Specific Antigen , Disease-Free Survival , Middle Aged , Neoplasm Staging
12.
Article in English | WPRIM | ID: wpr-719247

ABSTRACT

OBJECTIVE: To investigate the efficacy of image-guided radioactive 125I seed (IGRIS) implantation for pelvic recurrent cervical cancer (PRCC) after external beam radiotherapy (EBRT), and analyze the influence of clinical and dosimetric factors on efficacy. METHODS: From July 2005 to October 2015, 36 patients with PRCC received IGRIS. We evaluated local progression-free survival (LPFS) and overall survival (OS). RESULTS: The median follow up was 11.5 months. The 1- and 2-year LPFS rate was 34.9% and 20%, respectively. The multivariate analysis indicated recurrence site (central or pelvic wall) (hazard ratio [HR]=0.294; 95% confidence interval [CI]=0.121–0.718), lesion volume (HR=2.898; 95% CI=1.139–7.372), D 90 (HR=0.332; 95% CI=0.130–0.850) were the independent factors affecting LPFS. The 1- and 2-year OS rate was 52.0% and 19.6%, respectively. The multivariate analysis suggested pathological type (HR=9.713; 95% CI=2.136–44.176) and recurrence site (HR=0.358; 95% CI=0.136–0.940) were the independent factors affecting OS. The dosimetric parameters of 33 patients mainly included D 90 (128.5±47.4 Gy), D 100 (50.4±23.7 Gy) and V 100 (86.7%±12.9%). When D 90 ≥105 Gy or D 100 ≥55 Gy or V 100 ≥91%, LPFS was extended significantly, but no significant difference for OS. The 79.2% of 24 patients with local pain were suffering from pain downgraded after radioactive 125I seed implantation. CONCLUSION: IGRIS implantation could be a safe and effective salvage treatment for PRCC after EBRT, which could markedly release the pain. Recurrence site, tumor volume and dose were the main factors affected efficacy. Compared with central recurrence, it was more suitable for patients with pelvic wall recurrent cervical cancer after EBRT.


Subject(s)
Brachytherapy , Disease-Free Survival , Follow-Up Studies , Humans , Multivariate Analysis , Radiometry , Radiotherapy , Radiotherapy, Image-Guided , Recurrence , Salvage Therapy , Tumor Burden , Uterine Cervical Neoplasms
13.
Article in English | WPRIM | ID: wpr-785311

ABSTRACT

BACKGROUND: This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT).METHODS: A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed.RESULTS: The median follow-up period was 83 months (range, 3–201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the in-field para-aortic LN (PALN) failure rate (p=0.024). The pelvic and PALN size (≥10 mm) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ≥10 mm).CONCLUSION: A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.


Subject(s)
Brachytherapy , Chemoradiotherapy , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Hand , Humans , Lymph Nodes , Magnetic Resonance Imaging , Multivariate Analysis , Prognosis , Retrospective Studies , Uterine Cervical Neoplasms
14.
Article in English | WPRIM | ID: wpr-764530

ABSTRACT

OBJECTIVE: According to recent European Society of Medical Oncology, European Society of Gynaecological Oncology and European Society of Radiotherapy and Oncology guidelines, adjuvant vaginal brachytherapy (VB) is optional in patients with intermediate risk (IR) and high-intermediate risk (HIR) endometrial cancer (EC). The aim of this French retrospective, multicenter study was to assess the impact of VB in these groups on local recurrence rate, local recurrence-free survival (RFS) and overall survival (OS). METHODS: Data of 191 patients with IR and HIR EC who underwent primary surgery with or without VB and no other adjuvant treatment between 2000 and 2016 were extracted from the FRANCOGYN database. Rate of local recurrence, OS and local RFS in these two groups were compared using the Kaplan-Meier method. RESULTS: The number of patients with IR and HIR EC were 118 and 73 respectively. VB was used in 92 patients in IR group and 43 in HIR group. Median follow-up was 22 months. In the HIR group, the local recurrence rate was significantly higher in the no adjuvant therapy group in comparison with the VB group (16.7% and 0% respectively, p=0.02). There was also a significant improvement in local RFS (p=0.01) in VB group. In IR EC, there is no significant difference on local recurrence rate (4.2% and 3.2%, respectively, p=1.00) or local RFS (p=0.54) between the two groups. CONCLUSIONS: VB is an efficient adjuvant treatment for patients with HIR EC. VB is not associated with an improvement of RFS or OS in IR EC patient.


Subject(s)
Brachytherapy , Endometrial Neoplasms , Female , Follow-Up Studies , Humans , Medical Oncology , Methods , Neoplasm Recurrence, Local , Radiotherapy , Recurrence , Retrospective Studies
15.
Article in English | WPRIM | ID: wpr-764521

ABSTRACT

OBJECTIVE: To report hysteroscopic treatment combined with levonorgestrel-releasing intrauterine device (LNG-IUD) to treat women with early well differentiated endometrial cancer (EC) at high surgical risk. METHODS: Nine women diagnosed with stage IA, grade 1 endometrioid EC which was contraindicated or refused standard treatment with external beam radiation therapy with or without brachytherapy were enrolled in our prospective study. Endo-myometrial hysteroscopic resection of the whole uterine cavity and the placement of LNG-IUD for 5 years was performed. Response rate, perioperative complications, and recurrence of disease were evaluated. RESULTS: None had intra or post-operative complications and all were discharged no later than the third day of hospitalization. After 6 months from surgery, all the women showed a complete regression of the lesion. All the women completed the 5 years follow-up and in no case was detected sign of recurrence. Two women died for causes unrelated to the tumor or the ongoing therapy. CONCLUSION: The alternative treatment with endo-myometrial hysteroscopic resection and LNG-IUD in women with stage IA, grade 1 endometrioid EC showed initial encouraging outcomes in terms of effectiveness and safety.


Subject(s)
Brachytherapy , Endometrial Neoplasms , Female , Follow-Up Studies , Hospitalization , Humans , Hysteroscopy , Intrauterine Devices , Obesity , Pilot Projects , Prospective Studies , Recurrence
16.
São Paulo; s.n; 2019. 38 p. ilust, tabelas.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1179701

ABSTRACT

O melanoma de coroide é o tumor intraocular primário mais comum em adultos. Por possibilitar a conservação do globo ocular, a braquiterapia tem sido uma opção terapêutica nestes casos. Atualmente, o método de imagem mais utilizado para avaliação deste tumor é a ultrassonografia ocular, auxiliando na estimativa do tamanho e localização da lesão para controle e planejamento do tratamento. No entanto, a redução nas dimensões do tumor só é observada tardiamente após o tratamento. O objetivo deste trabalho é avaliar o papel da ressonância magnética (RM) com difusão na avaliação de pacientes com melanoma de coroide, no momento do diagnóstico e na avaliação de resposta terapêutica após braquiterapia. Foi realizado um estudo prospectivo, unicêntrico, aprovado pelo Comitê de Ética em Pesquisa, que incluiu pacientes com melanoma de coroide e indicação para braquiterapia. Foram propostos três exames de RM para cada paciente, sendo um antes e dois após o tratamento. Foi realizado cálculo do valor do coeficiente de difusão aparente (ADC) nos exames de RM e comparado com o controle tumoral local avaliado pelo acompanhamento oftalmológico (mapeamento de retina e ultrassonografia ocular). No período de 07/2018 a 06/2019, 19 pacientes foram incluídos, dos quais 13 realizaram exames de acompanhamento. A idade variou de 24 a 78 anos e 52,9% eram do sexo masculino. Na ultrassonografia ocular, a espessura e diâmetro médio dos tumores foi de 6,3 mm e 11,5 mm, respectivamente. Na RM inicial, a maioria dos tumores apresentava sinal alto ou intermediário em T1 (82,3%) e baixo em T2 (70,6%). Dois pacientes (15,4%) apresentaram sinais de progressão do tumor durante o acompanhamento e foi observada redução significativa nos valores de ADC médio entre a RM antes e após o tratamento nestes casos (p=0,02). Em conclusão, a RM com difusão demonstrou ser útil na avaliação de pacientes com melanoma de coroide e os valores de ADC médio podem ser utilizados para avaliação de resposta, permitindo identificar precocemente os pacientes com risco de progressão após a braquiterapia


Choroidal melanoma is the most common primary intraocular tumor in adults. Brachytherapy has been a therapeutic option in these cases because it allows the conservation of the eyeball. Currently, the most used imaging method for the evaluation of this tumor is ocular ultrasonography, helping to estimate the size and location of the lesion for treatment planning and follow-up. However, the reduction in tumor size is only observed late after treatment. The aim of this study is to evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of patients with choroidal melanoma at the time of diagnosis and in the evaluation of therapeutic response after brachytherapy. A prospective, unicentric study approved by the Research Ethics Committee, which included patients with choroidal melanoma and indication for brachytherapy, was performed. Three DW-MRI examinations were proposed for each patient, one before and two after treatment. The apparent diffusion coefficient (ADC) value was calculated on DW-MRI and compared with local tumor control assessed by ophthalmologic follow-up (retinal mapping and ocular ultrasound). From 07/2018 to 06/2019, 19 patients were included, of which 13 underwent follow-up examinations. Patients' age ranged from 24 to 78 years and 52.9% were male. At ocular ultrasound, the mean tumor thickness and diameter were 6.3 mm and 11.5 mm, respectively. At initial MRI, most tumors presented high or intermediate signal at T1 (82.3%) and low signal at T2 (70.6%). Two patients (15.4%) showed signs of tumor progression during follow-up and a significant reduction in mean ADC values was observed between MR before and after treatment in these cases (p = 0.02). In conclusion, DW-MRI has shown to be useful in assessing patients with choroidal melanoma and mean ADC values can be used for response assessment, allowing early identification of patients at risk for progression after brachytherapy


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Brachytherapy , Diffusion Magnetic Resonance Imaging , Eye Neoplasms , Response Evaluation Criteria in Solid Tumors , Melanoma
18.
Arq. bras. oftalmol ; 81(4): 330-335, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-950476

ABSTRACT

ABSTRACT Purpose: To evaluate the incidence, potential correlation with transcleral fine needle aspiration biopsy, and treatment of scleral necrosis in patients with posterior uveal melanomas treated by 125I plaque radiotherapy and assessed by transcleral fine needle aspiration biopsy. Methods: We per­formed a retrospective review of posterior uveal melanoma treated by 125I plaque radiotherapy at a single academic institution between July 2006 and July 2013. Consecutive patients diagnosed with a posterior uveal melanoma during the study period that had an anterior margin at or anterior to the equator who were evaluated by transcleral fine needle aspiration biopsy prior to 125I plaque radiotherapy were included. The main outcome measure was development of scleral necrosis, and the secondary outcome was treatment of this complication. Statistical analysis included computation of conventional descriptive statistics, cross-tabulation and chi-square tests of potential factors related to the development of scleral necrosis, and summarizing of treatment approaches and results. The incidence of treatment of scleral necrosis was calculated using the Kaplan-Meier method. Results: During the 7-year study period, 87 posterior uveal melanomas were evaluated by transcleral fine needle aspiration biopsy and treated by 125I plaque radiotherapy. The median largest basal diameter of the tumor was 13.3 mm, and the median thickness was 6.8 mm. Eight patients (9.2%) developed scleral necrosis during follow-up. Thicker tumors (> 6.5 mm) were more likely to develop scleral necrosis (n=7) than thinner tumors (p=0.05). The median interval between 125I plaque radiotherapy and detection of scleral necrosis was 19.1 months. The overall cumulative probability of scleral necrosis was 6.2% at 6 months and 14.3% at 24 months, subsequently remaining stable. For thicker tumors, the probability of scleral necrosis was 23.5% at 45.4 months. Five patients were treated by scleral patch graft (62.5%) and three by observation (37.5%). One patient underwent enucleation after two failed scleral patch attempts and recurrent scleral necrosis. The mean follow-up period for patients with scleral necrosis was 34.5 months. Conclusions: Thicker posterior uveal melanomas are more likely to develop scleral necrosis after 125I plaque radiotherapy and transcleral fine needle aspiration biopsy. While observation is sufficient for managing limited scleral necrosis, scleral patch graft is a viable alternative for eye preservation in extensive scleral necrosis.


RESUMO Objetivo: Avaliar incidência, possível correlação da biópsia aspirativa com agulha fina trans-escleral e manejo da necrose escleral em pacientes com melanoma da úvea posterior tratados com placa de Iodo-125 (PLACA) avaliados pela biópsia aspirativa com agulha fina trans-escleral. Métodos: Revisão retrospectiva de melanoma da úvea posterior tratados com placa de Iodo-125 entre 07/2006 e 07/2013 em uma única instituição acadêmica. Pacientes diagnosticados consecutivamente com melanoma da úvea posterior durante o intervalo desse estudo cuja margem anterior está no equador ou anterior ao mesmo e foram avaliados pela biópsia aspirativa com agulha fina trans-escleral antes do tratamento com PLACA foram incluídos. O principal desfecho avaliado foi desenvolvimento de necrose escleral e o desfecho secundário foi o manejo dessa complicação. Análise estatística incluiu computação de variáveis descritivas convencionais; tabulação e teste do Chi-quadrado de fatores potencialmente relacionados com o desenvolvimento de necrose escleral e sumarização do manejo dessa complicação. A incidência de necrose escleral foi calculada usando o método de Kaplan-Meier. Resultados: Durante o período de 7 anos desse estudo, 87 melanomas da úvea posterior foram avaliados pela biópsia aspirativa com agulha fina trans-escleral e tratados com placa. A mediana do maior diâmetro basal tumoral foi 13,3 mm e a mediana da espessura foi 6,8 mm. Oito pacientes (9,2%) desenvolveram necrose escleral durante o período de acompanhamento. Tumores mais espessos (> 6,5 mm) foram mais propensos a desenvolver necrose escleral (n=7) que tumores mais finos (p=0,05). O intervalo mediano entre PLACA e a detecção da necrose escleral foi 19,1 meses. Probabilidade cumulativa de desenvolvimento de necrose escleral foi 6,2% em 6 meses e 14,3% em 24 meses permanecendo estável subsequentemente. Em tumores espessos, a probabilidade de necrose escleral foi 23,5% em 45,4 meses. Cinco pacientes foram manejados com enxerto escleral (62,5%), 3 foram observados (37,5%). Um paciente foi enucleado após 2 enxertos esclerais com necrose escleral recidivada. Tempo de seguimento médio dos pacientes com necrose escleral foi 34,5 meses. Conclusões: Tumores espessos pareceram mais propensos a desenvolver necrose escleral após PLACA e biópsia aspirativa com agulha fina trans-escleral para melanoma da úvea posterior. Apesar de observação para necrose escleral limitada ser suficiente, enxerto de esclera é uma alternativa viável para preservação ocular em necrose escleral extensa.


Subject(s)
Humans , Male , Adult , Middle Aged , Sclera/pathology , Uveal Neoplasms/radiotherapy , Iodine Radioisotopes/therapeutic use , Melanoma/radiotherapy , Uveal Neoplasms/pathology , Brachytherapy/methods , Retrospective Studies , Follow-Up Studies , Biopsy, Fine-Needle , Melanoma/pathology , Necrosis
19.
Rev. pesqui. cuid. fundam. (Online) ; 10(3): 612-618, jul.-set. 2018.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-906167

ABSTRACT

Objetivo: Identificar a percepção da dor para mulheres em braquiterapia ginecológica na consulta de enfermagem. Método: Estudo qualitativo, realizado entre fevereiro a novembro de 2012, apoiado na abordagem da Fenomenologia Sociológica Compreensiva de Alfred Schutz. Treze mulheres participaram, maiores de dezoito anos, submetidas à braquiterapia ginecológica de dois serviços de radioterapia localizados no Rio de Janeiro e outro em São Paulo. Resultados: Uma característica que sobressaiu a partir dos depoimentos se referiu à dor na braquiterapia ginecológica, em que as mulheres revelaram o anseio por superá-la. Conclusão: Tal anseio independe da idade e do grau de instrução, é comum a todas e oriundo do vivido com o câncer. O que modifica é a maneira como se apresenta e a sua intensidade, que variam conforme a singularidade de cada sujeito


Objetivo: Identificar la percepción del dolor para las mujeres en braquiterapia ginecológica en la consulta de enfermería. Método: Estudio cualitativo, realizado de febrero a noviembre de 2012, a favor del enfoque de la fenomenología sociológica Integral de Alfred Schutz. Los participantes fueron trece las mujeres mayores de dieciocho años sometidos a la braquiterapia ginecológica dos servicios de radioterapia ubicadas en Río de Janeiro y otro en Sao Paulo. Resultados: Una característica que se destacó de los estados mencionados dolor en la braquiterapia ginecológica, en el que las mujeres revelan el deseo de superación. Conclusión: Este deseo es independiente de la edad y nivel de educación, es común a todos y procedentes de los vivos con el cáncer. Lo que cambia es la forma en que se presenta y su intensidad, que varían de acuerdo a la singularidad de cada sujeto


Objective: The study's goal has been to identify the perception of pain for women in gynecological brachytherapy in nursing consultation. Methods: It a qualitative study, carried out from February to November 2012, supported in the approach of the Sociological Phenomenology Comprehensive Alfred Schutz. Participants were thirteen women over eighteen years submitted to gynecological brachytherapy two radiotherapy services located in Rio de Janeiro and another in Sao Paulo. Results: One characteristic that emerged from the statements referred to pain in gynecological brachytherapy, in which women revealed the desire to overcoming it. Conclusion: This desire is independent of age and level of education; it is common to all and coming from the living with cancer. What changes is the way it is presented and its intensity, which vary according to the uniqueness of each subject


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Brachytherapy/psychology , Pain/nursing , Pain/radiotherapy , Brachytherapy/adverse effects , Nursing Care , Pain/psychology
20.
Appl. cancer res ; 38: 1-5, jan. 30, 2018.
Article in English | LILACS, Inca | ID: biblio-988298

ABSTRACT

Brachytherapy as a form of treatment for gynecological tumors has been used for a long time in Brazil (since 1991) and can be considered as a form of radiotherapy treatment. High Dose Rate (HDR) brachytherapy aims at delivering high dose rates of radiation in restricted volumes of the body, thereby increasing disease control and lower treatment toxicity for adjacent normal tissues. Cervical cancer (CC) is a disease that still affects women in developing countries and, despite being detected by laboratory and imaging tests, in many developing countries these techniques are not yet accessible to all that are affected by cervical cancer. HDR presents important results when isolated or in association with other treatment techniques. Numerous studies have shown that HDR for gynecological cancer presents results that can reach up to 85% cure, and with this it is concluded that there are few complications during or after treatment, since adjacent tissues are preserved, making HDR a safe procedure for patients and professionals.


Subject(s)
Humans , Female , Radiotherapy , Brachytherapy , Review Literature as Topic , Uterine Cervical Neoplasms , Endometrial Neoplasms , Genital Neoplasms, Female
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