Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics?

ABSTRACT Objective: To build a model to evaluate the impact of salvage radiotherapy (SRT) in men with PSA rise or persistent PSA after undergoing radical prostatectomy (RP). Materials and Methods: The study included 107 node-negative patients treated with SRT after RP at a single institution. Patients received SRT for either prostate-specific antigen (PSA) rising, or PSA persistence after RP. All patients received local radiation to the prostate / seminal vesicle bed. The primary measured outcome was the biochemical recurrence (BCR) free survival. Multivariable Cox regression analysis was used to develop a risk-stratification group to identify predictive factors associated with the probability of BCR at 5yr. Results: At a median follow-up of 52 months, the BCR free survival rate and overall survival in 5 years was 73% and 94%, respectively. At multivariable analysis, pre-SRT PSA level > 0.35ng / mL (p = 0.023), negative margins (p = 0.038), and seminal vesicles invasion (p = 0.001) were significantly associated with BCR free survival. Three risk groups using regression analysis for SRT administration was built. Low-, intermediate- and the high-risk groups had a BCR free survival in 5-years of 96%, 84%, and 44% (p = 0.0001), respectively. Conclusions: We developed a risk group stratification to show the impact of SRT based on prostate cancer characteristics. SRT showed to be extremely beneficial for patients with low- and intermediate-risk tumors. Moreover, the risk-group built could identify patients classified as high-risk who might benefit from more aggressive treatment for SRT.

Comparação da Eficiência do Treinamento em Entubação Orotraqueal com Vídeo Educacional versus Checklist / Comparing the Efficiency of Training in Orotracheal Intubation with Educational Video Versus Checklist

RESUMO O artigo relata uma experiência de desenvolvimento, por estudantes de Medicina, de vídeos educacionais que visam aprimorar o aprendizado e fortalecer o embasamento teórico e prático da entubação orotraqueal. Objetivo O objetivo do estudo é avaliar a retenção do aprendizado dos alunos da graduação por meio do uso de vídeos no ensino de procedimentos médicos no curso de Medicina. Métodos Foram avaliados 30 alunos da graduação do curso de Medicina, randomizados em dois grupos de estudo, um com vídeo e outro com material teórico (checklist), para estudo individualizado do tema de entubação orotraqueal. Resultados Todos os alunos melhoraram o conhecimento teórico e prático do procedimento de entubação orotraqueal (p < 0,00). Não houve diferença entre a execução do procedimento entre os grupos (p = 1). Quanto ao conhecimento teórico, o grupo de estudo com vídeos apresentou melhor desempenho na avaliação teórica (p < 0,041). Conclusão As duas ferramentas pedagógicas forneceram ganho de conhecimento ao aluno, sendo que o conteúdo teórico do procedimento foi superior no grupo de estudo com vídeos, mas o preparo e a execução do procedimento foram semelhantes entre os grupos.

ABSTRACT The paper reports on an experience by medical students to develop educational videos which aim to improve learning and strengthen the theoretical and practical foundations of orotracheal intubation. Objective The objective of this study is to evaluate the learning retention of undergraduate medical students through the use of educational videos containing medical procedures. Methods 30 undergraduate medical students were randomized in two study groups, one received educational videos and other received theoretical material (checklist). A comparison was made to evaluate and compare their learning in relation to the orotracheal intubation procedure. Results All the students demonstrated improved practical and theoretical knowledge of the orotracheal intubation procedure. (p < 0.00), no difference was found in the procedure execution between the groups (p = 1) and, regarding theoretical knowledge, the study group that used videos presented superior performance in the evaluation (p < 0.041). Conclusion The two pedagogical tools both enhanced the students’ knowledge, where the group that used videos showed deeper theoretical knowledge of the procedure, but procedure execution was identical between groups.