ABSTRACT
PURPOSE: Tracheobronchial foreign body aspiration is a common pediatric emergency and a leading cause of accidental deaths in children. The diagnosis remains sometimes difficult even with physical examination, medical history, and basic X-rays. This challenge necessitates the performance of endoscopy under general anesthesia, regardless of the potential for serious complications. The benefit of strategies like expiratory chest X-rays to reduce unnecessary endoscopies remains uncertain. We evaluated the effectiveness of expiratory chest X-rays in detecting airway foreign bodies to potentially reduce the need for endoscopies. METHODS: We retrospectively studied children with suspected foreign body aspiration who had X-ray and endoscopy. RESULTS: A total of 70 children were included in the study. Out of these, 19 cases (27.1 %) showed pathological findings on standard chest X-rays. However, when expiratory chest X-rays were added, the number of pathological radiographies increased to 37 cases (52.9 %). Out of the 36 foreign bodies that were present, only 2 were not detected. Furthermore, 3 chest X-rays displayed pathological results, while the endoscopies indicated normal findings. Consequently, the overall sensitivity, specificity, positive predictive value, and negative predictive value stood at 94.4 %, 91.1 %, 91.9 %, and 93.9 % respectively. CONCLUSION: The remarkable sensitivity of expiratory chest radiography can eliminate the need for unnecessary endoscopy, but it should be limited to centers lacking access to MDCT. The performance of endoscopy should only be considered when persistent clinical symptoms are observed during auscultation.
ABSTRACT
INTRODUCTION: Prostate cancer is the most common cancer in men. Thirty to forty-seven percent of patients treated with exclusive radiotherapy for prostate cancer will experience intraprostate recurrence. The use of radiotherapy in stereotactic conditions allows millimetric accuracy in irradiation to the target zone that minimizes the dose to organs at risk. In this study, we evaluated the clinical outcome of prostatic reirradiation with stereotactic body radiation therapy (SBRT) in patients with intraprostatic recurrence initially treated by radiotherapy. METHOD: This single-center retrospective study included 41 patients diagnosed with exclusive local recurrence of prostate cancer after radiotherapy and treatedby stereotactic Cyberknife irradiation. The objective of this study was to assess the efficacy and the safety of stereotactic reirradiation for patients with intraprostatic recurrence initially treated with radiotherapy. RESULTS: Median follow-up was 35 months. The 2-year biochemical relapse-free survival was 72.89%, the 2-year local recurrence free survival was 93.59%, the 2-year local regional recurrence-free survival was 85.24%, and the 2-year metastasis-free survival was to 91.49%. The analysis of toxicities showed a good tolerance of stereotactic irradiation. Urinary and gastro-intestinal adverse events was mostly of grades 1-2 (CTCAEv4). Grade 3 toxicity occurred in one to two patients. CONCLUSION: Stereotactic reirradiation appears effective and well-tolerated for local recurrence of prostate cancer and might allow to delay the introduction of hormonal therapy and its side effects.
