ABSTRACT
PurposeRENORT is an application (app) developed to assess the role of radiotherapy in the treatment of cancer using the oncology information systems (OIS).Methods/PatientsThe RENORT app was used to analyze the data for all patients seen and/or treated at six radiation oncology departments in Spain in 2019. This app can be used to extract the demographic data, treatment sequence, disease status, and radiotherapy treatments from the ARIA and Mosaiq OIS.ResultsA total of 6564 treatments were performed at these six centers in 2019. Most patients (56.9%) were males (females 43.1%). The mean patient age was 64.9 years. The most common treatment types and sites were as follows: metastases/palliative care (25.9%), followed by breast (19.0%), genitourinary (13.7%), lung (10.1%), head and neck (6.0%), rectal (6.0%), gynecological (4.9%), and other (< 4%) cancers. Distribution by disease stage was as follows: breast cancer: 75.5% early stage (stages 0, I, and II); lung: 63.1% advanced stage (III and IV); and head and neck: 72.1% advanced. Treatment intent was curative in 76.5% of cases and palliative in 23.5%. The most common techniques were intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) (41.4%), followed by three-dimensional conformal radiation therapy (3D-CRT) (39.2%); stereotactic body radiotherapy (SBRT) (8.1%); brachytherapy (5.5%); radiosurgery (2.1%); fractionated stereotactic radiotherapy to the brain (1.4%); and intraoperative radiotherapy (1.4%). Hypofractionation was used in 62.3% of curative treatments (mean number of fractions = 16.5).ConclusionsRENORT is a free app that is available for the two main oncology information systems used in most radiation oncology departments. This app has demonstrated the capacity to extract data from these systems, which in turns allows for a comprehensive analysis and better understanding of the role of radiotherapy in the treatment of cancer.
Subject(s)
Humans , Breast Neoplasms , Radiation Oncology , Radiosurgery/methods , Radiotherapy, Computer-Assisted/methods , SpainABSTRACT
PURPOSE: RENORT is an application (app) developed to assess the role of radiotherapy in the treatment of cancer using the oncology information systems (OIS). METHODS/PATIENTS: The RENORT app was used to analyze the data for all patients seen and/or treated at six radiation oncology departments in Spain in 2019. This app can be used to extract the demographic data, treatment sequence, disease status, and radiotherapy treatments from the ARIA and Mosaiq OIS. RESULTS: A total of 6564 treatments were performed at these six centers in 2019. Most patients (56.9%) were males (females 43.1%). The mean patient age was 64.9 years. The most common treatment types and sites were as follows: metastases/palliative care (25.9%), followed by breast (19.0%), genitourinary (13.7%), lung (10.1%), head and neck (6.0%), rectal (6.0%), gynecological (4.9%), and other (< 4%) cancers. Distribution by disease stage was as follows: breast cancer: 75.5% early stage (stages 0, I, and II); lung: 63.1% advanced stage (III and IV); and head and neck: 72.1% advanced. Treatment intent was curative in 76.5% of cases and palliative in 23.5%. The most common techniques were intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) (41.4%), followed by three-dimensional conformal radiation therapy (3D-CRT) (39.2%); stereotactic body radiotherapy (SBRT) (8.1%); brachytherapy (5.5%); radiosurgery (2.1%); fractionated stereotactic radiotherapy to the brain (1.4%); and intraoperative radiotherapy (1.4%). Hypofractionation was used in 62.3% of curative treatments (mean number of fractions = 16.5). CONCLUSIONS: RENORT is a free app that is available for the two main oncology information systems used in most radiation oncology departments. This app has demonstrated the capacity to extract data from these systems, which in turns allows for a comprehensive analysis and better understanding of the role of radiotherapy in the treatment of cancer.
Subject(s)
Breast Neoplasms , Radiation Oncology , Radiosurgery , Radiotherapy, Conformal , Radiotherapy, Intensity-Modulated , Aged , Female , Humans , Male , Middle Aged , Radiosurgery/methods , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy, Conformal/methods , Radiotherapy, Intensity-Modulated/methods , SpainABSTRACT
Radionecrosis with brain edema is a complication of radiosurgery. Three female patients harbouring a frontal pole, petrous and parasagital parietoocipital meningiomas respectively who had been treated with LINAC radiosurgery are presented. Those patients developed, between two and eight months later, a severe symptomatic radionecrosis with a huge brain edema resistant to the usual steroid therapy. Only after 40 sessions of hyperbaric oxygen, a good remission of the lesions was obtained. There are few cases reported in the literature with such a good outcome. Consequentely, this therapy must be taken into account to treat this type of radiosurgical complication before considering surgery.
Subject(s)
Brain Edema/therapy , Brain Injuries/therapy , Hyperbaric Oxygenation , Radiation Injuries/therapy , Radiosurgery/adverse effects , Aged , Brain Damage, Chronic/etiology , Brain Damage, Chronic/prevention & control , Brain Edema/etiology , Brain Edema/pathology , Brain Injuries/etiology , Brain Injuries/pathology , Cerebellar Neoplasms/surgery , Cerebellopontine Angle/pathology , Cerebellopontine Angle/radiation effects , Endothelium, Vascular/pathology , Endothelium, Vascular/radiation effects , Female , Humans , Magnetic Resonance Imaging , Meningeal Neoplasms/surgery , Meningioma/surgery , Middle Aged , Necrosis , Parietal Lobe/pathology , Parietal Lobe/radiation effects , Radiation Injuries/etiology , Radiation Injuries/pathology , Treatment OutcomeABSTRACT
La radio necrosis y el edema cerebral son complicaciones asociadas a la radiocirugía. Presentamos los casos de tres pacientes tratadas con radiocirugía mediante acelerador lineal, de un meningioma de polo frontal izquierdo, peñasco y para sagital parietooccipital, respectivamente, que desarrollaron, entre dos y ocho meses más tarde, lesiones de tipo radio necrótico con extenso edema peritumoral que resultaron resistentes al tratamiento con esteroides y que se han resuelto con la administración de 40 sesiones de oxígeno hiperbárico. Son pocos los casos publicados hasta ahora en la literatura con tan excelentes resultados, por lo que consideramos un hecho a tener muy en cuenta ante las posibles complicaciones de este tipo que puedan presentarse en el transcurso de la práctica radioquirúrgica antes de recurrir a la cirugía (AU)
Radionecrosis with brain edema is a complication of radiosurgery. Three female patients harbouring a frontal pole, petrous and parasagital parietoocipital meningiomas respectively who had been treated with LINAC radiosurgery are presented. Those patients developed, between two and eight months later, a severe symptomatic radionecrosis with a huge brain edema resistant to the usual steroid therapy. Only after 40 sessions of hyperbaric oxygen, a good remission of the lesions was obtained. There are few cases reported in the literature with such a good outcome. Consequentely, this therapy must be taken into account to treat this type of radiosurgical complication before considering surgery (AU)
Subject(s)
Humans , Female , Middle Aged , Brain Edema/therapy , Brain Injuries, Traumatic/therapy , Hyperbaric Oxygenation , Radiation Injuries/therapy , Radiosurgery/adverse effects , Brain Damage, Chronic/etiology , Brain Damage, Chronic/prevention & control , Brain Edema/etiology , Brain Edema/pathology , Brain Injuries, Traumatic/etiology , Brain Injuries, Traumatic/pathology , Cerebellar Neoplasms/surgery , Cerebellopontine Angle/pathology , Endothelium, Vascular/pathology , Endothelium, Vascular/radiation effects , Magnetic Resonance Imaging , Meningeal Neoplasms/surgery , Meningioma/surgery , Necrosis , Parietal Lobe/pathology , Parietal Lobe/radiation effects , Radiation Injuries/etiology , Radiation Injuries/pathology , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Adolescent , Adult , Female , Male , Middle Aged , Humans , Repression-Sensitization , Radiotherapy/methods , Glioma/radiotherapy , Pyrimidines/therapeutic use , Drug Therapy, Combination , Radiation Tolerance/physiology , Radiation Tolerance , Brain Neoplasms/radiotherapy , Polymers/metabolism , Polymers/classification , Phosphorylation , Phosphorylation/radiation effects , Methylguanidine/therapeutic useABSTRACT
Aún no ha sido establecido si las pacientes con cáncer de mama con un tumor primario menor o igual a 5 cm y con 1 a 3 ganglios axilares afectos en el momento del diagnóstico se beneficiarían de radioterapia postmastectomía. La radioterapia moderna ha demostrado su utilidad en pacientes con alto riesgo de recidiva local tanto en términos de mejor control loco-regional como en aumento de la supervivencia. Pero en el grupo de pacientes con riesgo moderado (pT1-2 N1 y 1 a 3 ganglios positivos) los ensayos aleatorizados están aún en marcha y no se espera obtener las primeras conclusiones en al menos diez años. La decisión de tratamiento se debería basar en el conocimiento del comportamiento biológico del cáncer de mama y en la evidencia científica acumulada. Revisamos extensamente ambos aspectos y concluimos que los pacientes en esta categoría tienen un beneficio en el control loco-regional que podría traducirse en mejor supervivencia en algunos subgrupos (AU)
Subject(s)
Female , Humans , Mastectomy , Radiotherapy/methods , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Risk Factors , Disease-Free Survival , Prognosis , Risk Assessment , Evidence-Based Medicine , Cost-Benefit Analysis , Neoplasm Recurrence, Local/prevention & controlABSTRACT
In the near future molecular biology will permit selection of patients with bladder cancer who can benefit more from radiotherapy and chemotherapy. There will also be an increase in the response rate due to the possibility of regulating the genes responsible for cellular radiosensitivity.
