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1.
Radiat Oncol ; 16(1): 131, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34266462

RESUMO

BACKGROUND: Symptomatic radiation pneumonitis (RP) may be a serious complication after thoracic radiation therapy (RT) for non-small cell lung cancer (NSCLC). This prospective observational study sought to evaluate the utility of a novel radiation-induced lung injury (RILI) grading scale (RGS) for the prediction of RP. MATERIALS AND METHODS: Data of 41 patients with NSCLC treated with thoracic RT of 60-66 Gy were analysed. CT scans were scheduled before RT, one month post-RT, and every three months thereafter for one year. Symptomatic RP was defined as Common Terminology Criteria for Adverse Events grade ≥ 2. RGS grading ranged from 0 to 3. The inter-observer variability of the RGS was assessed by four senior radiologists. CT scans performed 28 ± 10 days after RT were used to analyse the predictive value of the RGS. The change in the RGS severity was correlated to dosimetric parameters. RESULTS: The CT obtained one month post-RT showed RILI in 36 (88%) of patients (RGS grade 0 [5 patients], 1 [25 patients], 2 [6 patients], and 3 [5 patients]). The inter-observer agreement of the RGS grading was high (Kendall's W coefficient of concordance = 0.80, p < 0.01). Patients with RGS grades 2-3 had a significantly higher risk for development of RP (relative risk (RR): 2.4, 95% CI 1.6-3.7, p < 0.01) and RP symptoms within 8 weeks after RT (RR: 4.8, 95% CI 1.3-17.6, p < 0.01) compared to RGS grades 0-1. The specificity and sensitivity of the RGS grades 2-3 in predicting symptomatic RP was 100% (95% CI 80.5-100%) and 45.4% (95% CI 24.4-67.8%), respectively. Increase in RGS severity correlated to mean lung dose and the percentage of the total lung volume receiving 5 Gy. CONCLUSIONS: The RGS is a simple radiologic tool associated with symptomatic RP. A validation study is warranted.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/radioterapia , Processamento de Imagem Assistida por Computador/métodos , Lesão Pulmonar/patologia , Neoplasias Pulmonares/radioterapia , Órgãos em Risco/efeitos da radiação , Pneumonite por Radiação/patologia , Radioterapia de Intensidade Modulada/efeitos adversos , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Lesão Pulmonar/etiologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Prognóstico , Estudos Prospectivos , Pneumonite por Radiação/etiologia , Radiometria/métodos , Dosagem Radioterapêutica
2.
Surg Radiol Anat ; 43(9): 1431-1435, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33903948

RESUMO

PURPOSE: Constipation is among the most common gastrointestinal disorders, although, there is no generally accepted objective diagnostic criteria thereof. It has been proposed that colorectal dimensions assessed with Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) may support the diagnosis, but normative data are lacking. The aim of this study was to describe colorectal dimensions in a sample of the general population and to investigate whether the dimensions were under influence by age and gender. METHODS: The maximum diameters and cross-sectional areas of the ascending colon, descending colon and rectum were determined from 119 CT scans of trauma patients (age groups from 15 to 70 years, 84 men and 35 women). A regression model was applied to explore the impact of age and gender on colorectal dimensions. RESULTS: Overall, great variations were found for all colorectal diameters and cross-sectional areas (median diameter (5% percentiles; 95% percentiles): ascending 46 (26; 63) mm; descending 29 (16; 48) mm; rectum 39 (22; 67) mm. Women had larger rectal cross-sectional areas, reflecting more rectal content, compared to men (p = 0.003). Age did not affect colorectal diameters or cross-sectional areas (all p > 0.10). CONCLUSION: Great variations of colorectal dimensions were found. Larger rectal cross-sectional areas in women could likely reflect the fact that women have increased prevalence of constipation. Future studies should take gender into consideration when evaluating colorectal dimensions.


Assuntos
Colo/anatomia & histologia , Reto/anatomia & histologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Fatores Etários , Idoso , Variação Anatômica , Colo/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reto/diagnóstico por imagem , Estudos Retrospectivos
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