RESUMO
Extramedullary haemopoiesis (EMH) is a complication commonly associated with beta-thalassaemia intermedia; it is frequently asymptomatic but can sometimes lead to symptomatic tumour-like masses. No guidelines or common consensus are available in literature regarding the different treatment strategies and only single cases have been reported. We describe a case of spinal cord compression due to intrathoracic EMH masses treated with combined radiotherapy and hydroxyurea.
Assuntos
Hematopoese Extramedular/efeitos da radiação , Paraparesia , Recuperação de Função Fisiológica , Compressão da Medula Espinal , Talassemia beta , Humanos , Paraparesia/etiologia , Paraparesia/fisiopatologia , Paraparesia/radioterapia , Prognóstico , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/fisiopatologia , Compressão da Medula Espinal/radioterapia , Talassemia beta/complicações , Talassemia beta/fisiopatologia , Talassemia beta/radioterapiaRESUMO
PURPOSE: Accurate patient setup is a prerequisite for conformal radiotherapy (3D-CRT) and is based on various methods, including surface imaging systems. To evaluate the validity of a surface imaging system (AlignRT), we analysed setup reproducibility of a cohort of patients. MATERIALS AND METHODS: Nineteen patients affected by prostate adenocarcinoma were enrolled in this study. We acquired 653 surface images and 99 digital portal images (DPI). Setup errors were found by matching surface images with computed tomography (CT) and DPI images. RESULTS: The setup errors from the threshold of 5 mm detected by AlignRT along the Y, Z and X axes occurred in 47.4%, 42.1% and 5.3% of patients, respectively. For the threshold of 3 mm, shifts along the Y, Z and X axes were observed in 68%, 69% and 10%, respectively. Comparing AlignRT and DPI, we found a statistically significant difference in the detection of shifts along the Y and Z axes. For a threshold ≥ 5 mm, the two systems provided corresponding setup errors along the Y and Z axes, whereas along the X axis, the threshold was not necessary. CONCLUSIONS: AlignRT is an accurate technique for setup in 3D-CRT prostate cancer patients, especially along the lateral direction.