Gynecological brachytherapy for postoperative endometrial cancer: dosimetric analysis (Ir-192 vs Co-60).

INTRODUCTION: Endovaginal brachytherapy treatment dosimetry differences were studied using Ir-192 or Co-60 sources for postoperative endometrial cancer. MATERIALS AND METHODS: A prospective descriptive study was conducted. Thirty-six dosimetry plans of different patients were studied (15 by Ir-192 and 21 by Co-60). Variables studied included D2cc Rectum, D2cc Bladder, D2cc Sigmoid, dose percentage at point 0 (applicator surface on the top of the cylinder) and dose percentage at point 1 (5 mm deep on the top of the cylinder). A comparative analysis was performed of the values obtained from each variable between Ir-192 and Co-60 treatments. We compared average of each variables between Iridium and Cobalt by T Student for independent samples (SPSS 22). RESULTS: There were no significant differences on using Ir-192 or Co-60 by variables, except for dose percentage at point 1 in which we detected significant differences (Table 1). Table 1 The results Variables Sources Iridium 192 Cobalt 60 D2cc Rectum (mean dose) [rank] 6.01 Gy [3.99-7.90] 5.28 Gy [3.87-6,34] D2cc Bladder (mean dose) [rank] 5.82 Gy [4.20-8.38] 5.05 Gy [2.23-6.95] D2cc Sigmoid (mean dose) [rank] 4.43 Gy [1.66-6.67] 2.33 Gy [0.60-4.28] Dose percentage at point 0a (mean) [rank] 210.74% [120.90-234.90] 204.75% [177.10-223] Dose percentage at point 1b (mean) [rank] 93.49% [87.30-100.60] 100.11% [96.70-102] aPoint 0: point to the applicator surface bPoint 1: point to 5 mm applicator surface DISCUSSION: Brachytherapy treatment dosimetry plans are similar using Ir-192 or Co-60, except dose percentage at point 1. In the scientific literature, some differences exist and there are some advantages in using cobalt.

Evaluation of toxicity of surgery and/or chemoirradiation treatment of uterine cervix cancer.

OBJECTIVE: To evaluate acute and chronic toxicity of chemoirradiation treatment (neoadjuvant, adjuvant and radical treatment) in patients diagnosed with cervix cancer. METHODS: From December 1999 to August 2007, 53 patients diagnosed with adenocarcinoma or squamous cell carcinoma of the uterine cervix received neoadjuvant, adjuvant or radical chemoirradiation. RESULTS: Acute gastrointestinal toxicity of grade 3 or more in 9 patients (17%) and haematological toxicity of grade 3 or more in 9 patients (17%). Chronic toxicity of grade 3 or more was shown in only 2 patients (4%). The most frequent toxicities were gastrointestinal toxicity and haematological toxicity. The most frequent chronic toxicities were gastrointestinal toxicity and vaginal toxicity. CONCLUSIONS: We report that the combined neoadjuvant, adjuvant or radical chemoirradiation treatment with weekly cisplatin chemotherapy (40 mg/m(2)/week) in patients diagnosed with cervix cancer is a well tolerated treatment and chronic and acute toxicity is low-grade. This treatment scheme has easy compliance.

Re-irradiation to prevent ectopic bone formation after major hip surgery.

Ectopic bone formation may occur after total hip arthroplasty, but fortunately most patients are asymptomatic. Both pre-operative and post-operative radiotherapy are effective in prevention of ectopic bone formation. In the few patients who needed re-operation, we found that re-irradiation is possible and safe. This case report presents our experience with single dose reirradiation of the hip in an attempt to prevent post-operative ectopic bone formation.