Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
1.
Acta Otorrinolaringol Esp ; 63(5): 348-54, 2012.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22503508

RESUMO

INTRODUCTION AND OBJECTIVES: Squamous cell carcinomas of the oropharynx are aggressive tumours usually diagnosed at advanced stage. Their optimal treatment has not been established. The aim of this study was to compare the oncological and functional outcomes in patients with carcinomas of the oropharynx treated by radiotherapy (with chemotherapy in advanced stages) vs surgery (with radiotherapy in advanced stages). METHODS: A retrospective study on 50 patients with squamous cell cancer of the oropharynx treated by radiotherapy (with or without chemotherapy) at our institution between 1998 and 2008 was carried out. The oncological and functional results were compared with patients with same cancer location and stage treated by surgery (with or without radiotherapy). In both groups, the patients were classified as follows: 10% Stage I, 12% Stage II, 16% Stage III, 48% Stage IVa and 14% Stage IVb. RESULTS: The 5-year disease-specific survival was 33% in the radiotherapy group and 52% in the surgical group (P=.17). Five-year disease-specific survival for Stage I and II patients was 82% in the radiotherapy group and 70% in the surgical group. In Stage III and IV disease, 5-year disease-specific survival was higher in the surgical group (47% vs 17%). The functional results were similar; anatomical and functional preservation of the larynx was higher in the radiotherapy group but the successful return to oral food intake was higher in the surgical group. CONCLUSIONS: The prognosis of squamous cell carcinoma of the oropharynx is poor. Oncological results in Stages I and II were similar for radiotherapy and surgical treatments. In advanced stages, the prognosis was better in patients treated by surgery with or without radiotherapy. Functional results were similar in both treatment modalities.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Orofaríngeas/radioterapia , Neoplasias Orofaríngeas/cirurgia , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Antineoplásicos/uso terapêutico , Carboplatina/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Cetuximab , Quimioterapia Adjuvante , Cisplatino/uso terapêutico , Terapia Combinada , Intervalo Livre de Doença , Nutrição Enteral/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Neoplasias Laríngeas/tratamento farmacológico , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Recidiva Local de Neoplasia/epidemiologia , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/tratamento farmacológico , Neoplasias Orofaríngeas/patologia , Prognóstico , Qualidade de Vida , Estudos Retrospectivos , Fatores de Risco , Traqueotomia/estatística & dados numéricos , Resultado do Tratamento
2.
Int J Radiat Oncol Biol Phys ; 69(1): 95-102, 2007 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-17707267

RESUMO

PURPOSE: Rectal toxicity remains a serious complication affecting quality of life for prostate cancer patients treated with radiotherapy. We began an investigational trial injecting hyaluronic acid (HA) in the perirectal fat to increase the distance between the prostate and the anterior rectal wall. This is the first report using HA injection in oncology. METHODS AND MATERIALS: This is a trial of external beam radiation therapy with HDR brachytherapy boosts in prostate cancer. During the two high-dose-rate (HDR) fractions, thermoluminescent dosimeter dosimeters were placed in the urethra and in the rectum. Before the second HDR fraction, 3-7 mL (mean, 6 mL) of HA was injected under transrectal ultrasound guidance in the perirectal fat to systematically create a 1.5-cm space. Urethral and rectal HDR doses were calculated and measured. Computed tomography and magnetic resonance imaging were used to assess the stability of the new space. RESULTS: Twenty-seven patients enrolled in the study. No toxicity was produced from the HA or the injection. In follow-up computed tomography and magnetic resonance imaging, the HA injection did not migrate or change in mass/shape for close to 1 year. The mean distance between rectum and prostate was 2.0 cm along the entire length of the prostate. The median measured rectal dose, when normalized to the median urethral dose, demonstrated a decrease in dose from 47.1% to 39.2% (p < 0.001) with or without injection. For an HDR boost dose of 1150 cGy, the rectum mean Dmax reduction was from 708 cGy to 507 cGy, p < 0.001, and the rectum mean Dmean drop was from 608 to 442 cGy, p < 0.001 post-HA injection. CONCLUSION: The new 2-cm distance derived from the HA injection significantly decreased rectal dose in HDR brachytherapy. Because of the several-month duration of stability, the same distance was maintained during the course of external beam radiation therapy.


Assuntos
Tecido Adiposo Branco , Braquiterapia/efeitos adversos , Ácido Hialurônico/administração & dosagem , Neoplasias da Próstata/radioterapia , Lesões por Radiação/prevenção & controle , Protetores contra Radiação/administração & dosagem , Reto/efeitos da radiação , Idoso , Braquiterapia/métodos , Humanos , Injeções/métodos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Próstata/anatomia & histologia , Doses de Radiação , Proteção Radiológica/métodos , Radioterapia de Intensidade Modulada/métodos , Reto/anatomia & histologia , Reto/diagnóstico por imagem , Ultrassonografia
3.
Arch Esp Urol ; 58(3): 213-26; discussion 224, 2005 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-15906615

RESUMO

OBJECTIVES: Prostatic brachytherapy by permanent implant of I125 or Pd103 is a therapeutic option in the treatment of organ confined prostate cancer We analyze preliminary results and complications after five years in the group of patients who received I125 low dose rate brachytherapy as the only intention-to-cure treatment and evaluate the differences with the standard treatment (surgery). METHODS: From a case series of more than 400 patients treated with brachytherapy as radical intention-to-cure monotherapy for organ-confined prostate cancer we excluded patients with less than 12 months of follow-up for statistical analysis; the study group includes 275 patients enrolled between april 1999 and December 2003. Mean follow-up is 31 months (12-68). Biochemical failure was defined in accordance to the ASTRO criteria. Statistical survival analysis was carried out with the SPSS statistical software using the Kaplan Meyer method. Urinary and gastrointestinal complications were evaluated in accordance to the RTOG criteria. RESULTS: Mean age was 68 years (range 49-83 years). 93% of the patients presented a clinical stage < or ='3dT2a and 7% T2b, with 60 8% of the cases having a PSA < or ='3d 10 ng/ml. Gleason score was < or ='3d 6 in 94% of the cases. 9% of the cases had a prostate volume > 50 cc. Overall 5 year survival was 96%, with a 97% disease-free survival and a 99% biochemical failure-free survival. Figure 3 and tables II-VI summarize the complications in various series including this. CONCLUSIONS: Multiple published series seem to show similar results on biochemical control of the disease when comparing surgery and low dose rate brachytherapy in organ-confined disease. In comparison to surgery, brachytherapy has the advantage of having a lower percentage of immediate postoperative complications, lower incontinence rate, and a higher number of patients preserving erectile function.


Assuntos
Adenocarcinoma/radioterapia , Braquiterapia/métodos , Radioisótopos do Iodo/administração & dosagem , Neoplasias da Próstata/radioterapia , Idoso , Idoso de 80 Anos ou mais , Braquiterapia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...