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1.
Exp Eye Res ; 181: 240-251, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30716328

RESUMO

Radiation retinopathy is a serious vision-impairing complication of radiation therapy used to treat ocular tumors. Characterized by retinal vasculopathy and subsequent retinal damage, the first sign of radiation retinopathy is the preferential loss of vascular endothelial cells. Ensuing ischemia leads to retinal degradation and late stage neovascularization. Despite the established disease progression, the pathophysiology and cellular mechanisms contributing to radiation retinopathy remain unclear. Clinical experience and basic research for other retinal vasculopathies, such as diabetic retinopathy and retinopathy of prematurity, can inform our understanding of radiation retinopathy; however, the literature investigating the fundamental mechanisms in radiation retinopathy is limited. Treatment trials have shown modest success but, ultimately, fail to address the cellular events that initiate radiation retinopathy. Animal models of radiation retinopathy could provide means to identify effective therapies. Here, we review the literature for all animal models of radiation retinopathy, summarize anatomical highlights pertaining to animal models, identify additional physiological factors to consider when investigating radiation retinopathy, and explore the use of clinically relevant tests for studying in vivo models of radiation retinopathy. We encourage further investigation into the mechanistic characterization of radiation retinopathy in the hope of discovering novel treatments.


Assuntos
Braquiterapia/efeitos adversos , Neoplasias Oculares/radioterapia , Lesões Experimentais por Radiação , Teleterapia por Radioisótopo/efeitos adversos , Retina/efeitos da radiação , Doenças Retinianas/etiologia , Animais , Retina/patologia , Doenças Retinianas/diagnóstico
2.
Actas Urol Esp (Engl Ed) ; 43(1): 18-25, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30119969

RESUMO

INTRODUCTION AND OBJECTIVES: The onset of second primary tumours should be considered in high-risk prostate cancer patients in the natural course of the disease. Our aim was to evaluate the influence of primary treatment with curative intent for these patients on the development of second primary tumours. MATERIAL AND METHODS: A retrospective study of 286 patients diagnosed between 1996 and 2008, treated by radical prostatectomy (n=145) or radiotherapy and androgen blockade (n=141). The homogeneity of both series was analysed using the Chi-squared test for the qualitative variables, and the Student's t-test for the quantitative variables. A multivariate Cox regression analysis was performed to assess whether the type of primary treatment influenced the development of second tumours. RESULTS: The median age was 66 years, and the median follow-up was 117.5 months. At the end of follow-up, 60 patients (21%) had developed a second primary tumour. In the prostatectomy group it was located in the pelvis in 13 (9%) cases, and those treated with radiotherapy and hormonotherapy in 8 (5.7%) cases (P=.29). The most common organ sites were: colo-rectal in 17 (28.3%) patients, the lung in 11 (18.3%), and the bladder in 6 (10%) patients. In the multivariable analysis, the risk of a second tumour doubled for those treated with radiotherapy and hormonotherapy (HR=2.41, 95%CI: 1.31-4.34, P=.005) compared to the patients treated by prostatectomy. Age and rescue radiotherapy did not behave as independent predictive factors. CONCLUSIONS: The onset of a second primary tumour was related with the primary treatment given; thus the risk for those treated with radiotherapy and androgen deprivation therapy more than doubled.


Assuntos
Adenocarcinoma/terapia , Segunda Neoplasia Primária/epidemiologia , Neoplasias da Próstata/terapia , Adenocarcinoma/patologia , Idoso , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Braquiterapia/efeitos adversos , Neoplasias Colorretais/epidemiologia , Terapia Combinada , Seguimentos , Neoplasias Hematológicas/epidemiologia , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Segunda Neoplasia Primária/etiologia , Prostatectomia , Neoplasias da Próstata/patologia , Teleterapia por Radioisótopo/efeitos adversos , Estudos Retrospectivos
3.
Cancer Radiother ; 19(3): 168-74, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25863565

RESUMO

PURPOSE: Breast angiosarcomas are rare vascular malignancies that arise secondary to irradiation or de novo as primary tumours. The aim of this study is to know whether c-myc amplification can reliably discriminate these two entities. MATERIEL AND METHODS: Forty-seven patients treated for breast angiosarcomas were studied. Thirty-two patients were diagnosed with postradiation angiosarcomas after breast cancer treatment and 15 patients with primary angiosarcomas. Interphase fluorescence in situ hybridization (FISH) was performed by hybridization of probes covering C-MYC (chromosome 8q24.21) and CEP8 on tissue sections. RESULTS: Amplification (5- to 20-fold) of the c-myc oncogene was found in all breast radiation-induced angiosarcomas (32 tumours) but in none of the 15 primary angiosarcomas except one (7%). CONCLUSION: This study reinforces that there are true pathogenetic differences between the two types of breast angiosarcomas which are morphologically indistinguishable. These data point the pathways preferentially involved in the pathogenesis of post radiation angiosarcomas of the breast and may provide the basis for an additional targeted therapy.


Assuntos
Neoplasias da Mama/diagnóstico , Amplificação de Genes , Genes myc , Hemangiossarcoma/diagnóstico , Neoplasias Induzidas por Radiação/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Teleterapia por Radioisótopo/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/química , Neoplasias da Mama/genética , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/cirurgia , Cromossomos Humanos Par 8/genética , Cromossomos Humanos Par 8/ultraestrutura , Terapia Combinada , DNA de Neoplasias/genética , Diagnóstico Diferencial , Feminino , Hemangiossarcoma/química , Hemangiossarcoma/genética , Humanos , Hibridização in Situ Fluorescente , Interfase , Excisão de Linfonodo , Mastectomia , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/química , Neoplasias Induzidas por Radiação/genética , Segunda Neoplasia Primária/química , Segunda Neoplasia Primária/genética
4.
Cancer Radiother ; 15(5): 400-3, 2011 Aug.
Artigo em Francês | MEDLINE | ID: mdl-21664850

RESUMO

PURPOSE: To analyze the therapeutic results of cutaneous cancers on xeroderma pigmentosum through a series of 15 patients treated by radiotherapy. PATIENTS AND METHODS: Between 1993 and 2006, 15 patients with xeroderma pigmentosum and having cutaneous cancers were treated in the Radiotherapy Department of university hospital Habib-Bourguiba of Sfax in Tunisia. Seventy-three percent of the cases occurred in male patients and the mean age of appearance of the first tumour was 18.2 years. Tumour histology was squamous cell carcinoma in 74% of the cases. The total number of cutaneous tumours was 84. Ten patients had a surgical resection. Four patients did not respond to chemotherapy. The modality of irradiation was decided according to the size, thickness and localization of the tumour. The dose of radiotherapy was 60Gy or equivalent with classic irradiation. RESULTS: The total number of lesions treated with radiotherapy was 64. Forty-three lesions were treated with contact therapy, ten with brachytherapy and 11 with cobalt therapy. The following acute complications were observed: cutaneous infection (53.3% of patients), radioepithelite (80% of patients) and necroses (33.3% of patients). Evaluation after treatment showed a clinical complete remission in 73% of the cases. Late effects were noted in seven cases: telangiectasy and cutaneous atrophy. A recurrence in the irradiated zone was observed in one case. A nodal metastasis was observed in two cases. Another patient presented lung metastases. After a median follow up of 37.2 months, four patients died, seven are alive with cutaneous cancer and four are alive with complete remission. CONCLUSION: Radiotherapy is a possible and effective therapeutic alternative. Dose and methods are not defined for xeroderma pigmentosum.


Assuntos
Neoplasias Cutâneas/radioterapia , Xeroderma Pigmentoso/complicações , Adolescente , Adulto , Idade de Início , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/administração & dosagem , Braquiterapia/efeitos adversos , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Criança , Radioisótopos de Cobalto/efeitos adversos , Radioisótopos de Cobalto/uso terapêutico , Terapia Combinada , Feminino , Fluoruracila/administração & dosagem , Humanos , Masculino , Neoplasias Primárias Múltiplas/genética , Neoplasias Primárias Múltiplas/radioterapia , Neoplasias Primárias Múltiplas/cirurgia , Radiodermite/etiologia , Teleterapia por Radioisótopo/efeitos adversos , Dosagem Radioterapêutica , Indução de Remissão , Estudos Retrospectivos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/cirurgia , Tunísia/epidemiologia , Adulto Jovem
5.
Oral Maxillofac Surg ; 15(2): 71-7, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20512390

RESUMO

PURPOSE: Radiation-induced olfactory neuroblastoma (ONB) is an uncommon neoplasm that is generally associated with a poor prognosis. We describe a new case of olfactory neuroblastoma in a patient previously treated for astrocytoma with holocranial radiotherapy 9 years ago. MATERIALS AND METHODS: We reviewed the medical records of four patients with radiation-induced olfactory neuroblastoma between 2001 and 2009. RESULTS: This work supports the idea that ONB can be induced by radiation. CONCLUSIONS: As radiotherapy is a standard treatment in other tumors, clinicians must be aware of the possibility of a second tumor induced by radiation.


Assuntos
Astrocitoma/radioterapia , Neoplasias Encefálicas/radioterapia , Radioisótopos de Cobalto/efeitos adversos , Irradiação Craniana/efeitos adversos , Estesioneuroblastoma Olfatório/etiologia , Lobo Frontal , Cavidade Nasal , Segunda Neoplasia Primária/etiologia , Neoplasias Nasais/etiologia , Neoplasias dos Seios Paranasais/etiologia , Teleterapia por Radioisótopo/efeitos adversos , Adulto , Terapia Combinada , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/radioterapia , Estesioneuroblastoma Olfatório/cirurgia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/radioterapia , Segunda Neoplasia Primária/cirurgia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/radioterapia , Neoplasias dos Seios Paranasais/cirurgia , Planejamento da Radioterapia Assistida por Computador , Radioterapia Adjuvante
7.
Cancer Radiother ; 14(3): 169-75, 2010 Jun.
Artigo em Francês | MEDLINE | ID: mdl-20347607

RESUMO

PURPOSE: We retrospectively analyzed anatomoclinic, therapeutic and evolutive particularities of 74 young patients (< or =20 years) with nasopharyngeal carcinoma treated between 1993 and 2005. PATIENTS AND METHODS: Initial work-up included a fiberoptic nasofibroscopy with biopsy, tomodensitometry and/or MRI of nasopharynx and neck, chest X-ray, abdominal ultrasonography and bone scan. Patients were treated with either primary chemotherapy (epirubicin and cisplatin) followed by radiotherapy or concomitant radiochemotherapy (five fluorouracil and cisplatin). Radiotherapy was delivered to a total dose of 70 to 75 Gy to nasopharynx and involved cervical lymph nodes and 50 Gy to the remainder cervical areas. RESULTS: The median age was 16 years. Sixty-three percent of patients had undifferentiated tumors. Sixty-six percent had locally advanced tumor. With a median follow-up of 107 months, one patient presented a local relapse, 24 patients developed distant metastases with a median delay of 7 months. The 5 years overall survival and disease-free survival were 66 and 65 %. Late complications were dominated by dry mouth and endocrine disorders. COMMENTS: Pediatric nasopharyngeal carcinoma is characterized by an early metastatic diffusion. Local control is excellent but with severe late toxicities. New techniques of radiotherapy and new molecules of chemotherapy could improve these results.


Assuntos
Carcinoma/epidemiologia , Radioisótopos de Cobalto/uso terapêutico , Neoplasias Nasofaríngeas/epidemiologia , Teleterapia por Radioisótopo , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/administração & dosagem , Carcinoma/tratamento farmacológico , Carcinoma/radioterapia , Quimioterapia Adjuvante , Criança , Cisplatino/administração & dosagem , Terapia Combinada , Intervalo Livre de Doença , Epirubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Neoplasias Nasofaríngeas/tratamento farmacológico , Neoplasias Nasofaríngeas/radioterapia , Terapia Neoadjuvante , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/radioterapia , Neoplasias Induzidas por Radiação/etiologia , Segunda Neoplasia Primária/induzido quimicamente , Segunda Neoplasia Primária/etiologia , Teleterapia por Radioisótopo/efeitos adversos , Radioterapia Conformacional , Estudos Retrospectivos , Resultado do Tratamento , Xerostomia/epidemiologia , Xerostomia/etiologia , Adulto Jovem
9.
Ai Zheng ; 27(9): 942-6, 2008 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-18799032

RESUMO

BACKGROUND & OBJECTIVE: Cisplatin-based concurrent chemoradiotherapy has become the standard treatment modality for locally advanced cervical cancer. However, the optimal chemotherapy regimen combined with radiotherapy remains controversial. This study was to compare the therapeutic efficacy and toxicity of concurrent chemoradiotherapy with those of radiotherapy, and those among different regimens of concurrent chemoradiotherapy for stage IIB-IIIB cervical cancer. METHODS: From Jan. 2003 to Dec. 2004, 285 patients with stage IIB-IIIB cervical cancer treated in Maternal and Child Health Hospital of Jiangxi Province were randomly assigned to receive radiotherapy alone or concurrent chemoradiotherapy. According to different chemotherapy regimens, patients in the concurrent chemoradiotheapy group were randomly chosen to receive radiotherapy with chemotherapy of bleomycin and cisplatin (RT+BP), radiotherapy with chemotherapy of taxol and carboplatin (RT+TP), and radiotherapy with chemotherapy of 5-fluorouracil and cisplatin (RT+FP). The 3-year survival rates and toxicity of different groups were compared. RESULTS: After a median follow-up of 42 months, the 3-year survival was higher in the concurrent chemoradiotheray group (75%) than in the radiotherapy group (65%) (P=0.042). Acute treatment-related toxicity (grade III and IV) was higher in the concurrent chemoradiotherapy group than in the radiotherapy group (P<0.001); while the delayed treatment-related toxicity was similar in the two groups (P=0.613). The 3-year survival rates of BP, TP and FP chemoradiotherapy groups were 74%, 80% and 71%, without significant differences (P=0.792). Acute toxicities (grade III and IV) and delayed toxicities were similar among the three groups. CONCLUSIONS: Concurrent chemoradiotherapy significantly improves the survival for patients with stage IIB-IIIB cervical cancer compared to radiotherapy alone. Among the three chemoradiotherapy regimens, radiotherapy combined with taxol and carboplatin exerts a slightly higher 3-year survival than the other two regimens with tolerable toxicity.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/radioterapia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/radioterapia , Adulto , Idoso , Bleomicina/administração & dosagem , Braquiterapia/efeitos adversos , Braquiterapia/métodos , Carboplatina/administração & dosagem , Carcinoma de Células Escamosas/patologia , Cisplatino/administração & dosagem , Radioisótopos de Cobalto/uso terapêutico , Radioisótopos de Cobalto/toxicidade , Terapia Combinada , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Radioisótopos de Irídio/uso terapêutico , Radioisótopos de Irídio/toxicidade , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Paclitaxel/administração & dosagem , Teleterapia por Radioisótopo/efeitos adversos , Teleterapia por Radioisótopo/métodos , Taxa de Sobrevida , Neoplasias do Colo do Útero/patologia
10.
J Contemp Dent Pract ; 9(3): 40-7, 2008 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-18335118

RESUMO

AIM: Radiation-induced mucositis is an early effect of head and neck radiotherapy. Mucositis can cause ulcers, and patients may experience pain and dysphasia which need treatment. The aim of this study is to evaluate the effect of pure natural honey on radiation induced mucositis. METHODS AND MATERIALS: In this randomized single blind (examiner blind) clinical trial 40 patients with head and neck cancer requiring radiation to the oropharyngeal mucosa were randomly assigned to two groups. Twenty patients assigned to the study group received honey, while both the study and control groups received standard head and neck radiation therapy based on a standard protocol. In the study group patients were instructed to take 20 ml of honey 15 minutes before radiation therapy, then again at intervals of 15 minutes and six hours after radiation. In the control group patients were instructed to rinse with 20 ml of saline before and after radiation. Patients were evaluated weekly for progression of mucositis using the Oral Mucositis Assessing Scale (OMAS). Data were analyzed using the independent t-test, Mann-Whitney, and Friedman tests. RESULTS: A significant reduction in mucositis among honey-received patients compared with controls (p=0.000) occurred. CONCLUSION: Within the limits of this study the results showed the application of natural honey is effective in managing radiation induced mucositis. CLINICAL SIGNIFICANCE: Natural honey is a product with rich nutritional qualities that could be a pleasant, simple, and economic modality for the management of radiation mucositis.


Assuntos
Irradiação Craniana/efeitos adversos , Mel , Mucosite/terapia , Lesões por Radiação/terapia , Estomatite/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosite/etiologia , Neoplasias Orofaríngeas/radioterapia , Teleterapia por Radioisótopo/efeitos adversos , Método Simples-Cego , Estatísticas não Paramétricas , Estomatite/etiologia
11.
Int Endod J ; 40(11): 859-65, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17935497

RESUMO

AIM: To evaluate the early and delayed effects of fractioned teletherapy (radiotherapy) on the dental pulps of rats using Co(60). METHODOLOGY: In group 1 - rats (n = 15) were subjected to fractioned teletherapy by 30 daily sessions fractioned in doses of 200 cGy day(-1), totaling 60 Gy and the rats were killed immediately after the final dose of irradiation; group 2 - same protocol but killed 30 days following the final irradiation dose; groups 3 (n = 7) and 4 (n = 8) - formed controls without irradiation. Following perfusion, the left mandible of each rat was dissected and processed for histopathology. Serial sections (5 microm) were obtained and stained with HE or picrosirius. Observations were recorded for the coronal pulp tissue. A blinded observer evaluated HE sections using pre-defined indices of inflammation, nuclear alterations and extracellular matrix (ECM) hyalinization. Images of sections stained with picrosirius were converted to black and white for analysis by image-pro plus; areas in black (collagen) were measured as percentage area. The pulps of mandibular incisors of the specimens prepared for transmission electron microscopy (TEM) were subjected to descriptive analysis. Magnifications of 6300 and 10000 x were used to observe 10 pulp fibroblasts from each group. RESULTS: No inflammatory reactions or modification of the ECM status were found (P = 0.428) in any specimens. The collagen content also displayed no significant changes (P = 0.067) as a result of treatment. Groups 1 and 2 displayed significantly more nuclear alterations than the control groups (P < 0.05). The bubble-like aspect was more pronounced in group 1, and the bubbles looked smaller in group 2. The ECM showed no differences in the hyalinization status and there were no differences in the collagen area within the pulps. Under TEM, the pulp fibroblasts in group 1 displayed nuclear alterations that resembled circular, oval or elongated perforations; perforations also appeared in the cytoplasm. CONCLUSION: Fractioned teletherapy is capable of producing nuclear alterations in the dental pulp tissue of rats.


Assuntos
Polpa Dentária/efeitos da radiação , Teleterapia por Radioisótopo/efeitos adversos , Análise de Variância , Animais , Radioisótopos de Cobalto/efeitos adversos , Fracionamento da Dose de Radiação , Fibroblastos/efeitos da radiação , Masculino , Odontoblastos/efeitos da radiação , Ratos , Estatísticas não Paramétricas
12.
Strahlenther Onkol ; 183(9): 487-9, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17762922

RESUMO

CASE REPORT: A 45-year-old patient with cervix carcinoma received combined radiochemotherapy including cisplatin. After a cumulative dose of 240 mg/m(2) the patient suddenly became somnolent and developed a severe tetraparesis and generalized seizures. After ruling out intracranial bleeding, cerebral metastases as well as infectious and metabolic causes of this condition, a severe toxic encephalopathy was diagnosed based on the clinical findings and MRI scans. After symptomatic treatment on the intensive care unit all symptoms were completely reversible. CONCLUSION: Toxic encephalopathy is a rare but dramatic complication of various cytostatic drugs. With the widespread use of cisplatin this rare disorder should be kept in mind.


Assuntos
Antineoplásicos/efeitos adversos , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Cisplatino/efeitos adversos , Síndromes Neurotóxicas/etiologia , Radiossensibilizantes/efeitos adversos , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/radioterapia , Antineoplásicos/administração & dosagem , Braquiterapia/efeitos adversos , Carcinoma de Células Escamosas/patologia , Núcleo Caudado/efeitos dos fármacos , Núcleo Caudado/patologia , Cisplatino/administração & dosagem , Terapia Combinada , Imagem de Difusão por Ressonância Magnética , Epilepsia Generalizada/induzido quimicamente , Epilepsia Generalizada/diagnóstico , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Núcleos da Linha Média do Tálamo/efeitos dos fármacos , Núcleos da Linha Média do Tálamo/patologia , Estadiamento de Neoplasias , Exame Neurológico/efeitos dos fármacos , Síndromes Neurotóxicas/diagnóstico , Lobo Occipital/efeitos dos fármacos , Lobo Occipital/patologia , Radiossensibilizantes/administração & dosagem , Teleterapia por Radioisótopo/efeitos adversos , Remissão Espontânea , Tálamo/efeitos dos fármacos , Tálamo/patologia , Tomografia Computadorizada por Raios X , Neoplasias do Colo do Útero/patologia
13.
Arch Soc Esp Oftalmol ; 82(6): 361-4, 2007 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-17573646

RESUMO

CLINICAL CASE: An 82-year-old pseudophakic male patient developed several ocular complications after teletherapy for cavum carcinoma. Three years after receiving the radiotherapy, he presented with a right optic neuritis with some posterior improvement. Five years later he developed an ischemic retinopathy and a severe dry eye syndrome. DISCUSSION: Ocular complications due to radiotherapy used to treat nasopharyngeal carcinomas are not as common as those caused by epiescleral radiotherapy for choroidal melanoma, but must be taken into account due to their special severity. We present a single case of a patient who suffered several subsequent ocular complications after such radiotherapy.


Assuntos
Síndromes do Olho Seco/etiologia , Neurite (Inflamação)/etiologia , Teleterapia por Radioisótopo/efeitos adversos , Doenças Retinianas/etiologia , Idoso de 80 Anos ou mais , Humanos , Masculino
14.
Pol Merkur Lekarski ; 21(126): 602-6, 2006 Dec.
Artigo em Polonês | MEDLINE | ID: mdl-17405307

RESUMO

The optimal management of clinically localized (T1, T2) prostate cancer remains controversial. Patients have possibility of choice between prostatectomy and radiotherapy in two forms: external beam radiotherapy and brachytherapy. Multicentre studies show comparable results of theise two methods. The aim of this paper is to present current knowledge regarding treatment with conformal radiotherapy. Acute and late effects of ionizing radiation are described. Propriety of associate radiotherapy with hormonotherapy was analyzsed.


Assuntos
Braquiterapia/métodos , Carcinoma/radioterapia , Neoplasias da Próstata/radioterapia , Idoso , Idoso de 80 Anos ou mais , Carcinoma/epidemiologia , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Intervalo Livre de Doença , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Teleterapia por Radioisótopo/efeitos adversos , Teleterapia por Radioisótopo/métodos , Dosagem Radioterapêutica , Radioterapia Adjuvante/métodos , Radioterapia Conformacional/métodos , Análise de Sobrevida , Taxa de Sobrevida , Resultado do Tratamento
15.
Ai Zheng ; 24(6): 722-6, 2005 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-15946488

RESUMO

BACKGROUND & OBJECTIVE: Radiotherapy is the main treatment for nasopharyngeal carcinoma (NPC). The incidence of radiation-induced complications, especially radiation optic neuropathy (RON), increases along with prolonging survival time of the patients. This study was to investigate RON in NPC patients after irradiation by visual field and visual evoked potential (VEP) tests. METHODS: A total of 28 NPC patients, who underwent conventional external-beam irradiation, received visual field and VEP tests before irradiation, at the end of irradiation, and 5 years after irradiation. RESULTS: Thirty-four (60.7%) eyes in 21 patients developed pathological visual field; 15 (44.1%) of these 34 eyes occurred within 10-24 months after irradiation. Of the 34 eyes, 8 showed concentric visual field constriction; 6 showed bitemporal hemianopia; 8 showed local photosensitivity descend; 10 showed central or cecocentral scotoma; 2 showed scotoma enlargement. Forty-four (78.6%) eyes in 26 patients appeared VEP abnormity; 24 (54.5%) of these 44 eyes occurred within 14 months after irradiation. In small, medium, and large elements, VEP latencies were significantly longer within 1 year after irradiation than pre-irradiation (P < 0.001, P < 0.001, and P=0.001); VEP amplitudes were lower within 1 year after irradiation than pre-irradiation without significant difference (P=0.249, P=0.940, and P=0.450). One year after treatment, VEP latency delay maintained in each element (P=0.004, P < 0.001, P < 0.001); VEP amplitudes were decreased (P=0.002, P=0.189, P < 0.001). The incidence of pathologic visual field was significantly lower in patients received irradiation of < or =70 Gy than in patients received irradiation of > 70 Gy (50.0% vs. 77.3%, P=0.041). CONCLUSIONS: RON correlates to total irradiation dose. Pathologic visual field may indicate the position of RON.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Potenciais Evocados Visuais/efeitos da radiação , Neoplasias Nasofaríngeas/radioterapia , Teleterapia por Radioisótopo/efeitos adversos , Campos Visuais/efeitos da radiação , Adulto , Idoso , Carcinoma de Células Escamosas/fisiopatologia , Radioisótopos de Cobalto/efeitos adversos , Radioisótopos de Cobalto/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/fisiopatologia , Doses de Radiação
16.
Head Neck ; 27(3): 187-94, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15627248

RESUMO

BACKGROUND: Lhermitte's sign (LS) is a side effect of radiotherapy (RT) on the spinal cord and typically occurs shortly after the procedure has been conducted. When treating patients with cancer of the head and neck region with irradiation, it remains difficult to avoid exposing the cervical spinal cord to unintended radiation. In this study, we focused on nasopharyngeal cancer (NPC) alone and looked for various parameters that might influence the occurrence of LS associated with this disease after RT. METHODS: From 1979 through 1990, 1171 patients with NPC completed RT either with or without chemotherapy at the Lin-Kou Medical Center, Chang Gung Memorial Hospital (CGMH), Tao-Yuan, Taiwan; the RT regimens for these treated patients were very similar. The nasopharyngeal tumor was treated to 75 Gy by photon teletherapy and after-loading brachytherapy. The neck lymphatics were irradiated with photon irradiation to 46.8 Gy and then boosted with electron beams to 10 to 30 Gy, in accordance with the patient's nodal status, either unilaterally or bilaterally. Every patient was followed monthly for the first 3 months after therapy and subsequently every 2 to 3 months for the next 2 years and, finally, every 6 months thereafter. At follow-up, a neurologic checkup of each patient was performed to determine whether any injury to the spinal cord or brain stem had arisen. RESULTS: LS was observed for 121 patients (10.3%). The median development time for such signs was 3.0 months after the completion of RT (range, 0.2-72 months), and the appearance of such a sign lasted 1 to 82 weeks (median, 17 weeks). No statistically significant differences between the sexes were noted in the development of such a sign (p = .5263),or among various T classifications (p = .0757) and N classifications (p = .4412). The incidence of LS was significantly lower for those patients who had also received chemotherapy than it was for those who had not (p = .003), and it was also lower for patients older than 60 years than for those younger than 60 years (p = .0061). Of the subjects who did not undergo neck-lymphatic boosting or who had undergone only unilateral neck-lymphatic boosting, 7.2% had LS develop, whereas 11.5% of patients who had been boosted bilaterally had LS develop (p = .0285). CONCLUSIONS: The incidence of LS associated with NPC and after RT was higher in patients who underwent bilateral neck-lymphatic boosting by electron beams than for those who underwent unilateral boosting or who did not undergo boosting. A correlation between increased incidence of LS and RT dose on the cervical spinal cord was noted when the cord dose exceeded 48.9 Gy. Therefore, wherever possible, a CT simulator and a three-dimensional treatment-planning system should necessarily be used to verify the dose distribution of electron-beam RT to diminish the chance of radiation overdose on the cervical cord.


Assuntos
Braquiterapia/efeitos adversos , Neoplasias Nasofaríngeas/radioterapia , Teleterapia por Radioisótopo/efeitos adversos , Medula Espinal/efeitos da radiação , Adulto , Antineoplásicos/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Humanos , Linfonodos/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/tratamento farmacológico , Modelos de Riscos Proporcionais , Dosagem Radioterapêutica
17.
Radiol. bras ; 37(4): 265-269, jul.-ago. 2004. tab, graf
Artigo em Português | LILACS | ID: lil-364711

RESUMO

OBJETIVO: Análise comparativa da resposta bioquímica em pacientes submetidos à teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose para tumores localizados da próstata. MATERIAIS E MÉTODOS: De novembro de 1997 a janeiro de 2000, 74 pacientes foram submetidos à teleterapia com 45 Gy e reforço com braquiterapia de alta taxa de dose com irídio-192 e dose de 16 Gy em quatro inserções (BT). Estes foram comparados a 29 pacientes submetidos à teleterapia com 45 Gy e reforço com arcoterapia e dose mediana de 24 Gy (RT) entre outubro de 1996 e fevereiro de 2000. Nos dois grupos houve associação ocasional de hormonioterapia neoadjuvante. Sobrevida atuarial livre de doença em três anos (SB3) e fatores prognósticos pré-tratamento da resposta bioquímica, como o antígeno prostático-específico inicial (PSAi), escore de Gleason da biópsia de próstata (EG) e estádio clínico (EC), foram analisados. RESULTADOS: O seguimento mediano foi de 25 meses para o grupo RT e 37 meses para o BT. Na análise atuarial, a SB3 foi de 51 por cento e 73 por cento (p = 0,032) para RT e BT, respectivamente. Na análise estratificada pelo PSAi, a SB3 para RT e BT foi de 85,7 por cento e 79,1 por cento (p = 0,76) para PSAi < 10 ng/mL e de 38 por cento e 68 por cento (p = 0,023) para PSAi > 10 ng/mL, respectivamente. Quando estratificado pelo EG, a SB3 para RT e BT foi de 37 por cento e 80 por cento (p = 0,001) para EG < 6 e 78 por cento e 55 por cento para EG > 6 (p = 0,58); estratificando-se pelo EC, a SB3 para RT e BT foi de 36 por cento e 74 por cento (p = 0,018) para EC < T2a e 73 por cento e 69 por cento para EC > T2a (p = 0,692), respectivamente. O risco relativo bruto de recidiva bioquímica foi de 2,3 (95 por cento IC: 1,0-5,1) para os pacientes tratados com RT, em relação à BT; quando ajustado pelo PSAi e EG, o risco relativo de recidiva bioquímica foi de 2,4 (95 por cento IC: 1,0-5,7)...


OBJECTIVE: To compare the biochemical response in patients with locally advanced prostate cancer treated with external beam radiation therapy alone or in combination with conformal brachytherapy boost. MATERIALS AND METHODS: From November 1997 to January 2000, 74 patients received 45 Gy of pelvic external irradiation and four were treated with high dose rate iridium-192 conformal boost implants of 4 Gy each (BT). These were compared with 29 other patients treated with 45 Gy of pelvic external irradiation followed by a 24 Gy of bilateral ARC boost (RT) from October 1996 to February 2000. Some patients received neoadjuvant androgen deprivation therapy. Three-year actuarial biochemical control rates (BC3) and pretreatment biochemical response predictors such as prostate-specific antigen pretreatment (PSAi), Gleason score (GS) and clinical stage (CS), were evaluated. RESULTS: Median follow-up was of 25 months for the RT group and 37 months for the BT group. BC3 was 51% versus 73% (p = 0.032) for RT and BT, respectively. Comparisons of biochemical control by treatment group stratified by PSAi showed that BC3 for RT versus BT was 85.7% versus 79.1% (p = 0.76) for PSAi < 10 ng/mL and 38% versus 68% (p = 0.023) for PSAi > 10 ng/mL, respectively. For patients with GS < 6, BC3 was 37% versus 80% (p = 0.001) for RT versus BT and, for patients with GS > 6, BC3 was 78% versus 55% (p = 0.58) for RT versus BT, respectively. For patients with CS < T2a, BC3 was 36% versus 74% (p = 0.018) for RT versus BT and, for patients with CS > T2a, BC3 was 73% versus 69% (p = 0.692) for RT versus BT, respectively. The relative risk of biochemical relapse was 2.3 (95% IC: 1.0–5.1) for patients in RT group compared to the BT group. When adjusted for PSAi and GS, the relative risk of biochemical relapse was 2.4 (95% IC: 1.0–5.7)...


Assuntos
Humanos , Masculino , Braquiterapia , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata , Teleterapia por Radioisótopo , Teleterapia por Radioisótopo/métodos , Neoplasias da Próstata/fisiopatologia , Prognóstico , Medição de Risco , Relação Dose-Resposta à Radiação , Teleterapia por Radioisótopo/efeitos adversos
18.
Pol Arch Med Wewn ; 111(1): 53-6, 2004 Jan.
Artigo em Polonês | MEDLINE | ID: mdl-15088421

RESUMO

The myelotoxicity is one of the most severe adverse events of radiotherapy. Increase of CD34+ cells level in peripheral blood as result of raised output of granulocyte colony stimulating factor (G-CSF) can be result of hematopoiesis regeneration after radiotherapy. The aim of this study was to determine the hematopoiesis regeneration using analysis of CD34+ cells level in peripheral blood and serum concentration of G-CSF in patients treated with radiotherapy according to irradiated body region and irradiation field size. Two groups of irradiated patients were examined. Group I consisted of 11 patients (mean age 56) with gynecological malignancies (teletherapy dose 40-50 Gy for pelvic area and brachytherapy with Cs). Group II consisted of 10 patients (mean age 58) with head and neck malignancies (teletherapy only 50-70 Gy). Every patient was evaluated 3 times: before radiotherapy, in the day of ending and 14 days after therapy. 3 ml of blood for CD34 and serum for G-CSF estimation were collected. Blood cells were stained with monoclonal antibody specific for CD34 antigen and analysed by flow cytometry. G-CSF level was estimated by ELISA. After radiotherapy in both groups statistically significant leukopenia (p < 0.001) was observed. There was no difference between two groups in levels of CD34+ cells before and in the last day of therapy but there was significant increase of CD34+ cells in group I compared with group II 14 days after treatment (p < 0.01). Decrease of CD34+ cells during radiotherapy and after its ending in all patients was observed but only in group II was statistically significant. Positive correlation between amount of leukocytes and CD34+ cells percentage was stated. There were no statistically significant differences in serum G-CSF concentration within particular groups and between group I and II. Our results indicate that evaluation of CD34+ cells level in peripheral blood is useful in prediction of hematopoiesis regeneration after radiotherapy. G-CSF serum concentration is not prognostic factor in these groups of patients.


Assuntos
Antígenos CD34 , Neoplasias dos Genitais Femininos/radioterapia , Fator Estimulador de Colônias de Granulócitos , Neoplasias de Cabeça e Pescoço/radioterapia , Hematopoese/efeitos da radiação , Irradiação Hemicorpórea/efeitos adversos , Teleterapia por Radioisótopo/efeitos adversos , Regeneração , Idoso , Antígenos CD34/sangue , Antígenos CD34/efeitos da radiação , Ensaio de Imunoadsorção Enzimática , Feminino , Citometria de Fluxo , Fator Estimulador de Colônias de Granulócitos/sangue , Fator Estimulador de Colônias de Granulócitos/efeitos da radiação , Células-Tronco Hematopoéticas/efeitos da radiação , Humanos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas
19.
Urology ; 63(2): 354-8, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14972490

RESUMO

OBJECTIVES: To evaluate the incidence and type of incontinence after external beam radiotherapy (RT) and brachytherapy. Distinct late effects on the urinary bladder can occur and are frequently mild after adjuvant RT for Stage I endometrial carcinoma. Not all side effects that impair quality of life (eg, urinary incontinence) are classified in the commonly used grading system. METHODS: Forty-one patients were evaluated for newly occurred urinary incontinence after adjuvant RT. The mean follow-up was 64.8 months, and the mean age was 62.1 years. The validated incontinence score from Gaudenz was used. Additionally, quality-of-life questions were asked. RESULTS: Overall, 22 (53.7%) of 41 patients complained of urinary incontinence. Urge incontinence was classified in 45.5% (10 of 22 patients) and stress urinary incontinence in 54.5% (12 of 22 patients). CONCLUSIONS: The onset of stress urinary incontinence after brachytherapy can be explained by anatomic findings, such as adverse affects to the nerve supply of the rhabdosphincter. According to our results, the exposure to additional external beam RT can cause urge incontinence. Patients and doctors must be aware that urinary incontinence, with an occurrence rate of more than 50%, represents the most common side effect after surgery and RT for Stage I endometrial carcinoma. We conclude that, depending on the type of RT, a stress incontinence rate of 24.4% and an urge incontinence rate of 29.2% is possible.


Assuntos
Adenocarcinoma/radioterapia , Braquiterapia/efeitos adversos , Neoplasias do Endométrio/radioterapia , Complicações Pós-Operatórias/etiologia , Lesões por Radiação/etiologia , Teleterapia por Radioisótopo/efeitos adversos , Radioterapia Adjuvante/efeitos adversos , Incontinência Urinária/etiologia , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/radioterapia , Carcinoma Adenoescamoso/cirurgia , Terapia Combinada , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Feminino , Seguimentos , Humanos , Histerectomia , Incidência , Excisão de Linfonodo , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Qualidade de Vida , Lesões por Radiação/epidemiologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Incontinência Urinária/epidemiologia , Incontinência Urinária/psicologia , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/psicologia
20.
HNO ; 52(1): 25-32, 2004 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-14740111

RESUMO

INTRODUCTION: The aim of this study was to correlate structural, histomorphological damage of the salivary gland with scintigraphic findings during fractioned radiotherapy. METHODS: The head and neck area of 27 WAG/RijH rats was irradiated with (60)Co-gamma-rays (60 Gy/30f/6 weeks). A port-system was implanted and (99m)Tc-pertechnetat applied at different stages of irradiation (0, 16, 30, 46, 60 Gy and 6 months post irradiation). RESULTS: After the application of 16 Gy an intra- and extra-cellular oedema developed in the salivary glands. The progressive vacuolisation (30 Gy) passed over into lipomatosis (46 Gy) and necrosis (60 Gy) in the parotid and mandibular glands. Six months after irradiation treatment, the chronic histomorphological damage corresponded to stage II according to Seifert. The corresponding loss in gland function was 13% (16 Gy); 26% (30 Gy); 57% (46 Gy); 75% (60 Gy) and 66.5% (6 months post irradiation). CONCLUSION: This animal model demonstrates the correlation between histomorphological and scintigraphic findings.


Assuntos
Modelos Animais de Doenças , Fracionamento da Dose de Radiação , Lesões Experimentais por Radiação/diagnóstico por imagem , Protetores contra Radiação/farmacologia , Teleterapia por Radioisótopo/efeitos adversos , Cintilografia , Glândulas Salivares/efeitos da radiação , Animais , Radioisótopos de Cobalto , Relação Dose-Resposta à Radiação , Lipomatose/patologia , Masculino , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Glândula Parótida/efeitos da radiação , Lesões Experimentais por Radiação/patologia , Ratos , Ratos Endogâmicos , Glândulas Salivares/diagnóstico por imagem , Glândulas Salivares/patologia , Pertecnetato Tc 99m de Sódio , Estatística como Assunto , Glândula Submandibular/diagnóstico por imagem , Glândula Submandibular/patologia , Glândula Submandibular/efeitos da radiação
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