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Guerra J.L.L.,University of Texas M. D. Anderson Cancer Center | Guerra J.L.L.,Instituto Madrileno Of Oncologia | Guerra J.L.L.,Autonomous University of Barcelona | Gomez D.,University of Texas M. D. Anderson Cancer Center | And 7 more authors.
Radiotherapy and Oncology | Year: 2012

Purpose: We investigated the association between single nucleotide polymorphisms (SNPs) in the transforming growth factor β1 (TGFβ1) gene and the risk of radiation-induced esophageal toxicity (RE) in patients with non-small-cell lung cancer (NSCLC). Methods and materials: Ninety-seven NSCLC patients with available genomic DNA samples and mostly treated with intensity modulated radio(chemo)therapy from 2003 to 2006 were used as a test dataset and 101 NSCLC patients treated with 3-dimensional conformal radio(chemo)therapy from 1998 to 2002 were used as a validation set. We genotyped three SNPs of the TGFβ1 gene (rs1800469:C-509T, rs1800471:G915C, and rs1982073:T869C) by the polymerase chain reaction restriction fragment length polymorphism method. Results: In the test dataset, the CT/TT genotypes of TGFβ1 rs1800469:C-509T were associated with a statistically significant higher risk of RE grade ≥ 3 in univariate (P = 0.026) and multivariate analysis (P = 0.045) when compared with the CC genotype. These results were again observed in both univariate (P = 0.045) and multivariate (P = 0.023) analysis in the validation dataset. Conclusion: We found and validated that the TGFβ1 rs1800469:C-509T genotype is associated with severe RE. This response marker may be used for guiding therapy intensity in an individual patient, which would further the goal of individualized therapy. © 2012 Elsevier Ireland Ltd. All rights reserved.

Calvo F.A.,Complutense University of Madrid | Sole C.,Instituto Madrileno Of Oncologia | Ferrer C.,Instituto Oncologico | Garcia-Sabrido J.L.,Complutense University of Madrid
Revisiones en Cancer | Year: 2012

Adenocarcinoma of the exocrine pancreas is a disease model of particular interest and opportunities for radiotherapy. In comparison has a high morbidity and mortality in the context of intensive multimodal therapy. Radical resection is feasible in only 15-20% of patients, and only 3-4% of all patients presenting with this condition achieve long-term control and cure. Various strategies in the form of neoadjuvant and adjuvant treatment have been employed over the years to improve outcome, with limited success. The contribution of radiotherapy, remains controversial and is an area of active innovation that merits further research in well-conducted multicenter trials at various stages of the disease in combination with systemic agents and exploiting recent advances in the delivery of super-precise radiotherapy. An update of the published literature on the use components of radiotherapy or chemoradiation as an integrated modality in the interdisciplinary approach of various stages of pancreatic adenocarcinoma is reported. A highlight of areas that future trials in this field should target to move forward the efficient treatment in this malignancy are suggested. Copyright © 2012 Aran Ediciones, s. l.

Gonzalez J.A.,Instituto Madrileno Of Oncologia | Gonzalez J.A.,Hospital Universitario Infanta Cristina | Chust M.,Fundacion Instituto Valenciano Of Oncologia Ivo | Delgado R.,Hospital Regional Universitario Carlos Haya | And 4 more authors.
Clinical and Translational Oncology | Year: 2010

Introduction: A survey regarding radiobiological questions in the treatment of lung cancer (LC) was done to study the clinical aspects of radiotherapy in Spain, in order to standardise treatment decisions. Methods and materials: From November 2007 to March 2008, a survey was performed among radiation oncologists in Spain specialising in LC treatment via e-mail, which included questions regarding different radiobiological aspects of radiotherapy LC treatment. The extent of the resulting material made it necessary to divide it into two parts; the first is presented in this article. The second, which includes items about α/β-NTCP/TCP values and reirradiation criteria, will be reported elsewhere. Results: Thirty-one radiation therapists from 29 radiation oncology departments answered the survey. 77.4-93.5% of responders used the basic formula from the linear-quadratic model and/or computer software for radiobiological calculations; 100% used lung (mostly V20, median <30%) and spinal cord constraints (mostly a median of physical maximum dose <45.5 Gy); and 90.3% used heart and oesophagus constraints (very heterogeneous parameters in both organs). Conclusions: Radiobiological considerations are clearly present in the planning process of radiotherapy of LC in Spain, with a high coincidence with the literature regarding lung and spinal cord constraints. The heterogeneity shown for oesophagus and heart results demonstrates the need for continuing investigation into the standardisation of clinical, dosimetric and radiobiologic aspects of the treatment of this cancer. © 2010 Feseo.

Zamora L.I.,Hospital Universitario Reina Sofia | Forastero C.,Instituto Madrileno Of Oncologia | Guirado D.,Hospital Universitario San Cecilio | Guirado D.,CIBER ISCIII | And 2 more authors.
Medical Physics | Year: 2012

Purpose: To develop a Monte Carlo tool that permits to study the reduction in breast cancer mortality rate due to breast screening programs. Methods: Simulations implement woman histories undergoing a screening program, include a model of survival after local treatment of invasive cancers and use distributions of time gained due to screening detection against symptomatic detection and overall sensitivity of the screening obtained previously. Mortalities for the whole woman population and for those women with ages within the range considered in the program have been calculated. Results: For the whole woman population, a reduction in breast cancer mortality up to 29 has been found for a configuration that includes women aged between 50 and 70 years, with a screening interval of two years and 100 acceptance rate. If an acceptance of 70 is considered, this percentage reduces to 20. If, in the same conditions, the program starts at 40 years, the reduction of the mortality reaches 24 while if the screening interval is one year, this percentage raises to 28. If mortalities are calculated for those women with ages within the range included in the program these reductions are greater and no significant differences are found between the programs with age ranges [50-70] and [40-70]. In the model, radio-induced cancers have no effect in survival. Conclusions: The results agree reasonably well with those of different trials. Mortality reductions of 12-20 (between two and four deaths per year and 105 women) are obtained only for acceptances above 50. This could be considered as a threshold for the acceptance, which appears to be a critical parameter. © 2012 American Association of Physicists in Medicine.

Bourgier C.,Institute Gustave Roussy | Calvo F.A.,Hospital General Universitario Gregorio Maranon | Marsiglia H.,Instituto Madrileno Of Oncologia | Marsiglia H.,Institute Gustave Roussy | Martin M.,Hospital General Universitario Gregorio Maranon
Clinical and Translational Oncology | Year: 2011

Radiochemotherapy is a standard approach in human solid tumours, with localised stage and radical treatment intention. In the early-intermediate stages of breast cancer model, neoadjuvant radiochemotherapy is an alternative to induction chemotherapy alone and might further impact the surgical technical treatment characteristics (a downsizing effect). In the era of targeted therapy and personalised treatment for breast cancer patients with initial localised disease, radiochemotherapy needs to be explored as a component of optimised local treatment to potentially improve relevant local results, such as breast conservation, breast cosmesis and individualised breast cancer radiochemotherapy response prediction. An overview of available literature data regarding neoadjuvant treatment including radiotherapy component is analysed and discussed.

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