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Farre Bernado N.,Servicio de Oncologia Radioterapica | Estorch Cabrera M.,Hospital Of La Santa Creu I Sant Pau
DOLOR | Year: 2014

Bone metastases are the most common cause of cancer-related pain. The role of radiotherapy (RT) for palliation of painful bone metastases has been well established and achieves rates of pain relief in over 75[%] of patients. In the latest systematic reviews, there were no significant differences in complete and overall pain relief between single fraction (SF) and multiple fractions (MF), even though re-treatment rates were higher in patients treated with SF. Current radiotherapy techniques allow the administration of more accurate and less toxic treatments.


Brell M.,Hospital Universitario Son Dureta | Castaner S.,Servicio de Radiologia S. Castaner | Pujol-Farre T.,Lhospitalet Of Llobregat | Boluda S.,Servicio de Anatomia Patologica | And 9 more authors.
Revista de Neurologia | Year: 2011

Introduction. 1p19q loss of heterozygosity (LOH1p19q) in oligodendroglial tumors has shown to be prognostic of prolonged survival and predictive of therapeutic responsiveness. During the last years, research is actively being directed to the discovery of radiological characteristics related to LOH1p19q. Aims. To confirm the existence of molecular heterogeneity in oligodendroglial tumors in relation to their anatomic distribution, and to evaluate the correlation between molecular profile and other radiological and clinical characteristics and their prognostic impact. Patients and methods. Fifty-four patients with oligodendroglial tumors managed according to a previously established protocol were included. Preoperative SE T1, T1 post-gadolinium and T2 magnetic resonance images were reviewed by two independent neuroradiologists, blinded to clinical and molecular information. LOH analysis was assessed from paired tumor-blood DNA acid samples. Results. LOH1p was highly associated with LOH19q (p < 0.0001), LOH1p (odds ratio, OR = 6.19; 95% confidence interval, 95% CI = 1.66-22.68; p = 0.004), LOH19q (OR = 7.59; 95% CI = 1.84-31.34; p = 0.006) and LOH1p19q (OR = 5.38; 95% CI = 1.51-19.13; p = 0.007) were found to be more frequent in tumors located in the frontal lobe. Frontal location (hazard ratio, HR = 4.499; 95% CI = 1.027-193.708; p = 0.046), ring enhancement (HR = 0.213; 95% CI = 0.065-0.700; p = 0.011) and extent of resection (HR = 9.231; 95% CI = 1.737-49.050; p = 0.009) resulted independent prognostic factors for overall survival in the multivariate analysis. Conclusions. Glioma classification aims to better define patients prognosis. Besides histological and immunohistochemical analyses, molecular information has become of great importance. Our results indicate that the evaluation of some MR features may also be useful. Efforts must be directed toward the use of every available resource at each institution.


Manas A.,Hospital Universitario La Paz | Cerezo L.,Hospital La Princesa | De La Torre A.,Hospital Universitario Puerta Of Hierro | Garcia M.,Hospital Universitario Madrid Sanchinarro | And 7 more authors.
Clinical and Translational Oncology | Year: 2012

Objective: To describe the oropharyngeal candidiasis (OPC) prevalence in Spanish patients with head and neck cancer undergoing radiotherapy, alone or combined with chemotherapy. Secondary objectives were to determine the prevalence of Candida species colonization, and to explore whether different Candida species colonizing the oral cavity and the treatment were associated with a higher prevalence of OPC. Methods: This is an observational, cross-sectional, multicentre study, conducted in Spanish radiation oncology units. Patients were diagnosed with head and neck cancer and started a radiotherapy treatment alone or combined with chemotherapy at the moment of their inclusion (N = 92) Results: The OPC prevalence was 26 %. The identification of colonizing pathogens was performed in 49 patients, and Candida albicans was the dominant yeast (69 %), while non-albicans Candida was only found in 15 patients (31 %). Patients with C. albicans colonization had a significant higher prevalence of OPC compared to patients colonized by non-albicans Candida (p = 0.0273), but no difference was found regarding the OPC prevalence in patients receiving only radiotherapy compared to patients with both radiotherapy and chemotherapy treatments. Conclusions: Our data represent a step further in the knowledge of Candida species present in Spanish patients with head and neck tumors under radiation therapy. This is an essential step to manage the prophylaxis and treatment of OPC, since it might lead to severe clinical complications causing treatment interruption and, thus, representing a reduction in anti-tumor efficacy. © Federación de Sociedades Españolas de Oncología (FESEO) 2012.


Tornero-Lopez A.M.,Hospital Universitario Of Gran Canaria Dr Negrin | Torres del Rio J.,Hospital Universitario San Cecilio | Ruiz C.,Servicio de Oncologia Radioterapica | Perez-Calatayud J.,Hospital La Fe | And 2 more authors.
Physica Medica | Year: 2015

In brachytherapy using 125I seed implants, a verification of the air kerma strength of the sources used is required. Typically, between 40 and 100 seeds are implanted. Checking all of them is unaffordable, especially when seeds are disposed in sterile cartridges. Recently, a new procedure allowing the accomplishment of the international recommendations has been proposed for the seedSelectron system of Elekta Brachytherapy. In this procedure, the SourceCheck ionization chamber is used with a special lodgment (Valencia lodgment) that allows to measure up to 10 seeds simultaneously. In this work we analyze this procedure, showing the feasibility of the approximations required for its application, as well as the effect of the additional dependence with the air density that shows the chamber model used. Uncertainty calculations and the verification of the approximation needed to obtain a calibration factor for the Valencia lodgment are carried out. The results of the present work show that the chamber dependence with the air density is the same whether the Valencia lodgment is used or not. On the contrary, the chamber response profile is influenced by the presence of the lodgment. The determination of this profile requires various measurements due to the nonnegligible variability found between different experiments. If it is considered, the uncertainty in the determination of the air-kerma strength increases from 0.5% to 1%. Otherwise, a systematic additional uncertainty of 1% would occur. This could be relevant for the comparison between user and manufacturer measurements that is mandatory in the case studied here. © 2015 Associazione Italiana di Fisica Medica.


Tovar Martin M.I.,Hospital Universitario Virgen Of Las Nieves | Lopez Ramirez E.,Servicio de Oncologia Radioterapica | Saura Rojas E.,Hospital Universitario Virgen Of Las Nieves | Arregui Castillo G.,Servicio de Radiofisica | Zurita Herrera M.,Hospital Universitario Virgen Of Las Nieves
Clinical and Translational Oncology | Year: 2011

Background: Astrocytomas of the spinal cord have rarely been reported. We examined our experience, treatment and outcome of patients treated during the last four years. Material and methods: We reviewed the charts from patients treated for this neoplasm in a multidisciplinary team of Granada, Spain. The information was retrospectively obtained from the patients' hospital records. The patients were evaluated with clinical history, physical exam, spinal magnetic resonance (MR), surgery, location and histology, treatment, and follow-up. Results: In the last four years, we have treated 37 astrocytomas, of which only 3 were intramedullary. All patients underwent surgery, radiotherapy and chemotherapy. Two patients died, but one is alive and practically asymtomatic. Conclusion: The optimal treatment remains controversial. Radiotherapy should be considered for tumors with high-grade histopathology, clinically progressive and when a substantial resection cannot be achieved. New therapeutic strategies need to be studied to improve survival.


PubMed | Hospital Universitario San Cecilio, Hospital Universitario Of Gran Canaria Dr Negrin, University of Granada, Servicio de Oncologia Radioterapica and Hospital La Fe
Type: Journal Article | Journal: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) | Year: 2015

In brachytherapy using (125)I seed implants, a verification of the air kerma strength of the sources used is required. Typically, between 40 and 100 seeds are implanted. Checking all of them is unaffordable, especially when seeds are disposed in sterile cartridges. Recently, a new procedure allowing the accomplishment of the international recommendations has been proposed for the seedSelectron system of Elekta Brachytherapy. In this procedure, the SourceCheck ionization chamber is used with a special lodgment (Valencia lodgment) that allows to measure up to 10 seeds simultaneously. In this work we analyze this procedure, showing the feasibility of the approximations required for its application, as well as the effect of the additional dependence with the air density that shows the chamber model used. Uncertainty calculations and the verification of the approximation needed to obtain a calibration factor for the Valencia lodgment are carried out. The results of the present work show that the chamber dependence with the air density is the same whether the Valencia lodgment is used or not. On the contrary, the chamber response profile is influenced by the presence of the lodgment. The determination of this profile requires various measurements due to the nonnegligible variability found between different experiments. If it is considered, the uncertainty in the determination of the air-kerma strength increases from 0.5% to 1%. Otherwise, a systematic additional uncertainty of 1% would occur. This could be relevant for the comparison between user and manufacturer measurements that is mandatory in the case studied here.


Acea B.,Complexo Hospitalario Universitario | Calvo Martinez L.,Complexo Hospitalario Universitario | Antolin Novoa S.,Complexo Hospitalario Universitario | Albaina Latorre L.,Complexo Hospitalario Universitario | And 9 more authors.
Cirugia Espanola | Year: 2012

Sentinel lymph node (SLN) biopsy is the standard of practice for assessing axillary spread in clinically node-negative breast cancer patients. On the other hand, axillary lymph node dissection (ALND) is the ideal procedure for patients with SLN metastasis. Different studies over the last few years have suggested that some patients with positive SLN can be treated without ALND. This article presents a literature review carried out by our multidisciplinary group and its strategy for avoiding routine ALND in women with SLN metastases. In this new strategy ALND should not be performed on women with T1 tumours, with 1-2 positive SLN and undergoing breast conservative surgery. On the other hand, ALND would be indicated in those patients with three or more positive SLN, presence of extracapsular invasion, mastectomised women and triple negative subtype or HER2+ tumours that have not received biological treatment with antibodies. © 2011 AEC.


Lozano E.B.,Hospital Juan Ramon Jimenez | Latiesas X.S.,Servicio de Oncologia Radioterapica | Arcelus F.M.,Hospital la Fe | Lopez M.A.,Servicio de Oncologia Radioterapica
Revista de Senologia y Patologia Mamaria | Year: 2013

Sentinel lymph node biopsy (SLNB) is currently a standard approach for staging of the axilla in patients with breast cancer, with a clear tendency to minimize surgery even in the presence of a positive axillary sentinel lymph node (SLN). The strongest consensus (American Society of Clinical Oncology) and, until recently, the National Comprehensive Cancer Network guidelines used to recommend complete axillary lymphadenectomy when metastases were identified in the SLN. However, SLNB has replaced axillary lymphadenectomy in SLNnegative patients and has demonstrated equivalent survival. This approach results in excellent locoregional control and provides information that allows both the medical oncologist and the radiation oncologist to take decisions about adjuvant treatments. Many recent studies, however, have debated the therapeutic value of surgical lymphadenectomy. This debate has become particularly important after the publication of the trial of the American College of Surgeons Oncology Group (ACOSOG) Z0011, which questions the value of this therapeutic approach and proposes SLNB alone, without lymphadenectomy, in selected patients with one or 2 positive SLN. The scientific evidence indicates that radiotherapy may play a major role in the control of axillary disease and, to date, it is not known whether the low recurrence rate in the axilla reported in the above-mentioned studies may have been influenced by radiation of the breast and lower axilla. To answer this question, new and appropriately designed trials are needed. In the absence of more data, we propose the use of axillary radiation, but with assessment of the risk factors for locoregional recurrence in each patient. © 2013 SESPM. Published by Elsevier España, S.L. All rights reserved.


Approximately 60% of patients with a cancer diagnosis require radiotherapy. Although usually well tolerated, this treatment can sometimes produce radiation-related moderate-to-severe pain in certain locations or during painful procedures required for radiotherapy administration. This article describes two clinical situations of breakthrough pain in routine practice in radiotherapy departments: firstly, pain secondary to mucositis, which leads to weight loss and impaired quality of life; secondly, incidental pain caused by positioning and the maneuvers required for treatment administration. In both situations, we designed two prospective studies of fentanyl pectin nasal spray in the Fundación Jiménez Días. The results were satisfactory for both patients and healthcare professionals. These two studies remain open and are recruiting patients to confirm these results. © 2015 Sociedad Española de Cuidados Paliativos. Published by Elsevier España, S.L.U. All rights reserved.

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