Servicio de Radioterapia

Santiago, Chile

Servicio de Radioterapia

Santiago, Chile
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Talia Yudin P.,Servicio de Radioterapia | Leonardo Carmona R.,Servicio de Radioterapia | Ineke Duijndam V.,Servicio de Radioterapia | Leonardo Badinez V.,Servicio de Radioterapia
Revista Chilena de Obstetricia y Ginecologia | Year: 2010

Evaluating quality of life is a key element in the curative treatment and palliative treatment of cancer patients. Cervical cancer treatment has important sequels that are an obstacle to patients' quality of life. Objective: To evaluate the quality of life to cervical cancer patients treated in the Fundación Arturo López Pérez (FALP), using surveys for cancer in general (QOL-C30) and specific to cervical cancer (QOL-CX24) from the European Organization for Research and Treatment of Cancer (EORTC). Results: We evaluated quality of life of 72 patients. Emotional and economical problems, tiredness, body image, menopausical symptoms and everything related to sexual activity were found to be relevant. Conclusion: To evaluate the quality of life, must be part of general approach of this patients, to take good decisions and early detection of hidden problems.

Background: Aging is the main risk factor to acquire breast cancer (BC). Nevertheless BC in elderly patients is sub-represented in clinical trials. Aim: To describe the clinical characteristics and long term treatment results of localized BC in older women. Material and Methods: Review of medical records of 65 women aged 70 to 88 years, with localized BC, treated with surgery, postoperative radiotherapy or systemic therapy at a Clinical Hospital in Chile. Results: The presence of symptoms or abnormal findings on physical examination were the main reasons for consulting in 65% of cases. Compared with tumors detected on physical examination, those detected using screening mammogram were smaller and were in stage 1 with a higher frequency (18 and 59% respectively, p < 0.01). The pathological type was luminal in 80% of cases. Overall survival was better for luminal pathological type. All patients completed radiotherapy without interruptions developing minor acute toxicity. The most common co-morbidity was high blood pressure occurring in 46% of patients. Thirteen percent of patients had three or more co-morbidities. After a median follow up of 7 years, 23 (35%) patients had died and the cause of death was BC in 43% of cases. Two patients died of lung cancer. No patient had a local breast relapse. Conclusions: Screening mammogram in older women detected smaller tumors and it was associated with a better survival. BC is the ultimate cause of death in approximately half of cases.

Villalon-Lopez J.S.,Instituto Mexicano del Seguro Social | Souto-Del Bosque R.,Servicio de Radioterapia | Alonso-Briones M.V.,Servicio de Oncologia Medica. | Trujillo-De Anda A.P.,Servicio de Patologia
Cirugia y Cirujanos | Year: 2013

Background: breast metaplastic carcinomas are a heterogeneous group of neoplasms that exhibit a poor prognosis compared with invasive ductal carcinoma. Correspond less than 1% of all malignant neoplasms of the mammary gland. They usually present as high-grade tumors with a lower rate of lymph node metastases and decreased expression of estrogen and progesterone receptors and Her2 and increased expression of Her1 and Ki-67. Clinical case: we report a 52 year old woman with a breast carcinosarcoma presented with a left breast tumor fungated, ulcerated, polypoid and 18 cm in major diameter with lymph node metastases at diagnosis. She received multimodal management with neoadjuvant chemotherapy, followed by mastectomy and adjuvant chemotherapy; she presented progression of the disease with lung metastases and local massive recurrence, eventually died from complications associated to the disease. Conclusions: metaplastic carcinomas of the breast are extremely rare entities. Due the nature of disease and presentation, the prognosis is poor in these patients. There are several histologic subtypes based on studies of hematoxylin and eosin and immunohistochemical stains. It requires multimodal therapy (surgery, radiotherapy and chemotherapy) for best results.

Gulliford S.L.,National Health Research Institute | Foo K.,Wollongong Hospital | Morgan R.C.,Cancer Group | Aird E.G.,Mount Vernon Hospital | And 11 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2010

Purpose: Radical radiotherapy for prostate cancer is effective but dose limited because of the proximity of normal tissues. Comprehensive dose-volume analysis of the incidence of clinically relevant late rectal toxicities could indicate how the dose to the rectum should be constrained. Previous emphasis has been on constraining the mid-to-high dose range (≥50 Gy). Evidence is emerging that lower doses could also be important. Methods and Materials: Data from a large multicenter randomized trial were used to investigate the correlation between seven clinically relevant rectal toxicity endpoints (including patient- and clinician-reported outcomes) and an absolute 5% increase in the volume of rectum receiving the specified doses. The results were quantified using odds ratios. Rectal dose-volume constraints were applied retrospectively to investigate the association of constraints with the incidence of late rectal toxicity. Results: A statistically significant dose-volume response was observed for six of the seven endpoints for at least one of the dose levels tested in the range of 30-70 Gy. Statistically significant reductions in the incidence of these late rectal toxicities were observed for the group of patients whose treatment plans met specific proposed dose-volume constraints. The incidence of moderate/severe toxicity (any endpoint) decreased incrementally for patients whose treatment plans met increasing numbers of dose-volume constraints from the set of V30≤80%, V40≤65%, V50≤55%, V60≤40%, V65≤30%, V70≤15%, and V75≤3%. Conclusion: Considering the entire dose distribution to the rectum by applying dose-volume constraints such as those tested here in the present will reduce the incidence of late rectal toxicity. © 2010 Elsevier Inc. All rights reserved.

Lucic F.,Servicio de Radioterapia | Sanchez-Nieto B.,University of Santiago de Chile | Caprile P.,University of Santiago de Chile | Zelada G.,Servicio de Radioterapia | Goset K.,Servicio de Radioterapia
Journal of Applied Clinical Medical Physics | Year: 2013

Total skin electron irradiation (TSEI) has been used as a treatment for mycosis fungoides. Our center has implemented a modified Stanford technique with six pairs of 6 MeV adjacent electron beams, incident perpendicularly on the patient who remains lying on a translational platform, at 200 cm from the source. The purpose of this study is to perform a dosimetric characterization of this technique and to investigate its optimization in terms of energy characteristics, extension, and uniformity of the treatment field. In order to improve the homogeneity of the distribution, a custom-made polyester filter of variable thickness and a uniform PMMA degrader plate were used. It was found that the characteristics of a 9 MeV beam with an 8 mm thick degrader were similar to those of the 6 MeV beam without filter, but with an increased surface dose. The combination of the degrader and the polyester filter improved the uniformity of the distribution along the dual field (180cm long), increasing the dose at the borders of field by 43%. The optimum angles for the pair of beams were ± 27°. This configuration avoided displacement of the patient, and reduced the treatment time and the positioning problems related to the abutting superior and inferior fields. Dose distributions in the transversal plane were measured for the six incidences of the Stanford technique with film dosimetry in an anthropomorphic pelvic phantom. This was performed for the optimized treatment and compared with the previously implemented technique. The comparison showed an increased superficial dose and improved uniformity of the 85% isodose curve coverage for the optimized technique.

Pelayo Besa D.C.,Servicio de Radioterapia | Roberto Rosso A.,Servicio de Radioterapia | Marisa Bustos C.,Servicio de Radioterapia | Borghero Y.,Servicio de Radioterapia | And 2 more authors.
Revista Medica de Chile | Year: 2011

Background: Intensity modulated radiotherapy (IMRT) is an important step forward in cancer treatment. Aim: To report the first experience in Chile with IMRT for prostate cancer and compare the results obtained with different doses. Patients and Methods: From January 1997 through June 2008, 156 patients with a mean age of 70 years, were treated with radiotherapy and 121 with IMRT. Patients were staged according to American Commission on Cancer Staging. Their biochemical relapse risk was classified according to the MD Anderson classification. Patients were routinely checked during and after therapy to evaluate side effects and relapse. Results: Median follow up was 46 months (4-120). Overall five years survival was 85%. Biochemical relapse free five years survival for low, intermediate and high risk patients was 100, 82 and 70%, respectively. Biochemical relapse free survival for patients receiving radiotherapy doses over 76 Gy was 83%, compared to 30% for those receiving lower doses (p < 0.05). Urinary and gastrointestinal acute toxicity was low in 80% and 90% of patients respectively. Late toxicity developed in less than 3% of patients. Conclusions: IMRT for prostate cancer is readily available and safe in Chile. Biochemical disease free survival improved with higher doses with low toxicity rates.

Martinez Chavez Y.,National Autonomous University of Mexico | Marosi E.,National Autonomous University of Mexico | Zarco J.J.A.,Servicio de Radioterapia | Jacinto U.L.,University Latina Ac | Mercadillo R.E.,Metropolitan Autonomous University
Psicooncologia | Year: 2015

Cancer surviving children, whose disease and treatment involves the central nervous system, show a consistent pattern of neurocognitive deficits. We report a case diagnose of a 9 years boy with posterior fossa tumor treated with surgery, chemotherapy and radiotherapy. Neuropsychological evaluation post oncological therapies and post Cognitive Remediation Program (CRP) were made to document the effect of neuropsychological rehabilitation. The results of the post oncological therapies evaluation shows deficits in Constructional Skills, Visual and Auditory Attention, Percentage of Correct Answers and Correct Designs with Minimal Movements, Speed in Reading and Writing, Graphic Skills, Visual Coding, Verbal and Visual Memory, Perception Touch, Repetition and Comprehension of Language, Conceptual Skills, Verbal and Graphics Fluency, Reading Accuracy, Narrative Composition, Count, Numerical and Calculation Management. After CRP our results illustrate an increase in the score of: Graphic Skills, Verbal Memory, Speech and Language Understanding, Conceptual Skills, Verbal and Graphics Fluency, Count, Numerical Management, Calculation and Logical Mathematical Reasoning after CRP. With the implementation of standardized measures of Evaluación NeuropsicológicaInfantil we could compare the performance of our patient; which suggests that the CRP has enough potential to counteract some of the neurocognitive sequelae observed after tumor resection and radio and chemotherapy. © 2015 Spanish Association of Anglo-American Studies. All rights reserved.

Berlin A.,Servicio de Radioterapia | Berlin A.,Princess Margaret Cancer Center | Berlin A.,University of Toronto | Fernandez M.I.,Servicio de Urologia | Fernandez M.I.,University for Development
Revista Medica de Chile | Year: 2015

Prostate cancer represents the second cancer-related cause of death in North American and Chilean men. The main treatment for incurable stages of disease is surgical or pharmacological castration. However, with time and despite the addition of anti-androgens, the disease progresses to a clinical state that has been commonly referred to as “hormone refractory”. In recent years, the concept of hormone refractoriness has been challenged and replaced by “castration resistance”, acknowledging that further and optimal hormonal manipulation can be attained, beyond achieving testosterone levels at castration range. The purpose of this review is to summarize the recent therapeutic breakthroughs in the management of metastatic castrate resistant prostate cancer (mCRPC), with greater emphasis in the newer hormonal therapy agents such as Abiraterone and Enzalutamide. Future combination and sequential treatment strategies are contextualized in the current era of personalized cancer medicine and genomic characterization of prostate cancer. © 2015 Sociedad Medica de Santiago. All rights reserved.

Vedelago J.,National University of Cordoba | Vedelago J.,CONICET | Obando D.C.,National University of Cordoba | Obando D.C.,National University of Costa Rica | And 14 more authors.
Radiation Measurements | Year: 2016

Complexity in modern radiotherapy treatments demands advanced dosimetry systems for quality control. These systems must have several characteristics, such as high spatial resolution, tissue equivalence, three-dimensional resolution, and dose-integrating capabilities. In this scenario, gel dosimetry has proved to be a very promising option for quality assurance. In this study, the feasibility of Fricke and polymer gel dosimeters suitably shaped in form of thin layers and optically analyzed by visible light transmission imaging has been investigated for quality assurance in external radiotherapy. Dosimeter irradiation was carried out with a 6-MV photon beam (CLINAC 600C). The analysis of the irradiated dosimeters was done using two-dimensional optical transmission images. These dosimeters were compared with a treatment plan system using Monte Carlo simulations as a reference by means of a gamma test with parameters of 1 mm and 2%. Results show very good agreement between the different dosimetric systems: in the worst-case scenario, 98% of the analyzed points meet the test quality requirements. Therefore, gel dosimetry may be considered as a potential tool for the validation of other dosimetric systems. © 2016 Elsevier Ltd. All rights reserved.

PubMed | Servicio de Radioterapia, CNRS Gustave Roussy Institute and Hospital Militar
Type: | Journal: Ecancermedicalscience | Year: 2016

The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease.This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy.Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin.Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months.The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes.

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