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1.
Agata Karklelyte Konstantinas Povilas Valuckas Romas Griskevicius Ernestas Janulionis Eduardas Aleknavicius 《Reports of Practical Oncology and Radiotherapy》2018,23(4):284-289
Purpose
The aim of our study was to perform the final analysis of acute toxicity and quality of life data obtained from 221 consecutive patients who suffered from intermediate-to-high risk prostate cancer.Methods
In this trial, 221 patients were randomized to receive either hypofractionated (63?Gy in 20 fractions, 4 fractions/week) or conventionally fractionated (76?Gy in 38 fractions, 5 fractions/week) radiotherapy to the prostate and seminal vesicles. Elective pelvic lymph node irradiation with 46?Gy in 23 fractions sequentially and 44?Gy in 20 fractions simultaneously was also applied.Results
There was no statistically significant difference in acute GU and GI toxicity in men treated with hypofractionated (SIB) (Arm 2) in comparison with patients who had conventional fractionation (Arm 1) radiation therapy. Multivariate analysis using logistic regression showed statistical significant association between acute GU?≥?1 and PTV(LN) (p?=?0.008) only. We found out that clinically relevant decrease (CRD) was significantly higher only in the urinary domain of Arm 1 at month 3 (p?=?0.02).Conclusion
Our study demonstrated that hypofractionated radiotherapy was associated with a small but insignificant increase of acute toxicity. The reduction of overall treatment time has no significant influence on patients’ QOL in any domain. 相似文献2.
Miguel Ángel Souto-Del Bosque Miguel Ángel Cervantes-Bonilla Gerardo del Carmen Palacios-Saucedo 《Reports of Practical Oncology and Radiotherapy》2018,23(5):392-397
Aim
To identify clinical and dosimetric factors associated with the development of hematologic toxicity (HT) for cervical cancer (CC) treated with chemotherapy and 3D conformal radiotherapy.Background
Chemoradiotherapy is the standard of care management for CC patients with IB2-IVA clinical stages (CS). This treatment carries toxicities, standing out the one that occurs at the hematologic level.Subjects and methods
CC patients with IB2-IVA CS treated with chemotherapy and 3D conformal radiotherapy (50?Gy) plus Brachyterapy (7?Gy x3 or 9?Gy x2) at our institution between March 2016 and March 2017. Clinical and dosimetric factors were studied as was their probable association with the development of HT.Results
59 patients were analyzed. 89.8% of the subjects developed some grade of HT and 50.2% developed ≥grade 2 toxicity. No statistical relationship was found for the dosimetric factors: V10?>?90% (p?=?0.47) and V20?>?80% (p?=?0.17). Regarding clinical factors: neither age >50 years (p?=?0.88) nor diabetes mellitus (DM) showed statistical relationship with development of ≥grade 2 HT (p?=?0.88 and p?=?0.61, respectively). On the contrary, obesity showed a significant association (p?=?0.02). For other factors analyzed, we found statistical correlation for epidermoid histology and ≥III A CS (p?=?0.01 and p?=?0.02, respectively).Conclusions
We did not find statistical relationship between HT and the clinical factors of age >50 years and DM. Statistical relationship for the dosimetric factors V10?>?90% and V20?>?80% was not found as well. On the contrary, obesity, epidermoid histology and ≥IIIA CS, showed statistical significance for development of HT ≥grade 2. 相似文献3.
Marisa R. Moroney Dina Flink Jeanelle Sheeder Erin A. Blake Aakriti R. Carrubba Christine M. Fisher Saketh R. Guntupalli 《Reports of Practical Oncology and Radiotherapy》2018,23(5):331-336
Aim
To evaluate the associations of external beam radiation therapy (EBRT) and intracavitary brachytherapy (IB) with decreased sexual function.Background
There’s inconsistent evidence on whether radiation for gynecologic cancers has an impact on sexual health. IB, an underutilized treatment modality, is thought to have less adverse effects than EBRT.Materials and methods
A cross-sectional study examining decreased sexual function following radiation for gynecologic cancers. A decrease in sexual function was measured as a change in the Female Sexual Function Index (FSFI) from before to after treatment, with a significant decrease determined by Reliable Change Index Statistic (RCIS). Chi-square and t-tests were employed.Results
171 women completed the survey; 35% (n?=?60) received radiation, of whom 29 received EBRT and IB (48%), 15 EBRT alone (25%), 16 IB alone (27%). Women who received radiation had similar rates of decreased sexual function as women who did not (47% vs. 38%, P?=?0.262). EBRT and IB had similar rates of decreased sexual function compared to women with no radiation (50% vs. 38% P?=?0.166 and 47% vs. 38% P?=?0.309). Women experiencing decreased sexual function were more likely to be under 50 years old (OR 5.4, 95%CI 1.6–18.1), have received chemotherapy (OR 5.7, 95%CI 1.4–22.9), and have cervical cancer (OR 7.8, 95%CI 2.1–28.8).Conclusions
Treatment with EBRT or IB does not appear to impair sexual function in women with gynecologic cancer. Age less than 50, concurrent chemotherapy, and cervical cancer may place women with gynecologic cancer at higher risk for decreased sexual function following radiation. 相似文献4.
María Yicel Bautista Hernandez Pomponio José Lujan Castilla Abril Antonia Quézada Bautista 《Reports of Practical Oncology and Radiotherapy》2018,23(4):276-283
Aim
To evaluate whether hypofractionation with integrated boost to the tumour bed using intensity-modulated radiation therapy is an acceptable option and to determine whether this treatment compromises local control, toxicity and cosmesis.Background
Retrospective studies have demonstrated that patients who are treated with HF and integrated boost experience adequate local control, a dosimetric benefit, decreased toxicity and acceptable cosmesis compared with conventional fractionation.Materials and methods
A retrospective, observational and longitudinal study was conducted from January 2008 to June 2015 and included 34 patients with breast cancer (stage 0–II) who were undergoing conservative surgery.The prescribed doses were 45?Gy in 20 fractions (2.25?Gy/fraction) to the breast and 56?Gy in 20 fractions (2.8?Gy/fraction) to the tumour bed.Results
Thirty-four patients were included. The mean follow-up was 49.29 months, and the mean age was 52 years. The mean percentage of PTV from the mammary region that received 100% of the prescribed dose was 97.89% (range 95–100), and the mean PTV percentage of the tumour bed that received 100% of the dose was 98% (95–100).The local control and the overall survival were 100%, and the cosmesis was good in 82% of the patients. Grade 1 acute toxicity was present in 16 patients (47%), and grade 1 chronic toxicity occurred in 6 cases (18%).Conclusion
The results of the present study demonstrate that hypofractionation with integrated boost using intensity-modulated radiation therapy is an acceptable option that provides excellent local control and low toxicity. 相似文献5.
Olga Pons-Llanas Susana Roldan-Ortega Francisco Celada-Alvarez María José Perez-Calatayud Victoria Fornes-Ferrer Alejandro Tormo-Micó José Perez-Calatayud José Luis López-Torrecilla 《Reports of Practical Oncology and Radiotherapy》2018,23(4):290-297
Aim
The present retrospective study was to compare toxicity and survival outcomes in a group of low-risk PCa patients treated with either the preoperative planning technique (145?Gy) or the real-time IoP technique (160?Gy).Background
The two most common permanent seed implantation techniques are preoperative planning (PP) with 145?Gy and real-time intraoperative planning (IoP) with 160?Gy. Although IoP has largely replaced PP at many centres in recent years, few studies have directly compared these two techniques.Materials and methods
Retrospective study of 408 patients with low-risk PCa treated with permanent seed implant brachytherapy at our institution between October 2003 and December 2014. Of these, 187 patients were treated with PP at a dose of 145?Gy while 221 received real-time IoP with 160?Gy.Results
At a median follow up of 90 months, 5- and 8-year rates of biochemical relapse-free survival (BRFS) were 94.8% and 86% with the IoP technique versus 90.8% and 83.9%, respectively, with PP. The maximum dose to the urethra was <217?Gy with both techniques. Despite the higher dose, IoP did not cause any significant increase in toxicity (p?=?0.11).Conclusions
The present study shows that real-time intraoperative brachytherapy at a dose of 160?Gy yield better biochemical control than preoperative planning at 145?Gy. In addition, urinary toxicity did not increase, despite the dose escalation, probably because the dose constraints to the urethra were met despite the increased dose escalation. These findings support the use of real-time IoP. 相似文献6.
Rosa Belén Mohedano del Pozo Margarita Rubio Alonso Mª Soledad Cuétara García 《Revista iberoamericana de micología》2018,35(3):117-122
Background
The role of culture-independent techniques (galactomannan, (1-3)-β-d-glucan) in the early diagnosis of invasive fungal diseases (IFD) is well assessed in hematological patients, but there are no clear conclusions in patients with chronic obstructive pulmonary disease (COPD).Aims
To study the usefulness of nonculture-based techniques in the diagnosis of IFD in COPD-patients at risk for IFD.Methods
A prospective observational study based on monitoring COPD patients at risk for IFD during 2007–2010 was carried out. The presence of galactomannan, (1-3)-β-d-glucan and an indirect immunofluorescence of Candida albicans germ tube specific antibodies (CAGTA) were performed.Results
Among 43 COPD patients, 16 (37.2%) were diagnosed with IFD: seven cases were proven IFD (five invasive candidemia – IC, one invasive aspergillosis – IA and a rhinocerebral zygomycosis) and nine probable IFD (seven IA and two IC). In the diagnosis of IC and IA, the negative predictive value (NPV) of (1-3)-β-d-glucan was 100%. Regarding CAGTA in IC, NPV was 96.2%. Finally, NPV of galactomannan in IA was 91.2%. The area under the ROC curve for (1-3)-β-d-glucan in IC and for the rest of the IFD cases was 0.86 (95% CI, 0.79–0.93) and 0.60 (95% CI, 0.43–0.77), for CAGTA in IC was 0.83 (95% CI, 0.74–0.91) and for galactomannan in IA was 0.71 (95% CI, 0.56–0.85). Positive (1-3)-β-d-glucan preceded the growth of Candida (average of 1.7 days) in blood culture.Conclusions
In COPD patients at risk for IFD the assayed techniques are especially useful to rule out the presence of IFD. 相似文献7.
Florent Malard Myriam Labopin Christina Cho Didier Blaise Esperanza B. Papadopoulos Jakob Passweg Richard O’Reilly Edouard Forcade Molly Maloy Liisa Volin Hugo Castro-Malaspina Yosr Hicheri Ann A. Jakubowski Corentin Orvain Sergio Giralt Mohamad Mohty Arnon Nagler Miguel-Angel Perales 《Journal of hematology & oncology》2018,11(1):127
Background
Graft-versus-host disease (GVHD) is one of the leading causes of non-relapse mortality and morbidity after allogeneic hematopoietic stem cell transplantation (allo-HCT).Methods
We evaluated the outcomes of two well-established strategies used for GVHD prevention: in vivo T cell depletion using antithymocyte globulin (ATG) and ex vivo T cell depletion using a CD34-selected (CD34+) graft. A total of 525 adult patients (363 ATG, 162 CD34+) with intermediate or high-risk cytogenetics acute myeloid leukemia (AML) in first complete remission (CR1) were included. Patients underwent myeloablative allo-HCT using matched related or unrelated donors.Results
Two-year overall survival estimate was 69.9% (95% CI, 58.5–69.4) in the ATG group and 67.6% (95% CI, 60.3–74.9) in the CD34+ group (p?=?0.31). The cumulative incidence of grade II–IV acute GVHD and chronic GVHD was higher in the ATG cohort [HR 2.0 (95% CI 1.1–3.7), p?=?0.02; HR 15.1 (95% CI 5.3–42.2), p?<?0.0001]. Parameters associated with a lower GVHD-free relapse-free survival (GRFS) were ATG [HR 1.6 (95% CI 1.1–2.2), p?=?0.006], adverse cytogenetic [HR 1.7 (95% CI 1.3–2.2), p?=?0.0004], and the use of an unrelated donor [HR 1.4 (95% CI 1.0–1.9), p?=?0.02]. There were no statistical differences between ATG and CD34+ in terms of relapse [HR 1.52 (95% CI 0.96–2.42), p?=?0.07], non-relapse mortality [HR 0.96 (95% CI 0.54–1.74), p?=?0.90], overall survival [HR 1.43 (95% CI 0.97–2.11), p?=?0.07], and leukemia-free survival [HR 1.25 (95% CI 0.88–1.78), p?=?0.21]. Significantly, more deaths related to infection occurred in the CD34+ group (16/52 vs. 19/112, p?=?0.04).Conclusions
These data suggest that both ex vivo CD34-selected and in vivo ATG T cell depletion are associated with a rather high OS and should be compared in a prospective randomized trial.8.
Sweta Bandanatham Janaki Manur Gururajachar Mohan Kumar Somashekar 《Reports of Practical Oncology and Radiotherapy》2018,23(2):69-74
Aim
This prospective study aims to assess the compliance with bladder protocol and the correlation with enteritis during pelvic radiation.Background
Bladder protocol is routinely used for patients undergoing pelvic radiation to reduce radiation enteritis. It is very difficult to maintain constant volume especially in the last two weeks due to radiation enteritis and cystitis.Materials and methods
Histologically proven 35 cervical cancer patients treated with concurrent chemoradiation in a tertiary care center were the subjects of this prospective study. Following CT simulation and after every fraction, patients were asked to void urine in a calibrated urine container and the volume was documented. Patients were assessed for the highest grade of radiation enteritis weekly as per common toxicity criteria. The mean voided urine volume was correlated with the radiation enteritis.Results
The mean urine volume at planning CT scan was 295.85 ± 300 ml (SD) with a range of 75–650. At the end of treatment, it was reduced to 233.14 ± 250 ml (range 50–400 ml), a reduction by 21% (p < 0.001). The maximum grade of enteritis was grade I (11%), II (11.4%), III (3–29%) in week 1,2 and 3–5, respectively with a p value of <0.001. A mean urine volume of 230 ml was associated with grade III enteritis in the third week.Conclusions
Urine output volume measured using a calibrated container is a simple, efficient and practical method to monitor bladder distension thereby reducing enteritis in cervical cancer patients treated with concurrent chemoradiation. 相似文献9.
Karla Berenice Carrazco-Peña Katia Farías-Moreno Benjamín Trujillo-Hernández 《Revista espa?ola de geriatría y gerontología》2018,53(1):23-25
Objective
To determine the frequency of successful aging (SA) and its relationship with frailty in an elderly population.Material and methods
An analytical cross-sectional study of subjects ≥60 years of age seen as outpatients in a general hospital. Successful aging was defined as scores of ≥ 90 in the Barthel index and ≤ 2 in the Pfeiffer test. Frailty was determined using the Fried criteria.Results
The study included 400 subjects (272 women and 128 men), with a mean age of 71.6 ± 8.2 years. The SA frequency was 40.4%. frail status was statistically higher in non-successful aging subjects than in SA subjects (161.7 versus 7.9%; P<.001). Women were more frequently frail, while being a pensioner/retired and married were associated less frequently with frailty.Conclusions
Successful aging is associated with a lower level of frailty. 相似文献10.
Marianna Małek Bożena Bogusz Paulina Mrowiec Mariusz Szuta Maciej Opach Iwona Skiba-Kurek Paweł Nowak Karolina Klesiewicz Alicja Budak Elżbieta Karczewska 《Revista iberoamericana de micología》2018,35(3):140-146
Background
Fungal rhinosinusitis has become an increasingly recognized disease, being Aspergillus species responsible for most of the cases. Its diagnosis is quite difficult because of the non-specific symptoms and low sensitivity of the current diagnostic methods.Aims
An Aspergillus-specific nested polymerase chain reaction (PCR) assay using biopsy specimens taken from the maxillary sinuses was performed in order to assess its usefulness. Conventional diagnostic methods (histology and culture) were also carried out.Methods
A case–control study was performed in the Institute of Stomatology, Jagiellonian University in Kraków, between 2011 and 2014. The case group consisted of 21 patients with suspected rhinosinusal mycetoma while the control group included 46 patients with no suspicion of fungal rhinosinusitis. The two-step PCR assay amplified an Aspergillus specific portion of the 18S rRNA gene. Interval estimation of sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated to assess the diagnostic test performance. The agreement between the PCR and the other tests was evaluated using the Kappa coefficient (k).Results
Ninety percent of the samples obtained from patients diagnosed with mycetoma yielded positive PCR results. The PCR showed almost perfect concordance with histology (k = 0.88). Sensitivity, specificity, PPV and NPV estimates were 90%; 95% CI: (55.5–99.7%), 98.3%; 95% CI: (90.9–100%), 90%; 95% CI: (55.5–99.7%) and 98.3%; 95% CI: (90.9–100%), respectively. One clinical sample showed growth of Aspergillus fumigatus and positive PCR despite the negative histological examination.Conclusions
Nested PCR assay is a promising diagnostic tool to evaluate the presence of Aspergillus in the tissue of maxillary sinus from patients with suspicion of sinus aspergillosis. 相似文献11.
Francieli Chassot Tarcieli Pozzebon Venturini Fernanda Baldissera Piasentin Janio Morais Santurio Terezinha Inez Estivalet Svidzinski Sydney Hartz Alves 《Revista iberoamericana de micología》2019,36(1):44-47
Background
Candida parapsilosis may acquire resistance to echinocandins, a fact that prompts the search for new therapeutic options.Aims
The present study aimed to evaluate the in vitro activity of antifungal agents, alone and in combination, against four groups of C. parapsilosis strains: (1) echinocandin-susceptible (ES) clinical isolates (MIC ≤ 2 μg/ml), (2) anidulafungin-resistant strains (MIC ≥ 8 μg/ml), (3) caspofungin-resistant strains (MIC ≥ 8 μg/ml), and (4) micafungin-resistant strains (MIC ≥ 8 μg/ml).Methods
Antifungal interactions were evaluated by a checkerboard micro-dilution method. The determination of the MIC to each drug for every isolate according to the Clinical and Laboratory Standards Institute documents M27 (2017) and M60 (2017) was also done.Results
The echinocandins-resistant (ER) strains showed higher MICs to the tested antifungals than the ES strains, except for amphotericin B, for which the ER groups remained susceptible.Conclusions
Most combinations showed indifferent interactions. The use of monotherapy still seems to be the best option. As resistance to echinocandins is an emergent phenomenon, further studies are required to provide clearer information on the susceptibility differences between strains to these antifungal agents. 相似文献12.
Morbidity dynamics in proton–photon or photon radiation therapy for locally advanced prostate cancer
Evgeny V. Khmelevsky Irina N. Kancheli Vladimir S. Khoroshkov Andrey D. Kaprin 《Reports of Practical Oncology and Radiotherapy》2018,23(1):21-27
Aim
This study evaluated the frequency and long-term dynamics of early and late post irradiation damage after proton–photon or photon therapy for locally advanced prostate cancer.Background
The results of a randomized study of proton–photon or photon therapy using several fractionation regimes were analyzed in 272 patients with high and intermediate risk of progression.Materials and methods
Three variants of proton boost fractionation were studied sequentially: 3.0 (8 daily fractions), 4.0 (5 fractions, 3 or 5 fractions/week), and 5.5 (3 fractions, 3 fractions/week) Gy(RBE).Results
A significant decrease in the severity of both acute and late gastrointestinal injuries is achievable with a proton beam. The dynamics of late gastrointestinal and genitourinary toxicity over a 10-year period were generally characterized by a decrease in severity of morbidity by 30% and 15%, respectively.Conclusions
Local irradiation with a fractional dose of 3.0–5.5 Gy(RBE) and a cumulative dose of 28.0–28.8 Gy(RBE) for protons significantly reduces the early and late rectitis severity, but does not reduce the risk of lower urinary tract injuries. Fractionation regimens do not significantly differ in toxicity levels. 相似文献13.
Matthias Diebold Alex Soltermann Selma Hottinger Sarah R. Haile Lukas Bubendorf Paul Komminoth Wolfram Jochum Rainer Grobholz Dirk Theegarten Sabina Berezowska Kaid Darwiche Filiz Oezkan Malcolm Kohler Daniel P. Franzen 《Respiratory research》2017,18(1):210
Background
Although the majority of solitary fibrous tumors of the pleura (SFTP) follow a benign course, 10–25% of patients suffer from recurrence or metastatic disease. Several scoring models have been proposed to predict the outcome. However, none of these included immunohistochemical (IHC) markers as possible prognosticators.Methods
In this multicenter study, we collected clinical data and formalin-fixed and paraffin-embedded (FFPE) tissue blocks of patients with histologically proven SFTP which had been surgically resected between 2000 und 2015. After systematic and extensive IHC staining on tissue microarrays, the results were analyzed and compared to histomorphological and clinical data for their possible prognostic value.Results
In total, 78 patients (mean age 61?±?11 years) were included. Of these, 9 patients (11%) had an adverse outcome including SFTP recurrence (n?=?6) or SFTP-related death (n?=?3). Mean overall survival was 172?±?13 months. 1 and 10-year event-free survival rates were 99% and 93%. In the multivariable analysis only MIB-1 proliferation index (Ki-67) ≥10% (HR 12.3, CI 1.1–139.5, p?=?0.043), ≥4 mitoses per 10 high power fields (HR 36.5, CI 1.2–1103.7, p?=?0.039) and tumor size larger than 10 cm (HR 81.8, CI 1.7–4016.8, p?=?0.027) were independently associated with adverse outcome.Conclusion
A high proliferation rate by MIB-1 IHC was associated with impaired outcome. Upon this, we established a new score using mitosis, necrosis, size of the tumor and MIB-1, which performed better than the traditional scores in our data set. This prognostic score could help to better evaluate outcome of SFTP, but requires external validation.14.
Aparna Gangopadhyay 《Reports of Practical Oncology and Radiotherapy》2018,23(3):228-231
Aim
To identify risk factors that lower efficacy of antibiotic prophylaxis of febrile neutropenia among older patients on chemoradiation.Background
Audit of institutional data showed that older adults are at higher risk of febrile neutropenia during chemoradiation. In limited resource settings widespread use of Granulocyte-Colony Stimulating Factor (G-CSF) is not economically feasible and antibiotics are used commonly. Despite compliance with antibiotics, prophylaxis is inadequate in many patients owing to patient and tumor related factors.Materials and methods
Data from records of 219 older patients receiving antibiotic prophylaxis during chemoradiation were studied. Baseline assessment data and predisposing factors for febrile neutropenia were recorded. All patients received prophylactic fluoroquinolones. Incidence of febrile neutropenia and association with predisposing factors at baseline was analyzed by multiple logistic regression.Results
38.4% developed febrile neutropenia despite compliance. Multiple logistic regression revealed geriatric assessment (G8) score and tumor stage to be significant predictors of febrile neutropenia while on antibiotics (p < 0.0001). Odds ratios for two significant predictors G8 score and tumor stage, respectively, were 2.9 (95% CI 1.8036–4.6815) and 2.7 (95% CI 1.7501–4.1318). Correlation between these two significant predictors was found to be low in our cohort (Spearman's coefficient of rank correlation (rho) – 0.431, p < 0.0001).Conclusion
G8 score and tumor burden are significant predictors of efficacy of antibiotic prophylaxis among older adults receiving chemoradiation. In older patients having poor G8 scores and advanced tumors, antibiotic prophylaxis is unsuitable. Interestingly, co-morbidities and poor performance status did not impact efficacy of antibiotic prophylaxis among our elderly patients. 相似文献15.
Anna Boladeras Ferran Ferrer Valentin Navarro Rodolfo De Blas Oriol Cunillera David Mateo Cristina Gutierrez Evelyn Martinez Salvador Villà Joan Pera Montse Ferrer Ferran Guedea 《Reports of Practical Oncology and Radiotherapy》2018,23(5):360-368
Aim
To evaluate the association between dose–volume histogram (DVH) values in organs at risk (OAR) and patient-reported HRQoL outcomes.Background
Data on the association between DVHs and health-related quality of life (HRQoL) in prostate cancer (PCa) patients are limited.Materials and methods
Five-year follow-up study of 154 patients with organ-confined (stage T1/T2) PCa treated with EBRT between January 2003 and November 2005. HRQoL was evaluated with the Expanded Prostate Cancer Index (EPIC). DVH for OARs (penile bulb, rectum and bladder) were created for all patients for whom data were available (119/154; 77%). The functional data analysis (FDA) statistical method was used. HRQoL data was collected prospectively and data analysis was performed retrospectively.Results
Worsening of urinary incontinence and obstructive symptoms correlated with higher DVH dose distributions at 24 months. Increased rectal bleeding at months 24 and 60 correlated with higher DVH dose distributions in the 40–70?Gy range. Patients with deterioration in rectal incontinence presented a higher DVH distribution range than patients without rectal incontinence. Penile bulb DVH values and erectile dysfunction were not significantly associated.Conclusions
DVH parameters and post-radiotherapy HRQoL appear to be closely correlated, underscoring the importance of assessing DVH values prior to initiating EBRT to determine the risk of developing HRQoL related adverse effects. Advanced treatment modalities may be appropriate in high risk cases to minimize treatment-related toxicity and to improve treatment outcomes and HRQoL. Future studies are needed to better elucidate the association between pre-treatment DVH parameters in organs at risk and subsequent HRQoL. 相似文献16.
Hidekazu Tanaka Takahiro Yamaguchi Kae Hachiya Shingo Kamei Satoshi Ishihara Masahide Hayashi Shinichi Ogawa Hironori Nishibori Satoshi Goshima Masayuki Matsuo 《Reports of Practical Oncology and Radiotherapy》2018,23(1):28-33
Aim
This study aimed to evaluate the treatment result of intensity-modulated radiation therapy (IMRT) in a large number of Japanese patients with prostate cancer.Background
A total of 1091 patients with localized prostate cancer were recruited between March 2006 and July 2014. The patients were stratified into low- (n = 205 [18.8%]), intermediate- (n = 450 [41.2%]), high- (n = 345 [31.6%]), and very high-risk (n = 91 [8.3%]) groups according to the National Comprehensive Cancer Network classification. All patients were irradiated via IMRT at a dose of 74–78 Gy with or without androgen-deprivation therapy. The mean follow-up period was 50 months (range, 2–120 months).Results
The biochemical failure-free rate (BFFR), the clinical failure-free rate, and the overall survival rate at the 5-year follow-up for all patients was 91.3%, 96.2%, and 99.1%, respectively. In univariate analysis, the prostate-specific antigen (PSA) levels (≤20 vs. >20 ng/ml) were significantly correlated with BFFR. A trend toward higher BFFR was noted in patients with a Gleason score (GS) of ≤7 than in patients with GS ≥8. In multivariate analysis, only PSA (≤20 vs. >20 ng/ml) was significantly correlated with BFFR. The cumulative incidence rate of gastrointestinal and genitourinary toxicity (≥grade 2) at the 5-year follow-up was 11.4% and 4.3%, respectively.Conclusions
The findings of this study indicate that IMRT is well tolerated and is associated with both good long-term tumor control and excellent outcomes in patients with localized prostate cancer. 相似文献17.
M. Homo-Seban H. Slimani Thevenet B. Harache S. Boucheneb N. Ghazzar-Pierquet P. Weinmann 《Médecine Nucléaire》2018,42(6):432-438
Objective
Parotid gland incidentalomas are unexpected hypermetabolic foci in the parotid region that can be found when scanning the whole-body by PET/CT. The role of SUVmax is controversial to differentiate benign or malignant tumours in this indication. The aim of this study was to determine PET/CT features of malignant parotid incidentaloma, in order to improve medical care.Methods
We retrospectively reviewed 10,756 PET/CT scans performed during 3?years at our center in search of parotid gland incidentalomas. Twenty-eight patients were included. For each lesion, we have collected the results of parotid MRI, histology and/or subsequent imaging. Logistic regression was used to compare SUVmax, SUVmean, MTV and TLG, and ROC curves were used to assess threshold values.Results
Prevalence of parotid gland incidentalomas was 1.29% (n?=?139). Thirty-seven were included, among them, 46% were malignant. SUVmax, MTV and TLG were significantly higher for malignant tumours (P?≤?0.001). MTV?>?4?mL and TLG?>?7.5?mL were strongly associated with a malignant lesion (MTV and TLG: P?<?0.001; SUVmax: P?=?0.005; SUVmean: P?=?0.07). According to ROC curves, MTV thresholded at 4 had an AUC of 0.92 (Se 75%, Sp 100%) to differentiate benign and malignant lesions.Conclusions
MTV and TLG were predictive factors of malignancy, stronger than SUVmax. However, given the high proportion of malignant lesions and the suboptimal sensitivity of the MTV further exploration must be requested for any parotid gland incidentaloma. 相似文献18.
Giulia Carrano Simona Paulone Lucía Lainz María-Jesús Sevilla Elisabetta Blasi María-Dolores Moragues 《Revista iberoamericana de micología》2019,36(1):9-16
Background
Invasive candidiasis by Candida albicans is associated with high morbidity and mortality, due in part to the late implementation of an appropriate antifungal therapy hindered by the lack of an early diagnosis.Aims
We aimed to evaluate the in vitro antifungal activity of the antibodies against C. albicans germ tubes (CAGTA) raised in a rabbit model of candidemia.Methods
We measured the effect of CAGTA activity by colorimetric XTT and crystal violet assays, and colony forming units count, both on C. albicans planktonic cells and during the course of biofilm formation and maturation. Viability and cell morphology were assessed by optical, fluorescent or scanning electron microscopy.Results
CAGTA ≥50 μg/ml caused a strong inhibition of C. albicans blastospores growth, and DiBAC fluorescent staining evidenced a fungicidal activity. Moreover, electron microscopy images revealed that CAGTA induced morphological alterations of the surface of C. albicans germ tubes grown free as well as in biofilm. Interestingly, CAGTA ≥80 μg/ml reduced the amount of C. albicans biofilm, and this effect started at the initial adhesion stage of the biofilm formation, during the first 90 min.Conclusions
This is the first report showing that CAGTA reduce C. albicans growth, and impair its metabolic activity and ability to form biofilm in vitro. The antigens recognized by CAGTA could be the basis for the development of immunization protocols that might protect against Candida infections. 相似文献19.
Mariano de Miguel Artal Olga Roca Chacón Montse Martínez-Alonso Marcos Serrano Godoy Jaume Mas Atance Roberto García Gutiérrez 《Revista espa?ola de geriatría y gerontología》2018,53(5):247-254
Objective
The aim of this study is to identify the risks factors for mortality and functional recovery in elderly patients admitted to hospital with a hip fracture.Materials and methods
Longitudinal prospective study in patients 80 years old or more and patients between 75 and 79 in residential home care with a hip fracture and with a past medical history of dementia or followed-up by the Geriatric Unit. A total of 359 patients were included, and the demographic data, previous functional status, comorbidity, type of fracture, and dementia were recorded. The data collected during admission included time to surgery, delirium, functional recovery, length of stay, placement at discharge, and mortality. Patients were followed-up for one year and details were collected on placement at the end of follow-up, functional recovery, medical complications, and mortality.Results
The baseline characteristics of the patients with a strong association with mortality after a hip fracture were old age (> 92 years), medical complications delaying surgery (HR 2.17; 95% CI; 1.27-3.73), diagnosis of dementia (HR 1.78; 95% CI; 1.15-2.75), or heart failure (HR 1.75; 95% CI; 1.12-2.75). The fitted multivariable regression models showed that functional impairment before the hip fracture or lack of functional recovery are associated with higher mortality, and patients with increased age, delirium, dementia, and previous functional impairment showed worse functional recovery.Conclusion
In the elderly patients with a hip fracture, increased age, comorbidity and previous functional status is associated with mortality. Functional recovery prognosis will depend on age, previous functional status, past medical history of dementia, and the presence of delirium during admission. 相似文献20.
Rogelio de J. Treviño-Rangel Byron A. Bodden-Mendoza Alexandra M. Montoya Hiram Villanueva-Lozano Mariana Elizondo-Zertuche Efrén Robledo-Leal Gloria M. González 《Revista iberoamericana de micología》2018,35(1):17-21