radioterapia

放射性马甲
  • 文章类型: Systematic Review
    背景:世界范围内癌症幸存者的数量正在增长,但是放疗的副作用仍然很常见,影响努力能力,呼吸功能和生活质量。目的是了解体育锻炼如何影响呼吸功能和对努力的耐受性,在放疗后的乳腺癌患者中。
    方法:搜索在Pubmed的数据库中进行,PEDro,网络科学,科克伦,EMBASE,UptoDate和Tripdatabase。纳入了接受放射治疗并纳入锻炼计划的乳腺癌患者的研究。主要结果是:最大耗氧量,6分钟步行测试,强制肺活量,肺活量,1秒用力呼气量,休息室总容量,吸气量,以及肺部对一氧化碳的扩散能力。
    结果:结果表明,最大耗氧量提高了15%,在6分钟步行测试中提高了6.675%,虽然它们对呼吸功能有限。
    结论:体育锻炼可有效提高放疗治疗乳腺癌患者的努力能力,不改变呼吸功能。然而,有必要进行新的研究,以深入研究体育锻炼对这些和平时期的影响,以及程序的理想设计。
    BACKGROUND: The number of survivors with cancer is growing worldwide, but the adverse effects of the radiotherapy are still frequent, affecting effort capacity, respiratory function and quality of life. The objective is to know how the physical exercise influences the respiratory function and tolerance to effort, in pacients with breast cancer after the radiotherapy treatment.
    METHODS: The searches were carried out in the databases of Pubmed, PEDro, Web Of Science, Cochrane, EMBASE, UptoDate and Tripdatabase. Were included studies with patients with breast cancer treated with radiotherapy and included in an exercise program. The main results were: maximum oxygen consumption, 6 minutes walking test, forced vital capacity, vital capacity, forced expiratory volume in 1 second, total lounge capacity, inspiratory capacity, and the diffusion capacity of the lungs for carbon monoxide.
    RESULTS: The results show an increase of the effort capacity with 15% improvements in the maximum oxygen consumption and 6.675% in the 6 minutes walking test, while they are limited for the respiratory function.
    CONCLUSIONS: The physical exercise is effective for improve the effort capacity in pacients with breast cancer treated with radiotherapy, without changes in the respiratory function. Nevertheless, new studies are necessary to investigate deeply how the physical exercise influences in those pacients, and the ideal design of the programs.
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  • 文章类型: Journal Article
    Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in humans and its incidence is rising. Although surgery is the treatment of choice for cSCC, postoperative adjuvant radiotherapy has an important role in local and locorregional disease control. In this review, we analyze the value of postoperative radiotherapy in the management of high-risk cSCC (in particular, cases with perineural invasion), cSCC with positive surgical margins, and locally advanced cSCC (with parotid gland and/or lymph node metastasis).
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  • 文章类型: Journal Article
    BACKGROUND: High-dose rate brachytherapy (HDR-BT) is an increasingly popular treatment for patients with localised prostate cancer (PC).
    OBJECTIVE: To assess the safety and efficacy of HDR-BT as monotherapy in PC.
    UNASSIGNED: A systematic literature review was conducted through searches on MEDLINE (PubMed), Cochrane Library, CDR, ClinicalTrials and EuroScan. We assessed safety and efficacy indicators.
    UNASSIGNED: We selected 2 reviews and 12 uncontrolled studies, included in these 2 reviews. In terms of efficacy, local control in 6 studies was 97-100%. The biochemical progression-free survival varied as follows: 85-100% for low risk and 79-92% for high risk. Survival free of metastases was >95% at 8 years, except in one study where the survival rate was 87% at 5 years. The overall survival was ≥95% in 8 studies. In terms of safety, most of the studies recorded acute and long-term genitourinary and gastrointestinal complications, especially grade ≥2. Only 3 studies found grade 4 complications. All studies, except for one without complications, observed genitourinary complications that were more frequent and severe than the gastrointestinal complications. Two studies assessed the quality of life and showed an initial reduction in various domains and subsequent partial or total recovery, except in the sexual domain.
    CONCLUSIONS: HDR-BT is effective as monotherapy, especially in cases of low to intermediate risk. There is insufficient information on high-risk patients. The short to medium-term toxicity was acceptable. Further research needs to be funded to provide more information on the long-term safety and efficacy of this treatment.
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  • 文章类型: Journal Article
    背景:放射治疗后,大多数患者会出现一定程度的急性皮肤毒性。这项系统评价的目的是评估有关局部治疗对放疗后发生放射性皮炎的乳腺癌患者的有效性的现有证据。
    方法:该综述包括旨在评估局部疗法预防或治疗乳腺癌女性急性放射性皮炎的临床试验,于2009年至2014年间出版。书目搜索在以下数据库中进行:PubMed,Cinahl,CochranePlus,IBECS和LILACS。这些研究是由同行评审员使用西班牙语版本的关键评估技能计划独立选择的。
    结果:确定了86篇参考文献。对20篇临床试验的全文文章进行了评估,其中2篇因为未完成而被排除在外;12篇临床试验评估了使用乳膏和软膏的局部治疗,三个用皮质类固醇乳膏,其他三个用敷料。人表皮生长因子乳膏的有效性,亚油酸乳液,局部磺胺嘧啶银,这些临床试验中已显示皮质类固醇乳膏和聚氨酯敷料。
    结论:鉴于放射性皮炎是一个动态过程,这些外用药物在皮肤毒性的不同阶段都有效。其中一些延迟了发病,其他人降低了急性皮肤毒性程度的发展和严重程度,其他人改善了主观症状(瘙痒,疼痛,燃烧)。只有聚氨酯敷料表明在皮肤毒性的所有阶段都有效,在预防方面,管理不同程度的皮肤毒性和改善健康。
    BACKGROUND: After radiation therapy most patients experience acute skin toxicity to some degree. The purpose of this systematic review is to assess the available evidence concerning the effectivity of topical therapies on patients with breast cancer that experience radiodermatitis after radiotherapy.
    METHODS: The review included clinical trials aimed to evaluate topical therapies for prevention or treatment of acute radiodermatitis in women with breast cancer, which were published between 2009 and 2014. The bibliographic search was carried out in the following databases: PubMed, Cinahl, Cochrane Plus, IBECS and LILACS. The studies were selected independently by peer reviewers using the Critical Appraisal Skills Programme in its Spanish version.
    RESULTS: 86 bibliographical references were identified. Twenty full-text articles of clinical trials were assessed and two were excluded because they were not completed; 12 of clinical trials evaluated topical treatment with creams and ointments, three with corticosteroid creams and other three with dressings. The effectivity of human epidermal growth factor cream, linoleic acid emulsion, topical silver sulfadiazine, corticosteroids creams and polyurethane dressings has been shown in these clinical trials.
    CONCLUSIONS: Given that radiodermatitis is a dynamic process, these topical agents were effective in different stages of skin toxicity. Some of them delayed the onset, others decreased the development and severity of acute skin toxicity degree and others improved the subjective symptoms (itching, pain, burning). Only polyurethane dressings suggest effectiveness in all stages of skin toxicity, in prevention, management of the different skin toxicity degrees and improvement of wellbeing.
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  • 文章类型: Comparative Study
    BACKGROUND: New therapeutic alternatives can improve the safety and efficacy of prostate cancer treatment.
    OBJECTIVE: To assess whether hypofractionated radiation therapy results in better safety and efficacy in the treatment of prostate cancer.
    METHODS: Systematic review of the literature through searches on PubMed, Cochrane Library, CRD, ClinicalTrials and EuroScan, collecting indicators of safety and efficacy.
    UNASSIGNED: We included 2 systematic reviews and a clinical trial. In terms of efficacy, there is considerable heterogeneity among the studies, and no conclusive results were found concerning the superiority of the hypofractionated option over the normal fractionated option. In terms of safety, there were no significant differences in the onset of acute genitourinary complications between the 2 treatments. However, one of the reviews found more acute gastrointestinal complications in patients treated with hypofractionated radiation therapy. There were no significant differences in long-term complications based on the type of radiation therapy used, although the studies did have limitations.
    CONCLUSIONS: To date, there are no conclusive results that show that hypofractionated radiation therapy is more effective or safer than normal fractionated radiation therapy in the treatment of localized prostate cancer.
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