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Standard external beam radiotherapy is a treatment option for patients with localised prostate cancer and is used in patients with low-, intermediate- and high-risk disease with androgen deprivation according to the risk of the disease. In the last few years, hypofractionated radiotherapy has been demonstrated to be as safe as standard radiotherapy if given over a shorter time than standard radiotherapy with larger doses per fraction. External radiotherapy for localised prostate cancer typically delivers 37–42 fractions of 1·8–2·0 Gy per fraction given 5 days per week over 7·5–8·5 weeks. Hypofractionated radiotherapy delivers 20–28 fractions of 2·5–2·6 Gy per fraction given 5 days per week over 4–5·6 weeks.
Methods:
A retrospective analysis of assessment of 30 patients was undertaken from 2016 to 2018. The aim of this study was to evaluate the 2-year outcomes of 30 patients with prostate cancer treated with hypofractionated radiotherapy 70 Gy in 28 fractions.
Results:
Biochemical failure with hypofractionated radiotherapy was found in a total of 20% of patients. In the classification by risk groups, there were no biochemical failures in low-risk patients; in the low intermediate course, 3·3% of patients; in the high intermediate group, 3·3% patients; and in the high-risk group, the largest documented biochemical failure was in 13·3% of patients. For acute urinary toxicity, grade I was 56·6%; grade II, 6·6%. For acute rectal toxicity, grade I was 46·6%; grade II, 3·3%.
Conclusion:
This is one of the first studies of hypofractionated radiotherapy in prostate cancer in Latin America, and the results of this study demonstrated that the outcomes were similar to the standard regimen in all risk groups.
Multiform glioblastoma (MG) represents 70% of all gliomas, with half of patients older than 65 years with median survival of 12–18 months, hypofractionation seeks to reduce the intensity and duration of treatment without impacting on survival rates. The objective was to determine the global survival and recurrence-free survival of adults over 70 years old with MG treated with hypofractionated radiotherapy and standard scheme. The review of patients older than 70 years treated with radiotherapy from 2013 to 2016 was performed.
Results:
Twenty-four patients were analysed, with a median follow-up of 239 days, and there is no difference in overall survival 12·3 versus 10·5 months (p = 0·55) and recurrence-free survival 8·3 versus 3·4 months (p = 0·48) between both schemes, conventional versus hypofractioanted, respectively.
Conclusion:
The results in this study show that hypofractionated scheme could be comparable in overall survival and recurrence-free survival to conventional fractionation, but a longer patients’ trial should be done.
In this study, we undertake a dosimetric comparison of whole abdominal treatment plans of patients diagnosed with stage 3 Wilms tumour, to assess the benefits of treating these patients with volumetric arch therapy (VMAT) versus 3D conformal radiotherapy.
Material and methods
A retrospective study was undertaken on 23 patients receiving either VMAT or 3D conformal radiotherapy during 2013–2017. A dosimetric comparison was undertaken for both techniques, measuring planning target volume (PTV), conformity index (CI), homogeneity index (HI) and organs at risk (OAR).
Results
The dosimetric parameters for the PTV dose in the VMAT and 3D conformal technique showed no statistical difference (1,289·17 cGy versus 1,357·13 cGy, respectively, p=0·404). However, the VMAT technique had a better CI (1·04 VMAT versus 1·26 3D, p=0·004), and there was little difference in the HI (1·13 VMAT versus 1·15 3D, p=0·1606). In the statistical analysis, the decrease in dose to OAR for the VMAT technique is statistically significant for doses to lung and kidney (p=0·011 and p=0·002, respectively). Between the two techniques, there was no statistical significance in dose difference to the other OAR.
Conclusion
This work proposes using the VMAT technique in whole abdominal irradiation to improve conformity, without affecting the quality of the PTV coverage, when compared with the 3D conformal technique. In addition, VMAT reduces the doses to OAR such as the remaining kidney and lungs that are important to preserve to reduce the probability of radiation toxicity in these patients.
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