RESUMO
PURPOSE: To evaluate feasibility of accelerated partial breast irradiation (APBI) using stereotactic radiotherapy (SBRT) Thirty Gy delivered in 5 fractions for patients with early breast cancer. METHODS: Between January 1st, 2018, and December 31s, 2022, we conducted 117 treatments for patients with early-stage breast cancer. All patients underwent conservative surgery followed by APBI using stereotactic external beam radiotherapy. We analyzed local, regional, distant control, overall survival, toxicity, and cosmetic outcomes. RESULTS: The average age was 62 years. 21.3% ductal and 78.7% invasive carcinomas. Regarding the PTV volume, the median was 198.8 cc (38-794 cc). Treatments were completed in all cases. The median follow-up period was of 21 months (1-62 months). Regarding acute toxicity, no Grade 3-4 toxicities were recorded. One patient experienced Grade 2 neuropathic pain. One patient developed subacute fibrosis and two patients developed telangiectasia as subacute and chronic toxicity. Cosmetic results were "good" or "very good" in 96.3% of cases. None of the patients relapsed at any level (local, regional, or distant) and overall survival during follow.up was 100%. CONCLUSION: APBI with SBRT 30 Gy in 5 fractions in early-stage breast cancer is a feasible technique, very-well tolerated and has excellent oncologic and cosmetic outcome during our follow-up period.
Assuntos
Neoplasias da Mama , Fracionamento da Dose de Radiação , Estudos de Viabilidade , Radiocirurgia , Humanos , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Neoplasias da Mama/mortalidade , Pessoa de Meia-Idade , Radiocirurgia/métodos , Radiocirurgia/efeitos adversos , Idoso , Adulto , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Ductal de Mama/mortalidade , Idoso de 80 Anos ou mais , Seguimentos , Estudos Retrospectivos , Mastectomia SegmentarRESUMO
The study analyzes the current status of personalized medicine in pediatric oncology in Spain. It gathers national data on the tumor molecular studies and genomic sequencing carried out at diagnosis and at relapse, the centers that perform these studies, the technology used and the interpretation and clinical applicability of the results. Current challenges and future directions to achieve a coordinated national personalized medicine strategy in pediatric oncology are also discussed. Next generation sequencing-based (NGS) gene panels are the technology used in the majority of centers and financial limitations are the main reason for not incorporating these studies into routine care. Nowadays, the application of precision medicine in pediatric oncology is a reality in a great number of Spanish centers. However, its implementation is uneven and lacks standardization of protocols; therefore, national coordination to overcome the inequalities is required. Collaborative work within the Personalized Medicine Group of SEHOP is an adequate framework for encouraging a step forward in the effort to move precision medicine into the national healthcare system.
Assuntos
Hematologia , Neoplasias , Criança , Consenso , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Neoplasias/genética , Neoplasias/patologia , Neoplasias/terapia , Medicina de Precisão/métodos , EspanhaRESUMO
PURPOSE: Early phase trials are crucial in developing innovative effective agents for childhood malignancies. We report the activity in early phase paediatric oncology trials in Spain from its beginning to the present time and incorporate longitudinal data to evaluate the trends in trial characteristics and recruitment rates. METHODS: Members of SEHOP were contacted to obtain information about the open trials at their institutions. The study period was split into two equal periods for analysis: 2007-2013 and 2014-2020. RESULTS: Eighty-one trials and two molecular platforms have been initiated. The number of trials has increased over the time of the study for all tumour types, with a predominance of trials available for solid tumours (66%). The number of trials addressed to tumours harbouring specific molecular alterations has doubled during the second period. The proportion of industry-sponsored compared to academic trials has increased over the same years. A total of 565 children and adolescents were included, with an increasing trend over the study period. For international trials, the median time between the first country study approval and the Spanish competent authority approval was 2 months (IQR 0-6.5). Fourteen out of 81 trials were sponsored by Spanish academic institutions. CONCLUSIONS: The number of available trials, and the number of participating patients, has increased in Spain from 2007. Studies focused on molecular-specific targets are now being implemented. Barriers to accessing new drugs for all ranges of age and cancer diseases remain. Additionally, opportunities to improve academic research are still required in Spain.
Assuntos
Ensaios Clínicos como Assunto/estatística & dados numéricos , Oncologia/tendências , Neoplasias/terapia , Pediatria/tendências , Adolescente , Adulto , Criança , Seguimentos , Humanos , Estudos Longitudinais , Neoplasias/patologia , Sociedades Médicas , Adulto JovemRESUMO
We present a protocol to deterministically prepare the electromagnetic field in a large photon number state. The field starts in a coherent state and, through resonant interaction with one or few two-level systems, it evolves into a coherently displaced Fock state without any postselection. We show the feasibility of the scheme under realistic parameters. The presented method opens a door to reach Fock states, with nâ¼100 and optimal fidelities above 70%, blurring the line between macroscopic and quantum states of the field.
RESUMO
We report the experimental implementation of a new method for generating multiple dynamical optical tweezers, where each one of them is generated with an independent linear polarization state with arbitrary orientation. This also allows an independent simultaneous polarization-rotation control. The laser beam, both for generating multiple traps and polarization control, has been modulated using a single reflective nematic liquid crystal with parallel alignment. We present experimental results of controlled displacement, orientation and rotation of birefringent particles. In addition, a simple method for estimating and canceling out the primary astigmatism present in the system is presented.
Assuntos
Biofísica/métodos , Birrefringência , Holografia/instrumentação , Pinças Ópticas , Rotação , Algoritmos , DNA/química , Dimerização , Desenho de Equipamento , Holografia/métodos , Cristais Líquidos , Óptica e Fotônica/métodos , Tamanho da Partícula , Estresse Mecânico , Raios UltravioletaRESUMO
Clustered speckle patterns are a particular type of speckles that appear when a coherently illuminated diffuser is imaged through a multiple aperture pupil mask attached to a lens. The cluster formation is the result of the complex speckle modulations of the multiple interferences produced by the apertures. In this paper, a three-dimensional analytical approach to simulate cluster speckles everywhere after the lens is presented. This approach has the possibility of including multiple aperture masks at the lens and at the diffuser, in contrast to previous works which were also limited to the description of the patterns only at the image plane. This model contributes to the development of tailor made speckle patterns that can be used in diverse optical applications, including those lying in the focus region. The approach is validated under different conditions by comparing experimental results with simulations on a statistical basis. Some aspects of possible uses of these clusters are briefly revised, such as optical trapping, manipulation and metrology.
RESUMO
The epidemiology of animal trypanosomosis around Bobo-Dioulasso (Burkina Faso, West Africa) benefited a lot in the last years from the progress of molecular tools. The two most used molecular techniques were the polymerase chain reaction for the diagnosis of the disease in cattle and the characterization of the trypanosomes in the host and the vector on one hand, and the microsatellite DNA polymorphism in tsetse flies to study the intraspecific genetic variability of the vector on the other hand. The results obtained in the Sideradougou area during a recent two year survey with these techniques, associated with many other georeferenced informations concerning vector and cattle distribution, natural environment, landuse, ground occupation, livestock management, were combined in a Geographical Information System. This new approach of a complex pathogenic system led to a better evaluation of the risk of trypanosome transmission.
Assuntos
Tripanossomíase Africana/veterinária , Tripanossomíase Bovina/epidemiologia , África Ocidental/epidemiologia , Animais , Bovinos , Marcadores Genéticos , Repetições de Microssatélites , Fatores de Risco , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/epidemiologia , Tripanossomíase Africana/genética , Tripanossomíase Bovina/diagnóstico , Tripanossomíase Bovina/genéticaRESUMO
A pilot, open, comparative study was performed on patients with locally advanced cervical cancer to investigate the efficacy and safety of amifostine. Twenty patients with a histologic diagnosis of squamous cervical cancer were treated with radiotherapy and randomized in two groups. Group A received cisplatin at 20 mg/m2 for five days in two cycles during intracavitary radiotherapy and 100 mg/m2 x 2 cycles during external radiotherapy, and amifostine 825 mg/m2 15 min before the cisplatin infusion. Patients in group B received cisplatin in the same doses without amifostine. All patients had complete responses during a median follow-up of 20 months. Grade three neutropenia was present in two patients in group A and in four of the control group, P = 0.31; grade 2 neurologic toxicity was seen in four patients in group B and in one of the patients in group A, P = 0.15. One patient needed temporary interruption of amifostine due to hypotension. Eight of 10 patients in group A developed hypocalcemia during the treatment with amifostine. Our findings indicate that amifostine was well tolerated. In this series a mild neurologic and hematologic protection was found in patients that received amifostine, although this was not statistically significant. No differences in disease-free survival response and overall survival was seen between the two groups.
RESUMO
Levels of Zn, Cu and Fe were measured in blood serum samples of 320 children: 160 boys and 160 girls randomly selected, ages between 7 and 14 years, all considered healthy and residing in the City of Merida, Venezuela. The metals were determined using flow injection analysis-flame atomic absorption spectrometry. There was a tendency for serum Zn (SZn) to increase with age. There was no significant difference in SZn levels between males and females in the different age groups. Serum copper (SCu) decreases significantly (p < 0.05) with age in male children, whereas it increases in female children. The concentration of serum iron (SFe) tends to be lower than that reported in the literature. However, the age groups studied showed no statistically significant sex and age-related differences. The results are compared with values previously reported for healthy children studied in other communities. The present study has shown that there is a complex interaction between SZn, SCu, SFe and age and sex of the children. On the other hand, our observations also suggest that more detailed studies of these metals should be done, and that the study should include metabolic balances and associations between SZn, SCu, SFe and anthropometric variables (height, weight, body mass index and skinfold thickness).
Assuntos
Cobre/sangue , Saúde , Ferro/sangue , Zinco/sangue , Adolescente , Fatores Etários , Análise de Variância , Criança , Feminino , Humanos , Masculino , Fatores Sexuais , VenezuelaRESUMO
Se realiza una revisión de los datos clínicos, radiológicos y ecográficos observados en 3 casos de diverticulos de la uretra femenina. Se practicó cistouretrografía miccional a todas las pacientes, ecografía por vía vaginal y suprapúbica. Se discuten los resultados del estudio, así como el diagnóstico diferencial con otras masas de la misma localización
Assuntos
Humanos , Feminino , Adulto , Divertículo/cirurgia , Divertículo/diagnóstico , Divertículo , Divertículo/terapia , Uretra/patologia , Diagnóstico DiferencialRESUMO
Se realiza una revisión de los datos clínicos, radiológicos y ecográficos observados en 3 casos de diverticulos de la uretra femenina. Se practicó cistouretrografía miccional a todas las pacientes, ecografía por vía vaginal y suprapúbica. Se discuten los resultados del estudio, así como el diagnóstico diferencial con otras masas de la misma localización(AU)