ICO-ICS Praxis para el tratamiento médico y con irradiación del linfoma B difuso de célula grande

Tractament mèdic; Tractament amb irradiació; Limfoma B difús de cèl·lula granMedical treatment; Irradiation treatment; Diffuse large cell B lymphomaTratamiento médico; Tratamiento con irradiación; Linfoma B difuso de célula grandeEls limfomes no hodgkinians (LNH) són neoplàsies originades en cèl·lules limfoides en diferents estats maduratius, la qual cosa explica la gran heterogeneïtat biològica i clínica d’aquests tumors. Hi ha diversos sistemes de classificació, però el més utilitzat és la Classificació euroamericana revisada de limfomes de l'Organització Mundial de la Salut. El limfoma B difús de cèl·lula gran suposa aproximadament entre el 30-40% dels limfomes dels adults. Habitualment afecta adults amb una edat mitjana superior a 60 anys i el 60% dels pacients presenten els anomenats símptomes B (febre de 38 ºC o més, pèrdua de pes de més del 10% i/o sudoració nocturna. La majoria de casos són formes de novo però també poden ser deguts a la progressió o transformació d’una malaltia limfoproliferativa prèvia. Els objectius d'aquest document són: Desenvolupar, difondre, implementar i avaluar resultats de la ICO-ICSPraxi del limfoma B difús de cèl·lula gran. - Disminuir la variabilitat terapèutica entre els pacients tractats als diferents centres d'aquesta institució. - Implementar els resultats de la terapèutica en els pacients amb limfoma B difús de cèl·lula gran tractats d’acord amb les recomanacions d’aquesta guia

Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results

AimThis study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.BackgroundRadiation is frequently used for prostate cancer, but a 5–20% incidence of late radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined without a full agreement. For patients diagnosed of late chronic proctitis and/or cystitis grade ≥2 treatment is not well defined. Hyperbaric Oxygen Therapy (HBOT) has been used, but its effectiveness is not well known.Materials and methods257 patients were treated with radiation therapy for prostate cancer. Clinical, pharmacological and dosimetric parameters were collected. Patients having a grade ≥2 toxicity were treated with HBOT. Results of the intervention were measured by monitoring toxicity by Common Toxicity Criteria v3 (CTCv3).ResultsLate rectal toxicity was related to the volume irradiated, i.e. V50[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]53.64 (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.013); V60[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]38.59% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.005); V65[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]31.09% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.002) and V70[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]22.81% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.012). We could not correlate the volume for bladder. A total of 24 (9.3%) patients experienced a grade ≥2. Only the use of dicumarinic treatment was significant for late rectal toxicity (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.014). A total of 14 patients needed HBOT. Final percentage of patients with a persistent toxicity grade ≥2 was 4.5%.ConclusionRectal volume irradiated and dicumarinic treatment were associated to late rectal/bladder toxicity. When toxicity grade ≥2 is diagnosed, HBOT significantly ameliorate symptoms

Significantly reduced incidence and improved survival from prostate cancer over 25 years

Abstract Background Prostate cancer (PCa) was the second most frequent cancer and the fifth leading cause of cancer death among men in 2020. The aim of this study was to analyze trends in the incidence, mortality and survival of PCa in Girona, Spain, over 25 years. Methods Population-based study of PCa collected in the Girona Cancer Registry, 1994–2018. Age-adjusted incidence and mortality rates were calculated per 100,000 men-year. Joinpoint regression models were used for trends, calculating the annual percentage changes (APC). Observed and net survival were analyzed using Kaplan–Meier and Pohar-Perme estimations, respectively. Results A total of 9,846 cases of PCa were registered between 1994–2018. The age-adjusted incidence and mortality rates were 154.7 (95%CI: 151.7 157.8) and 38.9 (95%CI: 37.3 –40.6), respectively. An increased incidence of 6.2% was observed from 1994 to 2003 (95%CI: 4.4 –8.1), and a decrease of -2.7% (95%CI: -3.5 –;-1.9) between 2003 and 2018. Mortality APC was -2.6% (95%CI: -3.3 –-2.0). Five-year observed and net survival were 72.8% (95%CI: 71.8 – 73.7) and 87.2% (95%CI: 85.9 – 88.4), respectively. Five-year net survival increased over time from 72.9% (1994–1998) to 91.3% (2014–2018). Conclusions The analyses show a clear reduction in PCa incidence rates from 2003 on, along with an increase in overall survival when comparing the earlier period with more recent years