5 research outputs found
Intraoperative radiotherapy electron boost followed by moderate doses of external beam radiotherapy in resected soft-tissue sarcoma of the extremities
To analyze the patterns of failure and the toxicity profile of
intraoperative electron beam radiotherapy (IOERT) after resection of soft tissue
sarcomas of the extremities (STS). PATIENTS AND METHODS: Forty-five patients with
extremity STS were treated with IOERT and moderate-dose postoperative
radiotherapy (45-50 Gy). Twenty-six patients were treated for primary disease
(PD) and 19 patients for an isolated recurrence (ILR). Tumor size was >5 cm
(maximum diameter) in 36 patients (80%), and high-grade histology in PD patients
was present in 14 patients (54%). In nine patients, IOERT was used alone, due to
previous irradiation or patient refusal. Chemotherapy (neoadjuvant and/or
adjuvant) was mainly given to high-grade tumors. RESULTS: Nine patients relapsed
in the extremity (20%), and 12 patients in distant sites (28%). Actuarial local
control at 5 years was 88% for patients with negative/close margins and 57% for
patients presenting positive margins (P=0.04). Five patients (11%) developed
neuropathy associated with the treatment. Extremity preservation was achieved in
40 patients (88%). With a median follow-up of 93 months (range: 27-143 months)
for the patients at risk, 25 patients remain alive (a 7-year actuarial survival
rate of 75% for PD and 47% for ILR; P=0.01). CONCLUSIONS: IOERT combined with
moderate doses of external beam irradiation yields high local control and
extremity preservation rates in resected extremity STS. Peripheral nerves in the
IOERT field are dose-limiting structures requiring a dose compromise in the IOERT
component to avoid severe neurological damage
Phase II trial of image-based high-dose-rate interstitial brachytherapy for previously irradiated gynecologic cancer
Trends in Targeted Therapy Usage in Inflammatory Bowel Disease : TRENDY Study of ENEIDA
Markers that allow for the selection of tailored treatments for individual patients with inflammatory bowel diseases (IBD) are yet to be identified. Our aim was to describe trends in real-life treatment usage. For this purpose, patients from the ENEIDA registry who received their first targeted IBD treatment (biologics or tofacitinib) between 2015 and 2021 were included. A subsequent analysis with Machine Learning models was performed. The study included 10,009 patients [71% with Crohn's disease (CD) and 29% with ulcerative colitis (UC)]. In CD, anti-TNF (predominantly adalimumab) were the main agents in the 1st line of treatment (LoT), although their use declined over time. In UC, anti-TNF (mainly infliximab) use was predominant in 1st LoT, remaining stable over time. Ustekinumab and vedolizumab were the most prescribed drugs in 2nd and 3rd LoT in CD and UC, respectively. Overall, the use of biosimilars increased over time. Machine Learning failed to identify a model capable of predicting treatment patterns. In conclusion, drug positioning is different in CD and UC. Anti-TNF were the most used drugs in IBD 1st LoT, being adalimumab predominant in CD and infliximab in UC. Ustekinumab and vedolizumab have gained importance in CD and UC, respectively. The approval of biosimilars had a significant impact on treatment