espanolEste es un articulo de rev ision dirigido a odontologos y estomato logos generales. En el ... more espanolEste es un articulo de rev ision dirigido a odontologos y estomato logos generales. En el se plantea el problema de los tumores de las glandulas salivales con especial hincapie en los malignos y en el papel de la radioterapia (RT) en el contexto de su tratamiento . Dada su escasa incidencia global y, en particular, la de algunas ele sus variedades anatomopato logicas, la evolucion y el pronostico ele estos tumores es poco predecible. Aunque la cirugia sigue siendo el tratamiento principal , la tendencia a las recaidas tardias (regionales y sistemicas) y la necesidad ele preservar aspectos esteticos y fun cionales sustenta el interes ele la RT. Los resultados de la RT como tratamiento alternativo a la cirugia, con intencion curativa, son escasos, ya que la mayoria ele los pacientes son operados. Sin embargo, la adicion de RT postoperatoria ha reducido notablemente la tasa de recidivas locales y region ales. En pacientes inoperables, la RT es paliativa (solo pretende un control locorregional temporal). Por otra parte, se han publicado resultados alentadores respecto al control local mediante el empleo de neutrones y programas de hiperfraccionamiento con fotones y electrones y, en algunos tipos histologicos, combinando la rad ioterapia con la quimioterapia. EnglishThis is a review article far general dentists. lt poses the problem of salivary gland tumors, particularly the malignant ones, and the role of radiotherapy (RT) in its treatment. The smaff overa ff incidence (particularfy of some patho/ogic types) makes prognosis and evolution difficult to assess. The interest of RT in the treatment of these tumors is basecl upan their tendency to late recurrences (both regional and systemic) and the possibility to preserve cosmesis andfunction, although surgery is still the primary treatment. There are few reports of radical RT asan alternative treatment as most patients un.dergo surgery. However, postoperative RT has notably reduced the local and regional failure rate. In non operable patients, RT is palliative (just far temporal loco-regional control). On the other hand, some encouraging reports have been published using neutrons and hyperfractionating schemes withfotons and electrons and, in some anatomopathologic types, radiochemotherapy schemes.
International Journal of Radiation Oncology*Biology*Physics, 2021
PURPOSE/OBJECTIVE(S) SBRT-SG 05 is a collaborative (SBRT-SG, GICOR and SEOR) prospective multicen... more PURPOSE/OBJECTIVE(S) SBRT-SG 05 is a collaborative (SBRT-SG, GICOR and SEOR) prospective multicenter phase II trial testing SBRT and androgen deprivation therapy (ADT) in oligorecurrent prostate cancer patients. MATERIALS/METHODS Prostate cancer patients (hormone-sensitive or castration-resistant) in an oligorecurrent stage defined as less than 5 bone or lymph node metastases by Choline PET-CT or/and WB-DWI-MRI, after primary treatment, were assigned to receive ADT and SBRT (Vertebral metastases: 1 × 16-18Gy or 3 × 8-9Gy; lymph node metastases: 3 × 10-11 Gy or 6 × 7,5Gy; non-spinal bone metastases: 1 × 16Gy or 3 × 10Gy). Inclusion criteria included: more than 1 year from primary treatment to biochemical recurrence and PSA doubling time greater than 2 months. A minimum of 24 months of LhRh analogues from the time of the enrollment was required and concomitant treatment with chemotherapy, abiraterone or enzalutamide was not allowed. Oncologic outcomes defined by PCWG3 were evaluated separately for hormone-sensitive and castration-resistant patients, using Kaplan-Meier competing risks, and Cox regression. Toxicity was prospectively evaluated according to CTCAE.v4 criteria. RESULTS From 07/2014 to 12/2019, 81 patients from 14 Spanish centers were recruited with a total of 117 oligometastases treated, 67 in lymph nodes, 43 in non--spinal bones and 7 in spinal bones. 14 patients were recruited in a castration-resistance status. Median follow-up was 41 months, (range 18 - 72 months). 13 hormone-sensitive (19,4%) and 8 castration-resistant (57,1%) oligorecurrent patients presented distant disease progression. Median distant progression-free survival (DPFS) was 54,2 months (IC95% = 48,2 - 60,3). 18 of the patients who progressed (85,7%) were treated with SBRT for the new lesions, 7 of them presented a subsequent distant progression (38,9%), with a median of second DPFS of 24,4 months (95% CI = 23,7 - 25,2). In the castration resistant subgroup, median DPFS was 33,5 months (range 14,8 - 52,1), 42,9% of them were free from distant disease progression at last follow-up, without the need to start second generation hormonal treatment. Tolerance and toxicity profiles were excellent, none of the patients developed toxicity ≥G3 or symptoms related to local progression of the disease. CONCLUSION Combination of SBRT and ADT is a safe treatment approach with favorable clinical outcomes for hormone-sensitive and castration-resistant prostate cancer patients. Validation studies are needed in castration-resistant patients. ClinicalTrials.gov Identifier: NCT02192788.
espanolEste es un articulo de rev ision dirigido a odontologos y estomato logos generales. En el ... more espanolEste es un articulo de rev ision dirigido a odontologos y estomato logos generales. En el se plantea el problema de los tumores de las glandulas salivales con especial hincapie en los malignos y en el papel de la radioterapia (RT) en el contexto de su tratamiento . Dada su escasa incidencia global y, en particular, la de algunas ele sus variedades anatomopato logicas, la evolucion y el pronostico ele estos tumores es poco predecible. Aunque la cirugia sigue siendo el tratamiento principal , la tendencia a las recaidas tardias (regionales y sistemicas) y la necesidad ele preservar aspectos esteticos y fun cionales sustenta el interes ele la RT. Los resultados de la RT como tratamiento alternativo a la cirugia, con intencion curativa, son escasos, ya que la mayoria ele los pacientes son operados. Sin embargo, la adicion de RT postoperatoria ha reducido notablemente la tasa de recidivas locales y region ales. En pacientes inoperables, la RT es paliativa (solo pretende un control locorregional temporal). Por otra parte, se han publicado resultados alentadores respecto al control local mediante el empleo de neutrones y programas de hiperfraccionamiento con fotones y electrones y, en algunos tipos histologicos, combinando la rad ioterapia con la quimioterapia. EnglishThis is a review article far general dentists. lt poses the problem of salivary gland tumors, particularly the malignant ones, and the role of radiotherapy (RT) in its treatment. The smaff overa ff incidence (particularfy of some patho/ogic types) makes prognosis and evolution difficult to assess. The interest of RT in the treatment of these tumors is basecl upan their tendency to late recurrences (both regional and systemic) and the possibility to preserve cosmesis andfunction, although surgery is still the primary treatment. There are few reports of radical RT asan alternative treatment as most patients un.dergo surgery. However, postoperative RT has notably reduced the local and regional failure rate. In non operable patients, RT is palliative (just far temporal loco-regional control). On the other hand, some encouraging reports have been published using neutrons and hyperfractionating schemes withfotons and electrons and, in some anatomopathologic types, radiochemotherapy schemes.
International Journal of Radiation Oncology*Biology*Physics, 2021
PURPOSE/OBJECTIVE(S) SBRT-SG 05 is a collaborative (SBRT-SG, GICOR and SEOR) prospective multicen... more PURPOSE/OBJECTIVE(S) SBRT-SG 05 is a collaborative (SBRT-SG, GICOR and SEOR) prospective multicenter phase II trial testing SBRT and androgen deprivation therapy (ADT) in oligorecurrent prostate cancer patients. MATERIALS/METHODS Prostate cancer patients (hormone-sensitive or castration-resistant) in an oligorecurrent stage defined as less than 5 bone or lymph node metastases by Choline PET-CT or/and WB-DWI-MRI, after primary treatment, were assigned to receive ADT and SBRT (Vertebral metastases: 1 × 16-18Gy or 3 × 8-9Gy; lymph node metastases: 3 × 10-11 Gy or 6 × 7,5Gy; non-spinal bone metastases: 1 × 16Gy or 3 × 10Gy). Inclusion criteria included: more than 1 year from primary treatment to biochemical recurrence and PSA doubling time greater than 2 months. A minimum of 24 months of LhRh analogues from the time of the enrollment was required and concomitant treatment with chemotherapy, abiraterone or enzalutamide was not allowed. Oncologic outcomes defined by PCWG3 were evaluated separately for hormone-sensitive and castration-resistant patients, using Kaplan-Meier competing risks, and Cox regression. Toxicity was prospectively evaluated according to CTCAE.v4 criteria. RESULTS From 07/2014 to 12/2019, 81 patients from 14 Spanish centers were recruited with a total of 117 oligometastases treated, 67 in lymph nodes, 43 in non--spinal bones and 7 in spinal bones. 14 patients were recruited in a castration-resistance status. Median follow-up was 41 months, (range 18 - 72 months). 13 hormone-sensitive (19,4%) and 8 castration-resistant (57,1%) oligorecurrent patients presented distant disease progression. Median distant progression-free survival (DPFS) was 54,2 months (IC95% = 48,2 - 60,3). 18 of the patients who progressed (85,7%) were treated with SBRT for the new lesions, 7 of them presented a subsequent distant progression (38,9%), with a median of second DPFS of 24,4 months (95% CI = 23,7 - 25,2). In the castration resistant subgroup, median DPFS was 33,5 months (range 14,8 - 52,1), 42,9% of them were free from distant disease progression at last follow-up, without the need to start second generation hormonal treatment. Tolerance and toxicity profiles were excellent, none of the patients developed toxicity ≥G3 or symptoms related to local progression of the disease. CONCLUSION Combination of SBRT and ADT is a safe treatment approach with favorable clinical outcomes for hormone-sensitive and castration-resistant prostate cancer patients. Validation studies are needed in castration-resistant patients. ClinicalTrials.gov Identifier: NCT02192788.
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