PurposeThe purpose of this study was to assess the effectivity of upfront kilovoltage intraoperative radiotherapy (IORT) as a boost in high-risk early-stage breast cancer patients from an international pooled cohort.Materials/MethodsPatients from four centers in three different countries were retrospectively screened. Those with a minimum 1-year follow-up were included. Cumulative local (LR), regional (RR), and distant metastasis rates (DM) were analyzed. Additionally, the estimated overall survival (OS) was assessed. The Cox regression analysis was performed to identify failure predicting factors.ResultsA total of 653 patients from centers in Peru, Spain, and Germany were included. The median follow-up was 55 (12–180) months, and age was 58 (27–86) years. Clinical tumor (T) staging was T1 65.85%, T2 30.17%, and T3 3.98%. Positive margins were found in 7.9% and in-situ component in 20.06%. The median IORT dose was 20 (6–20). The median time from IORT to EBRT was 74.5 (13-364) days. An overall 3.4% (n = 22) of patients developed local recurrence at some point during follow-up. The 12-, 60-, and 120-month cumulative LR were 0.3%, 2.3%, and 7.9%, respectively. After multivariate analysis, only age <50 remained to be a significant prognostic factor for local recurrence (HR 0.19, 95% CI 0.08–0.47; p < 0.05). The 10-year estimated OS was 81.2%.ConclusionUpfront boost with IORT yields similar local control outcomes to those EBRT-based reports. Results from prospective trials, regarding toxicity, cosmesis, and effectivity are awaited to confirm these findings.
Resumo: Em Amar, verbo intransitivo, de Mário de Andrade, há uma passagem em que o Narrador sintetiza em um parágrafo as características do Expressionismo, a propósito de livros e revistas que Fräulein Elza tomara emprestados a um amigo recém-chegado da Alemanha: "uma coleção de "Der Sturm" e obras de Schikele, Franz Werfel e Casimiro Edschmid." (p. 46)
Dans ce texte on discute le prestige que subissent certains domaines des études littéraires, comme l'intertextualité et l'interdisciplinarité, ce qui n'est qu'un reflect du grand tableau sur leque! la fragmentation et le collage ont écrit la culture postmoderne. Parmi les études interdisciplinaires on met I'accent sur I'échange de concepts entre la littérature et la psychanalyse, le texte littéraire étant un lieu de plus pour les formations de l'inconscient.
RESUMOMostrando que a singularidade tio poético mantém os traços coletivos que caracterizam o universo mítico, este texto focaliza o Poema de setefaces, de Carlos Drummond tle Andrade, através tle um código esotérico: os Arcanos Maiores do Tarot.
RESUMETout en montrant que Ia singularité du poétiquc garde des traits collectifs qui caraclérisent lúnivers mythique, ce texte focalise le Poema de setefaces, de Carlos Drummond tle Andrade, par le biais d"un code ésotérique: les Arcancs Majeurs du Tarot.• Profa. Titular de Teoria da Literatura. FALE/UFMG (aposentada). Profa. Emérita da UFMG.•* Este texto é desenvolvimento de um trabalho apresentado na PUC/MG em 1987.
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