Braquiterapia intersticial para recidivas de câncer de colo uterino pós-radioterapia

Oliveira, Antonio Carlos Zuliani de; Esteves, Sérgio Carlos Barros; Feijo, L; Tagawa, Eduardo K.; Cunha, Maércio de Oliveira

doi:10.1590/s0100-39842005000200007

Radiol Bras

2005

DOI: 10.1590/s0100-39842005000200007

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Braquiterapia intersticial para recidivas de câncer de colo uterino pós-radioterapia

Antonio Carlos Zuliani de Oliveira

Sérgio Carlos Barros Esteves

L Feijo

et al.

Abstract: OBJETIVO: Analisar a resposta e toxicidade da braquiterapia de alta taxa de dose (BATD) intersticial para carcinoma do colo do útero com recidiva pélvica pós-radioterapia. MATERIAIS E MÉTODOS: Entre 1998 e 2001, 11 pacientes com carcinoma de colo de útero e que tiveram recidiva pélvica pós-radioterapia receberam BATD intersticial. Idade: 41 a 71 anos (média: 56,5 anos); estádios (FIGO): IIA, IIB, IIIB e IVA. Nove (82%) pacientes tinham carcinoma de células escamosas e duas (18%), adenocarcinoma. Dose total de … Show more

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“…With this approach, the rate of complications was considerably reduced (5)(6)(7) . Nowadays, the system fundamentals are the same, except for the incorporation of information technology to the process, in association with the utilization of highdose-rate isotopes, allowing much faster and more accurate procedures (8,9) .…”

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Algumas considerações sobre a retite actínica

Nadalin

2009

Radiol Bras

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EditorialThe article "Rectal dose assessment in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer" published in the present issue of Radiologia Brasileira deals with a relevant theme currently discussed in radiotherapy and oncology.Radiation proctitis is condition of the rectum caused by ionizing radiation. It may be acute (arising during or right after radiation therapy), and in these case is generally self-limited. Symptoms of acute proctitis are diarrhea, eventual bleeding, mucus loss or constipation.Histological changes are limited to the mucosa, and the cells with a more rapid turnover are the most sensitive ones.Late radiation proctitis may occur up to two years after radiation therapy with more severe symptoms: mucus loss, pain, rectal urgency, bleeding, ulceration, stenosis and even rectovaginal fistulas. In late radiation proctitis, histological findings correspond to changes of vascular nature and fibrosis of the subintimal layer.Radiation proctitis severity is directly proportional to the dose received and dose volume, as well as to the number of fractions and the length of the interval between them. It is this dose limitation (both in radiotherapy and chemotherapy) that produces better or worst results in the management of cancer.Radiation proctitis has been known for more than one century, but factors determining a worsening in the prognosis such as association with other diseases (diabetes, hypertension, collagen diseases, etc.) have only recently been confirmed.Wherever possible, the treatment for radiation proctitis should be conservative. In the acute phase of the disease, symptomatic medication is generally enough to relieve the symptoms. The discomfort can be relieved with corticoid retention enema, besides the utilization of sulphasalazine. Major bleedings can be managed with argon laser therapy. Although criticized by some authors, the utilization of hyperbaric oxygen therapy may also be useful. Colostomy should be the last resource to be adopted, in most resistant cases (1)(2)(3)(4) .So, considering the wealth of symptoms and the difficulty in the management of radiation proctitis, this complication should be avoided at maximum, without impairing the tumor management.How to do it? Up to few years ago, brachytherapy applicators were preloaded with radioactive seeds with a known activity. The applicator was introduced and, even if the dose distribution was not the ideal, there was nothing to do but observing.Early in the 1970's, afterloading applicators were introduced. With the applicators in place, "phantom" sources were introduced, and calculations were performed for 0100-3984 © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Some considerations about radiation proctitisAlgumas considerações sobre a retite actínica

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confidence: 99%

Algumas considerações sobre a retite actínica

Nadalin

2009

Radiol Bras

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Use of interstitial brachytherapy in pelvic recurrence of cervical carcinoma: Clinical response, survival, and toxicity

Silva

Diniz²,

Martins³

et al. 2019

Brachytherapy

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The usefulness of reirradiation in the treatment of pelvic recurrence of rectal and gynaecological tumours

2006

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SummaryPelvic tumors recurrences have diminished with the modern radiation therapy techniques. However, they are still observed, with or without distant metastases, leading to a serious and even mortal disease. The choice of an adequate therapy poses a clinical challenge. One of the procedures is the repetition of radiation therapy.In this review we manifest how complex is the treatment of gynecological and rectal tumors recidivations, and the importance of a detailed consideration of the available therapies in order to make a decision, specially when the primary tumor has been previously irradiated, be it as only treatment or combined with other therapies.

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Braquiterapia intersticial para recidivas de câncer de colo uterino pós-radioterapia

Cited by 3 publications

References 34 publications

Algumas considerações sobre a retite actínica

Algumas considerações sobre a retite actínica

Use of interstitial brachytherapy in pelvic recurrence of cervical carcinoma: Clinical response, survival, and toxicity

The usefulness of reirradiation in the treatment of pelvic recurrence of rectal and gynaecological tumours

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