Recursos académicos, investigaciones y materiales de referencia actualizados, diseñados para fortalecer la práctica médica y el aprendizaje continuo.
YanGao,MM,aLeiHuang,MS,aBoZhao,PhD,bLinMa,MD,aXuesongLi,MD,cXimengDeng,MM,aMingweiMa,MD,aXueyingRen,MD,aJiayanChen,MD,aHongzhenLi,MD,aandXianshuGao,MD,PhDa,*
KrishnanR.Patel,MD,MHS,aEricaSchott,CRNP,aErichP.Huang,PhD,bTheresaCooley-Zgela,RN,aHollyNing,PhD,aJasonCheng,PhD,aBarisTurkbey,MD,candDeborahE.Citrin,MDa,*
Este trabajo comparó la técnica Modulated Arc Therapy (mARC) con IMRT para la irradiación cerebral total con preservación hipocampal, siguiendo los criterios del protocolo RTOG 0933. Los resultados mostraron que IMRT logró ligeramente mejor conformidad del plan y menor dosis al hipocampo y otros órganos críticos. No obstante, la técnica mARC permitió reducciones significativas en el número de unidades monitoras y en el tiempo de tratamiento, lo que representa una ventaja operativa relevante. En conjunto, mARC se perfila como una alternativa técnicamente viable y eficiente para este tipo de tratamiento.
Este estudio evaluó la relación entre la distancia de contacto cardíaco (CCD) y la dosis máxima recibida por la arteria coronaria descendente anterior (LAD) en pacientes con radioterapia postmastectomía por cáncer de mama izquierdo. En una cohorte de 53 pacientes, se compararon planes con 3D-CRT, IMRT y VMAT. Se observó una correlación positiva entre la CCD y la dosis máxima a la LAD, lo que sugiere su utilidad como predictor anatómico de exposición coronaria. Asimismo, las técnicas moduladas mostraron mejor homogeneidad del plan y menor dosis cardíaca en comparación con la radioterapia conformal.
1. Objetivo del artículo Esta guía técnica de ESTRO busca establecer recomendaciones prácticas basadas en evidencia y consenso experto para la implementación de: IMRT (Intensity Modulated Radiotherapy) VMAT IGRT (Image-Guided Radiotherapy) en el tratamiento del cáncer de recto, dado que aunque estas técnicas ya son estándar en muchos centros, existía falta de guías técnicas detalladas para su implementación clínica.
3. "Dosimetric evaluation of a hybrid treatment planning for whole-brain radiation with hippocampal sparing" International Journal of Radiation Research (2024): 22(2): 321-328 La irradiación a holocráneo con preservación de hipocampos busca reducir el deterioro neurocognitivo asociado a la radioterapia en pacientes con metástasis cerebrales. Este estudio evaluó una técnica híbrida que combina IMRT y VMAT en 15 pacientes. Los resultados mostraron mejor conformidad y homogeneidad del plan en comparación con las técnicas utilizadas por separado, mientras que las dosis a órganos de riesgo y el tiempo de tratamiento fueron intermedios. La técnica híbrida se presenta como una alternativa prometedora para optimizar la planificación dosimétrica en tratamientos de holocráneo con preservación de hipocampos.
1. "Dosimetric study of a hybrid plan technique for external beam radiotherapy in patients with cervical cancer" Radiation and Environmental Biophysics (2021) 60:653–662 Este estudio comparó la calidad dosimétrica de planes de radioterapia IMRT, VMAT y una técnica híbrida que combina ambas modalidades en pacientes con cáncer cervicouterino. En un análisis retrospectivo de 20 casos, los planes híbridos mostraron mejor conformidad y homogeneidad en la cobertura del volumen blanco, así como reducción significativa de dosis en órganos de riesgo como vejiga y recto. Además, el número de unidades monitoras y el tiempo de tratamiento fueron intermedios respecto a IMRT y VMAT. Estos hallazgos sugieren que la planificación híbrida puede optimizar la calidad dosimétrica en radioterapia pélvica.
The People, Landmark Discoveries, and Innovations that Shaped a Field Malcolm Heard Charles R. Thomas Jr. Editors
The Royal College of Radiologists Clinical Oncology Guidance on auto-contouring in radiotherapy 2
Wei-Jian Mei, PhD 1; Xiao-Zhong Wang, MD 2 ; Xuan Zhang, PhD 3 ; Yue-Ming Sun, PhD 4; Chun-Kang Yang, PhD 5 ; Jun-Zhong Lin, PhD 1; Zu-Guang Wu, MD 6 ; Rui Zhang, PhD 7 ; Wei Wang, PhD 8; Yong Li, PhD 9,10; Ye-Zhong Zhuang, MD 11 ; Jian Lei, MD 12 ; Xiang-Bin Wan, PhD 13 ; Ying-Kun Ren, MD 13 ; Yong Cheng, PhD 14 ; Wen-Liang Li, PhD 15; Zi-Qiang Wang, MD 16; Dong-Bo Xu, MD 17 ; Xian-Wei Mo, PhD 18; Hai-Xing Ju, PhD 19 ; Sheng-Wei Ye, PhD 20 ; Jing-Lin Zhao, MD 21 ; Hong Zhang, PhD 22 ; Yuan-Hong Gao, PhD 23; Zhi-Fan Zeng, PhD 23 ; Wei-Wei Xiao, PhD 23; Xiao-Peng Zhang, MD 2 ; Yun-Feng Li, PhD 3 ; E Xie, MD 24 ; Yi-Fei Feng, MD 4 ; Jing-Hua Tang, PhD 1; Xiao-Jun Wu, PhD 1 ; Gong Chen, PhD 1 ; Li-Ren Li, PhD 1 ; Zhen-Hai Lu, PhD 1 ; De-Sen Wan, PhD 1 ; Jin-Xin Bei, PhD 25; Zhi-Zhong Pan, PhD 1 ; Jie-Hai Yu, PhD 1; andPei-Rong Ding, PhD 1 DOI https://doi.org/10.1200/
Mosby’s ® Radiation Therapy Study Guide and Exam Review SECOND EDITION Edited by Leia Levy, MAdEd, EdD, RT(T) Associate Professor Radiation Therapy Program Director Department of Natural and Health Sciences University of St. Francis Joliet, Illinois, United States
Dedicado a los físicos médicos y dosimetristas que a diario planifican y asisten en la administración de planes de oncología radioterápica a los pacientes. Sus esfuerzos a menudo pasan desapercibidos, pero son esenciales para desarrollar tratamientos curativos contra el cáncer.
Real-WorldDataonBarrigelandSpaceOARRectalSpacersinProstateCancerRadiationTherapy:AComparativeAnalysis ShrutiPrusty,MD,aDeborahCho,MD,aKenThong,MBBS,FRANZCR,bAlbertTiu,MBBS,MMED,FRACS,cNicholasMcLeod,BSc,BMed,FRACS,cLucyLeigh,PhD,BMath,BMRS,dJaradMartin,MBChB,PhD,DMed,BSc,a,eMichaelChao,MBBS,DMedSc,FRANZCR,fandEricWegener,MBBS,BMedSci,FRANZCRa,e,*
Purpose: This dose-volumehistogram(DVH)compendiumsharestheknowledgeandresourcescompiledbydisease-siteexpertsdur- ing animmenseundertakingbytheVeteransAffairs(VA)andAmericanSocietyforRadiationOncology(ASTRO)todevelopperfor- mance indicatorsforradiationtherapyaspartofqualitysurveillance.Theguidanceforbreast,headandneck,liver,lung,prostate,and rectal cancerssupportsphysiciandecision-makingduringdosimetrictreatmentplann
A B S T R A C T Background: One of the main technical challenges in craniospinal irradiation (CSI) is the risk of overdosing or underdosing in field overlap regions due to the need to match multiple treatment fields along the Planning Target Volume (PTV). To the authors’ knowledge, the technical and dosimetric feasibility of modulated arc therapy (mARC) has not yet been evaluated for CSI. Unlike other arc techniques, mARC delivers dose in discrete arcs. This study compared mARC with intensity-modulated radiation therapy (IMRT) and analyzed the impact of overlap region thickness, defined by the number of computed tomography (CT) slices, on plan quality. Methods: Treatment plans were generated for 10 patients using both mARC and IMRT on a Siemens Artiste linear accelerator. Optimization pseudo-structures were created with 4, 5, 6, and 7 tomographic slices at the craniothoracic and thoracolumbar junctions, resulting in eight plans per patient. The prescribed dose was 36 Gy in 20 fractions. Plans were evaluated by assessing PTV dosimetric parameters, doses to organs at risk (OARs), monitor units (MU), and treatment time. Statistical analysis employed two-way repeated-measures analysis of variance (ANOVA).
Abstract Background Cancer predisposition syndromes (CPSs) are inherited disorders that increase the risk of developing cancer from childhood through adulthood. They account for up to 10% of pediatric tumors, making early recognition important for reducing morbidity and mortality. Because these syndromes show variable penetrance and a wide range of clinical presentations even within the same family, identifying affected children can be challenging.
1. Introduction In recent years, the treatment paradigm for rectal cancer (RC) has increasingly shifted toward dose intensification strategies, aiming to enhance complete response (CR) rates [1,2]. Achieving CR is clinically meaningful, as it significantly increases the likelihood of organ preservation and functional sphincter-sparing outcomes—particularly critical in younger patients, for whom long-term quality of life (QoL) and avoidance of permanent colostomy are paramount [3,4] and older patients with comorbidities rendering them not suitable for surgery [5].
Introduction: Intensity Modulated Radiotherapy (IMRT) and Image Guided Radiotherapy (IGRT) have become an integral part of standard care for rectal cancer, but evidence-based detailed guidance is lacking to support its clinical implementation and use. This European SocieTy for Radiotherapy and Oncology (ESTRO) technical guideline aimed to assess the available evidence and provide recommendations for their use in rectal cancer treatment.
ESMO HANDBOOK OF CANCER GENETICS AND GENOMICS Edited by Angela George, David SP Tan, Marcia Hall and Tania Fleitas Kanonnikoff
Pediatric CNS tumors: Overview and treatment paradigms.
ESMO-ESTRO consensus statements on the safety of combining radiotherapy with CDK4/6, HER2, PARP, or mTOR inhibitors
APreciseReirradiationSupportingToolInitiative(PRISTIN)forPrescribingAbsorbedDoseandNumberofFractionsinReirradiation
Pediatric ALL Treatment Modifications in Low- and Middle-Income Countries: A Systematic Review
•Pediatric ALL Treatment Modifications in Low- and Middle-Income Countries: A Systematic Review
SEMINARIO EDUCATIVO SOBRE LA IMPORTANCIA DE LA RADIOTERAPIA EN LA ATENCIÓN INTEGRAL DEL CÁNCER.
Radiation therapy side effects for prostate cancer: what actually happens (and what doesn't)
Prognostic value of early treatment response to craniospinal irradiation in diffuse leptomeningeal glioneuronal tumors: a case series
Radiotherapy Prescription Dose and Normal Tissue Tolerance Dose Protocol Version 2.0, November 2022 Compiled by Dr. Balaji K, PhD Sr. Medical Physicist Gleneagles Global Hospitals, Chennai
A National Audit of Current UK Practice on the Use of Anti-Emetics for Chemotherapy-Induced Nausea and Vomiting in Children.
Radiotherapy Volume Relationships (Platy Graph).
Palliative Medicine and Hospice Care for Physician Associates.
Intensive chemotherapy for high-risk acute lymphoblastic leukemia in first remission: results from the NOPHO ALL2008 study.
PedROC 2.0: provider confidence in Wilms tumor management in sub-Saharan Africa: making the case for pediatric radiotherapy inclusion during basic medical training.
A Decade of Transformation in the Management of Childhood Acute Lymphoblastic Leukemia: From Conventional Chemotherapy to Precision Medicine.
AIEOP-BFM ALL 2017 International collaborative treatment protocol for children and adolescents with acute lymphoblastic leukemia.
Management of pediatric brain tumors in low- and middle-income countries.
Three decades of radiotherapy advancements for pediatric ependymoma.
Translational advancement of immunotherapeutics against pediatric central nervous system tumors.
Current advances in the management of atypical teratoid rhabdoid tumors (ATRT).
Non-germinomatous germ cell tumors of the CNS: Classification, diagnosis, and treatment.
Medulloblastoma chapter - past perspectives and future directions.
Emerging interventional treatments in the management of pediatric brain tumors.
Germinoma: Presentation, Management, and Recent Advances.
The precise definition of target volumes in radiotherapy represents one of the most critical steps in radiation treatment planning, directly impacting treatment efficacy and patient safety. The International Commission on Radiation Units and Measurements (ICRU) has established standardized terminology and protocols through a series of reports (ICRU 50, 62, 71, and 83) to ensure consistency across radiotherapy centers worldwide.
The palliative care team has been asked to see a 5-year-old boy in the pediatric intensive care unit (PICU) with hypoxic ischemic encephalopathy secondary to a drowning episode 3 years ago. The child is ventilation-dependent, and this is the fifth admission for recurrent pneumonia this year. The family has been very clear about their goals of care but do not feel supported by the medical team
As a leading organization in radiation oncology, the American Society for Radiation Oncology (ASTRO) is dedicated to improving quality of care and patient outcomes. A cornerstone of this goal is the development and dissemination of clinical practice guidelines based on systematic methods to evaluate and classify evidence, combined with a focus on patient-centric care and shared decision-making. ASTRO develops and publishes guidelines without
La Leucemia Linfoblástica Aguda (LLA) es el tipo de cáncer más común en la infancia, representa el 75% de los casos de leucemia en niños, niñas y adolescentes 1. Constituye un problema relevante de salud pública debido a su alta incidencia.
Recent developments in radiation and neuro-oncology provide the ability to deliver required radiation dose to target volumes for pediatric brain tumors while avoiding sensitive normal central nervous system (CNS) structures uninvolved by tumor. Many CNS target volumes are smaller than in previous years due to better understanding of areas at risk for recurrence or involvement and patterns of spread for a given diagnoses. Advances in neuroimaging and treatment planning software allow for better delineation of tumors and normal neuroanatomy
NCCN Guidelines Version 1.2026 Prostate Cancer
Lattice Radiation Therapy (LRT) is an innovative radiotherapy (RT) technique that allows to concurrently administering ablative doses inside neoplastic lesions and low doses near the adjacent organs at risks (OARs) (See Fig. 1). LRT can be considered as a type of spatially fractionated radiation therapy (SFRT) and it represents the 3-dimensional (3D) configuration of the 2-dimensional (2D) GRID therapy (See Fig. 2) [1]. The heterogeneous dose distribution of a LRT plans entails the creation of a 3D array inside the planning target volume (PTV), where high-dose (vertices or hotspots) and low-dose areas (periphery
While COG and Euronet use three risk groups (low, intermediate, and high), the authors chose to dichotomize groups as most included articles categorized patients as limited or advanced disease. Low- and intermediate-risk (IR) diseases in studies describing three risk groups were analyzed within the limited disease group. Each study had their own criteria for risk stratification. Two sets of bias assessments were conducted, using methodologies used by the Pediatric Normal Tissue Effects in Clinic
The consensus was discussed during monthly webbased national meetings, and the algorithms were revised until a consensus was achieved. Results: A total of 26 participants were involved in the development of the algorithms. Two treatment algorithms are proposed, one for the initiation of treatment and one for the discontinuation of treatment.
Background: Prostate cancer (PCa) is the most common malignant tumor in men in Mexico. There are two treatments with curative potential, such as radical prostatectomy (RP) for localized disease and radical radiotherapy (R-RT). Control rates are determined by the prognostic factors present. Objective: The objective of this study was to determine the control and survival rate with radical conformal radiotherapy (R-CR) in PCa. Methods: The 8.5-year results of an institutional series are presented using Cox proportional hazards analysis and Kaplan-Meier survival.
Childhood cancer is prevalent throughout the world.1 With modern technologies and therapies, high-income countries (HICs) now report cure rates as high as 80% for children with cancer.2,3 However, low- and middle-income countries (LMICs) struggle with lack of health care resources and infrastructure, resulting in upward of 90% of pediatric oncologic deaths occurring in these countries.2-4 As radiotherapy is a critical component of care for children with malignancies, improving quality and access to pediatric radiotherapy services in LMICs is vital.5 Ethiopia is a low-income country (LIC) in sub-Saharan Africa with a multitude of distinct ethnic groups, languages, and religions
El cáncer es la tercera causa de muerte en México con más de 91,500 fallecimientos anuales. Uno de cada dos pacientes requiere radioterapia como parte de su tratamiento, pero nuestro país cuenta con apenas 2 equipos por millón de habitantes, cuando la recomendación internacional es de 4. Esto coloca a México en desventaja incluso frente a países de ingresos bajos.
Introduction: Post-treatment surveillance is recommended for NSCLC owing to a high risk of recurrence, but evidence on the optimal surveillance method is lacking. This trial evaluates fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) versus contrast-enhanced CT (ceCT) for surveillance in patients with NSCLC.
Antecedentes: La irradiación cráneo-espinal (ICE) tiene un impacto decisivo en el control de tumores pediátricos con alta probabilidad de diseminación por líquido cefalorraquídeo, pero se asocia a defectos del desarrollo de la columna vertebral en etapa de crecimiento. Objetivo: Analizar las alteraciones de columna posteriores a ICE, y la comparación dosimétrica de las técnicas de radioterapia conformada (RC) y arco volumétrico de intensidad modulada (VMAT).
Precision oncology has transformed the management of NSCLC by tailoring treatment to the specific genetic alterations driving oncogenesis. Targeted therapies, such as tyrosine kinase inhibitors, have been found to dramatically improve survival in patients with advanced-stage NSCLC.
Summary Background In postmenopausal women with oestrogen receptor-positive early breast cancer, 5 years of adjuvant tamoxifen substantially reduces 15-year recurrence and mortality; aromatase inhibitor treatment (AIT) is even more effective. We assess the effects of further AIT among women recurrence-free after at least 5 years of endocrine therapy
AstraZeneca. He received travel support from the Radiosurgery Society. He is member of the data safety monitoring board or advisory board for Genentech, ViewRay, AstraZeneca, and Roche. He holds leadership or fiduciary roles in the Radiosurgery Society and ASTRO. Ben J. Slotman is president of the Radiosurgery Society.
a Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; b Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio; c Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; d Department of Radiation Oncology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; e Department of Radiation Oncology, Stanford University, Stanford, California; and f Department of Radiation Oncology, University of California San Francisco, San Diego, California
Purpose: Plasma Epstein−Barr virus (EBV) DNA is a widely used biomarker for nasopharyngeal carcinoma (NPC). Prior investigations predominantly assessed EBV DNA at a single time point, thus neglecting the differential prognostic implications of the temporal clearance pattern of EBV DNA during induction-concurrent (chemo)radiation therapy (RT).
Corresponding author: Matthew Poppe, MD; E-mail: matthew. poppe@hci.utah.edu This protocol is registered with ClinicalTrials.gov and may be viewed online at https://clinicaltrials.gov/study/NCT03345420 Author Responsible for Statistical Analysis: Kenneth Boucher, PhD. Disclosures: M.M.P. is an investor in PEEL Therapeutics, Inc., and K.E. B. serves as a consultant for Impedimed. M.M.P. also reports the following roles and associations: Vice Chair, Breast Committee, Alliance; Co-Chair, Breast Locoregional Working Group, Alliance; Member, Executive Committee and Board of Directors, Alliance; Member,
Background: The clinical significance of multi-kingdom skin microbiota in acute radiation dermatitis (ARD) is not well understood. We hypothesized that skin microbiota is associated with ARD in patients with breast cancer (BC) undergoing radiation therapy (RT) after reconstructive surgery
Guía para el manejo del dolor en pequeños procedimientos en pediatría. Dirigida a profesionales. DIRECCIÓN Y COORDINACIÓN Pilar Hilarión Subdirectora. Instituto Universitario Avedis Donabedian - Universitat Autònoma de Barcelona. Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC) Carola Orrego Subdirectora. Instituto Universitario Avedis Donabedian - Universitat Autònoma de Barcelona. Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC) Área Social de la Fundación Bancaria “la Caixa”.
The definitive management of many pediatric malignancies requires radiation therapy (RT) to the central nervous system (CNS) that may predispose survivors to neurologic complications. A detailed understanding of radiation dosevolume effects is required to maximize the therapeutic ratio of brain irradiation.
Treatment protocols for childhood cancer have changed rapidly over the years, maintaining a balance between effective therapy and acceptable toxicity.
As cancer survival rates continue to improve, longterm adverse effects of treatment on health and quality of life are increasingly important considerations for clinicians, patients, and familymembers. Neurocognitive deficits (NCD) are well established as a common adverse effect in brain tumor survivors, owing to the tumor itself, but also localized brain irradiation treatment.
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Abstract: Radiation therapy, a common treatment for central nervous system cancers, can negatively impact cognitive function, resulting in radiation-induced cognitive decline (RICD). RICD involves a decline in cognitive abilities such as memory and attention, likely due to damage to brain white matter, inflammation, and oxidative stress
Simple Summary: Radiation therapy-related brain damage with neurocognitive impairment is a common long-term side effect in cancer survivors and significantly impairs the quality of life. Increasing evidence indicates the increased vulnerability of the developing brain to the neurotoxic effects of ionizing radiation (IR).
Abstract: The brain undergoes ionizing radiation (IR) exposure in many clinical situations, particularly during radiotherapy for malignant brain tumors. Cranial radiation therapy is related with the hazard of long-term neurocognitive decline.
FAST-Forward Boost A randomised clinical trial testing a 1-week schedule of curative simultaneous integrated boost radiotherapy against a standard 3-week schedule in patients with early breast cancer.
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EAU - EANM - ESTRO - ESUR - ISUP - SIOG Guidelines on Prostate Cancer
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CONSENSO MEXICANO SOBRE DIAGNÓSTICO Y TRATAMIENTO DEL CÁNCER MAMARIO UNDÉCIMA REVISIÓN, ENERO 2025. RADIOONCOLOGÍA: Dra. Adela Poitevín Chacón Radiooncóloga Médica Sur, Ciudad de México. Dra. Christian Haydeé Flores Balcázar Radiooncóloga Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, SS., Ciudad de México.
TNM Classification of Malignant Tumours 9th Edition Edited by: James Brierley, Meredith Giuliani, Brian O'Sullivan, Brian Rous, Elizabeth Van Eycken WILEY
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