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[en] Since the very first beginning of the use of radiation in cancer treatment, cervical cancer has been one of the most suitable diseases for this application because it has a topography that is easy to assess for both diagnosis and the new emergent technology. This manuscript will present a brief overview of the evolution of radiotherapy in the treatment of cervical cancer, with the main achievements and perspectives in the field. (author)

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[en] Full text: Radical treatment of patients with uterine cervix cancer and positive para-aortic lymph nodes is a valid approach. In this regard, the Federatión Internationale de Gynecologie et Obstetrice (FIGO) staging has changed in 2018. Objective: To evaluate overall survival (OS), pelvic disease-free survival (PDFS), paraortic lymph node progression (PANP) and distant metastases-free survival (DMFS) of patients submitted to radical treatment for uterine cervix cancer FIGO stage IIIC2. Methods: Retrospective analysis of a single institution cohort. Inclusion criteria were biopsy proven cervical cancer and positive paraortic lymph nodes (IIIC2) in staging computed tomography, characterized as nodes larger than 1cm in any diameter. Three-year minimum follow-up was required. Radiotherapy (RT) and chemotherapy followed the institutional protocol: 45-50.4Gy to pelvic and para-aortic fields, with a boost up to 60Gy to macroscopic nodal disease. If brachytherapy was indicated, 4 fractions of 7-7.5Gy to point A were delivered. If not, a boost to primary site would be done up to 59.4Gy. Concurrent chemotherapy, when delivered, was with weekly cisplatin (40mg/m2). Demographic and treatment data were collected. OS, PDFS, PANP and DMFS were assessed from the first day of RT. Uni and multivariate analysis were performed. Results: From April 2010 to May 2017, 65 patients were included. Mean age was 53 years, 83.1% presented ECOG performance status (PS) 0 or 1, 90.8% had squamous cell carcinoma. Mean RT dose was 55.4Gy. Concomitant chemotherapy was delivered in 67.7% of the patients and 67.7% were submitted to brachytherapy. With a median follow-up of 31.6 months, mean overall survival was 53.9 months (1.8–102.9), with 35 deaths, most (77.1%) in the first 20 months of follow-up. Three and five-year OS, PDFS, PANP, and DMFS were respectively, 50.6% and 41.3%, 70.8% and 65.3%, 17.3% and 20.4%, 59.6% and 54.7%. In the univariate analysis, the variables that significantly (p<0.05) influenced the outcomes were: ECOG-PS (OS, DMFS), advanced T stage (T4) (OS, PDFS, DMFS), hydronephrosis (OS, PDFS, DMFS), brachytherapy (OS, DMFS) and concomitant chemotherapy (OS, PANP). No independent variable was selected in the multivariate analysis. Conclusion: Stage IIIC2 cervix cancer patients should be treated with curative intent, since long-term disease control and survival may be expected. Poor PS and more advanced pelvic disease may represent negative prognostic factors. Distant metastases are still a challenge for disease control. (author)

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[en] Objetives: To evaluate the results of radiotherapy (RT) for follicular lymphoma (FL) under different management scenarios. Methods: We retrospectively assessed consecutive patients with FL who had undergone irradiation between 2010 and 2018. All patients had biopsy-proven FL and were positron emission tomography-staged, although some (35.3%) were reassessed with computed tomography after treatment alone. Rituximab was only available to FL patients after 2016. Results: Thirty-four patients were selected, with a mean age at diagnosis of 61.6 years (34–89 years). The median follow-up duration was 49.4 months. Most patients were female (58.8%) and showed good performance on the Eastern Cooperative Oncology Group (ECOG) scale (ECOG 0-55.9%). The mean overall survival (OS) and progression-free survival were 48.7 and 33.6 months, respectively, with four deaths reported. OS rates at 2 and 3 years were 94.1% and 91.2%, respectively. Four patients showed transformation into aggressive lymphomas and underwent rituximab-based systemic treatment. Transformation-free survival was 47.8 months, and all patients with transformed disease were alive at assessment. Five patients had in-field relapse, all of them also relapsed elsewhere, and the mean relapse-free survival time was 40.3 months. No median end points were reached on assessment. Conclusion: FL is an indolent disease. Our findings show good outcomes for patients treated with radiation, with a low transformation rate and excellent management of relapsed disease. RT is an important part of these results. (author)

[en] Background and purpose: Low-and-middle-income countries have resource constraints and waiting lists for radiotherapy (RT). In this context, we sought to determine the survival of inpatients evaluated for palliative RT in a large referral cancer center in Brazil.