[en] Purpose: This retrospective analysis aims to report results and variables from patients with cervix cancer treated by radiation therapy alone with telecobalt and low-dose-rate brachytherapy (LDRB). Methods and Materials: Between September 1989 and September 1995, 190 patients with histologic diagnosis of cervix carcinoma were treated with telecobalt for external beam radiotherapy (EBR), followed by one or two insertions of LDRB. Stage distribution according to patients was the following: IB, 12; IIA, 4; IIB, 105; and IIIB, 69. Median dose of EBR at whole pelvis was 40 Gy, and median parametrial doses for Stages II and III patients were 50 Gy and 60 Gy, respectively. Median doses of LDRB at point A for patients treated with one and two insertions were 38 Gy and 50 Gy, respectively. Results: Median follow-up time was 70 months (range: 8-127 months). Overall survival, disease-free survival, and 5-year local control of patients at Stages I, II, and III were 83%, 78%, and 46%; 83%, 82%, and 49%; and 92%, 87%, and 58%, respectively. Overall incidence of late complications in the rectum, small bowel, and urinary tract was 15.3% (19/190), 4.2% (8/190), and 6.8% (13/190), respectively. The actuarial 5-year rectal, small bowel, and urinary incidence of late complications was 16.1%, 4.6%, and 7.6%, respectively. Clinical stage was the only significant variable for overall 5-year survival (p = 0.001), for disease-free survival (p=0.001), and for local control (p=0.001). Stage II patients more than 50 years old had better disease-free survival and local control at 5 years (p=0.004). None of the analyzed variables influenced the actuarial 5-year incidence of late complications. Conclusions: Results of this series suggest that the use of telecobalt equipment for EBR with doses up to 50 Gy at whole pelvis, prior to brachytherapy, is an acceptable technique for radiation therapy alone in the treatment of cervix cancer, especially in developing countries, including Brazil, where telecobalt machines still prevail

[en] Objective: The present study was aimed at comparing conformal and non-conformal radiotherapy plans designed for patients with prostate cancer, by analyzing radiation doses in target volumes and organs at risk. Materials and methods: Radiotherapy plans for 40 patients with prostate cancer were analyzed. Conformal, conformal isocentric and non-conformal plans utilizing the source-surface distance were simulated for each of the patients for comparison of radiation dose in target volumes and organs at risk. For comparison purposes, dose-volume histograms for target volumes and organs at risk were analyzed. Results: Median doses were significantly lower in the conformal planning, with 25%, 40% and 60% volumes in the rectum and 30% and 60% in the bladder. The median doses were significantly lower in the conformal planning analyzing the right and left coxofemoral joints. Maximum, mean and median doses in the clinical target volume and in the planned target volume were significantly higher in the conformal planning. Conclusion: The present study has demonstrated that the conformal radiotherapy planning for prostate cancer allows the delivery of higher doses to the target volume and lower doses to adjacent healthy tissues. (author)

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[en] The objective was to evaluate the precision of the absorbed radiation doses in bone marrow transplant therapy during whole body irradiation. Two-hundred CaSO₄:Dy + teflon tablets were calibrated in air and in 'phantom'. These tablets were randomly selected and divided in groups of five in the patients' body. The dosimetric readings were obtained using a Harshaw 4000A reader. Nine patients had their entire bodies irradiated in parallel and opposite laterals in a cobalt-60 Alcion II model, with a dose rate of 0.80 Gy/min at 80.5 cm, {(10 ? 10) cm² field. The dosimetry of this unit was performed using a Victoreen 500 dosimeter. For the determination of the mean dose at each point evaluated, the individual values of the tablets calibrated in air or 'phantom' were used, resulting in a build up of 2 mm to superficialize the dose at a distance of 300 cm. In 70% of the patients a variation of less than 5% in the dose was obtained. In 30% of the patients this variation was less than 10%, when values obtained were compared to the values calculated at each point. A mean absorption of 14% was seen in the head, and an increase of 2% of the administered dose was seen in the lungs. In patients with latero-lateral distance greater than 35 cm the variation between the calculated doses and the measured doses reached 30% of the desired dose, without the use of compensation filters. The measured values of the absorbed doses at the various anatomic points compared to the desired doses (theoretic) presented a tolerance of ± 10%, considering the existent anatomical differences and when using the individual calibration factors of the tablets. (author)

[en] Objective: To evaluate the percentage of I and II axillary levels receiving 45 Gy during adjuvant radiotherapy for breast cancer and correlate it with anatomical and planning variables. Methods: A retrospective study of 51 patients with breast cancer who received adjuvant external radiotherapy in breast or breast bed with tridimensional conformal technique during January 2008 to July 2013. Axillary levels were contoured according to the breast cancer atlas of Radiation Therapy Oncology Group (RTOG). The percentage of each axillary level that received 45 Gy (V45) was reviewed using the dose volume histogram (DVH). This was correlated with the surgery performed, the Clinical Target Volume (CTV), axillary volume, anteroposterior (APD) and laterolateral diameters (LLD) of chest, body mass index (BMI), gantry’s angle, distance between the input and output (DIO) of the radiation beam in chest, and patient position (ramp incline, height and angle of the arm). Results: The average V45 for level I and II was 44% (0 to 97.2%) and 17.7% (0 to 93.6%). The average dose in 95% of level I was 11.2 Gy (0.14-46.4 Gy) and 5 Gy (0.13-44.4 Gy) in level II. Variables with significant correlation to V45 of level I were the ramp incline (p<0.001) and DIO (p<0.019) and the ramp incline with level II V45(p= 0.004) in multiple univariate analysis. Ramp incline, DIO and LLD correlate with V45 of level I in multivariate analysis (p= 0.012, p= 0.007, p= 0.012, respectively). Patients with BMI>25 received higher doses in level I (p=0.026). Conclusion: Axillary coverage with 45 Gy during adjuvant breast irradiation is not adequate but appear to increase with a larger ramp incline and bigger DIO. Dose in Level I increases with BMI>25 although remains unsatisfactory. (author)

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No abstract available

[en] Surgery and radiation therapy are de main treatments for head and neck cancer. The side effects of the interaction of ionizing radiation on the tissues include dermatitis, mucositis, xerostomia, candidiasis, dysgeusia, dysphagia, caries, trismus, osteoradionecrosis. Objective: To assess dental condition of the patients using a protocol which allows avoiding or reducing the effects of radiation in the tissues of the oral cavity. Materials And Methods: Dental follow-up was performed before, during and up to 180 days after radiation therapy in 12 patients submitted to surgery and radiation therapy or radiation therapy alone. Results: The proportion of effects such as dermatitis, mucositis, dysgeusia, and dysphagia increased from the second week of the treatment until the end of the administrations. There was a clear decrease at the end of the treatment which was close to baseline values after 180 days. The reduction of xerostomia was slower and less effective. No case of caries, trismus, and osteoradionecrosis were observed during the assessment period. Conclusion: Regular dental follow-up associated with preventive measures such as prophylactic management of dental and oral diseases, adequate hygiene, mouth-washing with bicarbonate water and chamomile tea, and topic fluorine application contributed to improve the recovery conditions of patients with cancer of head and neck submitted to radiation therapy. (author)

[en] Three dosimetric systems were compared regarding dosimetry of small circular x ray fields used in radiosurgery. The dosimetric parameters for circular cones, with diameters ranging from 7 to 30 mm, were acquired using a 6 MV Clinac 600 C linear accelerator. For the measurement of tissue maximum ratios, total scatter factor and radiation field profile, Kodak X-Omat type V radiographic films, and ionization chamber of 0.1 cm³ and a plane parallel ionization chamber type Markus were used. The plane parallel ionization chamber showed satisfactory results for measurement of tissue maximum ratios and total scatter only for cone sizes larger than 11 mm in diameter. Beam profile showed better spatial resolution when films ere used. The main physical parameters of small circular fields used in radiosurgery can be obtained by combining the dosimetry results of radiation therapy equipment used in current clinical practice. (author)