Publications by authors named "Raul Hernanz"

Technological advances in radiation oncology are oriented towards improving treatment precision and tumor control. Among these advances, magnetic-resonance-image-guided radiation therapy (MRgRT) stands out, with technological advances to deliver targeted treatments adapted to a tumor's anatomy on the day while minimizing incidental exposure to organs at risk, offering an unprecedented therapeutic advantage compared to X-ray-based IGRT delivery systems. This new technology changes the traditional workflow in radiation oncology and requires an evolution in team coordination to administer more precise treatments.

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Article Synopsis
  • The study investigates whether magnetic resonance imaging (MRI) provides better visualization of hepatocellular carcinoma compared to computed tomography (CT) for delineating the gross tumor volume (GTV) in liver stereotactic radiotherapy.
  • Eight radiation oncologists evaluated CT and MRI scans to define GTV volumes in five patients, with results showing minor differences in average volume delineation between the two imaging modalities.
  • The findings suggest that while CT is sufficient for well-defined tumors, MRI can be beneficial for cases where tumors are not clearly visible, highlighting significant interobserver variability in GTV delineation.
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Background: The development of brain metastases is a common problem in patients diagnosed with non-small cell lung carcinoma (NSCLC). Technological advances in surgery and radiotherapy have allowed greater local control. Moreover, the emergence of targeted therapies and immunotherapy with greater activity on the central nervous system than classical chemotherapy have given way to new strategies in the treatment of brain metastases.

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The aim of neoadjuvant treatment in non-small cell lung cancer (NSCLC) is to eliminate micrometastatic disease to facilitate surgical resection. Neoadjuvant chemotherapy (ChT) in localised NSCLC has numerous advantages over other therapeutic modalities and is considered standard treatment in resectable disease. Treatment with immune checkpoint inhibitors (ICI) improves long-term survival in advanced disease and has a better toxicity profile than conventional therapies.

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Thymic epithelial tumours (TET) are rare, heterogeneous neoplasms that range from resectable indolent tumours to aggressive thymic carcinomas with a strong tendency to metastasize. The pathological diagnosis is complex, in part due to the existence of several different classification systems. The evidence base for the management of TETs is scant and mainly based on non-randomised studies and retrospective series.

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Background: Radon gas is the leading cause of lung cancer in the nonsmoking population. The World Health Organization (WHO) recommends indoor concentrations of < 100 Bq/m³. Several molecular alterations have been described in non-small-cell lung cancer (NSCLC), mainly in nonsmokers, with no risk factors identified.

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The demand for breast cancer care has increased as cancer treatment innovations have proliferated. Adjuvant radiotherapy to the breast is considered to be part of the standard treatment in breast cancer. The role of radiotherapy in terms of reducing loco-regional recurrence and increased survival after conservative surgery, and also after a mastectomy in selected cases, has been previously shown in several randomized trials.

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The gastric antral vascular ectasia (GAVE) is a well recognizable endoscopic entity characterized by the presence of multiple linear angioectatic vessels predominantly located in the antrum, with a typical appearance of "watermelon stomach". This condition typically affects elderly females presenting as iron-deficiency anaemia due to chronic gastric bleeding. Standard treatment is endoscopic ablation of the gastric mucosa.

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Background: Extramammary Paget disease (EMPD) is a rare condition that most commonly affects the anogenital region in the elderly. It may be associated with an underlying invasive carcinoma. Surgical excision is nowadays considered a standard treatment for extramammary Paget's disease, although this approach might not be suitable for all patients.

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Article Synopsis
  • Non-melanoma skin tumors (NMSC) are a common type of cancer, especially in older adults, leading to significant cosmetic and functional issues despite low mortality rates.
  • Surgical excision is the standard treatment, but high-dose-rate (HDR) plesiotherapy has shown good local control and cosmetic results for patients unsuitable for surgery.
  • In a study of nine patients treated with HDR plesiotherapy, there were no relapses after an average follow-up of 15 months, with acceptable toxicity and good cosmetic outcomes for most.
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