Was in accordance with your expectations?3,08 Did it take place in a favorable working environment?3,70 Were the methods adapted to the objectives?3,27 May it entail positive modifications in your professional exercise?3,29 Does it deserve to be recommended to your colleagues?3,56 Interest of the subject 3.27 Quality of the presentation 3.31

10.1016/s0167-8140(15)34011-1

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Robotic Radiosurgery for the Treatment of Intramedullary Spinal Cord Metastases: A Case Report and Literature Review

Cureus (2016)

Rafael García Kita Sallabanda I. Santa-Olalla José Luis López Guerra Lijia Avilés

Modern technologies allow the delivery of high radiation doses to intramedullary spinal cord metastases while lowering the dose to the neighboring organs at risk. Whether this dosimetric advantage translates into clinical benefit is not well known. This study evaluates the acute and late toxicity outcomes in a patient treated with robotic radiosurgery for an intramedullary spinal cord metastasis. A 50-year-old woman diagnosed in May 2006 with invasive ductal carcinoma of the right breast T2N3M1 (two liver metastases) received chemotherapy with a complete response. Subsequently, she underwent adjuvant whole-breast radiotherapy, along with tamoxifen. After several distant relapses, treated mainly with systemic therapy, the patient developed an intramedullary lesion at the C3-C4 level and was referred to our CyberKnife unit for assessment. A total dose of 14 Gy prescribed to the 74% isodose line was administered to the intramedullary lesion in one fraction. One hundred and two treatment beams were used covering 95.63% of the target volume. The mean dose was 15.93 Gy and the maximum dose, 18.92 Gy. Maximum dose to the spinal cord was 13.96 Gy, V12 ~ 0.13 cc and V8 ~ 0.43 cc. Three months after treatment, magnetic resonance imaging showed a reduction in size and enhancement of the intramedullary lesion with no associated toxicity. During this period, the patient showed a good performance status without neurological deficits. Currently, with a follow-up of 37 months, the patient has the ability to perform activities of daily life. Intramedullary spinal cord metastases is a rare and aggressive disease, often treatment-refractory. Our case demonstrates that radiation therapy delivery with robotic radiosurgery allows the achievement of a high local control without adding toxicity.

Cyberknife

10.7759/cureus.609

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Analysis of the model of pulmonary lesions of the cyberknife system tracking

A. Floriano Pardal I. Santa-Olalla A. Sánchez‐Reyes

Cyberknife

Tracking (education)

Tracking system

Source

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Quality control of image system of cyberknife VSI temporal evolution of the characteristics image

A. Floriano Pardal I. Santa-Olalla A. Sánchez‐Reyes

Cyberknife

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PS-093 Analysis of the variation in the platelet counts of patients treated with linezolid

European Journal of Hospital Pharmacy (2014)

I. Santa-Olalla I. G. Martin Beatriz Jiménez Rubio Massimo Manes Pablo Crespo

Background

Linezolid is an antimicrobial agent to treat infections of Gram-positive pathogens. While effective, linezolid treatment is frequently associated with haematological side effects. This adverse event does not seem to be of abrupt onset and consequently close monitoring for the blood test abnormalities is important.

Purpose

To analyse the incidence of thrombocytopenia, to determine the degree of thrombocytopenia and to decide whether the difference between initial values and final platelet values after linezolid (LZ) treatment is significant.

Materials and methods

Prospective study in a 2^nd-level hospital, we included all patients treated with LZ, from January 2012 to August 2013, who did not have TCP pre-treatment. Thrombocytopenia was defined as a decrease in the platelet count to <150,000 cells/mcL (mild: 150,000–1,000,000, moderate: 100,000–50,000 and severe: <50,000). The data collected were: number of patients, sex, age, days of LZ therapy, platelets at the beginning and at the end of LZ treatment. We performed the Kolmogorov-Smirnov test to check whether the data fitted a normal test and U-Mann Whitney to analyse the differences.

Results

167 patients were included (57.5% men) with a mean age of 68 (interquartile range (IQR): 21); Median days of linezolid therapy were 9 (IQR: 7). The incidence of thrombocytopenia incidence was 13.27% (28 cases). TCP was mild in 19 cases (9%), moderate in 8 (3.79%) and severe in 1 (0.47%). 71.5% of patients presented a reduction in the platelet values, and the difference between initial values and final platelet values after linezolid treatment was significant.

Conclusions

The incidence of thrombocytopenia observed in our study was similar to that described in the literature (2.4–64.7%). The thrombocytopenia was severe in 1 case. Other factors that could have been causing thrombocytopenia in patients treated with linezolid were not assessed. Pharmaceutical validation must incorporate an assessment of the platelet count, as it may contribute to early identification of thrombocytopenia. No conflict of interest.

Linezolid

Interquartile range

10.1136/ejhpharm-2013-000436.443

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