Browsing by Author "Orellana Vargas, María Paz"

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    Multimodal assessment of acute cardiac toxicity induced by thoracic radiotherapy in cancer patients : study protocol
    (2021) Merino Lara, Tomas Rodrigo; Pinto, Mauricio P.; Orellana Vargas, María Paz; Martínez, Gonzalo; Andía Kohnenkampf, Marcelo Edgardo; Muñoz Schuffenegger, Pablo; Acevedo Claros, Francisco Nicolás; Gabrielli, Luigi; Sánchez Rojel, César Giovanni; Pereira, Jaime
    Background : Today, cancer ranks as one of the leading causes of death. Despite the large number of novel available therapies, radiotherapy (RT) remains as the most effective non-surgical method to cure cancer patients. In fact, approximately 50% of all cancer patients receive some type of RT and among these 60% receive RT-treatment with a curative intent. However, as occurs with any other oncological therapy, RT treated patients may experience toxicity side effects that range from moderate to severe. Among these, cardiotoxicity represents a significant threat for premature death. Current methods evaluate cardiotoxic damage based on volumetric changes in the Left Ventricle Ejected Fraction (LVEF). Indeed, a 10% drop in LVEF is commonly used as indicator of cardiotoxicity. More recently, a number of novel techniques have been developed that significantly improve specificity and sensitivity of heart’s volumetric changes and early detection of cardiotoxicity even in asymptomatic patients. Among these, the Strain by Speckle Tracking (SST) is a technique based on echocardiographic analysis that accurately evaluates myocardial deformation during the cardiac cycle (ventricular and atrial function). Studies also suggest that Magnetic Resonance Imaging (MRI) is a high-resolution technique that enables a better visualization of acute cardiac damage. Methodology: This protocol will evaluate changes in SST and MRI in cancer patients that received thoracic RT. Concomitantly, we will assess changes in serum biomarkers of cardiac damage in these patients, including: high-sensitivity cardiac Troponin-T (hscTnT), N-Terminal pro-Brain Natriuretic Peptide (NTproBNP) and Circulating Endothelial Cells (CECs), a marker of endothelial dysfunction and vascular damage. Discussion: The presented protocol is to our knowledge the first to prospectively and with a multimodal approach, study serological and image biomarkers off early cardiac damage due to radiotherapy. With a practical clinical approach we will seek early changes that could potentially be in the future be linked to clinical mayor events with consequences for cancer survivors.
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    Physical exercise in Chilean breast cancer survivors: Qualitative study of barriers, facilitators and preferences
    (MEDWAVE ESTUDIOS LTD, 2024) Martínez Moscoso, Francia Loreto; Segura Ríos, Constanza Daniela; Orellana Vargas, María Paz; Acevedo Claros, Francisco Nicolás; Wallbaum, Benjamín; Sánchez Rojel, César Giovanni; Vergara, Luis; Ramírez Parada, Karol Lilia; Lara, Tomas Merino
    INTRODUCTION Breast cancer survivors often experience pre and post-treatment physical and psychological symptoms, negatively affecting their quality of life. Regular physical exercise is associated with better quality of life and lower recurrence of cancer, and therefore all oncological patients are recommended to practice it in a regular basis. Despite this, breast cancer survivors have low adherence to physical exercise. The purpose of this study is to identify barriers, facilitators and preferences of Chilean breast cancer survivors to practice physical exercise. METHODS Phenomenological qualitative study of 12 in-depth interviews with adjuvant radiation therapy concluded at least three months ago. RESULTS Breast cancer survivors ignored the benefits of physical exercise during and after treatment. The barriers were physical symptoms, psychological barriers, sociocultural barriers, health system barriers, disinformation and sedentary lifestyle. Facilitators were coping with physical symoptoms, psychological issues, having information and active lifestyle. The preferences were painless and familiar exercises. Preferred exercise was walking. CONCLUSIONS Breast cancer survivors may adhere to physical exercise despite barriers when certain facilitators are present, which may be promoted by the health team when reporting the benefits of the physical exercise, prescribing personalized, safe and painless physical exercise and educating both patient and her family about the role of the physical exercise in cancer recovering process.