Objective: Interest in low-dose radiotherapy (LD-RT) for the symptomatic treatment of nonmalignant conditions, including inflammatory and degenerative disorders of the joints and para-articular soft tissues, has increased substantially in recent years. In the present document, we provide a CT-based contouring atlas to help identify and delineate the most common osteoarticular regions susceptible to LD-RT. Methods: The clinical efficacy of LD-RT is supported by a large body of evidence. However, there is no consensus on the parameters for contouring the planning target volume (PTV). Moreover, 3D simulation and planning should be the standard of care even for nonmalignant disorders. For this reason, the present guidelines were prepared to help guide PTV contouring based on CT images, with the same quality criteria for patient immobilization, treatment simulation, planning and delivery as those routinely applied for cancer radiotherapy. Results: PTV for radiotherapy requires precise identification of the target areas based on CT and other imaging techniques. Using a series of cases treated at our institution, we have defined the PTVs for each location on the simulation CT to establish the relationship between the image and the anatomical structures to be treated. We also specify the immobilization systems used to ensure treatment accuracy and reproducibility. Conclusions: This comprehensive atlas based on CT images may be of value to radiation oncologists who wish to use LD-RT for the symptomatic treatment of degenerative or inflammatory osteoarticular diseases. Advances in knowledge: The recommendations and contouring atlas described in this article provide an eminently practical tool for LD-RT in non-malignant conditions, based on the same quality criteria recommended for all modern radiotherapy treatments in Spain.

Objectives:Show the results in pain and functionality, using low-dose radiotherapy in osteoarticular degenerative disorders (OADD). Review of the evidence.Material and methods:Patients suffering from OADD with no response to other treatments, receive 6Gy in 6 fractions of 1 Gy, each other day, repeating the scheme if necessary. Evaluation of pain based on Visual Analogic Scale, analgesia intake and VonPannewitz score.Results:Results observed in our series of patients treated with low doses of radiotherapy are similar to those previously published and reinforce the consideration of radiotherapy as an useful option for degenerative musculoskeletal disorders.Conclusion:Low dose radiotherapy seems to be a good alternative for aged patients suffering from OADD.

Purpose: Reaching a complete pathological response (pCR) after primary systemic treatment (PST), specifically in the subgroup of patients with triple negative (TNBC) or HER2-positive tumors, is associated with a significant survival gain. The combination of chemotherapy and radiotherapy could increase this synergistic benefit. Methods/Design: This is an unicentric prospective cohort study that is going to include 40 localized breast cancer patients (TNBC or HER-2 positive) T2N0 or higher to receive neoadjuvant chemoradiation based on Pertuzumab-Trastuzumab-Paclitaxel followed by anthracyclines in Her-2 positive patients and CBDCA-Paclitaxel based regimen followed by anthracyclines in TNBC patients. Chemoradiotherapy concomitance will be with CBDCAPaclitaxel/Paclitaxel-Her-2 double blockage. Dose prescribed will be 40,5 Gy in 15 fractions of 2.7 Gy, five fractions a week, to whole breast and ganglionar levels I-IV and ipsilateral internal mammary chain when indicated with simultaneous integrated boost of de 54 Gy in 15 fractions of 3.6 Gy to primary breast and/or axillary tumor (highlighted by PET). The primary study endpoint will be to asses pathological complete response rates (pCR) and objective response (OR) rates. Secondary endpoints will include to asses metabolic response rates by 18FDG-PETCT, locoregional control and disease-free survival rates, tolerance and viability and security of the surgery after preoperative chemoradiotherapy. Discussion: Tools and results developed in this study are aimed at answering if preoperative chemoradiation improves pathological and objective response and ultimately improves survival rates, tolerance and viability of surgery in desfavorable breast cancer subtypes.