Background/Objectives: Recent advancements in the treatment of LACC have focused on improving outcomes through systemic treatment intensification. Therefore, this review aims to analyze the brachytherapy (BT) techniques employed in recent studies that are likely to change upcoming clinical guidelines, and to discuss the evolving role of IGABT in optimizing patient outcomes. Methods: This review focuses on BT practices reported across main phase III trials—OUTBACK, INTERLACE, CALLA, and KEYNOTE A18—compared with the EMBRACE I study. Analyzed parameters include BT modality, dose prescription techniques, imaging guidance, and overall treatment time (OTT). Results: In EMBRACE I, MRI-based IGABT was mandatory, with 43% of patients receiving an intracavitary/interstitial (IC/IS) applicator; cumulative EQD2 D90 HR-CTV was 90 Gy with a median OTT of 46 days. The OUTBACK trial relied predominantly on point A-based BT, with limited use of volume-based BT (28%). The INTERLACE trial reported mixed BT approaches: 70% point A-based, 30% volume-based, and 20% 2D BT. A median cervical dose of 79.4 Gy was reported. CALLA maintained strong protocol adherence, with 60% volume-based BT and a median tumor EQD2 dose of 83 Gy, although lower in the Japan cohort. In the KEYNOTE A 18 cohort, volume-based BT was performed in 88% of patients, with a median D90 HR-CTV dose of 87 Gy; IC/IS applicators were used in 23% of cases. Conclusions: Across these major studies, the following consistent pattern emerges: the quality and technique of BT impact survival outcomes and toxicity profile in LACC. MRI-based IGABT—with the use of IC/IS applicators when needed—is essential.

Introduction/Objective. The purpose of the current Echocardiographic Society of Serbia (ECHOS) survey was to assess echocardiography practice in Serbia during Coronavirus disease 2019 (COVID-19) pandemic. Methods. An online survey consisting of 12 questions about the usage of echocardiography, the availability of portable ultrasound devices and personal protective equipment (PPE) was sent to all ECHOS members. Results. Overall, 126 ECHOS members (43%) answered the survey. One-third of respondents (36%) were physicians from specialized COVID-19 centers. During the pandemic, indications for echocardiographic examination were restricted in both COVID-19 and non-COVID-19 centers. In COVID-19 centers, 41% of respondents performed lung ultrasound (LUS) to each patient versus 26% in non-COVID-19 centers. Transesophageal echocardiography (ТЕЕ) was not performed in suspected or confirmed COVID-19 cases in any center. Portable ultrasound devices were available to 66% of respondents from COVID-19 versus 44% of respondents from non-COVID-19 centers (p=0.018). The respondents reported a regular use of PPE, regardless of the patient's COVID-19 status and found their personal knowledge about protective measures and use of PPE satisfactory. Conclusion. During the COVID-19 pandemic in Serbia, indications for echocardiography were restricted to clinical scenarios in which the results of examination were expected to alter the patient management. In both COVID-19 and non-COVID-19 centers, the use of PPE was in line with national and international recommendations. A wider availability of portable ultrasound devices and application of LUS could improve patient management in similar situations in the future.

Radiotherapy affects both cancer and healthy cells, potentially causing side effects. Factors like total dose administered or patient individual characteristics, such as genetic variability, influence radiotoxicity. Several biomarkers have been proposed to predict radiotoxicity, especially those based on apoptosis or DNA damage, like γ-H2AX, which correlates with DNA breaks. Our aim is to analyze how apoptosis and γ-H2AX correlate to each other and to link these results with selected SNPs associated with apoptosis. Blood samples from 60 breast cancer patients in remission were collected. Mononucleated cells were isolated and γ-H2AX kinetics was evaluated at 1, 2, 4 and 24 h after 2 Gy irradiation. Apoptosis in CD8+ lymphocytes was assessed at 24 and 48 h after 8 Gy irradiation. SNP genotyping was performed for 27 apoptosis-related SNPs. Individual basal levels of γ-H2AX and apoptosis correlated positively with those observed at different post-irradiation times. High interindividual variability was observed in both γ-H2AX and apoptosis under all tested conditions. When both biomarkers were analyzed together, a negative correlation was observed between basal and residual γ-H2AX levels and apoptosis at 48 h post-irradiation. SNP analysis identified two apoptosis-associated SNPs located at TP53 and FAS genes. These findings support previous studies done in cancer patients showing a negative correlation between apoptosis and γ-H2AX. Overall, our results seem to indicate that individuals with less efficiency in removing damaged cells, probably due to genetic polymorphisms, presented more basal and residual levels of DNA damage.