Radiothérapie de contact adjuvante des tumeurs malignes de la conjonctive : résultats préliminaires d’une série de 14 patients traités avec l’appareil Papillon 50

Purpose

To evaluate the results of an adjuvant contact irradiation using 50 kV photons after resection of conjunctival malignancies.

Complément de dose de protons pour les cancers du nasopharynx localement évolués : une expérience de l’institut Curie

PurposeThe aim of this study was to assess the treatment outcome and toxicity for patients with locally advanced nasopharyngeal carcinoma treated with a complementary dose with proton.Patients and methodsBetween November 1999 and September 2016, 17 patients have been treated for a stage III–IVa nasopharyngeal carcinoma in the proton therapy centre of Curie Institute. Bilateral lymph node in the neck (I–V levels) received from 40 to 54 Gy with photon beam. The primary tumor volume including microscopically extensions received a complementary dose with proton in order to reach the dose of 70 to 78 Gy. All the patients received a concomitant chemotherapy. The end-points of the study were loco-regional control, survival, and treatment-related toxicity.ResultsPatients characteristics were: median age 49, 71 % male, 88% stage IVa, with a majority (82%) of T4N0M0. The median follow-up was 99 months. The 2-, 5- and 10-year actuarial locoregional free survival and overall survival were 94% and 88%, 86% and 74%, and 86% and 66%, respectively. The grade ≥ 3 late adverse events were sphenoid bone radionecrosis (5.9%) and hearing loss (23.5%).ConclusionThis study showed that a complementary dose with proton seems to be a good option for the treatment of locally advanced nasopharyngeal carcinoma, particularly for T4N0M0.     

Éxacerbation de la douleur après la radiothérapie externe antalgique : étude prospective de 41 cas

Purpose

Radiotherapy plays a major role in relieving pain caused by bone metastases; paradoxically initial flare of symptom is common. Our objectives were to assess prospectively the incidence, and to identify predictor's factors of this acute complication.

Irradiation préventive en une séance de 10 Gy des sites d’intervention pleurale des patients atteints de mésothéliome pleural malin : étude de cohorte rétrospective monocentrique

Purpose

Prophylactic radiotherapy to prevent procedure-tracts metastases from malignant pleural mesothelioma remains controversial and clinical practice varies. The purpose was to assess the efficacy of local radiotherapy in a single fraction of 10 Gy in preventing malignant seeding at intervention pleural site in patients with malignant pleural mesothelioma.

Curiethérapie prostatique de rattrapage : solution pour les rechutes localisées après irradiation ?

Salvage brachytherapy after a first prostate radiation therapy is an emerging technique, which has to be considered in the therapeutic armamentarium in the clinically challenging context of patients with isolated local failure from prostate cancer who may still be considered for cure. These occult failures are more and more frequently diagnosed at an early stage, thanks to targeted biopsies and advances in imaging modalities, such as multiparametric MRI and PET-CT. Salvage brachytherapy benefits from the implantation accuracy of brachytherapy procedures using 3D dosimetry and has resulted in more than 50% tumour control rates with long-term. Incontinence rates are always below those of other salvage treatments such as radical prostatectomy, HIFU or cryotherapy. Today, a consensus has been reached to better define good candidates for salvage brachytherapy with respect to disease characteristics at baseline and at failure. No consensus has been clearly defined yet regarding the choice of the technique (low or high dose rate), the total dose to be delivered, or the volume to be implanted (whole gland or focal). While we await robust data from recently completed phase II studies and given the heterogeneous results in the literature, this technique (although already included in the last 2016 NCCN guidelines) remains to be precisely evaluated, optimally within the frame of controlled trials.     

Soins de support: les cancérologues sont-ils concernés?

Sans résumé     

Cancers cutanés après transplantation : quoi de neuf ?

Skin cancers are the commonest cancers after organ transplantation, affecting in the long term 60–75% of the patients. They include mostly carcinomas, especially squamous and basal cell carcinomas, but also melanoma, Kaposi’s sarcoma and other rare skin tumours such as Merkel cell carcinoma. The management of these tumours necessitates a multidisciplinary approach comprising dermatological treatments and revision of immunosuppression. Prevention consists of strict sun protection and early treatment of premalignant lesions.     

Radiothérapie des métastases osseuses : revue multi-approches de la littérature

External beam radiation therapy is an efficient treatment, which relieves pain associated with bone metastases, and is prescribed in worldwide. Although bone metastases palliative irradiation recommendations exist, international clinical practices remain variable. The purpose of this article is to show the clinical practices evolution though clinical trials, cost studies and techniques’ progression.     

Lymphome de Hodgkin primitif osseux de la région sacrée : un défi diagnostique et thérapeutique

Primary osseous Hodgkin's lymphoma is a very rare entity. Cases reported in the literature are limited with often insufficient initial exploration. We report a new case of a 24 years old patient with a diagnosis of primary osseous Hodgkin lymphoma of the lumbosacral region with extension to the soft tissues, without simultaneous lymph node involvement confirmed both by conventional and metabolic imaging. The patient received a combination chemotherapy (two courses BEACOPP^® and four courses ABVD) followed by radiotherapy of the lombosacral region at the dose of 40 Gy in 20 fractions. Fifteen months after the end of treatment, the patient was in complete remission.