[Overall treatment time assessment of radiotherapy delivered in a curative intent: A prospective study].
We report a single-center prospective study including all consecutive patients receiving a radiation therapy with curative intent, from 1st December 2013 to 28th February 2014, on the three linear accelerators of the radiotherapy department. For each fraction missed, the causes of non-completion were prospectively collected. This analysis took into account the following parameters: age, sex, occupation, transport type and duration, tumour localization, radiation dose, concomitant chemotherapy, hospitalization, type of linear accelerator. RESULTS: One hundred and fifty-five patients were included in the study (183 eval...
Source: Cancer Radiotherapie - October 15, 2015 Category: Cancer & Oncology Authors: Petit C, Suissa A, Finet A, Comte A, Soltys B, Daveau C, Ali D, Dessard-Diana B, Giraud P, Housset M, Durdux C Tags: Cancer Radiother Source Type: research

[Positron emission tomography and stereotactic body radiation therapy for lung cancer: From treatment planning to response evaluation].
ier H Abstract Stereotactic body radiation therapy is the standard treatment for inoperable patients with early-stage lung cancer. Local control rates range from 80 to 90 % 2 years after treatment. The role of positron emission tomography in patient selection is well known, but its use for target definition or therapeutic response evaluation is less clear. We reviewed the literature in order to assess the current state of knowledge in this area. PMID: 26476702 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - October 14, 2015 Category: Cancer & Oncology Authors: Bibault JE, Oudoux A, Durand-Labrunie J, Mirabel X, Lartigau É, Kolesnikov-Gauthier H Tags: Cancer Radiother Source Type: research

[Practical risk analysis].
Abstract Risk analysis is typically considered from two complementary points of view: predictive analysis performed prior, and retrospective analysis, which follows the internal reporting of adverse situations or malfunctions, both on the organizational and material or human aspects. The purpose of these additional analyzes is to ensure that planned or implemented measures allow to keep risks to a level deemed tolerable or acceptable at a given time and in a given situation. Where a risk is deemed unacceptable, risk reduction measures should be considered (prevention, limiting the consequences and protection). ...
Source: Cancer Radiotherapie - September 8, 2015 Category: Cancer & Oncology Authors: Lisbona A, Valero M Tags: Cancer Radiother Source Type: research

[Adaptive radiotherapy in routine use? State of the art: The medical physicist's point of view].
ier R Abstract The development of both image-guided and intensity-modulated radiotherapy has underlined the question of treatment adaptation to anatomical and/or biological changes occurring during radiotherapy course and modifying delivered dose to the patient. Adaptive radiotherapy has been introduced when several plans are used to treat a patient during radiotherapy. Adaptation may be performed online, offline or in a hybrid way. New images of the patient are needed for adaptive radiotherapy to perform many processes: image registration, segmentation and evaluation of cumulative dose. Deformable image registrat...
Source: Cancer Radiotherapie - September 7, 2015 Category: Cancer & Oncology Authors: Lafond C, Simon A, Henry O, Périchon N, Castelli J, Acosta O, de Crevoisier R Tags: Cancer Radiother Source Type: research

[Lung cancer: Stereotactic body radiation therapy and surgery].
Abstract Stereotactic body radiation therapy for lung cancer is now well established for patients who are not eligible to surgery. These patients can benefit from a curative treatment, which is a new therapeutic indication. Protocols are effective and well tolerated even for the most fragile patients. Three randomized trials comparing stereotactic body radiation therapy and surgery failed due to poor accrual. However, taking into account the favourable available data, the choice of stereotactic body radiation therapy in first intention arises. The treatment decision has to be discussed in a multidisciplinary way, ...
Source: Cancer Radiotherapie - September 7, 2015 Category: Cancer & Oncology Authors: Antoni D, Srour I, Mornex F Tags: Cancer Radiother Source Type: research

[Crossed audit of the quality management system: Optimization of professional practices in radiotherapy].
This article details the rationale for the project and conduct of the audit. PMID: 26344432 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Leroy É, Ponsard N Tags: Cancer Radiother Source Type: research

[How to maximize skin care during radiotherapy?]
e;e M Abstract No consensual guidelines exist regarding the management of early effects of radiotherapy. But preventive and curative care strategies could be adapted in the aim to delay erythema, limit complications and improve patients' comfort. Prevention involves encouraging patients to take care of their skin, avoid moisture, frictions, sun exposition and dry soap. When these rules seem insufficient, products (dressings, solution, or cream) could be prescribed, according to the individual risk of each patient. Preventive measures are accentuated when radiodermatitis appears and/or topics indicated for wound he...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Fromantin I, Lesport G, Le Mée M Tags: Cancer Radiother Source Type: research

[Mucosal tolerance and low level laser therapy: Is the delegation to radiation technicians possible?]
Abstract Mucositis remains a frequent complication of radiotherapy. Low level laser applications are used to accelerate the healing process. This technique is used routinely in our centre. It is performed by delegation by radiotherapists. The conditions of this delegation of tasks are addressed here. PMID: 26344434 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Duchosal S Tags: Cancer Radiother Source Type: research

[Benefit of a pretreatment planning library-based adaptive radiotherapy for cervix carcinoma?]
CONCLUSION: A pretreatment planning library-based adaptive radiotherapy in cervix carcinoma decreases the dose to the organs at risk and increases the dose to the CTV. PMID: 26344435 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Gobeli M, Simon A, Getain M, Leseur J, Lahlou E, Lafond C, Dardelet E, Williaume D, Rigaud B, de Crevoisier R Tags: Cancer Radiother Source Type: research

[Experience feedback committees (CREX) and beyond…].
[Experience feedback committees (CREX) and beyond…]. Cancer Radiother. 2015 Sep 3; Authors: Pourel N, Meyrieux-Croset C, Isambert A Abstract Since the late 2000years, under the incentive of the French agencies ANAP (previously MEAH) and HAS and following the decision DC-0103 of the ASN, experience feedback committees (known as 'Comité de retour d'expérience or Crex' in French) have widely been implemented within radiation oncology departments in France. Based on the declaration of error/near misses (precursor events) occurring during medical care to patients, an intuitive method o...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Pourel N, Meyrieux-Croset C, Isambert A Tags: Cancer Radiother Source Type: research

[Head and neck adaptive radiotherapy: A tool for the detection of patients requiring adaptive radiotherapy].
CONCLUSION: The development of the dosimetric tool allows the automatic detection, with no delineation needs, of patients suffering from head and neck cancers requiring an adaptive strategy. PMID: 26344437 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Huger S, Graff P, Marchesi V, Vogin G, Guinement L, Serre AA, Peiffert D Tags: Cancer Radiother Source Type: research

[Geriatric intervention in oncology for elderly patients].
Abstract Half of all cancers occur in patients older than 70 years. National cancer plans in France promote the emergence of geriatric oncology, whose aim is that every elder cancer patient receives a pertinent treatment, according to his frailty. Geriatric intervention has been evaluated in various conditions or patients since 30 years. Meta-analysis has shown the benefits on autonomy and mortality. But benefits are related to the organization of geriatric care, especially when integrated care is provided. Literature on geriatric oncology is relatively poor. But it is certain that a geriatric comprehensive assess...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Saint-Jean O, LeGuen J Tags: Cancer Radiother Source Type: research

[Radiation therapy for elderly patients].
Abstract Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatments against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed ...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Durdux C, Gisselbrecht M Tags: Cancer Radiother Source Type: research

[Radiomics: Definition and clinical development].
A, Azria D Abstract The ultimate goal in radiation oncology is to offer a personalized treatment to all patients indicated for radiotherapy. Radiomics is a tool that reinforces a deep analysis of tumors at the molecular aspect taking into account intrinsic susceptibility in a long-term follow-up. Radiomics allow qualitative and quantitative performance analyses with high throughput extraction of numeric radiologic data to obtain predictive or prognostic information from patients treated for cancer. A second approach is to define biological or constitutional that could change the practice. This technique included ...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Bourgier C, Colinge J, Aillères N, Fenoglietto P, Brengues M, Pèlegrin A, Azria D Tags: Cancer Radiother Source Type: research

[Use of minimally invasive approaches for stage I non-small cell lung cancer: A surgeon's point of view].
Abstract Lobectomy with lymphadenectomy is the standard of care of patients with early stage non-small cell lung cancer, and the use of minimally invasive approaches is associated with reduced morbidity when compared with thoracotomy. Segmentectomy with lymphadenectomy seems to provide a curative effect equivalent to that of lobectomy for stage IA tumours of 2cm or smaller, and for pure or predominant ground glass opacities. The combination of lung-sparing resections with minimally invasive approaches results in preserved pulmonary function, improved quality of life and very low morbidity. This benefit persists in...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Thomas PA Tags: Cancer Radiother Source Type: research

[What type of hypofractionated radiotherapy of primary tumours in palliative care?]
Abstract Palliative radiation therapy is well-known in the setting of metastatic lesions (haemostatic, analgesic, anti-inflammatory aims, etc.). Palliative primary tumour radiotherapy is less studied. Here we propose a review of palliative indications of primary tumours, the most studied in the literature, and their radiotherapy modalities (target volumes and fractionation). PMID: 26344442 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Bourgier C, Charissoux M, Boisselier P, Ducteil A, Azria D Tags: Cancer Radiother Source Type: research

[Good practice of image-guided radiotherapy].
This article reviews the modalities of IGRT, standard or under evaluation, according to the different tumour sites. PMID: 26344443 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: de Crevoisier R, Créhange G, Castelli J, Lafond C, Delpon G Tags: Cancer Radiother Source Type: research

[Which dose constraints on which critical organs in paediatric radiation therapy?]
Abstract Cancers in childhood are rare, representing 1% of all the cancers in developing countries. On the whole, the overall survival approaches 75% at 5years. The radiation dose decrease in lots of indications as well as better optimized planning treatments lead to decrease the long-term toxicities in some indications. However, the radiation toxicity remains frequent, often specific of pediatric situations. Long-term toxicities are mainly neurologic, sensitive, endocrine, or linked to growth impairment (bones or muscular). Radio-induced second-cancers are also frequent after a long follow-up after cancer in chil...
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Claude L, Laprie A Tags: Cancer Radiother Source Type: research

[Benefits of functional imaging in radiotherapy].
Abstract Functional imaging with positron emission tomography (PET) is interesting to optimize radiotherapy planning, and probably to perform dose redistribution in many cancers. However, in 2015, fluorodeoxyglucose (FDG)-PET is validated only for therapy planning for lung cancer. The interest of dose painting, PET in non-lung cancers, the interest of other tracers (even PET hypoxia tracers), DW-MRI, and PET-MR for radiotherapy needs to be demonstrated in prospective multicentric phase III studies on large series of patients. PMID: 26344445 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 3, 2015 Category: Cancer & Oncology Authors: Vera P, Thureau S Tags: Cancer Radiother Source Type: research

[Risk analysis study for patients care in radiotherapy: Learning curve and methodological evolution].
CONCLUSION: Risk mapping is an essential tool in the implementation of risk quality management, specifically when the methodology is progressive and takes into consideration all the members of a pluridisciplinary team. PMID: 26343031 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - September 2, 2015 Category: Cancer & Oncology Authors: El Bakri S, Fleury B, Le Grévellec M Tags: Cancer Radiother Source Type: research

[Image-guided radiotherapy: Overview of devices and practice in France in 2015].
ier R Abstract Image-guided radiation therapy consists in acquiring in-room images to improve patient and mainly tumour set up accuracy. Many devices based on ionising or non-ionising radiations were designed in recent years. The use of such devices is of major importance in the management of patient radiotherapy courses. Those imaging sessions require to clearly define procedures in each radiotherapy department (image modality, acquisition frequency, corrective action, staff training and tasks). A quick review of the different existing image-guided radiation therapy devices is presented. In addition, the results ...
Source: Cancer Radiotherapie - September 2, 2015 Category: Cancer & Oncology Authors: Delpon G, Chiavassa S, Supiot S, Boutry C, Darréon J, Desrousseaux J, Lafay F, Leysalle A, de Crevoisier R Tags: Cancer Radiother Source Type: research

[Ultrasmall nanoparticles for radiotherapy: AGuIX].
Abstract Since twenty years, many nanoparticles based on high atomic number elements have been developed as radiosensitizers. The design of these nanoparticles is limited by the classical rules associated with the development of nanoparticles for oncology and by the specific ones associated to radiosensitizers, which aim to increase the effect of the dose in the tumor area and to spare the health tissues. For this application, systemic administration of nanodrugs is possible. This paper will discuss the development of AGuIX nanoparticles and will emphasize on this example the critical points for the development of...
Source: Cancer Radiotherapie - September 2, 2015 Category: Cancer & Oncology Authors: Lux F, Detappe A, Dufort S, Sancey L, Louis C, Carme S, Tillement O Tags: Cancer Radiother Source Type: research

[Follow-up after stereotactic body radiation therapy for liver tumours: A review of the literature and recommendations].
Abstract Stereotactic body radiation therapy is a modern approach for delivering ablative high doses of irradiation in small volumes. This technique is being developed for the treatment of liver tumors, such as hepatocellular carcinoma, cholangiocarcinoma, or liver metastases. It represents a real alternative to surgical resection or liver transplantation when patients are inoperable or when tumours are unresectable. It is mandatory to standardize and simplify the current methods of evaluation and monitoring in order to benefit from a better understanding of the effectiveness and of the tolerance of this new treat...
Source: Cancer Radiotherapie - September 2, 2015 Category: Cancer & Oncology Authors: Janoray G, Mornex F Tags: Cancer Radiother Source Type: research

[Recommendations for the management of cancers of the anal canal].
Abstract Anal canal carcinomas remain rare, but their management has improved recently. The PET-CT is now used as a standard at the first diagnosis and after relapses. The introduction of intensity-modulated irradiation techniques makes it possible to better conform the pelviperineal and inguinal volumes, improving the homogeneity of the irradiation while sparing some pelvic structures, thus reducing acute and late effects. Nevertheless, the conversion from 3D to intensity-modulated radiotherapy needs a specific and careful approach, mainly for the management of the perineal region, where relapses and complication...
Source: Cancer Radiotherapie - September 1, 2015 Category: Cancer & Oncology Authors: Peiffert D Tags: Cancer Radiother Source Type: research

[Follow-up after lung stereotactic radiotherapy].
d P Abstract Nowadays, bronchopulmonary stereotactic body radiotherapy is recommended as the standard of care in treating medically inoperable patients with curative intent according to guidelines of multiple organizations. Changes in lung density on computed tomography are common after stereotactic body radiotherapy and can confound the early detection of recurrence. Radiation-induced computed tomography lung changes after bronchopulmonary stereotactic body radiotherapy differ from those observed after conventionally fractionated radiotherapy. It is mandatory to standardize and simplify our clinical, radiological...
Source: Cancer Radiotherapie - August 31, 2015 Category: Cancer & Oncology Authors: Waissi W, Noël G, Giraud P Tags: Cancer Radiother Source Type: research

[Current use and prospects for hadron therapy in 2015].
Abstract Hadron therapy (including protons and ions) is still expanding worldwide, although still limited by the cost and thus the number of available facilities. If the historical indications remain eye melanomas, skull base tumours and paediatric tumours for protontherapy; and salivary glands, paranasal sinus and nasal cavity tumours, and soft tissue sarcomas for carbon ions, no conclusion can be drawn about the role of these modalities for other tumours, such as prostate, lung cancers. Since 2013, more than 100 clinical trials are on-going, including comparisons between advanced photons modalities, protont...
Source: Cancer Radiotherapie - August 31, 2015 Category: Cancer & Oncology Authors: Feuvret L, Calugaru V, Ferrand R Tags: Cancer Radiother Source Type: research

[Current management of hepatocellular carcinoma].
ray C Abstract Hepatocellular carcinoma is the major complication of chronic liver diseases and particularly of cirrhosis whatever its etiology. Once encountered mainly in the endemic countries of hepatitis B and C, the incidence of hepatocellular carcinoma (6/100,000) is parallel to the global development of diabetes, overweight and alcohol consumption. Little progress has been made for this cancer, whose mortality is 100 % at 10 years. Liver transplantation is the only truly curative treatment (survival more than 50 % at 10 years) since it allows the eradication of hepatocellular carcinoma an...
Source: Cancer Radiotherapie - August 31, 2015 Category: Cancer & Oncology Authors: Ruiz I, Féray C Tags: Cancer Radiother Source Type: research

[Adaptive radiotherapy in routine: The radiation oncologist's point of view].
Abstract Adaptive radiotherapy is defined as all processes leading to the modification of a treatment plan on the basis of patient-specific variations observed during the course of a treatment. This concept is currently of particular relevance due to the development of onboard volumetric imaging systems, which allow for daily viewing of variations in both tumour and organs at risk in terms of position, shape or volume. However, its application in routine clinical practice is limited due to the demanding nature of the processes involved (re-delineation and replanning) and increased dependence on available human res...
Source: Cancer Radiotherapie - August 31, 2015 Category: Cancer & Oncology Authors: Henriques de Figueiredo B, Petit A, Sargos P, Kantor G, Pouypoudat C, Saut O, Zacharatou C, Antoine M Tags: Cancer Radiother Source Type: research

[Adaptive radiation therapy for non-small cell lung cancer].
aud P Abstract Anatomical changes and tumor regression during thoracic radiotherapy may alter the treatment volumes. These modifications are not taken into account into set-up or motion margins used for treatment planning. Their dosimetric impact could be significant and a better understanding of the changes occurring during the 6 to 7weeks of treatment could be useful in order to define quantitative thresholds before a new treatment planning is needed. Margins could also be reduced in order to better spare organs at risk and perform targeted dose escalation. This review assesses the potential of morphologic and m...
Source: Cancer Radiotherapie - August 31, 2015 Category: Cancer & Oncology Authors: Bibault JE, Arsène-Henry A, Durdux C, Mornex F, Hamza S, Trouette R, Thureau S, Faivre JC, Boisselier P, Lerouge D, Paragios N, Giraud P Tags: Cancer Radiother Source Type: research

[Follow-up after radiotherapy of anal canal carcinoma].
This article offers a review of the various post-treatment surveillance options both for early diagnosis of relapse and care for late treatment effects. While follow-up remains mostly clinical, we will discuss morphologic (endorectal echoendoscopy, pelvic magnetic resonance imaging, tomodensitometry and positron emission tomography) and biologic (squamous cell carcinoma antigen and pathology) follow-up so as to determine their diagnostic and prognostic value. PMID: 26323891 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - August 28, 2015 Category: Cancer & Oncology Authors: Meillan N, Huguet F, Peiffert D Tags: Cancer Radiother Source Type: research

Clinical radiotherapy audits in Belgium, 2011-2014.
Abstract Systematic clinical radiotherapy audits have been introduced in Belgium in 2011, as part of the Federal Cancer Plan. This is in compliance with article 11 of the 97/43 Council directive of Euratom states, translated into the Belgian legislation by royal decree in 2002. The principle of clinical audits has thus been part of the federal legal requirements for more than 10 years. However, its application had to wait for the development of a practical approach: what authority will audit, who will be the auditors, along which methodology, at what frequency, etc. Since 2002, the Federal College of Radiotherapy ...
Source: Cancer Radiotherapie - August 27, 2015 Category: Cancer & Oncology Authors: Scalliet PG, Federal College of Radiotherapy, Brussels Tags: Cancer Radiother Source Type: research

[Nutritional management of patients with head and neck cancer treated with radiation].
tot F Abstract Radiotherapy and chemotherapy are standard treatment of head and neck cancer alone or associated to surgical treatment. Early (during treatment or the following weeks) and late side effects contribute to malnutrition in this population at risk. In this context, nutritional support adapted by dietary monitoring and enteral nutrition (nasogastric tube or gastrostomy) are often necessary. The early identification of the patients with high malnutrition risk and requiring enteral nutrition is necessary to improve the tolerance and efficacy of treatment. PMID: 26321684 [PubMed - as supplied by publis...
Source: Cancer Radiotherapie - August 27, 2015 Category: Cancer & Oncology Authors: Thureau S, Lefebvre L, Dandoy S, Guérault F, Ebran M, Lebreton M, Veresezan O, Rigal O, Clatot F Tags: Cancer Radiother Source Type: research

[Recommendations for inspections of the French nuclear safety authority].
Abstract The French nuclear safety authority is responsible for the control of radiation protection in radiotherapy since 2002. Controls are based on the public health and the labour codes and on the procedures defined by the controlled health care facility for its quality and safety management system according to ASN decision No. 2008-DC-0103. Inspectors verify the adequacy of the quality and safety management procedures and their implementation, and select process steps on the basis of feedback from events notified to ASN. Topics of the inspection are communicated to the facility at the launch of a campaign...
Source: Cancer Radiotherapie - August 27, 2015 Category: Cancer & Oncology Authors: Rousse C, Chauvet B Tags: Cancer Radiother Source Type: research

[Radiotherapy of bone metastases: Which fractionations?]
Abstract First-line palliative radiotherapy for painful bone metastases is an effective treatment whatever its fractionation (single or multiple fractions). It is also indicated after failure or insufficient effect of a first irradiation, or the appearance of new painful site. Other indications are spinal cord compression, either as an adjuvant to surgery or as sole treatment, and after surgery for long bone metastases. The development of high precision techniques (stereotactic conditions) widens the possibility of re-irradiation when tolerance doses to normal tissues have already been delivered. Local control and...
Source: Cancer Radiotherapie - August 27, 2015 Category: Cancer & Oncology Authors: Thureau S, Leysalle A, Faivre JC, Lagrange JL Tags: Cancer Radiother Source Type: research

[Which rules apply to hypofractionated radiotherapy?]
pon G Abstract Hypofractionated radiotherapy is now more widely prescribed due to improved targeting techniques (intensity modulated radiotherapy, image-guided radiotherapy and stereotactic radiotherapy). Low dose hypofractionated radiotherapy is routinely administered mostly for palliative purposes. High or very high dose hypofractionated irradiation must be delivered according to very strict procedures since every minor deviation can lead to major changes in dose delivery to the tumor volume and organs at risk. Thus, each stage of the processing must be carefully monitored starting from the limitations and the c...
Source: Cancer Radiotherapie - August 25, 2015 Category: Cancer & Oncology Authors: Supiot S, Clément-Colmou K, Paris F, Corre I, Chiavassa S, Delpon G Tags: Cancer Radiother Source Type: research

[How to identify frailty in older patients with cancer? Available tools].
Abstract Management of cancer in the elderly needs more attention than in younger patients mainly because of comorbidities and geriatric syndromes. Each frailty encountered will facilitate adverse events and complications which are more frequent and more severe in the elderly and have to be anticipated to control for the risk of organ failure and dependencies. Fortunately, tools which have been developed and validated by geriatricians, are available to the oncologists and their validity has been demonstrated in oncology. Yet, they are quite time-consuming and consequently available for a minority of patients. Furt...
Source: Cancer Radiotherapie - August 25, 2015 Category: Cancer & Oncology Authors: Bellera C, Soubeyran P Tags: Cancer Radiother Source Type: research

[Radiation therapy and immunomodulation: Focus on experimental data].
The objective of this article is to review how tumour cells interact with the immune system and how ionizing radiation modulate this interaction and finally the combination of perspectives of immunotherapy and ionizing radiation by focusing on existing clinical data. PMID: 26293415 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - August 17, 2015 Category: Cancer & Oncology Authors: Deutsch É, Lévy A, Chargari C Tags: Cancer Radiother Source Type: research

[Radiotherapy in elderly patients, recommendations for the main localizations: Breast, prostate and gynaecological cancers].
Abstract Modifications of radiotherapy indications or schedules because of age could be discussed in view of a different evolution of the disease or because of specific toxicities. One important aim is to decrease the number of hospital transports. For breast cancer, the rate of local relapse after lumpectomy is lower in old patients; moreover, characteristics of the disease are often more favourable (hormonosensitivity, low grade). However, adjuvant irradiation decreases significantly the incidence of breast relapse and must be systematically proposed. Hypofractionnated schedules must be recommended; limited data...
Source: Cancer Radiotherapie - August 14, 2015 Category: Cancer & Oncology Authors: Hennequin C, Guillerm S, Quero L Tags: Cancer Radiother Source Type: research

[Which constraints for which organs at risk in radiotherapy for adult patients?]
l G Abstract The delineation of organs at risk is a part of the planning of irradiation treatments. With the delineation of the target volumes, this task is essential and is followed by the appropriate calculations of a dose distribution from radiation beams and the validation of the treatment plan. The contouring of organs at risk could influence the dosimetric parameters, treatment planning and also the outcome of the patient. The treatment intent (curative or palliative), doses and fractionations and also the type of organs at risk have an impact on the delineation. Optimized radiation techniques and reirradiat...
Source: Cancer Radiotherapie - August 14, 2015 Category: Cancer & Oncology Authors: Antoni D, Noël G Tags: Cancer Radiother Source Type: research

[Follow-up after radiation therapy for cervical cancer].
Abstract Radiation therapy plays a central role in treatment strategies of cervical cancer. Follow-up after external pelvic radiation therapy and brachytherapy is based upon French and international specific recommendations. It aims to assess early tumour response, and to detect local or metastatic recurrences which can be suitable for salvage treatment. Follow-up after radiation therapy for cervical cancer should also assess gastro-intestinal, urinary and sexual toxicities which may have an impact on quality of life. This is a major concern in the evaluation of the results of intensity-modulated radiation therapy...
Source: Cancer Radiotherapie - August 14, 2015 Category: Cancer & Oncology Authors: Cao KI, Mazeron R, Barillot I Tags: Cancer Radiother Source Type: research

[Clinical and paraclinical follow-up after radiotherapy for head and neck cancer].
The objective of this article is to review the modalities of short-term and long-term follow-up of patients who receive a radiotherapy for head and neck cancer. PMID: 26278985 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Clément-Colmou K, Troussier I, Bardet É, Lapeyre M Tags: Cancer Radiother Source Type: research

[Radiotherapy for gliomas in adults: What are the stakes of the follow-up?]
on JJ Abstract Linked to the difference of prognosis, the terms and conditions of the follow-up of low-grade and high-grade gliomas treated by irradiation differ highly. Patients treated for a low-grade glioma have prolonged survival. In this case, monitoring of toxicities linked to the treatment is a major objective. Opportunistic infections and depression are corticosteroids side effects widely underestimated. Radionecrosis search and differentiation with recurrent disease are done by MRI. Perfusion and spectroscopy showing a choline/creatine ratio increase are in favour of disease recurrence. Cognitive status a...
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Atallah V, Gariel F, Gillon P, Crombé A, Mazeron JJ Tags: Cancer Radiother Source Type: research

[Current status of hypofractionated external beam radiotherapy for early-stage breast cancer].
Abstract The benefits of adjuvant radiotherapy following lumpectomy for early-stage breast cancer are well established. The most widely used method consists of roughly twenty-five fractions of whole-breast irradiation. In recent years, there has been a growing trend towards hypofractionated external beam radiotherapy regimens. Many of these techniques have been shown to be equivalent in terms of tumor control and cosmetic results while minimizing inconvenience and costs both to the patient and health care system. Here, we present the various hypofractionation modalities, patient selection criteria, consensus guide...
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Tiberi D, Hijal T, Yassa M Tags: Cancer Radiother Source Type: research

Hypofractionated radiation therapy for prostate cancer: The McGill University Health Center experience.
DISCUSSION: Our technique changed from 3D to intensity modulated radiotherapy with the dose adjusted to 60Gy in 20 fractions. Lastly, we have expanded the program to high-risk patients where IMRT treatments are given to the pelvic nodes (44Gy in 20 fractions) with a simultaneous integrated boost delivery to the prostate (60Gy in the same 20 fractions). Our long-term results have shown that moderate hypofractionated radiotherapy for prostate cancer is safe and provides good tumor control comparable to high-dose conventionally fractionated radiotherapy. This hypofractionated regimen has been routinely used in our institution...
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Barbosa Neto O, Souhami L, Faria S Tags: Cancer Radiother Source Type: research

[Surveillance after prostate cancer radiotherapy: Evaluation and management of toxicity and relapse].
This article reports incidence of main side-effects (digestive, urinary and sexual) with their treatments and guidelines for clinical and biological follow-up with strategies of imaging studies and salvage treatments. PMID: 26278989 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Dupic G, Hennequin C Tags: Cancer Radiother Source Type: research

[Organ preserving strategies for rectal cancer treatment].
Rullier É Abstract For rectal cancers, the current standard of care consists of chemoradiation followed by radical surgery with total mesorectal excision. Oncologic results are good, especially regarding local recurrence rates, but at the cost of high morbidity rates and poor anorectal, urinary and sexual function results. Since chemoradiation yields 15 to 25% pathological complete response, the role of radical surgery is questioned for patients presenting with good response after chemoradiation and two organ preservation strategies have been offered: watch and wait strategy and local excision strategy. Th...
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Vendrely V, Denost Q, Amestoy F, Célérier B, Smith D, Rullier A, Rullier É Tags: Cancer Radiother Source Type: research

[Implementing new technology in radiation oncology: The French agency for nuclear safety (ASN) report].
Phare O, Aubert B Abstract In August 2013, the French nuclear safety agency (ASN) requested the permanent group of experts in radiation protection in medicine (GPMED) to propose recommendations on the implementation of new technology and techniques in radiation oncology. These recommendations were finalized in February 2015 by the GPMED. In April 2015, the ASN sent a letter to the French ministry of health (DGS/DGOS), and its national health agencies (ANSM, INCa, HAS). In these letters, ASN proposed that, from the 12 recommendations made by the GPMED, an action plan should be established, whose...
Source: Cancer Radiotherapie - August 13, 2015 Category: Cancer & Oncology Authors: Lartigau ÉF, Lisbona A, Isambert A, Cadot P, Derreumaux S, Dupuis O, Gérard JP, Ledu D, Mahé MA, Marchesi V, Mazurier J, De Oliveira A, Phare O, Aubert B Tags: Cancer Radiother Source Type: research

[Ultrahigh dose-rate, "flash" irradiation minimizes the side-effects of radiotherapy].
CONCLUSION: Flash irradiation shifted by a large factor the threshold dose required to initiate lung fibrosis without loss of the antitumour efficiency, suggesting that the method might be used to advantage to minimize the complications of radiotherapy. PMID: 26277238 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - August 12, 2015 Category: Cancer & Oncology Authors: Favaudon V, Fouillade C, Vozenin MC Tags: Cancer Radiother Source Type: research

[How to care for elderly patients with cognitive impairment?]
Abstract Mild cognitive impairment occurs frequently with ageing, concerning memory complaint, attention and executive dysfunction without any consequence on the activities of daily living. They are strongly linked to the presence of vascular risk factors in adulthood. Nevertheless with the continuous progression of life expectancy, the incidence of dementia drastically increases after sixty-five years of age and the number of old people with dementia is expected to increase by 75% in 2030 in France. Caring for elderly patients with cancer needs to face the possibility of cognitive impairment and its consequences ...
Source: Cancer Radiotherapie - August 12, 2015 Category: Cancer & Oncology Authors: Rainfray M Tags: Cancer Radiother Source Type: research

[Are extensive fields useful for radiotherapy of oesophageal cancer?]
CONCLUSION: With 5cm supero-inferior margins added to gross tumour volume, less than 3% of patients had an isolated out-field recurrence. However, half of the patients suffered in-field local recurrence and one third had metastases. These findings advocate for a limited prophylactic nodal irradiation. Trials are ongoing to assess dose escalation or surgery in order to increase local control. PMID: 26232314 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)
Source: Cancer Radiotherapie - July 28, 2015 Category: Cancer & Oncology Authors: Peyraga G, Capitain O, Rousseau D, Rio E, Septans AL, Baton O, Marquis A, Trémolières P, Gustin P, Ménager É, Branger F, Bressolette M, Deutsch É, Paumier A Tags: Cancer Radiother Source Type: research