RESUMEN
PURPOSE: To assess the impact of radiotherapy in paragangliomas (PGLs) with regard to overall survival, local control, volumetric response and particularly quality of life (QoL). MATERIALS AND METHODS: From 1985 to 2010, 130 cases of head and neck (H&N) PGLs were managed at Bordeaux University Hospital. With a median follow-up of 7.6 years, we retrospectively present a cohort of 30 consecutive patients treated with radiation therapy for H&N PGLs. QoL was evaluated for 20 patients by the EORTC QLQ-C30 and H&N35 questionnaires through a cross-sectional study. RESULTS: The 5-year overall survival and local control were 95% and 96% respectively. QoL is altered following management of PGLs. The H&N35 score is lower after combined modality therapy (surgery±embolization and radiation therapy) for speech and hearing (p=0.004), trismus (p=0.003) and total score (p=0.01) than after radiotherapy alone. Tumor shrinkage was significant at 2 and 3 years after radiotherapy (p=0.018; p=0.043). CONCLUSION: Ultimate QoL should be a major goal of any treatment strategy for this benign disease. Definitive radiotherapy should be considered as a reasonable alternative to multimodality treatment as it provides comparable disease control with an apparent improvement in QoL.
Asunto(s)
Neoplasias de Cabeza y Cuello/radioterapia , Paraganglioma/radioterapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Estudios de Cohortes , Estudios Transversales , Femenino , Neoplasias de Cabeza y Cuello/fisiopatología , Neoplasias de Cabeza y Cuello/psicología , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Estudios Retrospectivos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Nine patients with head-and-neck cancer underwent computerized tomography (CT) simulation and [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) to compare the radiotherapy target volumes. The PET volumes were delineated with an automatic segmentation based on the source-to-background ratio. The volume comparison showed a reduction and qualitative discrepancies between the PET- and CT-volumes.
Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Fluorodesoxiglucosa F18 , Neoplasias de Cabeza y Cuello/radioterapia , Tomografía de Emisión de Positrones , Radiofármacos , Planificación de la Radioterapia Asistida por Computador , Tomografía Computarizada por Rayos X , Carcinoma de Células Escamosas/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Fantasmas de ImagenRESUMEN
Prostate carcinoma is the most frequent cancer in French men. Prostate carcinoma in elderly is the topic of this review. The review included chapters on age as the main factor for prostate carcinoma, the modification of disease presentation or PSA level depending on age, and then the challenge of age in therapeutic decisions. Finally, we evaluate the place of elderly patients in prospective trials and in adjustable therapies.