Low to moderate dose 137Cs (γ) radiation promotes M2 type macrophage skewing and reduces atherosclerotic plaque CD68+ cell content in ApoE(-/-) mice.

The effects of low doses of ionizing radiation on atherosclerosis remain uncertain, particularly as regards the generation of pro- or anti-inflammatory responses, and the time scale at which such effects can occur following irradiation. To explore these phenomena, we exposed atheroprone ApoE(-/-) mice to a single dose of 0, 0.05, 0.5 or 1 Gy of 137Cs (γ) administered at a 10.35 mGy min-1 dose rate and evaluated short-term (1-10 days) and long-term consequences (100 days). Bone marrow-derived macrophages were derived from mice 1 day after exposure. Irradiation was associated with a significant skewing of M0 and M2 polarized macrophages towards the M2 phenotype, as demonstrated by an increased mRNA expression of Retnla, Arg1, and Chil3 in cells from mice exposed to 0.5 or 1 Gy compared with non-irradiated animals. Minimal effects were noted in M1 cells or M1 marker mRNA. Concurrently, we observed a reduced secretion of IL-1ß but enhanced IL-10 release from M0 and M2 macrophages. Effects of irradiation on circulating monocytes were most marked at day 10 post-exposure, when the 1 Gy dose was associated with enhanced numbers of both Ly6CHigh and Ly6Low cells. By day 100, levels of circulating monocytes in irradiated and non-irradiated mice were equivalent, but anti-inflammatory Ly6CLow monocytes were significantly increased in the spleen of mice exposed to 0.05 or 1 Gy. Long term exposures did not affect atherosclerotic plaque size or lipid content, as determined by Oil red O staining, whatever the dose applied. Similarly, irradiation did not affect atherosclerotic plaque collagen or smooth muscle cell content. However, we found that lesion CD68+ cell content tended to decrease with rising doses of radioactivity exposure, culminating in a significant reduction of plaque macrophage content at 1 Gy. Taken together, our results show that short- and long-term exposures to low to moderate doses of ionizing radiation drive an anti-inflammatory response, skewing bone marrow-derived macrophages towards an IL-10-secreting M2 phenotype and decreasing plaque macrophage content. These results suggest a low-grade athero-protective effect of low and moderate doses of ionizing radiation.

Conservation treatment of early breast cancer: long term results and complications.

Results of radiation therapy following breast-conserving surgery were analyzed for 410 patients with clinical Stage I-II mammary carcinoma having a minimum and median follow-up time of 5 years and 11 years, respectively. Crude survival rates were 82.2% at 5 years, 62.5% at 10 years, and 45.4% at 15 years. Local-regional recurrence was observed in 9.7% of patients. Seventy-five percent of these recurrences could be controlled locally by further treatment. Both local recurrences and metastatic deaths were more frequent in patients in clinical Stage II and in patients 40 years of age or younger. The cosmetic result was judged good to excellent in 77% of patients, with unacceptable results in 6.7%. The majority of poor results were seen in patients receiving 60 Gy or more to the entire breast. Arm edema occurred in 25% of patients having had axillary dissection, and in 3.4% of patients without axillary surgery. Edema was confined mainly to patients having had axillary doses of 60 Gy or more, and was never disabling. This study demonstrates that excellent long-term results are obtainable with breast-conserving techniques in early breast cancer. Satisfactory cosmetic results and a very low complication rate can be expected if extensive axillary surgery is avoided in conjunction with axillary radiation, and if the radiation dose applied to large treatment volumes is restricted to 50 Gy.

Radiation therapy of carcinomas of the skin of nose and nasal vestibule: a report of 1676 cases by the Groupe Europeen de Curiethérapie.

A retrospective multicentric analysis of the results of irradiation of 1676 carcinomas of the skin of the nose and nasal vestibule was performed by the Groupe Européen de Curiethérapie (Tunis, May 1986). Overall local control was 93% with a minimum follow-up of 2 years. Local control is dependent on the tumor size (diameter less than 2 cm: 96%, 2-3.9 cm: 88%, greater than or equal to 4 cm: 81%), and tumor site (external surface of the nose: 94%, vestibule: 75%). Local control was independent of histology for smaller tumors, but for those larger than 4 cm, basal cell carcinomas were more frequently controlled than squamous cell carcinomas. Recurrent tumors are less frequently controlled than those being treated for the first time (88 vs. 95%). There were few complications and cosmetic results were generally satisfactory. The results of implantation, orthovoltage and megavoltage irradiation are compared with respect to local control, complication rate and cosmesis. Implantation is usually the treatment of choice for vestibular tumors but for those of the external surface the choice depends on the tumor diameter. Implantation and orthovoltage irradiation are equivalent for tumors less than 2 cm. For those from 2 to 3.9 cm, the results of orthovoltage irradiation may be satisfactory in a selected population but implantation is usually more suitable for tumors with rapidly changing contour.(ABSTRACT TRUNCATED AT 250 WORDS)

Multicentre cross-over study of aminoglutethimide and trilostane in advanced postmenopausal breast cancer.

Trilostane and aminoglutethimide, both given with a physiological replacement dose of hydrocortisone, were randomly allocated to 112 eligible patients with postmenopausal advanced breast cancer. Following treatment failure on either drug the patient continued with the other, if they were in a suitable clinical condition. Sixty-three patients initially received trilostane, of whom 33 subsequently received aminoglutethimide; 49 patients initially had aminoglutethimide and 14 of these then received trilostane. Both groups of patients were comparable in all respects. There was no difference in the response rate to either drug or in the average time to disease progression for the two drugs. Of the 47 patients who received both drugs, nine (19%) showed a response to both, indicating no cross-resistance. Side effects were seen to both drugs in approximately half the patients; these were mainly gastrointestinal symptoms with trilostane and rashes and drowsiness with aminoglutethimide. There was no evidence of cross-over patient susceptibility to side effects.

[Value of radiotherapy in the treatment of prostatic cancers in the initial stages. Apropos of 111 cases]. / Intérêt de la radiothérapie dans le traitement des cancers de la prostate. aux stades initiaux. A propose de 111 cas.

The authors report on their experience with high energy radiation therapy in early-stage (I/II) carcinomas of the prostate. Among 191 cases of biopsy-proved carcinomas of the prostate, there were 111 stage I and II tumors, including 83 T1, T2 intracapsular tumors. 78 of the 111 patients received curative radiation therapy. Delivered doses did not exceed 65 to 70 grays to the prostate and 50 grays to the pelvis. High energy radiation was used. Extension of the lesions was determined using lymphography, abdominal and pelvic CT, and surgical removal of lymph nodes. Among the 78 irradiated patients, success rates at five years were 65% for the 52 T1-T2 tumors and 38% for the 26 T3 N0 tumors. Selection of patients, technical conditions and long term results are discussed, as well as the problems met in determining the stage of the tumor accurately. High energy radiation therapy can control localized carcinomas with a satisfactory quality of survival.

[Are there limits to conservative treatment of breast cancer?]. / Y a-t-il des limites au traitement conservateur du cancer du sein?

For nearly 40 years, a multidisciplinary team working in a private clinic has used a conservative approach to breast cancer for small tumours, i.e. T1-T2. Treatment is based on tumorectomy and radiotherapy. Good results, comparable to those obtained with mastectomy have been obtained and continue to improve with developments in therapeutic methods. The rate of recurrence remains below 7% and 95% of the women were able to keep their breast without any supplementary danger. There are satisfied.

[Time factor in local radiotherapy (author's transl)]. / Facteur temps en curiethérapie.

This study was aimed at determining the influence of time factor in local radiotherapy in patients with spindle cell neoplasms of the skin or basal cell carcinomas of the face, treatable in a single plane. These neoplasma were treated using identical doses (6,000 rads distributed over the envelope isodose), but divided at random into two groups corresponsing to two different spreads (60 +/- 12 hours and 156 +/- 12 hours). The biological effects observed (rate of disappearance of the lesion, intensity of skin reaction, duration of skin reaction) showed no difference between the two types of treatment. This results is unexpected considering the important influence of time factor in the case of fractionated irradiation. In fact, if it is accepted that between 60 and 156 hours, cellular multiplication phenomena are equivalent to approximately 30 rads per day, the difference in spread the two types of treatment is not sufficient to give a significant result.