[Stereotactic body radiotherapy: Prospective study to evaluate asthenia and quality of life]. / Radiothérapie en conditions stéréotaxiques : étude prospective évaluant la fatigue et la qualité de vie.

PURPOSE: To evaluate prospectively asthenia and the quality of life in patients treated by stereotactic body irradiation and to determine their predictive factors. METHODS AND MATERIALS: Quality of life was assessed by the EORTC QLQ-C30 and asthenia was evaluated with the Brief Fatigue Inventory (BFI), on the first day (T1), last day (T2) and 1-3 weeks after the end of treatment (T3). RESULTS: Sixty-three patients were treated with stereotactic body irradiation from February 2017 to May 2017 and 41 were included in the analysis (22 patients excluded for lack of understanding, organization, psychologic disorders or refusal). The mean number of fractions was 5 (±2). The compliance to quality of life assessment was 98%, 95% was 81% at T1, T2 and T3, respectively. An increase of asthenia and a worsened quality of life were found in 12 (29%) and 14 (34%) patients between T1 and T2. Univariate analysis demonstrated a correlation between asthenia and quality of life were correlated with performans status (P=0.03 and 0.05 respectively), hemoglobin level (p=0.01 and 0.004), albumin level (P=0.01 and 0.06), distance between home and radiotherapy department (P=0.05 and 0.02). Multivariate analysis demonstrated a correlation between female gender (P=0.012), albumin level (P<0.001), distance over 25km (P<0.001) with asthenia, and albumin level (P=0.003), hemoglobin level (P=0.004) and previous chemotherapy (P=0.003) with quality of life. No influence of stereotactic body ratiotherapy parameters was seen. CONCLUSION: Despite hypofractionation, stereotactic body radiotherapy induced asthenia and deterioration of quality of life.

[Cutaneous alternariosis revealing Cushing's disease. A case with ultrastructural study]. / Alternariose cutanée révélatrice d'une maladie de Cushing. Un cas avec étude ultrastructurale.

This case concerned a 67 old farmer who presented a vegetating and crusted tumor of the right knee. Histological examination revealed intracellular round structures PAS + within an inflammatory dermal granuloma, including epithelioid and giant cells. Alternaria could be isolated on cultures from biopsies of the tumor. Ultrastructural study specifies the morphological aspects of Alternaria within dermal granuloma; furthermore, large numerous myelinic bodies were present within the parasitic cells. The clinical aspect of the patient led to hormonal explorations and a Cushing's disease yet unrecognized was ascertained, that probably represented the "special terrain" which made the growth of Alternaria possible. The survey of the available literature revealed two cases of alternariosis and Cushing's syndrome, but in these two cases the diagnosis of the endocrinopathy was already established when the cutaneous infection developed. The lesion cleared within a month after electrocoagulation, local iodine compound and griseofulvine per os, with nonrelapse 12 months after.