[Dosimetric and clinical benefits of respiratory-gated radiotherapy for lung and breast cancers: results of the STIC 2003]. / Intérêts dosimétriques et cliniques de la radiothérapie asservie à la respiration des cancers du poumon et du sein : résultats du Stic 2003.

PURPOSE: To compare respiratory-gated conformal radiotherapy versus conventional conformal radiotherapy for the irradiation of non-small cells lung cancer and breast cancer. PATIENTS AND METHODS: The STIC 2003 project was a comparative, non-randomized, multicenter and prospective study that included in 20 French centers between April 2004 and June 2008, 634 evaluable patients, 401 non-small cells lung cancer and 233 breast cancers. RESULTS: The final results confirmed the feasibility and good reproducibility of the various respiratory-gated conformal radiotherapy systems regardless of tumour location. The results of this study demonstrated a marked reduction of dosimetric parameters predictive of pulmonary, cardiac and esophageal toxicity, especially for non-small cells lung cancer, as a result of the various respiratory gating techniques. These dosimetric benefits were mainly observed with deep inspiration breath-hold techniques (ABC and SDX), which markedly increased the total lung volume compared to the inspiration-synchronized system based on tidal volume (RPM). For non-small cells lung cancer, these theoretical dosimetric benefits were correlated with a significant reduction in clinically acute and late toxicities, especially the pulmonary. For breast cancer, although less clear due to the lower total dose, there was a decrease in the dose delivered to the heart, potentially reducing the risk of cardiac toxicity in the long-term, especially during the irradiation of the left breast, and a reduction in dose to the contra lateral breast. CONCLUSION: Respiratory-gated radiotherapy appears to be essential to reduce the risk of acute and late toxicities, especially for lungs and heart, during irradiation of non-small cells lung cancer and breast cancers.

Nasal polyposis and cystic fibrosis(CF): review of the literature.

The aim of this study was to address whether NP might be a predictive factor for severity of CF. The authors collected data from the literature on NP as a unique or associated sign in CF and reviewed the clinical and molecular aspects of CF associated with NP. CF genotypes and clinical severity in NP(+) vs. NP(-) patients were reviewed, taking into account pulmonary function, frequency of P. aeruginosa lung infection, frequency of allergy, nutritional status, and exocrine pancreatic function. The CFTR gene was also analyzed in a patient with isolated severe NP as the unique feature of CF. This review of the literature showed a `milder` phenotype in `NP+` vs. `NP-` CF patients, contrasting with a marked association between NP and `severe` CF mutations. In addition, a complex genotype was identified, associating four heterozygous variants, namely p.Q493X (a severe mutation) on the paternal allele, and p.V562I, p.A1006E, and (TG)11(T)5 (IVS8-5T) on the maternal allele, in a case of CF presenting as isolated NP. The authors speculate that genetic/environmental factors associated with NP might attenuate the functional impact of `severe` CF mutations. The overrepresentation of CF carriers among patients with isolated NP also advocates the need for CFTR molecular screening in such populations for genetic counselling purposes.

[Quality of life after LASIK: part II. Quality of life and satisfaction of a population of patients treated with LASIK]. / Qualité de vie après LASIK : partie II. Qualité de vie et satisfaction d'une population de patients opérée par LASIK.

INTRODUCTION: The objective of this study was to assess the refraction-related quality of life and patients' satisfaction in a LASIK-treated sample. METHODS: The French adaptation of the NEI-RQL-42 scale and a satisfaction questionnaire were sent to all patients consecutively treated with LASIK (all ages, all indications) in a same center between January and March 2008. The 13 scores of the NEI-RQL-42 were described. The scores "satisfaction with correction" and "glare" have been further analyzed using multivariate logistic regression. Answers to the satisfaction questionnaire were also described. RESULTS: The study sample (307 patients) has the expected characteristics of LASIK-treated patients. Quality of life scores are generally high (>70/100), except for the "glare" (65/100) and "expectations" (42/100) scores. Most of the scores are higher in myopes than in hyperopes. A lower "satisfaction with correction" score was associated with hyperopia (P<0.001) and with a lower "glare" score. A lower "glare" score was associated with ametropia severity (P=0.002), secondary surgery (P=0.02) and to the use of a non-customized treatment (P=0.047). Satisfaction rate was 95%. CONCLUSIONS: Quality of life scores and satisfaction rate are high in this sample, and suggesting how the refractive results impact patients' lives. They also show the importance of glare and other visual symptoms.