[Relationship between doses to anatomical structures and erectile dysfunction after radiotherapy for prostate cancer: A systematic review]. / Relations entre doses dans les structures anatomiques et dysfonction érectile après radiothérapie pour un cancer de la prostate : revue systématique de la littérature.

PURPOSE: During prostatic radiotherapy, damage to several anatomical structures could be the cause of erectile dysfunction: corpora cavernosa, internal pudendal arteries, penile bulb, and neurovascular bundles. Numerous studies have analysed the correlations between the dose received by these structures and erectile function. The objective of this article is to make a systematic review on current knowledge. MATERIALS AND METHODS: A systematic review was performed in the Medline database using the search engine PubMed. Keywords for the search included: erectile dysfunction, penile bulb, corpora cavernosa, cavernosum, neurovascular bundles, radiation therapy, cancer, prostate cancer. The selected articles must study a correlation between erectile dysfunction and the dose received by anatomical structures. A total of 152 articles were identified. Of these 152 articles, 45 fulfilled the defined selection criteria. RESULTS: For corpora cavernosa, seven studies were identified, only two studies demonstrated a significant correlation between the dose received by corpora cavernosa and the occurrence of erectile dysfunction. For penile bulb, only 15 of 23 studies showed a correlation. A mean dose on the penile bulb greater than 20Gy was found to be predictive of erectile dysfunction. None of the eight trials concerning neurovascular bundles succeeded to show a correlation between dose and erectile dysfunction. Only one study evaluated the relationship between the dose received by internal pudendal arteries and erectile dysfunction but was found to be negative. However, vessels-sparing studies showed good results on erectile function preservation without compromising the target volume. CONCLUSION: We currently have little data to show a correlation between erectile dysfunction and sexual structures. It would be necessary to have additional prospective studies evaluating the impact of an optimization on these sexual structures on erectile dysfunction.

[Stereotactic ablative body radiotherapy: Which machine for which therapeutic indication? A focus on prostate cancer]. / Radiothérapie stéréotaxique extracrânienne : quelle machine pour quelle indication ? Stéréotaxie prostatique.

For the last decade, stereotactic body radiotherapy has become a leading treatment for localized prostate cancer. It can be delivered using a wide array of radiotherapy machines. However, although numerous clinical studies, both prospective and retrospective, have been published, the different techniques have never been properly compared. This article aims at giving an overview of the published trials, and at pointing out the major differences between the machines, from a clinical (efficacy end toxicity), technical and radiobiological point of view.

[Management of neuroendocrine prostate carcinoma: Literature review]. / Prise en charge des carcinomes neuroendocrines de prostate : revue de la littérature.

Neuroendocrine prostate carcinoma is a rare entity causing both diagnostic and therapeutic issues. There are basically four histological forms (adenocarcinoma with neuroendocrine differentiation, carcinoid tumors, small cell neuroendocrine carcinomas, large cell neuroendocrine carcinomas), which can be pure or mixed associated with prostatic carcinoma. There is no consensus on the management or the prognosis of these various tumor subtypes. We conducted a literature review aiming to determine the potential therapeutic implications.

Potential interest of developing an integrated boost dose escalation for stereotactic irradiation of primary prostate cancer.

INTRODUCTION: The stereotactic irradiation is a new approach for low-risk prostate cancer. The aim of the present study was to evaluate a schema of stereotactic irradiation of the prostate with an integrated-boost into the tumor. MATERIAL AND METHODS: The prostate and the tumor were delineated by a radiologist on CT/MRI fusion. A 9-coplanar fields IMRT plan was optimized with three different dose levels: 1) 5 × 6.5 Gy to the PTV1 (plan 1), 2) 5 × 8 Gy to the PTV1 (plan 2) and 3) 5 × 6.5 Gy on the PTV1 with 5 × 8 Gy on the PTV2 (plan 3). The maximum dose (MaxD), mean dose (MD) and doses received by 2% (D2), 5% (D5), 10% (D10) and 25% (D25) of the rectum and bladder walls were used to compare the 3 IMRT plans. RESULTS: A dose escalation to entire prostate from 6.5 Gy to 8 Gy increased the rectum MD, MaxD, D2, D5, D10 and D25 by 3.75 Gy, 8.42 Gy, 7.88 Gy, 7.36 Gy, 6.67 Gy and 5.54 Gy. Similar results were observed for the bladder with 1.72 Gy, 8.28 Gy, 7.01 Gy, 5.69 Gy, 4.36 Gy and 2.42 Gy for the same dosimetric parameters. An integrated SBRT boost only to PTV2 reduced by about 50% the dose difference for rectum and bladder compared to a homogenous prostate dose escalation. Thereby, the MD, D2, D5, D10 and D25 for rectum were increased by 1.51 Gy, 4.24 Gy, 3.08 Gy, 2.84 Gy and 2.37 Gy in plan 3 compared to plan 1. CONCLUSIONS: The present planning study of an integrated SBRT boost limits the doses received by the rectum and bladder if compared to a whole prostate dose escalation for SBRT approach.

[Pelvic irradiation in prostate cancer: what place for what volumes?]. / Radiothérapie pelvienne des cancers de la prostate : quelle place pour quels volumes ?

External beam radiotherapy alone is a standard treatment for prostate cancer. According to clinical, histological and biological characteristics of the tumour, lymph node irradiation can be done in combination with irradiation of the prostate. The completion of pelvic irradiation remains controversial and may cause complications by increasing volumes of irradiated healthy tissues. The accuracy of the delineation of lymph node becomes an important issue. This article proposes to take on the characteristics of the pelvic lymph node drainage of the prostate, to review the literature on pelvic irradiation and the definition of volumes to be irradiated.

[Primary liver cancer]. / Tumeurs primitives hépatiques.

Due to its increasing incidence and a grim prognosis, primary liver cancer remains a diagnostic and therapeutic challenge. For small localized tumors, surgical resection and liver transplantation are standard treatments with a curative-intent. Therapeutic options for locally advanced or metastatic diseases are limited. Globally, surgery fits less than 20% of patients. Early detection in high-risk patients and prevention of risk factors remain the key points in the standard care. External radiotherapy is a non invasive treatment with encouraging results for non operable patients. Emerging stereotactic radiotherapy yields high rates of local control without compromising toxicity. Tumors with bad prognostic factors could be cured with this approach.

Magnetic and Mössbauer investigation of the photomagnetic Prussian blue analogue Na(0.32)Co[Fe(CN)6](0.74).3.4H2O: cooperative relaxation of the thermally quenched state.

Thanks to thermal quenching we investigated the relaxation of the metastable state of Na(0.32)Co[Fe(CN)6](0.74).3.4H2O at low temperature. A self-accelerated process has been observed in agreement with the cooperative character of the system, responsible for the large thermal hysteresis of the charge-transfer-induced spin transition. The mean-field analysis of the relaxation is discussed with respect to the equilibrium properties. A sizable deviation from mean-field behavior is observed at the beginning of the relaxation process, which might be attributed to a preliminary structural relaxation of the quenched state.

Psychopathologic characteristics of the presuicidal syndrome.

The presuicidal syndrome (PS) is presented in this study with its prodromal symptoms which usually foresee suicide. One hundred patients with a PS were investigated taking into consideration all specific risk factors. Three stages of PS were outlined: psychic charging, marginal situation (Grenze-Situation) and psychic discharge. Interpretation of PS places it at the border between the clinical psychiatric fields and the ontological problems of humanity and leads to the understanding not only of the morbid psychic phenomenon in general and of the suicide in particular, but also to the major reasons of the human being who is trapped critical circumstances.