ABSTRACT
PURPOSE: To report on patterns of relapse following implementation of intensity-modulated radiotherapy and subsequent changes in practice in a tertiary care centre. PATIENTS AND METHODS: Between 2008 and 2011, 188 consecutive patients (mean age 59 years old) received intensity-modulated radiotherapies with curative intent for squamous cell carcinomas of the oral cavity (17.5%), oropharynx (43%), hypopharynx (21%), larynx (14%), sinonasal cavities (6%), nasopharynx (1.5%) at the university hospital of Besançon. There were stage I and II 9%, III 24.5%, IV 66.5%. One hundred and thirty-eight underwent exclusive intensity-modulated radiotherapy, 50 underwent postoperative intensity-modulated radiotherapy, 174 had concurrent chemotherapy, 57 had induction chemotherapy. Dynamic intensity-modulated radiotherapy with static fields was performed for all patients using sequential irradiation in 174 patients and simultaneous integrated boost irradiation in 14 patients. RESULTS: With a median follow-up was 27.5 months, there was 79% of locoregional failures occurred in the 95% isodose. Two-year overall survival, disease-free, local failure-free and locoregional failure-free survival rates were73%, 60%, 79% and 72%, respectively. Prognostic factors for disease-free survival were stage (IV vs. I-III) with a relative risk of 1.7 [1.1-2.8] (P=0.02) and T stage with 1.6 [1.04-2.5] (P=0.03). CONCLUSION: The current series showed similar patterns of failure as in other tertiary care centres. We did not identify intensity-modulated radiotherapy specific relapse risks.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Head and Neck Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , Disease-Free Survival , Female , France/epidemiology , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/surgery , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/epidemiology , Prognosis , Radiation Injuries/epidemiology , Radiation Injuries/etiology , Radiotherapy Dosage , Radiotherapy, Intensity-Modulated/adverse effects , Retrospective Studies , Tertiary Care CentersABSTRACT
BACKGROUND: The aim of this study was to test the psychometric properties of the French version of the European Organization for Research and Treatment (EORTC) quality-of-life colorectal questionnaire (QLQ-CR38) and the functional assessment of cancer therapy-colorectal version 4 (FACT-C). METHOD: This prospective study included 209 patients with colorectal cancer: 71 undergoing chemotherapy, 56 radiation, 15 surgery, and 67 survivors. Patients first completed in random order the FACT-C and the EORTC QLQ-CR38 and were asked if they had any preference for either questionnaire. The timing of administration of instruments differed according to patients' treatment to better assess psychometric properties. RESULTS: The FACT-C showed good acceptability, good reproducibility and excellent internal consistency. The QLQ-CR38 had lower internal consistency. Patients did not express a preference for one survey over another. CONCLUSION: This study confirms the value of the FACT-C and suggests some limits of the QLQ-CR38 for patients with colorectal cancer.
Subject(s)
Colorectal Neoplasms/psychology , Quality of Life/psychology , Aged , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/surgery , Female , France , Health Surveys , Humans , Male , Middle Aged , Prospective Studies , Psychological Tests , Psychometrics , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
We report two cases of leptomeningeal metastatic dissemination to the spinal cord of a grade B oligodendroglioma. Diagnosis was suspected on MRI but imaging findings were nonspecific. The pathways by which the intramedullary part of the spinal is reached by metastatic cells remains controversial. In the reported cases, both frontal and cystic primary intracerebral lesions were observed. Chemotherapy after radiotherapy appears to improve outcome. Nevertheless, prognosis remains very poor.
