Multidisciplinary management and role of reirradiation in the treatment of a breast cancer patient with four locoregional recurrences.

Breast cancer is a frequent and sometimes fatal disease. The risk of locoregional recurrence has considerably decreased since the introduction of adjuvant treatments (radiotherapy, chemotherapy, hormone therapy). Nevertheless, some patients present a risk of multiple local recurrences. We report here the case of a patient who had four locoregional breast cancer recurrences. There is currently no validated biomarker that allows the prediction of recurrence. Salvage surgery, most often mastectomy, remains the recommended treatment for the management of these recurrences in the irradiated field. However, increasingly, depending on the patient's wishes and the technical possibilities of multiple surgeries, the question of a second conservative treatment and reirradiation arises. This type of management must in all cases be multidisciplinary and in specialized centers. Reirradiation must in any case try to give maximum priority to the protection of healthy tissue already irradiated.

Cáncer de próstata: utilidad de 18F-fluciclovina PET/TC en la detección y diagnóstico diferencial de una metastasis ósea precoz para un tratamiento exitoso con radioterapia ablativa estereotáctica radioguiada / Prostate cancer: usefulness of 18F-fluciclovine PET/CT in the detection and differential diagnosis of an early bone metastasis for successful treatment with radio-guided stereotactic ablative radiotherapy

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Hodkgin lymphoma concomitant of tuberculosis, a therapeutic challenge for multidisciplinary management.

Hodgkin lymphoma (HL) is a disease characterized by a high curability rate, and the treatment benefit-risk balance must be carefully addressed to achieve complete disease control with low risk of long-term toxicities. Most patients are treated with a combination of chemotherapy and radiotherapy, after disease staging and response to treatment evaluated by FDG PET/CT. We report the case of a 28-year-old patient concomitantly diagnosed of a Hodgkin lymphoma and active tuberculosis. Initial staging was difficult due to pulmonary and abdominal tuberculosis localization that induced FDG PET/CT hypermetabolism. Anti-tuberculosis treatment was first started, allowing secondary an early accurate Hodgkin lymphoma staging by FDG PET/CT. The patient was then treated by chemotherapy and radiotherapy. Helical TomoTherapy® was used with involved site (IS) irradiation volume was performed to decrease the high doses to organs-at-risk (OAR), especially lungs in this context of tuberculosis.