Radiotherapy for parotid cancer: 10 years of experience in a single center.

<b><br>Introduction:</b> We report our experience in the treatment of parotid cancers by radiotherapy delivered with curative intent over a period of 10 years.</br> <b><br>Aim:</b> The aim of this study was to evaluate the therapeutic results and prognostic factors.</br> <b><br>Materials and methods:</b> This is a retrospective study of patients with parotid cancer treated with radiotherapy between 2008 and 2017 at the National Institute of Oncology in Rabat. Patients who received adjuvant or exclusive radiotherapy were included in this study. We performed a multivariate analysis for the factors related to locoregional control and overall survival.</br> <b><br>Results:</b> Initially, 74 patients (45 men and 29 women), at a median age of 57 years. were identified. At the time of diagnosis, 10 (13.6%), 36 (48.6%), and 28 (37.8%) patients were in stage II, III, and IVab, respectively. Sixty patients received adjuvant radiotherapy after parotidectomy and 14 patients received exclusive radiotherapy for an unresectable tumor. At 5 years, the rate of locoregional control and overall survival were 68.2% and 53.7%, respectively. Surgical resection and negative margins were significantly correlated with locoregional control. Lymph node involvement, unresectable tumors, high-grade histological types, and cystic adenoid carcinoma were significantly correlated with poor overall survival.</br> <b><br>Conclusions:</b> Acceptable long-term results are obtained with surgery combined with radiotherapy. Surgical resection remains essential for parotid cancer, given the disappointing results of treatment with radiotherapy alone.</br>.

[Ramadan fasting during treatment with external beam radiotherapy]. / L'observance du jeûne de Ramadan pendant le traitement par radiothérapie externe.

INTRODUCTION: Many Muslim cancer patients insist on fasting during the month of Ramadan, even during treatment. The purpose of this observational study is to study the practice of fasting, in patients receiving external radiation therapy. METHODS: Our study was conducted during the month of Ramadan 1441 (2018) in the radiotherapy department of Ibn Rochd University Hospital of Casablanca. We included all patients who received external radiotherapy during this period. We thus collected the characteristics of patients, disease and treatment modalities. After an interview, with a pre-established questionnaire, we were able to establish the observance of the fast. RESULTS: We collected a total of 209 patients. The most frequently represented locations were breast cancer followed by gynecological cancers in 35.4% and 18.7% respectively. All our patients were fasting Ramadan before the diagnosis of cancer, however, only 39.2% were fasting during the treatment by radiotherapy, and just 40% of patients have discussed the possibility of fasting with their oncologist. In multivariate analysis, the stage of the disease was the only factor related to the fasting status of our patients. DISCUSSION: Even under treatment, many of our patients fast during the month of Ramadan. Further studies are needed to evaluate the tolerance of fasting in order to better answer the question "can I fast?".

Hypofractionated Regional Nodal Irradiation for Women With Node-Positive Breast Cancer.

PURPOSE: To evaluate the effect of hypofractionated radiation therapy (HFRT) of the breast/chest wall and regional nodes on overall survival (OS), disease-free survival (DFS), locoregional control and on treatment-related toxicity in patients with breast cancer and nodal involvement. METHODS AND MATERIALS: Two hundred fifty-seven patients treated between October 2009 and June 2011 with hypofractionated locoregional radiation therapy (42 Gy in 15 fractions) were retrospectively reviewed, 51 (19.8%) after breast-conserving surgery and 206 (80.2%) after radical surgery. Patients treated with breast-conserving surgery received a boost dose to the tumor bed (delivered by photons, electrons, or interstitial high-dose-rate brachytherapy). Two hundred fifty-six (99.6%) patients underwent chemotherapy, 209 (81.3%) had hormonal treatment, and 65 (25.3%) had anti-HER2 targeted therapy. RESULTS: The median follow-up time was 64 months (range, 11-88 months). The rates of 5-year OS, DFS, locoregional recurrence (LRR)-free survival, and distant metastasis (DM)-free survival were 86.6%, 84.4%, 93.9%, and 83.1%, respectively. In multivariate analysis (MVA), lymph node ratio >65%, lymphovascular invasion, and negative hormone receptor status predicted for OS, DSF, and DM. T3 to 4 stage was also associated with worse DFS and DM. Finally, for LRR the independent prognostic factors on MVA were N2 to 3 stage and grade 3. Hyperpigmentation was observed in 19.2% of patients, telangiectasia in 12.3%, and fibrosis in 30.7%. Grade ≥2 lymphedema was recorded in 5.8% of cases. During the study follow-up, no cardiac or symptomatic pneumonitis was observed, nor were plexopathy or rib fractures. CONCLUSION: According to the findings from this retrospective study, HFRT seems to be an acceptable alternative for patients with breast cancer who need regional nodal irradiation. However, prospective randomized trials are necessary to confirm these preliminary results.

[Radiotherapy in the management of painful bone metastases at The National Institute of Oncology in Morocco: data from one year follow-up of 86 patients]. / Traiment antalgique des metastases osseuses par radiothérapir externe à l'lnstitut National d'Oncologie du Maroc: Donnnées d'une année de suive86 patients.

BACKGROUND: Radiation therapy plays an essential role in the management of pain caused by bone metastases Objectives: Evaluate the effect of radiation for the relief of pain caused by bone metastases. METHODS: We conducted a prospective study of 86 patients suffering from pain associated with bone metastases treated at our department by external radiotherapy between September 2010 and December 2011. Patients recorded pain severity in the numeric rating scale and analgesic requirements before, at the end of irradiation, then weekly for a month, and every month for a year. RESULTS: The median age of patients was 54 years (28-75 years). There were 45 (52.3%) women and 41 (47.7%) men. Radiotherapy was delivered in a multifraction schedule to a total dose of 30 Gy in 72% of patients or in a single fraction of 8 Gy in 28% of patients. A favorable analgesic response was observed in 59 (68.6%) patients with 8 (9.3%) complete responses and 51 (59.3%) partial responses. The median time-to-response was 2 weeks (0-7 weeks), and the median duration of pain relief was 22 weeks (9-46 weeks). CONCLUSION: Radiotherapy is effective in relieving pain associated with bone metastases in the majority of patients.