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1.
Cancer Radiother ; 23(6-7): 658-661, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31471252

RESUMO

Stereotactic radiotherapy represents a fundamental change in the practice of radiotherapy of lung cancers. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Stereotactic radiotherapy can be realized either by a dedicated accelerator (CyberKnife®) or by a conventional accelerator associated with specific systems. The two modalities deliver a very precise irradiation whose very good results published to date are similar. Some technical characteristics specific to each type of linear accelerator could guide the choice according to the target volume treated.


Assuntos
Neoplasias Pulmonares/radioterapia , Aceleradores de Partículas , Radiocirurgia/instrumentação , Humanos , Movimentos dos Órgãos , Órgãos em Risco/efeitos da radiação , Radiocirurgia/métodos , Respiração , Resultado do Tratamento
2.
Cancer Radiother ; 23(6-7): 496-499, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31471251

RESUMO

Stereotactic radiotherapy of oligometastases, mono- or hypofractionated, represents a fundamental change in the practice of the specialty as it was developed for a century. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Four main phase II and III trials are underway in France. Future research concerns the association of stereotactic radiotherapy with immunotherapy or different conventional chemotherapy protocols, the identification of the best clinical presentations, and optimization of fractionation and biological dose for poor prognosis localizations.


Assuntos
Ensaios Clínicos Fase II como Assunto , Ensaios Clínicos Fase III como Assunto , Neoplasias/radioterapia , Radiocirurgia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/radioterapia , Terapia Combinada/métodos , Previsões , França , Humanos , Imunoterapia , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/radioterapia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Masculino , Metástase Neoplásica , Neoplasias/patologia , Neoplasias/terapia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia
3.
Cancer Radiother ; 23(5): 365-369, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31300329

RESUMO

PURPOSE: The main goal of palliative radiotherapy is to reduce patient's discomfort. But sometimes patients do not receive any benefits from this treatment because of rapid worsening of their general condition. This prospective monocentric study assessed the effective delivery of palliative radiotherapy. MATERIALS AND METHODS: From 1st December 2015 to 29th February 2016, all consecutive patients receiving palliative radiotherapy in our hospital were included. The primary endpoint was the effective delivery of palliative radiotherapy according to the initial prescription (total dose, overall treatment time and fractionation). The secondary endpoints were the number of treatment breaks, the clinical benefit, the number of deaths and the delays for admission in the palliative care unit. RESULTS: Fifty-nine patients were included and 64 treatments were analysed. The treatment sites were: bone (70.3%) and brain (21.9%). The treatment goals were: pain control only (43.8%), decompression only (21.9%), pain control and decompression (32.8%), haemostatic aim (1.6%). Palliative treatment was achieved in 57 cases (89%). Temporary interruption of the radiotherapy treatment was necessary in six cases (9.4%; three for medical reason, three for logistic reason). The main reason of permanent interruption was worsening of performance status (seven cases). Palliation of symptoms (complete or partial responses) was obtained in 44 cases (68.8%). Seven patients (11.9%) died during the month after the end of the treatment. No delay or cancellation for admission in the palliative care unit were observed. CONCLUSION: Palliative radiotherapy was completed as originally planned in 51 cases (79.9%) with a clinical benefit for 44 cases (68.8%). Radiation therapy must not be neglected as a palliative treatment at the end-of-life.


Assuntos
Neoplasias Ósseas/secundário , Neoplasias Encefálicas/secundário , Cuidados Paliativos , Radioterapia Conformacional , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/radioterapia , Neoplasias Encefálicas/radioterapia , Fracionamento da Dose de Radiação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Dosagem Radioterapêutica , Radioterapia Conformacional/métodos , Resultado do Tratamento
4.
Cancer Radiother ; 23(4): 316-321, 2019 Jul.
Artigo em Francês | MEDLINE | ID: mdl-31153770

RESUMO

PURPOSE: To evaluate prospectively asthenia and the quality of life in patients treated by stereotactic body irradiation and to determine their predictive factors. METHODS AND MATERIALS: Quality of life was assessed by the EORTC QLQ-C30 and asthenia was evaluated with the Brief Fatigue Inventory (BFI), on the first day (T1), last day (T2) and 1-3 weeks after the end of treatment (T3). RESULTS: Sixty-three patients were treated with stereotactic body irradiation from February 2017 to May 2017 and 41 were included in the analysis (22 patients excluded for lack of understanding, organization, psychologic disorders or refusal). The mean number of fractions was 5 (±2). The compliance to quality of life assessment was 98%, 95% was 81% at T1, T2 and T3, respectively. An increase of asthenia and a worsened quality of life were found in 12 (29%) and 14 (34%) patients between T1 and T2. Univariate analysis demonstrated a correlation between asthenia and quality of life were correlated with performans status (P=0.03 and 0.05 respectively), hemoglobin level (p=0.01 and 0.004), albumin level (P=0.01 and 0.06), distance between home and radiotherapy department (P=0.05 and 0.02). Multivariate analysis demonstrated a correlation between female gender (P=0.012), albumin level (P<0.001), distance over 25km (P<0.001) with asthenia, and albumin level (P=0.003), hemoglobin level (P=0.004) and previous chemotherapy (P=0.003) with quality of life. No influence of stereotactic body ratiotherapy parameters was seen. CONCLUSION: Despite hypofractionation, stereotactic body radiotherapy induced asthenia and deterioration of quality of life.


Assuntos
Astenia/etiologia , Qualidade de Vida , Radiocirurgia/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Prospectivos , Hipofracionamento da Dose de Radiação , Albumina Sérica/análise , Fatores Sexuais , Inquéritos e Questionários
5.
Cancer Radiother ; 22(8): 773-777, 2018 Dec.
Artigo em Francês | MEDLINE | ID: mdl-30360973

RESUMO

PURPOSE: In 2008, the French national society of radiation oncology (SFRO) and the association for radiation oncology continued education (AFCOR) created Siriade, an e-learning website dedicated to contouring. MATERIAL AND METHODS: Between 2015 and 2017, this platform was updated using the latest digital online tools available. Two main sections were needed: a theoretical part and another section of online workshops. RESULTS: Teaching courses are available as online commented videos, available on demand. The practical section of the website is an online contouring workshop that automatically generates a report quantifying the quality of the user's delineation compared with the experts'. CONCLUSION: Siriade 2.0 is an innovating digital tool for radiation oncology initial and continuous education.

6.
Cancer Radiother ; 22(6-7): 515-521, 2018 Oct.
Artigo em Francês | MEDLINE | ID: mdl-30153976

RESUMO

An increasing number of patients with cardiac implantable electronic devices benefit from radiotherapy, warranting specific collaborative management between both radiation oncologists and cardiologists. Interactions between electromagnetic fields, secondary particles and cardiac implantable electronic devices may result in transient and reversible malfunctions with significant consequences depending on the underlying cardiac pathology and the level of patient's cardiac implantable electronic devices dependency. Numerous international guidelines on patients' management have been proposed and all agree on a total cumulated dose limit at the battery of 5Gy and on the need for an initial as well as repeated evaluation over time, up to 6months after the last radiation. The analysis of the published data revealed relatively rare incidence of significant adverse events. The most recent international guidelines underline the feasibility and safety of radiotherapy for cardiac implantable electronic devices holders, with the need for systematic local protocol in all radiotherapy centers.


Assuntos
Desfibriladores Implantáveis , Marca-Passo Artificial , Radioterapia , Humanos , Guias de Prática Clínica como Assunto , Radioterapia/efeitos adversos
7.
BMC Med Educ ; 18(1): 15, 2018 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-29334939

RESUMO

BACKGROUND: Little information is currently available concerning young medical students desire to pursue a career in oncology, or their career expectations. METHODS: This project is a cross-sectional epidemiological study. A voluntary and anonymous questionnaire was distributed to all young oncologists studying in France between the 2nd of October 2013 and the 23rd of February 2014. RESULTS: The overall response rate was 75.6%. A total of 505 young oncologists completed the questionnaire. The main determining factors in the decision to practice oncology were the cross-sectional nature of the field (70.8%), the depth and variety of human relations (56.3%) and the multi-disciplinary field of work (50.2%). Most residents would like to complete a rotation outside of their assigned region (59.2%) or abroad (70.2%) in order to acquire additional expertise (67.7%). In addition, most interns would like to undertake a fellowship involving care, teaching and research in order to hone their skills (85.7%) and forge a career in public hospitals (46.4%). Career prospects mainly involve salaried positions in public hospitals. Many young oncologists are concerned about their professional future, due to the shortage of openings (40.8%), the workload (52.8%) and the lack of work-life balance (33.4%). CONCLUSIONS: This investigation provides a comprehensive profile of the reasons young oncologists chose to pursue a career in oncology, and their career prospects.


Assuntos
Escolha da Profissão , Educação de Pós-Graduação em Medicina , Internato e Residência , Oncologia , Especialização , Estudantes de Medicina , Estudos Transversais , Emprego , França , Humanos , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
8.
Cancer Radiother ; 21(3): 239-243, 2017 May.
Artigo em Francês | MEDLINE | ID: mdl-28433591

RESUMO

Performing randomised comparative clinical trials in radiation oncology remains a challenge when new treatment modalities become available. One of the most recent examples is the lack of phase III trials demonstrating the superiority of intensity-modulated radiation therapy in most of its current indications. A new paradigm is developing that consists in the mining of large databases to answer clinical or translational issues. Beyond national databases (such as SEER or NCDB), that often lack the necessary level of details on the population studied or the treatments performed, electronic health records can be used to create detailed phenotypic profiles of any patients. In parallel, the Record-and-Verify Systems used in radiation oncology precisely document the planned and performed treatments. Artificial Intelligence and machine learning algorithms can be used to incrementally analyse these data in order to generate hypothesis to better personalize treatments. This review discusses how these methods have already been used in previous studies.


Assuntos
Inteligência Artificial , Radioterapia (Especialidade) , Radioterapia , Humanos
9.
Cancer Radiother ; 20(8): 790-793, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27769636

RESUMO

PURPOSE: With the increase of treatment complexity, enhancing safety is a key concern in radiation oncology. Beyond the involvement of the healthcare professional, patient involvement and empowerment could play a major role in that setting. We explored how patients perceived and fulfilled that role during their radiation treatment. MATERIALS AND METHODS: A voluntary and anonymous questionnaire was administered to all patients treated in our department between November 2013 and May 2014. The following data were collected: sociodemographic profile; information received and initiatives to search for additional information; behavior when an unusual treatment event was perceived; active involvement in the safety of the treatment; nature and perception of their own involvement. A statistical analysis was performed to assess behavioral predictors. RESULTS: A total of 155 patients answered the survey. Most of them were treated for prostate (n=58, 37.4%), lung (n=27, 17.4%), head and neck (n=26, 16.8%) and breast (n=25, 16.1%). Only eight patients (5%) had previously received radiation therapy. Ninety-five percent of the patients estimated they had received enough information about their treatment, but 48% would have wanted more. When patients noticed an unusual event during their treatment session, most of them (61%) reported it to the radiation therapist. CONCLUSION: Patient participation to radiation therapy safety should be encouraged to ensure a cooperative risk management. Healthcare professionals need to inform the patients on the basic technical processes involved in their treatment. Patient empowerment should be added to the verifications made by the radiation therapists and physicians but should not replace them.


Assuntos
Participação do Paciente , Segurança do Paciente , Proteção Radiológica , Radioterapia/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/radioterapia , Aceitação pelo Paciente de Cuidados de Saúde , Educação de Pacientes como Assunto , Gestão de Riscos , Gestão da Segurança , Fatores Socioeconômicos , Inquéritos e Questionários
10.
Cancer Radiother ; 20(5): 357-61, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27345843

RESUMO

PURPOSE: Intensity-modulated radiation therapy (IMRT) has shown its interest for head and neck cancer treatment. In parallel, cetuximab has demonstrated its superiority against exclusive radiotherapy. The objective of this study was to assess the acute toxicity, local control and overall survival of cetuximab associated with different IMRT modalities compared to platinum-based chemotherapy and IMRT in the ARTORL study (NCT02024035). PATIENTS AND METHOD: This prospective, multicenter study included patients with epidermoid or undifferentiated nasopharyngeal carcinoma, epidermoid carcinoma of oropharynx and oral cavity (T1-T4, M0, N0-N3). Acute toxicity, local control and overall survival were compared between groups (patients receiving cetuximab or not). Propensity score analysis at the ratio 1:1 was undertaken in an effort to adjust for potential bias between groups due to non-randomization. RESULTS: From the 180 patients included in the ARTORL study, 29 patients receiving cetuximab and 29 patients treated without cetuximab were matched for the analysis. Ten patients (34.5%) reported acute dermal toxicity of grade 3 in the cetuximab group versus three (10.3%) in the non-cetuximab group obtained after matching (P=0.0275). Cetuximab was not significantly associated with more grade 3 mucositis (P=0.2563). There were no significant differences in cutaneous or oral toxicity for patients treated with cetuximab between the different IMRT modalities (P=1.000 and P=0.5731, respectively). There was no significant difference in local relapse-free survival (P=0.0920) or overall survival (P=0.4575) between patients treated with or without cetuximab. CONCLUSION: Patients treated with cetuximab had more cutaneous toxicities, but oral toxicity was similar between groups. The different IMRT modalities did not induce different toxicity profiles.


Assuntos
Antineoplásicos/uso terapêutico , Cetuximab/uso terapêutico , Erupção por Droga/etiologia , Neoplasias de Cabeça e Pescoço/terapia , Mucosite/etiologia , Radioterapia de Intensidade Modulada , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Quimioterapia Adjuvante , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Pontuação de Propensão , Estudos Prospectivos
11.
Cancer Radiother ; 20(8): 765-767, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28270322

RESUMO

PURPOSE: Treatment safety has become a priority in health policies after several incidents occurred around the world in radiation oncology departments. The aim of this study was to analyse the patients' contribution in that field and to understand which actions empower the patient in that regard. METHODS: Several methods were used in a general hospital and in a comprehensive cancer centre to analyse the activities of the radiation therapists and the patients and the interactions between them: treatment session observations, semidirective interviews with radiation therapists and patients, self and alloconfrontation with radiation therapists and explanatory interviews with patients. RESULTS: Cooperation of the patients in treatment safety acts as an additional step that contributes to safer treatments. Radiation therapy sessions are a creative opportunity for the patient to observe, learn and analyse what is happening. Changes between treatment sessions are a source of anxiety for the patients. This study highlights the factors that favour the patients' participation. A trusting relationship and support from the health professionals can be leveraged in that manner. CONCLUSION: There is a common will shared between the patients and the health professionals towards better treatment safety. The cooperation is still not well-known and underused. This empowerment of the patient cannot be mandatory but should be promoted and developed.


Assuntos
Participação do Paciente , Segurança do Paciente , Relações Profissional-Paciente , Radioterapia/efeitos adversos , Institutos de Câncer , Feminino , França , Hospitais Gerais , Humanos , Masculino , Neoplasias/radioterapia , Proteção Radiológica
12.
Cancer Radiother ; 19(8): 790-4; quiz 795-9, 2015 Dec.
Artigo em Francês | MEDLINE | ID: mdl-26476702

RESUMO

Stereotactic body radiation therapy is the standard treatment for inoperable patients with early-stage lung cancer. Local control rates range from 80 to 90 % 2 years after treatment. The role of positron emission tomography in patient selection is well known, but its use for target definition or therapeutic response evaluation is less clear. We reviewed the literature in order to assess the current state of knowledge in this area.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Tomografia por Emissão de Pósitrons , Radiocirurgia , Fluordesoxiglucose F18 , Humanos , Planejamento de Assistência ao Paciente , Compostos Radiofarmacêuticos
13.
Cancer Radiother ; 19(6-7): 458-62, 2015 Oct.
Artigo em Francês | MEDLINE | ID: mdl-26337476

RESUMO

Anatomical changes and tumor regression during thoracic radiotherapy may alter the treatment volumes. These modifications are not taken into account into set-up or motion margins used for treatment planning. Their dosimetric impact could be significant and a better understanding of the changes occurring during the 6 to 7 weeks of treatment could be useful in order to define quantitative thresholds before a new treatment planning is needed. Margins could also be reduced in order to better spare organs at risk and perform targeted dose escalation. This review assesses the potential of morphologic and metabolic imaging during treatment for adaptive radiotherapy in non-small cell lung cancer.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Planejamento da Radioterapia Assistida por Computador , Humanos
14.
Cancer Radiother ; 18(5-6): 387-90, 2014 Oct.
Artigo em Francês | MEDLINE | ID: mdl-25179253

RESUMO

Stereotactic body radiation therapy is a rapidly growing advanced treatment technique that delivers high radiation dose with great precision. The implementation of stereotactic body radiation therapy should be associated with a specific initial training and continuing professional education for radiation oncologists and medical physicists. The creation of a French stereotactic body radiation therapy group gathering radiation oncologists (SFRO and AFCOR) and medical physicists (SFPM) is mandatory in order to create dedicated national guidelines, prospective databases and to promote clinical trials in this field.


Assuntos
Educação Profissionalizante , Física Sanitária/educação , Radioterapia (Especialidade)/educação , Radiocirurgia/educação , Ensaios Clínicos como Assunto , Comportamento Cooperativo , Bases de Dados Factuais , Educação Continuada , Educação Médica Continuada , França , Humanos , Internet , Neoplasias/cirurgia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Radiocirurgia/normas , Radiocirurgia/estatística & dados numéricos , Sociedades Médicas/normas
15.
Cancer Radiother ; 18(1): 28-34, 2014 Jan.
Artigo em Francês | MEDLINE | ID: mdl-24332865

RESUMO

PURPOSE: The goal of this study was to evaluate the interest of the members of the French society of young radiation oncologists (SFjRO) for brachytherapy as well as their theoretical and practical level in this radiation technique. MATERIALS AND METHODS: An anonymous survey was conducted regarding practical and theoretical teaching of brachytherapy before the French national courses on brachytherapy. RESULTS: Among the 106 residents attending this teaching course, 99 (93%) answered the survey. Most of them were interested in brachytherapy but 82% considered they had not received sufficient teaching. Relevant indications of brachytherapy were known by 76% of the residents for gynaecological malignancies and 70% for prostate. Seventy-one percent of the residents have seen at least one gynecological brachytherapy but only 12% knew how to deal with this technique. Fifty-six percent have seen vaginal high dose rate brachytherapy and 21% had acquired the technique. For prostate brachytherapy, 65% had seen and done an implant and only 4% had acquired the technique. Fifty percent have performed at least one brachytherapy treatment during their residency. Residents expressed a strong wish for more courses about dosimetry (82%), technique (75%) and treatment planning (90%). CONCLUSION: Our study shows the interest of French residents for brachytherapy but suggests that practical teaching courses and an evaluation of the existing theoretical courses are warranted.


Assuntos
Braquiterapia , Internato e Residência , Radioterapia (Especialidade)/educação , Braquiterapia/estatística & dados numéricos , Estudos Transversais , Currículo , Coleta de Dados , Feminino , França , Neoplasias dos Genitais Femininos/radioterapia , Humanos , Masculino , Neoplasias da Próstata/radioterapia , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Inquéritos e Questionários , Materiais de Ensino
16.
Cancer Radiother ; 17(5-6): 370-7, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24011599

RESUMO

OBJECTIVES: A national survey was conducted among the radiation oncology residents about their clinical activities and responsibilities. The aim was to evaluate the clinical workload and to assess how medical tasks are delegated and supervised. MATERIALS AND METHODS: A first questionnaire was administered to radiation oncology residents during a national course. A second questionnaire was mailed to 59 heads of departments. RESULTS: The response rate was 62% for radiation oncology residents (99 questionnaires) and 51% for heads of department (30). Eighteen heads of department (64%) declared having written specifications describing the residents' clinical tasks and roles, while only 31 radiation oncology residents (34%) knew about such a document (P=0.009). A majority of residents were satisfied with the amount of medical tasks that were delegated to them. Older residents complained about insufficient exposure to new patient's consultation, treatment planning and portal images validation. The variations observed between departments may induce heterogeneous trainings and should be addressed specifically. CONCLUSION: National specifications are necessary to reduce heterogeneities in training, and to insure that the residents' training covers all the professional skills required to practice radiation oncology. A frame endorsed by academic and professional societies would also clarify the responsibilities of both residents and seniors.


Assuntos
Delegação Vertical de Responsabilidades Profissionais , Internato e Residência/organização & administração , Radioterapia (Especialidade)/educação , França , Humanos , Radioterapia (Especialidade)/organização & administração , Inquéritos e Questionários
17.
Diagn Interv Imaging ; 94(3): 255-62, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23276463

RESUMO

Stereotactic radiation therapy (SRT) is becoming more and more important in the treatment of inoperable patients with early stages of pulmonary carcinomas (T1-T2 N0M0). In certain cases, evaluation of the response is still problematical and it can be difficult to differentiate response from progression. The aim of this paper is to set out these various changes and to produce a protocol for optimal monitoring. By comparing our clinical experience with data from the literature, the main visual aspects on a CT scan are set out and illustrated for each clinical situation: radiation pneumonitis, radiation fibrosis, therapeutic response and progression. The literature was reviewed by querying the main databases and selecting papers concerning pulmonary SRT and post-therapeutic radiological appearance. CT appearance induced by SRT differs significantly from images after classic conformal radiation therapy, both morphologically and chronologically. In particular, the modifications induced by stereotactic radiation therapy are only seen in a limited volume surrounding the volume treated. Knowledge of the radiological criteria necessary to differentiate between a therapeutic response and recurrence is of major importance in the present context of increase in use of this technique.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Radiocirurgia , Tomografia Computadorizada por Raios X , Humanos , Radiocirurgia/efeitos adversos
18.
Cancer Radiother ; 14(8): 690-7, 2010 Dec.
Artigo em Francês | MEDLINE | ID: mdl-20674448

RESUMO

PURPOSE: Stereotactic radiation therapy using the CyberKnife(®) has been introduced in France in 2006. Two treatment modalities are currently available: the first one (Synchrony(®)) is a real-time fiducial-based target tracking system, while the other (Xsight Lung Tracking [XLT] System(®)) is completely fiducial-free. PATIENTS AND METHODS: Sixty-eight patients were treated for a pulmonary tumor between June 2007 and November 2009. Since august 2008, the XLT System(®) was used for 26 patients. We report the necessary conditions for the XLT System (position, laterality and size of the tumor), the toxicity and outcome of this treatment. RESULTS: Twenty-two patients were analyzed. Median follow-up was 6 months (min=3; max=16). Local control rate was 100%. The main toxicity was grade grade 1 pulmonary alveolitis (27%). No grade 3 or 4 toxicities were reported. CONCLUSION: The high local control rate and low toxicity obtained with the CyberKnife(®) XLT System(®) suggest that such treatment is an alternative for inoperable patients.


Assuntos
Carcinoma/cirurgia , Sistemas de Computação , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pulmonares/cirurgia , Radiocirurgia/métodos , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Carcinoma/diagnóstico por imagem , Fracionamento da Dose de Radiação , Feminino , Marcadores Fiduciais/efeitos adversos , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador/instrumentação , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Órgãos em Risco , Aceleradores de Partículas/instrumentação , Seleção de Pacientes , Imagens de Fantasmas , Pneumonite por Radiação/etiologia , Radiografia , Radiologia Intervencionista , Radiocirurgia/efeitos adversos , Radiocirurgia/instrumentação , Estudos Retrospectivos , Robótica , Resultado do Tratamento
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