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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(6-7): 732-736, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31400955

RESUMO

When localized, the reference treatment of urothelial, muscle-invasive bladder tumours relies on radical cystectomy with reconstruction by enterocystoplasty if possible or Bricker bypass. Trimodal therapy combining transurethral resection of the tumour followed by concomitant chemotherapy may be considered as a therapeutic alternative to radical cystectomy in well-selected patients with unifocal tumours, stage T2, non-diverticular location, without in situ carcinoma or hydronephrosis and with macroscopically complete transurethral resection. The functional prognosis of the bladder and quality of life should be discussed with the patient as well as the need for salvage surgery for persistent tumour at a 45-Gy dose level, the latter being a highly unfavourable prognosis factor. On the other hand, this trimodal treatment is the reference in case of surgical contraindication. This article details the methods and results of the main series available in the literature in terms of local control, survival, bladder preservation rates and complications, as well as study prospects.


Assuntos
Quimiorradioterapia/métodos , Tratamentos com Preservação do Órgão/métodos , Neoplasias da Bexiga Urinária/terapia , Bexiga Urinária , Antineoplásicos/uso terapêutico , Terapia Combinada/métodos , Cistectomia/métodos , Humanos , Qualidade de Vida , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia
4.
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
5.
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
6.
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.

7.
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
8.
Cancer Radiother ; 19(8): 703-9, 2015 Dec.
Artigo em Francês | MEDLINE | ID: mdl-26482168

RESUMO

PURPOSE: To assess the overall treatment time of radiotherapy delivered with curative intent in a cohort of 185 consecutive patients and the causes of this possible delay. If delay, to propose corrective actions. MATERIALS AND METHODS: We report a single-center prospective study including all consecutive patients receiving a radiation therapy with curative intent, from 1st December 2013 to 28th February 2014, on the three linear accelerators of the radiotherapy department. For each fraction missed, the causes of non-completion were prospectively collected. This analysis took into account the following parameters: age, sex, occupation, transport type and duration, tumour localization, radiation dose, concomitant chemotherapy, hospitalization, type of linear accelerator. RESULTS: One hundred and fifty-five patients were included in the study (183 evaluable, two did not complete treatment). The overall treatment time was respected for 31 patients (17%). It was lengthened on 4.6 days (d) (0-29 d; median: 3d). The mean number of delayed fractions was 3.4 (0-17; median: 2). The reasons of delay were: breakdown 32.2%; maintenance 29.3%; holiday 11%; treatment toxicity 9.4%; inadequate planning 8.6%; other disease 3.9%; treatment refusal 2.1%; unspecified personal reasons 1.5%; refusal to wait 0.8%; transportation 0.3%; error of communication 0.3%; other 0.6%. Two parameters had a significant impact on the overall treatment time: the type of linear accelerator in relation to breakdown occurrence (P<0.001) and transportation duration (more or less than 40 min, P=0.022). One hundred and thirty-eight patients (75%) and 79 patients (43%) were treated on one or more than two Saturdays. Treatment on Saturday significantly reduced the overall treatment time (median, 1.9 d; P<0.001). CONCLUSION: The overall treatment time was globally respected excluding break down and maintenance. Their impact on the overall treatment time is minimized by the systematic opening of the department on Saturdays.


Assuntos
Fracionamento da Dose de Radiação , Neoplasias/radioterapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceleradores de Partículas , Estudos Prospectivos , Radioterapia/métodos , Fatores de Tempo
9.
Cancer Radiother ; 19(6-7): 391-6, 2015 Oct.
Artigo em Francês | MEDLINE | ID: mdl-26344439

RESUMO

Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatments against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed on logistic and technical aspects of radiation, as dose, irradiated volume, fractionation and the potential usefulness of new technologies.


Assuntos
Neoplasias/radioterapia , Idoso , Humanos , Planejamento de Assistência ao Paciente
10.
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
11.
Artigo em Inglês | MEDLINE | ID: mdl-24924114

RESUMO

Adjuvant radiotherapy after surgery or exclusive radiotherapy, with or without concurrent chemotherapy is a valuable treatment option in the great majority of patients with head and neck cancer. Recent technical progress in radiotherapy has resulted in a decreased incidence of xerostomia. Another common toxicity of radiotherapy is dysphagia, which alters the nutritional status and quality of life of patients in remission. The objective of this review is to describe the physiology of swallowing function, the pathophysiology of radiation-induced dysphagia and the various strategies currently available to prevent this complication.


Assuntos
Transtornos de Deglutição/etiologia , Transtornos de Deglutição/prevenção & controle , Neoplasias de Cabeça e Pescoço/radioterapia , Deglutição/fisiologia , Transtornos de Deglutição/fisiopatologia , Humanos , Radioterapia/efeitos adversos
12.
Cancer Radiother ; 17(3): 202-7, 2013 Jun.
Artigo em Francês | MEDLINE | ID: mdl-23643361

RESUMO

PURPOSE: To retrospectively assess the impact of age on tolerance and oncologic outcomes treated by neoadjuvant treatment for patients of 70 years old or above with locally advanced rectal cancer. PATIENTS AND METHODS: Ninety-one consecutive patients were divided into three groups: group 1 from 70 to 75 years (n=31); group 2: 76 to 79 years (n=31) and group 3, patients aged 80 years or above (n=29). Radiation therapy was delivered according two schemes: 25Gy in five fractions (short scheme) or 45 to 50Gy with a classical fractionation (long scheme). Long scheme patients received a concomitant chemotherapy with 5-fluoro-uracile alone or associated with oxaliplatin. RESULTS: The three groups were comparable for performance status, Charlson's score and T staging. Long scheme radiation therapy and chemotherapy were performed in 77.5, 74.5 and 48.3% of patients (P=0.03) and 77.4, 71 and 41.4% (P=0.006) in the groups 1, 2 and 3, respectively. All patients treated with the short scheme irradiation received the treatment without any acute toxicity. In the long scheme group, 65% of patients received the treatment on time and grade 3 or above toxicity was observed in 12% of patients who did not receive oxaliplatin and in 48% of patients who received oxaliplatin. The overall survival rate at 3 and 5 years was 66.9% and 60.8% in the group 1, 90.5% and 75.9% in the group 2 and 80.5% and 73.8% in the group 3 (P=0.15). CONCLUSION: Neoadjuvant treatment is feasible with encouraging survival rates for patients aged 70 years and older. Short scheme radiation therapy seems to be an interesting option in this population.


Assuntos
Terapia Neoadjuvante , Neoplasias Retais/mortalidade , Neoplasias Retais/terapia , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Quimioterapia Adjuvante , Fracionamento da Dose de Radiação , Feminino , Fluoruracila/uso terapêutico , Humanos , Metástase Linfática , Masculino , Recidiva Local de Neoplasia , Compostos Organoplatínicos/uso terapêutico , Oxaliplatina , Neoplasias Retais/patologia , Estudos Retrospectivos
13.
Cancer Radiother ; 16(4): 257-62, 2012 Jul-Aug.
Artigo em Francês | MEDLINE | ID: mdl-22748977

RESUMO

PURPOSE: To evaluate the predictors of acute radiation pneumonitis after conformal thoracic radiotherapy in the treatment of locally advanced non-small cell lung cancer. PATIENTS AND METHODS: Forty-seven consecutive patients were treated with conformal thoracic irradiation for locally advanced non-small cell lung cancer and retrospectively analysed. The mean total dose of radiotherapy was 65 Gy with respiratory gating in 19 cases. Neoadjuvant and concomitant chemotherapy was performed in 33 patients (70%) and 41 patients (87%) respectively. RESULTS: Eleven patients (23%) had an acute radiation pneumonitis, resulting in death for one patient. In univariate analysis, age, sex, pretherapeutic value of forced expiratory volume, non-gated radiotherapy and type of concomitant chemotherapy did not appear as contributing factors in contrast to the administration of neoadjuvant gemcitabine (P=0.03). The occurrence of acute radiation pneumonitis was significantly associated with non-tumour lung volumes irradiated to 13 Gy (V13, P=0.04), 20 Gy (V20, P=0.02) and 25 Gy (V25, P=0.006), the mean lung dose (P=0.008) and lung normal tissue complication probability (P=0.004). In multivariate logistic regression analysis, the occurrence of acute radiation pneumonitis was significantly associated with age above 75 years (odds ratio [OR]=16.72 ; P=0.02) and with administration of neoadjuvant gemcitabine (OR=18.08, P=0.04). CONCLUSION: Acute radiation pneumonitis is a common acute side effect of the conformal thoracic radiotherapy of locally advanced non-small cell lung cancer, requiring close post-treatment follow-up, particularly for elderly patients. The use of gemcitabine before radiation should be avoided. The benefits and risks of conformal thoracic radiotherapy must be carefully analyzed in view of the dosimetric parameters obtained.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Pneumonite por Radiação/etiologia , Radioterapia Conformacional/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonite por Radiação/epidemiologia , Estudos Retrospectivos , Fatores de Risco
14.
Cancer Radiother ; 16(4): 272-81, 2012 Jul-Aug.
Artigo em Francês | MEDLINE | ID: mdl-22721757

RESUMO

PURPOSE: To compare respiratory-gated conformal radiotherapy versus conventional conformal radiotherapy for the irradiation of non-small cells lung cancer and breast cancer. PATIENTS AND METHODS: The STIC 2003 project was a comparative, non-randomized, multicenter and prospective study that included in 20 French centers between April 2004 and June 2008, 634 evaluable patients, 401 non-small cells lung cancer and 233 breast cancers. RESULTS: The final results confirmed the feasibility and good reproducibility of the various respiratory-gated conformal radiotherapy systems regardless of tumour location. The results of this study demonstrated a marked reduction of dosimetric parameters predictive of pulmonary, cardiac and esophageal toxicity, especially for non-small cells lung cancer, as a result of the various respiratory gating techniques. These dosimetric benefits were mainly observed with deep inspiration breath-hold techniques (ABC and SDX), which markedly increased the total lung volume compared to the inspiration-synchronized system based on tidal volume (RPM). For non-small cells lung cancer, these theoretical dosimetric benefits were correlated with a significant reduction in clinically acute and late toxicities, especially the pulmonary. For breast cancer, although less clear due to the lower total dose, there was a decrease in the dose delivered to the heart, potentially reducing the risk of cardiac toxicity in the long-term, especially during the irradiation of the left breast, and a reduction in dose to the contra lateral breast. CONCLUSION: Respiratory-gated radiotherapy appears to be essential to reduce the risk of acute and late toxicities, especially for lungs and heart, during irradiation of non-small cells lung cancer and breast cancers.


Assuntos
Neoplasias da Mama/radioterapia , Neoplasias Pulmonares/radioterapia , Radioterapia Conformacional/métodos , Técnicas de Imagem de Sincronização Respiratória , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Dosagem Radioterapêutica
15.
Cancer Radiother ; 14 Suppl 1: S189-97, 2010 Nov.
Artigo em Francês | MEDLINE | ID: mdl-21129663

RESUMO

Bladder cancer is an urologic common tumor after prostate carcinoma. Radical treatment of localized invasive tumor is based on cystectomy. Surgical mutilation could be important when Bricker's urinary derivation is performed. Moreover, delayed metastasis frequently appeared in spite of radical surgery. Thus, chemoradiotherapy is a valid alternative treatment to cystectomy for selected patients. Cisplatin or derivatives are usually concurrently administered to radiation therapy up to 60 - 65 Gy. Patients undergo control cystoscopy at midtime of treatment in order to select responders from non responders. For majority of cases, the empty bladder should be entirely treated with added margins (about 20 mm) to build the PTV. Control assessment could be improved by echography, cone beam imaging as well as bladder fiduciaries implantation before treatment. From a case report, this review summarizes the technical aspects of radiation therapy (GTV, CTV and PTV, organs at risk, planning) and main acute and late related toxicities.


Assuntos
Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/radioterapia , Antineoplásicos/uso terapêutico , Cisplatino/uso terapêutico , Terapia Combinada , Humanos , Incidência , Masculino , Invasividade Neoplásica , Neoplasias da Próstata/epidemiologia , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/efeitos adversos , Planejamento da Radioterapia Assistida por Computador/métodos , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
16.
Bull Cancer ; 97 Suppl Cancer de la vessie: 19-25, 2010.
Artigo em Francês | MEDLINE | ID: mdl-20534386

RESUMO

Bladder cancer is the second most common urologic tumor after prostate cancer. Radical cystectomy is the standard treatment of localized muscle-invasive tumors. However, urinary diversion (using a conduit or continent diversion) following radical cystectomy can be debilitating. Moreover, delayed metastases appear frequently in spite of radical surgery. So, for selected patients, chemoradiotherapy is a valid therapeutic alternative to cystectomy. Cisplatin or derivatives are administered concurrently to radiation therapy up to 60-65 Gy. Patients undergo control cystoscopy at mid-course in treatment in order to select responders from non responders. This review summarizes the main published series of radiochemotherapy in invasive bladder cancer. Results for local control, survivals, bladder preservation rates and toxicity are presented.


Assuntos
Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/radioterapia , Terapia Combinada , Humanos , Invasividade Neoplásica , Neoplasias da Bexiga Urinária/patologia
17.
Cancer Radiother ; 14(4-5): 363-8, 2010 Jul.
Artigo em Francês | MEDLINE | ID: mdl-20435498

RESUMO

The bladder is a hollow visco-elastic organ involved in urinary continence. In relation to its anatomical location, bladder is exposed in whole or in part to ionizing radiation in external radiotherapy or in brachytherapy of the pelvic region. The acute and late functional changes after external beam radiation consist in urinary frequency, compliance defaults and hematuria. Incidence of urinary side-effects, as well as related modalities of radiotherapy, is poorly described in the literature. Medline literature searches were performed via PubMed using the keywords "bladder--radiotherapy--toxicity--radiation cystitis--tolerability--organ at risk" to describe urinary side-effects due to radiation. Some recommendations exist on the dose constraints applied to bladder. These were mainly established from prostate radiation therapy studies but without definitive consensus. In clinical practice, dose constraints take into account clinical settings: bladder cancer which requires total bladder irradiation or others pelvic tumours (prostate, uterus...) in which the bladder is considered as an organ at risk. Risks of radiation cystitis increase with total dose (above 60 Gy), bladder irradiated volume and concomitant chemoradiation. Modern techniques using conformal radiotherapy with modulated intensity will probably have beneficial impact on bladder toxicity.


Assuntos
Tolerância a Radiação , Radioterapia/efeitos adversos , Bexiga Urinária/efeitos da radiação , Terapia Combinada/efeitos adversos , Diurese/fisiologia , Diurese/efeitos da radiação , Feminino , Humanos , Masculino , Probabilidade , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Cintilografia , Radioterapia/métodos , Dosagem Radioterapêutica , Bexiga Urinária/anatomia & histologia , Bexiga Urinária/fisiologia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/radioterapia , Transtornos Urinários/diagnóstico por imagem , Transtornos Urinários/etiologia , Neoplasias Uterinas/tratamento farmacológico , Neoplasias Uterinas/radioterapia
18.
Cancer Radiother ; 13(6-7): 609-14, 2009 Oct.
Artigo em Francês | MEDLINE | ID: mdl-19729331

RESUMO

Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatment against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed on logistic and technical aspects of radiation, as dose, irradiated volume and fractionation.


Assuntos
Neoplasias/radioterapia , Radioterapia/métodos , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/radioterapia , Comorbidade/tendências , Países Desenvolvidos/estatística & dados numéricos , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Incidência , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/cirurgia , Radioterapia/normas , Dosagem Radioterapêutica/normas , Técnicas Estereotáxicas , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/radioterapia
19.
Cancer Radiother ; 12(6-7): 548-53, 2008 Nov.
Artigo em Francês | MEDLINE | ID: mdl-18691927

RESUMO

Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatment against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed on logistic and technical aspects of radiation. Special techniques are also reviewed that have particular relevance to the treatment of the elderly.


Assuntos
Envelhecimento/efeitos da radiação , Neoplasias/radioterapia , Radioterapia/métodos , Idoso , Neoplasias da Mama/radioterapia , Comorbidade/tendências , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Neoplasias Pulmonares/radioterapia , Seleção de Pacientes , Neoplasias Uterinas/radioterapia
20.
Cancer Radiother ; 11(6-7): 331-7, 2007 Nov.
Artigo em Francês | MEDLINE | ID: mdl-17962061

RESUMO

After a request for proposal initiated by National Institute against cancer (INCa) in 2005, three French centers in France started tomotherapy in the first semester of 2007. A national policy of evaluation was performed to study the feasibility of this innovative technique and to compare the interest of helicoidal tomotherapy with other modalities of conformal therapy. Common protocols have been designed to facilitate this evaluation. Description of dose, IMRT levels and constraints are achieved according to each selected indication as: sarcoma, head and neck tumors, lung cancer, mesothelioma, bone metastases, anal carcinoma and craniospinal irradiation.


Assuntos
Neoplasias/radioterapia , Radioterapia Conformacional/métodos , Tomografia Computadorizada Espiral/métodos , Adulto , Fatores Etários , Protocolos Clínicos , Irradiação Craniana/métodos , Estudos de Viabilidade , Feminino , França , Humanos , Masculino , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Radioterapia Conformacional/efeitos adversos , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Fatores de Risco , Fatores Sexuais , Fatores de Tempo
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