Outcomes of radiation therapy of indolent cutaneous B-cell lymphomas and literature review.

BACKGROUND: Primary cutaneous B-cell lymphomas represent approximately 25% of primary cutaneous lymphomas. Follicular centre cell lymphomas (PCFCL) and marginal zone lymphomas (PCMZL) are the two histological subtypes that present an indolent evolution. Radiotherapy is one of the recommended treatment options with few series reported. OBJECTIVE: This study aimed to evaluate radiotherapy outcomes in term of overall survival (OS) and disease-free survival (DFS) for patients suffering from a PCMZL or PCFCL, to search for predictive factors of recurrence, and to evaluate chronic and aesthetics adverse events and patient's satisfaction. METHODS: Patients treated with contact low energy radiotherapy for a PMZCL or PCFCL from April 2009 to June 2017 in Saint Louis hospital were retrospectively analysed. Total dose ranged from 18 to 30 Gy. Objective response (OR) rates, DFS and OS as patterns of recurrence according to radiation fields were analysed. Univariate analysis of DFS has been performed according to clinical and biological parameters. Acute toxicity, long-term adverse events and satisfaction were collected via individualized questionnaires. RESULTS: Forty-six patients were included. Median follow-up was 43.5 months. OR was achieved for 100% of cases. Recurrence occurred in 39% of cases. Median DFS was 44 months. Three-year DFS and 5-year DFS were 56% and 51%, respectively. OS at 3 and 5 year was 100%. Only sex was significantly associated with DFS. Acute AEs occurred in 48% of cases without grade 3 and 4. 55% reported some moderate aesthetic sequelae for long-term AEs. 97% were satisfied with treatment. CONCLUSION: This study confirms the good risk-benefit of radiotherapy for the treatment of primary cutaneous indolent B-cell lymphomas due to the high response rate and a long DFS. No significant factor for recurrence was identified, except female sex. Long-term aesthetic evaluation was good or excellent for most of the patients.

[Prostate localization systems for prostate radiotherapy]. / Dispositifs de repositionnement prostatique sous l'accélérateur linéaire.

The development of sophisticated conformal radiation therapy techniques for prostate cancer, such as intensity-modulated radiotherapy, implies precise and accurate targeting. Inter- and intrafraction prostate motion can be significant and should be characterized, unless the target volume may occasionally be missed. Indeed, bony landmark-based portal imaging does not provide the positional information for soft-tissue targets (prostate and seminal vesicles) or critical organs (rectum and bladder). In this article, we describe various prostate localization systems used before or during the fraction: rectal balloon, intraprostatic fiducials, ultrasound-based localization, integrated CT/linear accelerator system, megavoltage or kilovoltage cone-beam CT, Calypso 4D localization system tomotherapy, Cyberknife and Exactrac X-Ray 6D. The clinical benefit in using such prostate localization tools is not proven by randomized studies and the feasibility has just been established for some of these techniques. Nevertheless, these systems should improve local control by a more accurate delivery of an increased prescribed dose in a reduced planning target volume.

[Cervical cystic lymphangioma in children]. / Lymphangiomes kystiques cervicaux chez l'enfant.

INTRODUCTION: Cervical cystic lymphangioma are rare and benign, but the prognosis can be serious in terms of its development and management. OBJECTIVES: To describe the epidemiological, clinical and therapeutic characteristics. MATERIALS AND METHODS: A retrospective study of eight cases. RESULTS: The mean age was 7 years, with a slight female predominance. Ultrasound scanning was sufficient to establish the diagnosis. CT scan or MRI scan was used if parapharyngeal or a mediastinal extension was suspected. All patients in this series underwent surgical excision. There were no postoperative complications or recurrence at one year post-surgery. DISCUSSION: These lesions present as soft compressible cervical swellings of variable size. Radiological imaging (CT, MRI) aid diagnosis and demonstrate extent, however final diagnosis is made by histopathological examination. The treatment of choice is surgical excision. Another option is the use of sclerosing agents. These are used by some surgeons as a first line treatment and also for surgical recurrence.

[Ameloblastic fibro-odontoma of the maxillary sinus]. / Fibro-odontome améloblastique du sinus maxillaire.

INTRODUCTION: Ameloblastic fibro-odontoma, ameloblastic fibroma, and odontoma are rare malformations, which are classified as odontologic tumors. They usually progress in an asymptomatic way, and making the histological distinction between these variants is very difficult. OBSERVATION: We report the case of a 14-year-old girl presenting with an ameloblastic fibro-odontoma of the maxillary sinus. The clinical signs were nasal obstruction and jugular tumefaction. Surgical excision was performed through a paralateronasal approach. The diagnosis of fibro-odontoma was confirmed by the histopathological analysis of the surgical piece. DISCUSSION: Odontologic tumors form a complex entity, the histological nature and the correlations of which are discussed.