Sample records for radiotherapie des seminomes

  1. Long-term tumor control and fertility after limited paraaortic radiotherapy in stage I seminoma; Langzeittumorkontrolle und Fertilitaet nach paraaortal limitierter Radiotherapie des Seminoms im Stadium I

    Sedlmayer, F.; Deutschmann, H.; Rahim, H.; Merz, F.; Kogelnik, H.D. [Landeskliniken Salzburg (Austria). Inst. fuer Radiotherapie und Radio-Onkologie; Joos, H. [Landeskliniken Salzburg (Austria). Urologische Abt.


    very unlikely. (orig.) [Deutsch] Hintergrund: Nach alleiniger paraaortaler Bestrahlung testikulaerer Seminome im Stadium I wurden bislang nur wenige Langzeitdaten publiziert. Unser Patientengut wurde retrospektiv hinsichtlich Lokalisation und Zeitpunkt des Auftretens von Rezidiven analysiert. Hodenstreudosen und ihre Auswirkungen auf die Serumspiegel des follikelstimulierenden Hormons (FSH) wurden prospektiv erfasst. Patienten und Methodik: Von 1980 bis 1995 wurden 58 Patienten mit Seminomen im klinischen Stadium I nach der Semikastration ausschliesslich paraaortal bestrahlt (Th12 bis L4). Die applizierte mittlere Gesamtdosis betrug 28,07 Gy ({+-}2,2 SD), die Einzeldosis im Mittel 1,62 Gy ({+-}0,083 SD). Seit 1989 wurde routinemaessig die Streudosis am Resthoden mittels Thermolumineszenzdosimetrie (TLD) erfasst (45 Patienten). FSH-Serumspiegel wurden nach dem Ende der Radiotherapie bei 26 Patienten mit normalen FSH-Ausgangswerten wiederholt bestimmt, um potentielle bestrahlungsinduzierte Stoerungen in der Spermiogenese zu erfassen. Ergebnisse: 57 Patienten wurden im Mittel 69,4 Monate (30 bis 210 Monate) nachbeobachtet, ein Patient wurde aus der Nachbeobachtung verloren. Zwei der 57 Patienten entwickelten ipsilaterale iliakale Lymphknotenrezidive (3,5%), wobei die Rezidive nach 14 Monaten bzw. fuenf Jahren auftraten. Das rezidivfreie Ueberleben betrug nach fuenf Jahren 96,5%, das Gesamtueberleben nach Salvage-Chemotherapie 100%. Die mittlere Hodenstreudosis betrug 22,4 cGy ({+-}8,73 SD). Sieben von 26 Patienten (26,9%) zeigten einen passageren FSH-Anstieg ueber den oberen Normbereich, wobei die Maximalwerte im Mittel 4,2 Monate nach dem Ende der Radiatio erreicht wurden und sich spaetestens innerhalb von 18 Monaten normalisierten. Unterhalb von 20 cGy wurden keine FSH-Erhoehungen beobachtet. Die Hodenstreudosen zeigten keine klare Korrelation zur Wahrscheinlichkeit des Auftretens einer FSH-Erhoehung. Schlussfolgerung: Nach alleiniger paraaortaler Radiotherapie liegt

  2. Radiotherapy in stage 1 testicular seminoma: retrospective study and review of literature; Radiotherapie des seminomes testiculaires de stade 1: etude retrospective et revue de la litterature

    Bauduceau, O.; Le-Moulec, S.; Bernard, O. [Hopital des Armees du Val-de-Grace, Service de Radiotherapie et Oncologie, 75 - Paris (France); Souleau, B. [Hopital des Armees Percy, Service d' Hematologie, 92 - Clamart (France); Houlgatte, A. [Hopital des Armees du Val-de-Grace, Service d' Urologie, 75 - Paris (France)


    Introduction. - Seminoma accounts for about 40% of germ cell tumours of the testicle. In this retrospective analysis, we review literature concerning management of stage I seminoma. Materials and methods. - Between March 1987 and April 2001, 65 patients with stage I pure testicular seminoma received adjuvant radiotherapy with a 25 MV linear accelerator. Results. - Median age was 33 years. Testicular tumour has been found on the right testis in 39 patients and on the left one in 24 patients. Patients have been treated using an anterior-posterior parallel pair and have received 20-25 Gy in 10-14 fractions. The target volume consisted of paraaortic, and paraaortic + homolateral iliac lymph nodes in 17 and 46 patients, respectively. Acute toxicity was mainly digestive, 38% of patients presenting nausea and vomiting. Median follow-up time was 37 months. All patients are alive in complete remission. Discussion. - Because of good radio-sensitivity of seminoma, radiotherapy is regarded as standard adjuvant treatment (5 years relapse rate: 3-5%). Acute toxicity is dominated by moderate gastro-intestinal side effects. Secondary neoplasia represents one of the worst possible long-term complications of therapy. Waiting for ongoing randomized trials, the modern literature for seminoma reflects a trend toward lower radiation doses (20-25 Gy) and smaller treatment volumes (paraaortic field). Adjuvant chemotherapy with two courses of carbo-platin, might be equivalent to radiotherapy but must be investigated in randomized trials. A surveillance policy is one of the other management options less recommended. (author)

  3. Stage I seminoma and radiotherapy: To bury it or not?; Seminome de stade I, faut-il enterrer la radiotherapie?

    Pouessel, D.; Azria, D. [Centre Regional de Lutte Contre le Cancer Val d' Aurelle-Paul-Lamarque, Dept. d' Oncologie Medicale et d' Oncologie Radiotherapie 34 - Montpellier (France); Culine, S. [Centre Hospitalier Universitaire Henri-Mondor, Service d' Oncologie Medicale, 94 - Creteil (France)


    Post-orchidectomy management of stage I testis seminoma has evolved for many years. Three treatment options should be discussed after surgery. Surveillance tends toward taking a more significant place to avoid over-treatment, adjuvant chemotherapy with carbo-platin has demonstrated its efficiency, and for some, preventive radiotherapy, the historical reference treatment, is losing momentum. Whatever the chosen orientation, long-term prognosis is excellent with overall survival closed to 100%. In this context, this review underlines the advantages and the drawbacks of the three attitudes but also the unknowns relative to each. Indeed, their knowledge is crucial for informing clearly and with an objective way. Without gold-standard, but with three therapeutic options available, informing our patients is the key so they make an informed choice in dialogue with the oncologist. (authors)

  4. Second malignancies after radiotherapy for testicular seminoma: 2 cases; Seconds cancers apres radiotherapie pour seminome testiculaire: a propos de deux cas

    Servagi-Vernat, S.; Crehange, G.; Lorchel, F.; Bontemps, P.; Bosset, J.F. [Centre Hospitalier Universitaire Jean Minjoz, Service de Radiotherapie, 25 - Besancon (France)


    Orchidectomy with adjuvant radiotherapy of retroperitoneal paraaortic and ipsilateral iliac nodes is the standard treatment for localized testicular seminoma (I, IIA, IIB). Post therapeutic follow-up allows to detect local relapse and radio-induced second cancer. Nevertheless, evaluation of risk of second malignancy still remains difficult. We report 2 cases of rectal cancer after radiotherapy for testicular seminoma. (authors)

  5. Radiotherapy of prostate cancer; Strahlentherapie des Prostatakarzinoms

    Krause, S.; Herfarth, K. [Universitaetsklinikum Heidelberg, Klinik fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany)


    With the development of modern radiation techniques, such as intensity-modulated radiotherapy (IMRT), a dose escalation in the definitive radiotherapy of prostate cancer and a consecutive improvement in biochemical recurrence-free survival (BFS) could be achieved. Among others, investigators at the Memorial Sloan-Kettering Cancer Center (MSKCC) saw 5-year BFS rates of up to 98%. A further gain in effectiveness and safety is expected of hypofractionation schedules, as suggested by data published by Kupelian et al., who saw a low 5-year rate of grade {>=}2 rectal side-effects of 4.5%. However, randomized studies are just beginning to mature. Patients with intermediate or high-risk tumors should receive neoadjuvant (NHT) and adjuvant (AHT) androgen deprivation. Bolla et al. could show an increase in 5-year overall survival from 62-78%. The inclusion of the whole pelvis in the treatment field (WPRT) is still controversial. The RTOG 94-13 study showed a significant advantage in disease-free survival after 60 months but long-term data did not yield significant differences between WPRT and irradiation of the prostate alone. The German Society of Urology strongly recommends adjuvant radiotherapy of the prostate bed for pT3 N0 tumors with positive margins. In a pT3 N0 R0 or pT2 N0 R+ situation, adjuvant radiotherapy should at least be considered. So far, no randomized data on NHT and AHT have been published, so androgen deprivation remains an individual decision in the postoperative setting. In a retrospective analysis Spiotto et al. reported a positive effect for adjuvant WPRT and biochemical control. This article summarizes the essential publications on definitive and adjuvant radiotherapy and discusses the additional use of androgen deprivation and WPRT. (orig.) [German] Die Entwicklung der intensitaetsmodulierten Radiotherapie (IMRT) ermoeglichte in den letzten Jahren eine Dosiseskalation bei der primaeren Radiotherapie des Prostatakarzinoms und damit eine Verbesserung

  6. Radiation therapy of regional lymph nodes in the treatment of seminomas compared with retroperitoneal lymphadenectomy. A retrospective analysis of 161 patients; Die Strahlentherapie der regionaeren Lymphknotenstationen bei der Behandlung des Seminoms im Vergleich zur retroperitonealen Lymphadenektomie. Eine retrospektive Auswertung von 161 Patienten

    Warszawski, N. [Klinik fuer Strahlentherapie, Magdeburg Univ. (Germany); Schmuecking, M. [Klinik fuer Strahlentherapie, Magdeburg Univ. (Germany); Samtleben, M. [Klinik und Poliklinik fuer Urologie, Magdeburg Univ. (Germany); Gademann, G. [Klinik fuer Strahlentherapie, Magdeburg Univ. (Germany); Allhoff, E.P. [Klinik und Poliklinik fuer Urologie, Magdeburg Univ. (Germany)


    Stadien betreffende retroperitoneale Rezidive waren bei der retroperitonealen Lymphadenektomie (9,5%) signifikant haeufiger als bei der Strahlentherapie (2,0%); Rezidive ausserhalb des Operationssitus bzw. Bestrahlungsfeldes traten nicht signifikant unterschiedlich auf (4,8% bzw. 7,1%). Die rezidivfreien Ueberlebensraten sanken signifikant mit zunehmendem Tumorstadium (Wilcoxon-Test, p<0,001). Stadienabhaengig stieg die Rezidivrate von 4,1% im Stadium I auf 58,3% im Stadium IIC. Nach Semikastration wegen eines Seminoms ist die Strahlentherapie der regionaeren Lymphknoten die Therapie der Wahl. Die retroperitoneale Lymphadenektomie gilt heute zurecht als obsolet. (orig./MG)

  7. The treatment of stage I testicular pure seminoma, the value of prophylactic radiotherapy. Traitement des seminomes purs du testicule stade I, interet de la radiotherapie prophylactique

    Reinfuss, M.; Skolyszewski, J.; Glinski, B.; Kociolek, D.; Kowalska, T. (Instytut Onkologii, Cracow (Poland))


    Teleradiotherapy is the treatment of choice for stage 1 testicular pure seminoma. In this study of 130 patients, we compared the dose of 35 and 30 Gy given prophylactically. No statistically significant difference in survival was observed between the groups. 29 Refs.

  8. Radiotherapy for testicular seminoma: changes over the past 10 years; Radiotherapie des seminomes testiculaires: ce qui a change ces dix dernieres annees

    Mirimanoff, R.O. [Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne (Switzerland)


    The STIC 2001 and STIC 2002 projects intend to allow the implementation and the assessment of Intensity Modulated Radiation Therapy in France. IMRT is an innovative technique in which the high-dose radiation volume conforms to an accurately defined target volume with less morbidity to the surrounding normal tissues. The main medical objectives of the projects are (1) to improve the therapeutic index while decreasing acute toxicity and late sequelae (mainly xerostomia and acute mucite for head and neck tumors), which allows an increase in the radiation dose to the tumor and then a better tumor control; (2) to propose a salvage treatment to patients who locally recurred in previously irradiated sites; (3) to determine the optimal treatment guidelines for a safe use of the technique in clinical routine. Our projects also aim at comparing IMRT and 3D conformal treatments on the one hand (STIC 2001), and IMRT and conventional treatments on the other hand (STIC 2002), with regard to costs. As a matter of fact, the use of IMRT is presently limited in France because its implementation requires high investment and personnel costs. The seventeen French Regional Cancer Centres involved in the two projects intend to study the additional cost of the use IMRT in comparison with the use of standard techniques, which appears to be a step for a wide use of this technique in France. Each of the studies is two-year prospective, and includes patients with head and neck tumors treated with a curative intend (post operative or exclusive treatments for STIC 2002 and STIC 2002), and patients with a prostate cancer (STIC 2001). (author)

  9. Radiotherapy of cutaneous lymphomas; Radiotherapie des lymphomes cutanes

    Kirova, Y.M.; Piedbois, Y.; Pan, Q.; Guo, J.P.; Le Bourgeois, J.P. [Hopital Henri-Mondor, 94 - Creteil (France). Dept. de cancerologie


    Radiotherapy plays an important role in the treatment of cutaneous lymphomas. In the treatment of Mycosis fungoides, total skin electron beam radiation therapy is efficient for patients with limited and superficial forms of the disease. Radiotherapy is also efficient for the locally advanced forms of non-epidermo-tropic lymphomas. The palliative radiotherapy is indicated for advanced, nodular and treatment resistant forms of cutaneous lymphomas and for voluminous lymphadenopathies. (authors)

  10. External radiotherapy or surveillance of stage 1 testes seminomas: comparison of irradiation doses delivered to the last testis; Radiotherapie externe ou surveillance des seminomes testiculaires de stade 1: comparaison des doses d'irradiation delivrees au testicule restant

    Massabeau, C.; Filleron, T.; Delpuech, B.; Chevreau, C.; Mourey, L.; Bachaud, J.M. [Institut Claudius-Regaud, 31 - Toulouse (France); CHU Rangueil, 31 - Toulouse (France)


    Objective of the study: After orchidectomy, the standard treatment of seminoma s (stage 1) is adjuvant irradiation of ganglions currently supplanted by the strategy of simple surveillance because of recurrence rate under 20% and an excellent prognosis. Our prospective study had for objective to study by in vivo dosimetry the radiation doses delivered to the sane testis during an adjuvant irradiation of ganglion versus CT scan surveillance. The adjuvant irradiation of stage 1 seminomas delivers an insignificant dose to the sane testis in the guise of lead protection, almost twenty times inferior to that one delivered during a CT scan surveillance on ten years. These doses are negligible regarding the doses susceptible to affect the spermatogenesis and the fertility. (N.C.)

  11. How to irradiate bone metastases?; Radiotherapie des metastases osseuses: quel est le meilleur schema de radiotherapie?

    Pradier, O.; Bouchekoua, M.; Albargach, N.; Muller, M.; Malhaire, J.P. [Centre Hospitalier Universitaire, Service de Radiotherapie, Institut de Cancerologie et d' Hematologie, 29 - Brest (France)


    Radiotherapy for bone metastases represents an important part of daily practice in our departments of radiotherapy. Majority of treatments deliver either one fraction (6 to 10 Gy) or multi-fractions mainly using 30 Gy in ten fractions. In the past decade, several randomized trials aimed to determine the optimal scheme of radiotherapy in this setting. In the present review, the efficacy of radiotherapy on bone metastases will be evaluated using the following parameters: the partial or complete responses on pain, the reduction of antalgic intake, bone re-calcification, and need for reirradiation. Other parameters must also be considered, such as the primary site, number of metastasis, performance status, overall prognosis and side effects of radiotherapy. (authors)

  12. Radiotherapy in early stage Dupuytren`s contracture; Radiotherapie im fruehen Stadium des Morbus Dupuytren. Indikation, Technik und Langzeitergebnisse

    Keilholz, L. [Univ. Erlangen-Nuernberg, Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik; Seegenschmiedt, M.H. [Univ. Erlangen-Nuernberg, Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik]|[Alfried-Krupp-Krankenhaus, Essen (Germany). Klinik fuer Radiologie, Strahlentherapie und Nuklearmedizin; Born, A.D. [Univ. Erlangen-Nuernberg, Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik; Sauer, R. [Univ. Erlangen-Nuernberg, Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik


    Radiotherapie; das langfristige Ergebnis wurde zwischen Februar und April 1994 ermittelt. Die Nachbeobachtungszeit betrug damit 6{+-}2 (1 bis 12) Jahre. 57 Patienten mit einem minimalen Follow-up von fuenf (Median 7,5; 5 bis 12) Jahren wurden in bezug auf langfristige Resultate (Stabilisierung, Progression) gesondert ausgewertet. Die akute und chronische Toxizitaet der Radiotherapie wurde gemaess der RTOG/EORTC-Kriterien bestimmt. Ergebnisse: Bezogen auf das Stadium, waren 130 (92%) Haende drei Monate nach Radiotherapie stabil, zehn (7%) verbesserten und zwei Haende (1%) verschlechterten sich. Eine objektivierbare Reduktion von Knoten und Straengen wurde bei 107 (75%) Faellen erzielt. Zusaetzlich bemerkten 84 (87%) Patienten einen Rueckgang der Symptomatik. Zum aktuellen Follow-up waren 16 von 142 (11%) Faellen progredient im Stadium. In der Gruppe mit einem Follow-up von {>=}5 Jahren (n=57) waren 44 (77%) Faelle stabil und 13 (23%) progredient, achtmal innerhalb und fuenfmal ausserhalb des Radiotherapie-Feldes. Einige `Versager` haetten vermieden werden koennen, wenn ein groesserer Sicherheitssaum bei der Radiotherapie beruecksichtigt worden waere; einige Versager wurden jedoch noch ein weiteres Mal erfolgreich bestrahlt oder operiert. (orig./AJ)

  13. Simulation of pulmonary movements for external radiotherapy; Simulation des mouvements pulmonaires pour la radiotherapie externe

    Laurent, R.; Henriet, J.; Gschwind, R.; Makovicka, L. [IRMA/ENISYS/Institut FEMTO - UMR CNRS 6174, Pole Universitaire des Portes du Jura, 4 Place Tharradin - BP 71427, 25211 Montbeliard (France); Dumas, J.L.; Bosset, J.F. [Departement de Radiotherapie, CHU Jean Minjoz, 3 boulevard Flemming, 25030 Besancon (France)


    The Planning Target Volume (PTV) is one of the existing margins during the treatment of cancerous tumours by radiotherapy. It includes tumoral tissues as well as the patient positioning error between each radiotherapy session, and more particularly the intentional or unintentional patient movements. While focusing on pulmonary movements, and as the pulmonary tumour moves as the patient breathes, the authors aim at developing a weakly ionizing technique to catch the pulmonary movement of each patient, and therefore decrease the PTV. Several algorithms are implemented to process 2D and 3D images

  14. Intraoperative and external beam radiotherapy for pancreatic carcinoma; Intraoperative und perkutane Radiotherapie des Pankreaskarzinoms

    Eble, M.J. [Abt. Klinische Radiologie, Radiologische Universitaetsklinik Heidelberg (Germany); Maurer, U. [Klinikum der Stadt Mannheim (Germany). Inst. fuer Radiologie


    Therapeutic strategies in the treatment of pancreatic carcinoma are based on the high number of non-resectable cancers, the high relative radioresistance and the high distant metastases rate. Even in curatively resected carcinomas, a locally effective treatment modality is needed because of the risk of microscopical residual disease in the peripancreatic tissue. The efficacy of radiotherapy is dose dependent. Based on an analysis of published data a dose of more than 50 Gy is recommended, resulting in a high morbidity rate with external beam radiotherapy alone. The use of intraoperative radiotherapy allows locally restricted dose escalation without increased perioperative morbidity. In adjuvant and in primary treatment, local tumor control was improved (70-90%). With palliative intent, pain relief was obtained rapidly in over 60% of patients and led to improved patient performance. As a result of the high distant metastases rate, even in curatively resected carcinomas, the overall prognosis could not be significantly improved. Further dose escalation is limited by the increasing incidence of upper gastrointestinal bleeding (20-30%). (orig.) [Deutsch] Therapiestrategien beim Pankreaskarzinom werden bestimmt durch den hohen Anteil primaer nicht resektabler Karzinome, der hohen relativen Strahlenresistenz und der hohen Fernmetastasierungsrate. Selbst kurativ resezierte Karzinome erfordern durch ihre hohe lokale Tumorzellpersistenz eine lokal effektive adjuvante Behandlungsmassnahme. Die Effektivitaet einer Radiotherapie ist dosisabhaengig. Aus der Analyse publizierter Daten wird eine Dosis von >50 Gy, welche bei der alleinigen perkutanen Bestrahlung mit einer hohen Morbiditaet verbunden ist, empfohlen. Mit der intraoperativen Radiotherapie ist eine lokal begrenzte Dosiseskalation ohne erhoehte perioperative Morbiditaet moeglich. Sowohl in der adjuvanten als auch in der primaeren Behandlung kann die lokale Tumorkontrolle deutlich verbessert werden (70-90%). Unter

  15. Radiotherapy for cutaneous cancers with xeroderma pigmentosum; Radiotherapie des cancers cutanes au cours du xeroderma pigmentosum

    Ben Salah, H.; Bahri, M.; Turki, H.; Abdelmoula, M.; Frikha, M.; Daoud, J. [Service de radiotherapie, CHU Habib-Bourguiba, route Majida-Bouleila, 3029 Sfax (Tunisia)


    Purpose. - To analyze the therapeutic results of cutaneous cancers on xeroderma pigmentosum through a series of 15 patients treated by radiotherapy. Patients and methods. - Between 1993 and 2006, 15 patients with xeroderma pigmentosum and having cutaneous cancers were treated in the Radiotherapy Department of university hospital Habib-Bourguiba of Sfax in Tunisia. Seventy-three percent of the cases occurred in male patients and the mean age of appearance of the first tumour was 18.2 years. Tumour histology was squamous cell carcinoma in 74% of the cases. The total number of cutaneous tumours was 84. Ten patients had a surgical resection. Four patients did not respond to chemotherapy. The modality of irradiation was decided according to the size, thickness and localization of the tumour. The dose of radiotherapy was 60 Gy or equivalent with classic irradiation. Results. - The total number of lesions treated with radiotherapy was 64. Forty-three lesions were treated with contact-therapy, ten with brachytherapy and 11 with cobalt-therapy. The following acute complications were observed: cutaneous infection (53.3% of patients), radio-epithelitis (80% of patients) and necroses (33.3% of patients). Evaluation after treatment showed a clinical complete remission in 73% of the cases. Late effects were noted in seven cases: telangiectasia and cutaneous atrophy. A recurrence in the irradiated zone was observed in one case. A nodal metastasis was observed in two cases. Another patient presented lung metastases. After a median follow up of 37.2 months, four patients died, seven are alive with cutaneous cancer and four are alive with complete remission. Conclusion. - Radiotherapy is a possible and effective therapeutic alternative. Dose and methods are not defined for xeroderma pigmentosum. (authors)

  16. Postoperative radiotherapy of prostate cancer; Radiotherapie postoperatoire des cancers de la prostate

    Richaud, P.; Sargos, P.; Henriques Figueiredo, B. [Service de radiotherapie, centre regional de lutte contre le cancer, institut Bergonie, 33 - Bordeaux (France); Latorzeff, I. [Service de radiotherapie, clinique Pasteur, 31 - Toulouse (France); Mongiat-Artus, P. [Service d' urologie, hopital Saint-Louis, 75 - Paris (France); Houede, N. [Service d' oncologie medicale, centre regional de lutte contre le cancer, institut Bergonie, 33 - Bordeaux (France); Salomon, L. [Service d' urologie, 94 - Creteil (France); Wallerand, H. [Service d' urologie, faculte de medecine Victor-Segalen, CHU Pellegrin-Tripode, 33 - Bordeaux (France)


    After radical prostatectomy, the risk of biological recurrence at 5 years varies from 10 to 40 % and this natural evolution of the disease has led radiation therapy being proposed as a supplement to surgery. When the recurrence risk is essentially local, supplementary radiotherapy is justified in the aim of improving biological recurrence-free survival, local control, metastasis-free survival and specific and global survival, while respecting patient quality of life. Three recent studies, EORTC 22911, ARO 9602 and SWOG 8794 found a similar advantage for biological recurrence-free survival without higher major additional toxicity. However, only the SWOG 8794 study found a significant improvement for metastasis-free survival and global survival. In an adjuvant setting, the optimal moment to propose this postoperative radiotherapy remains uncertain: should it be proposed systematically to all pT3 R1 patients, running the risk of pointlessly treating patients who will never recur, or should it only be proposed at recurrence? The GETUG AFU 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. (authors)

  17. Postoperative radiotherapy in N0 laryngeal cancer; Radiotherapie postoperatoire des cancers larynges classes N0

    Maillard, S.; Cauchois, A.; Froissart, D.; Nguyen, T.D. [Institut Jean-Godinot, Service de radiotherapie, 51 - Reims (France); Jovenin, N. [Centre Hospitalier Universitaire, DIM, 51 - Reims (France); Merol, J.C.; Chays, A. [Centre Hospitalier Universitaire, Service d' otorhinolaryngologie, 51 - Reims (France)


    Purpose. - A retrospective study to re-assess the indications for postoperative radiation therapy in squamous cell carcinoma of the larynx staged N0 after gross resection. Patients and methods. - Between January 1975 and December 2000, 166 patients with squamous cell carcinoma of the larynx were treated by total laryngectomy with or without neck dissection. Surgery was completed by external radiotherapy delivering 45 to 65 Gy to the tumour bed and 45 to 50 Gy to cervical lymphatic chains. Minimal follow-up was 36 months and median follow-up was 98 months. Results. - The rate of nodal recurrence was 6% (median time for relapse was 9 months). The survival rates at 1. 2, 3 and 5 years were 93.5, 84, 80 and 69% respectively, with a 8 year 3 month median survival. The univariate analysis showed 4 parameters, which significantly increased the risk of local recurrence: the medical necessity for immediate tracheotomy, the sub-glottic involvement, the involvement of the whole larynx and the presence of lymphatic emboli in the neck dissection. There was no statistically significant difference between the patients with or without a neck dissection. Fifty-nine secondary cancers were observed, 15 of them occurring in the head and neck area. The Late complications consisted of cervical subcutaneous fibrosis (7%), oesophageal stricture (4%), oeso-tracheal fistula (1%). hypothyroidism (3%), bone necrosis (1%). Conclusion. - Prophylactic cervical radiotherapy in laryngeal cancers resulted in 6% cervical node recurrence rate. This value may resent the maximal rate to accept if one would favour new therapeutic strategies based on restricted indications for radiotherapy. (authors)

  18. The value of radiotherapy for the treatment of meningeal melanocytoma; Stellenwert des Strahlentherapie bei der Behandlung des meningealen Melanozytoms

    Rades, D.; Karstens, J.H. [Abt. fuer Strahlentherapie und spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Tatagiba, M. [Abt. fuer Neurochirurgie, Medizinische Hochschule Hannover (Germany); Brandis, A. [Abt. fuer Neuropathologie, Medizinische Hochschule Hannover (Germany); Dubben, H.H. [Abt. fuer Strahlentherapie und Radioonkologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)


    Background: Meningeal melanocytoma is described as rare benign lesion with a high risk of recurrence. There are no well-substantiated treatment recommendations in the literature. Only case reports have been published by now. Patients and Methods: In 1997 a patient was irradiated for a recurrent spinal meningeal melanocytoma and 2 years later for brain metastases indicating malignant transformation. This case gave rise to a literature review for therapeutic options. All sufficiently documented cases published since 1972, when the term meningeal melanocytoma was established, were evaluated. Based on published and on original data recurrence and overall survival rates up to 5 years were calculated for three different therapeutic approaches, namely complete tumor resection, incomplete resection with subsequent radiotherapy, and incomplete resection alone. Statistical evaluation was performed using the {chi}{sup 2} test and Kaplan-Meier-analysis. Results: 53 patients (including our patient) met selection criteria. Complete tumor resection was superior to incomplete resection alone with lower recurrence (4-38% versus 50-92%) and better overall survival rates (86-95% versus 30-58%). After incomplete resection radiotherapy seemed to improve prognosis (recurrence 15-45%; overall survival 91-92%). Between complete resection and incomplete resection plus radiotherapy no significant differences were observed. Conclusions: For meningeal melanocytoma complete resection must be regarded as the best of the modalities compared. After incomplete resection radiotherapy should be considered, although a specific radiotherapeutic regimen cannot be recommended at present. However, for multiple cranial or spinal lesions total cranial irradiation or craniospinal irradiation is indicated. (orig.) [German] Hintergrund: Das meningeale Melanozytom wird als seltene benigne Tumorentitaet mit hoher Rezidivneigung beschrieben. In der Literatur gibt es bislang keine fundierten Therapieempfehlungen

  19. Intraoperative radiotherapy in primary rectal cancer; Intraoperative Radiotherapie des primaeren Rektumkarzinoms

    Mund, Christian


    According to the results of several studies intraoperative radiotherapy seems to influence local control for primary rectal cancer in UICC-Stage II / III positively, though recommendations in therapy cannot be given as studies of high evidence level do not exist. As IORT is rarely available and makes patient recruitment difficult, prospective randomised trials have not been carried out yet. This emphasizes the importance of non-randomised trials for an evaluation of IORT. A comparison of 21 patients with locally advanced rectal cancer who had been treated with intraoperative radiation therapy and 21 similar cases without an application of IORT could not show any significant improvements in prognosis (recurrences, metastases and disease-specific survival). Nevertheless the employment of intraoperative radiation showed a trend in improvement of local control. This hast been shown by several other studies before. Thus the application of IORT in patients with locally advanced rectal cancer is considered a useful part in multimodal treatment and should further be evaluated in specialized centres. In case-control studies 1:1-matching leads to a good comparability of groups and renders conclusions of high internal validity possible. To gain a sufficient power, this type of trials should however primarily be carried out by centres with a high number of cases.

  20. Bone pain palliation with internal radiotherapy; Traitement antalgique des metastases osseuses douloureuses par radiotherapie interne vectorisee

    Tessonnier, L.; Fontana, X.; Chaborel, J.P.; Bussiere, F.; Darcourt, J. [CRLCC Centre Antoine-Lacassagne, Service Central de Medecine Nucleaire, 06 - Nice (France); Ciais, C. [CRLCC Centre Antoine-Lacassagne, Unite Mobile d' algologie, 06 - Nice (France); Valerio, L. [Centre Hospitalier Universitaire de Nice, Service de Sante Publique, Hopital de l' Archet, 06 - Nice (France); Carrier, P.; Darcourt, J. [Centre Hospitalier Universitaire de Nice, Service de Medecine Nucleaire-centre TEP, Hopital de l' Archet, 06 - Nice (France)


    The aim of this retrospective study was to evaluate the efficacy and the safety of Quadramet and Metastron in 76 patients with painful bone metastases. The analgesic response was evaluated at six weeks, three months and six months. Blood counts performed every week allowed an assessment of the toxicity. The internal radiotherapy reduced the pain in 60% of patients with a complete pain disappearance in 26% and a reduction of analgesic consumption in 67% of them. This study did not show any statistically significant difference between the two treatments. However, we demonstrated that patients with a relatively long survival ({>=} 4 months) had a better analgesic response (73 against 29%, p = 0.0004). The patients with a less than four months survival and those with CIVD and liver metastasis had a higher risk of thrombopenia. This retrospective study suggests that these treatments should be given preferably to treat patients with a relatively tong life expectancy and that the detection of sub-clinic CIVD and liver metastasis could help to avoid severe thrombopenia. (authors)

  1. Stage 1 testicular seminoma; Seminomes testiculaire de stade 1

    Gross, E.; Champetier, C.; Zaccariotto, A.; Duberge, T. [Departement de radiotherapie, hopital de la Timone, 13 - Marseille (France); Pointreau, Y. [Service de radiotherapie, centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hpital Bretonneau, 37 - Tours (France); Chauvet, B. [Institut Sainte-Catherine, 84 - Avignon (France)


    Testicular cancer is rare, representing only 1 % of malignant tumors, but the most common cancer in young men, 15 to 35 years. Adjuvant radiotherapy after orchidectomy in testicular seminoma stage I, reduces risk of relapse. It aims to eradicate micro-metastatic disease in lymph drainage territories. In the case of adjuvant radiotherapy, the relapse-free survival of 96 % with an overall survival of 98 % at 5 years. The irradiation volume is made up of lymph nodes paraaortic which it is possible to add the ipsilateral renal hilum to the testicular lesion. The current recommended dose is 20 Gy in 10 fractions and 2 weeks, usually delivered by two antero-posterior beams. The acute toxicities, mainly represented by nausea and diarrhea are usually quickly resolved to the end of irradiation. Regarding toxicities long-term, preservation of semen should be considered after surgery because of fear of infertility post-treatment. The risk of second cancer associated with exposure to ionizing radiation, albeit small, is especially important to consider these patients to significant life expectancy. Nevertheless, developments in radiotherapy techniques and lower doses and irradiated volumes can probably reduce this risk further. (authors)

  2. Low-dose testicular irradiation in seminoma patients. In-vivo dosimetry; Gonadenbelastung bei Lymphabflussbestrahlung operierter Seminome. In-vivo-Dosimetrie

    Gruber, G.; Schwegler, N. [Kantonsspital Aarau (Switzerland). Abt. Strahlentherapie


    measurements. (orig.) [Deutsch] Hintergrund: Dieser Beitrag soll die Problematik bezueglich Gonadenbelastung bei der Lymphabflussbestrahlung operierter Seminome, eigene Ergebnisse von Schutzmassnahmen sowie moegliche Konsequenzen fuer Therapie und Patientenberatung aufzeigen. Patienten und Methode: Seit November 1993 wurde im Rahmen der `Hockey-stick`-Bestrahlung bei 43 Patienten im Stadium I/II nach Royal Marsden die Gonadendosis mit Hilfe zweier Ionisationskammern in insgesamt 80 Messungen bestimmt, bei sechs Patienten im Direktvergleich mit und ohne Schutz. Die Bestrahlung erfolgte anterior-posterior/posterior-anterior (ap/pa) an einem 6-MV-Linearbeschleuniger bis zu einer Gesamtdosis von 34,2 (n=13), spaeter 30,6 Gy (n=30). Eine Abschirmung, anfaenglich selbst kreiert (n=6), spaeter in Form einer industriell gefertigten Hodenkapsel von ap, wurde 33mal verwendet. Zehn Patienten mit abgeschlossenem Kinderwunsch erhielten keinen Gonadenschutz. Bei sechs konnte ein Direktvergleich mit und ohne Schutz vorgenommen werden. Mit der Anfertigung eines Spermiogramms kurz vor Radiotherapiebeginn erklaerten sich 25 Patienten einverstanden. Ergebnisse: Bei 56% der untersuchten Patienten liess sich eine Oligo- oder Azoospermie vor Radiotherapiebeginn feststellen. Die mittlere Gonadendosis betrug bei Patienten ohne Hodenschutz (n-Patienten=10, m-Messungen=15) rund 2,4% der Referenzdosis (RD) (4,8 cGy), bei Patienten mit dem Eigenbau (n=6, m=7) 1,8% RD (3,2 cGy) und zusaetzlich angelegter Hodenkapsel (n=33, m=58) lediglich 1,0% RD (1,8 cGy) pro Fraktion. Die korrespondierenden Medianwerte betrugen 2,1% (SD 1,07), 1,7% (SD 0,28) und 1,0% (SD 0,41) RD. Aufgrund des Direktvergleichs bei sechs Patienten laesst sich im Normalfall eine Reduktion auf rund die Haelfte erwarten. Individuelle Dosisschwankungen von 11,6% im Mittel (median 10%) muessen dabei beruecksichtigt werden. Schlussfolgerung: Schutzmassnahmen stellen neben einer Abstandserhoehung eine ausgezeichnete Moeglichkeit dar, die

  3. Radiotherapy in early stage dupuytren's contracture; Die Radiotherapie des Morbus Dupuytren im Fruehstadium. Langzeitresultate nach einer medianen Nachbeobachtungszeit von 10 Jahren

    Adamietz, B.; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Keilholz, L. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Praxis fuer Strahlentherapie, Klinikum Fuerth (Germany); Gruenert, J. [Abt. fuer Plastische und Handchirurgie der Chirurgischen Universitaetsklinik Erlangen-Nuernberg, Erlangen (Germany)


    Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [German] Hintergrund: Im Fruehstadium des Morbus Dupuytren wird die externe Radiotherapie mit dem Ziel eingesetzt, den progressiven Verlauf der Erkrankung zu verhindern. Eine aktuelle Langzeitverlaufskontrolle soll die Ergebnisse und Nebenwirkungen der Radiotherapie darstellen. Patienten und Methode: Wir untersuchten 99 Patienten (176 Haende), welche sich von 1982-1994 einer Radiotherapie an unserer Klinik unterzogen. Jeder Patient erhielt zwei Serien einer Radiotherapie mit jeweils 5 x 3 Gy (Gesamtdosis 30 Gy, 120 kV, 4 mm Al, Bestrahlungspause von 6-8 Wochen nach 15 Gy). Die Beugekontraktur wurde nach Tubiana et al. eingeteilt. Von Juli bis November 1999 erfolgte nach einer medianen Nachbeobachtungszeit von 10 Jahren (7-18 Jahre) eine Kontrolluntersuchung. Die

  4. Automatic image segmentation for treatment planning in radiotherapy; Segmentation automatique des images pour la planifi cation dosimetrique en radiotherapie

    Pasquiera, D. [Centre Galilee, polyclinique de la Louviere, 59 - Lille (France); Peyrodie, L. [Ecole des hautes etudes d' ingenieur, 59 - Lille (France); Laboratoire d' automatique, genie informatique et signal (LAGIS), Cite scientifi que, 59 - Villeneuve d' Ascq (France); Denis, F. [Centre Jean-Bernard, 72 - Le Mans (France); Pointreau, Y.; Bera, G. [Clinique d' oncologie radiotherapie, Centre Henry-S.-Kaplan, CHU Bretonneau, 37 - Tours (France); Lartigau, E. [Departement universitaire de radiotherapie, Centre O. Lambret, Universite Lille 2, 59 - Lille (France)


    One drawback of the growth in conformal radiotherapy and image-guided radiotherapy is the increased time needed to define the volumes of interest. This also results in inter- and intra-observer variability. However, developments in computing and image processing have enabled these tasks to be partially or totally automated. This article will provide a detailed description of the main principles of image segmentation in radiotherapy, its applications and the most recent results in a clinical context. (authors)

  5. Radiotherapy

    Rema Jyothirmayi


    Full Text Available Purpose. Conservative treatment in the form of limited surgery and post-operative radiotherapy is controversial in hand and foot sarcomas, both due to poor radiation tolerance of the palm and sole, and due to technical difficulties in achieving adequate margins.This paper describes the local control and survival of 41 patients with soft tissue sarcoma of the hand or foot treated with conservative surgery and radiotherapy. The acute and late toxicity of megavoltage radiotherapy to the hand and foot are described. The technical issues and details of treatment delivery are discussed. The factors influencing local control after radiotherapy are analysed.

  6. Radiotherapy of cutaneous lymphoma other than mycosis fungoides. Radiotherapie des lymphomes cutanes autres que le mycosis fongoide

    Ma, L.; Calitchi, E.; Levy, E.; Mazeron, J.J.; Le Bourgeois, J.P. (Hopital Henri-Mondor, 94 - Creteil (France))


    For cutaneous lymphoma (other than mycosis fungoides) in the early states, radiotherapy, whole-body electron irradiation included, may induced total remissions. As a palliative (state 4), a local irradiation allows a transitory control of cutaneous lesions. (A.B.). 4 refs., 1 tab.

  7. Blood volume changes after radiotherapy of the CNS; Blutvolumenveraenderungen nach Strahlentherapie des zentralen Nervensystems

    Wenz, F. [Radiologische Universitaetsklinik, Heidelberg (Germany); Fuss, M. [Radiologische Universitaetsklinik, Heidelberg (Germany); Scholdei, R. [Radiologische Universitaetsklinik, Heidelberg (Germany); Essig, M. [Abt. Onkologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Lohr, F. [Radiologische Universitaetsklinik, Heidelberg (Germany); Rempp, K. [Abt. Klinische Neuroradiologie, Univ. Heidelberg (Germany); Brix, G. [Abt. Biophysik und Medizinische Strahlenphysik, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Knopp, M.V. [Abt. Onkologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Engenhart, R. [Radiologische Universitaetsklinik, Heidelberg (Germany); Wannenmacher, M. [Radiologische Universitaetsklinik, Heidelberg (Germany)


    The pathogenesis of late delayed radiation damage in normal brain tissue is most likely due to damage to the vascular endothelium. The mitotic activity of gliomas was shown to correlate with the tumor induced angiogenesis. Dynamic susceptibility contrast MR imaging (DSC MRI) allows the measurement of the cerebral hemodynamics based on the indicator dilution theory. We describe theory and technique of the method and present our experience with blood volume measurements after irradiation of the CNS. We established a double slice technique on a standard 1.5 T MR system without hardware modifications, which allows an absolute quantification of the blood volume in regions of interest (ROI) within the brain. Fifty-five T2* weighted double slice images were acquired before, during and after bolus injection of Gd-DTPA (0.1 mmol/kg in 5 sec.) using a SD FLASH sequence (simultaneous dual fast low angle shot, TR/TE1/TE2 31/16/25, flip angle 10 ). Concentration-time curves were calculated from the measured signal-time curves. Blood volume values in tissue were normalised and calculated in absolute values (ml/100 g) based on the knowledge of the arterial input function (AIF), which was measured in the brain supplying arteries. The whole procedure requires only 2 to 3 minutes, the time for post processing is about 15 to 20 minutes. Blood volume parameter images of representative cases demonstrate the blood volume changes after radiotherapy. A reduction in blood volume could be observed in normal brain tissue and low-grade gliomas, while recurrent tumors were accompanied by a local increase in blood volume. Radiation induced blood volume changes in the CNS can be measured using dynamic susceptibility contrast MR imaging. The measurements in normal brain tissue allow a functional in-vivo analysis of late delayed radiation reactions of the CNS. (orig.) [Deutsch] Die Pathogenese von Strahlenspaetfolgen am Gehirn wird auf eine Schaedigung der Gefaessendothelien zurueckgefuehrt. Die

  8. The significance of radiotherapy in a multidisciplinary treatment approach of bladder cancer. Die Radiotherapie im interdisziplinaeren Behandlungskonzept des Harnblasenkarzinoms

    Dunst, J. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik)


    Bladder cancer accounts for approximately 3% of all malignancies. About 70% of bladder cancers are superficial tumors (Ta, Tis, T1), the remaining 30% are muscleinvasive (T2-4). Important prognostic factors include TNM-stage, histologic grade, multifocality, associated Tis, and residual tumor after TUR. Superficial cancers are managed by TUR and, if necessary, intravesical chemotherapy, and bladder preservation is possible. In case of T1 G3-cancers, we favour TUR plus irradiation with a moderate dose instead of cystectomy. Even advanced bladder cancers may be treated by an organ sparing approach. TUR plus radiotherapy or radiochemotherapy offer comparable survival figures and local control rate as compared to radical cystectomy. The 5-year survival rates are 60-70% for T1-2, 40% for T3, and 15% for T4-tumors. About 70% of long-term survivors maintain a functioning bladder. Radiochemotherapy (RCT) with platin compounds is equally effective but less toxic as compared to multi-agent chemotherapy or intraarterial administrations. We do not recommend preoperative radiotherapy or RCT with planned cystectomy because of the definitive organ loss. Optimal treatment results are achieved by complete TUR prior to irradiation. Persistent or recurrent tumor after radiotherapy requires salvage cystectomy. Intravesical recurrences in the spared bladder have a good prognosis. Adjuvant chemotherapy of bladder cancer is not established. Neoadjuvant chemotherapy may result in 20-30% complete remissions, but these figures are lower than those after radiotherapy or radiochemotherapy. Nevertheless, adjuvant treatment protocols are necessary because of the fact that even sophisticated local treatment with increased local control has not yet improved the overall survival rates. (orig./MG).

  9. Radiotherapy of maxillary sinuses carcinoma: state of art; Radiotherapie des carcinomes des sinus maxillaires: l'etat de l'art

    Chargari, C.; Bauduceau, O.; Vedrine, L.; Fayolle, M.; Ceccaldi, B. [Hopital d' Instruction des Armees Val-de-Grace, Service d' Oncologie Radiotherapie, 75 - Paris (France); Chargari, C.; Magne, N. [Institut Gustave-Roussy, Dept. de Radiotherapie, 94 - Villejuif (France); Haen, P. [Hopital d' Instruction des Armees Begin, Service de Chirurgie Maxillofaciale et Plastique de la Face, 94 - Vincennes (France); Conessa, C. [Hopital d' Instruction des Armees Val-de-Grace, Clinique d' Otorhinolaryngologie et de Chirurgie Cervicofaciale, 75 - Paris (France)


    Maxillary sinus carcinomas are rare malignancies of the face, characterized by high local relapsing rate. Modalities of treatment are without consensus and respective roles of radiation therapy and surgery remain controversial. As those malignancies are often diagnosed at locally advanced stage, radiation therapy may frequently be used for patients having unresectable advanced disease. Nevertheless, surgery remains treatment of choice for more localized malignancies, in association with systematic postoperative radiotherapy. For those patients whose prognosis remains pejorative, it is necessary to precise the role of radiotherapy in first intention for inoperable tumors, to define necessity for nodal treatment performing and evaluate the place of neo-adjuvant or concomitant chemotherapy in a multimodal strategy. (authors)

  10. Radiotherapy for glioblastomas: from radiobiology to concomitant chemotherapy; Radiotherapie des glioblastomes: de la radiobiologie a la chimiotherapie concomitante

    Simon, J.M.; Toubiana, T.; Lang, P.; Taillibert, S.; Mazeron, J.J. [Groupe Hospitalier Pitie-Salpetriere, Assistance Publique-Hopitaux de Paris, Service d' Oncologie Radiotherapique, 75 - Paris (France); Taillibert, S. [Groupe Hospitalier Pitie-Salpetriere, Assistance Publique-Hopitaux de Paris, Federation de Neurologie Mazarin, 75 - Paris (France)


    Primary signet ring cell carcinoma of urinary bladder is a rare tumor; accounting for approximately 0,24% of all bladder malignancies. In this study, we report a case of a 58-year old man who consulted for complaints of gross hematuria, the bladder biopsied showed signet ring cell carcinoma; the exploration of gastrointestinal tract did not reveal any other tumor localizations. A total cysto-prostatectomy was performed followed by radiotherapy. The aim of this study is to determine the anatomo-clinical, therapy and evolution characteristics of this rare tumor. (authors)

  11. External beam radiotherapy for basal cell carcinoma. Local control and cosmetic outcome; Strahlentherapie des Basalzellkarzinoms. Lokale Kontrolle und kosmetisches Ergebnis

    Seegenschmiedt, M.H.; Oberste-Beulmann, S.; Guntrum, F.; Olschewski, T. [Krankenhaus Essen (Germany). Klinik fuer Radioonkologie, Strahlentherapie und Nuklearmedizin; Lang, E.; Lang, B. [Praxis fuer Dermatologie, Essen (Germany)


    in kosmetisch unguenstiger Lokalisation stellt die perkutane Radiotherapie eine ebenso gute Therapieform dar. Patienten und Methode: Von 1986 bis 1999 wurden 60 Frauen und 39 Maenner mit 127 histologisch gesicherten Basaliomen primaer bestrahlt. Die Tumoren lagen meistens im Gesichtsbereich an Schlaefe, Nase und Stirn. Die Radiotherapie erfolgte am Orthovoltgeraet mit Energien bis 100 kV. Die Einzeldosis schwankte zwischen 2 und 5 Gy bezogen auf die 80%-Isodosentiefe; die Wochendosis betrug 8-25 Gy und die Gesamtdosis 25-60 Gy. Die Nachbeobachtung des Kollektivs betrug im Mittel 36{+-}21 Monate. Die akuten Nebenwirkungen wurden nach CTC-Kriterien und die radiogenen Spaetfolgen als Einzelereignisse bezogen auf das Bestrahlungsfeld beurteilt. Ergebnisse: Bis auf einen Patienten erzielten alle (99%) 3 Monate nach Therapieabschluss eine komplette Tumorremission (CR). Bei allen Faellen wurde eine akute Strahlenreaktion im Bestrahlungsfeld beobachtet: CTC-Grad 1 in 100%, CTC-Grad 2 in 54% und CTC-Grad 3 in 30% der Faelle. Alle Nebenwirkungen heilten unter einfachen lokalen Massnahmen komplikationslos ab. Spaetfolgen traten nur in drei Faellen (3%) auf. Das kosmetische Gesamtergebnis war bei allen bis auf zwei Patienten (98%) gut bis ausgezeichnet. Bei zwei Faellen (2%) kam es zu einem Lokalrezidiv 6 bzw. 20 Monate nach Ende der Strahlentherapie. Schlussfolgerung: Die perkutane Radiotherapie erzielt sehr gute Tumorkontrollraten und ein gutes kosmetisches Ergebnis im Langzeitverlauf. Die von Dermatologen gepraegte empirische Dosisverschreibung muss in Zukunft des strahlenphysikalischen ICRU-Dosisverschreibung und den neuen radiobiologischen Erkenntnissen zur Fraktionierung Rechnung tragen. (orig.)

  12. Intensity-modulated radiotherapy for cancers in childhood; Radiotherapie conformationnelle par modulation d'intensite des tumeurs pediatriques

    Leseur, J.; Le Prise, E. [Centre Eugene-Marquis, Service de Radiotherapie, 35 - Rennes (France); Leseur, J.; Carrie, C.; Beneyton, V. [Centre Leon-Berard, Service de Radiotherapie, 69 - Lyon (France); Bernier, V. [Centre Alexis-Vautrin, Service de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Beneyton, V. [Centre Paul-Strauss, Service de Radiotherapie, 67 - Strasbourg (France); Mahee, M.A.; Supiot, S. [Centre Rene-Gauducheau, Service de Radiotherapie, 44 - Nantes - Saint-Herblain (France)


    Approximately 40-50% of children with cancer will be irradiated during their treatment. Intensity-modulated radiotherapy (I.M.R.T.) by linear accelerator or helical tomo-therapy improves dose distribution in target volumes and normal tissue sparing. This technology could be particularly useful for pediatric patients to achieve an optimal dose distribution in complex volumes close to critical structures. The use of I.M.R.T. can increase the volume of tissue receiving low-dose radiation, and consequently carcinogenicity in childhood population with a good overall survival and long period of life expectancy. This review will present the current and potential I.M.R.T. indications for cancers in childhood, and discuss the benefits and problems of this technology aiming to define recommendations in the use of I.M.R.T. and specific doses constraints in Pediatrics. (authors)

  13. Virtual bolus for inversely planned intensity modulated radiotherapy in adjuvant breast cancer treatment; Virtueller Bolus zur inversen Bestrahlungsplanung bei intensitaetsmodulierter Radiotherapie des Mammakarzinoms im Rahmen der adjuvanten Therapie

    Thilmann, C.; Grosser, K.H.; Rhein, B.; Zabel, A. [Deutsches Krebsforschungszentrum Heidelberg (Germany). Klinische Kooperationseinheit Strahlentherapie; Wannenmacher, M. [Heidelberg Univ. (Germany). Klinische Radiologie; Debus, J. [Deutsches Krebsforschungszentrum Heidelberg (Germany). Klinische Kooperationseinheit Strahlentherapie; Heidelberg Univ. (Germany). Klinische Radiologie


    Background: Intensity modulated radiotherapy (IMRT) provides better sparing of normal tissue. We investigated the feasibility of inverse treatment planning for IMRT in adjuvant radiotherapy for breast cancer. Material and Methods: In addition to radiotherapy planning in conventional technique with tangential wedged 6-MV-photon beams we performed inversely planned IMRT (KonRad trademark). In the CT scans for treatment planning we defined a 10-mm bolus of -60 HE density. The influence of this bolus on planning optimization was determined by optimization without and dose calculation with and without bolus. Dose calculation after dose optimization with bolus was performed using different bolus thickness to determine the influence of the bolus on dose calculation. The results were compared with dose distribution in conventional technique. Results: Inverse optimization with a dose algorithm which considers tissue inhomogeneity results in unintended dose increase at the patient surface. With a virtual 10-mm bolus used for inverse optimization the dose increase was reduced. Thus, skin sparing was identical to conventional planning. The relative dose distribution was negligibly affected by the use of a 10-mm bolus. Difference in absolute dose was 3.4% compared to calculation without bolus. Therefore, the bolus must be removed before final dose calculation. (orig.) [German] Fragestellung: Die intensitaetsmodulierte Strahlenbehandlung (IMRT) verspricht eine verbesserte Schonung von Risikostrukturen. Wir untersuchten, in welcher Form eine inverse Bestrahlungsplanung zur IMRT der Restbrust beim Mammakarzinom durchfuehrbar ist. Methodik: Neben einer Bestrahlungsplanung in konventioneller Technik mit tangentialen 6-MB-Keilfilter-Feldern wurde eine IMRT-Bestrahlungsplanung mit inverser Planoptimierung (KonRad trademark) durchgefuehrt. Im Planungs-CT wurde ein Bolus von 10 mm Dicke und einer Dichte von -60 HE definiert. Der Einfluss des Bolus auf die Planoptimierung wurde bestimmt

  14. Conformal radiotherapy of locally advanced bile duct carcinoma; Radiotherapie conformationnelle des cholangiocarcinomes de la voie biliaire principale localement evolues

    Bouras, N.; Caudry, M.; Bonnel, C.; Trouette, R.; Demeaux, H.; Maire, J.P. [Centre Hospitalier Universitaire, Hopital Saint-Andre, Service de Radiotherapie, 33 - Bordeaux (France); Saric, J.; Rullier, E. [Centre Hospitalier Universitaire, Hopital Saint-Andre, Service de Chirurgie Viscerale et de Transplantation Hepatique, 33 - Bordeaux (France)


    Purpose. - Retrospective study of 23 patients treated with conformal radiotherapy for a locally advanced bile duct carcinoma. Patients and methods. - Eight cases were irradiated after a radical resection (RO), because they were N+; seven after microscopically incomplete resection (R1) ; seven were not resected (R2). A dose of 45 of 50 Gy was delivered, followed by a boost up to 60 Gy in R1 and R2 groups. Concomitant chemotherapy was given in 15 cases. Results.-Late toxicity included a stenosis of the duodenum, and one of the biliary anastomosis. Two patients died from cholangitis, the mechanism of which remains unclear. Five patients are in complete remission, six had a local relapse, four developed a peritoneal carcinosis, and six distant metastases. Actuarial survival rate is 75%, 28% and 7% at 1, 3 and 5 years, respectively (median: 16.5 months). Seven patients are still alive with a 4 to 70 months follow-up. Survival is similar in the 3 small subgroups. The poor local control among RON+ cases might be related to the absence of a boost to the 'tumor bed'. In R1 patients, relapses were mainly distant metastases, where'as local and peritoneal recurrences predominated in R2. Conclusion. - Conformal radio-chemotherapy delivering 60 Gy represents a valuable palliative approach in locally advanced biliary carcinoma. (authors)

  15. Treatment modalities of oral mucositis after radiation of head and neck cancers; Prise en charge des mucites apres radiotherapie des cancers des voies aerodigestives superieures

    Lapeyre, M.; Charra-Brunaud, C.; Kaminsky, M.C.; Geoffrois, L.; Dolivet, G.; Pourel, N.; Marchal, C.; Bey, P.; Maire, F.; Simon, M. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Toussaint, B. [Hopital Central, Service de Chirurgie ORL, 54 - Nancy (France)


    Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

  16. Irradiation of low rectal cancers; Radiotherapie des carcinomes du bas rectum

    Ardiet, J.M.; Coquard, R.; Romestaing, P.; Fric, D.; Baron, M.H.; Rocher, F.P.; Sentenac, I.; Gerard, J.P. [Centre Hospitalier Lyon-Sud, 69 -Pierre-Benite (France)


    The low rectal cancers are treated by anorectal amputation and pose the problem of the sphincter conservation. Some authors extend the clinical definition to developed injuries until 12 cm from the anal margin. The rectal cancer is a frequent tumour which remains serious. When the tumour is low, the treatment consists in an anorectal amputation with a permanent colostomy. The radical non preserving surgery is the usual treatment of these injuries. Until 1960 the rectal adenocarcinoma was considered as a radioresistant tumour because of the impossibility to deliver an enough dose to the tumour by external radiotherapy. But other studies showed that those lesions were radiosensitive and often radiocurable. The medical treatments haven`t yet demonstrated their efficiency in the treatment of the rectal cancer. We`ll study the radiotherapy in the treatment of the low rectal cancer, solely radiotherapy, radiosurgical associations. 32 refs., 5 tabs.

  17. Radiotherapy of brain metastases from lung cancer. Strahlentherapie von Hirnmetastasen des Bronchialkarzinoms

    Nieder, C. (Radiologische Universitaetsklinik der Univ. des Saarlandes, Homburg/Saar (Germany). Abt. fuer Strahlentherapie); Niewald, M. (Radiologische Universitaetsklinik der Univ. des Saarlandes, Homburg/Saar (Germany). Abt. fuer Strahlentherapie); Schnabel, K. (Radiologische Universitaetsklinik der Univ. des Saarlandes, Homburg/Saar (Germany). Abt. fuer Strahlentherapie)


    Purpose: The data of 132 patients who were treated between 1983 and 1992 because of cerebral metastases from lung cancer were retrospectively analysed, in order to find criteria for patients selection to radiotherapy with simultaneous application of corticosteroids. Methods: Radiotherapy was given either in 10 fractions of 3 Gy over 2 weeks (97 patients) or in 20 fractions of 2 Gy over 4 weeks (35 patients), always in form of a whole-brain irradiation. Before and during radiotherapy dexamethasone was administered. Results: The local remission rate was 56% for both treatment schedules. In cases with a complete remission median survival was significantly longer compared with partial remission or no change. The median survival of the whole group was 4 months. Patients with extracerebral metastases and a Karnofsky-score <7 or brain metastases [>=]2,5 cm had a median survival of only 2 months, whereas patients with only brain metastases and a Karnofsky-score [>=]7 or brain metastases <2,5 cm had a median survival of 6 months. 11% of the patients were asymptomatic. A symptomatic relief, additional to the effect of corticosteroid therapy, was found in 43% of cases, which was dependent on local remission and tendencially on dose of corticosteroids. In a multivariate analysis performance status, extracerebral metastases, and size of cerebral metastases were found to be prognostic parameters. Conclusion: Radiotherapy with 10x3 Gy seems to be appropriate for the majority of patients, when expense and hospitalisation time are compared with results and benefit. Selected patients may profite from a more aggressive treatment approach. In some cases radiotherapy may be an unsuitable overtreatment. (orig.)

  18. A cooperative building up of care security: patient participation to risk management in radiotherapy; Co-construire la securite des soins: la participation des patients a la gestion des risques en radiotherapie

    Pernet, A.; Mollo, V. [Laboratoire d' ergonomie, Centre de recherche sur le travail et le developpement, CRTD-EA 4132, 75 - Paris (France); Giraud, P. [Service d' oncologie radiotherapie, Hopital europeen Georges-Pompidou, 75 - Paris (France); Universite Paris Descartes, 75 - Paris (France)


    Based on observations of radiotherapy consultations, interviews of professionals (physicians and operators), of ex-patients and patients under treatment, and on analysis of questionnaires sent to patients, this study aimed at understanding how, and to which levels, participation of patients can optimize risk management. It outlines the major role of therapeutic information and education of patients, but also of health professionals, in order to reach a shared cooperative management of cares. Short communication

  19. Post irradiation eardrum: a rare complication of the radiotherapy of naso-pharynx carcinomas; Necrose tympanique postradique: une complication rare de la radiotherapie des carcinomes nasopharynges

    Siala, W.; Mnejja, W.; Daoud, J. [CHU Habib-Bourguiba, Service de Radiotherapie Oncologique, Sfax (Tunisia); Khabir, A. [CHU Habib-Bourguiba, Service d' Anatomopathologie, Sfax (Tunisia); Ghorbel, A. [CHU Habib-Bourguiba, Service d' ORL, Sfax (Tunisia); Frikha, M. [CHU Habib-Bourguiba, Service d' Oncologie Medicale, Sfax (Tunisia)


    The eardrum necrosis is a serious and dreadful complication but rarely described after irradiation of cavum cancers. We report in this work five cases of eardrum necrosis after radiotherapy of nasopharynx carcinomas. Patients and methods: between february 1993 and december 2004 239 patients suffering of anon metastatic nasopharynx cancer have been treated by classical irradiation associated or not to a chemotherapy. The radiotherapy was delivered at the dose of 70 to 75 Gy in the cavum and the ganglions initially reached according a classical modality of hyperfractionated one. We analysed retrospectively the delayed complications occurred six months or more after the radiotherapy beginning. Results: Five cases of eardrum necrosis were reported sixty five months after the end of radiotherapy. these patients suffered of hypoacusia and buzzing. The clinical examination allowed to bring out the eardrum perforation that did not exist before radiotherapy. The total dose of irradiation was 75 Gy for a patient and 71.5 Gy according a hyperfractionated modality for four patients. Three patients had an hearing prosthesis in order to improve their quality of life. Conclusion: the eardrum necrosis after radiotherapy for nasopharynx cancer is a rare and unusual complication, very few reported in the literature. The total dose of irradiation is considered as the principal factor of occurrence risk in such complication. (N.C.)

  20. Choanal stenosis: a rare complication of radiotherapy for nasopharyngeal carcinoma; Stenose choanale post-radique: une complication rare de la radiotherapie des carcinomes nasopharynges

    Bonfils, P.; Preobrajenski, N. de [Universite Rene-Descartes, Hopital Europeen Georges-Pompidou, Service d' ORL et de Chirurgie Cervicofaciale, Faculte de Medecine Paris-Descartes, 75 - Paris (France); Florent, A. [Cabinet d' ORL, 75 - Paris (France); Bensimon, J.L. [Cabinet de radiologie, 75 - Paris (France)


    Choanal stenosis is usually a congenital anomaly in children. Acquired choanal stenosis after radiotherapy for nasopharyngeal carcinoma is a very rare pathology; only two publications report seven cases in the literature. We describe the clinical history, preoperative evaluation, surgical treatment and outcome of a case of acquired choanal stenosis after radiotherapy. The patient, a 56-year-old woman, presented with a history of nasopharyngeal carcinoma (T2- NO-MO) one year before that had been successful treated with radiotherapy (68 Gy). At the end of radiotherapy, she complained of complete nasal obstruction, anosmia and hearing loss due to a bilateral serous otitis media. Bilateral complete choanal stenosis was confirmed by endoscopy and CT scan. Functional endoscopic surgery was performed, and nasal stents were left in place for 3 weeks. One year after, the patient have good airflow, and a patent nasopharynx without choanal stenosis. In conclusion, choanal stenosis is an unusual complication of radiotherapy that can be successfully treated with trans-nasal endoscopic resection. (authors)

  1. Concurrent radiotherapy and fotemustine for brain metastases of non small cell cancer of the lung. Association concomitante de radiotherapie et de fotemustine dans le traitement des metastases cerebrales des cancers du poumon non a petites cellules

    Pignon, T.; Ruggieri, S.; Orabona, P.; Muracciole, X.; Juin, P. (Hopital de la Timone, 13 - Marseille (France)); Astoul, P.; Vialette, J.P.; Boutin, C. (Hopital de la Conception, 13 - Marseille (France))


    The radiotherapy is the most employed in the treatment of cerebral metastases, even if results are deceptive. The tests with chemotherapy are not better and the nitrosoureas remain the most employed drugs. The fotemustin is a new one which can give good results for bearing cerebral metastases patients's response. The associations radiotherapy and chemotherapy are developing to potentiate radiotherapy action but are still a little studied in the cases of cerebral metastases; that is why we choose to treat in an open study the patients bearers of cerebral metastases in lungs cancers with no little cells. 18 refs.

  2. Systematic review of stereotactic radiotherapy for high-grade gliomas; Radiotherapie en conditions stereotaxiques des gliomes de haut grade: une revue de la litterature

    Clavier, J.B.; Noel, G. [Departement de radiotherapie, centre de lutte contre le cancer Paul-Strauss, 67 - Strasbourg (France); Voirin, J.; Kehrli, P. [Service de neurochirurgie, hopital de Hautepierre, 67 - Strasbourg (France)


    The purpose of this literature systematic review was the use of stereotactic radiotherapy in glioma. Research was performed in Medline/PubMed and associated references found in published articles without publication date limit. The quality of series is variable and many biases can be evidenced. Only two randomized trials have been published using stereotactic radiotherapy for up-front treatment. There is a lack of evidence of survival advantages to use this treatment at the time of diagnosis or relapse. There is also insufficient evidence regarding the benefice/harms in the use of stereotactic fractionated radiation therapy for patients with glioma. No recommendations can be formulated. Stereotactic irradiation as boost in primary diagnosed glioma or relapsed tumour is not associated with survival improvement. For relapsed patients, treatment needs to be discussed according to the other treatment options. (authors)

  3. Palliative radiotherapy for hematuria complicating the local evolution of primitive bladder cancers; Radiotherapie palliative pour hematurie compliquant l'evolution locale des cancers primitifs de vessie

    Saillard, S.M.; Benyoucef, A.; Dubray, B. [Centre Henri-Becquerel, 76 - Rouen (France); Smaali, C.; Albouy, B.; Pfister, C.; Grise, P. [Centre hospitalier universitaire, 76 - Rouen (France)


    As a haemostatic irradiation is often proposed to patients suffering from a primitive bladder cancer, the authors report a retrospective mono-centric analysis of the effects of an external bi-dimensional palliative radiotherapy on patients taken into care for relapsing macroscopic hematuria after failure of local urological treatments. The assessment concerns the hematuria persistence, the interval without hematuric relapse, global survival, and transfusion needs. Based on a sample of 21 patients submitted to different irradiation schemes, the authors notice that a simple pelvic irradiation technique results in a fast symptomatic improvement of hematuria among fragile patients. Short communication

  4. Combined hormonal deprivation and radiotherapy in non-metastatic cancer of prostate; Hormono-radiotherapie des cancers de la prostate non metastatiques

    Richaud, P. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, Service de Radiotherapie, 33 - Bordeaux (France); Mazeron, J.J. [Hopital Pitie-Salpetriere, Centre des Tumeurs, Service de Radiotherapie, 75 - Paris (France)


    Patients presenting with non-metastatic cancer of prostate have a high probability of relapse if they are treated by either surgery alone or irradiation alone, when poor prognosis factors are present. Clinical stage ({>=}T3a), Gleason score, and PSA level ({>=}20 ng/mL) are the more significant factors. It is likely that many patients can draw benefit of combined androgenic suppression and radiotherapy. However, despite results of European and American trials published the last decade, a number of questions remain without a clear response, especially on the modalities of treatment according to the characteristics of the disease. (author)

  5. Automatic definition of targeted biological volumes for the radiotherapy applications; Definition automatique des volumes biologiques cibles pour les applications de radiotherapie

    Hatt, M.; Visvikis, D. [LaTIM, U650 Inserm, 29 - Brest (France); Cheze-Le-Rest, C. [Service de medecine nucleaire, 29 - Brest (France); Pradier, O. [Service de radiotherapie, 29 - Brest (France)


    The proposed method: Fuzzy locally adaptive Bayesian (F.L.A.B.) showed its reliability and its precision on very complete collection of realistic simulated and real data. Its use in the context of radiotherapy allows to consider easily the studies implementation and scenari of dose painting or dose escalation, including in complex cases of heterogenous fixations. It is conceivable to apply F.L.A.B. on PET images with F.M.I.S.O. ({sup 18}F fluoro misonidazole) or F.L.T. (fluoro-L-thymidine) to complete the definition of the biological target volume. (N.C.)

  6. Adjuvant radiotherapy in patients with endometrial cancers; Place de la radiotherapie dans la prise en charge postoperatoire des patientes atteintes de cancer de l'endometre

    Mazeron, R.; Monnier, L.; Belaid, A.; Berges, O.; Haie-Meder, C. [Service de curietherapie, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif cedex (France); Morice, P. [Service de chirurgie gynecologique, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif cedex (France); Pautier, P. [Service d' oncologie medicale, Institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif cedex (France)


    The treatment of patients with endometrial cancer has been extensively modified in recent years. Several randomized studies have redefined the indications for adjuvant therapy in tumours staged 1. In the absence of poor prognostic factors, the management tends to be less aggressive than before, often limited to vaginal brachytherapy. Conversely, for more advanced lesions, for which prognosis is poor, combinations of chemo-radiation are currently being evaluated. This literature review aims to provide an update on recent developments in the management of adjuvant radiotherapy for endometrial carcinoma. (authors)

  7. Are lymphangiograms necessary for patients with seminomatous testicular tumor. Ist die Lymphographie beim Seminom noch aktuell

    Kampen, M. van (Klinikum Nuernberg (Germany). Abt. Strahlentherapie); Andreas, P. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik); Renner, H. (Klinikum Nuernberg (Germany). Abt. Strahlentherapie)


    In the radiotherapist's point of view lymphography and computed tomography scan compete for staging and therapy planning of testicular seminoma. We investigated whether lymphogram can be replaced by computed tomography scan. 114 patients with histologically confirmed seminoma of the testis were treated by radiotherapy from 1978 through 1991. Radiological staging included both computed tomography scan and lymphography in all cases. The results of both methods were similar in 79%. Computed tomography scan led to an upstaging in 4% while lymphography was negative. 17% of the patients showed negative results considering computed tomography scan while lymphogram was positive. In accordance with these data treatment portals or doses were altered in 21%. Using the M.D. Anderson Hospital clinical staging system a stage IIa is not safely identified by computed tomography scan. Just lymphography can safely identify a stage IIa patient. On the other hand, lymphography shows a very high amount of false positive interpretations. However, two conclusions are made: 1. Using a conventional technic (radiation of paraaortal and ipsilateral iliacal region, dose about 30 Gy HD) lymphogram can be superseded by computed tomography scan. 2. In the case of reducing treatment volume and/or dose lymphogram should be added to computed tomography scan. (orig./MG)

  8. Outcome of radiation biology in radiotherapy. Past and future directions; Applications cliniques des recherches en radiobiologie. Etat des lieux et perspectives

    Hennequin, C. [Hopital Saint-Louis, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Favaudon, V. [Centre Universitaire d' Orsay, Institut Curie, Section de Recherche, Lab. Raymond-Latarjet, Unite 350 Inserm, 91 (France)


    Over the last ten years the impact of fundamental radiation biology into daily radiotherapy has been of concern chiefly to fractionation, prediction of radiation response, tumour oxygenation, intrinsic radiosensitivity including genetic approaches, and the determinants of the outcome of chemoradiotherapy combinations. Future goals will rely on sophisticated approaches, based on the progress of molecular and cellular biology and the characterization of new targets for radiation. Some of these novel advances will be discussed. (authors)

  9. Interest of FDG-PET for lung cancer radiotherapy; Interet de la TEP au FDG pour la radiotherapie des cancers bronchiques

    Thureau, S.; Mezzani-Saillard, S.; Dubray, B. [Departement de radiotherapie et de physique medicale et QuantIF - Litis, EA 4108, CRLCC Henri-Becquerel, 1, rue d' Amiens, 76038 Rouen (France); Modzelewski, R.; Edet-Sanson, A.; Vera, P. [Departement de medecine nucleaire et QuantIF - Litis, EA 4108, CRLCC Henri-Becquerel, 1, rue d' Amiens, 76038 Rouen (France)


    The recent advances in medical imaging have profoundly altered the radiotherapy of non-small cell lung cancers (NSCLC). A meta-analysis has confirmed the superiority of FDG PET-CT over CT for initial staging. FDG PET-CT improves the reproducibility of target volume delineation, especially close to the mediastinum or in the presence of atelectasis. Although not formally validated by a randomized trial, the reduction of the mediastinal target volume, by restricting the irradiation to FDG-avid nodes, is widely accepted. The optimal method of delineation still remains to be defined. The role of FDGPET-CT in monitoring tumor response during radiotherapy is under investigation, potentially opening the way to adapting the treatment modalities to tumor radiation sensitivity. Other tracers, such as F-miso (hypoxia), are also under clinical investigation. To avoid excessive delays, the integration of PET-CT in routine practice requires quick access to the imaging equipment, technical support (fusion and image processing) and multidisciplinary delineation of target volumes. (authors)

  10. Primary and secondary prevention of acute complications of radiotherapy of head and neck cancers; Prevention primaire et secondaire des complications aigues de la radiotherapie des cancers de la tete et du cou

    Lambrexhe, M.; Frederick, B.; Burie, D.; Cavuto, C.; Rob, L.; Rasquin, I.; Coiffier, N.; Untereiner, M. [Centre national de Radiotherapie, Centre Francois-Baclesse (CFB), Esch-sur-Alzette (Luxembourg)


    Purpose: the standard treatment of head and neck cancers associates a 70 Gy irradiation and weekly concomitant chemotherapy by 5-fluoro-uracils and cisplatin or targeted therapy by Erbitux. A retrospective study realised at the Francois Baclesse center in 2004-2005 for 84 patients suffering of ear-nose-throat cancers whom treatment was a concomitant chemoradiotherapy, showed the noxious effects of the treatment on the patients nutritional situation: weight loss for 90% of patients; temporary interruption or definitive stop of radiotherapy for 28% of patients. based on this observation, a preventive approach of the nutritional risk was implemented. The objective was to reduce the malnutrition risk linked to radiotherapy associated to chemotherapy or to the targeted therapy. (N.C.)

  11. Can or must the patient participate to risk management in radiotherapy?; Le patient peut-il et doit-il participer a la gestion des risques en radiotherapie?

    Mollo, V.; Pernet, A. [Laboratoire d' ergonomie, centre de recherche sur le travail et le developpement - CRTD-EA 4132, Conservatoire national des arts et metiers - Cnam, 41, rue Gay-Lussac, 75005 Paris, France (France); Moutel, G. [Universite Paris Descartes, 12, rue de l' ecole-de-Medecine, 75270 Paris cedex 06 (France); Unite de medecine sociale et d' ethique medicale, hopital Corentin-Celton, 4, parvis Corentin-Celton, 92133 Issy-les-Moulineaux cedex, France (France); Duchange, N. [Laboratoire d' ethique medicale et de medecine legale, universite Paris Descartes, 45, rue des Saints-Peres, 75006 Paris (France); Giraud, P. [Universite Paris Descartes, 12, rue de l' ecole-de-Medecine, 75270 Paris cedex 06 (France); Service d' oncologie radiotherapie, hopital europeen Georges-Pompidou (HEGP), 20, rue Leblanc, 75015 Paris (France)


    Purpose. - The present study aimed at analyzing if patient participation constitutes a promising way of improvement of patient safety, or not. The hypothesis is that patient participation is a means to develop a safety culture based on the cooperation between patients and health care providers, to improve patients' satisfaction and to reduce the costs associated to adverse events. Patients and methods. - A half-day session was organized on this theme during a training of radiotherapy professionals on risk management. Professionals were first distributed in three subgroups according to their specialty (radiation oncologists, radiation physicists and medical technicians), and had to work on four main questions relating to participation, among which the collection of real situations in which patients effectively contributed (positively or negatively) to patient safety. Results were then collectively discussed. Results. - Patient participation allows not only to detect and recover some mistakes or errors made by the professionals (error of identity), but also to decrease patients' risk behaviors (purposely taking the place of another patient in order to be treated faster). However, it must be seen as a possibility offered to patients, and not as an obligation. Conclusion. - Patient participation to patient safety is a field of study, which requires to be developed in order to define the conditions enhancing such participation and to implement a set of actions to improve health care safety by a cooperative management of this one. (authors)

  12. Molecular signature of the radioinduction in the thyroid tumors developed after radiotherapy; Signature moleculaire de la radio-induction dans des tumeurs de la thyroide developpees apres radiotherapie

    Mallard, Ch.


    Several epidemiological studies enlightens an increase of the number of thyroid cancers among children and adolescents exposed to ionizing radiation after an internal exposure ( Chernobylsk accident) or external one as a radiotherapy. No increase arose for adults.The analysis of the transcriptome was realised with micro arrays prepared on the genomic platform of the Cea at Evry that allow to study simultaneously the expression of 6000 genes. this study allows to enlighten a signature of radioinduction constituted by series of genes specifically expressed in one or other type of cancer in function of its etiology. This signature includes 59 genes expressed differentially between the sporadic carcinomas and 45 genes in the case of adenomas. with this signature an analysis in principal components allowed to determine correctly the etiology of 12 tumors among 13, the etiology of a sporadic adenoma was not determined. Besides, the study of the expression of genes specific to thyroid (TSHR, TG, TPO, TTF1, TTF2, PAX8) in relation with the presence of arrangements RET/PTC or mutations of BRAF was made. It allowed to enlighten the loss of TPO expression in the cancers changed for BRAF as well as a new mechanism of BRAF activation. (N.C.)

  13. Value of conventionally fractionated radiotherapy for the local treatment of HIV associated Kaposi`s sarcoma; Wertigkeit konventionell fraktionierter Radiotherapie bei der lokalen Behandlung des HIV-assoziierten Kaposi-Sarkoms

    Saran, F. [Abt. fuer Strahlentherapie und Onkologie, Zentrum der Radiologie, Frankfurt Univ. (Germany); Adamietz, I.A. [Abt. fuer Strahlentherapie und Onkologie, Zentrum der Radiologie, Frankfurt Univ. (Germany); Mose, S. [Abt. fuer Strahlentherapie und Onkologie, Zentrum der Radiologie, Frankfurt Univ. (Germany); Thilmann, C. [Abt. fuer Strahlentherapie und Onkologie, Zentrum der Radiologie, Frankfurt Univ. (Germany); Boettcher, H.D. [Abt. fuer Strahlentherapie und Onkologie, Zentrum der Radiologie, Frankfurt Univ. (Germany)


    From June 1991 to June 1993, 43 patients with 111 HIV-associated Kaposi`s sarcoma of the skin or oral cavity were treated. Lesions were irradiated with 5 to 12 MeV electrons or 60Co gamma-rays. The fractionation scheme was 5 times 2 Gy/week for skin and enoral lesions with a total reference dosage of up to 20 Gy. Side effects were assessed during therapy and the therapeutic result 6 weeks after end of treatment. Thirty-eight out of 111 lesions were judged as complete response (CR) (34%), 61/111 as partial response (PR) (55%) and 12/111 were judged as no change (NC) (11%). Overall response (CR + PR) was 89%. Two patients with lesions of oral cavity suffered from RTOG grade-IV mucositis after 10 and 14 Gy. In 71/106 skin lesions (67%), radiation induced RTOG grade-I reactions were observed. Conclusion: In patients with HIV associated Kaposi`s sarcoma effective palliation can be achieved by means of radiotherapy with an overall dose of 20 Gy in conventional fractionation. Yet, the fraction of patients with complete responses is with 34 to 47% lower compared with doses above 20 Gy (66 to 100%). With reference to the reported data our results point to a dose-response relationship for Kaposi`s sarcoma. Therefore higher total reference doses, e.g. 30 Gy with weekly 5 times 2 Gy or 24 Gy with 5 times 1.6 Gy for mucous lesions, respectively, are suggested as by this mean the complete response rate can be coubled. (orig./MG) [Deutsch] Von Juni 1991 bis Juni 1993 wurden 43 Patienten mit 111 HIV-assoziierten Kaposi-Sarkomen der Haut oder des Mund- und Rachenraums behandelt. Die Laesionen wurden mit 5- bis 12-MeV-Elektronen oder Co-60-Gammastrahlen bestrahlt. Das Fraktionierungsschema betrug 5mal 2 Gy/Woche bei kutanen und enoralen Laesionen bis zu einer Gesamtreferenzdosis von 20 Gy. Nebenwirkungen wurden waehrend und das Ergebnis sechs Wochen nach Abschluss der Radiotherapie beurteilt. In 38 von 111 Laesionen wurde eine komplette Remission (CR) erzielt (34%), in 61/111 eine

  14. Palliative or curative treatments: Targeted radiotherapy of endocrine tumours; Traitements a visee palliative ou curative: la radiotherapie vectorisee des tumeurs endocrines

    Vuilleza, J.P. [Centre Hospitalier Universitaire, Service de Biophysique et Medecine Nucleaire, Hopital Michallon, 38 - Grenoble (France)


    Internal targeted radiotherapy (I.T.R.), which consists in irradiation of small disseminated tumour lesions using injected radiopharmaceuticals has been for a long time successfully used for differentiated thyroid carcinoma treatment, as an adjuvant treatment after surgery, but as an efficient treatment of metastatic disease (especially lung involvement) as well. New efficient radiopharmaceuticals for tumour targeting become available, making feasible such successful I.T.R. treatment for other endocrine tumours (E.T.). Malignant pheochromocytomas have firstly been treated with {sup 131}I-meta-iodo-benzyl-guanidine (M.I.B.G.) and more recently radiolabeled ligands of somatostatin receptors (S.S.R.) which are over expressed by most of E.T. have been proved to be an effective treatment of these tumours. Moreover, radiolabelled antibodies, which have been used successfully in malignant lymphoma treatment, could have an interest in E.T., mainly medullary thyroid carcinoma. Using I.T.R. for E.T. treatment suppose clinical indications are well defined, according to the new W.H.O. classification of E.T.: only non-differentiated not eradicable and/or metastatic progressive tumours should be treated. Furthermore, efficiency of I.T.R. is greater than could be thought as minor responses and even prolonged stabilizations are now considered as positive responses. Randomized studies are still necessary, however, in order to demonstrate, beyond its efficiency, a clinical impact of I.T.R. on quality of life and survival, and to determine the right place of I.T.R. in the global therapeutic management of E.T.. (author)

  15. Parallelization of learning problems by artificial neural networks. Application in external radiotherapy; Parallelisation de problemes d'apprentissage par des reseaux neuronaux artificiels. Application en radiotherapie externe

    Sauget, M


    This research is about the application of neural networks used in the external radiotherapy domain. The goal is to elaborate a new evaluating system for the radiation dose distributions in heterogeneous environments. The al objective of this work is to build a complete tool kit to evaluate the optimal treatment planning. My st research point is about the conception of an incremental learning algorithm. The interest of my work is to combine different optimizations specialized in the function interpolation and to propose a new algorithm allowing to change the neural network architecture during the learning phase. This algorithm allows to minimise the al size of the neural network while keeping a good accuracy. The second part of my research is to parallelize the previous incremental learning algorithm. The goal of that work is to increase the speed of the learning step as well as the size of the learned dataset needed in a clinical case. For that, our incremental learning algorithm presents an original data decomposition with overlapping, together with a fault tolerance mechanism. My last research point is about a fast and accurate algorithm computing the radiation dose deposit in any heterogeneous environment. At the present time, the existing solutions used are not optimal. The fast solution are not accurate and do not give an optimal treatment planning. On the other hand, the accurate solutions are far too slow to be used in a clinical context. Our algorithm answers to this problem by bringing rapidity and accuracy. The concept is to use a neural network adequately learned together with a mechanism taking into account the environment changes. The advantages of this algorithm is to avoid the use of a complex physical code while keeping a good accuracy and reasonable computation times. (author)

  16. The role of radiotherapy in the treatment of meningeal melanocytoma; Die Rolle der Strahlentherapie bei der Behandlung des Meningealen Melanozytoms

    Rades, D.; Fehlauer, F.; Alberti, W. [Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Schild, S. [Mayo Clinic, Scottsdale, Arizona (United States). Dept. of Radiation Oncology; Tatagiba, M. [Klinik fuer Neurochirurgie, Eberhard-Karls-Universitaet Tuebingen (Germany); Molina, H. [Clinica y Maternidad Suizo-Argentina, Buenos Aires (Argentina). Lab. of Neuropathology


    Because of its great rarity an optimal therapeutic regime for this entity has yet to be found. This holds especially for the role of radiotherapy following incomplete resection. The present analysis compares four therapeutic regimes in terms of local control and survival, thus contributing to the formulation of an optimal treatment concept. [German] Angesichts der grossen Seltenheit dieser Entitaet ist das optimale Therapieregime bislang nicht hinreichend geklaert. Dies gilt insbesondere fuer die Rolle der Strahlentherapie nach inkompletter Resektion. Die vorliegende Analyse vergleicht vier Therapieschemata im Hinblick auf die lokale Kontrolle und das Gesamtueberleben, um einen Beitrag zur Definition eines optimalen Behandlungskonzepts zu leisten. (orig.)

  17. Cartography and risk management in radiotherapy: a collaborative work of the department of radiotherapy and the department of quality and risk management Institute Jean-Godinot; Cartographie et gestion des risques en radiotherapie: un travail commun du departement de radiotherapie et du departement de la qualite et de la gestion des risques de l'institut Jean-Godinot

    Nguyen, T.D.; Loiseau, M. [Institut Jean-Godinot, Dept. de radiotherapie, 51 - Reims (France); Devie, I.; Heusghem, M. [Institut Jean-Godinot, Dept. de la qualite et de la gestion des risques, 51 - Reims (France); Gaillot-Petit, N. [Institut Jean-Godinot, Unite de radiophysique medicale, 51 - Reims (France)


    Purpose To deploy an inductive process for radiotherapy risk management in a regional cancer centre and to infer the actions required to solve the situations of criticality. Methods Close collaboration between the department of radiation oncology-biophysics and the department of quality and risk management in the same institution allowed to create a multi professional and multidisciplinary task force and to make the experience feedback easier. A preliminary risk analysis method was used to identify the generic dangers, the mapping of risks and the specification of the scales of criticality. This method helped to evaluate and to rate each apprehended event. Four scales have been defined: seriousness scale in five levels, likelihood scale in five classes, endeavour scale in four levels and criticality scale in three categories: acceptable (criticality 1) tolerable under control (criticality 2) and unacceptable (criticality 3). Results Fifty-seven level 1 dangerous situations linked to 78 scenarios of criticality acceptable, tolerable and unacceptable in 24, 44 and 10 cases respectively have been identified in the department of radiotherapy leading to carry out 28 risk reduction actions. Conclusions The performed risk analysis offered an original frame for a collective thinking among the care providers and contributed to modify their mode of conceiving both security and radioprotection. The study allowed us to give a relevant answer to the High Authority of Health and the Authority of Nuclear Security demands either in terms of efficient management of the risks in radiotherapy or regarding the daily concerns of the care-givers. (authors)

  18. Short course of radiation therapy in elderly patients with multiform glioblastoma; Radiotherapie hypofractionnee acceleree pour les glioblastomes des sujets ages

    Idbaih, A.; Taillibert, S.; Simon, J.M.; Lopez, S.; Lang, P.; Toubiana, T.; Feuvret, L.; Mazeron, J.J. [Groupe Hospitalier Pitie-Salpetriere, AP.HP, Service de Radiotherapie Oncologique, 75 - Paris (France); Idbaih, A.; Taillibert, S.; Psimaras, D.; Delattre, J.Y. [Groupe Hospitalier Pitie-Salpetriere, AP.HP, Service de Neurologie Mazarin, 75 - Paris (France); Schneble, H.M. [Groupe Hospitalier Lariboisiere, AP.HP, Service de Neurologie, 75 - Paris (France)


    Purpose: The optimal schedule of irradiation in elderly patients suffering from glioblastoma multiform (G.B.M.) is unsettled. Materials and methods: This study reviewed the charts of 28 consecutive G.B.M. patients aged 70 years or more with a Karnofsky Performance Status (K.P.S.) greater than or equal to 70 who received a short course of radiotherapy (40 grays in 15 fractions over three weeks). Results: The median age at surgery was 74.6 years (range, 70.1 - 85.7). No patient received prior or concomitant chemotherapy. The median progression-free survival and overall survival were 21.6 weeks (95% CI, 17.0 - 39.9) and 50.6 weeks (95% CI, 26.3 - 62.0), respectively. Even within a narrow range (< 90 or = 90), K.P.S. remained a prognostic factor (p = 0.03). Tolerance appeared acceptable in terms of K.P.S. changes and corticosteroid use during radiation therapy. Conclusion: These results support the efficacy of short schedule radiotherapy for G.B.M. in elderly patients with a good K.P.S.. (authors)

  19. Late xerostomia after intensity-modulated conformational radiotherapy of upper aero-digestive tract cancers: study 2004-03 by the head and neck oncology and radiotherapy Group (Gortec); Xerostomie tardive apres radiotherapie conformationnelle avec modulation d'intensite des cancers des voies aero-digestives superieures: etude 2004-03 du Groupe oncologie et radiotherapie de la tete et du cou (Gortec)

    Toledano, I.; Lapeyre, M. [Centre Jean-Perrin, 63 - Clermont-Ferrand (France); Graff, P. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Serre, C. [Centre Val d' Aurelle, 34 - Montpellier (France); Bensadoun, R.J. [CHU La Miletrie, 86 - Poitiers (France); Bensadoun, R.J.; Ortholan, C. [Centre Antoine-Lacassagne, 06 - Nice (France); Calais, G. [CHU Bretonneau, 37 - Tours (France); Alfonsi, M. [Institut Sainte-Catherine, 84 - Avignon (France); Giraud, P. [Institut Curie, 75 - Paris (France); Hopital europeen Georges-Pompidou, 75 - Paris (France); Racadot, S. [Centre Leon-Berrard, 69 - Lyon (France)


    The authors report a retrospective assessment of late xerostomia according to the RTOG (Radiation Therapy Oncology Group) classification of the European Organization for Research and Treatment of Cancer (EORTC) among patients treated by intensity-modulated conformational radiotherapy (IMRT) and suffering from upper aero-digestive tract carcinomas of different stages. Some of these patients have bee operated, and some have been treated by chemotherapy. It appears that the IMRT results in a reduction of late xerostomia, and even in an absence of salivary toxicity. Short communication

  20. Literature review on radiotherapy of face Darier-Ferrand dermato-fibro-sarcomas: about two cases; Revue de la litterature sur la radiotherapie des dermatofibrosarcomes de Darier-Ferrand de la face: a propos de deux cas

    Chami, S.; Mekki, F. [Service de radiotherapie, centre Pierre-et Marie-Curie, Alger (Algeria)


    The authors discuss two cases of radiotherapy of Darier-Ferrand dermato-fibro-sarcomas. One patient was 34 year old and the other one 73. The authors discuss the tumour appearance, the consequences of several surgical operations, and the effect of radiotherapy. They outline that diagnosis is generally good in absence of metastases, and that adjuvant radiotherapy was necessary in the two reported cases where surgery was insufficient. Short communication

  1. Mammary radiotherapy and patients-risks management with continue evaluation of clinical indicators; Radiotherapie mammaire et gestion des risques-patients avec evaluation continue d'indicateurs cliniques

    Untereiner, M.; Frederick, B.; Burie, D.; Cavuto, C.; Rob, L.; Coiffier, N.; Colet, M. [Centre National de Radiotherapie du Luxembourg, Centre Francois-Baclesse (CFB), Esch-sur-Alzette (Luxembourg)


    Purpose: The breast irradiation represents 25% of radiotherapy indication in the radiotherapy centers. The modeling of the management of complications risks and recurrences in relation with mammary irradiation constitutes a methodological base allowing to develop a general concept for any other indication of radiotherapy. The objective of the study was a continuous evaluation of clinical risks to get indicators of the therapy results: for the institution, to get an auto-evaluation tool of the functioning (continuous evaluation of clinical results, identification of sentinel events); for the patients to get precise and detailed information on the risks linked to their treatment (communication of clinical results, comparison with the literature, benchmarking). (N.C.)

  2. Proposition of resolution tending to create an inquiry commission concerning the safety conditions of the radiotherapy practices; Proposition de resolution tendant a creer une commission d'enquete concernant les conditions de securite des pratiques de radiotherapie



    Towards the number of radiotherapy acts made every year and the increase of the number of the revealed accidents, it is absolutely indispensable to have an feedback experience and an assessment of the existing means today to control the radioprotection. This work has to allow to give propositions to improve the radiotherapy quality and safety, and provide the patients safety before, during and after the ionizing radiation exposure. (N.C.)

  3. Stereotactic radiotherapy for non-small cell lung cancer: From concept to clinical reality. 2011 update; Radiotherapie stereotaxique des cancers broncho-pulmonaires non a petites cellules: d'un concept a une realite clinique. Actualites en 2011

    Girard, N. [Service de pneumologie, hopital Louis-Pradel, hospices civils de Lyon, 28, avenue du Doyen-Jean-Lepine, 69500 Bron (France); UMR 754, universite Claude-Bernard Lyon 1, 43, boulevard du 11-Novembre-1918, 69622 Villeurbanne cedex (France); Mornex, F. [Departement de radiotherapie oncologie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Benite cedex (France); EA 37-38, universite Claude-Bernard Lyon 1, 43, boulevard du 11-Novembre-1918, 69622 Villeurbanne cedex (France)


    Only 60% of patients with early-stage non-small cell lung cancer (NSCLC), a priori bearing a favorable prognosis, undergo radical resection because of the very frequent co-morbidities occurring in smokers, precluding surgery to be safely performed. Stereotactic radiotherapy consists of the use of multiple radiation micro-beams, allowing high doses of radiation to be delivered to the tumour (ranging from 7.5 to 20 Gy per fraction) in a small number of fractions (one to eight on average). Several studies with long-term follow-up are now available, showing the effectiveness of stereotactic radiotherapy to control stage I/II non-small cell lung cancer in medically inoperable patients. Local control rates are consistently reported to be above 95% with a median survival of 34 to 45 months. Because of these excellent results, stereotactic radiation therapy is now being evaluated in operable patients in several randomized trials with a surgical arm. Ultimately, the efficacy of stereotactic radiotherapy in early-stage tumours leads to hypothesize that it may represent an opportunity for locally-advanced tumors. The specific toxicities of stereotactic radiotherapy mostly correspond to radiation-induced chest wall side effects, especially for peripheral tumours. The use of adapted fractionation schemes has made feasible the use of stereotactic radiotherapy to treat proximal tumours. Overall, from a technical concept to the availability of specific treatment devices and the publication of clinical results, stereotactic radiotherapy represents a model of implementation in thoracic oncology. (authors)

  4. Standards, options and recommendations for the radiotherapy of patients having an endometrium neoplasm; Standards, options et recommandations pour la radiotherapie des patientes atteintes de cancer de l'endometre

    Thomas, L.; Pigneux, J. [Institut Bergonie Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Bataillard, A.; Fervers, B. [Federation Nationale des Centres de Lutte Contre le Cancer, 75 - Paris (France); Bremond, A.; Farsi, F.; Guastalla, J.P. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Fondrinier, E. [Centre de Lutte Contre le Cancer Paul-Papin, 49 - Angers (France); Achard, J.L.; Bailly, C. [Centre Jean-Perrin, 63 - Clermont-Ferrand (France); Lansac, J. [Centre Hospitalier Universitaire Bretonneau, 37 - Tours (France); Hoffstetter, S. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Basuyau, J.P.; D' Anjou, J. [Centre Henri Becquerel, 76 - Rouen (France); Deschamps, P. [Centre Hospitalier Universitaire, 49 - Angers (France); Laffargue, F. [Centre Hospitalier Universitaire, Hopital Arnaud-de-Villeneuve, 34 - Montpellier (France); Rodier, J.F. [Centre Paul-Strauss, 67 - Strasbourg (France); Vincent, P. [Clinique Sainte-Catherine, 84 - Avignon (France)


    The 'Standards, Options and Recommendations'(SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the radiotherapy of carcinoma of the endometrium. Data were identified by searching Medline and personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French Cancer Centres. The main recommendations for the radiotherapy of carcinoma of the endometrium are: For grade 1 and 2 stage IA tumours, follow-up alone is standards as additional treatment. For grade 1 and 2 stage IB tumours, vaginal brachytherapy or follow-up alone are options. For grade 3, stage IB tumours and stage IC disease, there are two treatment options: external pelvic radiotherapy with a brachytherapy boost or vaginal brachytherapy. Treatment for stage II disease can be preoperative when stage II disease has been suggested by a positive endometrial curettage. Postoperative vaginal brachytherapy is given for stage IIA tumours if the penetration of the myometrium is less than 50% or if the tumour is grade 1 or 2. In the case of deep penetration, or higher grade disease, or for stage IIB external radiotherapy with brachytherapy boosting must be undertaken routinely. After surgery, for stage IIIA disease, either external pelvic radiotherapy or abdomino

  5. Internal mammary chain irradiation in breast cancer: State of the art; Radiotherapie de la chaine mammaire interne dans les cancers du sein: etat des lieux

    Auberdiac, P.; Cartier, L.; Hau Desbat, N.H.; De Laroche, G.; Magne, N. [Unite de curietherapie, departement de radiotherapie, institut de cancerologie de la Loire, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex (France); Chargari, C. [Service d' oncologie radiotherapie, hopital d' instruction des armees du Val-de-Grace, 74, boulevard Port-Royal, 75230 Paris cedex 5 (France); Zioueche, A. [Service de radiotherapie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges (France); Melis, A. [Departement d' oncologie medicale, institut de cancerologie de la Loire, 108 bis, avenue Albert-Raimond, 42271 Saint-Priest-en-Jarez cedex (France); Kirova, Y.M. [Service de radiotherapie oncologique, institut Curie, 26, rue d' Ulm, 75005 Paris (France)


    Radiation therapy has a major role in the management of infiltrative breast cancers. However, there is no consensus for the prophylactic treatment of the internal mammary chain (IMC), with strategies that show strong differences according to centers and physicians. Indications for internal mammary chain radiotherapy are debated, since this treatment significantly increases the dose delivered to the heart and leads to potential technical difficulties. Important prospective data recently suggested that internal mammary chain radiotherapy would not be necessary, even in cases of internal or central tumor locations, or in patients with positive axillary lymph nodes. Although these data warrant confirmation by two other prospective trials, there is evidence that the indications for internal mammary chain radiotherapy should be careful and that high quality techniques should be used for decreasing the dose delivered to the heart. This review of literature presents the state of art on the radiotherapy of internal mammary chain, with special focus on the indications, techniques, and potential toxicity. (authors)

  6. Investigation of dose modifications related to dental cares in an ORL radiotherapy treatment; Etude des modifications de dose liees aux soins dentaires dans un traitement radiotherapeutique ORL

    De Conto, C.; Gschwind, R.; Makovicka, L. [IRMA/ENISYS/FEMTO-ST, UMR-CNRS 6174 Pole Universitaire des Portes du Jura, BP 71427, 25211 Montbeliard (France); De Conto, C.; Martin, E. [Service de Radiotherapie - Oncologie, Centre Hospitalier de Belfort - Montbeliard, Site du Mittan, 25200 Montbeliard (France)


    The authors report the investigation of the influence of dental implants on the dose received during an ORL radiotherapy treatment in order to optimize both the dosimetric planning and the patient radioprotection. They report experimental measurements performed on a phantom representing a lower jaw in irradiation conventional conditions. Then, they report the Monte Carlo simulation of the dose distribution in the phantom using the BEAMnrc code designed for radiotherapy

  7. Proceedings of the International Conference on Modern Radiotherapy. Advances and Challenges in Radiation Protection of Patients; Actes de la conference internationale sur la radiotherapie moderne. Defis et progres dans le domaine de la radioprotection des patients



    The use of ionizing radiation in medicine has led to major improvements in the diagnosis and treatment of human diseases. While bringing new benefits for cancer treatment, modern radiotherapy also poses new challenges in terms of radiation protection of patients. Prevention of radiotherapy incidents and accidents is a major issue in this area. In December 2009, the French Nuclear Safety Authority (ASN) organised the 1. international conference on radiation protection of patients in radiotherapy. The major objective of the conference was to provide a platform for exchanging experience, and reviewing the actions implemented to improve the radiation safety in radiotherapy both at national and international level. The expected result was: - to reach a consensus about the necessity to strengthen existing international actions for prevention of incidents and accidents, - to set up an international cooperation to improve management for overexposed patients, - to outline a strategy for strengthening regulation, - to contribute to the elaboration of an international scale to rate patient related events for communication and reporting purpose. 360 delegates from 50 countries across the world participated at the 3-day conference. 41 presentations were made and 67 posters were displayed. The conference brought together a broad spectrum of expertise: scientists, health professionals, medical devices manufacturers, risk management specialists, radiation protection experts, representatives from Radiation Protection and Health Authorities as well as patient's associations. The programme covered both scientific and medical issues, such as patient sensitivity to ionising radiation and the treatment of complications. It also provided scope to discuss the benefits and risks of modern radiotherapy and to explore treatment safety issues from various perspectives, including human resources, expertise, education and training along with control and prevention strategies. The

  8. Intensity modulated radiotherapy as adjuvant post-operative treatment for retroperitoneal sarcoma: Acute toxicity; Radiotherapie avec modulation d'intensite dans le traitement postoperatoire des sarcomes retroperitoneaux: profil de toxicite aigue

    Paumier, A.; Roberti, E.; Le Pechoux, C. [Departement de radiotherapie, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif (France); Bonvalot, S.; Rimareix, F. [Departement de chirurgie generale, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif (France); Beaudre, A.; Lefkopoulos, D. [Unite de physique, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif (France); Terrier, P. [Departement de biologie et de pathologie medicales, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif (France); Domont, J.; Le Cesne, A. [Departement de medecine oncologique, institut de cancerologie Gustave-Roussy, 114, rue edouard-Vaillant, 94805 Villejuif (France)


    Purpose. - To assess the acute toxicity of intensity modulated radiotherapy as post-operative adjuvant treatment for retroperitoneal sarcoma. Patients and methods. - Patients who received adjuvant intensity modulated radiotherapy from January 2009 to September 2010 were retrospectively reviewed. Results. - Fourteen patients entered the study (seven primary tumours and seven relapses). All tumours were liposarcoma and had macroscopically complete resection, epiploplasty was systematically realized. Median tumour size was 21 cm (range: 15-45), median planning target volume was 580 cm{sup 3} (range: 329-1172) and median prescribed dose was 50.4 Gy (range: 45-54). Median follow-up was 11.5 months (range: 2-21.4). Acute toxicity was mild: acute digestive toxicity grade 1-2 occurred in 12/14 patients (86%). However, there was no weight loss of more than 5% during radiotherapy and no treatment interruption was required. Two months after completion of radiotherapy, digestive toxicity grade 1 remained present in 1/14 patients (7%). One case of grade 3 toxicity occurred during follow-up (transient abdominal pain). Three relapses occurred: two were outside treaded volume and one was both in and outside treated volume. Conclusions. - Intensity modulated radiotherapy in the postoperative setting of retroperitoneal sarcoma provides low acute toxicity. Longer follow-up is needed to assess late toxicity, especially for bowel, kidney and radio-induced malignancies. (authors)

  9. Role of radiotherapy in the treatment of head and neck rhabdomyosarcomas in children; Role de la radiotherapie dans le traitement des rhabdomyosarcomes de la tete et du cou chez l'enfant

    Nouni, K.; Kebdani, T.; Hassouni, K.; Benjaafer, N.; Elgueddari, B. [Institut national d' oncologie, Rabat (Morocco)


    The authors report the assessment of clinic results obtained for the radiotherapy of head and neck rhabdomyosarcomas in children. The study is based on a sample of 22 children. The authors report epidemiologic, clinic, and above all therapeutic and evolutional aspects: age, symptoms, radiological examination (scanography, MRI), tumour location, histological characterization, chemotherapeutic and radiotherapeutic treatment, local relapses, pulmonary and hepatic metastases, survival. Short communication

  10. Radiosurgery and stereotaxic radiotherapy of cerebral metastases: results of 107 patients retrospective series; Radiochirurgie et radiotherapie stereotaxique des metastases cerebrales: resultats d'une serie retrospective de 107 patients

    Botti, M.; Bourdin, S.; Brunet, G.; Thillays, F.; Campion, L.; Mahe, M.A. [Centre Regional de Lutte Contre le Cancer Rene-Gauducheau, 44 - Nantes (France); Menegalli, D.; Martin, S. [Hopital Laennec, 44 - Nantes (France)


    This retrospective study has confirmed the effectiveness of a radiosurgery or a stereotaxic radiotherapy in terms of survival and local control in patients with one to three cerebral metastases and the prognostic value of the performance index of Who,of a primary cancer control, of the recursive partitioning analysis (R.P.A.) group and of the age. (N.C.)

  11. Radiotherapy for pancreas and biliary tree cancers. Gross tumor volume (GeV) and clinical target volume (CTV); Radiotherapie des cancers du pancreas et des cancers des voies biliaires extra-hepatiques. Volume tumoral macroscopique (GTV). Volume-cible anatomoclinique (CTV)

    Atlan, D. [Hopital Europeen Georges Pompidou, Oncologie-Radiotherapie, 75 - Paris (France); Mornex, F. [Centre Hospitalier Lyon-Sud, 69 - Pierre Benite (France)


    Anatomical data of pancreas, biliary tree, regional lymph nodes is required to define GTV and CTV. In case of postoperative irradiation, CTV is designed in collaboration with radiation oncologist and surgeon oncologist. For exclusive radiotherapy, endo-digestive ultrasonography, CT scan and MRI could help radiation oncologist defining GTV. Although, accuracy of all the imaging techniques in past years remains poor. Currently, no available literature is published regarding security margins for the definition of CTV. Therefore, recommendations according to clinical experience are proposed. (authors)

  12. Radiotherapy professionals faced with the obligation of treatments safety improvement; Les professionnels de la radiotherapie face a l'obligation d'ameliorer la securite des traitements



    The occurrence of a major accident in Epinal (2006), followed by one in Toulouse (2007), led the Ministry of Health to mobilize the whole actors in radiotherapy in order to define national measures intended to improve health care security. Compiled in the so-called 'road map', these measures were presented in November 2007, and implemented in the 2009-2013 cancer programme. The French Institute for Radiological Protection and Nuclear Safety (IRSN) undertook a study aiming at assessing the effects of the above-mentioned measures on organization and safety management of radiotherapy facilities, but also on treatment achievement procedures and health professionals. More specifically, IRSN sought to examine the ability of health professionals to take into account new safety demands and to adapt their practices accordingly. With these purposes objectives, a qualitative study using the methods of ergonomics and sociology of organizations was completed in 2009-2010. The results of the study presented in this report show an effective improvement of health care safety along with a variable integration of safety measures depending on radiotherapy facilities and units. In particular, integration depends on 1) the governance mode of the health care facility, more or less conducive to promoting safety, 2) the pre-existence of a safety culture and safety organization, and 3) the facility commitment to health care safety improvement actions. The study also reveals that the implementation of new safety demands and the changes they involve create new constraints, which put pressure on health professionals and may threaten the durability of the improvements made. In order to facilitate the appropriation and implementation by radiotherapy units of the measures meant to improve health care safety, IRSN identifies 6 lines of thought: - strengthen coordination between institutional actors in order to ensure the consistency of the requests addressed to the facilities and limit

  13. Evaluation of internal vectorized radiotherapy by Mibg-{sup 131}I in the treatment of malignant pheochromocytomas/paraganglioma; Evaluation de la radiotherapie interne vectorisee par MIBG-131I dans le traitement des pheochromocytomes/paragangliomes malins

    Moret, M.; Borson-Chazot, F. [Federation d' endocrinologie, GHE, hospices civils de Lyon, (France); Girre, M.; Bournaud, C. [service de medecine nucleaire, GHE, hospices civils de Lyon, (France); Chabre, O. [service d' endocrinologie, CHU Michallon, Grenoble, (France); Caravel, J.P. [service de medecine nucleaire, CHU Michallon, Grenoble, (France); Baguet, J.P. [service de cardiologie, CHU Michallon, Grenoble, (France)


    With the results, the internal vectorized radiotherapy by Mibg-{sup 131}I seems more efficient in case of low tumoral mass and exclusive extra osseous metastases. It would be interesting to study this therapy modality in prospective way in adjuvant treatment of the pheochromocytomas/paraganglioma (P.H./P.G.L.) surgery following the example {sup 131}I in the papillary cancer of thyroid. (N.C.)

  14. Stereotaxic radio-therapies of hepatic and pulmonary metastases with the 'stereotactic body frame'; Radiotherapies stereotaxiques des metastases hepatiques et pulmonaires avec le 'stereotactic body frame'

    Wachter, T.; Bouscayrol, H. [CHR d' Orleans, 45 (France)


    This treatment is particularly well adapted to pulmonary and hepatic metastases that represent well limited targets for patients tired by previous chemotherapies. The tolerance has been excellent and the results encouraging for patients without any other therapy solution. The use of 'stereotactic body frame' appears as an alternative for the development of stereotaxic radiotherapy in comparison with investment in the dedicated machines. (N.C.)

  15. Organ motion study and dosimetric impact of respiratory gating radiotherapy for esophageal cancer; Etude de mobilite organique et impact dosimetrique de l'asservissement respiratoire dans la radiotherapie des cancers de l'oesophage

    Lorchel, F


    Chemoradiotherapy is now the standard treatment for locally advanced or inoperable esophageal carcinoma. In this indication, conformal radiotherapy is generally used. However, prognosis remains poor for these patients. Respiratory gating radiotherapy can decrease healthy tissues irradiation and allows escalation dose in lung, liver and breast cancer. In order to improve radiotherapy technique, we propose to study the feasibility of respiratory gating for esophageal cancer. We will study the respiratory motions of esophageal cancer to optimize target volume delineation, especially the internal margin (I.M.). We will test the correlation between tumour and chest wall displacements to prove that esophageal cancer motions are induced by respiration. This is essential before using free breathing respiratory gating systems. We will work out the dosimetric impact of respiratory gating using various dosimetric analysis parameters. We will compare dosimetric plans at end expiration, end inspiration and deep inspiration with dosimetric plan in free-breathing condition. This will allow us to establish the best respiratory phase to irradiate for each gating system. This dosimetric study will be completed with linear quadratic equivalent uniform dose (E.U.D.) calculation for each volume of interest. Previously, we will do a theoretical study of histogram dose volume gradation to point up its use. (author)

  16. Quality control of the treatment planning systems dose calculations in external radiation therapy using the Penelope Monte Carlo code; Controle qualite des systemes de planification dosimetrique des traitements en radiotherapie externe au moyen du code Monte-Carlo Penelope

    Blazy-Aubignac, L


    The treatment planning systems (T.P.S.) occupy a key position in the radiotherapy service: they realize the projected calculation of the dose distribution and the treatment duration. Traditionally, the quality control of the calculated distribution doses relies on their comparisons with dose distributions measured under the device of treatment. This thesis proposes to substitute these dosimetry measures to the profile of reference dosimetry calculations got by the Penelope Monte-Carlo code. The Monte-Carlo simulations give a broad choice of test configurations and allow to envisage a quality control of dosimetry aspects of T.P.S. without monopolizing the treatment devices. This quality control, based on the Monte-Carlo simulations has been tested on a clinical T.P.S. and has allowed to simplify the quality procedures of the T.P.S.. This quality control, in depth, more precise and simpler to implement could be generalized to every center of radiotherapy. (N.C.)

  17. Brain tumor chemo-radiotherapy: a study of direct intratumoral perfusion with antineoplastic drugs; Chimio-radiotherapie des tumeurs cerebrales: interet de l'injection intratumorale de drogues antineoplasiques

    Rousseau, J


    High grade gliomas are aggressive tumors for which current treatments remain palliative. Radiotherapy efficacy is restricted by the surrounding brain tissue tolerance. One method based on the concomitant use of chemotherapeutic drugs and external photon irradiation has been proposed to improve the treatment outcome. The systemic administration of drugs is not effective in achieving the therapeutic level of drug needed for brain tumor treatment. This is due to the blood brain barrier (BBB) that prevents molecules passing through the vascular endothelium. Recent methods have been developed to circumvent the BBB. Among them, convection-enhanced delivery (CED) relies on the continuous infusion of a fluid containing a therapeutic agent, under a pressure gradient. It permits a homogeneous and controlled drug distribution. The aims of this study were to characterise the CED method, and then to utilize it for glioma treatment in preclinical studies. Several drugs were tested: cisplatin, carbo-platin, oxaliplatin, and iodo-deoxyuridine. Two radiation modalities were evaluated: synchrotron stereotactic radiotherapy (monochromatic beam < 100 keV) and high energy irradiation (6 MV) obtained with a conventional medical linear accelerator. The results obtained reveal that the effectiveness of the combined treatment (platinated drug plus photon irradiation) is highly related to that of the chemotherapy. The data, obtained with the platinated chemotherapy, also show that high-energy X-ray irradiation (6 MV) is as effective as synchrotron X-ray irradiation. The results broaden the applicability of this chemotherapeutic approach to clinical trials. (author)

  18. Ballistic optimisation with intensity modulation with integration of a concomitant boost for the radiotherapy of glioblastomas; Optimisation de la balistique en modulation d'intensite avec integration d'un boost concomitant pour la radiotherapie des glioblastomes

    Supper, C.; Franceries, X. [Universite Paul-Sabatier, 31 - Toulouse (France); Supper, C.; Vieillevigne, L.; Ken, S.; Simon, L.; Rives, M.; Moyal, E.; Delannes, M.; Noel, A.; Laprie, A. [Deparement de radiotherapie, Institut Claudius-Regaud, 31 - Toulouse (France); Franceries, X.; Ken, S.; Laprie, A. [Inserm UMR 825 Imagerie cerebrale et handicapes neurologiques, 31 - Toulouse (France); Noel, A. [Departement de radiotherapie, Centre Alexis-Vautrin, 54 - Nancy (France)


    The authors report a study aimed at the optimisation of the ballistics of intensity-modulated conformation radiotherapy (IMRT) treatment with a boost for the preparation of a multi-centric prospective trial financed by a program on glioblastoma treatment. This treatment consists in using the boost technique to obtain an increase of the dose delivered by the IMRT in sites presenting a strong predictive value for relapse. These sites are defined by means of magnetic resonance spectrometric imagery. Conformation indexes, planning target volumes, doses delivered to organs at risk are analysed. The proximity of organs at risk was the main difficulty, but a good dosimetry has been obtained with the use of five coplanar beams. Short communication

  19. External dosimetry for ionising radiation. From the national standard to the users in radiotherapy and radiation protection; La dosimetrie externe des rayonnements ionisants de la reference nationale aux utilisateurs en radiotherapie et en radioprotection

    Bordy, J.M


    This report presents a review of the external dosimetry of the ionising radiations for the protection of the human being. Looking at this topic, at first we are confronted with its diversity: the protection of the workers and the public against radiations, the medical exposures for radiotherapy, diagnosis and surgery, and the accidental situations. These aspects are often artificially separated so that the global comprehension becomes more difficult. We underline the points of convergence and the bonds which exist between the concepts of dosimetry adopted to deal with its different aspects. It also appeared useful to avoid proposing a dictionary of definitions copied in the reports of the international commissions, and adopting the formalism of the ICRU reports. This is why the definitions, when they are essential, are put in appendix. This text presents the reasons which led to the adoption of the system of quantity used today for the external dosimetry of the ionising radiations. After an introduction dealing with the general principle, the first chapter deals with the 'physical' quantities and the methods used for the determination of the national references. The second chapter, through the protection against radiation of the workers and the public, describes the bonds between the measurable 'operational' quantities and the non measurable 'protections' quantities which allow establishing the radiation protection limits and check that they are respected. The third chapter deals with the difficulties encountered for the measurements in area and personal dosimetry. The fourth chapter deals with the specificities of the medical exposures with the 'practical' quantities, the principle of optimisation and how radiotherapy is implemented. The fifth chapter briefly describes the case of the concerted exposures and of the accident. In conclusion, we analyse the needs and some potential new avenues of work for the metrology of the

  20. Comparative evaluation of the results following palliative radiotherapy of cerebral metastases from mammary and bronchial carcinomas. Vergleich der Therapieergebnisse bei palliativer Strahlentherapie von Hirnmetastasen des Mamma- und Bronchialkarzinomas

    Hergarten, A.


    A total of 96 patients showing cerebral metastases were evaluated, who had been treated at any time during the period between 1971 and 1984. The mean interval from the point of time when the primary tumour was diagnosed to the first appearance of metastases in the brain was determined to be 20 months for mammary carcinomas and 0.8 months for bronchial carcinomas. As a rule, telecobalt 60 rays were used; the area of radiation was chosen so as to cover the total cranium and included two opposite lateral fields, the therapeutic programme and area of treatment being determined in each case on an individual basis. Generally, a total dose of 30 Gy was given under the protection of cortisone, split up into individual doses of 2 Gy administered 4-5 times weekly. The success of therapy thus achieved was judged from changes in neuological parameters. It was found that 50% of the patients showed considerable improvement. In view of an average survival time of 7.5 months it may be stated that the chances of survival for patients with mammary carcinomas receiving radiotherapy were considerably better than would have been assumed on the basis of data from relevant literature. In bronchial carcinomas radiotherapy is beneficial in that the symptoms are relieved, even though the mean survival time still is only 3.8 months.

  1. A rectal balloon catheter as internal immobilization device for conformal radiotherapy of prostate cancer; Die Bedeutung eines Rektumballons als interne Immobilisation bei der konformalen Strahlentherapie des Prostatakarzinoms

    Gerstner, N.; Wachter, S.; Dorner, D.; Goldner, G.; Colotto, A.; Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, Wien (Austria)


    Background: As known from the literature, prostate motion depends on different bladder and/or rectum fillings. The aim of this study was to analyze the influence of a rectum balloon catheter, used as an internal immobilization device, on prostate and rectum motion during the treatment course. Moreover we have analysed if the balloon enables an increase of the distance between the prostate and the posterior rectum wall. Results: An increase of the distance between the prostate and the posterior rectal wall of 8 mm was observed at the base of the prostate when using the rectum balloon. Moreover prostate motion in the ventrodorsal direction {>=}4 mm (1 SD) was reduced from 6/10 patients (60%) to 1/10 patients (10%) using the rectal balloon. In general, deviations in the latero-lateral and cranio-caudal directions were less (mean {<=} 2 mm, 1 SD), no difference between both examination series (with and without balloon) was observed. Conclusion: Rectal balloon catheter offers a possibility to reduce prostate motion and rectum filling variations during treatment course. In addition it enables an increase in the distance between prostate and posterior rectal wall, which could enable an improved protection of the posterior rectal wall. (orig./AJ) [Deutsch] Hintergrund: Die Lageveraenderung der Prostata, bedingt durch unterschiedliche Harnblasen- und Rektumfuellungen, wurde bereits in einigen Studien untersucht. Ziel dieser Studie war es, zu pruefen, ob durch die Anwendung eines Rektumballonkatheters als interne Immobilisation der Prostata eine Reduktion der Prostataeigenbeweglichkeit moeglich ist. Darueber hinaus wurde untersucht, inwieweit durch den Rektumballon der Abstand zwischen Prostata und Rektumhinterwand vergroessert werden kann. Ergebnisse: Durch die Anwendung des Rektumballons konnte der Abstand zwischen Prostata und Rektumhinterwand an der Prostatabasis im Mittel um 8 mm vergroessert werden. Insgesamt konnte durch den Rektumballon die Prostatabewegung in

  2. Retrospective study of the evolution of nutritional, inflammatory and bacteriological profiles of patients suffering from inoperable aero-digestive duct tumour during sequential or concomitant chemo-radiotherapy; Etude retrospective de l'evolution des profils nutritionnels, inflammatoires et bacteriologiques des patients atteints de tumeur des voies aero digestives inoperable au cours des chimioradio-therapies sequentielles ou concomitantes

    Martin, L. [Centre Guillaume-le-Conquerant, 76 - Le Havre (France); Brocard, C. [CMC Ormeaux-Vauban, 76 - Le Havre (France); Coudray, C. [Hopital Monod, 76 - Montivilliers (France); Pavlovitch, J.M. [Clinique du Petit-Colmoulin, 76 - Harfleur (France)


    The authors report a retrospective study which aimed at analysing a cohort of consecutive patients in terms of clinic and biological aspects reflecting their nutritional and inflammatory status as well as the status of their buccal bacterial flora during a sequential or concomitant chemo-radiotherapy. The objective was to detect a possible difference between these both therapeutic modalities, and a possible relationship with toxicity. Several data have been collected for patients suffering from inoperable aero-digestive tract tumour: weight, body mass index, prealbumin, albumin, orosomucoid, C-reactive protein, PINI index, and buccal bacterial flora. The evolution of these nutritional biological criteria appears to depend on the treatment modality. Short communication

  3. Therapeutic options in early stage testicular seminoma. Literature survey on first results of a prospective multi-center study on radiotherapy of seminoma in the clinical stages I, IIA and IIB; Therapieoptionen bei testikulaeren Seminomen in den fruehen Stadien. Literaturuebersicht mit ersten Ergebnissen einer prospektiven multizentrischen Studie zur Radiotherapie bei Seminomen in den klinischen Stadien I, IIA und IIB

    Schmidberger, H. [Radiologische Universitaetsklinik Tuebingen (Germany). Abt. fuer Strahlentherapie; Bamberg, M. [Radiologische Universitaetsklinik Tuebingen (Germany). Abt. fuer Strahlentherapie


    Testicular seminoma in the early stages is treated with orchiectomy and radiotherapy to the retroperitoneal nodes. Despite the high cure rates of this treatment, there is an ongoing controversy concerning the extent of the radiation fields and the radiation doses to be given in the clinical stages I, IIA and IIB. In the present literature review, these controversial issues are discussed. Four hundred and ninety-one patients in stage I testicular seminoma received adjuvant paraaortic irradiation with a total dose of 26 Gy. Forty-one patients in stage IIA, and 19 patients in stage IIB received 30 Gy or 36 Gy respectively to the paraaortic and ipsilateral iliacal nodes. Paraaortic radiotherapy in stage I disease was associated with low acute side effects and a disease-free survival in 97.1% of the patients after a median observation of 13 months. In stage IIA the disease-free survival was 100%, in stage IIB 94.7%. The literature review and preliminary results of the reported ongoing trial are indicating that paraaortic irradiation in stage I and paraaortic with ipsilateral iliacal irradiation in stages IIA and IIB seem to be a sufficient treatment in early stage testicular seminoma with low treatment associated morbidity. (orig./MG) [Deutsch] Testikulaere Seminome in den fruehen Stadien werden nach der Semikastratio mit einer Radiatio der retroperitonealen Lymphknotenstationen behandelt. Trotz der hohen Heilungsraten dieser Behandlung bestehen kontroverse Ansichten sowohl ueber die adaequate Ausdehnung der Bestrahlungsfelder als auch ueber die Dosierung der Bestrahlung in den klinischen Stadien I, IIA und IIB. In dem vorliegenden Literaturueberblick werden diese kontroversen Standpunkte diskutiert. 491 Patienten mit testikulaeren Seminomen im Stadium I erhielten eine adjuvante Bestrahlung der Paraaortalregion mit einer Gesamtdosis von 26 Gy. 41 Patienten im Stadium IIA und 19 Patienten im Stadium IIB erhielten eine Bestrahlung mit jeweils 30 Gy bzw. 36 Gy auf die

  4. Intensity-modulated radiation therapy for anal carcinoma; Radiotherapie conformationnelle avec modulation d'intensite des cancers de l'anus

    Peiffert, D.; Moreau-Claeys, M.V.; Tournier-Rangeard, L.; Huger, S.; Marchesi, V. [Departement de radiotherapie, centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandoeuvre-les-Nancy cedex (France)


    Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this 'complex U shaped' volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control. (authors)

  5. Comparison of target volumes in radiotherapy defined on scanner and on PET-T.D.M. with {sup 18}F-F.D.G. in the frame of head and neck cancers; Comparaison des volumes cibles en radiotherapie definis sur scanner et sur TEP-TDM au 18F FDG dans le cadre des cancers de la tete et du cou

    Henriques De Figueiredo, B.; Barret, O.; Allard, M.; Fernandez, P. [Service de medecine nucleaire, CHU de Pellegrin, Bordeaux, (France); Demeaux, H.; Maire, J.P.; Lagarde, P. [service de radiotherapie, hopital Saint-Andre, Bordeaux, (France); Kantor, G.; Richau, P. [departement de radiotherapie, institut Bergonie, Bordeaux, (France); De Mones Del Pujol, E. [service d' ORL, hopital Pellegrin, Bordeaux, (France)


    The objective is to study in a prospective way, in the frame of head and neck cancers, the impact of the positron computed tomography with {sup 18}F fluorodeoxyglucose (PET-F.D.G.) on the limitation of target volumes in radiotherapy. In conclusions, the gross tumor volume (G.T.V.) defined on PET is smaller than this one defined on scanner, that could be interesting in radiotherapy, in the perspective of a dose escalation. In addition, areas of discordance exist between the clinical target volumes (C.T.V.70 and C.T.V.50) defined on PET and on scanner. These discordances, synonyms of under or over estimation of target volumes, could have important clinical consequences in term of local control and toxicity. (N.C.)

  6. Prospective study on 12 patients of salivary glands radiotherapy as treatment of salivary stasis in patients suffering from amyotrophic lateral sclerosis; etude prospective sur 12 patients de radiotherapie des glandes salivaires comme traitement de la stase salivaire chez des patients atteints de sclerose laterale amyotrophique

    Assouline, A.; Delanian, S. [Oncologie radiotherapie, centre clinique de la Porte-de-Saint-Cloud, Boulogne (France); Lenglet, T.; Bruneteau, G.; Le Forestier, N.; Salachas, F.; Lebouteux, M.; Abdelnour, M.; Meininger, V.; Pradat, P.F. [Departement des maladies du systeme nerveux, groupe hospitalier Pitie-Salpetriere, AP-HP, Paris (France)


    The authors report a study which aimed at assessing the efficiency and tolerance of salivary gland radiotherapy in patients suffering from amyotrophic lateral sclerosis. Twelve patients have been treated by conformational irradiation after a planning scanography with support mask. Results are discussed in terms of salivary discomfort (almost immediate disappearance in 11 cases), and other minor effects. Although a greater number of patients is still needed, the treatment gives promising results. Short communication

  7. Psychometric properties of the stress index radiooncology (SIRO) - a new questionnaire measuring quality of life of cancer patients during radiotherapy; Psychometrische Eigenschaften des Stress Index RadioOnkologie (SIRO) - ein neuer Fragebogen zur Erfassung der Lebensqualitaet bei Patienten unter Strahlentherapie

    Sehlen, S.; Fahmueller, H.; Lenk, M.; Duehmke, E. [Klinik und Poliklinik fuer Strahlentherapie, Ludwig-Maximilians-Univ., Klinikum Grosshadern, Muenchen (Germany); Herschbach, P. [Inst. und Poliklinik fuer Psychosomatische Medizin, Psychotherapie und Medizinische Psychologie, Technische Univ., Muenchen (Germany); Aydemir, U. [Inst. fuer Biometrie und Epidemiologie, Ludwig-Maximilians-Univ., Klinikum Grosshadern, Muenchen (Germany)


    Purpose: In the course of radiotherapy oncological patients often experience considerable psychosocial distress. For its measurement however, no specific questionnaire is available. The stress index radiooncology (SIRO), which is based upon the results of extensive preliminary studies, will be made available as a screening-instrument to facilitate measurement of psychosocial distress of cancer patients, including radiotherapy-induced distress. The aim of this study is, to psychometrically evaluate the preliminary version of the questionnaire, to transfer it to the final version (SIRO) and to gain information about the psychosocial distress of radiooncological patients at the beginning of radiotherapy. Patients and Methods: 104 cancer patients (18 to 85 years) with different diagnoses have been included in the study (Table 1). The data have been assessed by means of the preliminary version of the new questionnaire SIRO, the HADS, EORTC QLQ-C30 and LS. With 25 patients semistructured clinical interviews have been conducted. (orig.) [German] Hintergrund: Die strahlentherapeutische Behandlung von Tumorpatienten ist haeufig mit starken psychosozialen Belastungen verbunden, fuer deren Erfassung es bisher keinen spezifischen Fragebogen gibt. Mit dem stress index radioonkologie (SIRO), der auf den Analyseergebnissen umfangreicher Voruntersuchungen beruht, soll erstmals ein Screening-Instrument zur Verfuegung gestellt werden, mit dem die psychosozialen Belastungen von Tumorpatienten, einschliesslich der durch Strahlentherapie induzierten, erfasst werden koennen. Ziel dieser Studie ist, die Fragebogen-Vorform psychometrisch zu evaluieren und in die endgueltige Fragebogenversion (SIRO) zu ueberfuehren. Darueber hinaus sollen Informationen ueber das psychosoziale Belastungsprofil radioonkologischer Patienten zu Beginn einer Strahlentherapie gewonnen werden. Patienten und Methoden: 104 Tumorpatienten (18-85 Jahre) mit unterschiedlichen Diagnosen wurden in die Studie aufgenommen

  8. Radiotherapy; Strahlentherapie

    Wannenmacher, M. [Heidelberg Univ., Mannheim (Germany). Abt. fuer Klinische Radiologie; Debus, J. [Univ. Heidelberg (Germany). Abt. Radioonkologie und Strahlentherapie; Wenz, F. (eds.) [Universitaetsklinikum Mannheim (Germany). Klinik fuer Strahlentherapie und Radioonkologie


    The book is focussed on the actual knowledge on the clinical radiotherapy and radio-oncology. Besides fundamental and general contributions specific organ systems are treated in detail. The book contains the following contributions: Basic principles, radiobiological fundamentals, physical background, radiation pathology, basics and technique of brachytherapy, methodology and technique of the stereotactic radiosurgery, whole-body irradiation, operative radiotherapy, hadron therapy, hpyerthermia, combined radio-chemo-therapy, biometric clinical studies, intensity modulated radiotherapy, side effects, oncological diagnostics; central nervous system and sense organs, head-neck carcinomas, breast cancer, thorax organs, esophagus carcinoma, stomach carcinoma, pancreas carcinoma, heptabiliary cancer and liver metastases, rectal carcinomas, kidney and urinary tract, prostate carcinoma, testicular carcinoma, female pelvis, lymphatic system carcinomas, soft tissue carcinoma, skin cancer, bone metastases, pediatric tumors, nonmalignant diseases, emergency in radio-oncology, supporting therapy, palliative therapy.

  9. Literature review on the role of radiotherapy in the treatment of nasopharyngeal cystic adenoid carcinomas about two cases; Revue de la litterature sur la place de la radiotherapie dans le traitement des carcinomes adenoides kystiques du nasopharynx a propos de deux cas

    Hemmich, M.; Hassouni, K.; Elkacemi, H.; Errachdi, A.; Mouhajir, N.; Zaidi, H.; Benjaafar, N. [Institut national d' oncologie, Rabat (Morocco)


    The authors discuss the characteristics and the radiotherapy treatment procedures of cystic adenoid carcinomas, and more precisely the treatment of two of such cases of nasopharyngeal carcinomas. The first one had an incomplete resection surgery followed by curing radiotherapy: he has then been in local-regional control situation for 8 months. The second one had lung metastases, was treated chemotherapy and radiotherapy (decompressive treatment), and died six months after diagnosis. Radiotherapy is considered to be the treatment basis, whereas chemotherapy is a matter of controversy. Short communication

  10. Prognosis value of the COX-2 expression on radiotherapy efficiency and on survival without progression of patients reached by an unoperative glioblastoma; Valeur pronostique de l'expression de COX-2 sur l'efficacite de la radiotherapie et sur la survie sans progression des patients atteints d'un glioblastome inoperable

    Simon, J.M.; Mazeron, J.J. [Groupe Hospitalier de la Pitie-Salepetriere, APHP, Service de Radiotherapie Oncologique, 75 - Paris (France); Mokhtari, K. [Groupe Hospitalier de la Pitie-Salepetriere, APHP, Lab. de Neuropathologie, 75 - Paris (France); Genestie, C. [Groupe Hospitalier de la Pitie-Salepetriere, APHP, Lab. d' Anatomie Pathologique, 75 - Paris (France); Bissery, A. [Groupe Hospitalier de la Pitie-Salepetriere, APHP, Dept. de biostatistiques et d' Anformation Medicale, 75 - Paris (France); Jaillon, P. [Hopital Saint-Antoine, Service de Pharmacologie, 75 - Paris (France)


    The expression of COX-2 is a prediction factor of the lack of response to the radiotherapy of glioblastomas and a less good survival rate without tumor progression, aside other known prognosis factors. These results suggest a selective treatment by an anti-COX-2 could have a radiosensitizer contribution during the radiotherapy of glioblastomas. (N.C.)

  11. Fallbericht: Seltene Raumforderungen der Leiste in der klinischen Erscheinung inguinaler Hernien: eine seminomatöse Lymphknotenmetastase und ein Liposarkom des Samenstranges

    Burger M


    Full Text Available Einleitung: Wir berichten über eine seminomatöse inguinale Lymphknotenmetastase und ein Liposarkom des Samenstranges, die sich klinisch als eine inguinale Hernie präsentierten. Kasuistik: Fall 1: Ein 53jähriger Patient wurde unter der Annahme einer inguinalen Hernie links in einer chirurgischen Abteilung operiert. Es fand sich eine Raumforderung, welche in der Schnellschnittuntersuchung den Befund einer seminomatösen Lymphknotenmetastase ergab. In der folgenden Abklärung ergab sich ein linksseitiges pT2-Seminom. Anamnestisch wurde vor 26 Jahren eine inguinale Varikozelektomie links vorgenommen. Fall 2: Ein 61jähriger Patient stellte sich mit einer schmerzlosen Raumforderung der rechten Leiste vor, die klinisch als inguinale Hernie imponierte und seit drei Jahren größenprogredient war. Die Ultraschall- und MRT-Befunde wurden als eine inguinale Hernie mit einem Peritonealfett enthaltenden Bruchsack gedeutet. Intraoperativ fand sich ein Liposarkom des Samenstranges. Schlußfolgerung: Trotz der Häufigkeit inguinaler Herniotomien sind überraschende maligne Raumforderungen selten. Man sollte diese Möglichkeit aber bei transskrotalen Eingriffen in der Anamnese und bei nicht eindeutig einzuordnenden Befunden differentialdiagnostisch bedenken. Inguinale Lymphknotenmetastasen testikulärer Neoplasien sind selten, in der Literatur ist ein eindeutiger Zusammenhang mit Eingriffen im Skrotal- und Leistenbereich beschrieben. Die klinische Erscheinung einer solchen als Leistenhernie ist bisher noch nicht beschrieben worden. Liposarkome des Samenstranges sind ebenfalls selten. Therapeutisch sollte eine radikale chirurgische Exzision und in Fällen unklarer Absetzungsränder eine Radiatio erfolgen. Lokalrezidive treten häufig und eventuell auch spät auf.

  12. Air breath control radiotherapy in severe insufficiency respiratory patients with N.S.C.L.: application for deformable registration method in thoracic radiotherapy; Radiotherapie avec blocage respiratoire pour les grands insuffisants respiratoires atteints d'un carcinome pulmonaire non a petites cellules (Protocole RESPI 2000): application a la modelisation des deformations d'organes par recalage deformable

    Sarrut, D.; Pommier, P.; Carrie, C. [Centre Leon-Berard, Dept. de Radiotherapie, CREATIS, Unite CNRS 5515, Inserm 630, 69 - Lyon (France); Perol, D. [Centre Leon-Berard, Dept. de Biostatistique, 69 - Lyon (France)


    Purpose. Using deformable registration methods from a phase two clinical study of air breath control during radiotherapy in patients suffering from severe respiratory insufficiency and non-small cell lung carcinoma. Patients and methods, Between April 2002 and November 2005, 22 patients with severe respiratory insufficiency were treated with curative intent by conformal therapy combined with active breathing control. Results. After a mean of follow-up of 22 months, the local control rate is 28% and the method is feasible despite the severe respiratory insufficiency. However the overall survival is still poor due to metastatic widespread. For the second part of the study, the clinical protocol was also used for two studies using deformable registration methods. In the first study, a deformable registration method has been developed in order to register several breath-hold 3D CT of the same patient acquired at several days of interval. It allowed quantifying the inter-fraction breath-hold reproducibility by analysing the resulting displacement field. For 6 patients, the breath-hold was effective, while for 2 patients, motion greater than 10 mm were detected. The second study aimed to simulate 4D images from 3D breath-hold images. Developing an ad-hoc methodology based on the interpolation of 3D dense deformation fields performed it. The approach has been validated with expert selected landmarks, with accuracy lower than 3 mm. Conclusion. ABC is feasible, even in case of severe insufficiency respiratory syndrome but metastatic widespread disease is still a major challenge even with an acceptable local control rate without serious side effects: regarding the deformable registration method. Such artificial 4D images could allow decreasing the dose need to acquire a full 4D image, to simulate irregular breathing pattern and to be used for 4D dosimetry planning. (author)

  13. Breast cancer and per-operation electron radiotherapy: a review of the first 100 patients treated at the Jules-Bordet Institute; Cancer du sein et radiotherapie peroperatoire par electrons: revue des 100 premieres patientes traitees a l'institut Jules-Bordet

    Philippson, C.; Simon, S.; Vandekerkhove, C.; Veys, I.; Noterman, D.; Hertens, D.; Neubourg, F. De; Larsimont, D.; Van Houtte, P.; Nogaret, J.M. [Institutjules-Bordet, Bruxelles (Belgium)


    The authors briefly discuss the results obtained on a cohort of women treated by per-operation radiotherapy for breast cancer. This technique enables a dose equivalent to that of a conventional fractionated external radiotherapy to be delivered in a single session in the tumour bed. Moreover, a weaker dose can be delivered as a boost before a conventional irradiation. Immediate morbidity is steady. Some rare complications have been noticed. Short communication

  14. Postmastectomy radiotherapy

    Shikama, Naoto; Koguchi, Masahiko; Sasaki, Shigeru; Kaneko, Tomoki; Shinoda, Atsunori; Nishikawa, Atsushi [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine


    Since there have been few reports on postmastectomy radiotherapy having a high evidence level in Japan, the significance of postoperative radiotherapy and the irradiation techniques were reviewed based on reports from Western countries. Authors focused on the indications for postoperative irradiation, irradiation methods (irradiation sites, irradiation techniques; prosthetics, methods of irradiating the chest wall and lymph nodes, timing of irradiation), and complications, and discuss them. The factors thought to be adaptable to postmastectomy radiotherapy have been listed. Axillary lymph node metastasis and the size of the primary focus are thought to be important factors in locoregional recurrence. The chest wall and the supraclavicular lymph nodes are the usual sites of irradiation after mastectomy. The irradiation method consists of tangential irradiation of the chest wall and single-field irradiation of the supraclavicular lymph nodes, with 46-50 Gy in fractional doses of 1.8-2 Gy x 5/w is administered for 4.5-5.5 weeks. The timing of irradiation in the West is generally after chemotherapy. Adverse radiation effects include ischemic heart disease, pneumonitis, arm edema, rib fractures, and brachial plexus paralysis. The frequency of these complications is increased by the combined use of chemotherapy or surgery. The breast cancer cure rate in Japan is generally better than in the West. It remains to be determined whether the clinical data from Europe and America are applicable to the treatment of breast cancer in Japan. To address this issue, a clinical investigation should be performed in Japan with close cooperation between surgeons, physicians, pathologists, and radiotherapists. (K.H.)

  15. The morpho-PET with {sup 18}F-F.D.G. improves the definition of the target volume for the radiotherapy of child Hodgkin disease; Le morpho-TEP au 18F-FDG ameliore la definition du volume cible pour la radiotherapie des maladies de Hodgkin de l'enfant

    Metwally, H.; Courbon, F.; David, I.; Blouet, A.; Izar, F.; Rives, M.; Filleron, T.; Vial, J.; Laprie, A. [Institut Claudius-Regaud, Toulouse, (France); Robert, A. [CHU Toulouse, (France)


    The objective is to study the impact of PET-T.D.M. images re-timing before chemotherapy with these ones of dosimetric scanner ( post chemotherapy) on the target volume determination and their inter observers variability among children receiving a closing radiotherapy for a Hodgkin disease. Conclusions: the inter observers variability for the clinical target volume (C.T.V.) definition is significantly reduced by the re-timing of initial PET-T.D.M. images on the ballistic scanner. This study illustrates the interest of the multidisciplinary cooperation between nuclear doctor and radiotherapist for the radiotherapy optimization. (N.C.)

  16. Place of radiotherapy in head and neck paraganglioma: about a series of 30 patients treated at the Bordeaux university hospital centre between 1987 and 2010; Place de la radiotherapie des paragangliomes de la tete et du cou: a propos d'une serie de 30 patients traites au centre hospitalier universitaire de Bordeaux entre 1987 et 2010

    Galland-Girodet, S.; Darrouzet, V.; Maire, J.P.; De-Mones-del-Pujol, E.; Demeaux, H.; Digue, L.; Benech, J.; Protat, B.; Trouette, R.; Aymeri, H. [Service de radiotherapie, CHU de Bordeaux, Bordeaux (France)


    The authors report a study which aimed at revealing the long term effect of radiations on the tumour para-ganglionic tissue, at assessing the efficiency and the role of radiotherapy in taking into care of cervical-cephalic paraganglioma, and at assessing the post-therapeutic quality of life. The study is based on a retrospective analysis of 30 patients treated by irradiation, and the analysis is performed in terms of treatment type, received dose, response to radiotherapy, survival rate, tumour control. Short communication

  17. Hypofractionated stereotactic body radiotherapy (SBRT) for liver metastases. A retrospective analysis of 74 patients treated in the Klinikum rechts der Isar Munich; Die hypofraktionierte, stereotaktische Strahlentherapie von Lebermetastasen. Eine retrospektive Analyse von 74 Patienten des Klinikums rechts der Isar Muenchen

    Heppt, Franz Johannes


    Purpose of this study was to evaluate the outcome of stereotactic body radiotherapy (SBRT) of liver metastases and prognostic factors for local control and overall survival. From 2000 to 2009 74 patients with 91 metastases were treated at the Department for Radiation Therapy and Oncology (TU Muenchen). With an observed local control rate of 75% after 1 year, SBRT proved as an effective local treatment option. Unfortunately, systemic tumor progression still dominates long term survival in many patients.

  18. Assessment of the perfusion of glioblastomas before and during radiotherapy: longitudinal comparison between H{sub 2}-{sup 15}O positron emission tomography and perfusion MRI; Evaluation de la perfusion des glioblastomes en avant et pendant la radiotherapie: comparaison longitudinale entre la tomographie par emission de positons H2 15O et l'IRM de perfusion

    Laprie, A.; Ken, S.; Moyal Cohen-Jonathan, E. [Departement de radiotherapie, institut Claudius-Regaud, 31 - Toulouse (France); Laprie, A.; Ken, S.; Lotterie, J.A.; Franceries, X.; Celsis, P.; Payoux, P.; Berry, I. [Inserm imagerie cerebrale et handicaps neurologiques UMR 825, 31 - Toulouse (France); Lotterie, J.A.; Berry, I. [Departement de biophysique, centre hospitalier universitaire de Rangueil, 31 - Toulouse (France); Barcelo, C. [Departement de radiologie, centre hospitalier universitaire de Purpan, 31 - Toulouse (France)


    The authors report the comparison of different perfusion imagery modalities for patients suffering form glioblastomas and included in a phase-1 clinic trial comprising conformational radiotherapy concomitant with the use of a farnesyl-transferase inhibitor (tipifarnib). With these different techniques, perfusion MRI and perfusion positron emission tomography, the authors made respectively a qualitative and quantitative assessment of the tumour vascularisation. Short communication

  19. Contribution of the return of experience cell (C.R.E.X.) in the risk prevention and management in radiotherapy; Apport de la cellule de retour d'experience (CREX) dans la prevention et la gestion des risques en radiotherapie

    Coche Dequeant, B.; Dumortier, V.; Bouillon, J.; Cheval, V.; Forrest, M.; Giscard, S.; Lacornerie, T.; Lasue, A.; Malfait, B.; Lartigau, E. [Centre Oscar-Lambret, 59 - Lille (France)


    This study concerns the setting up of an analysis and follow up system of unwanted events in the radiotherapy department of the Oscar Lambret center at Lille. This work began on January 2007, the report will precise the functioning details and the first results of this cell. (N.C.)

  20. Influence of patient positioning on heart and coronary doses in the context of radiotherapy for breast cancer; Einfluss der Patientenlagerung auf die Dosisbelastung von Herz und Herzkranzgefaessen bei der Strahlentherapie des Mammakarzinoms

    Stoltenberg, Solveigh Liza


    In this thesis the doses of heart and coronaries as well as the lung dose have been evaluated in the context of patient positioning (prone (pp) and supine position (sp)) in 3D-conformal radiotherapy for breast cancer within 46 patients (33 left-sided, 13 right-sided cancers). The protection of lung tissue reported in various publications has been confirmed. On the other hand, there was no increase of heart dose to be seen in pp. Despite the lack of increase of heart dose in pp, an increase of LAD (left anterior descending)-dose has been detected.

  1. Internal hemipelvectomy with intraoperative and external beam radiotherapy in the limb-sparing treatment of a pelvic girdle chondrosarcoma

    Hoekstra, HJ; Szabo, BG


    The case of a patient with an extensive pelvic girdle chondrosarcoma treated with internal hemipelvectomy and intraoperative radiotherapy, followed by adjuvant high-dose external beam radiotherapy, with a successful attempt in achieving long-term local tumor control and limb-sparing treatment is des

  2. Mediastinal radiotherapy after multidrug chemotherapy and prophylactic cranial irradiation in patients with SCLC - treatment results after long-term follow-up and literature overview; Radiotherapie mediastinale apres chimiotherapie et irradiation prophylactique de l'encephale chez des patients atteints d'un carcinome bronchique a petites cellules - Resultats et revue de la litterature

    Herrmann, M.K.A.; Bloch, E.; Overbeck, T.; Wolff, H.A.; Hille, A.; Hess, C.F.; Christiansen, H. [Department of Radiotherapy, University Hospital Goettingen, Robert-Koch-Str. 40, 37075 Goettingen (Germany); Koerber, W. [Department of Pneumology, Weende Hospital, Section Lenglern, Pappelweg 5, 37120 Bovenden-Lenglern (Germany); Vorwerk, H. [Department of Hematology and Oncology, University Hospital Goettingen, Robert-Koch-Str. 40, 37075 Goettingen (Germany); Muller, M.; Pradier, O. [Department de cancerologie, CHU Morvan, 5, avenue Foch, 29200 Brest cedex (France)


    Introduction. - Curative therapy for patients with small-cell lung cancer (SCLC) is based on multidrug chemotherapy combinations and radiotherapy. After a long time follow-up, the aim of the study was to evaluate the efficacy and toxicity of sequential chemo-radiotherapy and the effect of prophylactic cranial irradiation (PCI). Methods. - From 1995-2005, 96 patients with SCLC (64 limited-disease [LD], 32 extensive-disease [ED]; median age 61 years [range 39-79]) were treated at our department with varying chemotherapy regimens and sequential mediastinal radiotherapy (50 Gy + 10 Gy boost in case of residual disease after chemotherapy). Afterwards, 15 patients with LD, good general condition and at least partial response after local treatment received PCI (30 Gy). Results. - After a median follow-up of 78.6 months, 20 patients remained alive (20.8%, median survival time 18.2 months). The 2-/5-year overall survival rates were 33.8% and 12.6%, the 2-/5-year loco-regional control rates were 30.3% and 24.5%, respectively. Distant metastases occurred in 43 patients (24 cerebral). Cerebral metastasis occurred in 6.7% and 27.2% of the patients with PCI and without PCI respectively. Only tumor stage showed a statistically significant impact on overall survival and loco-regional control in multivariate analysis. Radiotherapy was well tolerated. Grade 3/4 toxicity occurred in seven patients. Prognosis of patients with SCLC remains poor. Administration of PCI in selected patients bears a decrease in the incidence of cerebral metastases. Alternative chemotherapy schemes as well as irradiation schemes and techniques should be the substance of future randomized trials. (authors)

  3. Radiotherapy for Hodgkin lymphoma

    Specht, Lena [Rigshospitalet Copenhagen Univ. (Denmark). Depts. of Oncology and Haematology; Yahalom, Joachim (eds.) [Memorial Sloan-Kettering Cancer, New York, NY (United States). Dept. of Radiation Oncology


    This book deals in detail with all aspects of the best practice in modern radiotherapy for Hodgkin lymphoma. It provides the background and rationale for the inclusion of radiotherapy in today's combined-modality approach, including special clinical situations such as Hodgkin lymphoma in children, in the pregnant patient, and in the elderly. Radiotherapy planning using state-of-the-art imaging, target definition, planning software, and treatment equipment is expounded in detail. Acute and long-term side effects of radiotherapy are analyzed, and the implications for modern radiotherapy approaches in Hodgkin lymphomas are explained. (orig.)

  4. Feedback on the significant events of radiation protection declared to Asn in external radiotherapy, from necessity of a quality management to the service of risk management; Retour d'experience sur les evenements significatifs de radioprotection declares a l'asn en radiotherapie externe, de la necessite d'un management de la qualite au service de la gestion des risques

    Marchal, C. [ASN, 75 - Paris (France); Garandel, S.; Godet, J.L. [Angers Univ., 49 (France)


    The declaration of events in the perspective of a experience feedback towards the professionals contributes to improve the treatments safety. The stakes in term of treatments safety is in the capitalization of these experience feedbacks from declarations. Well, the publication of regulatory obligations in matter of quality assurance and their appropriation by the whole of medical teams should improve the treatment safety and and increase their quality. To the end, without being unaware of the current difficulties encountered y some centers because of the lack of radio physicists, the approach of significant events declaration and risk analysis should allow to the french radiotherapy to become an international reference. (N.C.)

  5. Conformal radiotherapy with intensity modulation and integrated boost in the head and neck cancers: experience of the Curie Institute; Radiotherapie conformationnelle avec modulation d'intensite et boost integre des cancers de la tete et du cou: experience de l'institut Curie

    Toledano, I.; Serre, A.; Bensadoun, R.J.; Ortholan, C.; Racadot, S.; Calais, G.; Alfonsi, M.; Giraud, P. [Centre Jean-Perrin, 63 - Clermont-Ferrand (France); Graff, P.; Serre, A.; Bensadoun, R.J.; Ortholan, C.; Racadot, S.; Calais, G.; Alfonsi, M.; Giraud, P. [Hopital Europeen Georges-Pompidou, 75 -Paris (France)


    The modulated intensity radiotherapy (I.M.R.T.) is used in the treatment of cancers in superior aero digestive tracts to reduce the irradiation of parotids and to reduce the delayed xerostomia. This retrospective study presents the results got on the fourteen first patients according an original technique of I.M.R.T. with integrated boost. It appears that this technique is feasible and allows to reduce the xerostomia rate without modifying the local control rate. To limit the average dose to the parotids under 30 Gy seems reduce the incidence of severe xerostomia. (N.C.)

  6. National radiotherapy Observatory. Inquiry report: situation at the end of 2010 and evolution since 2007. Context and method, results of data from 2010, conclusion; Observatoire national de la radiotherapie. Rapport d'enquete: situation fin 2010 et evolution depuis 2007. Contexte et methode, resultats des donnees 2010, conclusion



    Illustrated by data tables and graphs, this document presents and discusses the results of an inquiry made on radiotherapy centres about their equipment (linear accelerators and additional equipment, number of days opened to patients, use, quality control and maintenance duration, treatment preparation, equipment dedicated to quality control), their activities (evolution of the number of treated patients, of treatments, and of treatment sessions between 2007 and 2010, number of sessions per apparatus, dosimetry, techniques), their personnel (evolution of the number of radiotherapists, radio-physicists, operators and dosimetrists, time dedicated to training), and their practices

  7. Des tuiles, des toits et des couleurs

    Bonnot, Thierry


    La Bourgogne est une des régions françaises dont l’image de marque est le plus imprégnée par la notion de tradition. Elle est présentée comme un terroir où il fait bon vivre, où la gastronomie demeure à travers les siècles une valeur de base, où les paysages sont majestueux et où la gloire passée est sans cesse rappelée par de somptueux monuments. Parmi quelques emblèmes, l’hôtel-Dieu de Beaune et ses toitures de tuiles colorées sont très souvent mobilisés pour représenter ces valeurs « tradi...

  8. [French experience in paediatric total body irradiation: A study from the radiotherapy committee of the Société française des cancers de l'enfant (SFCE)].

    Demoor-Goldschmidt, C; Supiot, S; Claude, L; Carrie, C; Mazeron, R; Helfré, S; Alapetite, C; Jouin, A; Coche, B; Padovani, L; Muracciole, X; Bernier, V; Vigneron, C; Noël, G; Leseur, J; Le Prisé, É; Stefan, D; Habrand, J L; Kerr, C; Bondiau, P Y; Ruffier, A; Chapet, S; Mahé, M A


    A survey was conducted in 2015 in France on the care of children in radiotherapy services. We present the results for total body irradiation in children, a specific technique of radiation treatment, which needs dedicated controls for this particular population. Of the 17 centres interviewed, 16 responded, and 13 practiced total body irradiation. Patients are positioned in lateral decubitus in 11 centres and supine/prone in two centres. Doses used for total body irradiation in myeloablative bone marrow transplantation are the same in all centres (12Gy); treatments are always fractionated. Lung shielding is positioned to limit the dose at an average of 8Gy with extremes ranging from 6 to 10Gy. The shape of the shieldings varies depending on departments' protocol, with a smaller size in case of mediastinal mass. Four centres have experience of total body irradiation under general anaesthesia, despite twice-daily fractions. In total, practice is relatively homogeneous throughout France and is inspired by the knowledge obtained in adults.

  9. Peripheral dose from neutrons and photons in the radiation treatment of pelvic tumors with conventional technique or VMAT. A review; Periphere Neutronen- und Photonendosis bei der Radiotherapie von Tumoren des Beckens mit konventioneller Technik oder VMAT. Eine Literaturuebersicht

    Winkler, P. [Medizinische Univ. Graz (Austria). Comprehensive Cancer Center


    Peripheral neutron and photon doses from external beam radiation therapy are associated with the risk of carcinogenesis in organs distant to the treated volume. In the irradiation of tumors and target volumes in the pelvis with convention photon-radiotherapy beams with high nominal energies (above 15 MeV) are typically used. During the last years volumetric modulated arc therapy (VMAT) techniques have gained a wide-spread use for pelvic treatments. The beam-energies that are primarily used in VMAT are below 10 MeV. Therefore, a reduction in peripheral dose due to the absence of neutrons can be expected when VMAT is utilized. On the other hand the number of monitor units is increased in increased in VMAT, as compared to conventional unmodulated fields, by a factor of two to three. This leads to an increase in transmission dose from the machine's treatment head, such that the potential benefit might be outbalanced. The question, whether the increasing use of VMAT might lead to a reduction of peripheral dose, is the subject of several studies. Those studies use either measurements in phantom settings or Monte-Carlo simulations. A systematic review of the literature shows diverging, and sometimes even contradictory, findings. Therefore, the issue of peripheral dose and the risk for secondary malignancies requires further investigation. In our opinion, the focus should be put on measurements and simulations, but also on modelling of dose-response correlations.

  10. Electronic compensation for breast external radiotherapy: use of digital reconstruct radiograph; Compensation electronique dans les traitements de cancer du sein par irradiation: utilisation des radiographies numeriques reconstruites (digital reconstruct radiograph [DRR])

    Gres, B.; Foulquier, J.N.; Orthuon, A.; Huguet, F.; Keraudy, K.; Touboul, E. [Hopital Tenon, Service de Radiotherapie, 75 - Paris (France)


    Purpose In case of external breast radiotherapy, the usual treatment consists of two tangential beams homogeneously attenuated by a dynamic or physics wedge in order to obtain the most homogeneous dose distribution as possible. Depending of the shape and size of the breast volume, we may observe with this technique dose heterogeneity over 20% from the recommendation of the International Committee on Radiation Units and Measurements (95-107%). We propose to study breast treatment planning by compensating tissues thickness in order to decrease dose heterogeneity observed on the dose distribution for conventional treatment. Materials and methods We have segmented the initial tangential beams used for this kind of treatment into several smaller beams. Their shape was adapted to the distribution of the greys level on the D.R.R. image. Therefore, we have compensated the thickness gradient and we have given the right dose to the right thickness group. Results Dose distribution performed with this method shows an improvement of the dose homogeneity in the three space dimensions and a decrease of the maximal dose between 5 and 10% over the ICRU recommendation. Conclusion This technique allows us to perform breast irradiation on a single photon energy linac even if the treated volume presents important thickness gradient. However, in case of large breast, this method is not able to reduce the overdosage at the entry of the volume due to inappropriate photon energy relative to the breast thickness. (authors)

  11. Gross tumor volume (GTV) and clinical target volume (CTV) for radiation therapy of benign skull base tumours; Volume tumoral macroscopique (GTV) et volume-cible anatomoclinique (CTV) dans la radiotherapie des tumeurs benignes de la base du crane

    Maire, J.P. [Centre Hospitalier Universitaire de Bordeaux, Hopital Saint Andre, Service d' Oncologie Radiotherapie, 33 - Bordeaux (France); Liguoro, D.; San Galli, F. [Centre Hospitalier Universitaire de Bordeaux, Hopital Saint Andre, Service de Neurochirurgie A, 33 - Bordeaux (France)


    Skull base tumours represent a out 35 to 40% of all intracranial tumours. There are now many reports in the literature confirming the fact that about 80 to 90% of such tumours are controlled with fractionated radiotherapy. Stereotactic and 3-dimensional treatment planning techniques increase local control and central nervous system tolerance. Definition of the gross tumor volume (GTV) is generally easy with currently available medical imaging systems and computers for 3-dimensional dosimetry. The definition of the clinical target volume (CTV) is more difficult to appreciate: it is defined from the CTV plus a margin, which depends on the histology and anterior therapeutic history of the tumour. It is important to take into account the visible tumour and its possible extension pathways (adjacent bone, holes at the base of skull) and/or an anatomic region (sella turcica + adjacent cavernous sinus). It is necessary to evaluate these volumes with CT Scan and MRI to appreciate tumor extension in a 3-dimensional approach, in order to reduce the risk of marginal recurrences. The aim of this paper is to discuss volume definition as a function of tumour site and tumour type to be irradiated. (authors)

  12. Severe Dry Eye Syndrome After Radiotherapy for Head-and-Neck Tumors

    Bhandare, Niranjan, E-mail: [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Moiseenko, Vitali [Vancouver Cancer Centre, Vancouver, BC (Canada); Song, William Y. [University of California, San Diego, San Diego, CA (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Bhatti, M. Tariq [Department of Ophthalmology and Medicine (Division of Neurology), Duke University Medical Center, Durham, NC (United States); Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)


    Purpose: To investigate the incidence of severe dry eye syndrome (DES) after external beam radiotherapy for head-and-neck cancer and its dependence on the parameters relevant to external beam radiotherapy. Methods and Materials: The present retrospective study included 78 patients treated for primary extracranial head-and-neck tumors between 1965 and 2000, whose lacrimal apparatus/entire globe was exposed to fractionated external beam radiotherapy. The dose received by the major lacrimal gland was used for analysis. The end point of the present study was the ophthalmologic diagnosis of severe DES leading to vision compromise. Results: Of the 78 patients, 40 developed severe DES leading to visual compromise. The incidence of DES increased steadily from 6% at 35-39.99 Gy to 50% at 45-49.99 Gy and 90% at 60-64.99 Gy. With a mean of 0.9 years (range, 1 month to 3 years), the latency of DES was observed to be a function of the total dose and the dose per fraction. On univariate and multivariate analysis, the total dose (p < .0001 and p < .0001, respectively) and dose per fraction (p {<=} .0001 and p = .0044, respectively) were significant. However, age, gender, and the use of chemoradiotherapy were not. The actuarial analysis indicated a 5-year probability of freedom from DES of 93% for doses <45 Gy, 29% for 45-59.9 Gy, and 3% doses {>=}60 Gy. A logistic normal tissue complication probability model fit to our data obtained a dose of 34 and 38 Gy corresponding to a 5% and 10% incidence of DES. Conclusion: With a dose of 34 Gy corresponding to a 5% incidence of DES, the risk of severe DES increased, and the latency decreased with an increase in the total dose and dose per fraction to the lacrimal gland. The effect of chemoradiotherapy and hyperfractionation on the risk of DES needs additional investigation.

  13. Radiotherapy of esthesioneuroblastoma. Radiotherapie beim Aesthesioneuroblastom

    Strnad, V. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik); Grabenbauer, G.G. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik); Dunst, J. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik); Sauer, R. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik)


    From 1985 through 1990, twelve patients with estehesioneuroblastoma have been treated at the Department of Radiotherapy at the University of Erlangen. Two had Kadish stage A, one stage B, and nine stage C. There were seven males and five females with a mean age of 43 years. Eleven patients had combined trancranial-transbasal surgery prior to radiotherapy (five R0-, four R1-, and two patients R2-resections) and one received radiotherapy only. The dose was 12 to 60 Gy (mean 54 Gy) in 1.8 Gy to 2 Gy per fraction. 8/12 patients (67%) were locally controlled. One had progressive disease during radiotherapy after partial resection and died. Three had local recurrences, one in-field and two marginal. One patient with a local recurrence developed cervical lymph node metastases, and one locally controlled patient developed bone metastases but is alive eight years after chemotherapy plus radiotherapy for metastatic disease. The five-year-overall and recurrence-free survival was 72% and 55%, respectively. (orig./MG)

  14. Hypoxyradiotherapy - changes in selected physiological parameters of healthy tissue during breathing of hypoxic gas-mixture; Hypoxie-Radiotherapie: Veraenderungen ausgewaehlter physiologischer Parameter des gesunden Gewebes bei Atmung eines hypoxischen Gasgemisches

    Strnad, V. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Grebmeier, J. [Erlangen-Nuernberg Univ., Erlangen (Germany). Abt. Kernspintomographie; Riepl, M. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Kirschner, M. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie


    {sup 31}Phosphor-Magnetresonanz-Spektroskopie ({sup 31}P-MRS) bestimmt. Um den hypoxischen Zustand herbeizufuehren und fuer die notwendige Dauer zu halten, verwendeten wir ein Gasgemisch mit 8,2% O{sub 2}. Die {sup 31}P-MRS erfolgte an einem Magnetom 1,5 Tesla am Muskulus triceps surae. In der Gruppe A veraenderten sich signifikant die Werte von Sauerstoffpartialdruck (pO{sub 2}), Sauerstoffsaettigung (O{sub 2}ST) und Pulsfrequenz. Die pO{sub 2}-Werte sanken in der fuenften Minute um mehr als 50% des Ausgangswertes. In Gruppe B haben wir keine statisch signifikanten Veraenderungen der Quotienten der Phosphorylmetaboliten gefunden. Die Daten zeigen eine sehr gute Vertraeglichkeit der Atmung der hypoxischen Gasmischung und bestaetigen, dass die Gasmischung mit 8,2% O{sub 2} eine Senkung der pO{sub 2}-Werte um mehr als 50% herbeifuehrt. Dies ist notwendig, um einen dosismodifizierenden Faktor in Hoehe von mindestens 1,15 bis 1,20 zu erreichen. Die Veraenderungen in den Quotienten der Phosphorylmetaboliten spiegeln am wahrscheinlichsten die Faehigkeit des gesunden Gewebes wider, sich an die hypoxischen Bedingungen - beginnend ab der zehnten Minute - einzustellen, was letztendlich nach etwa 30 Minuten zum Verlust der radioprotektiven Wirkung fuehrt. (orig.)

  15. Targeted tumor radiotherapy

    Unak Perihan


    Full Text Available Targeted tumor radiotherapy is selectively delivery of curative doses of radiation to malignant sites. The aim of the targeted tumor radiotherapy is to use the radionuclides which have high LET particle emissions conjugated to appropriate carrier molecules. The radionuclides are selectively collected by tumor cells, depositing lethal doses to tumor cells while no admission occur to normal cells. In theory, targeted radiotherapy has several advantages over conventional radiotherapy since it allows a high radiation dose to be administered without causing normal tissue toxicity, although there are some limitations in the availability of appropriate targeting agents and in the calculations of administered doses. Therefore, for routine clinical applications more progress is still needed. In this article, the potential use of targeted tumor radiotherapy is briefly reviewed. More general aspects and considerations, such as potential radionuclides, mechanisms of tumor targeting was also outlined.

  16. Intra-operative implantation of Gliadel (BCNU, carmustine) wafers in patients suffering from a multiform glioblastoma and which are to be submitted to a concomitant radiotherapy and chemotherapy by temozolomide according to the Stupp protocol: efficiency and toxicity; Implanation peroperatoire de pastilles de Gliadel (BCNU, carmustine) chez des patients atteints d'un glioblatome multiforme devant recevoir par la suite une radiotherapie et une chimiotherapie concomitante par temozolomide selon le protocole de Stupp: efficacite et toxicite

    Miglierini, P.; Bouchekoua, M.; Rousseau, B.; Malhaire, J.P.; Pradier, O. [Service de radiotherapie, ICH, CHU Morvan, 29 - Brest (France)


    The author report a study aimed at assessing the tolerance and efficiency of a technique which has been used for some years and which comprises the implantation of Gliadel wafers in the operative bed before performing a concomitant radiotherapy and chemotherapy with temozolomide, followed by six adjuvant chemotherapy sessions with the Stupp protocol. Four women and seven men have been implanted with Gliadel wafers. Only one patient did not have the concomitant chemo-radiotherapy. The global survival and global survival without progression have been assessed. Even though the obtained results are encouraging, the concomitant chemo-radiotherapy had to be stopped for three patients due to haematological consequences. Short communication

  17. Dosimetric evaluation of an automatic segmentation tool of pelvic structures from MRI images for prostate cancer radiotherapy; Evaluation dosimetrique d'un outil de delineation automatique des organes pelviens a partir d'images IRM pour la radiotherapie du cancer prostatique

    Pasquier, D.; Lacornerie, T.; Lartigau, E. [Centre Oscar-Lambret, Dept. Universitaire de Radiotherapie, 59 - Lille (France); Pasquier, D. [Centre Galilee, Polyclinique de la Louviere, 59 - Lille (France); Pasquier, D.; Betrouni, N.; Vermandel, M.; Rousseau, J. [Lille-2 Univ., U703 Thiais, Inserm, Lab. de Biophysique EA 1049, Institut de Technologie Medicale, CHU de Lille, 59 (France)


    Purpose: An automatic segmentation tool of pelvic structures from MRI images for prostate cancer radiotherapy was developed and dosimetric evaluation of differences of delineation (automatic versus human) is presented here. Materials and methods: C.T.V. (clinical target volume), rectum and bladder were defined automatically and by a physician in 20 patients. Treatment plans based on 'automatic' volumes were transferred on 'manual' volumes and reciprocally. Dosimetric characteristics of P.T.V. (V.95, minimal, maximal and mean doses), rectum (V.50, V.70, maximal and mean doses) and bladder (V.70, maximal and mean doses) were compared. Results: Automatic delineation of C.T.V. did not significantly influence dosimetric characteristics of 'manual' P.T.V. (projected target volume). Rectal V-50 and V.70 were not significantly different; mean rectal dose is slightly superior (43.2 versus 44.4 Gy, p = 0.02, Student test). Bladder V.70 was significantly superior too (19.3 versus 21.6, p = 0.004). Organ-at-risk (O.A.R.) automatic delineation had little influence on their dosimetric characteristics; rectal V.70 was slightly underestimated (20 versus 18.5 Gy, p = 0.001). Conclusion: C.T.V. and O.A.R. automatic delineation had little influence on dosimetric characteristics. Software developments are ongoing to enable routine use and interobserver evaluation is needed. (authors)

  18. Exclusive radiotherapy and concurrent endocrine therapy for the management of elderly breast cancer patients: Case study and review of hypo-fractionated schemes; Hormonoradiotherapie exclusive dans la prise en charge du cancer du sein de la personne agee: cas clinique et revue de la litterature des schemas hypofractionnes

    Auberdiac, P.; Cartier, L.; Malkoun, N.; Chauleur, C.; De Laroche, G.; Magne, N. [Departement de radiotherapie, institut de cancerologie de la Loire, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex (France); Chargari, C. [Service d' oncologie radiotherapie, hopital d' instruction des armees du Val-de-Grace, 74, boulevard de Port-Royal, 75230 Paris cedex 5 (France); Melis, A.; Jacquin, J.P. [Departement d' oncologie medicale, institut de cancerologie de la Loire, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex (France)


    Normo-fractionated radiotherapy is standard for adjuvant management of patients treated with breast conservative surgery for breast cancer. However, many elderly patients are not eligible to such strategy, either because of concurrent diseases, or because the tumor is inoperable. Several protocols of exclusive radiotherapy have been reported in the literature, frequently using hypo-fractionated radiotherapy and endocrine therapy. We report a case of a patient treated with exclusive endocrine and radiotherapy and address the state of the art on hypo-fractionated schemes for the management of elderly breast cancer patients. While hypo-fractionated radiotherapy does not compromise the oncologic or cosmetic outcome, there is no prospective data that assesses the place of radiotherapy for the exclusive treatment of elderly patients. This strategy should be further assessed in clinical randomized trial. (authors)

  19. Impact of computed tomography (CT) and {sup 18}F-deoxyglucose positron emission tomography (FDG-PET) image fusion for conformal radiotherapy in esophageal carcinoma; Tomographie par emission de positons et fusion d'images de simulation virtuelle par tomodensitometrie. Impact sur la planification de la radiotherapie conformationnelle des cancers de l'oesophage

    Moureau-Zabotto, L.; Touboul, E.; Lerouge, D.; Deniaud-Alexandre, E.; Foulquier, J.N.; Gres, B.; El Balaa, H.; Keraudy, K. [Hopital Tenon AP-HP, Service d' Oncologie-Radiotherapie, Paris-6 Univ., CancerEst, GHU Est, 75 - Paris (France); Grahek, D.; Petenief, Y.; Kerrou, B.K.; Montravers, F.; Talbot, J.N. [Hopital Tenon AP-HP, Service de Medecine Nucleaire, Paris-6 Univ., CancerEst, GHU Est, 75 - Paris (France); Tiret, E. [Hopital Saint-Antoine AP-HP, Service de Chirurgie Digestive, Paris-6 Univ., CancerEst, GHU Est, 75 - Paris (France); Gendre, J.P. [Hopital Saint-Antoine AP-HP, Service de Gastroenterologie et Nutrition, Paris-6 Univ., CancerEst, GHU Est, 75 - Paris (France); Grange, J.D. [Hopital Tenon AP-HP, Service de Gastroenterologie, Paris-6 Univ., CancerEst, GHU Est, 75 - Paris (France); Hourry, S. [Hopital Tenon AP-HP, Service de Chirurgie Digestive, Paris-6 Univ., CancerEst, GHU Est, 75 - Paris (France)


    Purpose. - To study the impact of fused {sup 18}F-fluoro-deoxy-D-glucose (FDG)-hybrid positron emission tomography (PET) and computed tomography (CT) images on conformal radiation therapy (CRT) planning for patients with esophageal carcinoma. Patients and Methods. - Thirty-four patients with esophageal carcinoma were referred for concomitant radiotherapy and chemotherapy with radical intent. Each patient underwent CT and FDG-hybrid PET for simulation treatment in the same radiation treatment position. PET-images were co-registered using five fiducial markers. Target delineation was initially performed on CT images and the corresponding PET data were subsequently used as an overlay to CT data to define the target volume. Results. - FDG-PET identified previously undetected distant metastatic disease in 2 patients, making them ineligible for curative CRT. The Gross Tumor Volume (GTV) was decreased by CT and FDG image fusion in 12 patients (35%) and was increased in 7 patients (20.5%). The GTV reduction was {>=} 25% in 4 patients due to reduction of the length of the esophageal tumor. The GTV increase was {>=} 25% with FDG-PET in 2 patients due to the detection of occult mediastinal lymph node involvement in one patient and an increased length of the esophageal tumor in the other patient. Modifications of the GTV affected the planning treatment volume (PTV) in 18 patients. Modifications of delineation of GTV and displacement of the isocenter of PTV by FDG-PET also affected the percentage of total lung volume receiving more than 20 Gy (VL20) in 25 patients (74%), with a dose reduction in 12 patients and a dose increase in 13 patients. Conclusion. - In our study, CT and FDG-PET image fusion appeared to have an impact on treatment planning and management of patients with esophageal carcinoma related to modifications of GTV. The impact on treatment outcome remains to be demonstrated. (authors)

  20. Standards and options: recommendations for the use of erythropoiesis-stimulating agents (ESA) in anemic cancer patients undergoing radiotherapy (2007 update); Standards, options: recommandations 2007. Indication des agents stimulants l'erythropoiese (ASE) dans la prise en charge de l'anemie induite par la radiotherapie

    Marchal, Ch. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Misset, J.L. [Hopital Saint-Louis, 75 - Paris (France); Casadevall, N. [Hopital Saint Antoine, 75 - Paris (France); Marec-Berard, P.; Ray-Coquard, I. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Chastagner, P. [Hopital d' Enfants Nancy, 54 (France); Kassab-Chahmi, D. [Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC), 75 - Paris (France)


    Introduction. - Beginning 1998, a working group of specialists convened by the guidelines department (Standards, Options and Recommendations: S.O.R.) of the National French Federation of Comprehensive Cancer Centres (F.N.C.L.C.C.) published then regularly updated Recommendations relative to the use of ESA (epoetin alfa, epoetin beta, darbepoetin) in anemic patients with cancer. This article presents the updated Recommendations set up in 2007. Methods. - This updating process is based on the methodology developed and used in the 'Standards, Options: Recommendations' programme. The methodological approach combines systematic review with the judgement of a multidisciplinary group of experts. On the basis of analysis of literature, the conclusions and their level of evidence are established. Then, the conclusions accompanied by experts judgement lead to the Recommendations. A Recommendation is a proposal of one or several clinical attitudes intended to improve cancer patient care. Before publication, the R.P.C.-S.O.R. are re-examined by independent reviewers selected according to the same principles as the group of expert writers. Results. - New data, relative to the 'use of ESA in anemic cancer patients undergoing radiotherapy', did not lead to update the latest Recommendations validated in 2003. However, new data relative to the 'use of ESA in anaemia prophylaxis among adult patients with cancer' and to the 'use of iron with ESA in cancer patients' were sufficient to generate either major or minor modifications to the initial Recommendations. Conclusions. - Thus, it appears relevant to re-examine these Recommendations according to a systematic monitoring process which should be renewed in two years. (authors)

  1. Planning a Radiotherapy Department.

    van der Merwe, D


    The master planning of new radiotherapy facilities requires the input and engagement of a range of highly specialised professionals, both in the construction and health sector. Although radiation protection and safety aspects of radiotherapy services are universal, low and middle income countries are often presented with unique challenges that also need to be considered, e.g. competing needs within the health sector, lack of financial and human resources, environmental factors like poor provision of transport or electrical power, inadequate regulatory infrastructure, etc. Efforts to establish, upgrade or expand radiotherapy services should therefore not only focus on the technology that is appropriate and sustainable, but also be mindful of the need for quality, safety and optimal utilisation of technology. The workflow in a radiotherapy department can be facilitated by strategic placement of the main functional areas into the concept design. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Nanoparticle-guided radiotherapy


    The present invention relates to a method and nano-sized particles for image guided radiotherapy (IGRT) of a target tissue. More specifically, the invention relates to nano-sized particles comprising X-ray-imaging contrast agents in solid form with the ability to block x-rays, allowing for simult...... for simultaneous or integrated external beam radiotherapy and imaging, e.g., using computed tomography (CT)....

  3. Loin des sciences sociales.

    René-Éric Dagorn


    Full Text Available Plusieurs numéros de Livres Hebdo et du Monde des Livres des mois de janvier-février 2002 permettent de proposer un rapide survol des grandes ventes de l’année 2001 et de quelques tendances éditoriales de l’année 2002. Quelques points ressortent particulièrement de la lecture des articles de ces deux sources : l’intérêt de la nouvelle méthode d’estimation des ventes proposée par l’institut Ipsos et Livres Hebdo , le tableau des grandes ventes en 2001 (et ...

  4. La metamorphose des cypris femelles des Rhizocephales

    Veillet, A.


    Depuis la découverte de la métamorphose des cypris de Sacculina carcini Thompson par Delage, peu de biologistes se sont intéressés au développement des Rhizocéphales. On admet aujourd'hui que tous les Cirripèdes parasites ont, comme Sacculina carcini, une forme kentrogone qui inocule le parasite au



    L'étude de l'art et des biens culturels en général est longtemps restée en ... en économie et management), Université d'Angers / Chef de projet chez Arterial Network. ... culturelles publiques sont apparues à partir de la fin des années 1990.

  6. Des racines et des ailes

    Stéphanie Vincent-Geslin


    Full Text Available Les mobilités pendulaires semblent être en augmentation en Europe depuis une dizaine d’années. Cette croissance du temps passé à se déplacer amène à remettre en question la conjecture de Zahavi et apparaît relativement inexplicable en regard du paradigme classique de l’acteur rationnel traditionnellement utilisé dans le champ des transports. Si, dans la littérature, les temps de déplacements sont principalement expliqués par le contexte résidentiel, la forme urbaine et le travail, ce cadre explicatif ne dit rien des processus de décision eux-mêmes qui amènent aux pendularités intensives.À partir d’une enquête qualitative menée auprès de pendulaires français, suisses et belges, cette contribution propose d’analyser les arbitrages et les éléments déterminants des processus de la grande pendularité. Les mobilités quotidiennes pendulaires apparaissent comme le résultat de compromis entre activité professionnelle, attachement résidentiel et choix de vie et prennent ainsi la forme de stratégies de conciliation entre vie privée et vie professionnelle. Ces mobilités spatiales permettent alors paradoxalement la préservation des ancrages résidentiels, sociaux et familiaux.Roots and wings. Long-distance commuting patterns, or how to conciliate professional and personal lifeLong-distance commuting patterns appear to be increasing in Europe over the last ten years. These raising mobility patterns lead to reappraise the Zahavi conjecture and appear largely inexplicable by the classical rational actor paradigm traditionally used in transportation research. In literature, commuting is mainly explained by residential contexts, urban forms and job. Nevertheless this theoretical frame says little about the decision-making processes themselves. Based on a qualitative survey conducted in three European countries - France, Belgium and Switzerland – among a population of high commuters, this paper proposes an analysis of

  7. Radiotherapy for the medulloblastoma

    Gose, Kyuhei; Imajo, Yoshinari; Imanaka, Kazufumi (Kobe Univ. (Japan). School of Medicine)


    Eighteen patients with medulloblastoma, treated between 1972 and 1981, at Kobe University School of Medicine, were retrospectively studied. Of those completing post operative irradiation, 50% have survived for 2 years, 15% for 5 years and mean survival periods was 22.2 months. 13 out of 18 patients developed local recurrence and spinal dissemination. The mean time from the initial radiotherapy to recurrence was 8.5 months. It was suggested that posterior fossa should recieve 5,000 rad, the spine should 2,000 rad and recurrences should be treated by the combination of radiotherapy and chemotherapy.

  8. Xerostomia induced by radiotherapy

    Alimi D


    Full Text Available David Alimi Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USAWe read with great interest the excellent review on xerostomia induced by radiotherapy, by Pinna et al.1 The authors should be congratulated for a very detailed review of the physiopathology, clinical symptoms, and therapeutic management of an extremely difficult condition. Although we agree that the use of anticholinergic medication represents treatment, it requires the patient to have residual salivary gland function. Unfortunately, it is well established that in most cases radiotherapy destroys most of the salivary gland and associated salivary secretions.     

  9. Erythropoietin and radiotherapy; Erythropoietine et radiotherapie

    Le Fur, E.; Albarghach, M.N.; Pradier, O. [CHU de Morvan, Dept. de radiotherapie, 29 - Brest (France)


    Erythropoietin (E.P.O.) is a glycoprotein hormone. This hormone is a growth factor for red blood cells precursors in the bone marrow. The decrease of oxygen partial pressure, a reduced number of erythrocytes caused by bleeding or excessive destruction, or increased tissues oxygen requirements lead to increased secretion of E.P.O.. Its action takes place on bone marrow erythroblastic cells through specific receptors. E.P.O. stimulates the proliferation of red cell precursors stem cells in the bone marrow, thus increasing their production in one to two weeks. The effectiveness of E.P.O. at increasing haemoglobin and improving patients quality of life has been demonstrated by several studies. However, its use in radiotherapy remains controversial. While tumour hypoxia caused by anaemia is a factor of radio resistance and thus a source of local failure, tumour expression of E.P.O. receptors presents a significant risk for tumour progression and neo-angiogenesis, which would be increased during the administration of E.P.O.. The purpose of this article is to answer the question: is there a place for E.P.O. in combination with radiotherapy in the management of cancer?

  10. Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

    Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik


    Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

  11. Radiotherapy of calcaneal spur; Strahlentherapeutische Behandlung des schmerzhaften Fersenbeinsporns

    Schaefer, U. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Micke, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Glashoerster, M. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Ruebe, C. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Prott, F.J. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Willich, N. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie


    From April 1981 through December 1991, 18 patients with painful heel were irradiated mostly with the caesium or telecobalt unit, usually with a dose of 4 times 0.5 Gy. Among these patients, 12 could be followed up during a prolonged period on the basis of questionnaires. According to the categories of v. Pannewitz 17% of the patients were pain-free by the end of the treatment course, 22% showed marked improvement, 33% showed improvement and in 28% the pain was not influenced. Over an average of 41.5 months 58% of the patients reported freedom from pain. (orig./MG) [Deutsch] Von April 1981 bis Dezember 1991 wurden 18 Patienten mit einem schmerzhaften Fersenbeinsporn am Caesium- oder Telekobaltbestrahlungsgeraet behandelt, in der Regel mit einer Einstrahldosis von viermal 0,5 Gy. Von diesen Patienten konnten zwoelf mit Hilfe von Frageboegen ueber einen laengeren Zeitraum nachbeobachtet werden. Entsprechend der Einteilung nach von Pannewitz waren 17% der Patienten sofort nach der Behandlung schmerzfrei, 22% wesentlich gebessert, 33% gebessert und 28% unbeeinflusst. Nach im Median 41,5 Monaten berichteten 58% der Patienten von Schmerzfreiheit. (orig./MG)

  12. Innovations in Radiotherapy Technology.

    Feain, I J; Court, L; Palta, J R; Beddar, S; Keall, P


    Many low- and middle-income countries, together with remote and low socioeconomic populations within high-income countries, lack the resources and services to deal with cancer. The challenges in upgrading or introducing the necessary services are enormous, from screening and diagnosis to radiotherapy planning/treatment and quality assurance. There are severe shortages not only in equipment, but also in the capacity to train, recruit and retain staff as well as in their ongoing professional development via effective international peer-review and collaboration. Here we describe some examples of emerging technology innovations based on real-time software and cloud-based capabilities that have the potential to redress some of these areas. These include: (i) automatic treatment planning to reduce physics staffing shortages, (ii) real-time image-guided adaptive radiotherapy technologies, (iii) fixed-beam radiotherapy treatment units that use patient (rather than gantry) rotation to reduce infrastructure costs and staff-to-patient ratios, (iv) cloud-based infrastructure programmes to facilitate international collaboration and quality assurance and (v) high dose rate mobile cobalt brachytherapy techniques for intraoperative radiotherapy. Copyright © 2016 The Royal College of Radiologists. All rights reserved.

  13. Radiotherapy for craniopharyngioma.

    Aggarwal, Ajay; Fersht, Naomi; Brada, Michael


    Radiotherapy remains the mainstay of multidisciplinary management of patients with incompletely resected and recurrent craniopharyngioma. Advances in imaging and radiotherapy technology offer new alternatives with the principal aim of improving the accuracy of treatment and reducing the volume of normal brain receiving significant radiation doses. We review the available technologies, their technical advantages and disadvantages and the published clinical results. Fractionated high precision conformal radiotherapy with image guidance remains the gold standard; the results of single fraction treatment are disappointing and hypofractionation should be used with caution as long term results are not available. There is insufficient data on the use of protons to assess the comparative efficacy and toxicity. The precision of treatment delivery needs to be coupled with experienced infrastructure and more intensive quality assurance to ensure best treatment outcome and this should be carried out within multidisciplinary teams experienced in the management of craniopharyngioma. The advantages of the combined skills and expertise of the team members may outweigh the largely undefined clinical gain from novel radiotherapy technologies.

  14. [Radiotherapy for Graves' ophthalmopathy].

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J


    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  15. Liste des intrants 2015

    Speiser, Bernhard; Tamm, Lucius; Maurer, Veronika; Berner, Alfred; Schneider, Claudia; Chevillat, Véronique


    La liste des intrants contient tous les produits phytosanitaires, les engrais, les substrats du commerce, les produits de lutte contre les mouches des étables, les agents d'ensilage, les aliments minéraux et complémentaires, les produits pour la désinfection des stabulations et les produits contre les maladies des abeilles autorisés pour l'agriculture biologique. Cette liste est contraignante pour les producteurs de Bio Suisse. Sur les fermes Bio Suisse, seuls les produits mentionnés sont aut...

  16. Radiotherapy of hemangiomas

    Gauwerky, F.


    The findings about the regular, spontaneous and complete regression of cavernous skin hemangiomas occurring in infants and those findings about the damaging effects due to ionising radiation - here particularly local growth disturbances - led to the development of very cautious diagnostic methods and to a considerate individual dosage and radiotherapy, which always takes into consideration the spontaneous regression tendency of the hemangiomas. However, a function-impairing localisation at the orifices, fulminant macrosomia, tendency to hemorrhages and poly-infection with superficial ulceration and even thrombopenic syndromes of the Kasabach-Merritt type may become necessary, urgent and also vital indications for a particular radiotherapy. For the sake of the patients, irradiation methods, which do not provoke any risk of radiation hazards, have to be preserved and applied in practice. Certainly further research and the nosologic nature of hemangiomas is required. A general non-treatment of hemangiomas is refused.

  17. Melanoma: Last call for radiotherapy.

    Espenel, Sophie; Vallard, Alexis; Rancoule, Chloé; Garcia, Max-Adrien; Guy, Jean-Baptiste; Chargari, Cyrus; Deutsch, Eric; Magné, Nicolas


    Melanoma is traditionally considered to be a radioresistant tumor. However, radiotherapy and immunotherapy latest developments might upset this radiobiological dogma. Stereotactic radiotherapy allows high dose per fraction delivery, with high dose rate. More DNA lethal damages, less sublethal damages reparation, endothelial cell apoptosis, and finally clonogenic cell dysfunction are produced, resulting in improved local control. Radiotherapy can also enhance immune responses, inducing neoantigens formation, tumor antigen presentation, and cytokines release. A synergic effect of radiotherapy with immunotherapy is expected, and might lead to abscopal effects. If hadrontherapy biological properties seem able to suppress hypoxia-induced radioresistance and increase biological efficacy, ballistic advantages over photon radiations might also improve radiotherapy outcomes on usually poor prognosis locations. The present review addresses biological and clinical effects of high fraction dose, bystander effect, abscopal effect, and hadrontherapy features in melanoma. Clinical trials results are warranted to establish indications of innovative radiotherapy in melanoma.

  18. DEGRO practical guidelines: radiotherapy of breast cancer III - radiotherapy of the lymphatic pathways

    Sautter-Bihl, M.L. [Staedtisches Klinikum Karlsruhe, Klinik fuer Radioonkologie und Strahlentherapie, Karlsruhe (Germany); Sedlmayer, F.; Fussl, C. [LKH Salzburg, Paracelsus Medical University Hospital, Department of Radiotherapy and Radiation Oncology, Salzburg (Austria); Budach, W. [University Hospital Duesseldorf, Duesseldorf (Germany); Dunst, J. [University Hospital Schleswig-Holstein, Luebeck (Germany); Feyer, P. [Klinikum Neukoelln, Berlin (Germany); Fietkau, R.; Sauer, R. [University Hospital Erlangen, Erlangen (Germany); Harms, W. [St. Clara Hospital, Basel, Basel (Switzerland); Piroth, M.D. [Helios-Klinikum Wuppertal, Klinik fuer Strahlentherapie und Radioonkologie, Wuppertal (Germany); Souchon, R. [University Hospital Tuebingen, Tuebingen (Germany); Wenz, F. [University Hospital Mannheim, Mannheim (Germany); Haase, W.


    suggest that the current restrictive use of RNI should be scrutinized because the risk-benefit relationship appears to shift towards an improvement of outcome. (orig.) [German] Aktualisierung der DEGRO-Leitlinie von 2008 zur adjuvanten Strahlentherapie des regionalen Lymphabflusses bei Mammakarzinom und Ergaenzung der allgemeinen Empfehlungen der interdisziplinaeren S3-Leitlinie der Deutschen Krebsgesellschaft von 2012 durch spezifisch radioonkologische Leitlinien zur Indikation, Zielvolumendefinition und Technik der postoperativen Radiotherapie. Die DEGRO-Expertengruppe Mammakarzinom fuehrte eine systematische Literaturrecherche nach randomisierten Studien, Metaanalysen sowie internationalen Leitlinien durch, die nach 2008 publiziert wurden und sich an den Kriterien evidenzbasierter Medizin orientierten. Suchbegriffe waren ''breast cancer'', ''radiotherapy'' und ''regional node irradiation''. Die Studien wurden sowohl auf ihre Ergebnisse als auch hinsichtlich der Unterschiede in den Zielvolumina analysiert und auf 3-D-Planungsschnittbilder mit CT-konturierten Lymphabflussgebieten projiziert. Die Indikation zur regionalen Lymphabflussbestrahlung (RNI) wird in internationalen Leitlinien unterschiedlich gestellt. Bei Patientinnen mit 1-3 befallenen axillaeren Lymphknoten wurden nach RNI im Vergleich zur alleinigen Bestrahlung der Brust oder Brustwand Verbesserungen der lokoregionalen Kontrolle und des Ueberlebens beobachtet. Mehrere randomisierte Studien und eine Metaanalyse zeigten nach RNI (mit unterschiedlichen Zielvolumina) eine zwar geringe, jedoch signifikante Verbesserung des Ueberlebens. Bei positivem Sentinel-Lymphknoten (SN) ist die Lymphabflussbestrahlung einer axillaeren Lymphonodektomie (ALND) gleichwertig in der lokalen Tumorkontrolle, geht aber mit einer deutlich geringeren Lymphoedemrate einher. Zur Frage, ob ein solch limitierter Lymphknotenbefall und selbst eine Mikrometastasierung langfristig

  19. Radiotherapy of vertebral hemangiomas

    Sakata, Kohichi; Hareyama, Masato; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Tamakawa, Mituharu; Akiba, Hidenari; Morita, Kazuo [Dept. of Radiology, Sapporo Medical Univ., School of Medicine (Japan)


    Between 1975 and 1996, 14 patients (11 females, 3 males) with vertebral hemangioma received treatment with radiotherapy. Thirteen patients had a history of back pain or lumbago and 2 patients had neurological symptoms such as sensory impairment or paraplegia. The standard dose administered was 36 Gy in 18 fractions (five treatments per week). In the 13 patients with pain, this was completely or partially relieved. The condition of a man with hypesthesia of the legs deteriorated and a woman with paraplegia who was treated with decompressive laminectomy followed by radiotherapy recovered completely after irradiation. CT scan before irradiation showed thickened trabeculae as small punctate areas of sclerosis in all patients. At MR imaging before irradiation, T2-weighted MR images showed areas of high intensity in all patients and MR images demonstrated lesion enhancement. However, none of the patients who were treated successfully with radiation demonstrated any changes of the affected vertebra in the conventional radiographic films, CT scan or MR imaging, even 5 years after irradiation. Radiological imaging is indispensable for the diagnosis of vertebral hemangiomas but does not appear to be useful for evaluating the effects of radiotherapy. (orig.).

  20. Gestion des risques

    Louisot, Jean-Paul


    Depuis le début du lie siècle, la gestion des risques connaît une véritable révolution culturelle. Jusqu'alors fonction technique, centrée autour de l'achat de couverture d'assurances, elle est devenue une discipline managériale et transversale : une valise d'instruments que chaque manager doit connaître et appliquer quels que soient son domaine de compétence et ses missions au sein de l'organisation. En effet, la gestion des risques est une culture qui doit être assimilée par chacun des acteurs. C'est précisément l'ambition des 101 questions rassemblées dans cet ouvrage : apporter à chaque manager d'entreprise, de collectivité, d'établissement de santé..., des réponses claires au " pourquoi " et au " comment " : Comment identifier les risques ? Comment analyser les risques ? Quels sont les objectifs de la gestion des risques ? Une carte des risques pour quoi faire ? Pourquoi faut-il financer les risques ? Les entreprises ont-elles des responsabilités pénales ? En quoi consiste la gestion...

  1. Le dialogisme intertextuel des contes des Grimm


    « Le caractère le plus important de l’énoncé, ou en tous cas le plus ignoré, est son dialogisme, c’est-à-dire sa dimension intertextuelle », constate Todorov en référence à la conception dialogique du langage proposée par Bakthine. Cet article introductif postule que ce constat s’applique aussi aux contes des Grimm. En partant des recherches déjà menées sur Apulée, Straporola, Basile, Perrault, La Fontaine et Lhéritier, il présente des concepts (réponse intertextuelle, reconfiguration génériq...

  2. Plan optimization for stereotactic radiotherapy

    J.A. de Pooter (Jacobus Abraham)


    textabstractCancer is one of the leading causes of death in the world. Next to surgery and chemotherapy, radiotherapy is one of the most used treatment modalities for cancer. About 50% of the patients with cancer will be treated with radiotherapy during the management of their disease. In radiothera

  3. The Confluence of Radiotherapy & Immunotherapy

    Ralph Robert Weichselbaum


    Full Text Available Radiotherapy has been considered a local modality and outcomes have emphasized local and regional control of tumors. Recent data suggests that radiotherapy may activate the immune system and the combination of radiation therapy and immune therapies may have the potential to improve both local and distant control of tumor deposits. Below we review principals underlying the concepts of combining both modalities.

  4. Bystander effects and radiotherapy.

    Marín, Alicia; Martín, Margarita; Liñán, Olga; Alvarenga, Felipe; López, Mario; Fernández, Laura; Büchser, David; Cerezo, Laura


    Radiation-induced bystander effects are defined as biological effects expressed after irradiation by cells whose nuclei have not been directly irradiated. These effects include DNA damage, chromosomal instability, mutation, and apoptosis. There is considerable evidence that ionizing radiation affects cells located near the site of irradiation, which respond individually and collectively as part of a large interconnected web. These bystander signals can alter the dynamic equilibrium between proliferation, apoptosis, quiescence or differentiation. The aim of this review is to examine the most important biological effects of this phenomenon with regard to areas of major interest in radiotherapy. Such aspects include radiation-induced bystander effects during the cell cycle under hypoxic conditions when administering fractionated modalities or combined radio-chemotherapy. Other relevant aspects include individual variation and genetics in toxicity of bystander factors and normal tissue collateral damage. In advanced radiotherapy techniques, such as intensity-modulated radiation therapy (IMRT), the high degree of dose conformity to the target volume reduces the dose and, therefore, the risk of complications, to normal tissues. However, significant doses can accumulate out-of-field due to photon scattering and this may impact cellular response in these regions. Protons may offer a solution to reduce out-of-field doses. The bystander effect has numerous associated phenomena, including adaptive response, genomic instability, and abscopal effects. Also, the bystander effect can influence radiation protection and oxidative stress. It is essential that we understand the mechanisms underlying the bystander effect in order to more accurately assess radiation risk and to evaluate protocols for cancer radiotherapy.

  5. Radiotherapy of benign diseases

    Haase, W.


    Still today radiotherapy is of decisive relevance for several benign diseases. The following ones are briefly described in this introductory article: 1. Certain inflammatory and degenerative diseases as furuncles in the face, acute thrombophlebitis, recurrent pseudoriparous abscesses, degenerative skeletal diseases, cervical syndrome and others; 2. rheumatic joint diseases; 3. Bechterew's disease; 4. primary presenile osteoporosis; 5. syringomyelia; 6. endocrine ophthalmopathy; 7. hypertrophic processes of the connective tissue; 8. hemangiomas. A detailed discussion and a profit-risk analysis is provided in the individual chapters of the magazine.

  6. Photonique des Morphos

    Berthier, Serge


    La photonique est déjà présente dans notre vie quotidienne, et on attend maintenant que la manipulation des photons permette aussi le traitement logique des informations. Cependant, l’élément de base qui permet cette manipulation de la lumière, le cristal photonique, est d’une réalisation complexe et mal contrôlée. Dans la course à la maîtrise de la lumière, les structures photoniques naturelles ont beaucoup à nous apprendre. C’est ce que nous montre Serge Berthier qui étudie dans ce livre la structure des écailles des Morphos. Tenant compte de l’essor récent des approches biomimétiques, il présente de manière détaillée plus de dix-huit techniques expérimentales utilisées pour ses analyses, ainsi que les diverses approches théoriques développées pour la modélisation de structures multi-échelles complexes. Première étude quasi-exhaustive des structures fines d’un genre et des propriétés optiques ainsi que colorimétriques générées, ce livre fournit aux entomologiste...

  7. Droit des organisations internationales

    Sorel, Jean-Marc; Ndior, Valère


    Cet ouvrage collectif offre aux enseignants et chercheurs en droit international, aux praticiens et aux étudiants, une analyse actualisée du droit des organisations internationales. Il dresse en cinq parties un tableau, illustré par des exemples variés, des problématiques que soulève le phénomène polymorphe d institutionnalisation de la société internationale. La première partie est consacrée au phénomène des « organisations internationales », sous l angle à la fois de l institutionnalisation progressive des relations internationales et de la difficulté à cerner une catégorie unifiée. La deuxième partie rend compte de la création, de la disparition et des mutations des organisations internationales, ici envisagées comme systèmes institutionnels et ordres juridiques dérivés. La troisième partie analyse l autonomie que l acquisition de la personnalité juridique et de privilèges et immunités, un organe administratif intégré, un personnel ou un budget propres confèrent aux organi...

  8. Proton minibeam radiotherapy

    Girst, Stefanie


    The risk of developing adverse side effects in the normal tissue after radiotherapy is often limiting for the dose that can be applied to the tumor. Proton minibeam radiotherapy, a spatially fractionated radiotherapy method using sub-millimeter proton beams, similar to grid therapy or microbeam radiation radiotherapy (MRT) using X-rays, has recently been invented at the ion microprobe SNAKE in Munich. The aim of this new concept is to minimize normal tissue injuries in the entrance channel and especially in the skin by irradiating only a small percentage of the cells in the total irradiation field, while maintaining tumor control via a homogeneous dose in the tumor, just like in conventional broad beam radiotherapy. This can be achieved by optimizing minibeam sizes and distances according to the prevailing tumor size and depth such that after widening of the minibeams due to proton interactions in the tissue, the overlapping minibeams produce a homogeneous dose distribution throughout the tumor. The aim of this work was to elucidate the prospects of minibeam radiation therapy compared to conventional homogeneous broad beam radiotherapy in theory and in experimental studies at the ion microprobe SNAKE. Treatment plans for model tumors of different sizes and depths were created using the planning software LAPCERR, to elaborate suitable minibeam sizes and distances for the individual tumors. Radiotherapy-relevant inter-beam distances required to obtain a homogeneous dose in the target volume were found to be in the millimeter range. First experiments using proton minibeams of only 10 μm and 50 μm size (termed microchannels in the corresponding publication Zlobinskaya et al. 2013) and therapy-conform larger dimensions of 100 μm and 180 μm were performed in the artificial human in-vitro skin model EpiDermFT trademark (MatTek). The corresponding inter-beam distances were 500 μm, 1mm and 1.8 mm, respectively, leading to irradiation of only a few percent of the cells

  9. Breast cancer radiotherapy: controversies and prospectives

    YU Jin-ming; WANG Yong-sheng


    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  10. Dental Encounter System (DES)

    Department of Veterans Affairs — Dental Encounter System (DES) is an automated health care application designed to capture critical data about the operations of VA Dental Services. Information on...

  11. Table des illustrations


    Tableaux Dates d’inauguration des grands hôtels japonais entre 1860 et 1945… 19 Histoire, tourisme et hôtellerie en Corée depuis les années 1870… 59-60 Dates d’inauguration des grands hôtels chinois depuis 1863… 84 Les hôtels de luxe et leurs capacités d’hébergement en Corée en 2000… 103 Les flux de personnes suscités par les hôtels « super luxe » de Séoul en 2000… 105 L’activité des grands hôtels à Séoul en 1999 (en wons)… 106 Propriété et gestion des grands hôtels à Séoul en 1999…. 110 La c...

  12. Chimie des processus biologiques

    Fontecave, Marc


    La chimie du vivant : enzymes et métalloenzymes, des biocatalyseurs fascinants La catalyse enzymatique, ce pouvoir que possèdent certaines protéines d’accélérer de façon extraordinaire et d’orienter avec une précision fascinante les réactions chimiques de la cellule, reste, encore aujourd’hui, l’un des grands mystères des systèmes vivants. Les réactions dont il est question vont de la simple hydrolyse de liaisons peptidiques à des processus poly-électroniques d’une très grande complexité, com...

  13. Vom Ort des Philosophierens

    Damir Barbaric


    Im Aufsatz wird versucht, den ursprünglichen Sinn der Platonischen Bestimmung vom Staunen als Anfang der Philosophie zu ermitteln, und zwar durch eine kritischen Abhebung von ihrer Umdeutung bei Aristoteles, und dann insbesondere in der Stoa wie auch bei Spinoza und Hegel. Dabei wird auf die frühgriechische Erfahrung vom Staunen als _______ aufmerksam gemacht, wo es vor allem die Grundstimmung des Dabeiseins des Göttlichen und der menschlichen Teilnahme am Göttlichen bedeutet. Dem entspricht ...

  14. Liste des auteurs


    Fariba Adelkhah est chargée de recherche à la Fondation nationale des sciences politiques, Centre d’études et de recherches internationales (CERI) [] Jean-Marie Bouissou est chargé de recherche à la Fondation nationale des sciences politiques, Centre d’études et de recherches internationales (CERI) [] Jean-Louis Briquet est chargé de recherche au CNRS, Centre d’études et de recherches internationales (CERI) [...

  15. La revolution des savants

    Chavanne, A


    Premiere cassette : - 1666 : impact de la creation de l'Academie des Sciences par Colbert, trente ans apres le proces de Galile, et au moment des disparitions de Pascal, Descartes et Fermat. Elle dirigee par le hollandais Huyggens jusqu'a sa fuite de France au moment de la revocation de l'Edit de Nantes. - 1750 : l'Encyclopedie (ou "Dictionnaire raisonne des Sciences, des Arts et des Metiers") de Diderot et d'Alembert, soutenus par Malherbes, Buffon, Condorcet et Rousseau. - 1789 : Revolution francaise. - 8 aout 1793 : l'Assemblee, par une declaration de Marat, dissout l'Academie des Sciences. Celle-ci continue cependant ses travaux pour les poids et mesures jusqu'en 1795. - la Terreur : la condamnation a mort, pas au nom d'une "Revolution qui n'a pas besoin de savants" mais pour d'autres raisons, de trois grands hommes de science : Lavoisier, Bailly et Condorcet. - 1793-1794 : Au printemps 93, le Comite de Salut Publique s'inquiete du demi-million de soldats etrangers de toutes les pays frontaliers qui essai...

  16. Adaptive Motion Compensation in Radiotherapy

    Murphy, Martin J


    External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution--adapting delivery to natural movement--a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy. This authoritative book discusses: Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and pati

  17. Le dialogisme intertextuel des contes des Grimm


    Loin d'être « purement allemands », nombre de contes des Grimm réécrivent les contes français largement diffusés en Allemagne au XVIIIe siècle en les « reconfigurant » selon leurs propres paradigmes esthétiques et idéologiques. L'étude introductive de la comparatiste Ute Heidmann montre que ce dialogisme européen est resté peu exploré en raison d’une « scénographie en trompe-l’œil » qui les présente comme issus du « terroir » hessois. Toutefois, les notes des Grimm (constituées en volume auto...

  18. Maladie des vibrations

    Shen, Shixin (Cindy); House, Ronald A.


    Résumé Objectif Permettre aux médecins de famille de comprendre l’épidémiologie, la pathogenèse, les symptômes, le diagnostic et la prise en charge de la maladie des vibrations, une maladie professionnelle importante et courante au Canada. Sources d’information Une recherche a été effectuée sur MEDLINE afin de relever les recherches et comptes rendus portant sur la maladie des vibrations. Une recherche a été effectuée sur Google dans le but d’obtenir la littérature grise qui convient au contexte canadien. D’autres références ont été tirées des articles relevés. Message principal La maladie des vibrations est une maladie professionnelle répandue touchant les travailleurs de diverses industries qui utilisent des outils vibrants. La maladie est cependant sous-diagnostiquée au Canada. Elle compte 3 éléments : vasculaire, sous la forme d’un phénomène de Raynaud secondaire; neurosensoriel; et musculosquelettique. Aux stades les plus avancés, la maladie des vibrations entraîne une invalidité importante et une piètre qualité de vie. Son diagnostic exige une anamnèse minutieuse, en particulier des antécédents professionnels, un examen physique, des analyses de laboratoire afin d’éliminer les autres diagnostics, et la recommandation en médecine du travail aux fins d’investigations plus poussées. La prise en charge consiste à réduire l’exposition aux vibrations, éviter les températures froides, abandonner le tabac et administrer des médicaments. Conclusion Pour assurer un diagnostic rapide de la maladie des vibrations et améliorer le pronostic et la qualité de vie, les médecins de famille devraient connaître cette maladie professionnelle courante, et pouvoir obtenir les détails pertinents durant l’anamnèse, recommander les patients aux cliniques de médecine du travail et débuter les demandes d’indemnisation de manière appropriée. PMID:28292812

  19. La convergence des rôles respectifs des relationnistes et des journalistes influence-t-elle la perception qu'ils ont les uns des autres?

    Valentini, Chiara


    la convergence des rôles respectifs des praticiens des relations publiques et des journalistes a un effet favorable sur la perception qu’ils ont les uns des autres. L’effet est plus marqué chez les praticiens des relations publiques, car leur vision de la profession en journalisme correspond à celle...

  20. Postoperative radiotherapy for endometrial cancer

    Choi, Eun Cheol; Kim, Jin Hee; Kim, Ok Bae; Byun, Sang Jun; Park, Seung Gyu; Kwon, Sang Hoon


    .... Sixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study...

  1. Targeted intraoperative radiotherapy in oncology

    Keshtgar, Mohammed; Wenz, Frederik


    Targeted intraoperative radiotherapy is a major advance in the management of cancer patients. With an emphasis on practical aspects, this book offers an ideal introduction to this innovative  technology for clinicians.

  2. Stereotactic radiotherapy for vestibular schwannoma

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno;


    ; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

  3. À propos des occasionnalismes

    Dal Georgette


    Full Text Available Les occasionnalismes (nonce formations ou contextual formations dans la terminologie anglo-saxonne, qu’on définira provisoirement comme de “new complex word[s] created by a speaker/writer on the spur of the moment to cover some immediate need” (Bauer, 1983 : 45 ont, à notre connaissance, peu retenu l’attention des morphologues du domaine francophone. Pourtant, toutes les conditions sont désormais réunies pour que cet objet, invisible lorsqu’il s’agissait de décrire le système morphologique du français (ou d’autres langues à partir de ressources dictionnairiques, émerge en tant qu’observable dans une morphologie puisant ses données dans le réel langagier des locuteurs. Par définition en effet, on s’attend à ce qu’un occasionalisme soit absent des dictionnaires (nous verrons que, dans les faits, la situation est plus complexe que cela, et que ces contextual formations ne puissent pas être étudiées en dehors du contexte dans lequel elles ont été produites. À cet égard, la Toile et les produits qui en dérivent constituent des ressources de choix. C’est particulièrement vrai des forums, dans lesquels les internautes s’expriment librement, laissant libre cours à leur potentiel créatif (ou ce qu’ils pensent tel. Dans la présente communication, après avoir défini la notion d’occasionalisme, nous utiliserons un corpus constitué au fil d’autres recherches pour dégager des motifs récurrents propices à leur apparition, autrement dit pour établir une grammaire des occasionnalismes.

  4. Des Vents et des Jets Astrophysiques

    Sauty, C.

    well expected result from the theory. Although, collimation may be conical, paraboloidal or cylindrical (Part 4), cylindrical collimation is the more likely to occur. The shape of outflows may then be used as a tool to predict physical conditions on the flows or on their source. L'éjection continue de plasma autour d'objets massifs est un phénomène largement répandu en astrophysique, que ce soit sous la forme du vent solaire, de vents stellaires, de jets d'étoiles en formation, de jets stellaires autour d'objets compacts ou de jets extra-galactiques. Cette zoologie diversifiée fait pourtant l'objet d'un commun effort de modélisation. Le but de cette revue est d'abord de présenter qualitativement le développement, depuis leur origine, des diverses théories de vents (Partie 1) et l'inter disciplinarité dans ce domaine. Il s'agit d'une énumération, plus ou moins exhaustive, des idées proposées pour expliquer l'accélération et la morphologie des vents et des jets, accompagnée d'une présentation sommaire des aspects observationnels. Cette partie s'abstient de tout aspect faisant appel au formalisme mathématique. Ces écoulements peuvent être décrits, au moins partiellement, en résolvant les équations magnétohydrodynamiques, axisymétriques et stationnaires. Ce formalisme, à la base de la plupart des théories, est exposé dans la Partie 2. Il permet d'introduire quantitativement les intégrales premières qu'un tel système possède. Ces dernières sont amenées à jouer un rôle important dans la compréhension des phénomènes d'accélération ou de collimation, en particulier le taux de perte de masse, le taux de perte de moment angulaire ou l'énergie du rotateur magnétique. La difficulté de modélisation réside dans l'existence de points critiques, propres aux équations non linéaires, qu'il faut franchir. La nature physique et la localisation de ces points critiques fait l'objet d'un débat important car ils sont la clef de voute de la r

  5. Radioprotectors in Radiotherapy

    Nair, C.K.K. [Bhabha Atomic Research Centre, Mumbai (India); Parida, D.K.; Nomura, Taisei


    This review article focuses on clinically relevant radioprotectors and their mechanisms of radioprotection. Radiotherapy is the most common modality of human cancer therapy. Obtaining optimal results requires a judicious balance between the total dose of radiotherapy delivered and the threshold limit of critical surrounding normal tissues, and the normal tissues need to be protected against radiation injury to obtain better tumor control by using a higher dose. For this reason, radiation-protective agents play an important role in clinical radiotherapy. Radiation-protective agents can be classified into three groups: radioprotectors, adaptogens, and absorbents. The first group generally consists of sulfhydryl compounds and other antioxidants. They include several myelo-, entero-, and cerebro-protectors. Adaptogens act as promotors of radioresistance. They are natural protectors that offer chemical protection against low levels of ionizing radiation. Absorbents protect organs from internal radiation and chemicals. They include drugs that prevent incorporation of radioiodine by the thyroid gland and absorption of radionuclides. This article thoroughly describes the properties, mechanisms of action, and perspectives on clinical application of the following categories of radioprotectors: sulfhydryl compounds (e.g., cysteine, cysteamine, glutathione, AET, WR 2127, and other WR-compounds), antioxidants (e.g., tempace, Hoechst 33342, vitamin A, E, and C, TMG, melatonin), angiotensin-converting enzyme (ACE) inhibitors (e.g., captopril, elanopril, penicillamine, pentoxifylline, L-158, 809), cytoprotective agents (mesna, dexrazoxane, and amifostin), metalloelements (e.g., manganese chloride, cadmium salts, bismuth subnitrate), immunomodulators (gamma-interferon, polysaccharides AM5, AM218, heat-killed lactobacillus cells, broncho-vaxom, trehalose dicorynomycolate, and AS101), lipopolysaccharides and prostaglandins, plant extracts and compounds isolated from plants (curcmin

  6. Table des illustrations


    Intégrer les Tsiganes Hongrie, 1970 (photo DR) 34 Discuter entretient la fraternité. (photo M. Stewart) 35 La veille du mariage (photo M. Stewart) 36 Le « salon » (photo M. Stewart) 37 Les activités économiques des Tsiganes sont conçues comme des jeux. (photo M. Stewart) 39 Lev cheval (photo I. Nemeth) 41 Le cortège d’un mariage (photo M. Stewart) 43 Avant le mariage (photo M. Stewart) 43 C’est par le chant (photo M. Stewart) 45 Des « frères » boivent en harmonie (photo M. Stewart) 46 Les che...

  7. Geschichte des SIN

    Pritzker, Andreas


    Dieses Buch erzählt die Geschichte des Schweizerischen Instituts für Nuklearforschung (SIN). Das Institut wurde 1968 gegründet und ging 1988 ins Paul Scherrer Institut (PSI) über. Die Gründung des SIN erfolgte in einer Zeit, als die Physik weitherum als Schlüsseldisziplin für die technologische und gesellschaftliche Entwicklung galt. Der Schritt war für ein kleines Land wie die Schweiz ungewöhnliche und zeugte von Mut und Weitsicht. Ungewöhnlich waren der Folge die Leistungen des SIN im weltweiten Vergleich sowie sein Einfluss auf die schweizerische, teils auf die internationale Wissenschaftspolitik.

  8. Les lueurs des sables

    Les lueurs des sables


    Two CERN ladies are getting ready for the “Trophée Roses des Sables” rally adventure: Julie and Laetitia are finalizing the last details before setting off on Monday 7th October 2013. Julie from EN-MEF group and Laetitia from DGS-SEE group, met at the CERN Rugby club. This year, they are participating in the 100 % female rally which will take place in Morocco from 10 to 20 October. They will be carrying along 100 kg of humanitarian donation for children such as some clothes, books and medical material. Do not hesitate to show your support at their farewell party to be held on Monday 7 October, from 4 to 6 pm in front of the St Genis-Pouilly Mairie (city Hall). Follow their exciting adventure on the blog and on their association’s Facebook page Les Lueurs des Sables.

  9. Conservative treatment of anal canal carcinoma with external radiotherapy and interstitial brachytherapy, with or without chemotherapy: long-term results; Traitement conservateur des cancers du canal anal par irradiation suivie de curietherapie interstitielle, avec ou sans chimiotherapie: resultats a long terme

    Berger, C.; Felix-Faure, C.; Chauvet, B.; Vincent, P.; Alfonsi, M.; Coudurier, P.; Plat, F.; Reboul, F. [Clinique Sainte-Catherine, 84 - Avignon (France)


    Purpose: a retrospective analysis of conservative treatment of anal canal cancers with external radiation therapy and interstitial brachytherapy with or without chemotherapy. Patients and methods: from 1986 to 1996, 69 patients were treated with external radiotherapy (40 Gy/20 fractions) and interstitial brachytherapy (20 Gy) after a mean interval of six weeks for a localized epidermoid carcinoma of the anal canal. Patients who did not complete the whole therapeutic sequence were not included. Forty-five patients received additional 5-fluorouracil- and/or mitomycin C-based chemotherapy regimen. Results: acute toxicity was acceptable. Complete response rate was 81%. Actuarial local control rate was at two and five years, 65% and 59% respectively (median follow-up: eight years). At two, five and ten years, actuarial colostomy rate was 26%, 33% and 33% respectively, and colostomy-free survival rates 61%, 47% and 37%. Overall survival at two, five and ten years was 81%, 65% and 53% respectively. Distant metastases occurred in 11 patients (16%). Prognostic factors for overall survival were performance status (PS) (79% survival at five years for patients with PS 0 versus 50% for patients with PS 1-3, P = 0.04) and tumor stage (80% at five years for T1-T2 versus 53% for T3-T4, P = 0.03). Overall treatment time less than 12 weeks and time interval between external radiotherapy and brachytherapy inferior than six weeks were associated with a better local control (P = 0.05). In multivariate analysis, these prognostic factors were not significant. Conclusion: these results confirm the efficacy of external radiotherapy and brachytherapy in the treatment of small anal canal cancers, and point out the need for improving treatment outcome of larger tumors. (author)

  10. Des Groupes et des Œuvres

    Grojnowski, Daniel


    À la fin du xixe siècle, les groupes de bohèmes se multiplient et se diversifient, des salons privés aux tavernes ou cabarets. Une étude aussi attentive que possible de trois d’entre eux (les Zutiques, les Hydropathes, les Incohérents) montre la diversité de leurs configurations, ainsi que l’importance déterminante que leurs productions revêt au regard de la postérité.

  11. Differentialdiagnose des Ulcus cruris

    Binder B


    Full Text Available Das Ulcus cruris ist eine Erkrankung vor allem des höheren Lebensalters. Ungefähr 1 % der Bevölkerung leidet an einer chronischen Wunde. An die 90 % der Ulzera sind vaskulärer Genese, doch gibt es vielfältige weitere Ursachen. Die Kenntnis der relevanten Differentialdiagnosen ist insbesondere bei therapierefraktären Verläufen von Bedeutung. Dazu gehören Neuropathien, myeloproliferative Erkrankungen, Infektionen, Medikamente oder Hauttumore. Für eine erfolgreiche Behandlung des Ulcus cruris ist die Identifikation der Genese von entscheidender Bedeutung, um eine kausale, interdisziplinäre Therapie zu ermöglichen.

  12. Liste des Auteurs


    Amor Hakima, Université Cadi Ayyad, Faculté des sciences Semlalia, Département de biologie, Laboratoire d’écologie humaine, Marrakech, Maroc. Angeli Aurora, Universita degli studi di Bologna, Dipartimento di scienze statiche “Paolo Fortunati”, Bologne, Italie. Baali Abdellatif, Université Cadi Ayyad, Faculté des sciences Semlalia, Département de biologie, Laboratoire d’écologie humaine, Marrakech, Maroc. Bachtarzi T., Hôpital Ibn Sina, CHU Annaba, Algérie. Baudot Patrick, Université de Proven...

  13. Liste des Auteurs


    Amor Hakima, Université Cadi Ayyad, Faculté des sciences Semlalia, Département de biologie, Laboratoire d’écologie humaine, Marrakech, Maroc. Angeli Aurora, Universita degli studi di Bologna, Dipartimento di scienze statiche “Paolo Fortunati”, Bologne, Italie. Baali Abdellatif, Université Cadi Ayyad, Faculté des sciences Semlalia, Département de biologie, Laboratoire d’écologie humaine, Marrakech, Maroc. Bachtarzi T., Hôpital Ibn Sina, CHU Annaba, Algérie. Baudot Patrick, Université de Proven...

  14. Radiotherapy and skin tumors; Radiotherapie et tumeurs curanees

    Calitchi, E.; KIrova, Y.; Le bourgeois, J.P. [Hopital Henri-Mondor, 94 - Creteil (France)


    Radiotherapy plays an important role in treatment of skin tumours. For skin carcinomas, external irradiation (kilo-voltage X-rays or electrons according to clinical characteristics) is more valuable than interstitial brachytherapy, which is recommended for tumours of the lip and of the nasal vestibule. In mycosis fungoides, total cutaneous electron beam radiation therapy is efficient for patients with limited superficial plaques. In the classical form of Kaposi`s sarcoma, radiotherapy can achieve local control-whereas it obtains good palliative results in the epidemic form. (author)

  15. Evaluating the attendance of medical staff and room occupancy during palliative radiotherapy

    Adamietz, Irenaeus A. [University of Bochum, Department of Radiation Oncology, Bochum (Germany); Marienhospital Herne, Department of Radiotherapy and Radiation Oncology, Herne (Germany); Micke, Oliver [Franziskus-Hospital, Department of Radiation Oncology, Bielefeld (Germany); Popp, Wolfgang [Prime Networks AG, Basel (Switzerland); Sack, Horst [DEGRO, Berlin (Germany)


    nonpalliative treatment. Because of unexpected events, the time schedule before and during radiotherapy may reveal strong interindividual variability. (orig.) [German] Einsatz des Personals und Verbrauch von Ressourcen waehrend der Behandlung beeinflussen die Kosten. Fuer die palliative Radiotherapie gibt es darueber keine verlaesslichen Daten. Aus diesem Grund beschaeftigte sich diese prospektive Studie mit der Bestimmung ausgewaehlter Schluesselparameter (Personalbindungszeit und Raumbelegung) waehrend taeglicher palliativer Bestrahlung. Die Analyse war Bestandteil einer groesseren, von der Deutschen Gesellschaft fuer Radioonkologie (DEGRO) initiierten Studie. Zwischen Oktober 2009 und Maerz 2010, wurden insgesamt 172 palliative Strahlenbehandlungen prospektiv dokumentiert. Die Studie wurde an zwei Krankenhaeusern mit hoher Expertise durchgefuehrt. Die Studie evaluierte die Personalbindungszeit und die Raumbelegung bezogen auf die ausgewaehlten Schritte der Behandlungsprozedur, naemlich die Bestrahlungsplanung und die taegliche Applikation der Strahlendosis. Die Computertomographie zur Behandlungsplanung belegte die Einheit ueber 19 min (Bereich 17-22 min). Die Lokalisation des Zielvolumens erforderte im Mittel 28 min des MTRA-Einsatzes. Die vollstaendige mittlere Personalbindung waehrend der Bestrahlungsplanung betrug 159 min und die Raumbelegung 140 min. In Abhaengigkeit von ihrer Art dauerten die Bestrahlungssitzungen im Mittel zwischen 8-18 min. Das Personal war waehrend der Ersteinstellung (inklusive portaler Bildgebung) zwischen 8-27 min beschaeftigt. Die durchschnittliche Raumbelegung betrug 18 min (Bereich 6-65 min). Die laengste Personalbindung wurde waehrend der Ersteinstellung verzeichnet (Durchschnittswert 11 min). Die Bestrahlungssitzungen mit der woechentlich durchgefuehrten Feldverifikationen belegten die Raeume etwas laenger (Durchschnittswert 10 min, Bereich 4-25 min) als die gewoehnlichen taeglichen Bestrahlungen (Durchschnittswert 9 min, Bereich 3-29 min

  16. Hypofractionated radiotherapy for localized prostate cancer

    Hoecht, Stefan [Xcare Gruppe, Radiologie, Nuklearmedizin und Strahlentherapie, Saarlouis (Germany); Aebersold, Daniel M. [University of Bern, Universitaetsklinik fuer Radio-Onkologie, Inselspital, Bern (Switzerland); Albrecht, Clemens [Universitaetsklinikum der Paracelsus Medizinischen Privatuniversitaet, Klinik fuer Radioonkologie und Gemeinschaftspraxis fuer Strahlentherapie, Klinikum Nuernberg Nord, Nuremberg (Germany); Boehmer, Dirk [Charite Universitaetsmedizin, Klinik fuer Radioonkologie und Strahlentherapie, Berlin (Germany); Flentje, Michael [Universitaetsklinikum Wuerzburg, Klinik und Poliklinik fuer Strahlentherapie, Wuerzburg (Germany); Ganswindt, Ute [Ludwig-Maximilians-Universitaet Muenchen, Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Munich (Germany); Hoelscher, Tobias [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Dresden (Germany); Martin, Thomas [Klinikum Bremen-Mitte, Klinik fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Sedlmayer, Felix [Universitaetsklinikum der Paracelsus Medizinischen Privatuniversitaet, Universitaetsklinik fuer Radiotherapie und Radio-Onkologie, Landeskrankenhaus, Salzburg (Austria); Wenz, Frederik [Universitaetsmedizin Mannheim, Universitaet Heidelberg, Klinik fuer Strahlentherapie und Radioonkologie, Mannheim (Germany); Zips, Daniel [Universitaetsklinikum Tuebingen, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany); Wiegel, Thomas [Universitaetsklinikum Ulm, Abteilung Strahlentherapie, Ulm (Germany)


    This article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use. Based on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control. Several large-scale trials on moderate hypofractionation with single doses from 2.4-3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term toxicity. Large phase 3 trials on extreme hypofractionation with single doses above 4.0 Gy are lacking and only very few prospective trials have follow-up periods covering more than just 2-3 years. Until the results on long-term follow-up of several well-designed phase 3 trials become available, moderate hypofractionation should not be used in routine practice without special precautions and without adherence to the highest quality standards and evidence-based dose fractionation regimens. Extreme hypofractionation should be restricted to prospective clinical trials. (orig.) [German] Diese Uebersichtsarbeit soll den aktuellen Status der hypofraktionierten Radiotherapie des Prostatakarzinoms mit dem Fokus auf die Anwendung in der Routinetherapie darstellen. Basierend auf einem kuerzlich erschienen systematischen Review zur Hypofraktionierung sind durch das DEGRO Expertengremium zusaetzliche, in der Zwischenzeit verfuegbar gewordene Informationen mit beruecksichtigt worden. Die Validitaet der Aussagen zu Ergebnissen wurde speziell im Hinblick auf die Langzeittoxizitaet und -erkrankungskontrolle bewertet. Mehrere grosse Phase-3-Studien zur moderaten Hypofraktionierung mit Dosen von 2,4-3,4 Gy pro Fraktion

  17. Die lebensvision des semonides

    Milivoj Sironić


    Full Text Available Der Autor analysiert die Weibersatire des Semonides und andere seiner kurzen Fragmente. Dabei kommt er zu der Schlussfolgerung, dass sich die Verse der Satire durch eine gute Technik auszeich­ nen, dass aber auch eine unnötige Weitschweifigkeit nicht zu Ubersehen ist. Trotzdem kann man jedoch dem Dichter nicht die künstlerische Überzeugungskraft absprechen, wie auch die Ten­ denz nach Detailschilderungen und die Feinheit geistreicher Charakterisierungen. Die Aussage beinhaltet manchmal eine be­ stimmte innere Ironie in der Einfachheit der Wörter.In kurzen Fragmenten wird die Fähigkeit des Semonides sichtbar, sich sehr präzise auszudrücken. Seine ironisch-epische Sprache ist sehr reich  und verdient vom linguistischen Standpunkt aus Auf­ merksamkeit wegen ihres reichhaltigen lexischen und termino­ logischen Materials, insbesondere was die Bereiche der Tier­ welt und des Essens anbelangt.Die Weltanschauung des Dichters ist in dem ersten Fragment recht deutlich erkennbar. Da sieht man, dass er düster und pessimistisch auf das Leben blickt. Das Fehlen jeglicher positiven Einstellung hat dann den Sar­ kasmus zur Folge, mit dem der Dichter die Darstellung der Weiber einkleidet, ihn aber auch auf die Menschen schlechthin ausweitet.

  18. La physique des infinis

    Bernardeau, Francis; Laplace, Sandrine; Spiro, Michel


    Écrire l'histoire de l'Univers, tel est l'objectif commun des physiciens des particules et des astrophysiciens. Pour y parvenir, deux approches s'épaulent : la voie de l'infiniment petit, que l'on emprunte via de gigantesques accélérateurs de particules, et celle de l'infiniment grand, dont le laboratoire est l'Univers. Un Univers qui est bien loin d'avoir livré tous ses secrets. On connaît à peine 4,8 % de la matière qui le constitue, le reste étant composé de matière noire (25,8 %) et d'énergie noire (69,4 %), toutes deux de nature inconnue. Et si la récente découverte du boson de Higgs valide le Modèle standard de la physique des particules, celui-ci est toujours incomplet et doit être étendu à ou dépassé. Est-on arrivé au bout du jeu de poupées russes de la matière ? Quelles sont les particules manquantes ? Faut-il revoir les lois fondamentales ? Quels instruments faut-il mettre en œuvre pour accéder à cette « nouvelle physique » ? Comment parler de Super Big Science aux citoye...



    The annual gala dinner of Chaine des Rotisseurs was hosted by Hilton Beijing. The “Ballet Dinner” - a great creation for both art and fine dining lovers was taken place in varies places within the hotel, including hotel lobby, 3rd floor and lobby lounge.


    Club de Yoga


    REPRISE DES COURS – Venez nombreux ! Yoga, Sophrologie, Tai Chi La liste des cours pour le semestre allant du 1er septembre 2015 au 31 janvier 2016 est disponible sur notre site web : Lieu Les cours ont lieu dans la salle des clubs, à l’entresol du restaurant No 2, Bât. 504 (dans la salle no 3 pour la Sophrologie). Prix des cours Le prix pour le semestre (environ 18 leçons) est fixé à 220 CHF plus 10 CHF d’adhésion annuelle au Club. Couple : 200 CHF par personne. 2 cours par semaine : 400 CHF. Inscriptions Les inscriptions aux cours seront prises directement auprès du professeur, lors de la 1ère séance. Avant de s’inscrire pour le semestre, il est possible d’essayer une séance gratuitement. Informations : -----------------------------------------

  1. Potenziale des Mobile Commerce

    Turowski, Klaus


    Potenziale des Mobile Commerce / B. Bazijanec, K. Turowski. - In: Mobile economy : 4. Workshop Mobile Commerce, 02.-03. Februar 2004, Univ. Augsburg / Key Pousttchi ... (Hrsg.). - Bonn : Ges. für Informatik, 2004. - S. 7-11. - (GI-Edition : Proceedings ; 42)

  2. Vom Ort des Philosophierens

    Damir Barbaric


    Full Text Available Im Aufsatz wird versucht, den ursprünglichen Sinn der Platonischen Bestimmung vom Staunen als Anfang der Philosophie zu ermitteln, und zwar durch eine kritischen Abhebung von ihrer Umdeutung bei Aristoteles, und dann insbesondere in der Stoa wie auch bei Spinoza und Hegel. Dabei wird auf die frühgriechische Erfahrung vom Staunen als _______ aufmerksam gemacht, wo es vor allem die Grundstimmung des Dabeiseins des Göttlichen und der menschlichen Teilnahme am Göttlichen bedeutet. Dem entspricht die bei Platon stark hervorgehobene Rolle des “Pathetischen” am Staunen, das in der nachkommenden Tradition grundsätzlich verlorengegangen ist. Für Platon entspringt das Staunen einem nie zu überwindenden Zustand der wesentlichen philosophischen “Weglosigkeit” (_____, welche schon bei Aristoteles nur noch im Sinne eines unbedingt zu verlassenden Ausgangspunkts der methodisch sicher fortfahrenden philosophischen Wissenschaft verstanden wird. Durch ein Zurückgreifen auf die Diotimas Lehre im Dialog Symposion wird dementgegen die Sokratisch-Platonische “Weglosigkeit” als der einzig angemessene “Ort” des echten Philosophierens bestimmt, welchen es, als das “Zwischen” für das Weltspiel der Unsterblichen und Sterblichen, um jeden Preis zu bewahren und offen zu halten gilt.

  3. Technological advances in radiotherapy for esophageal cancer

    Milan; Vosmik; Jiri; Petera; Igor; Sirak; Miroslav; Hodek; Petr; Paluska; Jiri; Dolezal; Marcela; Kopacova


    Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer.The goal of modern radiotherapy approaches,based on recent technological advances,is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning),reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy),and by better dose delivery to the precisely defined planning ...

  4. Injectabilite des coulis de ciment dans des milieux fissures

    Mnif, Thameur

    Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

  5. Dopage et protection des jeunes sportifs : Loin des affaires

    Guy, Daniel


    National audience; Loin des affaires et des révélations polémiques de la presse, les jeunes plébiscitent massivement les activités sportives. Sport compétition, sport participation, sport détente... Pourtant, quand la pratique devient intense, que les entraînements et les compétitions s'enchaînent à un rythme soutenu, l'ombre des conduites dopantes vient déchirer la quiétude des uns et des autres. Or, que savons-nous réellement de la pratique des jeunes sportifs ? Comment préparent-ils les co...

  6. Radiotherapy in desmoid tumors. Treatment response, local control, and analysis of local failures

    Santti, Kirsi; Beule, Annette; Tuomikoski, Laura; Jaeaeskelaeinen, Anna-Stina; Saarilahti, Kauko; Tarkkanen, Maija; Blomqvist, Carl [Helsinki University Hospital and University of Helsinki, Comprehensive Cancer Center, Helsinki (Finland); Roenty, Mikko [HUSLAB and University of Helsinki, Department of Pathology, Helsinki (Finland); Ihalainen, Hanna [Helsinki University Hospital and University of Helsinki, Department of Plastic Surgery, Helsinki (Finland)


    zwischen 1987 und 2012 mit 49 Strahlentherapien behandelt wurden. Das Ansprechen wurde anhand der radiologischen Aufnahmen neu beurteilt und der Behandlungserfolg gemaess RECIST-1.1-Kriterien registriert. Fuer Patienten mit Lokalrezidiv wurde die Dosisverteilung der Radiotherapie durch Fusion von diagnostischen CT- und MRT-Bildern mit den Planungs-CT-Aufnahmen fuer jedes Lokalrezidiv bestimmt. Die Rezidive wurden je nach Lage eingeteilt in: innerhalb, am Rande und ausserhalb des ehemaligen Bestrahlungsvolumens gelegen. Prognostische Faktoren fuer ein Therapieversagen wurden ausgewertet. Die Gesamtdosen der Strahlentherapie lagen zwischen 20 und 63 Gy (Median 50 Gy) mit einer medianen Fraktionierung von 2 Gy. Die objektive Ansprechrate war 55 % (12/22 Patienten). Die mediane Zeit bis zum Therapieerfolg betrug 14 Monate. Eine statistisch signifikante Dosis-Wirkungs-Beziehung fuer die definitive und die postoperative Strahlentherapie wurde sowohl in der univariaten (p-Wert 0,002) als auch in der fuer potentielle Stoerfaktoren korrigierenden multivariaten Analyse (p-Wert 0,02) beobachtet. Neun von 11 (82 %) Lokalrezidiven wurden als Feldrandrezidive und zwei von 11 (18 %) als innerhalb des Bestrahlungsfelds liegende Rezidive bewertet. Kein Lokalrezidiv trat komplett ausserhalb des Bestrahlungsfelds auf. Die Strahlentherapie ist eine wertvolle Therapiewahl zur Behandlung aggressiver Fibromatosen. Die Strahlentherapiedosis hat einen signifikanten Einfluss auf die lokale Kontrolle. (orig.)

  7. Thalassaemic osteoarthropathy treated with radiotherapy

    Davies, A.N. (King' s Coll. Hospital, London (United Kingdom))


    Patients with beta thalassaemia may develop a specific osteoarthropathy involving the feet. A number of different treatments for this condition have been tried, including rest, analgesia and hypertransfusion. We report a case of a patient with thalassaemic osteoarthropathy who responded to radiotherapy after failing conventional treatment. (author).

  8. Oral complications of cancer radiotherapy

    Dreizen, S.; Daly, T.E.; Drane, J.B.; Brown, L.R.


    Injury to surrounding tissues during radiotherapy for oral cancer can have devastating physical and psychologic consequences for the patient. Oral complications include xerostomia, dental decay, mucositis, taste loss, osteoradionecrosis, infection, and trismus. In many instances, these problems can be eradicated or controlled with appropriate treatment.

  9. Le corps des anges



    Ce séminaire fait suite à un cycle de conférences données en 2014 sur la notion de corps de chair dans le premier christianisme. Cette année la recherche a porté sur le corps spécifique des anges dans la patristique grecque et latine. Sur la base d’un corpus de textes délimité, j’ai essayé de montrer deux choses principales : d’un côté, on ne peut pas comprendre la spécificité du corps des anges sans l’inscrire dans le champ de l’angélologie chrétienne, qui assimile l’ange et l’âme, et d’un a...

  10. Typologie des Accidents Cyclistes

    Amoros, Emmanuelle; BILLOT-GRASSET, Alice; Hours, Martine


    L'usage du vélo est en hausse en ville ; cette pratique est encouragée dans le cadre du développement durable et de la lutte contre la sédentarité. Pour accompagner cela, il faut réduire les risques d'accident, et pour ce faire, mieux les connaître. Nous utilisons le Registre des victimes de la circulation routière du Rhône, basé sur les services hospitaliers (dont les urgences) ; il est quasi-exhaustif : env. 1100 blessés à vélo/an versus 120 dans les données officielles. L'ensemble des cycl...

  11. Table des tableaux


    Présentation schématique de la production et de la transformation de l’acier 16 Chronologie des nationalisations en France 33 Importations de coke de la France 48 Comparaison entre les prix de l’acier en Allemagne et en France, août 1949 99 Prix du marché intérieur et du marché mondial pour les laminés marchands (qualité Thomas) 101 Évolution de la production allemande et française d’acier brut 119 Comparaison des coûts de l’extraction de charbon en Allemagne et en France, 1949 138 Évolution ...

  12. Table des illustrations


    Illustration de couverture : Dolmen n° 2 des Géandes avec le Mont Ventoux en arrière-plan, octobre 2006 (cliché Wolfgang Pape). Illustration de la quatrième de couverture : René Gilles sur le dolmen n° 5 des Géandes en mars 1989 (cliché Wolfgang Pape). Fig. 1 - Gorges de l’Ardèche au niveau de la grotte de Saint-Marcel (cliché Bernard Gély) 21 Fig. 2 - Doline de Bidon (cliché Wolfgang Pape) 21 Fig. 3 - Paysage de garrigue (cliché Wolfgang Pape) 22 Fig. 4 - Données radio-chronométriques de l’A...

  13. Direction des Publications


    accroissement des pressions sur les écosystèmes et les espèces qu‟ils renferment. La pollution de ... Exacerbée par le changement climatique, cette anthropisation .... majeure partie de son aire de répartition. .... de cette région. .... savoir les impacts à plus grande échelle et ..... habitats et la totalité de l'aire géographique.

  14. Le vernis des apparences

    Grazia Nicosia


    Full Text Available Le but de cet article est de comprendre l’incidence sémiotique du nettoyage d’un tableau ainsi que la résultante cognitive induite sur l’observateur. Cette étude confronte l’analyse des phénomènes visuels engendrés par le jaunissement du vernis et son retrait, à des entretiens réalisés à dessein. Le retrait d’un vernis jauni change considérablement l’image. L’heure, le climat, la saison et l’activité même des personnages s’en trouvent ainsi modifié. La patine peut être perçue, soit comme un obstacle à l’exploration, soit pour ceux qui l’apprécient, comme le medium d’une relation plus intime entre l’œuvre et l’observateur.The purpose of this article is to understand the semiotic impact of the cleaning of a painting and the cognitive effects induced on the observer. This study analyses conjointly the visual phenomenon generated by yellowing varnish and its removal and controlled interviews of observers.The removal of yellowing varnish modifies considerably the perception of the picture. Daytime, climate, season and characters activities are modified. The patina may be perceived either as an obstacle to the painting exploration, or, for those who appreciate it, as a medium for a closer relationship between the painting and the observer.

  15. Dictionnaire des risques psychosociaux

    Zawieja, Philippe


    Stress, suicide, harcèlement, épuisement professionnel, workaholism... Au-delà de la souffrance qu'elles désignent, ces notions souvent récentes constituent une approche inédite, et demandent à mieux être comprises, dans leur ensemble et isolément. C'est tout l'enjeu de ce dictionnaire, pionnier en son genre. Le lecteur y trouvera représentés, avec les 314 entrées (rédigées par 251 contributeurs) qui le composent, tous les champs disciplinaires s'intéressant à la souffrance au travail : psychologie du travail et des organisations, psychologie sociale et psychosociologie, psychanalyse, psychopathologie et psychiatrie, ergonomie, sociologie du travail et des organisations, médecine du travail, droit du travail et de la sécurité sociale, sciences de gestion, philosophie... Y sont détaillés les principaux concepts, notions, approches, méthodes, théories, outils, études, etc., ayant cours dans l'étude des risques psychosociaux, mais aussi certaines professions emblématiques (infirmières,...

  16. Grundlagen des Tissue Engineering

    Mayer, Jörg; Blum, Janaki; Wintermantel, Erich

    Die Organtransplantation stellt eine verbreitete Therapie dar, um bei krankheitsoder unfallbedingter Schädigung eines Organs die Gesamtheit seiner Funktionen wieder herzustellen, indem es durch ein Spenderorgan ersetzt wird. Organtransplantationen werden für die Leber, die Niere, die Lunge, das Herz oder bei schweren grossflächigen Verbrennungen der Haut vorgenommen. Der grosse apparative, personelle und logistische Aufwand und die Risiken der Transplantationschirurgie (Abstossungsreaktionen) sowie die mangelnde Verfügbarkeit von immunologisch kompatiblen Spenderorganen führen jedoch dazu, dass der Bedarf an Organtransplantaten nur zu einem sehr geringen Teil gedeckt werden kann. Sind Spenderorgane nicht verfügbar, können in einzelnen Fällen lebenswichtige Teilfunktionen, wie beispielsweise die Filtrationsfunktion der Niere durch die Blutreinigung mittels Dialyse ersetzt oder, bei mangelnder Funktion der Bauchspeicheldrüse (Diabetes), durch die Verabreichung von Insulin ein normaler Zustand des Gesamtorganismus auch über Jahre hinweg erhalten werden. Bei der notwendigen lebenslangen Anwendung apparativer oder medikamentöser Therapie können für den Patienten jedoch häufig schwerwiegende, möglicherweise lebensverkürzende Nebenwirkungen entstehen. Daher werden in der Forschung Alternativen gesucht, um die Funktionen des ausgefallenen Organs durch die Implantation von Zellen oder in vitro gezüchteten Geweben möglichst umfassend wieder herzustellen. Dies erfordert biologisch aktive Implantate, welche die für den Stoffwechsel des Organs wichtigen Zellen enthalten und einen organtypischen Stoffwechsel entfalten.

  17. Radiation therapy of lung carcinoma; Strahlentherapie des Bronchialkarzinoms

    Oertel, S.; Debus, J.; Hof, H.; Bischof, M. [Universitaetsklinikum Heidelberg, Abteilung Radioonkologie und Strahlentherapie, Heidelberg (Germany)


    At first presentation and primary diagnosis approximately 50% of patients with non-small cell lung carcinoma (NSCLC) and 25% of patients with small cell lung carcinoma (SCLC) have a potentially curable tumor stage. Definitive, adjuvant and neoadjuvant radio- (chemo-)therapy play an important role as part of multimodal treatment approaches. High radiation doses can be achieved in tumor areas with modern radiotherapy planning and treatment techniques without an increase of side-effects. The 3 year overall survival after primary radiotherapy is approximately 50% for patients with NSCLC in stage I and 20% in stage IIIA. Radiotherapy can be used in patients with progressive metastatic disease after insufficient response to systemic therapy with threatening thoracic symptoms and for palliative treatment of cerebral, lymphatic and osseous metastases. (orig.) [German] Etwa 50% der Patienten mit einem nichtkleinzelligen Bronchialkarzinom (NSCLC, ''non-small cell lung carcinoma'') und 25% der Patienten mit einem kleinzelligen Bronchialkarzinom (SCLC, ''small cell lung carcinoma'') befinden sich zum Zeitpunkt der Primaerdiagnose in einem potenziell heilbaren Tumorstadium. Die definitive, adjuvante und neoadjuvante Radio- (chemo-)therapie hat im Rahmen der multimodalen Behandlungskonzepte einen festen Stellenwert. Durch den Einsatz modernster Techniken bei der Bestrahlungsplanung und -therapie koennen hohe Strahlendosen bei gleichzeitiger Schonung des gesunden Gewebes appliziert werden. Die 3-Jahres-Ueberlebensraten fuer Patienten mit NSCLC betragen nach primaerer Bestrahlung {approx}50% im Stadium I und {approx}20% im Stadium IIIA. Im metastasierten Stadium wird eine Radiotherapie bei unzureichendem Ansprechen der systemischen Behandlung mit drohender thorakaler Symptomatik sowie zur palliativen Behandlung zerebraler, lymphogener oder ossaerer Metastasen eingesetzt. (orig.)

  18. Reticulation des fibres lignocellulosiques

    Landrevy, Christel

    Pour faire face à la crise économique la conception de papier à valeur ajoutée est développée par les industries papetières. Le but de se projet est l'amélioration des techniques actuelles de réticulation des fibres lignocellulosiques de la pâte à papier visant à produire un papier plus résistant. En effet, lors des réactions de réticulation traditionnelles, de nombreuses liaisons intra-fibres se forment ce qui affecte négativement l'amélioration anticipée des propriétés physiques du papier ou du matériau produit. Pour éviter la formation de ces liaisons intra-fibres, un greffage sur les fibres de groupements ne pouvant pas réagir entre eux est nécessaire. La réticulation des fibres par une réaction de « click chemistry » appelée cycloaddition de Huisgen entre un azide et un alcyne vrai, catalysée par du cuivre (CuAAC) a été l'une des solutions trouvée pour remédier à ce problème. De plus, une adaptation de cette réaction en milieux aqueux pourrait favoriser son utilisation en milieu industriel. L'étude que nous désirons entreprendre lors de ce projet vise à optimiser la réaction de CuAAC et les réactions intermédiaires (propargylation, tosylation et azidation) sur la pâte kraft, en milieu aqueux. Pour cela, les réactions ont été adaptées en milieu aqueux sur la cellulose microcristalline afin de vérifier sa faisabilité, puis transférée à la pâte kraft et l'influence de différents paramètres comme le temps de réaction ou la quantité de réactifs utilisée a été étudiée. Dans un second temps, une étude des différentes propriétés conférées au papier par les réactions a été réalisée à partir d'une série de tests papetiers optiques et physiques. Mots Clés Click chemistry, Huisgen, CuAAC, propargylation, tosylation, azidation, cellulose, pâte kraft, milieu aqueux, papier.

  19. Etude des cas: Gestion alternatîves des conflits

    Lo, H.


    Metadata only record Pour mieux consolider les acquis consensuels pour la gestion alternative des conflits, il nous paraît essentiel de maîtriser un certain nombre de facteurs ayant trait au "partage" des gommeraies entre autres: Available in SANREM office, FS

  20. Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer

    Pinkawa, Michael; Schubert, Carolin; Escobar-Corral, Nuria; Holy, Richard; Eble, Michael J. [RWTH Aachen University, Department of Radiation Oncology, Aachen (Germany)


    In contrast to primary radiotherapy, no reports are available for a hydrogel spacer application in postoperative salvage radiotherapy for prostate cancer. A 77-year-old patient presented 20 years after radical prostatectomy with a digitally palpable local recurrence at the urethrovesical anastomosis (PSA 5.5 ng/ml). The hydrogel spacer (10 ml, SpaceOAR trademark) was injected between the local recurrence and rectal wall under transrectal ultrasound guidance. Treatment planning was performed with an intensity-modulated technique up to a total dose of 76 Gy in 2-Gy fractions. The same planning was performed based on computed tomography before spacer injection for comparison. The local recurrence, initially directly on the rectal wall, could be displaced more than 1 cm from the rectal wall after hydrogel injection. With a mean total dose of 76 Gy to the planning target volume, rectal wall volumes included in the 70 Gy, 60 Gy, 50 Gy isodoses were 0 cm{sup 3}, 0 cm{sup 3}, and 0.4 cm{sup 3} with a spacer and 2.9 cm{sup 3}, 4.5 cm{sup 3}, and 6.2 cm{sup 3} without a spacer, respectively. The patient reported rectal urgency during radiotherapy, completely resolving after the end of treatment. The PSA level was 5.4 ng/ml a week before the end of radiotherapy and dropped to 0.9 ng/ml 5 months after radiotherapy. A hydrogel spacer was successfully applied for dose-escalated radiotherapy in a patient with macroscopic local prostate cancer recurrence at the urethrovesical anastomosis to decrease the dose at the rectal wall. This option can be considered in specifically selected patients. (orig.) [German] Im Gegensatz zum Einsatz bei der primaeren Radiotherapie gibt es bisher keine Berichte zum Einsatz eines Hydrogel-Abstandhalters bei der postoperativen Salvage-Radiotherapie des Prostatakarzinoms. Ein 77-jaehriger Patient stellte sich 20 Jahre nach radikaler Prostatektomie mit einem digital palpablem Lokalrezidiv im Bereich der urethrovesikalen Anastomose vor (PSA 5,5 ng

  1. Patient-specific dosimetric endpoints based treatment plan quality control in radiotherapy.

    Song, Ting; Staub, David; Chen, Mingli; Lu, Weiguo; Tian, Zhen; Jia, Xun; Li, Yongbao; Zhou, Linghong; Jiang, Steve B; Gu, Xuejun


    In intensity modulated radiotherapy (IMRT), the optimal plan for each patient is specific due to unique patient anatomy. To achieve such a plan, patient-specific dosimetric goals reflecting each patient's unique anatomy should be defined and adopted in the treatment planning procedure for plan quality control. This study is to develop such a personalized treatment plan quality control tool by predicting patient-specific dosimetric endpoints (DEs). The incorporation of patient specific DEs is realized by a multi-OAR geometry-dosimetry model, capable of predicting optimal DEs based on the individual patient's geometry. The overall quality of a treatment plan is then judged with a numerical treatment plan quality indicator and characterized as optimal or suboptimal. Taking advantage of clinically available prostate volumetric modulated arc therapy (VMAT) treatment plans, we built and evaluated our proposed plan quality control tool. Using our developed tool, six of twenty evaluated plans were identified as sub-optimal plans. After plan re-optimization, these suboptimal plans achieved better OAR dose sparing without sacrificing the PTV coverage, and the dosimetric endpoints of the re-optimized plans agreed well with the model predicted values, which validate the predictability of the proposed tool. In conclusion, the developed tool is able to accurately predict optimally achievable DEs of multiple OARs, identify suboptimal plans, and guide plan optimization. It is a useful tool for achieving patient-specific treatment plan quality control.

  2. Missile Aerodynamics (Aerodynamique des Missiles)


    guerre froide la production des missiles a baisse’, avec pour consequence une diminution des budgets de d6veloppement. Les nouveaux types de conflits ...Roma) Directeur - Gestion de l’information LUXEMBOURG (Recherche et developpement) - DRDGI 3 Voir Belgique Ministbre de la Difense nationale NORVEGE

  3. Pediatric radiotherapy planning and treatment

    Olch, Arthur J


    "This is a very well-written and -organized book covering the planning and delivery aspects unique to pediatric radiotherapy. The author is a respected and well-known medical physicist with extensive pediatric radiotherapy experience. … a very useful book for any clinical physicist treating pediatric cases and seeking contextual and historical perspective. … a great reference for medical physicists who may not see many pediatric cases and can look to this text as a one-stop shop for not only a comprehensive overview, but detailed explanation for specific pediatric disease sites. Overall, it is a great addition to the reference library of any radiation therapy physicist."-Medical Physics, April 2014.

  4. Proton Radiotherapy for Pediatric Sarcoma

    Ladra, Matthew M.; Yock, Torunn I., E-mail: [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114 (United States)


    Pediatric sarcomas represent a distinct group of pathologies, with approximately 900 new cases per year in the United States alone. Radiotherapy plays an integral role in the local control of these tumors, which often arise adjacent to critical structures and growing organs. The physical properties of proton beam radiotherapy provide a distinct advantage over standard photon radiation by eliminating excess dose deposited beyond the target volume, thereby reducing both the dose of radiation delivered to non-target structures as well as the total radiation dose delivered to a patient. Dosimetric studies comparing proton plans to IMRT and 3D conformal radiation have demonstrated the superiority of protons in numerous pediatric malignancies and data on long-term clinical outcomes and toxicity is emerging. In this article, we review the existing clinical and dosimetric data regarding the use of proton beam radiation in malignant bone and soft tissue sarcomas.

  5. Gel dosimetry for conformal radiotherapy

    Gambarini, G. [Department of Physics of the University and INFN, Milan (Italy)]. e-mail:


    With the continuum development of conformal radio therapies, aimed at delivering high dose to tumor tissue and low dose to the healthy tissue around, the necessities has appeared of suitable improvement of dosimetry techniques giving the possibility of obtaining dose images to be compared with diagnostic images. Also if wide software has been developed for calculating dose distributions in the fields of various radiotherapy units, experimental verifications are necessary, in particular in the case of complex geometries in conformal radiotherapy. Gel dosimetry is a promising method for imaging the absorbed dose in tissue-equivalent phantoms, with the possibility of 3D reconstruction of the spatial dose distribution, with milli metric resolution. Optical imaging of gel dosimeters, based on visible light absorbance analysis, has shown to be a reliable technique for achieving dose distributions. (Author)

  6. Therapie des Status epilepticus

    Trinka E


    Full Text Available Der Status epilepticus (SE ist nach dem Schlaganfall der häufigste neurologische Notfall. Er stellt als generaliserter konvulsiver SE (GKSE die schwerste Ausprägung eines epileptischen Anfalls dar, der mit einer signifikanten Morbidität und einer ca. 20%igen Letalität verbunden ist. Nur bei der Hälfte der Patienten mit SE besteht zuvor eine Epilepsie; die meisten Fälle sind symptomatisch, wobei Schädel- Hirn-Traumata, zerebrovaskuläre Erkrankungen, ZNS-Infektionen und metabolische Ursachen führend sind. Bei Patienten mit vorbestehender Epilepsie lässt sich eine frühe Phase des GKSE erkennen, in der die Anfälle crescendoartig zunehmen, bis sie in kontinuierliche Anfallsaktivität münden (etablierte Phase. Das Management eines GKSE verlangt rasches und beherztes Vorgehen. Neben der sofort einzuleitenden Therapie muss gleichzeitig die artdiagnostische Zuordnung des SE und die Ursache erkannt und behandelt werden. Als Therapie der ersten Wahl sind Benzodiazepine etabliert, wobei intravenösem (i.v. Lorazepam gegenüber Diazepam der Vorzug zu geben ist. Versagt die Therapie mit Benzodiazepinen, muss rasch und konsequent nach einem Stufenschema vorgegangen werden. Phenytoin/Fosphenytoin, Valproinsäure, Levetiracetam und Lacosamid sind als i.v. Formulierung erhältliche Antiepileptika. Obwohl Vergleichsstudien hier fehlen, wird Phenytoin bevorzugt. Valproat und Levetiracetam sind nicht sedierend und kardiovaskulär gut verträglich, sodass hier Alternativen zu Phenytoin vorhanden sind. Lacosamid ist eine neue Therapieoption, deren Stellenwert erst bestimmt werden muss. Versagt auch die zweite Therapiestufe, so muss der Patient intubiert und in Allgemeinanästhesie intensivmedizinisch behandelt werden. Dafür stehen Thiopental, Propofol oder hoch dosiertes Midazolam zu Verfügung. Durch den eklatanten Mangel an randomisierten Studien bleibt die Therapie des GKSE empirisch und durch den Off-label-Einsatz gekennzeichnet.

  7. Mécanique des fluides

    Cengel, Y A


    La mécanique des fluides est un outil performant qui permet d'expliquer les phénomènes qui nous entourent de l'échelle microscopique à l'échelle macroscopique. Elle est aussi à la base du développement de nombreuses technologies. Cet ouvrage à destination des étudiants donne une vision complète de la mécanique des fluides. Bien que la mécanique des fluides puisse souvent paraître rébarbative aux yeux des étudiants, cet ouvrage valorise ce domaine d'enseignement en l'illustrant de nombreux exemples issus de l'ingénierie navale, l'aéronautique, la météorologie, etc.

  8. Technological advances in radiotherapy of rectal cancer

    Appelt, Ane L; Sebag-Montefiore, David


    PURPOSE OF REVIEW: This review summarizes the available evidence for the use of modern radiotherapy techniques for chemoradiotherapy for rectal cancer, with specific focus on intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) techniques. RECENT FINDINGS: The dosimetric....... Overall results are encouraging, as toxicity levels - although varying across reports - appear lower than for 3D conformal radiotherapy. Innovative treatment techniques and strategies which may be facilitated by the use of IMRT/VMAT include simultaneously integrated tumour boost, adaptive treatment...

  9. Inflammatory Skin Conditions Associated With Radiotherapy.

    Hernández Aragüés, I; Pulido Pérez, A; Suárez Fernández, R


    Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max;


    The TARGIT-A trial compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy (TARGIT) versus fractionated external beam radiotherapy (EBRT) for breast cancer. We report 5-year results for local recurrence and the first analysis of overall survival....

  11. Molekulare Formen des PSA in der Diagnostik des Prostatakarzinoms

    Lein M


    Full Text Available Das prostataspezifische Antigen ist die wichtigste Kenngröße in der Diagnostik und Therapieüberwachung des Prostatakarzinoms. Zur besseren Abgrenzung zwischen Männern mit und ohne Prostatakarzinom, aber auch zur Früherkennung, haben sich die molekularen Formen des PSA als wertvolle Entscheidungshilfen erwiesen. Es wird eine Übersicht über bisher vorliegende Informationen zur Aussagekraft des freien PSA, des an alpha 1-Antichymotrypsin gebundenen PSA und des komplexierten PSA (cPSA zusammen mit eigenen Resultaten gegeben. Der Quotient aus freiem und Gesamt-PSA hat sich als eine wichtige Entscheidungsgröße in der urologischen Praxis etabliert, mit der Sensitivität und Spezifität der Prostatakarzinomdiagnostik verbessert werden. Die Zahl von Prostatastanzbiopsien im Gesamt-PSA-Bereich von 4–10 ng/ml kann damit reduziert werden. Ein diagnostischer Vorteil der alleinigen Bestimmung des komplexierten PSA bzw. der entsprechenden Quotienten im Vergleich zum Gesamt-PSA und des Quotienten freies PSA zu Gesamt-PSA konnte bisher nicht sicher nachgewiesen werden.

  12. Role of radiotherapy in hospice care

    Nishimura, Tetsuo; Sugiyama, Akira; Shimizu, Teppei; Ichinohe, Kenji; Teshima, Takeshi; Kaneko, Masao; Hara, Yoshio; Chihara, Satoshi.


    The aim of palliative radiotherapy for the terminally ill is to improve the quality of the remaining span of life. From November 1982 to September 1987, 69 patients in the Seirei Hospice have been treated with such radiotherapy, and symptomatic relief was obtained in 64% of these patients. Radiotherapy also proved useful in achieving an improvement in their performance status. While the aim of hospice care is not directed towards treatment of the underlying disease, the use of radiotherapy is considered to have an important role in hospice care.

  13. Mécanique des sols et des roches

    Vullier, Laurent; Zhao, Jian


    La mécanique des sols et la mécanique des roches sont des disciplines généralement traitées séparément dans la littérature. Pour la première fois, un traité réunit ces deux spécialités, en intégrant également les connaissances en lien avec les écoulements souterrains et les transferts thermiques. A la fois théorique et pratique, cet ouvrage propose tout d'abord une description détaillée de la nature et de la composition des sols et des roches, puis s'attache à la modélisation de problèmes aux conditions limites et présente les essais permettant de caractériser les sols et les roches, tant d'un point de vue mécanique qu'hydraulique et thermique. La problématique des sols non saturés et des écoulements multiphasiques est également abordée. Une attention particulière est portée aux lois de comportement mécanique et à la détermination de leurs paramètres par des essais in situ et en laboratoire, et l'ouvrage offre également une présentation détaillée des systèmes de classi...

  14. Le silence des agneaux



    Full Text Available Ce texte est avant tout une réflexion sur la notion d'obéissance, initiée à partir de deux évènements impliquant étroitement des membres de la profession infirmière. L'auteur se réjouit de la prise de parole et de l'implication directe d'infirmières dans le contexte du printemps érable. Il estime que la posture de ces infirmières s'inscrit dans ce que l'éthicien Guy Durand, appelle une obéissance autonome qui peut, du coup, mener à la désobéissance civile, à l'objection de conscience. En prenant exemple sur le silence des infirmières dans le contexte de la fermeture de postes d'infirmières en Minganie, l'auteur estime que cette posture est marginale chez les infirmières qui, majoritairement, adoptent une position de soumission et d'obéissance hétéronome.

  15. La médicalisation des humeurs des enfants

    Monzée, Joël


    Les enfants qui ont des comportements dérangeants ou qui souffrent de problèmes neurologiques, comme le trouble déficitaire de l’attention avec ou sans hyperactivité (TDAH), remettent en question nos moyens d’intervention pour les aider. Alors que le contexte européen tend à privilégier une intervention psychoéducative, les milieux nord-américains recourent davantage aux psychostimulants pour réduire les effets des problèmes comportementaux des enfants. Cet article aborde quelques problématiq...

  16. Radiotherapy and local control in rectal cancer.

    Valentini, V; Rosetto, M E; Fares, C; Mantini, G; Salvi, G; Turriziani, A


    Recurrence is a stage in the natural history of rectal cancer. Preoperative radiotherapy or postoperative radiochemotherapy lower the rate of recurrence, improving local control. From 1980 to 1997, at the "Divisione di Radioterapia" of the "Università Cattolica del S. Cuore" of Rome 380 patients with rectal cancer of early clinical stage T2-3, candidates for surgery for cure, underwent radiation therapy. 119 patients underwent postoperative radiotherapy (45-50 Gy); 45 patients underwent "sandwich" radiotherapy (45 Gy:27 Gy before and 28 Gy after surgery), of whom 7 were treated with preoperative radiotherapy alone; 145 patients underwent preoperative concomitant radiochemotherapy according to 3 different protocols, radiotherapy (38 Gy) combined with mitomycin C and 5-FU; radiotherapy (50.4 Gy) combined with cisplatin and 5-FU; radiotherapy (45 Gy) combined with 5-FU and folinic acid. 71 patients were treated with preoperative radiotherapy (38 Gy) combined with IORT (10 Gy). Median follow-up was 6 years. Overall local control was 85% at 3 years, 83% at 5 years, 81% at 10 years. The rate of local control at 5 years was: 76% for postoperative radiotherapy, 83% for "sandwich" radiotherapy, 84% for preoperative radiochemotherapy and 93% for preoperative radiotherapy combined with IORT. Local control was shown to be significantly better with preoperative treatment as compared to postoperative treatment (p = 0.02). The incidence of metastases was 35% in the patients with local recurrence and 16% in those with local control. The difference in survival was highly significant in patients with local control as compared to those with local recurrence: at 5 years 87% and 32% respectively. Patients with local control showed a lower incidence of metastasis and a better survival.

  17. Habilitations à diriger des recherches


    Full Text Available Pierre Corbin, Avec des dictionnaires pour compagnons.Habilitation à diriger des recherches soutenue le 24 novembre 2006.Composition du juryHenri Béjoint (Lyon 2Franz Josef Hausmann (Erlangen-NürnbergBenoît Habert (Paris 10Pierre Rézeau (CNRSMichel Roché (Toulouse 2Danièle Van de Velde (Lille 3, UMR STL, Directrice d'habilitation.Philippe Sabot, La philosophie, entre pratiques de lecture et pratiques d'écritureHabilitation à diriger des recherches soutenue le 24 novembre 2006.Compositio...

  18. Des cartes dans la classe…

    R. Gimeno


    Full Text Available La majorité des enseignants qui veulent faire des cartes — et les faire réaliser aux élèves — pour répondre aux exigences des instructions officielles, doivent surmonter leur manque de compétences en cartographie et en didactique ainsi que les difficultés propres aux logiciels de cartographie encore peu performants. Ces compétences et la réflexion qui les accompagne sont pourtant accessibles aux enfants de l’école élémentaire…

  19. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)


    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  20. Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

    Lemoigne, Yves


    This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

  1. Wider die Verherrlichung des Weiblichen : Kritik des Ökofeminismus

    Attia, Iman


    Die Studie ist eine Kritik am Frauen- und Gesellschaftsbild des Ökofeminismus. Nach der Darstellung wesentlicher theoretischer Kategorien des Ökofeminismus, die sich zentrieren im Ideal der Hausarbeit als wichtigste Form von Subsistenzarbeit, stellt die Autorin zusammenfassend fest, daß der Ökofeminismus die gesellschaftlichen Unterschiede und historischen Veränderungen ignoriert, indem er den Weiblichkeitsbegriff aus der Gebärfähigkeit ableitet. Jede Ausbeutungsform wird reduziert auf biolog...

  2. Reducing radiation induced emesis in abdominal radiotherapy

    Griffin, K. (Royal Marsden Hospital, Sutton (United Kingdom))


    In patients with seminoma testes, a comparison was made between radiation induced emesis suffered by patients receiving 'dogleg' radiotherapy with those suffered by patients who received para-aortic radiotherapy. The same comparisons were made between the effects suffered by those patients who received the anti-emetic, Ondansetron, and those suffered by patients who received conventional anti-emetics. (UK).

  3. Radiotherapy versus combined modality in early stages

    Specht, L.; Carde, P.; Mauch, P.;


    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a glob...

  4. [Radiotherapy promises: focus on lung cancer].

    Jouin, Anaïs; Durand-Labrunie, Jérôme; Leroy, Thomas; Pannier, Diane; Wagner, Antoine; Rault, Erwan; Lartigau, Eric


    Radiotherapy is a key cancer treatment, which greatly modified its practice in recent years thanks to medical imaging and technical improvements. The systematic use of computed tomography (CT) for treatment planning, the imaging fusion/co-registration between CT/magnetic resonance imaging (MRI) or CT/positron emission tomography (PET) improve target identification/selection and delineation. New irradiation techniques such as image-guided radiotherapy (IGRT), stereotactic radiotherapy or hadron therapy offer a more diverse therapeutic armamentarium to patients together with lower toxicity. Radiotherapy, as well as medical oncology, tends to offer a personalized treatment to patients thanks to the IGRT, which takes into account the inter- or intra-fraction anatomic variations. IGRT leads to adaptive radiotherapy (ART) with a new planification in the treatment course in order to decrease toxicity and improve tumor control. The use of systemic therapies with radiations needs to be studied in order to improve efficiency without increasing toxicities from these multimodal approaches. Finally, radiotherapy advances were impacted by radiotherapy accidents like Epinal. They led to an increased quality control with the intensification of identity control, the emergence of in vivo dosimetry or the experience feedback committee in radiotherapy. We will illustrate through the example of lung cancer.

  5. Postoperative radiotherapy for endometrial cancer

    Choi, Eun Cheol; Kim, Jin Hee; Kim, Ok Bae; Byun, Sang Jun; Park, Seung Gyu; Kwon, Sang Hoon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)


    To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. Sixty four patients with stage I?III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended fi eld. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.

  6. La fabrique des extraterrestres

    Poulain, Sébastien


    Grâce à différentes stratégies discursives et médiatiques, Radio Ici et Maintenant joue un rôle dans la fabrication de la rumeur de l’existence des extraterrestres. Cette rumeur, teintée de complot, doit servir à légitimer l’utopie messianique et millénariste de cette radio New Age qui dispose de 5 000 auditeurs au quotidien. Cette radio prophétique et thérapeutique participe donc, jusqu’à un certain degré, au renouvellement de l’espace du politico-religieux. Thanks to various media and di...

  7. Therapie des Harnwegsinfekts

    Stoiser B


    Full Text Available Harnwegsinfektionen gehören zu den häufigsten entzündlichen Erkrankungen im niedergelassenen Bereich. Eine intelligente Therapiestrategie stellt damit nicht nur eine klinische Herausforderung dar, sondern ermöglicht rasche Heilung, Vermeidung von Resistenzbildungen sowie oft unnötiger, teurer diagnostischer Schritte. Der erste entscheidende Schritt ist die genaue Klassifizierung des Harnweginfektes – asymptomatische Bakteriurie bis zur komplizierten Pyelonephritis. Hier entscheiden sich bereits Aggressivität der Behandlung sowie diagnostischer Aufwand. Für die Entwicklung einer empirischen antimikrobiellen Therapie ist die Kenntnis der häufigsten Erreger sowie lokaler Resistenzmuster wichtig. Bei gezieltem Vorgehen können die meisten Harnwegsinfekte ohne erhöhten diagnostischen Aufwand therapiert werden.

  8. Basic radiotherapy physics and biology

    Chang, David S; Das, Indra J; Mendonca, Marc S; Dynlacht, Joseph R


    This book is a concise and well-illustrated review of the physics and biology of radiation therapy intended for radiation oncology residents, radiation therapists, dosimetrists, and physicists. It presents topics that are included on the Radiation Therapy Physics and Biology examinations and is designed with the intent of presenting information in an easily digestible format with maximum retention in mind. The inclusion of mnemonics, rules of thumb, and reader-friendly illustrations throughout the book help to make difficult concepts easier to grasp. Basic Radiotherapy Physics and Biology is a

  9. Quality and safety in radiotherapy

    Pawlicki, Todd


    The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers: Quality Management

  10. Radiobiology of human cancer radiotherapy

    Andrews, J.R.


    The author has systematically collected and collated the scientific literature correlating the basic and clinical sciences in this field in order to produce a definitive treatise. The book thoroughly reviews the biology and biochemistry relevant to radiobiology and describes the critical locus for the extinction of cell reproductive capacity. Extensive coverage is given to oxygen effect, hyperthermia, high linear energy transfer, cell populations, and similar topics. Separate sections cover time, dose, and fractionation; radiation hematology; cancer chemotherapy; and cancer immunology. The book also contains invaluable discussions of techniques for optimizing radiotherapy alone and in combination with other therapies.


    Samira MOUTAKIL


    Full Text Available L’idée de cet article nous est venue d’un cours qu’on assure pour les futurs guides touristiques en Jordanie. En traduisant des textes - français-arabe ou arabe-français, les étudiants se heurtent à certains problèmes pour rendre le texte vers la langue cible et qui soit convenable syntaxiquement et sémantiquement. On a remarqué donc que la traduction des prépositions vers l’une ou l’autre langue présente un dilemme pour les apprenants. On a décidé de composer un corpus de phrases contenant les propositions en français, « à » avec toutes ses formes, « dans et sur » et de l'arabe "على", "في" . Dans un premier temps, on a constitué le corpus avec 25 phrases dans les deux langues et on les a soumises aux étudiants, la liste en français aux étudiants du niveau A2 et la liste ne arabe aux étudiants du niveau A1. Par la suite, on a dégagé ce qui ressort de leurs traductions ce qui nous a permis de faire une analyse sémantico-syntaxique assez détaillée. En conclusion de cet article, on présente les résultats de cette expérience très intéressante.

  12. Radiotherapy in patients with connective tissue diseases.

    Giaj-Levra, Niccolò; Sciascia, Savino; Fiorentino, Alba; Fersino, Sergio; Mazzola, Rosario; Ricchetti, Francesco; Roccatello, Dario; Alongi, Filippo


    The decision to offer radiotherapy in patients with connective tissue diseases continues to be challenging. Radiotherapy might trigger the onset of connective tissue diseases by increasing the expression of self-antigens, diminishing regulatory T-cell activity, and activating effectors of innate immunity (dendritic cells) through Toll-like receptor-dependent mechanisms, all of which could potentially lead to breaks of immune tolerance. This potential risk has raised some debate among radiation oncologists about whether patients with connective tissue diseases can tolerate radiation as well as people without connective tissue diseases. Because the number of patients with cancer and connective tissue diseases needing radiotherapy will probably increase due to improvements in medical treatment and longer life expectancy, the issue of interactions between radiotherapy and connective tissue diseases needs to be clearer. In this Review, we discuss available data and evidence for patients with connective tissue diseases treated with radiotherapy.

  13. Marais Des Cygnes Wildlife Area

    US Fish and Wildlife Service, Department of the Interior — This brochure is for the Marais des Cygnes Wildlife Area, managed by Kansas Department of Wildlife, Parks and Tourism, and located in the floodplain of the Marais...

  14. Digitalisierung des Kulturellen Erbes (Europas)

    Gruber, Marion


    Gruber, M. R. (2011, 13 December). Digitalisierung des Kulturellen Erbes (Europas). Guest lecture at the IPMZ - Institute of Mass Communication and Media Research, Devision Media Change & Innovation, University of Zurich, Switzerland.

  15. Potential clinical predictors of outcome after postoperative radiotherapy of non-small cell lung cancer

    Buetof, R. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); Kirchner, K.; Appold, S. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Loeck, S. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); Rolle, A. [Lungenfachklinik Coswig, Department of Thoracic and Vascular Surgery, Coswig (Germany); Hoeffken, G. [Lungenfachklinik Coswig, Department of Pneumology, Coswig (Germany); Krause, M.; Baumann, M. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany)


    The aim of this analysis was to investigate the impact of tumour-, treatment- and patient-related cofactors on local control and survival after postoperative adjuvant radiotherapy in patients with non-small cell lung cancer (NSCLC), with special focus on waiting and overall treatment times. For 100 NSCLC patients who had received postoperative radiotherapy, overall, relapse-free and metastases-free survival was retrospectively analysed using Kaplan-Meier methods. The impact of tumour-, treatment- and patient-related cofactors on treatment outcome was evaluated in uni- and multivariate Cox regression analysis. No statistically significant difference between the survival curves of the groups with a short versus a long time interval between surgery and radiotherapy could be shown in uni- or multivariate analysis. Multivariate analysis revealed a significant decrease in overall survival times for patients with prolonged overall radiotherapy treatment times exceeding 42 days (16 vs. 36 months) and for patients with radiation-induced pneumonitis (8 vs. 29 months). Radiation-induced pneumonitis and prolonged radiation treatment times significantly reduced overall survival after adjuvant radiotherapy in NSCLC patients. The negative impact of a longer radiotherapy treatment time could be shown for the first time in an adjuvant setting. The hypothesis of a negative impact of longer waiting times prior to commencement of adjuvant radiotherapy could not be confirmed. (orig.) [German] Das Ziel der vorliegenden Analyse war, den Einfluss von tumor-, patienten- und therapieabhaengigen Kofaktoren auf die lokoregionale Tumorkontrolle und das Ueberleben nach postoperativer adjuvanter Strahlentherapie bei Patienten mit einem nicht-kleinzelligen Bronchialkarzinom (NSCLC) zu untersuchen. Ein spezieller Fokus lag dabei auf der Wartezeit zwischen Operation und Beginn der Strahlentherapie sowie der Gesamtbehandlungszeit der Strahlentherapie. Fuer 100 Patienten, die eine postoperative

  16. Mesenchymal stem cells, a hope for the treatment of radiotherapy complications; Les cellules souches mesenchymateuses, un espoir pour le traitement des complications des radiotherapies

    Gourmelon, P. [Institut de Radioprotection et de Surete Nucleaire, Dir. de la Radioprotection de l' Homme, 92 - Fontenay-aux-Roses (France); Semont, A.; Benderitter, M. [Institut de Radioprotection et de Surete Nucleaire. Laboratoire de Radiopathologie et Therapies Experimentales, 92 - Fontenay-aux-Roses (France)


    This article reports experimental researches performed by IRSN researchers in the field of cell therapy, notably for the treatment of severe accidental radiological burns. It shows than mesenchymal stem cells have been very efficient for the treatment of radio-induced of muscular cutaneous lesions, notably by reducing the pain where conventional analgesic treatments fail. A positive effect has been also obtained by using these stem cells for the treatment of severe intestinal lesions on mice locally irradiated with high doses. The tumorigenic risk associated with the use of these mesenchymal stem cells is also discussed

  17. Documentation and publication of information reporting side effects of radiotherapies. Workshop report; Dokumentation und Veroeffentlichung von Nebenwirkungen der Strahlentherapie. Workshop-Bericht

    Doerr, W. [GSF-Institut fuer Strahlenbiologie, Oberschleissheim (Germany)]|[Klinik und Poliklinik fuer Strahlentherapie, Dresden (Germany); Seegenschmiedt, M.H. [Strahlentherapeutische Klinik und Poliklinik, Erlangen (Germany); Herrmann, T. [Klinik und Poliklinik fuer Strahlentherapie, Dresden (Germany); Dubben, H.H. [Inst. fuer Biophysik und Strahlenbiologie, Hamburg (Germany)


    The contribution presents a summary of the information and results compiled and discussed by a workshop accompanying the 4th Symposium on Experimental Radiotherapy and Clinical Radiotherapy, held in Hamburg on 25 February 1995. The Workshop was intended to collect and lay down available information on the current practice of data archivation and publication, basic conditions (evaluation principles and schemes, infrastructure), and statistics aspects of an efficient evaluation and interpretation of data reporting side effects of radiotherapies. (orig./MG) [Deutsch] Die derzeitige Veroeffentlichungspraxis, die Voraussetzungen (Beurteilungsschemata, Infrastruktur) sowie statistische Gesichtspunkte fuer eine sinnvolle Beurteilung und Auswertung von Nebenwirkungen waren Gegenstand eines im Rahmen des 4. Symposiums Experimentelle Strahlentherapie und klinische Strahlentherapie in Hamburg am 25. 2. 1995 durchgefuehrten Workshops. Die erarbeiteten Ergebnisse werden zusammengefasst dargestellt. (orig./MG)

  18. Optimization of human cancer radiotherapy

    Swan, George W


    The mathematical models in this book are concerned with a variety of approaches to the manner in which the clinical radiologic treatment of human neoplasms can be improved. These improvements comprise ways of delivering radiation to the malignan­ cies so as to create considerable damage to tumor cells while sparing neighboring normal tissues. There is no unique way of dealing with these improvements. Accord­ ingly, in this book a number of different presentations are given. Each presentation has as its goal some aspect of the improvement, or optimization, of radiotherapy. This book is a collection of current ideas concerned with the optimization of human cancer radiotherapy. It is hoped that readers will build on this collection and develop superior approaches for the understanding of the ways to improve therapy. The author owes a special debt of thanks to Kathy Prindle who breezed through the typing of this book with considerable dexterity. TABLE OF CONTENTS Chapter GENERAL INTRODUCTION 1. 1 Introduction 1...

  19. DEGRO practical guidelines: radiotherapy of breast cancer II. Radiotherapy of non-invasive neoplasia of the breast

    Souchon, R. [University Hospital Tuebingen, Klinik fuer Radioonkologie, Tuebingen (Germany); Sautter-Bihl, M.L. [Municipal Hospital Karlsruhe, Karlsruhe (Germany); Sedlmayer, F. [LKH Salzburg, Paracelsus Medical University Hospital, Salzburg (Austria); Budach, W. [University Hospital Duesseldorf, Duesseldorf (Germany); Dunst, J. [University Hospital Schleswig-Holstein, Luebeck (Germany); Feyer, P. [Klinikum Neukoelln, Berlin (Germany); Fietkau, R.; Sauer, R. [University Hospital Erlangen, Erlangen (Germany); Harms, W. [St. Clara Hospital, Basel (Switzerland); Wenz, F. [University Hospital Mannheim, Mannheim (Germany); Haase, W.


    . Randomized clinical trials and a huge number of mostly observational studies have unanimously demonstrated that RT significantly reduces recurrence risks of ipsilateral DCIS as well as invasive breast cancer independent of patient age in all subgroups. The recommended total dose is 50 Gy administered as whole breast irradiation (WBI) in single fractions of 1.8 or 2.0 Gy given on 5 days weekly. Retrospective data indicate a possible beneficial effect of an additional tumor bed boost for younger patients. Prospective clinical trials of different dose-volume concepts (hypofractionation, accelerated partial breast irradiation, boost radiotherapy) are still ongoing. Postoperative radiotherapy permits breast conservation for the majority of women by halving local recurrence as well as reducing progression rates into invasive cancer. New data confirmed this effect in all patient subsets - even in low risk subgroups (LoE 1a). (orig.) [German] Aktualisierung und Ergaenzung der 2007 von der DEGRO-Expertengruppe Mammakarzinom publizierten Leitlinie zur Radiotherapie (RT) des Mammakarzinoms. Aufgrund der zunehmenden klinischen Relevanz nicht-invasiver epithelialer Neoplasien der Brust wurde diesen in der aktuellen Version ein eigenes Kapitel gewidmet. Schwerpunkte der hier vorgelegten Empfehlungen sind - in Ergaenzung zu den S3-Leitlinien der Deutschen Krebsgesellschaft von 2012 - die Indikation und Technik der postoperativen RT nach brusterhaltender Operation. Die DEGRO-Expertengruppe fuehrte eine Literaturrecherche aktueller klinisch kontrollierter Studien, systematischer Reviews und Metaanalysen, orientiert an den Kriterien der evidenzbasierten Medizin, im Hinblick auf neue Aspekte gegenueber 2005 und 2007 durch. Die Recherche umfasst die Zeitspanne 2008 bis September 2012 und erstreckte sich auf in PubMed und Guidelines International Network (G-I-N) gelisteten Publikationen. Suchbegriffe waren ''non invasive breast cancer'', ''ductal carcinoma in situ

  20. Psychological and physical distress of cancer patients during radiotherapy

    König, A


    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is...

  1. Adjuvant radiotherapy for gallbladder cancer: A dosimetric comparison of conformal radiotherapy and intensity-modulated radiotherapy

    Xiao-Nan Sun; Qi Wang; Ben-Xing Gu; Yan-Hong Zhu; Jian-Bin Hu; Guo-Zhi Shi; Shu Zheng


    AIM: To assess the efficacy and toxicity of conformal radiotherapy (CRT) and compare with intensity-modulated radiotherapy (IMRT) in the treatment of gallbladder cancer.METHODS: Between November 2003 and January 2010, 20 patients with gallbladder cancer were treated with CRT with or without chemotherapy after surgical resection. Preliminary survival data were collected and examined using both Kaplan-Meier and actuarial analysis. Demographic and treatment parameters were collected. All patients were planned to receive 46-56 Gy in 1.8 or 2.0 Gy per fraction. CRT planning was compared with IMRT.RESULTS: The most common reported acute toxicities requiring medication (Radiation Therapy Oncology Group, Radiation Therapy Oncology Group Grade2) were nausea (10/20 patients) and diarrhea (3/20).There were no treatment-related deaths. Compared with CRT planning, IMRT significantly reduced the volume of right kidney receiving > 20 Gy and the volume of liver receiving > 30 Gy. IMRT has a negligible impact on the volume of left kidney receiving > 20 Gy. The 95% of prescribed dose for a planning tumor volume using either 3D CRT or IMRT planning were 84.0% ±6.7%, 82.9% ± 6.1%, respectively (P > 0.05).CONCLUSION: IMRT achieves similar excellent target coverage as compared with CRT planning, while reducingthe mean liver dose and volume above threshold dose. IMRT offers better sparing of the right kidney compared with CRT planning, with a significantly lower mean dose and volume above threshold dose.

  2. Predictors for trismus in patients receiving radiotherapy.

    van der Geer, S Joyce; Kamstra, Jolanda I; Roodenburg, Jan L N; van Leeuwen, Marianne; Reintsema, Harry; Langendijk, Johannes A; Dijkstra, Pieter U


    Trismus, a restricted mouth opening in head and neck cancer patients may be caused by tumor infiltration in masticatory muscles, radiation-induced fibrosis or scarring after surgery. It may impede oral functioning severely. The aims of our study were to determine: (1) the incidence of trismus at various time points; and (2) the patient, tumor, and treatment characteristics that predict the development of trismus after radiotherapy in head and neck cancer patients using a large database (n = 641). Maximal mouth opening was measured prior to and 6, 12, 18, 24, 36, and 48 months after radiotherapy. Patient, tumor, and treatment characteristics were analyzed as potential predictors for trismus using a multivariable logistic regression analysis. At six months after radiotherapy, 28.1% of the patients without trismus prior to radiotherapy developed trismus for the first time. At subsequent time points the incidence declined. Over a total period of 48 months after radiotherapy, the incidence of trismus was 3.6 per 10 person years at risk. Patients who had tumors located in the oral cavity, oropharynx or nasopharynx, and the salivary glands or ear, and who had a longer overall treatment time of radiotherapy, were more likely to develop trismus in the first six months after radiotherapy. Maximal mouth opening was a predictor for developing trismus at all time points. Incidence of trismus is 3.6 per 10 person years at risk. Tumor localization and overall treatment time of radiotherapy are predictors for developing trismus the first six months after radiotherapy. Maximal mouth opening is a significant predictor for developing trismus at all time points. Regular measurements of maximal mouth opening are needed to predict trismus.

  3. [Current status and perspectives of radiotherapy for esophageal cancer].

    Wu, S X; Wang, L H


    Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy-based combined-modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

  4. Radiotherapy for MTRA/RT; Strahlentherapie fuer MTRA/RT

    Luetter, Christiana [Bonn Univ. (Germany). Radiologische Klinik


    The radiological practice textbook covers the following issues: tumor diseases, tumor diagnostics, fundamentals of radiotherapy, DIN, irradiation planning, documentation and quality assurance, strategies of tumor therapy, basic physics of radiotherapy and dosimetry, radiation protection - regulations and guidelines, radiobiology, biological radiation effects, special organ toxicity, psychological and medical attendance of patients, special oncology of the most important organ carcinomas, palliative radiotherapy, radiotherapy of benign diseases, other indications of radiotherapy, supportive therapy.

  5. Impact of comorbidity on survival after palliative radiotherapy

    Nieder, Carsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Engljaehringer, Kirsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); Angelo, Kent [University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway)


    To evaluate prognostic factors for survival after palliative radiotherapy (PRT) with consideration of different comorbidities and the Charlson comorbidity index (CCI). Between 2007 and 2012, 525 consecutive patients were treated with PRT and included in this retrospective study. Most patients received PRT for bone metastases, for brain metastases, or in order to improve thoracic symptoms from lung cancer. Median age was 69 years. Uni- and multivariate analyses were performed. We recommend assessment of comorbidity when prescribing PRT and selecting the optimal fractionation regimen, because most patients with severe comorbidities had limited survival. One of the possible explanations could be that only a minority of these patients are fit for systemic therapy, which plays an important role in the overall treatment concept. (orig.) [German] Auswertung der prognostischen Faktoren nach palliativer Strahlentherapie (PST) unter besonderer Beruecksichtigung von Begleiterkrankungen und des Charlson Komorbiditaetsindex (CCI). Zwischen 2007 und 2012 wurden 525 konsekutive Patienten mit PST behandelt und in diese retrospektive Studie eingeschlossen. Die haeufigsten PST Indikationen waren Skelett- und Hirnmetastasen bzw. symptomatische Lungentumoren. Das mediane Alter betrug 69 Jahre. Die Ueberlebensdaten wurden in uni- und multivariaten Modellen analysiert. Nur 7 % der Patienten hatten keinerlei Begleiterkrankungen. Bei 49 % lag ein CCI von 1-2 vor, bei 36 % von 3-4 und bei 9 % von mehr als 4. Juengere Patienten, Frauen und Nichtraucher hatten signifikant weniger Begleiterkrankungen. Patienten ohne Begleiterkrankungen waren in signifikant besserem Allgemeinzustand (AZ) und erhielten oefter eine zusaetzliche palliative systemische Therapie. Sowohl Patienten mit niedrigem CCI als auch solche mit nur einer Krebserkrankung in der Anamnese ueberlebten signifikant laenger. In der multivariaten Analyse waren auch noch der AZ und die Anzahl der mit Metastasen befallenen Organe mit

  6. Carotid artery stenosis after neck radiotherapy

    Shimamura, Munehisa; Hashimoto, Yoichiro; Kasuya, Junji; Terasaki, Tadashi [Kumamoto City Hospital (Japan); Uchino, Makoto


    Carotid artery stenosis sometimes occurs after cervical radiotherapy. We report a 70-year-old woman with a history of radiotherapy for thyroid cancer at the age of 28 years. She had no signs and symptoms except the skin lesion at the irradiation site. Duplex ultrasonography revealed heterogeneous plaques showing 50% stenosis of bilateral common carotid arteries. Those lesions were observed within segment of irradiation, where atheromatous plaque usually seldom occurs. These indicated that the carotid stenosis was induced by radiotherapy. Although the efficacy of antiplatelet therapy for radiation-induced plaque is not clear, the plaques remained unchanged for 4 years in spite of aspirin administration. (author)

  7. Terre des hommes

    Staff Association


    Transformez votre téléphone portable en geste de solidarité ! Collecte du 12 au 23 novembre 2012   Faites un geste simple et utile en déposant vos téléphones portables inutilisés dans les urnes installées dans les trois restaurants du CERN. En Suisse, une personne change tous les 12 à 18 mois de téléphone portable. La plupart de nos vieux appareils sont simplement laissés à l’abandon avec comme seule fonction de parer une éventuelle panne à venir. On  estime ainsi que 8 millions de portables sont inutilisés, alors qu'entre 30 et 50% peuvent être réutilisés. L'action Solidarcomm leur offre une deuxième vie ! Terre des Hommes Suisse, dans le cadre de la campagne Solidarcomm, collecte et valorise vos téléphones inutilis&...

  8. Onlinespieler abseits des Mainstreams

    Harald Baumgartlinger


    Full Text Available MMO(RPGs „Massively Multiplayer Online (Role-Playing Games“ nehmen einen Sonderstatus unter den Onlinespielen ein, welcher durch den wachsenden wirtschaftlichen Erfolg, insbesondere durch den „breakthrough hit“ (Duchenaut et al. 2006: 407 World of Warcraft (WoW, auch an Bedeutung für die Medien- und Kommunikationswissenschaft gewinnt (vgl. Inderst 2009: 15; vgl. Seifert/Jöckel 2008: 297. Der Primus des Genres, WoW, repräsentiert gemeinsam mit einigen nahezu identen Titeln insgesamt 85 Prozent der gespielten MMOGs (vgl. Williams et al. 2008: 999. Daher befasst sich auch die Mehrheit der vorliegenden Studien mit eben diesen Spielen. Neue Formen von MMO(Gs können jedoch zu ebenso neuartigen Spielerfahrungen führen und damit unterschiedliche Nutzungsmotive befriedigen (vgl. Seifert/Jöckel 2008: 309 und folglich zu einem gänzlich anderen Spielerleben führen. Während im Mainstream die kooperativen Spielerbeziehungen überwiegen, dominiert in Darkfall Online der soziale Wettbewerb. Der von Williams et al. 2008 verwendete Fragebogen diente als Rohling für die Kreation eines für die speziellen Anforderungen adaptierten Erhebungstools zur Erforschung der Spielertypologie und der Motive der Darkfall-Online-SpielerInnen. Die in der Onlinebefragung (N = 506 gesammelten Daten belegen, dass sich sowohl die Spielerdemographie, als auch die Motive der Spieler von den Mainstream MMOs unterscheiden. Zudem konnten realweltliche Eigenschaften der Spieler als signifikante Einflussfaktoren für die Spielzuwendung identifiziert werden.

  9. Peste des petits ruminants.

    Parida, S; Muniraju, M; Mahapatra, M; Muthuchelvan, D; Buczkowski, H; Banyard, A C


    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  10. CCC/WPA study : Des Lacs NWR

    US Fish and Wildlife Service, Department of the Interior — Summary of the Civilian Conservation Corps (CCC) camp at Des Lacs National Wildlife Refuge from July 1935-May 1942 to carry on restoration and development of Des...

  11. Radiogenomics and radiotherapy response modeling

    El Naqa, Issam; Kerns, Sarah L.; Coates, James; Luo, Yi; Speers, Corey; West, Catharine M. L.; Rosenstein, Barry S.; Ten Haken, Randall K.


    Advances in patient-specific information and biotechnology have contributed to a new era of computational medicine. Radiogenomics has emerged as a new field that investigates the role of genetics in treatment response to radiation therapy. Radiation oncology is currently attempting to embrace these recent advances and add to its rich history by maintaining its prominent role as a quantitative leader in oncologic response modeling. Here, we provide an overview of radiogenomics starting with genotyping, data aggregation, and application of different modeling approaches based on modifying traditional radiobiological methods or application of advanced machine learning techniques. We highlight the current status and potential for this new field to reshape the landscape of outcome modeling in radiotherapy and drive future advances in computational oncology.

  12. Tomodensitometry images: integration in radiotherapy

    Dessy, F.; Hoornaert, M.T. [Jolimont Hospital, Haine Saint Paul (France). Cancer and Nuclear Medicine Dept.; Malchair, F. [Biomed Engineering, Boncelles (France)


    With a view to utilization of CT scan images in radiotherapy, the effective energy and the linearity of four different scanners (Siemens somatom CR, HiQS, Plus and Picker PQ 2000) and two non standard scanners, simulators with CT option (Webb 1990) (Varian Ximatron and Oldelft Simulx CT) has been measured using the method described by White and Speller in 1980. When the linearity relation in presented using the density or the electron density as the abscissa, a blurred area where two different components of equal density or electron density can have two different Hounsfield`s numbers. Using the linearity relation, the density of Rando`s lung heterogeneity is determined. We calculated a treatment planning (TP) using this value and made a comparison between the TP and the real absorbed dose with was measured using diodes. The comparison between the TP and the relative Absorbed doses showed a difference of up to 4.5%.

  13. Radiotherapy. 2. rev. ed.; Strahlentherapie

    Wannenmacher, Michael; Debus, Juergen [Radiologische Klinik, Heidelberg (Germany). Abteilung fuer Radioonkologie und Strahlentherapie; Wenz, Frederik (ed.) [Universitaetsmedizin Mannheim (Germany). Klinik fuer Strahlentherapie und Radioonkologie


    The purpose of this medical specialty book, besides presenting the state of the art in clinical radiotherapy and radiooncology, is to explain the basic principles of medical physics and radiobiology. Following a number of chapters on general topics and theory it provides detailed coverage of the individual organ systems, briefly addressing future aspects in the process. The authors relate their view that radiooncology as a medical specialty will continue to be under pressure to change and that it will take continuous innovation to secure its status within the interdisciplinary context around the treatment of cancer patients. The authors of this, the textbook's second edition, have dedicated much space to modern methods and techniques in order to do justice to these developments.

  14. Proton radiotherapy of skin carcinomas

    Umebayashi, Y.; Uyeno, K.; Otsuka, F. (Tsukuba Univ. (Japan). School of Medicine); Tsujii, H. (Proton Medical Research Center, Tsukuba (Japan))


    At the Proton Medical Research Centre, University of Tsukuba, a pilot study of proton-beam radiotherapy was performed in 12 patients with the following types of carcinoma: Bowen's disease (4), oral verrucous carcinoma (5), and squamous cell carcinoma (3). They received total doses of 51-99.2 Gy in fractions of 2-12.5 Gy. All tumours responded well to the treatment. All four lesions of Bowen's disease, three of the five oral verrucous carcinomas, and the three squamous cell carcinomas completely regressed following irradiation. Two squamous cell carcinomas recurred during the follow-up period. One recurrent squamous cell carcinoma was successfully treated by a salvage surgical operation, and in the other case the patient refused further therapy. In two verrucous carcinomas there was 90% regression of tumour volume. No severe radiation-related complication occurred. (Author).

  15. Current algebra; Algebre des courants

    Jacob, M. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires


    The first three chapters of these lecture notes are devoted to generalities concerning current algebra. The weak currents are defined, and their main properties given (V-A hypothesis, conserved vector current, selection rules, partially conserved axial current,...). The SU (3) x SU (3) algebra of Gell-Mann is introduced, and the general properties of the non-leptonic weak Hamiltonian are discussed. Chapters 4 to 9 are devoted to some important applications of the algebra. First one proves the Adler- Weisberger formula, in two different ways, by either the infinite momentum frame, or the near-by singularities method. In the others chapters, the latter method is the only one used. The following topics are successively dealt with: semi leptonic decays of K mesons and hyperons, Kroll- Ruderman theorem, non leptonic decays of K mesons and hyperons ( {delta}I = 1/2 rule), low energy theorems concerning processes with emission (or absorption) of a pion or a photon, super-convergence sum rules, and finally, neutrino reactions. (author) [French] La premiere partie de ce cours (trois premiers chapitres), traite des generalites concernant l'algebre de courants. Apres une definition rapide des courants faibles et un rappel de leurs proprietes (hypothese V-A, conservation du courant vecteur, regles de selection, courant axial partiellement conserve,...), l'on introduit l'algebre de Gell-Mann SU (3) x SU (3), et discute les proprietes generales de l'Hamiltonien faible non leptonique. Les chapitres IV a IX sont consacres a des applications importantes de l'algebre des courants. En premier lieu l'on demontre la formule de Adler et Weisberger, par deux methodes differentes, celle dite du repere de moment infini et celle des singularites proches. Cette derniere est seule utilisee dans la suite. Puis, l'on traite successivement les problemes suivants: desintegrations semi-leptoniques des mesons K et des hyperons, theoreme de Kroll

  16. La théorie des industries culturelles (et informationnelles, composante des SIC

    Bernard Miège


    Full Text Available Inaugurer le Cahier central de la Revue des SIC est certes une forme de reconnaissance, mais cela comporte des obligations, au premier rang desquelles la nécessité d’intéresser des lecteurs a priori pas immédiatement concernés par la thématique.Si la théorie des industries culturelles est devenue progressivement une approche marquante des SIC, en France, en Europe et plus largement encore (avec des dénominations variables et des modalités spécifiques, ce n’est en effet ni en le proclamant ha...

  17. Neologismen des Lettischen anhand des schriftstellerischen Werkes von Zigmunds Skujins

    Javojss, Skaidrite


    Untersuchung: Aus acht Werken des zeitgenössischen Schriftstellers Zigmunds Skujins wurden 500 lettische Wörter untersucht, die in den drei umfangreichsten lettischen Wörterbüchern nicht verzeichnet und somit möglicherweise Neologismen des Autors sind. Analysiert werden die Wortarten, die Komposita, die Herkunft der assimilierten Lehnwörter, orthographische und andere Varianten bereits lexikalisierter Wörter, die Arten der Diminutivbildung und der Präfigierung. Außerdem werden Aussagen über d...

  18. Reirradiation for recurrent head and neck cancers using charged particle or photon radiotherapy

    Yamazaki, Hideya [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kamigyo-ku, Kyoto (Japan); Soseikai General Hospital, CyberKnife Center, Shimotoba Fushimi-ku, Kyoto (Japan); Demizu, Yusuke; Okimoto, Tomoaki [Hyogo Ion Beam Medical Center, Department of Radiology, Tatsuno, Hyogo (Japan); Ogita, Mikio [Fujimoto Hayasuzu Hospital, Radiotherapy Department, Miyakonojo, Miyazaki (Japan); Himei, Kengo [Japanese Red Cross Okayama Hospital, Department of Radiology, Okayama, Okayama (Japan); Nakamura, Satoaki; Suzuki, Gen [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kamigyo-ku, Kyoto (Japan); Yoshida, Ken; Kotsuma, Tadayuki [National Hospital Organization Osaka National Hospital, Department of Radiation Oncology, Osaka, Osaka (Japan); Yoshioka, Yasuo [Osaka University Graduate School of Medicine, Department of Radiation Oncology, Suita, Osaka (Japan); Oh, Ryoongjin [Miyakojima IGRT Clinic, Osaka (Japan)


    To examine the outcomes of reirradiation for recurrent head and neck cancers using different modalities. This retrospective study included 26 patients who received charged particle radiotherapy (CP) and 150 who received photon radiotherapy (117 CyberKnife radiotherapy [CK] and 36 intensity-modulated radiotherapy [IMRT]). Inverse probability of treatment weighting (IPTW) involving propensity scores was used to reduce background selection bias. Higher prescribed doses were used in CP than photon radiotherapy. The 1-year overall survival (OS) rates were 67.9% for CP and 54.1% for photon radiotherapy (p = 0.15; 55% for CK and 51% for IMRT). In multivariate Cox regression, the significant prognostic factors for better survival were nasopharyngeal cancer, higher prescribed dose, and lower tumor volume. IPTW showed a statistically significant difference between CP and photon radiotherapy (p = 0.04). The local control rates for patients treated with CP and photon radiotherapy at 1 year were 66.9% (range 46.3-87.5%) and 67.1% (range 58.3-75.9%), respectively. A total of 48 patients (27%) experienced toxicity grade ≥3 (24% in the photon radiotherapy group and 46% in the CP group), including 17 patients with grade 5 toxicity. Multivariate analysis revealed that younger age and a larger planning target volume (PTV) were significant risk factors for grade 3 or worse toxicity. CP provided superior survival outcome compared to photon radiotherapy. Tumor volume, primary site (nasopharyngeal), and prescribed dose were identified as survival factors. Younger patients with a larger PTV experienced toxicity grade ≥3. (orig.) [German] Bestimmung der Ergebnisse einer Rebestrahlung von wiederkehrenden Kopf-Hals-Tumoren mittels verschiedener Modalitaeten. Die retrospektive Studie umfasst 26 Patienten, die mit der Ionenstrahlentherapie (CP), und 150 Patienten, die mit der Photonenstrahlentherapie (117 Stereotaxien [CK] und 36 intensitaetsmodulierte Strahlentherapien [IMRT]) behandelt

  19. Pancreatic insufficiency secondary to abdominal radiotherapy

    Dookeran, K.A.; Thompson, M.M.; Allum, W.H. (Leicester Royal Infirmary (United Kingdom). Dept. of Surgery)


    Delayed post-irradiation steatorrhoea secondary to acute pancreatic insufficiency is rare. The authors describe a case occurring in a patient 23 years following radical abdominal radiotherapy for testicular seminoma. (Author).

  20. Historical aspects of heavy ion radiotherapy

    Raju, M.R.


    This paper presents historical developments of heavy-ion radiotherapy including discussion of HILAC and HIMAC and discussion of cooperation between Japan and the United States, along with personal reflections.

  1. Stereotactic body radiotherapy a practical guide

    Gaya, Andrew


    Collecting the key information in this burgeoning field into a single volume, this handbook for clinical oncology trainees and consultants covers all of the basic aspects of stereotactic radiotherapy systems and treatment and includes plenty of case studies.

  2. Heavy particle radiotherapy: prospects and pitfalls

    Faju, M.R.


    The use of heavy particles in radiotherapy of tumor volumes is examined. Particles considered are protons, helium ions, heavy ions, negative pions, and fast neutrons. Advantages and disadvantages are discussed. (ACR)

  3. Evaluer des études de gestion des entreprises : combiner des éléments principales avec des éléments pratiques

    Pennink, B.J.W.


    Evaluer la recherche de gestion demande une combinaison des critères classiques et des critères pratiques. Par cette combinaison il est possible de trouver une réponse cerrecte concernant la validité et l'effet de la recherche. Dans cet article nous allons décrire comment une combinaison des

  4. Alimentation des tortues terrestres herbivores

    Morin, Nicolas


    Chez les tortues, la plupart des affections rencontrées sont directement ou indirectement liées à un défaut dans les conditions d’entretien et notamment à une alimentation inadéquate. Les ouvrages de référence ne proposent généralement que des rations qualitatives déterminées empiriquement. Ce travail se veut une synthèse bibliographique des différents travaux qui ont été menés sur les tortues terrestres herbivores, dont le but est de dégager les paramètres physiologiques sous-jacents au ...


    Deaconu Alecxandrina


    Full Text Available Les préoccupations pour bien comprendre la complexité des organisations sont bien connues dans la théorie et la pratique du management. La motivation la plus fréquente pour toutes les recherches et les investigationes faites a été fondée sur le besoin de savoir gérer les situations diverses en vue de maximiser la performance organisationnelle. En ce qui nous concerne, pour enrichir les informations disponibles, nous voulons élargir, dans notre communication, les approches traditionelles, focaliser l’attention sur la dimension psychologiques des organisations et présenter les mécanismes qui favorisent l’implication des salariés.

  6. L’Internet des objets

    Benghozi, Pierre-Jean; Bureau, Sylvain; Massit-Folléa, Françoise


    L’ « internet des objets » est une dimension majeure de l’internet du futur. Mais tout le monde ne s’accorde pas encore sur sa définition, ni sur la mesure de son importance économique ou des risques qu’il induit. L’étude de nombreux rapports prospectifs et l’observation des innovations d’ores et déjà engagées a permis de mettre en relief les incertitudes techniques, économiques et socio-politiques qui pèsent sur cette véritable mutation programmée de l’internet et de proposer une approche eu...

  7. L’Internet des objets

    Benghozi, Pierre-Jean; Bureau, Sylvain; Massit-Folléa, Françoise


    L’ « internet des objets » est une dimension majeure de l’internet du futur. Mais tout le monde ne s’accorde pas encore sur sa définition, ni sur la mesure de son importance économique ou des risques qu’il induit. L’étude de nombreux rapports prospectifs et l’observation des innovations d’ores et déjà engagées a permis de mettre en relief les incertitudes techniques, économiques et socio-politiques qui pèsent sur cette véritable mutation programmée de l’internet et de proposer une approche eu...

  8. Blisters - an unusual effect during radiotherapy.

    Höller, U; Schubert, T; Budach, V; Trefzer, U; Beyer, M


    The skin reaction to radiation is regularly monitored in order to detect enhanced radiosensitivity of the patient, unexpected interactions (e.g. with drugs) or any inadvertent overdosage. It is important to distinguish secondary disease from radiation reaction to provide adequate treatment and to avoid unnecessary discontinuation of radiotherapy. A case of bullous eruption or blisters during radiotherapy of the breast is presented. Differential diagnoses bullous pemphigoid, pemphigus vulgaris, and bullous impetigo are discussed and treatment described.

  9. Radiotherapy in Dupuytren's contracture

    Koehler, A.H. (Bezirkskrankenhaus Cottbus (German Democratic Republic))


    In Dupuytren's contracture grade I by Iselin radiotherapy is indicated. With X-ray half-depth therapy and a total dose of 20.0 Gy the disease could be treated successfully in 82 % of the cases in a sense of inhibition of progression, whereas in 18 % radiotherapy failed. Possibly the results can be improved by increase of the radiation dose and/or modified fractionating.

  10. Stereotactic multiple are radiotherapy. IV--Haemangioblastoma.

    Chakraborti, P R; Chakrabarti, K B; Doughty, D; Plowman, P N


    Our initial experience in the treatment of haemangioblastoma using conventional external beam radiotherapy and stereotactic radiotherapy (radiosurgery), by the linear accelerator method, is reported. Six haemangioblastomas in five patients were treated with a mean follow-up of 40 months (range 14-60). Five haemangioblastomas in four patients were treated with stereotactic radiotherapy, where four showed complete radiological response and the fifth was static. Neurological symptoms and signs improved in those patients. The sixth haemangioblastoma was situated close to the pituitary and optic chiasm, and was treated with conventionally fractionated external beam radiotherapy. The lesion showed partial response. No complications were noted in this patient group. This series complements and extends the relatively sparse published literature demonstrating that radiotherapy is an effective option for treating haemangioblastomas. Radiosurgery often lends itself particularly well to these discrete lesions allowing highly focused treatment. For patients with multiple and metachronous cerebellar haemangioblastomas as part of the von Hipple-Lindau syndrome, the data support a policy of conventionally fractionated external beam radiotherapy to the whole cerebellum of 50-55 Gy followed, after a period of time, by radiosurgery to persisting lesions (patients 3 and 4).

  11. Géographie des cryptarchies

    Gilles Fumey


    Full Text Available Si toute la surface du globe est appropriée, certains territoires sont encore revendiqués par des personnes ou petits groupes usurpateurs, conquérants ou aventuriers. Leur «conquête» porte sur des espaces physiques ou virtuels (internet. Elle traduit avec constance dans l'histoire le rôle considérable de l'ancrage territorial qui reste, pour l'homme, un antidote à toutes les formes d'organisation qui le dépassent.

  12. Cardiotoxicité des psychotropes

    TAHIRI, Abdallah


    Même à dose thérapeutique, les médicaments psychotropes sont susceptibles d'engendrer des troubles du rythme cardiaque graves avec risque létal concourant à expliquer la pré valence de la mort subite dans la population psychiatrique. Les situations cliniques à risque telles que poly médication (des psychotropes entre eux ou d'un psychotrope avec un non psychotrope allongeur de QTc), interactions médicamenteuses aussi bien pharmacodynamiques que pharmacocinétiques, traitement pa...

  13. Physique statistique des Fluides Classiques

    Aslangul, Claude


    0 - Préambule.Préambule, table des matières1 - Rappels sur la description d'un système à l'équilibre thermodynamiqueQuelques propriétés des systèmes macroscopiques. Nature statistique de l'entropie. Grandeurs internes et grandeurs externes. Relations thermodynamiques fondamentales. Potentiels thermodynamiques. Ensembles microcanonique, canonique, grand-canonique et isotherme - isobare. Exemple: fonction de partition d'un fluide classique. Principe variationnel pour l'énergie libre.2 - Stabili...

  14. Radiotherapy for pain management of bone metastases

    Rezende Junior, Ismar de; Mattos, Marcos Duarte de; Nakamura, Ricardo; Lemes Junior, Joaquim; Vanzelli, Talita Lozano, E-mail: [Radioterapia do Hospital de Cancer de Barretos, SP (Brazil)


    Purpose: This is the first Brazilian study intended to evaluate the response of pain relief with radiotherapy in three different fractionation and the clinical differences in managing pain in patients with painful bone metastases. Methods: Prospective study of patients with painful bone metastases referred to the Radiotherapy Sector of the Hospital de Cancer de Barretos for pain-relieving radiotherapy between March and December 2010. It is known that radiotherapy seems to alter the activation of osteoclast-mediated bone resorption, relieving pain in cases of painful bone metastases. Patients were assessed in relation to the status of pain intensity before and after the initiation of radiotherapy. Either a single fraction of 8Gy, five fractions of 4Gy or ten fractions of 3Gy were given. A visual analog scale (VAS) was applied by doctors, nurses and nursing technicians to assess pain intensity at each session of radiotherapy, and follow-up at 8, 30 and 90 days from the end of treatment. Results: We evaluated 92 consecutive patients, 48 male and 44 female, with a median age of 58 years. We found that 14% of patients referred from the Palliative Care or Clinical Oncology sectors need better pharmacological analgesia due to severe pain, compared with 40.5% of patients from the other sectors (p = 0.004). We also found that the onset of pain relief to patients receiving 10 fractions of 300cGy analgesia without changing the pre-radiotherapy analgesia occurred with significance after the fifth fraction. Improvement in pain experienced within 90 days of follow-up was found in eighty percent of patients, independent of fractionated radiotherapy, site of metastases and the clinical condition of the patient. Discussion/Conclusion: The Palliative Care and Clinical Oncology sectors expressed greater concern in regards to analgesia for the patient with painful bone metastases. Radiotherapy is an effective pain-relieving treatment in different fractionation studied, even though the

  15. La maison des mathématiques

    Villani, Cédric; Moncorgé, Vincent


    Comment travaillent les mathématiciens ? C'est peut-être en se promenant dans les couloirs de la première des " maisons des mathématiques " de France, l'institut Henri Poincaré, que l'on trouvera quelques réponses. Le mathématicien Cédric Villani et le physicien Jean-Philippe Uzan nous invitent à découvrir cette discipline et ses acteurs. Au fil des pages on suit, à travers de superbes images signées du photographe Vincent Moncorgé, la façon dont se fabrique cette science qui reste souvent mystérieuse. Toutes les dimensions, scientifique, esthétique et poétique, des mathématiques sont convoquées grâce à des regards croisés : la diversité des inspirations des chercheurs, la source de leur créativité, l'imaginaire littéraire et artistique des mathématiques, la drôle de tribu des mathématiciens. Un voyage au cœur de cette " auberge espagnole " des mathématiques, campus " à la française " accueillant des centaines de chercheurs du monde entier, devenu un lieu d'émulation et d'éc...

  16. La compaction des sols forestiers en Wallonie

    Destain, Marie-France


    Dans nos pays industrialisés, l’exploitation forestière fait appel à des machines de plus en plus lourdes pour assurer la vidange des coupes et le débardage des grumes. Lorsque des charges élevées sont appliquées sur des sols sensibles, une compaction du sol peut se produire entraînant une réduction de porosité, avec des conséquences néfastes sur la vitalité des peuplements. Au niveau environnemental, du fait de la compaction, l’infiltration de l’eau dans le sol est réduite, principalement...

  17. Etude des erreurs d'estimation des populations par la méthode des captures successives (DeLURY, 2 captures et des captures-recaptures (PETERSEN



    Full Text Available L'estimation des populations naturelles par capture-recapture et par captures successives est souvent entachée d'erreur car, dans de nombreux cas, l'hypothèse fondamentale d'égalité des probabilités de captures pour tous les individus dans le temps et dans l'espace n'est pas respectée. Dans le cas des populations de poissons envisagés ici, les captures ont lieu par la pêche électrique. On a pu chiffrer l'ordre de grandeur des erreurs systématiques faites sur l'estimation des peuplements, en fonction des conditions particulières, biotiques et abiotiques, des différents milieux inventoriés.

  18. Recherche des oscillations de Neutrinos $\

    Gangler, E


    Le detecteur nomad, place sur le faisceau de neutrinos wide-band-beam du sps, de contamination en neutrino tau marginale, permet de rechercher des oscillations neutrino muon - tau dans la region de pertinence cosmologique et de distinguer statistiquement les courants charges des neutrinos tau essentiellement par leur mesure cinematique. Une large part du travail de these a donc ete consacree a la reconstruction des evenements dans les chambres a derive, cible instrumentee et cur de l'experience, dont la physique de detection est decrite. Une methode de recherche de traces fut developpee, utilisant certaines informations d'un autre sous-detecteur de nomad, le trd. Pour combler une perte d'efficacite de reconstruction, une methode de recherche de traces courtes s'appuyant sur des vertex deja constitues fut developpee en exploitant les potentialites du filtre de kalman, algorithme iteratif d'ajustement de traces. Ces methodes sont utilisees en production par la collaboration. Cette these porte sur la recherche d...

  19. Reduction des effectifs ou licenciements

    Maiani, Luciano


    "Vous faites un amalgame entre la reduction en cours des effectifs du CERN (organisation europeenne pour la recherche nucleaire) et les economies que le laboratoire doit realiser dans les cinq ans a venir pour financer le projet de grand collisionneur de hadrons (Le Monde du 4 septembre)" (1/2 page).

  20. Bangalore, ville des nouvelles technologies

    Clarisse Didelon


    Full Text Available Bangalore est devenue la Silicon Valley de l’Inde. Une partie de ses habitants y vit à l’occidentale mais le reste de la population souffre de la croissance spectaculaire de la ville. Face à l’insuffisance des infrastructures, Bangalore devient de moins en moins attractive pour les entreprises internationales.

  1. Radiotherapy for breast cancer and pacemaker; Radiotherapie pour un cancer du sein et stimulateur cardiaque

    Menard, J.; Campana, F.; Bollet, M.A.; Dendale, R.; Fournier-Bidoz, N.; Marchand, V.; Mazal, A.; Fourquet, A.; Kirova, Y.M. [Oncologie-radiotherapie, institut Curie, 26, rue d' Ulm, 75005 Paris (France); Kirov, K.M.; Esteve, M. [Departement d' anesthesie-reanimation-douleur, institut Curie, 75005 Paris (France)


    Purpose. - Patients with permanent cardiac pacemakers occasionally require radiotherapy. Therapeutic Irradiation may cause pacemakers to malfunction due to the effects of ionizing radiation or electromagnetic interference. We studied the breast cancer patients who needed breast and/or chest wall and lymph node irradiation to assess the feasibility and tolerance in this population of patients. Patients and methods. - From November 2008 to December 2009, more than 900 patients received radiotherapy for their breast cancer in our department using megavoltage linear accelerator (X 4-6 MV and electrons). Among them, seven patients were with permanent pacemaker. All patients have been treated to the breast and chest wall and/or lymph nodes. Total dose to breast and/or chest wall was 50 Gy/25 fractions and 46 Gy/23 fractions to lymph nodes. Patients who underwent conserving surgery followed by breast irradiation were boosted when indicated to tumour bed with 16 Gy/8 fractions. All patients were monitored everyday in presence of radiation oncologist to follow the function of their pacemaker. All pacemakers were controlled before and after radiotherapy by the patients' cardiologist. Results. - Seven patients were referred in our department for postoperative breast cancer radiotherapy. Among them, only one patient was declined for radiotherapy and underwent mastectomy without radiotherapy. In four cases the pacemaker was repositioned before the beginning of radiotherapy. Six patients, aged between 48 and 84 years underwent irradiation for their breast cancer. Four patients were treated with conserving surgery followed by breast radiotherapy and two with mastectomy followed by chest wall and internal mammary chain, supra- and infra-clavicular lymph node irradiation. The dose to the pacemaker generator was kept below 2 Gy. There was no pacemaker dysfunction observed during the radiotherapy. Conclusion. - The multidisciplinary work with position change of the pacemaker

  2. Radiotherapy Treatment Planning for Testicular Seminoma

    Wilder, Richard B., E-mail: [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States); Buyyounouski, Mark K. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Efstathiou, Jason A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)


    Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 Multiplication-Sign 1-2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior-posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior-posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

  3. Post Pelvic Radiotherapy Bony Changes

    Huh, Seung Jae [Samsung Medical Center, Seoul (Korea, Republic of)


    There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as 8.2{approx}20% after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

  4. Osteoporose und Genetik des Knochenstoffwechsels

    Obermayer-Pietsch B


    Full Text Available Osteoporose ist in hohem Maß genetisch determiniert. Neue Wege der molekularbiologischen Forschung haben sich in den letzten Jahren auf diesem Gebiet etabliert. "Gene mapping" mit polymorphen genetischen Markern auf der Suche nach Phänotyp-assoziierten Genen ist ein aufwendiges, aber vielversprechendes Verfahren und wird durch die Erkenntnisse des Human Genome Projects beschleunigt. So wurde jüngst u. a. das Low-density Lipoprotein 5-Gen als wichtig für den Knochenstoffwechsel identifiziert. Kandidaten-gene wie Hormonrezeptor-, Cytokin- oder Kollagen-Gene werden hinsichtlich ihrer Gen-Gen- und Gen-Umwelt- Interaktionen untersucht und erlauben neue funktionelle Einsichten in Erkrankungen des Knochenstoffwechsels. Mutationen der Kollagen-Gene sind bei einigen seltenen Erkrankungen, wie dem Osteoporose-Pseudogliom-Syndrom oder der Osteogenesis imperfecta gefunden worden, könnten aber auch für häufige Varianten von Bindegewebsstörungen wie der congenitalen Hüftdysplasie verantwortlich sein, die etwa 10 % der weiblichen kaukasischen Bevölkerung in unterschiedlichem Ausmaß betrifft. Osteoporose am Schenkelhals und erhöhte Gelenkslaxizität sowie andere generalisierte Veränderungen des Knochen- und Kollagenstoffwechsels können hier möglicherweise ebenfalls durch Störungen des Kollagen I alpha 1-Gens erklärt werden. In Summe können wir zahlreiche neue Einsichten in die Pathophysiologie des Skelettsystems erwarten, die uns auch neue Zugangswege für Diagnostik und Therapie unserer Patienten ermöglichen werden.

  5. L'astronomie des Anciens

    Nazé, Yaël


    Quelle que soit la civilisation à laquelle il appartient, l'être humain cherche dans le ciel des réponses aux questions qu'il se pose sur son origine, son avenir et sa finalité. Le premier mérite de ce livre est de nous rappeler que l'astronomie a commencé ainsi à travers les mythes célestes imaginés par les Anciens pour expliquer l'ordre du monde et la place qu'ils y occupaient. Mais les savoirs astronomiques passés étaient loin d'être négligeables et certainement pas limités aux seuls travaux des Grecs : c'est ce que l'auteur montre à travers une passionnante enquête, de Stonehenge à Gizeh en passant par Pékin et Mexico, fondée sur l'étude des monuments anciens et des sources écrites encore accessibles. Les tablettes mésopotamiennes, les annales chinoises, les chroniques médiévales, etc. sont en outre d'une singulière utilité pour les astronomes modernes : comment sinon remonter aux variations de la durée du jour au cours des siècles, ou percer la nature de l'explosion qui a frappé tant d'observateurs en 1054 ? Ce livre offre un voyage magnifiquement illustré à travers les âges, entre astronomie et archéologie.

  6. Tambov. Le camp des Malgré Nous alsaciens et mosellans prisonniers des Russes

    Claerr-Stamm, Gabrielle


    « La faim, le froid, l’injustice. Et puis le silence… Tambov égale silence. Silence de la grande majorité de ceux qui en sont revenus, silence dans les familles, silence des historiens, silence des archives, silence des écrivains et des artistes, silence de l’opinion publique ». « Il a fallu l’opiniâtre courage de poignées d’individus – anciens prisonniers, responsables d’associations, quelques élus, des historiens et des journalistes – pour que la parole et la reconnaissance trouvent progres...

  7. Vers une typologie des formes spatiales des limites de l’Europe

    de Ruffray, Sophie


    Penser l’Europe et ses limites consiste souvent à rechercher une identité européenne, un projet ou des comportements communs dans l’espace. L’approche par les représentations mentales permet de compléter par des perspectives plus subjectives, la perception des frontières. Cet article, réalisé à partir des résultats de l’enquête du projet de recherches Eurobroadmap sur la vision de l’Europe dans le monde permet de mettre en évidence une typologie des formes spatiales des limites de l’Europe. D...

  8. Stereotactic body radiotherapy for renal cell cancer and pancreatic cancer. Literature review and practice recommendations of the DEGRO Working Group on Stereotactic Radiotherapy

    Panje, Cedric; Andratschke, Nikolaus; Guckenberger, Matthias [Zurich University Hospital, Department of Radiation Oncology, Zurich (Switzerland); Brunner, Thomas B. [Freiburg University Hospital, Department of Radiation Oncology, Freiburg (Germany); Niyazi, Maximilian [University of Munich, Department of Radiation Oncology, Munich (Germany)


    This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a literature review and practice recommendations for stereotactic body radiotherapy (SBRT) of primary renal cell cancer and primary pancreatic cancer. A literature search on SBRT for both renal cancer and pancreatic cancer was performed with focus on prospective trials and technical aspects for clinical implementation. Data on renal and pancreatic SBRT are limited, but show promising rates of local control for both treatment sites. For pancreatic cancer, fractionated SBRT should be preferred to single-dose treatment to reduce the risk of gastrointestinal toxicity. Motion-compensation strategies and image guidance are paramount for safe SBRT delivery in both tumor entities. SBRT for renal cancer and pancreatic cancer have been successfully evaluated in phase I and phase II trials. Pancreatic SBRT should be practiced carefully and only within prospective protocols due to the risk of severe gastrointestinal toxicity. SBRT for primary renal cell cancer appears a viable option for medically inoperable patients but future research needs to better define patient selection criteria and the detailed practice of SBRT. (orig.) [German] Die Arbeitsgruppe ''Stereotaktische Radiotherapie'' der Deutschen Gesellschaft fuer Radioonkologie (DEGRO) legt eine Zusammenfassung der aktuellen Literatur und daraus resultierende Empfehlungen zur Durchfuehrung der stereotaktischen Strahlentherapie (SBRT) beim Nierenzellkarzinom und beim Pankreaskarzinom vor. Es erfolgte eine Literaturrecherche zur Evidenz der SBRT beim Nierenzell- und Pankreaskarzinom, wobei der Schwerpunkt auf prospektive Studien und technische Aspekte fuer die klinische Umsetzung gelegt wurde. Fuer die SBRT beim Pankreaskarzinom und Nierenzellkarzinom sind bisher nur wenige Studien veroeffentlicht worden, die jedoch konsistent eine hohe Rate an lokaler Tumorkontrolle

  9. Prospective study of factors of prognosis of survival without disease and of global five year and ten-year survival in a series of 90 patients suffering from a stage IIB or III cervical epidermoid carcinoma which had been treated by concomitant chemo-radiotherapy; etude prospective des facteurs pronostiques de survie sans maladie et de survie globale a cinq et dix dans une serie de 90 patientes atteintes d'un carcinome epidermoide du col uterin de stade IIB ou III dont le traitement etait une chimioradiotherapie concomitante

    Ferdi, N.; Djekkoun, R.; Aouati, E.; Chirouf, A.; Aouati, S.; Afiane, M. [CHU de Constantine (Algeria)


    The authors report the study of some factors (TNM stage, tumour size, histological sub-type and haemoglobin concentration) of survival without disease and of global survival by analyzing the files of 90 patients who had chemotherapy concomitantly with external radiotherapy (five 1,8 Gy sessions a week for four to five weeks) followed by utero-vaginal curietherapy. It appears that chemo-radiotherapy is well tolerated and that some factors very significantly affect global survival and survival without disease. Concomitant chemo-radiotherapy significantly delays the occurrence of recurrence and metastases, notably for locally advanced tumours. Short communication

  10. A systematic review of antiproton radiotherapy

    Martin-Immanuel eBittner


    Full Text Available Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  11. Clinical efficacy of radiotherapy combined with sodium glycididazole ...

    Purpose: To assess the clinical efficacy and side effects of radiotherapy combined with sodium glycididazole in ... effect in the treatment of recurrent oesophageal carcinoma than radiotherapy alone. Keywords: ..... Chen J, Zhou ZR. Research ...

  12. Administration et gestion des contrats XL

    Senouf, J


    Les grands contrats de travaux génèrent un grand nombre de commandes (OSVC) passées par un grand nombre de responsables techniques. Ils sont généralement basés sur des bordereaux de prix associés à un éventail de conditions économiques adaptées aux besoins complexes et variés des multiples utilisateurs du CERN nécessitant des calculs sophistiqués. L'administration des commandes, le suivi des travaux et de la facturation doivent répondre aux besoins de tous les acteurs. Les responsables techniques doivent jouir de la plus large indépendance administrative dans le respect des règlements CERN et des conditions contractuelles. Le contrôle des métrés et décomptes doit être rigoureux et d'une traçabilité complète. L'utilisation des bases de données Oracle a déjà permis l'intégration des données administratives et techniques. Le Web nous invite à une communication totale et transparente entre les utilisateurs, les services techniques et les contractants. De nouveaux types de contrat so...

  13. Enquête de satisfaction des restaurants

    Staff Association


    Comité de surveillance des restaurants L’Association du personnel est représentée dans plusieurs comités dont le Comité de surveillance des restaurants (CSR) qui a pour mandat : de donner son avis sur toute question relative à la politique générale de l’Organisation en matière de restauration sur le site, y compris en ce qui concerne les termes et l’attribution des contrats d’exploitation des restaurants ; de définir dans le cadre des contrats d’exploitation des restaurants, les prestations correspondant aux besoins et, dans la mesure du possible, aux désirs du personnel ; de surveiller les prestations des restaurants, y compris en ce qui concerne la qualité et la préparation des produits ; de négocier avec les concessionnaires des restaurants au sujet des tarifs et de surveill...

  14. La territorialisation des politiques environnementales

    Amédée Mollard


    Full Text Available Le point de départ de cet article est la grande variabilité de la pollution nitrique diffuse de l’eau due à l’agriculture. Celle-ci dépend en particulier du climat, des types de sol et des systèmes de production agricole. Nos recherches réalisées de façon interdisciplinaire à partir de deux sites différents en France, montrent que cette hétérogénéité spatio-temporelle conditionne les pratiques agricoles mises en œuvre pour réduire la pollution au niveau de la norme admise. De ce fait, les pratiques les plus « coût-efficaces » diffèrent d’un territoire à l’autre, en fonction des caractéristiques locales. Ces résultats mettent donc en évidence une efficacité potentielle d’une territorialisation des politiques publiques. En théorie, de telles politiques sont considérées comme optimales par les économistes, car elles incitent les agents à moduler leurs efforts en fonction de la sensibilité du milieu. Mais, selon les études empiriques, cet avantage serait annulé par un coût élevé de mise en œuvre, de contrôle et de surveillance. Pour maintenir leur avantage sur des politiques uniformes, les politiques territorialisées devraient être mises en œuvre à un niveau spatial optimal. Un tel niveau devrait au minimum atteindre un compromis entre l’économie réalisée grâce à une modulation adaptée aux conditions locales et les sur-coûts dus à la décentralisation des solutions mises en œuvre. Cet article analyse la pertinence d’une prise en compte de ces spécificités par des politiques territorialisées. L’efficacité d’une régulation différenciée de la pollution nitrique est étudiée ici en évaluant l’importance de la variabilité spatiale des paramètres physiques et des coûts de la territorialisation.The paper starts with the wide variability of nonpoint water nitrogenous pollution generated by agriculture. This variability depends especially on climate, soil types and farming

  15. [From quality management to dynamic management through quality: Deployment within a radiotherapy group].

    Guerrier, B; Halm, É; Craman, M; Dujols, J-P; Norkowski, J-L; Meynard, K


    In 2015, the quality group of the radiotherapy clinic Groupement de Radiothérapie et d'Oncologie des Pyrénées (GROP, Pau, France) decided to review the deployment of its quality approach in order to optimize it continuously. For this, two improvements were proposed: an involvement of process drivers and a material and financial investment in document management software. The implementation of these organizational and managerial provisions enabled us to better cover the requirements of the ISO 9001 standard, the international reference in quality management. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  16. Optimization of radiotherapy for Dupuytren's disease; Optimierung der Radiotherapie bei Morbus Dupuytren. Erste Ergebnisse einer kontrollierten Studie

    Seegenschmiedt, M.H.; Olschewski, T.; Guntrum, F. [Alfried-Krupp-Krankenhaus Essen (Germany). Klinik fuer Radioonkologie, Strahlentherapie und Nuklearmedizin


    prophylactic radiotherapy for the contralateral hand due to disease progression. Conclusions: Prophylactic radiotherapy reduces symptoms and prevents disease progression in early-stage Dupuytren's disease. Both treatment concepts are well-tolerated and equally effective. Acute toxicity is slightly increased with treatment concept B (7 times 3 Gy), while chronic sequelae are low in both treatment groups. Long-term evaluation with follow-up of more than 5 years has to be awaited to recommend one or the other dose concept. (orig.) [German] Ziel: Es werden zwei Dosiskonzepte bei Bestrahlung des Morbus Dupuytren verglichen, um die Progression der Erkrankung bzw. eine Handoperation zu verhindern. Patienten und Methode: 129 Patienten (67 Maenner, 62 Frauen) wurden prospektiv in zwei Gruppen behandelt und fuer mindestens ein Jahr nachbeobachtet. 69 Patienten waren an beiden Haenden, 60 an einer Hand erkrankt (gesamt: 198 bestrahlte Haende). Nach Tubiana befanden sich 73 Haende im Stadium N, 61 im Stadium N/I ({<=}10 Beugekontraktur), 59 im Stadium I (11 bis 45 ) und fuenf im Stadium II (46 bis 90 ). Bestrahlt wurde am Orthovoltgeraet (120 kV) mit 40 cm Abstand und individuellen Bleigummi-Blenden. Gruppe A (63 Patienten/95 Haende) erhielt 10-mal 3 Gy (gesamt: 30 Gy); 5-mal 3 Gy taeglich in zwei Serien, acht Wochen Pause zwischen den Serien; Gruppe B (66 Patienten/103 Haende) erhielt 7-mal 3 Gy (gesamt: 21 Gy) in zwei Wochen. Die Patienten- und Krankheitsparameter waren in beiden Gruppen gleich verteilt. Die Auswertung (Toxizitaet, Effektivitaet) erfolgte drei und zwoelf Monate nach Bestrahlung. Subjektive (Patient) und objektive Parameter (Palpation, Messungen, Photovergleich-Arzt) wurden bewertet. Ergebnisse: Die Akuttoxizitaet war gering: 76 (38%) Haende hatten Hautreaktionen CTC-Grad 1 und zwoelf (6%) CTC-Grad 2. Chronische Folgen (Trockenheit, Atrophie, Sensibilitaetsstoerungen, LENT-Grad 1) traten bei neun (5%) Haenden auf. Drei und zwoelf Monate nach Radiotherapie wurde

  17. Evaluation des systèmes existants pour le suivi à long terme des déformations des ponts

    BURDET, Olivier; Muttoni, Aurelio


    Le projet de recherche Evaluation des systèmes existants pour le suivi à long terme des déformations des ponts a été initié dans le but de préparer sous forme condensée une présentation et une évaluation des systèmes de mesure existants pour le suivi à long terme des déformations de ponts ainsi que des recommandations en vue d’applications particulières. Ce sujet est d’actualité car d’une part il importe de gérer au mieux les ouvrages et les ressources et d’autre part parce que plusieurs cas ...

  18. Géographie des interfaces. Une nouvelle vision des territoires

    Marie Redon


    Full Text Available Littéralement, une interface est une surface de séparation entre deux états distincts de la matière. Le terme, ayant cheminé de la physique à la biologie, et aussi désormais d’usage répandu en informatique. En géographie, l’usage du mot s’est développé dans les années 1980 et peut être défini comme un espace permettant la mise en relation de deux espaces/territoires différents, influencé par des échanges entre l’un et l’autre, et se distinguant par là-même des deux espaces contigus. Intégrant...

  19. Evaluation des performances des protocoles de routage Ad hoc

    Boushaba, Abdelali; Oumsis, Mohammed; Benabbou, Rachid


    International audience; L'objectif de ce travail est d'une part, de confronter par la simulation, à l'aide de NS-2, les performances de quatre protocoles de routage Ad hoc: DSR, AODV, OLSR et DSDV et d'autre part, d'examiner l'impact de la charge du trafic, de la mobilité et de la densité des nœuds sur le comportement de ces protocoles. Les résultats montrent qu'il n'y a pas un protocole qui est favori pour tous les critères d'évaluation. En effet, chaque protocole a des comportements différe...

  20. Radiotherapy-induced hypopituitarism: a review.

    Sathyapalan, Thozhukat; Dixit, Sanjay


    Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic-pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic-pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic-pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH.

  1. Pelvic radiotherapy and sexual dysfunction in women

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute


    of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. METHODS: An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological...... and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. RESULTS...... during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. CONCLUSIONS: Pelvic radiotherapy has a persistent deteriorating effect on the vaginal mucosa impacting negatively on the sexual...

  2. Estimating the Risks of Breast Cancer Radiotherapy

    Taylor, Carolyn; Correa, Candace; Duane, Frances K


    and cause-specific mortality and excess RRs (ERRs) per Gy for incident lung cancer and cardiac mortality. Smoking status was unavailable. Third, the lung or heart ERRs per Gy in the trials and the 2010 to 2015 doses were combined and applied to current smoker and nonsmoker lung cancer and cardiac mortality.......06) ERR per Gy whole-heart dose. Estimated absolute risks from modern radiotherapy were as follows: lung cancer, approximately 4% for long-term continuing smokers and 0.3% for nonsmokers; and cardiac mortality, approximately 1% for smokers and 0.3% for nonsmokers. Conclusion For long-term smokers......Purpose Radiotherapy reduces the absolute risk of breast cancer mortality by a few percentage points in suitable women but can cause a second cancer or heart disease decades later. We estimated the absolute long-term risks of modern breast cancer radiotherapy. Methods First, a systematic literature...

  3. [Radiotherapy of choroid metastases in breast carcinoma].

    Dobrowsky, W; Schmid, A P; Dobrowsky, E


    From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

  4. Growth Laws in Cancer: Implications for Radiotherapy

    Castorina, P; Gabriele, P; Guiot, C


    Comparing both, the more conventional Gompertz tumor growth law (GL) and the ``Universal'' law (UL), recently proposed and applied to cancer,we have investigated the growth law's implications on various radiotherapy regimen. According to GL, the surviving tumor cell fraction could be reduced 'ad libidum', independently of the initial tumor mass,simply by increasing the number of treatments. On the contrary, if tumor growth dynamics would indeed follow the Universal scaling law, there is a lower limit of the survival fraction that cannot be reduced any further regardless of the total number of treatments. This finding can explain the so called ``tumor size effect'' and re-emphasizes the importance of early diagnosis as it implies that radiotherapy may be successful provided the tumor mass at treatment onset is rather small. Taken together with our previous works, implications of these findings include revisiting standard radiotherapy regimen and overall treatment protocols.

  5. Track structure modelling for ion radiotherapy

    Korcyl, Marta


    In its broadest terms, doctoral dissertation entitled "Track structure modelling for ion radiotherapy" is part of the supporting research background in the development of the ambitious proton radiotherapy project currently under way at the Institute of Nuclear Physics PAN in Krak\\'ow. Another broad motivation was the desire to become directly involved in research on a topical and challenging subject of possibly developing a therapy planning system for carbon beam radiotherapy, based in its radiobiological part on the Track Structure model developed by prof. Robert Katz over 50 years ago. Thus, the general aim of this work was, firstly, to recapitulate the Track Structure model and to propose an updated and complete formulation of this model by incorporating advances made by several authors who had contributed to its development in the past. Secondly, the updated and amended (if necessary) formulation of the model was presented in a form applicable for use in computer codes which would constitute the "radiobio...

  6. Oral verrucous carcinoma. Treatment with radiotherapy

    Nair, M.K.; Sankaranarayanan, R.; Padmanabhan, T.K.; Madhu, C.S.


    Fifty-two cases of oral verrucous carcinoma treated with radiotherapy at the Regional Cancer Centre, Trivandrum, Kerala, India in 1982 were evaluated to determine the distribution within the oral cavity, clinical extent, and effectiveness of radiotherapy in controlling the disease. The most common site was the buccal mucosa. Fifty percent of the patients had clinically negative regional lymph nodes and 33% were in earlier stages (T1, T2, N0, and M0). The overall 3-year no evidence of disease (NED) survival rate was 44%. The 3-year NED survival rate with radium implant was 86%. We cannot comment on anaplastic transformation after radiotherapy because our treatment failures have not been subjected for biopsy concerning this matter. Because the results are comparable with those of well-differentiated squamous cell carcinoma, we think that the treatment policies advocated for oral squamous cell carcinoma are also applicable to oral verrucous carcinoma.

  7. Prevention and treatment of the orofacial complications of radiotherapy

    Rothwell, B.R.


    Radiotherapy of malignant head and neck tumors often causes extensive, permanent changes in salivary glands, peridental alveolar bone, and mucosal structures. Dental neglect and inappropriate dental management can cause complications. The potential orofacial side effects of radiotherapy are reviewed, as are preventive strategies for the dental treatment of patients scheduled to undergo radiotherapy.

  8. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    Fietkau, R. [Strahlentherapeutische Klinik und Poliklinik, Rostock Univ. (Germany)]|[Strahlentherapeutische Klinik und Poliklinik, Erlangen Univ. (Germany)


    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [Deutsch] Hintergrund: Der Ernaehrungsstatus von Tumorpatienten ist haeufig bereits vor jeder antitumoroesen Therapie reduziert und kann sich durch die notwendige Radio(chemo)therapie weiter verschlechtern. Methode: Im Rahmen dieses Uebersichtsartikels werden die Moeglichkeiten und Risiken der enteralen und parenteralen Ernaehrung waehrend einer Radiotherapie besprochen. Die Indikationen der enteralen Ernaehrung werden anhand von eigenen Ergebnissen begruendet. Ergebnisse: Die Langzeiternaehrung wird am besten ueber einen enteralen Zugang durchgefuehrt. In einer prospektiven, nichtrandomisierten Studie konnten wir zeigen, dass eine enterale Ernaehrung mittels perkutaner endoskopisch kontrollierter Gastrostomie (PEG) nicht nur die anthropometrischen und biochemischen Parameter waehrend einer Radio(chemo)therapie verbessert, sondern auch die Lebensqualitaet. Eine weitere Moeglichkeit besteht in der

  9. Marie-Pierre Lassus, Gaston Bachelard musicien. Une philosophie des silences et des timbres

    Marida Rizzuti


    Marie-Pierre Lassus, Gaston Bachelard musicien. Une philosophie des silences et des timbres (Villeneuve d’Ascq, Presses Universitaires du Septentrion, 2010, 268 pp. ISBN: 978-275-740-1613) di     Marida Rizzuti

  10. Radiotherapy in the management of Graves` ophthalmopathy

    Sakata, Koh-ichi; Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo; Nagakura, Hisayasu; Morita, Kazuo; Osanai, Hajime; Ohtsuka, Kenji; Hinoda, Yuji [Sapporo Medical Univ. (Japan). School of Medicine


    To report the results of radiotherapy for patients with failure, adverse reactions or relative contraindications to the use of steroids or immunosuppressants, by using newly developed quantitative indexes. Fourteen female and six male patients with Graves` ophthalmopathy were treated with radiotherapy between 1989 and 1996. Prior to radiotherapy, eight patients received treatment with prednisone, four received immunosuppressants and four received a combination of both. Four patients with contraindications to steroids were initially managed with radiotherapy. Most of the patients received a dose of 24-28 Gy in 2 Gy fractions. We used the newly developed motility limitation index to assess extraocular motility. Treatment was well tolerated. There have been no late complications. All 12 patients with soft tissue signs such as edema, irritation, tearing and pain were improved. Proptosis did not improve or improved only slightly, 3 mm at best. However, proptosis in all but two has been stabilized and has not deteriorated in the follow-up period. Most of the patients have experienced an improvement of eye-muscle motility. Extraocular muscles that work for elevation were impaired more severely than the other muscles and this tended to remain. Of the 16 patients using steroids before or when radiotherapy was initiated, 15 were tapered off and only one patient required additional steroids, thus sparing the majority from steroid adverse reactions. Radiotherapy was effective in preventing exacerbations of active inflammatory ophthalmopathy in patients with Graves` disease with minimal morbidity and thus eliminated the adverse reactions associated with protracted corticosteroid use. The newly developed motility limitation index was useful in detecting delicate changes in motility of individual extraocular muscles. (author)

  11. [Recent developments in radiotherapy of hepatocellular carcinoma].

    Seong, Jinsil


    With the accumulation of clinical experiences, the efficacy of radiotherapy has been recognized in management scheme for HCC. While hepatologists are beginning to show less reluctance for applying radiotherapy to the treatment of HCC, it is necessary that the hepatologists be informed of the rapid developments in technical strategy for radiation oncology. Recent advances in several technologies have opened a new era in radiation oncology. Modern imaging technologies can provide a 3-dimensional model of patient's anatomy, and this allows radiation oncologists to identify accurate tumor volumes as well as the tumors' relationship with the adjacent normal tissues. Moreover, the development of the computer-controlled multileaf collimator systems now enables physicians to perform precise beam shaping and to modulate the radiation dose distribution. A combination of these systems, 3-DCRT, is rapidly replacing the more conventional 2-D radiotherapy. 3-DCRT has evolved into a more sophisticated technology, intensity modulated radiotherapy (IMRT). In IMRT, with the powerful computer-aided optimization process, the radiation dose can be delivered to the target using highly complex isodose profiles. This new technology has been further developed into IGRT, which combines the CT-images scanning system and radiation equipments into one hardware package, and this system is currently ready for clinical application. In parallel with the radiation technologies described above, the strategy of stereotactic radiation has evolved from the conventional linear accelerator-based system to a gammaknife, and more recently, to a cyberknife. These systems are primarily based on the concept of radiosurgery. Currently, various radiation technologies have been adopted for the radiotherapy of HCC. In this article, each strategy will be discussed as well as the indications for radiotherapy and the radiation-related complications.

  12. Conformal radiotherapy of prostate carcinoma: Procedure description

    Erak Marko


    Full Text Available Introduction. Today, three-dimensional conformal radiotherapy is a standard way in the radical treatment of localized prostate cancer, and it is an alternative to the radical prostatectomy. This method of radiotherapy treatment is widely accepted in the treatment of prostate cancer patients, and provides irradiation of targeted volume (prostate, seminal vesicles with dose escalation sparing the surrounding healthy tissues (rectum, bladder at the same time. That is not possible with the conventional twodimension technique. Procedure description. Three-dimensional conformal radiotherapy is a volumetric, visual simulation according to the computed tomography slices; it defines the tumour and organ at risk individually in each patient. Results of several studies have shown that there is a significant decrease in the development of acute toxicity when prostate cancer patients are treated with conformal radiotherapy. High dose irradiation gives excellent results in treatment of localized prostate carcinoma and improves treatment results in the patients with locally advanced carcinoma of prostate. Discussion. Prostate carcinoma irradiation techniques have been changed dramatically during recent years. Data obtained by computed tomography are important since the size and shapes of the prostate as well as its anatomic relations towards the rectum and bladder are considerably different in individual patients. The three-dimension plan of irradiation can be designed for each patient individually by performing computed tomography technique when planning radiotherapy. Conclusion. The advanced planning systems for conformal radiotherapy can reconstruct the anatomic structures of pelvis in three-dimension technique on the basis of computed tomography scans, which provides better conformality between the irradiation beam and geometrical shape of the tumour with minimal irradiation of the surrounding healthy tissue.

  13. Summary of the report Asn n. 2006 E.N.S.T.R. 019 - I.G.A.S. n. R.M. 2007-015 P. on the radiotherapy accident occurring at Epinal, presented by Guillaume WACK (Asn) and the doctor Francoise LALANDE, member of the General Inspection of social affairs, with the help of Marc David SELIGMAN; Resume du rapport ASN n. 2006 ENSTR 019 - IGAS n. RM 2007-015P sur l'accident de radiotherapie d'Epinal, presente par Guillaume WACK (ASN), et le docteur Francoise LALANDE, membre de l'Inspection Generale des affaires sociales, avec le concours de Marc David SELIGMAN



    In may 2004, the protocol of conformal radiotherapy applied to the prostate tumors has been modified. The change concerned the use of dynamic wedges in place of static wedges. This change supposed to change also the parameters of the calculation of irradiation intensity but this will not be made for some patients. This error could be corrected if the in vivo dosimetry had been kept and if the calculation of the number of monitors units had been maintained. 23 patients were submitted to an overexposure between the 6. may 2004 and the 1. august 2005. The first symptoms appeared in january 2005. The patients consulted their personal practitioner who sent them to a gastro-enterologist. The endoscopy revealed the existence of a rectitis which went by aggravating. In August, 2005 they were ten patients with severe hurts. During summer 2005, a radiotherapist doctor and a radio physicist found the error of overdose, They warned the manager of the hospital who warned in her turn, the D.D.A.S.S. (department direction of sanitary and social affairs) and A.R.H. (regional authority of hospitalization). Only seven patients were informed of the overdose, the sixteen other ones supposed wrongly unhurt, were not informed about the accident. The national authorities (I.R.S.N.) were warned in july 2006. Between september 2005 and september 2006 four patients died. Ten patients had severe damages, nine a moderate one. The report gives some propositions to avoid these kind of accidents in the future. (N.C.)

  14. Pelvic radiotherapy and sexual function in women

    Froeding, Ligita Paskeviciute


    Background During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. Methods An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. Results The literature search revealed a few RCTs with FSD evaluated as a PRO and being a secondary outcome measure in endometrial and in rectal cancer patients. Very limited information could be extracted regarding FSD in bladder, vulva, and anal cancer patients. The literature before and after 2010 confirms that pelvic radiotherapy, independent on modality, increases the risk significantly for FSD both compared to data from age-matched healthy control women and compared to data on patients treated by surgery only. There was only very limited data available on modern radiotherapy modalities. These are awaited during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. Conclusions

  15. Radiotherapy in the management of aggressive fibromatosis

    Atahan, I.L.; Akyol, F.; Zorlu, F.; Guerkaynak, M. (Hacettepe University Hospital, Ankara (Turkey). Dept. of Radiology)


    Four case reports are summarised concerning the management of aggressive fibromatosis in children and adolescents up to the age of 15. It was concluded that radiotherapy should be reserved for recurrences or inoperable cases. A dose of 5000-6000 cGy in 25-30 fractions depending on age of patient, site, and size of tumour is necessary, since most surgical recurrences appear in 12 months, all cases with positive surgical margins should receive doses in the range 4000-4500 cGy for microscopic disease. Radiotherapy-chemotherapy combinations can also be used. (UK).

  16. Radiotherapy versus combined modality in early stages

    Specht, L; Carde, P; Mauch, P;


    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a global...... be kept at a minimum. Recently, trials have been carried out testing chemotherapy alone. The results of these trials are however conflicting. In order not to jeopardize the good results achieved with the standard treatments developed over the last three decades, newer treatment approaches should...... be carefully tested in large randomized trials before being implemented for general clinical use....

  17. Second Study of Hyper-Fractionated Radiotherapy

    R. Jacob


    Full Text Available Purpose and Method. Hyper-fractionated radiotherapy for treatment of soft tissue sarcomas is designed to deliver a higher total dose of radiation without an increase in late normal tissue damage. In a previous study at the Royal Marsden Hospital, a total dose of 75 Gy using twice daily 1.25 Gy fractions resulted in a higher incidence of late damage than conventional radiotherapy using 2 Gy daily fractions treating to a total of 60 Gy. The current trial therefore used a lower dose per fraction of 1.2 Gy and lower total dose of 72 Gy, with 60 fractions given over a period of 6 weeks.

  18. Étude des impacts écologiques du dynamisme spatio-temporel des ...

    4 nov. 2013 ... du changement des habitats naturels sur les espèces menacées de sa faune. ... le contexte des changements climatiques. La situation de la .... naturels des espèces de la faune menacée dans la région évo- luent au cours du ... distribution des espèces cibles a ensuite été cartographiée sur la couche ...

  19. Beeinflussung des Essentiellen Tremors und des Tremors beim Morbus Parkinson durch transkranielle Gleichstromstimulation

    Hellriegel, Helge


    Ziel dieser Arbeit war es die Rolle des primärmotorischen Kortex bei der Entstehung und Weiterleitung des Essentiellen Tremors und des Tremors beim Morbus Parkinson zu untersuchen. Hierzu wurde eine transkranielle Gleichstromstimulation über dem primärmotorischen Kortex bei Patienten mit oben genannten Tremorsyndromen durchgeführt und die klinischen sowie elektrophysiologisch messbaren Änderungen des Tremors beurteilt.

  20. Contribution à la Gestion des Cercosporioses du bananier dues à ...


    31 mai 2017 ... the state of disease progression after each treatment. Results and applications ..... 2007, des logiciels SPSS (Statistical Package for Social. Sciences) version ... un facteur suivies d'un test de comparaison des moyennes des ...

  1. La gestion des adoptions internationales

    Boéchat, Hervé


    Après les rumeurs nées lors du tsunami et le désastre avéré de L’Arche de Zoé, l’adoption – et plus généralement le sort des enfants – est devenue une préoccupation majeure en cas de catastrophe naturelle ou de conflit. Haïti, pays depuis longtemps ouvert à l’adoption internationale, n’a pas échappé à la polémique. Hervé Boéchat nous livre l’appréciation de son institution sur cet épisode qui n’a sans doute pas contribué à apaiser le ressentiment des Haïtiens contre la « communauté internati...

  2. Better compliance with hypofractionation vs. conventional fractionation in adjuvant breast cancer radiotherapy. Results of a single, institutional, retrospective study

    Rudat, Volker; Nour, Alaa; Hammoud, Mohamed; Abou Ghaida, Salam [Saad Specialist Hospital, Department of Radiation Oncology, Al Khobar (Saudi Arabia)


    The aim of the study was to identify factors significantly associated with the occurrence of unintended treatment interruptions in adjuvant breast cancer radiotherapy. Patients treated with postoperative radiotherapy of the breast or chest wall between March 2014 and August 2016 were evaluated. The radiotherapy regimens and techniques applied were either conventional fractionation (CF; 28 daily fractions of 1.8 Gy or 25 fractions of 2.0 Gy) or hypofractionation (HF; 15 daily fractions of 2.67 Gy) with inverse planned intensity-modulated radiotherapy (IMRT) or three-dimensional planned conformal radiotherapy (3DCRT). Logistic regression analysis was used to identify factors associated with noncompliance. Noncompliance was defined as the missing of at least one scheduled radiotherapy fraction. In all, 19 of 140 (13.6%) patients treated with HF and 39 of 146 (26.7%) treated with CF experienced treatment interruptions. Of 23 factors tested, the fractionation regimen emerged as the only independent significant prognostic factor for noncompliance on multivariate analysis (CF; p = 0.007; odds ratio, 2.3; 95% confidence interval, 1.3-4.2). No statistically significant differences concerning the reasons for treatment interruptions could be detected between patients treated with CF or HF. HF is significantly associated with a better patient compliance with the prescribed radiotherapy schedule compared with CF. The data suggest that this finding is basically related to the shorter overall treatment time of HF. (orig.) [German] Ziel der Untersuchung war es, Faktoren zu identifizieren, die mit ungeplanten Behandlungsunterbrechungen bei der adjuvanten Strahlentherapie des Mammakarzinoms assoziiert sind. Es wurden Patienten untersucht, die eine adjuvante Strahlentherapie der Mamma oder Brustwand zwischen Maerz 2014 und August 2016 erhielten. Zur Anwendung kamen als Fraktionierungsprotokoll und strahlentherapeutische Technik eine konventionell fraktionierte (CF; 28 Fraktionen mit

  3. Catalogue ostéologique des oiseaux

    Oort, van E.D.


    Je le crois utile de faire précéder le présent Catalogue par quelques remarques. J’ai énuméré autant que possible les parties, qui font défaut aux squelettes. L’absence de plusieurs osselets, comme des doigts, des vertèbres caudales, des côtes etc. au même échantillon, est indiqué par „incomplet” ou

  4. Le piratage des biens d'information

    Paul Belleflamme


    Où se situe le juste milieu entre les propos alarmistes des uns (“le piratage tue la production musicale!”) et les appels libertaires des autres (“l'accès à toute information doit être libre!”) ? Une analyse économique simple nous permet de mieux comprendre les enjeux et de dégager des pistes de réflexion pour l'avenir.

  5. 79 Influences des rejets des eaux usées domestiques dans les ...


    L'usage agricole d'effluents liquides peut être considéré comme une ... Rares sont celles qui sont alimentées par une eau de source [8]. ... nutriments, des Eléments Traces Métalliques (ETM) [9], des micro- ... essentiels pour la croissance des plantes ; ils provoquent cependant une prolifération excessive d' algues. La.

  6. Radiotherapy-induced emesis. An overview

    Feyer, P.; Buchali, A.; Hinkelbein, M.; Budach, V. [Department Radiotherapy, Humboldt-University Berlin (Germany); Zimmermann, J.S. [Department Radiotherapy, Christian Albrechts-University Kiel (Germany); Titlbach, O.J. [Department of Medicine I, Hospital Friedrichshain, Berlin (Germany)


    Background: A significant number of patients receiving radiotherapy experience the distressing side effects of emesis and nausea. These symptoms are some of the most distressing problems for the patients influencing their quality of life. Methods: International study results concerning radiotherapy-induced emesis are demonstrated. A German multicenter questionnaire examining the strategies to prevent or to treat radiotherapy-induced nausea and emesis is presented. An international analysis concerning incidence of emesis and nausea in fractionated radiotherapy patients is discussed. Finally the consensus of the consensus conference on antiemetic therapy from the Perugia International Cancer Conference V is introduced. Results: Untreated emesis can lead to complications like electrolyte disorders, dehydration, metabolic disturbances and nutrition problems with weight loss. Prophylactic antiemetics are often given to patients receiving single high-dose radiotherapy to the abdomen. A survey has revealed that antiemetic prophylaxis is not routinely offered to the patients receiving fractionated radiotherapy. However, there is a need for an effective treatment of emesis for use in this group of patients, too. In 20% of patients nausea and emesis can cause a treatment interruption because of an inadequate control of symptoms. Like in chemotherapy strategies there exist high, moderate, and low emetogenic treatment regimens in radiotherapy as well. The most emetogenic potential has the total body irradiation followed by radiotherapy to the abdomen. Radiotherapy induced emesis can be treated effectively with conventional antiemetics up to 50%. Conclusions: Studies with total body irradiation, fractionated treatment and high-dose single exposures have cleary demonstrated the value of 5-HT3-receptor antagonist antiemetics. There is a response between 60 and 97%. There is no difference in the efficacy of the different 5-HT3-antagonists. High-risk patients should be prophylactic

  7. Présentation des textes

    Freitag, Michel


    Les textes choisis n’ont pas pour but la reconstitution ou le survol d’une carrière, mais la mise en valeur des étapes saillantes d’une double éclosion, celle d’Elizabeth Cady Stanton comme féministe et avec elle celle du mouvement de défense des droits des femmes aux États-Unis. Un tel objectif implique donc des limites temporelles en amont et en aval de l’événement fondateur que fut la Convention de Seneca Falls en 1848, origine du texte non moins fondateur de la Déclaration de sentiments r...

  8. Annuaire du Bureau des longitudes - 2006

    Imcce; Bureau Des Longitudes


    This annual publication provides ephemerides and data to the use of professionnal and amateur astronomers. Divided in 11 chapters it covers concordance of various calendars, explanation of fondamental astronomy and various time scales, explanation for the use of ephemerides; tables provide ephemerides (positions, rise/set/passage) of the Sun and the Moon, planets, planetary satellites, asteroids, comets, bright stars; data and explanation for the physical observation of the surface of the Sun, the Moon, and planets; chart of the sky and a list of constellations and galaxies; prediction and ephemerides for astronomical phenomenon: occultation by the moon, stellar occultations by asteroids and appulses, solar eclipses and lunar eclipses; and an additional review about a hot scientific topic, this year: "Legendre et le méridien terrestre, 200 ans après". Cette publication annuelle fournit des éphémérides et des données à l'usage des astronomes professionnels et des astronomes amateurs. Composée de 11 chapitres elle comprend les rubriques sur les différents calendriers et leurs concordance, les fêtes légales en France, les dates et décrets sur les heures légales en France métropolitaine ; une introduction à l'astronomie fondamentale et aux différentes échelles de temps, des explications sur l'utilisation des éphémérides ; des tables fournissent les éphémérides (positions, heures de lever/coucher/passage) du Soleil et de la Lune, de planètes, de satellites naturels, d'astéroïdes, de comètes, d'étoiles brillantes ; des données pour l'observation de la surface du Soleil, de la Lune, et des planètes ; des cartes du ciel ainsi qu'une liste de constellations et de galaxies ; des prédictions des phénomènes astronomiques : occultation par la Lune, occultation stellaires par des astéroïdes et appulses, éclipses de Soleil et de la Lune; la liste et les coordonnées des observatoires astronomiques les plus connus ; et enfin un cahier th

  9. Vivre et survivre au bord des villes

    Michel Péraldi


    Full Text Available De quels revenus vivent, ou plutôt survivent, les populations des quartiers dits défavorisés ? Telle est, malgré son apparente banalité, la question qui initie aujourd'hui une partie de nos recherches. Question banale en effet puisque les médias et le débat politique nous donnent une réponse sans appel, statistiquement fiable : dans ces univers sociaux où se croisent des communautés issues des plus récentes migrations et les fractions les plus fragiles économiquement des classes populaires fr...

  10. La compaction des sols agricoles en Wallonie

    Destain, Marie-France


    Dans nos pays industrialisés, l’agriculture fait appel à des machines de plus en plus lourdes. Lorsque des charges élevées sont appliquées sur des sols sensibles, une compaction du sol peut se produire conduisant à des diminutions de rendements suite aux difficultés que rencontrent les racines pour prélever l’eau et les nutriments et à la perturbation de l’activité de la pédofaune. Au niveau environnemental, du fait de la compaction, l’infiltration de l’eau dans le sol est réduite, princip...

  11. Film dosimetry in conformal radiotherapy

    Danciu, C.; Proimos, B.S. [Patras Univ. (Greece). Dept. of Medical Physics


    Dosimetry, through a film sandwiched in a transverse cross-section of a solid phantom, is a method of choice in Conformal Radiotherapy because: (a) the blackness (density) of the film at each point offers a measure of the total dose received at that point, and (b) the film is easily calibrated by exposing a film strip in the same cross-section, through a stationary field. The film must therefore have the following properties: (a) it must be slow, in order not to be overexposed, even at a therapeutic dose of 200 cGy, and (b) the response of the film (density versus dose curve) must be independent of the photon energy spectrum. A few slow films were compared. It was found that the Kodak X-Omat V for therapy verification was the best choice. To investigate whether the film response was independent of the photon energy, response curves for six depths, starting from the depth of maximum dose to the depth of 25 cm, in solid phantom were derived. The vertical beam was perpendicular to the anterior surface of the phantom, which was at the distance of 100 cm from the source and the field was 15x15 cm at that distance. This procedure was repeated for photon beams emitted by a Cobalt-60 unit, two 6 MV and 15 MV Linear Accelerators, as well as a 45 MV Betatron. For each of those four different beams the film response was the same for all six depths. The results, as shown in the diagrams, are very satisfactory. The response curve under a geometry similar to that actually applied, when the film is irradiated in a transverse cross-section of the phantom, was derived. The horizontal beam was almost parallel (angle of 85) to the plane of the film. The same was repeated with the central ray parallel to the film (angle 90) and at a distance of 1.5 cm from the horizontal film. The field size was again 15x15 at the lateral entrance surface of the beam. The response curves remained the same, as when the beam was perpendicular to the films.

  12. Grounded theory for radiotherapy practitioners: Informing clinical practice

    Walsh, N.A., E-mail: Nadia.Walsh@gstt.nhs.u [Medical Physics Department, Guy' s and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London SE1 7EH (United Kingdom)


    Radiotherapy practitioners may be best placed to undertake qualitative research within the context of cancer, due to specialist knowledge of radiation treatment and sensitivity to radiotherapy patient's needs. The grounded theory approach to data collection and analysis is a unique method of identifying a theory directly based on data collected within a clinical context. Research for radiotherapy practitioners is integral to role expansion within the government's directive for evidence-based practice. Due to the paucity of information on qualitative research undertaken by radiotherapy radiographers, this article aims to assess the potential impact of qualitative research on radiotherapy patient and service outcomes.

  13. Advancements in radiotherapy for lung cancer in China

    Lujun Zhao; Luhua Wang


    Lung cancer is the leading cause of death due to cancer in China. In recent years, great progress has been made in radiotherapy for lung cancer patients in China. The main advance-ments include the fol owing aspects:(1) stereotactic ablative radiotherapy for early stage non-smal cel lung cancer (NSCLC), (2) post-operative radiotherapy for NSCLC, (3) combined chemotherapy and radiotherapy for local y advanced NSCLC, (4) improved radiotherapy for advanced NSCLC, and 5) prediction of radiation-induced lung toxicity.

  14. Radiotherapy in the management of early breast cancer

    Wang, Wei [Westmead Breast Cancer Institute, Westmead Hospital, Westmead, New South Wales (Australia); Department of Radiation Oncology, Westmead Hospital, New South Wales (Australia)


    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies that underpin our current practice are discussed briefly.


    D Slimani


    Full Text Available Des couches minces du titane pur ont été déposées avec la méthode de pulvérisation cathodique sur des substrats en acier, type FF80 K-1 contenants ~1% mass. en carbone. La réaction entre les deux parties du système substrat-couche mince est activée avec des traitements thermiques sous vide dans l’intervalle de températures de 400 à900°Cpendant 30 minutes. Les Spectres de diffraction de rayons x confirment l’inter- diffusion des éléments  chimiques du système résultants la formation et la croissance des nouvelles phases en particulier le carbure binaire TiC ayant des caractéristiques thermomécaniques importantes. L’analyse morphologique des échantillons traités  avec le microscope électronique à balayage (MEB montre l’augmentation du flux de diffusion atomique avec la température de recuit, notamment la diffusion du manganèse et du fer vers la surface libre des échantillons aux températures élevées provoquant la dégradation des propriétés mécaniques des revêtements contrairement au premiers stades d’interaction où on a obtenu des bonnes valeurs de la microdureté.

  16. Treatment results of radical radiotherapy of carcinoma uterine cervix using external beam radiotherapy and high dose rate intracavitary radiotherapy

    Azad S


    Full Text Available Aim: To report the outcome of carcinoma cervix patients treated radically by external beam radiotherapy and high dose rate intracavitary radiotherapy. Material and Methods: From January 2005 to December 2006, a total of 709 newly diagnosed cases of carcinoma cervix were reported in our department. All cases were staged according to the International Federation of Gynecologist and Oncologist staging system. Out of 709 cases, 342 completed radical radiotherapy and were retrospectively analyzed for the presence of local residual disease, local recurrence, distant metastases, radiation reaction, and disease free survival. Results: There were 11(3.22%, 82(23.98%, 232(67.83%, and 17(4.97% patients in stages I, II, III, and IV, respectively. The median follow up time for all patients was 36 months (range 3 -54 months. The overall treatment time (OTT ranged from 52 to 69 days (median 58 days. The 3 year disease free survival rate was 81.8%, 70.7%, 40.08%, and 11.76% for stages I, II, III, and IV, respectively. There were 91 (26.6% cases with local residual diseases, 27(7.9% developed distant metastasis, and 18(5.26% pts had local recurrence. Discussion: The results of this study suggest that radical radiotherapy with HDR brachytherapy was appropriate for the treatment of early staged cancer of uterine cervix. For locally advanced cancer of cervix addition of concurrent chemotherapy, higher radiation doses, reduction of overall treatment time to less than 8 weeks, and use of latest radiotherapy techniques such as IMRT is recommended to improve the results.

  17. Stereotactic radiotherapy of vestibular schwannoma. Hearing preservation, vestibular function, and local control following primary and salvage radiotherapy

    Putz, Florian; Mueller, Jan; Wimmer, Caterina; Goerig, Nicole; Knippen, Stefan; Semrau, Sabine; Fietkau, Rainer; Lettmaier, Sebastian [Friedrich-Alexander-University Erlangen-Nuremberg, Department of Radiation Oncology, Erlangen (Germany); Iro, Heinrich; Grundtner, Philipp [Friedrich-Alexander-University Erlangen-Nuremberg, Department of Otorhinolaryngology - Head and Neck Surgery, Erlangen (Germany); Eyuepoglu, Ilker; Roessler, Karl [Friedrich-Alexander-University Erlangen-Nuremberg, Department of Neurosurgery, Erlangen (Germany)


    The aim of this publication is to present long-term data on functional outcomes and tumor control in a cohort of 107 patients treated with stereotactic radiotherapy (RT) for vestibular schwannoma. Included were 107 patients with vestibular schwannoma (primary or recurrent following resection) treated with stereotactic RT (either fractioned or single-dose radiosurgery) between October 2002 and December 2013. Local control and functional outcomes were determined. Analysis of hearing preservation was limited to a subgroup of patients with complete audiometric data collected before treatment and during follow-up. Vestibular function test (FVT) results could be analyzed in a subset of patients and were compared to patient-reported dizziness. After a mean follow-up of 46.3 months, actuarial local control for the whole cohort was 100% after 2, 97.6% after 5, and 94.1% after 10 years. In patients with primary RT, serviceable hearing was preserved in 72%. Predictors for preservation of serviceable hearing in multivariate analysis were time of follow-up (odds ratio, OR = 0.93 per month; p = 0.021) and pre-RT tumor size (Koos stage I-IIa vs. IIb-IV; OR = 0.15; p = 0.031). Worsening of FVT results was recorded in 17.6% (N = 3). Profound discrepancy of patient-reported dizziness and FVT results was observed after RT. In patients with primary RT, worsening of facial nerve function occurred in 1.7% (N = 1). Stereotactic RT of vestibular schwannoma provides good functional outcomes and high control rates. Dependence of hearing preservation on time of follow-up and initial tumor stage has to be considered. (orig.) [German] Praesentation von Langzeitdaten zu funktionellen Ergebnissen und Tumorkontrolle nach stereotaktischer Radiotherapie (RT) in einer Kohorte von 107 Patienten mit Akustikusneurinom. Zwischen Oktober 2002 und Dezember 2013 wurden 107 Patienten mit Akustikusneurinom (primaer oder rezidiviert nach vorangegangener Resektion) mittels stereotaktischer RT behandelt

  18. Prostate cancer radiotherapy in elderly person; Radiotherapie du cancer de la prostate chez la personne agee

    Serre, A. [Centre Alexis-Vautrin, Nancy (France)


    The author discusses the issue of prostate cancer radiotherapy in the case of elderly persons. The choice of the therapeutic strategy (local, hormonotherapy, simple monitoring) is complex. Different aspects must be considered: the carcinologic situation assessment, the patient health condition, the patient life expectancy, and the possible side effects of treatment. Radiotherapy appears to be a major therapeutic asset, but dose levels, toxicity effects must then be considered. Short communication

  19. Barriers to palliative radiotherapy referral: A Canadian perspective

    Samant, Rajiv S.; Fitzgibbon, Edward; Meng, Joanne; Graham, Ian D. [Univ. of Ottawa. Ottawa, ON (Canada)


    Radiotherapy is an effective but underutilized treatment modality for cancer patients. We decided to investigate the factors influencing radiotherapy referral among family physicians in our region. A 30-item survey was developed to determine palliative radiotherapy knowledge and factors influencing referral. It was sent to 400 physicians in eastern Ontario (Canada) and the completed surveys were evaluated. The overall response rate was 50% with almost all physicians seeing cancer patients recently (97%) and the majority (80%) providing palliative care. Approximately 56% had referred patients for radiotherapy previously and 59% were aware of the regional community oncology program. Factors influencing radiotherapy referral included the following: waiting times for radiotherapy consultation and treatment, uncertainty about the benefits of radiotherapy, patient age, and perceived patient inconvenience. Physicians who referred patients for radiotherapy were more than likely to provide palliative care, work outside of urban centres, have hospital privileges and had sought advice from a radiation oncologist in the past. A variety of factors influence the referral of cancer patients for radiotherapy by family physicians and addressing issues such as long waiting times, lack of palliative radiotherapy knowledge and awareness of Cancer Centre services could increase the rate of appropriate radiotherapy patient referral.

  20. Transport quantique dans des nanostructures

    Naud, C.


    structure des oscillations de conductance en fonction du flux du champ magnétique de période h/e dont l'amplitude est beaucoup plus importante que celle mesurée sur un réseau carré de même dimension. Cette différence constitue une signature d'un effet de localisation induit par le champ magnétique sur la topologie mathcal{T}3. Pour des valeurs spécifiques du champ magnétique, du fait des interférences destructives Aharonov-Bohm, la propagation des fonctions d'ondes est limitée à un ensemble fini de cellule du réseau appelé cage. De la dépendance en température des oscillations de période h/e mesurées sur le réseau mathcal{T}3 nous avons tiré une longueur caractéristique qui peut être rattachée au périmètre des cages. Un phénomène inattendu fut l'observation, pour des champs magnétiques plus importants, d'un doublement de fréquence des oscillations. Ces oscillations de période h/2e pouvant avoir une amplitude supérieure aux oscillations de période h/e, une interprétation en terme d'harmonique n'est pas possible. Enfin, l'influence de la largeur électrique des fils constituant le réseau et donc celle du nombre de canaux par brin a été étudiée en réalisant des grilles électrostatique. Les variations de l'amplitude des signaux en h/e et h/2e en fonction de la tension de grille ont été mesurés.

  1. Sorafenib and radiotherapy association for hepatocellular carcinoma; Sorafenib et radiotherapie dans le carcinome hepatocellulaire

    Girard, N. [Service de pneumologie, hopital Louis-Pradel, hospices Civils de Lyon, 28, avenue du Doyen-Jean-Lepine, 69500 Bron (France); UMR 754, universite Claude-Bernard Lyon 1, 43, boulevard du 11-novembre-1918, 69622 Villeurbanne cedex (France); Mornex, F. [UMR 754, universite Claude-Bernard Lyon 1, 43, boulevard du 11-novembre-1918, 69622 Villeurbanne cedex (France); Departement de radiotherapie-oncologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Benite cedex (France)


    Conformal radiotherapy is a promising therapeutic strategy for hepatocellular carcinoma (HCC), producing local control rates above 90% within the radiation beam. However, survival after radiotherapy remains limited by the high frequency of intra- and extra-hepatic recurrences, which occurs in 40-50 and 20-30% of cases, respectively. Sorafenib (BAY43-9006, Nexavar; Bayer, West Haven, CT) is a small molecule inhibitor that demonstrated potent activity to target v-raf murine sarcoma oncogene homologue B1 (BRAF) and VEGFR tyrosine kinases. Sorafenib is the only drug that demonstrated effectiveness to increase overall survival in advanced or metastatic hepatocellular carcinoma. The rationale to combine radiotherapy with sorafenib is the following: (1) targeting RAS-RAF-MAPK and VEGFR signaling pathways, which are specifically activated after exposure to radiation, and responsible for radio-resistance phenomenon; (2) enhancing the oxygen effect through normalization of the surviving tumor vasculature; and (3) synchronization of the cell cycle. Sorafenib and radiotherapy represent complementary strategies, as radiotherapy may be useful to prolong the effect of sorafenib through control of the macroscopic disease, when sorafenib may target latent microscopic disease. Sorafenib and radiotherapy associations are thus based on a relevant biological and clinical rationale and are being evaluated in ongoing phase I-II trials. (authors)

  2. Radiotherapy for inverted papilloma: a case report

    Levendag, P.C.; Annyas, A.A.; Escajadillo, J.R.; Elema, J.D. (Rijksuniversiteit Groningen (Netherlands). Academisch Ziekenhuis)


    Inverted papilloma is an infrequent tumour of the nasal cavity and paranasal sinuses associated with controversy. The incidence of carcinoma in situ associated with inverted papilloma, has not been very well documented until now. Therefore the authors present a case report characterized by an aggressive clinical behaviour, treated by extensive surgery and ultimately controlled by radiotherapy.

  3. Radiotherapy for inverted papilloma: a case report.

    Levendag, P C; Annyas, A A; Escajadillo, J R; Elema, J D


    Inverted papilloma is an infrequent tumour of the nasal cavity and paranasal sinuses associated with controversy. The incidence of carcinoma in situ associated with inverted papilloma, has not been very well documented until now. Therefore, we present a case report characterized by an aggressive clinical behaviour, treated by extensive surgery and ultimately controlled by radiotherapy.

  4. Towards online MRI-guided radiotherapy

    Bol, G.H.


    First, we present two offline position verification methods which can be used in radiotherapy for detecting the position of the bony anatomy of a patient automatically with portal imaging, even if every single portal image of each segment of an (IMRT) treatment beam contains insufficient matching in

  5. Effects of radiotherapy on bone tissue

    Cunha, Samantha Seara da; Almeida, Darcy de [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil)]. E-mail:; Sarmento, Viviane Almeida; Ramalho, Luciana Maria Pedreira; Freitas, Andre Carlos de [Universidade Federal da Bahia (UFBA), Salvador, BA (Brazil). Faculdade de Odontologia; Tavares, Maria Eulina; Souza, Jailton Caetano [Hospital Santa Izabel (HSI), Salvador, BA (Brazil); Veeck, Elaine Bauer; Costa, Nilza Pereira da [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil)


    Objective: To investigate the effects of radiotherapy on bone tissues and the accuracy of gray level measurements on radiographic images. Materials and methods: Four Wistar rats were submitted to external radiotherapy (single 3000 cGy dose) on an area of 2 cm x 2 cm of their right legs. The animals were sacrificed six weeks after radiotherapy, and both irradiated and contralateral (non-irradiated) legs were removed, dissected, evaluated for thickness, x-rayed in a standardized form and histologically processed (stained with hematoxylin-eosin and picrosirius red). The radiographs were digitalized and the gray level average was measured with the ImageTool{sup R} software. Results: The femur thickness of non-irradiated legs was greater than that of the irradiated legs (p < 0.05). Radiographically, the findings indicated a higher bone density in the non-irradiated legs, although with no statistically significant difference (p > 0.05). Histological analysis of the irradiated legs demonstrated a decrease in the number of osteocytes and Haversian canals, although with no statistically significance (p > 0.05). On the other hand, a significant increase in adipocytes was observed, resulting in a reduction of medullary tissue in the irradiated legs (p < 0.05), besides a higher osteoblastic activity in the non-irradiated legs (p < 0.05). Conclusion: Radiotherapy within the above mentioned parameters determined a decrease in activity of bone remodeling, which could be radiographically detected in the majority of the evaluated specimens. (author)

  6. The Role of Radiotherapy in Acromegaly.

    Hannon, Mark J; Barkan, Ariel L; Drake, William M


    Radiotherapy has, historically, played a central role in the management of acromegaly, and the last 30 years have seen substantial improvements in the technology used in the delivery of radiation therapy. More recently, the introduction of highly targeted radiotherapy, or 'radiosurgery', has further increased the therapeutic options available in the management of secretory pituitary tumors. Despite these developments, improvements in primary surgical outcomes, an increase in the range and effectiveness of medical therapy options, and long-term safety concerns have combined to dictate that, although still deployed in selected cases, the use of radiotherapy in the management of acromegaly has declined steadily over the past 2 decades. In this article, we review some of the main studies that have documented the efficacy of pituitary radiotherapy on growth hormone hypersecretion and summarize the data around its potential deleterious effects, including hypopituitarism, cranial nerve damage, and the development of radiation-related intracerebral tumors. We also give practical recommendations to guide its future use in patients with acromegaly, generally, as a third-line intervention after neurosurgical intervention in combination with various medical therapy options.


    Strojan, Primoz; Ferlito, Alfio; Langendijk, Johannes A.; Silver, Carl E.

    Up-front surgery and postoperative radiotherapy constitute a well-recognized treatment concept for locally or regionally advanced squamous cell carcinoma of the head and neck. This "treatment package" is further intensified with the concomitant application of chemotherapy during irradiation when

  8. Three dimensional conformal postoperative radiotherapy for ...

    Azza Helal


    Jun 17, 2013 ... showed the best dose homogeneity and conformity and lowest max dose to PTV and to the ... nique, size of treatment field, total dose and dose/fraction.6,7 ..... Cooperative Group: the role of radiotherapy in the treatment of.

  9. Oral sequelae of head and neck radiotherapy

    Vissink, A; Jansma, J; Spijkervet, FKL; Burlage, FR; Coppes, RP

    In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e. g., salivary glands, oral mucosa, bone, dentition,

  10. [Hopes of high dose-rate radiotherapy].

    Fouillade, Charles; Favaudon, Vincent; Vozenin, Marie-Catherine; Romeo, Paul-Henri; Bourhis, Jean; Verrelle, Pierre; Devauchelle, Patrick; Patriarca, Annalisa; Heinrich, Sophie; Mazal, Alejandro; Dutreix, Marie


    In this review, we present the synthesis of the newly acquired knowledge concerning high dose-rate irradiations and the hopes that these new radiotherapy modalities give rise to. The results were presented at a recent symposium on the subject. Copyright © 2017. Published by Elsevier Masson SAS.

  11. Magnetic resonance imaging in radiotherapy treatment planning

    Moerland, Marinus Adriaan


    From its inception in the early 1970's up to the present, magnetic resonance imaging (MRI) has evolved into a sophisticated technique, which has aroused considerable interest in var- ious subelds of medicine including radiotherapy. MRI is capable of imaging in any plane and does not use ionizing rad

  12. Tumour-host dynamics under radiotherapy

    Placeres Jimenez, Rolando, E-mail: [Departamento de Fi' sica, Universidade Federal de Sao Carlos, Sao Carlos - SP (Brazil); Ortiz Hernandez, Eloy [Centre of Medicine and Complexity, Medical University Carlos J. Finlay, Carretera Central s/n, Camagueey (Cuba)


    Highlight: > Tumour-host interaction is modelled by Lotka-Volterra equations. > A brief review of the motion integral and analysis of linear stability is presented. > Radiotherapy is introduced into the model, using a periodic Dirac delta function. > A two-dimensional logistic map is derived from the modified Lotka-Volterra model. > It is shown that tumour can be controlled by a correct selection of therapy strategy. - Abstract: Tumour-host interaction is modelled by the Lotka-Volterra equations. Qualitative analysis and simulations show that this model reproduces all known states of development for tumours. Radiotherapy effect is introduced into the model by means of the linear-quadratic model and the periodic Dirac delta function. The evolution of the system under the action of radiotherapy is simulated and parameter space is obtained, from which certain threshold of effectiveness values for the frequency and applied doses are derived. A two-dimensional logistic map is derived from the modified Lotka-Volterra model and used to simulate the effectiveness of radiotherapy in different regimens of tumour development. The results show the possibility of achieving a successful treatment in each individual case by employing the correct therapeutic strategy.

  13. Radical radiotherapy for urinary bladder cancer

    Fokdal, Lars; von der Maase, Hans; Høyer, Morten


    The exact value of radiotherapy in the treatment of muscle-invasive       bladder cancer is difficult to establish, as most studies exploring this       issue are retrospective with different procedures for selecting patients       for treatment, as well as varying treatment strategies. An estima...

  14. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

  15. Using XML to encode TMA DES metadata

    Oliver Lyttleton


    Full Text Available Background: The Tissue Microarray Data Exchange Specification (TMA DES is an XML specification for encoding TMA experiment data. While TMA DES data is encoded in XML, the files that describe its syntax, structure, and semantics are not. The DTD format is used to describe the syntax and structure of TMA DES, and the ISO 11179 format is used to define the semantics of TMA DES. However, XML Schema can be used in place of DTDs, and another XML encoded format, RDF, can be used in place of ISO 11179. Encoding all TMA DES data and metadata in XML would simplify the development and usage of programs which validate and parse TMA DES data. XML Schema has advantages over DTDs such as support for data types, and a more powerful means of specifying constraints on data values. An advantage of RDF encoded in XML over ISO 11179 is that XML defines rules for encoding data, whereas ISO 11179 does not. Materials and Methods: We created an XML Schema version of the TMA DES DTD. We wrote a program that converted ISO 11179 definitions to RDF encoded in XML, and used it to convert the TMA DES ISO 11179 definitions to RDF. Results: We validated a sample TMA DES XML file that was supplied with the publication that originally specified TMA DES using our XML Schema. We successfully validated the RDF produced by our ISO 11179 converter with the W3C RDF validation service. Conclusions: All TMA DES data could be encoded using XML, which simplifies its processing. XML Schema allows datatypes and valid value ranges to be specified for CDEs, which enables a wider range of error checking to be performed using XML Schemas than could be performed using DTDs.

  16. Using XML to encode TMA DES metadata.

    Lyttleton, Oliver; Wright, Alexander; Treanor, Darren; Lewis, Paul


    The Tissue Microarray Data Exchange Specification (TMA DES) is an XML specification for encoding TMA experiment data. While TMA DES data is encoded in XML, the files that describe its syntax, structure, and semantics are not. The DTD format is used to describe the syntax and structure of TMA DES, and the ISO 11179 format is used to define the semantics of TMA DES. However, XML Schema can be used in place of DTDs, and another XML encoded format, RDF, can be used in place of ISO 11179. Encoding all TMA DES data and metadata in XML would simplify the development and usage of programs which validate and parse TMA DES data. XML Schema has advantages over DTDs such as support for data types, and a more powerful means of specifying constraints on data values. An advantage of RDF encoded in XML over ISO 11179 is that XML defines rules for encoding data, whereas ISO 11179 does not. We created an XML Schema version of the TMA DES DTD. We wrote a program that converted ISO 11179 definitions to RDF encoded in XML, and used it to convert the TMA DES ISO 11179 definitions to RDF. We validated a sample TMA DES XML file that was supplied with the publication that originally specified TMA DES using our XML Schema. We successfully validated the RDF produced by our ISO 11179 converter with the W3C RDF validation service. All TMA DES data could be encoded using XML, which simplifies its processing. XML Schema allows datatypes and valid value ranges to be specified for CDEs, which enables a wider range of error checking to be performed using XML Schemas than could be performed using DTDs.

  17. The Results of Radiotherapy in Locally Advanced

    Jang, Hyun Soo; Kang, Seung Hee; Kim, Sang Won; Jun, Mi Seon; Jo, Seon Mi; Lim, Jun Cheol; Oh, Young Taek; Kang, Seock Yoon [Ajou University School of Medicine, Suwon (Korea, Republic of)


    We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only. Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA{approx}III) who received radiotherapy ({>=}30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients. The follow-up period ranged from 2{approx}40 months (median, 8 months). The median survival, and the 1-and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occurred in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels {>=}200 U/ml. CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.

  18. Hypopharyngeal and upper esophageal ulceration after cervical spine radiotherapy concurrent with crizotinib

    Zimmermann, Marcus H.; Beckmann, Gabriele; Flentje, Michael [University Hospital of Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany); Jung, Pius [University Hospital of Wuerzburg, Department of Pneumonology, Medical Clinic I, Wuerzburg (Germany)


    Herein, the authors describe the case of a 31-year-old female patient with primary metastatic adenocarcinoma of the lung referred for radiation therapy of newly diagnosed intramedullary spinal cord metastasis at C4/5 and an adjacent osteolytic lesion. Radiotherapy of the cervical spine level C3 to C5, including the whole vertebra, was performed with 30 Gy in 10 fractions. The patient's systemic therapy with crizotinib 250 mg twice daily was continued. After 8 fractions of radiation the patient developed increasing dysphagia. Ulceration of the hypopharynx and the upper esophagus were obvious in esophagoscopy and CT. Hospitalization for analgesia and percutaneous endoscopic gastrostomy (PEG) was required. First oral intake was possible 3 weeks after the onset of symptoms. The early onset, severity, and duration of mucositis seemed highly unusual in this case. A review of the literature failed to identify any reference to increased mucositis after radiation therapy concurrent with crizotinib, although references to such an effect with other tyrosine kinase inhibitors (TKI) were found. Nevertheless, the authors presume that a considerable risk of unexpected interactions exists. When crizotinib and radiotherapy are combined, heightened attention toward intensified reactions seems to be warranted. (orig.) [German] Die Autoren berichten ueber eine 31-jaehrige Patientin mit primaer metastasiertem Adenokarzinom der Lunge, die ihnen zur Bestrahlung einer neu aufgetretenen intraspinal-intramedullaeren Metastase auf Hoehe der Bandscheibe C 4/5 sowie einer benachbarten osteolytischen Laesion zugewiesen wurde. Es erfolgte eine Bestrahlung der Halswirbelsaeule von C 3 bis C 5 mit 30 Gy in 10 Fraktionen. Die bestehende Systemtherapie mit 250 mg Crizotinib 2-mal taeglich wurde fortgesetzt. Nach 8 Fraktionen entwickelte die Patientin eine zunehmende Dysphagie. In der Oesophagoskopie sowie computertomographisch zeigte sich eine Ulzeration des Hypopharynx und des oberen




    L’article est consacré aux problématiques liées à l’acquisition des compétences lexicales à partir des textes littéraires et des œuvres de coloriage de l’art-thérapie. En s’appuyant sur l’analyse psycholinguistique du fonctionnement des émotions dans la production des images mentales des mots, on propose une méthode pédagogique, basée sur la synergie des émotions, sensations et cognition. La méthode peut être utilisée dans le cadre institutionnel (collège, lycée, université), ainsi que pour l...

  20. Vers une meilleure comprehension des savoirs disciplinaires et curriculaires des enseignants ou Ie paradigme retrouve

    Stephane Martineau


    Full Text Available eet article se veut essentieUement un travail de synthese sous la forme d 'une breve revue de litterature au sujet des savoirs disciplinaires et curriculaires en enseignement. Plus specifiquement, il vise a determiner queUes sont les principales conclusions qui se degagent de la lecture des recherches empiriques sur les savoirs disciplinaires et curriculaires des enseignants des ordres d'enseignement primaire et secondaire. Il propose donc une classification des differentes dimensions constitutives du rapport entre les savoirs disciplinaires et curriculaires et la pratique enseignante. Les resultats mis au jour permettent d 'une part, d'identifier les facteurs qui entrainent des differences dans les connaissances disciplinaires et curriculaires des enseignants et d'autre part, de mieux saisir comment ces connaissances de l'enseignant peuvent influencer en retour sa pratique.

  1. GENOMIQUE ET LIPIDES Génomique et métabolisme des lipides des plantes

    Delseny Michel


    Full Text Available Il existe dans les bases de données publiques une énorme quantité de séquences d’ADN dérivées de plantes, et notamment la séquence complète du génome d’Arabidopsis thaliana, une plante modèle pour les oléagineux, proche parente du colza. Ces données constituent une ressource importante non seulement pour la compréhension de métabolisme lipidique et de sa régulation, mais aussi pour la sélection et le développement de variétés nouvelles d’oléagineux produisant davantage d’huiles ou des huiles de composition nouvelle. Cette abondance de séquences peut être exploitée, en utilisant les recherches d’homologies, pour identifier les gènes, pour obtenir des informations sur leur fonction, comme pour repérer des gènes candidats codant des fonctions nouvelles. L’analyse de ces bases de données a révélé que la majeure partie des gènes codant des enzymes impliquées dans le métabolisme lipidique appartient à des petites familles multigéniques, reflétant la diversification des fonctions des isoformes. Une analyse du catalogue des ADNc séquencés en aveugle reflète les niveaux d’expression des différents gènes et fournit un aperçu des régulations des flux au travers des voies métaboliques conduisant à la biosynthèse des lipides de réserve. La disponibilité de mutants et de lignées transgéniques d’Arabidopsis et le développement de puces à ADN qui permettent l’analyse simultanée de plusieurs milliers de gènes conduiront à une meilleure compréhension des facteurs qui régulent le métabolisme des huiles dans les graines. Une telle connaissance facilitera la manipulation de la composition des huiles et des quantités produites dans les graines.

  2. Catégorisation aspectuelle des concepts

    Karolak Stanisław


    Full Text Available (francuski Le contenu de l'article est le problème connu en aspectologie comme celui de la dépendance entre le sens lexical des verbes et l'aspect. Les contraintes qu'imposent les langues à la distribution des grammèmes d'aspect ont fait supposer qu'il existe des règles de leur co-occurrence avec les sémantèmes. Le problème est posé ici dans une perspective conceptuelle. Dans cette perspective, les verbes dont les sémantèmes ont tel ou tel aspect n'exigent pas la co-occurrence avec des grammèmes qui véhiculent le même aspect. En revanche, ils peuvent se combiner avec des grammèmes de sens aspectuel opposé pour dériver des catégories de verbes secondaires à partir des catégories primaires. On postule l'existence d'un mécanisme dérivationnel qui engendre des verbes polyaspectuels.

  3. Supply Chain et Gestion des ressources humaines

    Nondonfaz, Robert


    Rappels de quelques exigences de la Supply Chain en matière de gestion des ressources humaines; spécificités de certains métiers : chauffeur, magasinier, acheteur, gestionnaire de stock, gestion des imprévus

  4. internationalisation et nouvelles implantations des firmes ...


    de disparités culturelles ou dans les pratiques des affaires ou encore dans le .... plus pertinents afin d'expliquer l'évolution du modèle (cas de la distance psychique par ..... Elles constituent plutôt une lecture globale et intégrée des processus.

  5. La tuberculose des amygdales palatines

    Oudidi Abdelatif


    Full Text Available INTRODUCTION:La localisation tuberculeuse des amygdales palatines est très rare même dans un pays d’endémie tuberculeuse. Le diagnostic peut être suspecté cliniquement dans un contexte évocateur, mais il ne peut être certifié qu’au stade histologique. PATIENTS ET METHODES:Cinq cas de tuberculose des amygdales palatine ont été diagnostiqués sur une période de 5 ans et inclus dans une étude rétrospective. Nous avons recensé trois hommes et deux femmes (âge moyen de 28 ans. La dysphagie haute était le maître symptôme. L’examen a objectivé une hypertrophie amygdalienne chez tous les patients avec des ulcérations chez trois d’entre eux. Une biopsie a été effectuée chez trois patients et une amygdalectomie a été réalisée chez les deux autres. L’étude anatomopathologique a posé le diagnostic chez tous les patients. Un traitement médical antituberculeux selon un régime court allant de 6 à 9 mois a été instauré. Dans tous les cas, l’évolution à long terme a été favorable avec un recul moyen de 13 mois. CONCLUSION: La tuberculose amygdalienne est rare. Son diagnostic repose essentiellement sur le résultat anatomopathologique de la biopsie où de l’amygdalectomie. L’évolution sous traitement anti-bacillaire est souvent favorable, la récidive est exceptionnelle.

  6. Schopenhauer und die Paradoxien des Erhabenen

    François Arnaud


    Full Text Available Hauptunterscheidung zwischen den Schopenhauerschen und Kantschen Auffassungen des Erhabenen liegt nach diesem Artikel darin, dass der Zuschauer im letzten Fall zu einer nur möglichen Gefahr muss unterworfen werden, während er im Ersten wirklich erschreckt sein muss. Die Haupttriebfeder des Gefühls des Erhabenen ist nämlich bei Schopenhauer der Einsatz des Willens, der also wirklich bedroht werden muss. Daraus folgen einige Paradoxien und Originalitäten der Schopenhauerschen Lehre des Erhabenen, hauptsächlich aus dem ethischen Aussichtspunkt, deren Spuren ich zu folgen versuche.

  7. Improved Mask Protected DES using RSA Algorithm

    Asha Latha S.


    Full Text Available The data encryption standard is a pioneering and farsighted standard which helped to set a new paradigm for encryption standards. But now DES is considered to be insecure for some application. Asymmetric mask protected DES is an advanced encryption method for effectively protecting the advanced DES. There are still probabilities to improve its security. This paper propose a method, which introduce a RSA key generation scheme in mask protected DES instead of plain key, which result in enhancement in the security of present asymmetric mask protected DES. We further propose a Vedic mathematical method of RSA implementation which reduce the complexity of computation in RSA block thereby resulting in reduced delay (four timesthat improves the performance of overall system. The software implementation was performed using Xilinx 13.2 and Model-Sim was used for the simulation environment.

  8. Des fantômes

    Sjef Houppermans


    Full Text Available La première pièce de théâtre de Laurent Mauvignier, Tout mon amour, est créée en 2012 par la compagnie Les Possédés. La thématique habituelle de Mauvignier (secrets des familles, solitude, violence sociale s’y retrouve, mais tout en utilisant pleinement les moyens de la scène (distanciation, présence physique, espace théâtral, discours rythmés.

  9. Early hematologic changes during prostate cancer radiotherapy predictive for late urinary and bowel toxicity

    Pinkawa, Michael; Djukic, Victoria; Klotz, Jens; Holy, Richard; Eble, Michael J. [RWTH Aachen University, Department of Radiation Oncology, Aachen (Germany); Ribbing, Carolina [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, Aachen (Germany)


    Gruppe von 91 Patienten mit einem Prostatakarzinom, die sich zur primaeren (n = 51) oder postoperativen (n = 40) Radiotherapie (RT) vorgestellt haben, wurden Blutproben (Blutbild, Akute-Phase-Proteine und Zytokine) vor (T1), dreimal waehrend (T2-T4) und 6-8 Wochen nach RT (T5) untersucht. Vor RT (Ausgangsbefund), am letzten Tag (akute Toxizitaet), median 2 Monate und 16 Monate (Spaettoxizitaet) nach RT haben die Patienten einen validierten Fragebogen beantwortet (Expanded Prostate Cancer Index Composite). Akute Scoreaenderungen > 20 Punkte und spaete Aenderungen > 10 Punkte wurden als klinisch relevant bewertet. Die Radiotherapie fuehrte zu signifikanten Veraenderungen der haematologischen Parameter, mit dem groessten Effekt auf Lymphozyten (mittlerer Abfall von 31-45 %) und signifikanter Abhaengigkeit vom Zielvolumen. Eine Erhoehung des C-reaktiven Proteins (CRP) auf > 5 mg/l und ein Haemoglobinabfall ≥ 5 G/l zum Zeitpunkt T2 waren unabhaengig praediktiv fuer akute Miktionsbeschwerden (jeweils p < 0,01). Eine CRP-Erhoehung fand sich vorwiegend bei primaerer RT der Prostata (p = 0,02). Ein frueher Lymphozytenanstieg ≥ 0,3G/l bei T2 war protektiv gegen spaete Miktions- und Darmbeschwerden (jeweils p = 0,02). Weitere signifikante praediktive Faktoren fuer spaete Darmbeschwerden waren abfallende Haemoglobinwerte (Grenzwert ≥ 5 G/l) bei T2 (p = 0,04); Veraenderungen der TNFα- (Tumornekrosefaktor; p = 0,03) und Ferritinspiegel (p = 0,02) bei T5. Alle Patienten mit spaeten Darmbeschwerden hatten Interleukin-(IL-)6-Werte < 1,5 ng/l bei T2 (vs. 63 % ohne Darmbeschwerden; p = 0,01). Fruehe haematologische Veraenderungen waehrend der Radiotherapie beim Prostatakarzinom sind praediktiv fuer spaete Miktions- und Darmbeschwerden. (orig.)

  10. Des pauvres de la politique à la politique des pauvres

    Ratiba Hadj-Moussa


    Full Text Available S’attachant aux nouvelles modalités de production du politique issues des études subalternes, l’article situe dans un premier temps ces travaux et, dans un deuxième temps, en fait une présentation en s’appuyant sur les éléments qui y sont privilégiés et qui font le lien entre « les pauvres et la production du politique ». Cette présentation s’appuie essentiellement sur les travaux portant sur les pays du Sud, en particulier l’Inde et quelques pays du Moyen Orient (l’Égypte et l’Iran. Elle réfère aussi au Maghreb qui est le terrain principal de l’analyse. La présentation tient compte en particulier des travaux qui s’appuient sur des recherches empiriques substantielles mais dont la portée théorique est très peu discutée. Enfin, si le renvoi aux études subalternes ou postcoloniales est dans ce texte non négligeable, il est aussi fait recours à des travaux produits dans des contextes pluralistes, comme la France.Poor Policy to the Policy of the PoorThis article has its origins in the new methods of production of policy based on subaltern studies. Firstly, it will locate these studies and then it will present its main arguments as well as the relationship between “the poor and policy production”. This presentation is based essentially on the works on countries of the south, particularly India, and few other countries from the Middle East (Egypt and Iran. It also refers to North Africa, which is the major fieldwork of this analysis. This presentation takes into account the works that rely upon substantial empirical research but for which the theoretical range is very little. Finally, if the referral to subaltern or postcolonial studies is significant in this article, it also refers to works produced in pluralistic contexts such as France.De los pobres de la política a la política de los pobresBasándose en estudios subalternos, el artículo se sitúa dentro del marco de los nuevos modos de producci

  11. Association of genetic variants in apoptosis genes FAS and FASL with radiation-induced late toxicity after prostate cancer radiotherapy

    Thurner, E.M.; Krenn-Pilko, S.; Kapp, K.S.; Langsenlehner, T. [Medical University of Graz, Department of Therapeutic Radiology and Oncology, Graz (Austria); Langsenlehner, U. [Division of Internal Medicine, GKK Outpatient Department, Graz (Austria); Renner, W. [Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz (Austria); Gerger, A. [Medical University of Graz, Division of Oncology, Department of Internal Medicine, Graz (Austria)


    Einzelnukleotidpolymorphismen in den Genen FAS und FASL mit dem Risiko von hoehergradigen Spaetfolgen nach Radiotherapie des Prostatakarzinoms. Assoziationen zwischen Genvarianten in FAS (- 1377G > A, rs2234767 und - 670A > G, rs1800682) und FASL (- 844C > T, rs763110) und hoehergradigen rektalen und/oder urogenitalen Spaetfolgen (definiert als Spaettoxizitaet EORTC/RTOG Grad ≥ 2) wurden bei 607 Prostatakarzinompatienten untersucht. Nach DNA-Isolierung wurde die Genotypisierung der Kandidatenpolymorphismen mittels eines 5'-Nuklease-(TaqMan-)Assays durchgefuehrt. Innerhalb einer medianen Nachbeobachtungszeit von 82 Monaten traten bei 175 Patienten (29,7 %) hoehergradige rektale und/oder urogenitale Spaetfolgen auf. In der univariaten Analyse zeigte sich ein signifikant niedrigeres Risiko fuer das Auftreten von hoehergradigen Spaetfolgen bei Traegern des - 844T-FASL-Allels. Auch die nachfolgende multivariate Analyse ergab fuer Traeger mit zumindest einem - 844T-FASL-Allel (CT- oder TT-Genotyp) ein niedrigeres Risiko fuer hoehergradige Spaetfolgen als fuer Patienten mit dem CC-Genotyp (Hazard Ratio [HR] 0,585; 95 %-KI 0,39-0,878; p = 0,010). Bei Patienten mit dem - 844-TT-Genotyp lag die HR fuer Spaetfolgen bei 0,404 (95 %-KI 0,171-0,956; p = 0,039). Fuer die uebrigen Genpolymorphismen konnten keine signifikanten Zusammenhaenge gefunden werden. Aus den Ergebnissen geht hervor, dass das Vorhandensein des - 844T-FASL-Allels moeglicherweise einen protektiven Effekt hinsichtlich des Auftretens von Spaetfolgen nach Radiotherapie bei Prostatakarzinompatienten mit sich bringt. (orig.)

  12. Role of postoperative radiotherapy in the management of malignant pleural mesothelioma. A propensity score matching of the SEER database

    Abdel-Rahman, Omar [Ain Shams University, Clinical Oncology department, Faculty of medicine, Cairo (Egypt)


    This study assessed the prognostic impact of postoperative radiotherapy in patients with surgically resected malignant pleural mesothelioma (MPM). MPM patients diagnosed between 2000 and 2013 were identified from the SEER (Surveillance, Epidemiology, and End Results) database. A propensity-matched analysis was performed considering baseline characteristics (age, gender, race, histology, TNM stage, and type of surgery). A total of 2166 patients were identified. The median age was 60 years (range 25-85 years), and 469 patients received postoperative radiotherapy. Both before and after propensity score matching, overall survival (P < 0.0001 and P = 0.012, respectively) was better in the postoperative radiotherapy group. When the overall survival was stratified by histology, postoperative radiotherapy did not improve the survival in sarcomatoid histology patients both before and after matching (P = 0.424 and P = 0.281, respectively). In multivariate analysis of the matched population, not receiving postoperative radiotherapy did not correlate with worse survival (hazard ratio: 1.175; P = 0.12). Factors associated with worse survival include sarcomatoid histology, nodal positivity, and age ≥70. Evidence from this analysis is insufficient on its own to routinely recommend postoperative radiotherapy for surgically resected MPM. However, large-scale prospective clinical trials are warranted to further evaluate this intervention in nonsarcomatoid histology. (orig.) [German] In der vorliegenden Studie wurde der prognostische Einfluss der postoperativen Strahlentherapie bei Patienten mit chirurgisch reseziertem malignem Pleuramesotheliom (MPM) untersucht. In der SEER-Datenbank (Surveillance, Epidemiology, and End Results) wurden Patienten ermittelt, bei denen zwischen 2000 und 2013 die Diagnose eines MPM gestellt worden war. Unter Beruecksichtigung der Ausgangsmerkmale (Alter, Geschlecht, Ethnizitaet, Histologie, TNM-Stadium und Art des chirurgischen Eingriffs) wurde eine

  13. Évaluation des émissions de gaz à effet de serre des filières de traitement et de valorisation des boues issues du traitement des eaux usées

    Reverdy, A.L.; Pradel, M.


    / Ce rapport présente l'inventaire des différentes consommations énergétiques, en consommables et des GES pour chaque poste de traitement et de valorisation des boues issues du traitement des eaux usées.

  14. Distribution spatiale intra-urbaine des particules fines : monitoring ...


    30 sept. 2014 ... Intra-urban spatial distribution of particulate matter: monitoring by leaf Saturation Isothermal Remanent ... les changements microclimatiques au sein des villes ... déterminer l'impact des saisons sur la teneur des ... Ce District jouit d'un climat de type ... Sélection et description des espèces : Un inventaire.

  15. Performances de production des cobayes (Cavia porcellus L.) en ...

    Au Cameroun, l'élevage des cobayes se pratique encore dans les cuisines et à même le sol et leur ..... Figure 1 : Evolution des poids des mères allaitantes de la naissance au sevrage des petits. .... lecture critique du manuscrit ; EM a participé.

  16. Isomers chart; Table des isomeres

    Dupont-Gautier, P.; Chantelot, S.; Moisson, N. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires


    The nuclear isomers are nuclides offering the same mass number and the same atomic number, but different energy levels. In the following chart the zero energy ground states are omitted and the metastable isomers, i.e. of non-zero energy, known and of measurable lifetime, are listed. The lower limit of this lifetime was set here to 0.1 x 10{sup -6} s. The various isomers were classified in increasing lifetimes. (authors) [French] Les isomeres nucleaires sont des nucleides presentant le meme nombre de masse et le meme numero atomique, mais des niveaux energetiques differents. Dans la table suivante, on a neglige les etats fondamentaux d'energie nulle et on a recense les isomeres metastables, c'est-a-dire d'energie non nulle, connus et de periode mesurable. La limite inferieure de cette periode a ete fixee ici a 0,1 x 10{sup -6} s. Les differents isomeres ont ete classes par periodes croissantes. (auteurs)

  17. Isomers chart; Table des isomeres

    Dupont-Gautier, P.; Chantelot, S.; Moisson, N. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires


    The nuclear isomers are nuclides offering the same mass number and the same atomic number, but different energy levels. In the following chart the zero energy ground states are omitted and the metastable isomers, i.e. of non-zero energy, known and of measurable lifetime, are listed. The lower limit of this lifetime was set here to 0.1 x 10{sup -6} s. The various isomers were classified in increasing lifetimes. (authors) [French] Les isomeres nucleaires sont des nucleides presentant le meme nombre de masse et le meme numero atomique, mais des niveaux energetiques differents. Dans la table suivante, on a neglige les etats fondamentaux d'energie nulle et on a recense les isomeres metastables, c'est-a-dire d'energie non nulle, connus et de periode mesurable. La limite inferieure de cette periode a ete fixee ici a 0,1 x 10{sup -6} s. Les differents isomeres ont ete classes par periodes croissantes. (auteurs)

  18. Radiotherapy of unicentric mediastinal Castleman's disease

    Yue-Min Li; Yong-Dong Pu; Peng-Hui Liu; Yu-Hai Zhang; Huo-Sheng Xia; Liang-Liang Li; Yi-Mei Qu; Yong Wu; Shou-Yun Han; Guo-Qing Liao


    Castleman's disease is a slowly progressive and rare lymphoproliferative disorder. Here, we report a 55-year-old woman with superior mediastinal Castleman's disease being misdiagnosed for a long term. We found a 4.3 cm mass localized in the superior mediastinum accompanied with severe clinical symptoms. The patient underwent an exploratory laparotomy, but the mass failed to be totally excised. Pathologic examination revealed a mediastinal mass of Castleman's disease. After radiotherapy of 30 Gy by 15 fractions, the patient no longer presented previous symptoms. At 3 months after radiotherapy of 60 Gy by 30 fractions, Computed tomography of the chest showed significantly smaller mass, indicating partial remission. Upon a 10-month follow-up, the patient was alive and free of symptoms.

  19. Proton Radiotherapy for Solid Tumors of Childhood

    Cotter, Shane E.; McBride, Sean M.; Yock, Torunn I.


    The increasing efficacy of pediatric cancer therapy over the past four decades has produced many long-term survivors that now struggle with serious treatment related morbidities affecting their quality of life. Radiation therapy is responsible for a significant proportion of these late effects, but a relatively new and emerging modality, proton radiotherapy hold great promise to drastically reduce these treatment related late effects in long term survivors by sparing dose to normal tissues. Dosimetric studies of proton radiotherapy compared with best available photon based treatment show significant dose sparing to developing normal tissues. Furthermore, clinical data are now emerging that begin to quantify the benefit in decreased late treatment effects while maintaining excellent cancer control rates. PMID:22417062

  20. The efficacy of radiotherapy for vertebral hemangiomas.

    Miszczyk, L; Ficek, K; Trela, K; Spindel, J


    Vertebral hemangiomas are benign, slowly growing tumors sometimes causing local pain in the spine and/or neurologic disorders. The present paper includes 14 cases of painful vertebral hemangiomas treated by radiotherapy. All patients were irradiated using standard fractionation scheme with a total dose 20-30 Gy. One month after the treatment complete pain relief was noted in 36% of cases, five months later in 67% of cases, but in the remaining cases partial pain relief was noted. No correlation between treatment outcome and different biological and technical factors was found. No dose-response relationship was noted. The results suggest that anti-inflamatory effect of radiation plays the major role in this kind of treatment and that radiotherapy for vertebral hemangiomas is easy, short and highly effective analgetic treatment modality.

  1. The Use of Creams in Radiotherapy

    Martinsen, May-Lin; Frost, Else; Bergmansen, Nina


    Purpose/Objective: At the Danish wards for radiotherapy there are different rules regarding the intervals that have to pass from the moment the patients applies moisturizer until they can be treated. This is due to the fact that it is unclear whether the cream can cause bolus effect, thereby...... causing the dose to move towards the skin. This would increase the damages to the patient’s skin during the radiotherapy. There is no evidence on the use of moisturizers. Materials and Methods: We have carried out an experimental trial testing whether creams cause bolus effect. We used two pieces of pork...... which we each divided into three squares in order to test our three preparations: Decubal Original Clinic Cream, Panthenol cream and Panthetonol ointment. All scans were carried out using a 64 slice Philips Brilliance Big Bore CT scanner. Conclusions: According to our results of the ml. measurements we...

  2. Etude des effets du martelage repetitif sur les contraintes residuelles

    Hacini, Lyes

    L'assemblage par soudage peut engendrer des contraintes residuelles. Ces contraintes provoquent des fissurations prematurees et un raccourcissement de la duree de vie des composants. Dans ce contexte, le martelage robotise est utilise pour relaxer ces contraintes residuelles. Trois volets sont presentes: le premier est l'evaluation des effets des impacts unitaires repetes sur le champ de contraintes developpe dans des plaques d'acier inoxydable austenitique 304L vierges ou contenant des contraintes residuelles initiales. Dans la deuxieme partie de ce projet, le martelage est applique grace au robot SCOMPI. Les contraintes residuelles induites et relaxees par martelage sont ensuite mesurees par la methode des contours, qui a ete adaptee a cet effet. Dans la troisieme partie, le martelage est modelise par la methode des elements finis. Un modele axisymetrique developpe grace au logiciel ANSYS permet de simuler des impacts repetes d'un marteau elastique sur une plaque ayant un comportement elastoplastique.

  3. Preliminary Study of Stereotactic Radiotherapy for Lung Cancer


    From March 1997 to November 1999, 45 patients with lung cancer were treated by astereotactic radiotherapy, with 15 cases treated by a stereotactic radiotherapy alone, and 30 cases by the external radiotherapy plus stereotactic radiotherapy. The clinical target volume was 1.89-187. 26 cm3 with the median being 18. 17 cm3. The doses of plan target volume (PTV) edge was 16-30 Gy/2-3 times and the doses of center was 120 % to 150 % of PTV edge doses. The overall response rate was 84.4 % (38/45), with 11 complete response (CR) and 27 partial response (PR). This study confirmed that the stereotactic radiotherapy is a safe and effective therapy for lung cancer. For those early-stage patients who can tolerate neither operation nor even conventional radiotherapy for various reasons, it can both achieve therapeutic purpose and improve quality of life.

  4. Role of palliative radiotherapy in brain metastases

    Ramesh S Bilimagga


    Full Text Available Background: Brain metastases are a common manifestation of systemic cancer and exceed primary brain tumors in number and are a significant cause of neurologic problems. They affect 20-40% of all cancer patients. Aggressive management of brain metastases is effective in both symptom palliation and prolonging the life. Radiotherapy has a major role to play in the management of brain metastases. AIM: The aim of the study was to know the outcome of palliative radiotherapy in symptomatic brain metastases in terms of improvement in their performance status. Materials and Methods: This is a retrospective study of 63 patients diagnosed to have brain metastases and treated with palliative whole brain radiotherapy to a dose of 30 Gy in 10 fractions over two weeks between June 1998 and June 2007. Diagnosis was done in most of the cases with computed tomography scan and in a few with magnetic resonance imaging. Improvement in presenting symptoms has been assessed in terms of improvement in their performance status by using the ECOG scale. Results: Fifty-four patients completed the planned treatment. Eight patients received concurrent Temozolamide; 88% of patients had symptom relief at one month follow-up; 39/54 patients had a follow-up of just one to three months. Hence survival could not be assessed in this study. Conclusion: External beam radiotherapy in the dose of 30 Gy over two weeks achieved good palliation in terms improvement in their performance status in 88% of patients. Addition of concurrent and adjuvant Timozolamide may improve the results.

  5. Radiotherapy treatment planning linear-quadratic radiobiology

    Chapman, J Donald


    Understand Quantitative Radiobiology from a Radiation Biophysics PerspectiveIn the field of radiobiology, the linear-quadratic (LQ) equation has become the standard for defining radiation-induced cell killing. Radiotherapy Treatment Planning: Linear-Quadratic Radiobiology describes tumor cell inactivation from a radiation physics perspective and offers appropriate LQ parameters for modeling tumor and normal tissue responses.Explore the Latest Cell Killing Numbers for Defining Iso-Effective Cancer TreatmentsThe book compil

  6. Partial breast radiotherapy with simple teletherapy techniques

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán, E-mail:


    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  7. Partial breast radiotherapy with simple teletherapy techniques.

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán


    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p 90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  8. Adaptive Radiotherapy for an Uncommon Chloroma

    Soufya Majdoul


    Full Text Available Granulocytic sarcomas, also referred to as chloromas or myeloid sarcomas, are extramedullary neoplasms that are composed of immature myeloid cells. This uncommon disease is known to be radiosensitive. However, the total dose and dose per fraction are not standardized. In addition, during the course of radiation therapy, significant reduction of the tumor is usually obtained. Thus, target volume reduction may require an intermediate radiotherapy plan evaluation for an adaptive treatment. A second plan at mid-dose is highly recommended.

  9. Glioblastoma multiforme after radiotherapy for acromegaly

    Piatt, J.H. Jr.; Blue, J.M.; Schold, S.C. Jr.; Burger, P.C.


    A case of glioblastoma multiforme that occurred 14 years after radiotherapy for acromegaly is presented. The striking correspondence between the anatomy of the tumor and the geometry of the radiation ports is suggestive of a causal relationship. Previously reported cases of radiation-associated glioma are reviewed, and a brief appraisal of the evidence for induction of these lesions by radiation is presented. The differentiation of radiation-associated neoplasms from radionecrosis is also discussed.

  10. Current concepts on imaging in radiotherapy

    Lecchi, Michela; Elisei, Federica; Lucignani, Giovanni [University of Milan, Institute of Radiological Sciences, Milan (Italy); San Paolo Hospital, Unit of Nuclear Medicine, Milan (Italy); Fossati, Piero [University of Milan, Institute of Radiological Sciences, Milan (Italy); CNAO Foundation, Milan (Italy); Orecchia, Roberto [University of Milan, Institute of Radiological Sciences, Milan (Italy); CNAO Foundation, Milan (Italy); European Institute of Oncology, Department of Radiation Oncology, Milan (Italy)


    New high-precision radiotherapy (RT) techniques, such as intensity-modulated radiation therapy (IMRT) or hadrontherapy, allow better dose distribution within the target and spare a larger portion of normal tissue than conventional RT. These techniques require accurate tumour volume delineation and intrinsic characterization, as well as verification of target localisation and monitoring of organ motion and response assessment during treatment. These tasks are strongly dependent on imaging technologies. Among these, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US) and positron emission tomography (PET) have been applied in high-precision RT. For tumour volume delineation and characterization, PET has brought an additional dimension to the management of cancer patients by allowing the incorporation of crucial functional and molecular images in RT treatment planning, i.e. direct evaluation of tumour metabolism, cell proliferation, apoptosis, hypoxia and angiogenesis. The combination of PET and CT in a single imaging system (PET/CT) to obtain a fused anatomical and functional dataset is now emerging as a promising tool in radiotherapy departments for delineation of tumour volumes and optimization of treatment plans. Another exciting new area is image-guided radiotherapy (IGRT), which focuses on the potential benefit of advanced imaging and image registration to improve precision, daily target localization and monitoring during treatment, thus reducing morbidity and potentially allowing the safe delivery of higher doses. The variety of IGRT systems is rapidly expanding, including cone beam CT and US. This article examines the increasing role of imaging techniques in the entire process of high-precision radiotherapy. (orig.)

  11. Current concepts on imaging in radiotherapy.

    Lecchi, Michela; Fossati, Piero; Elisei, Federica; Orecchia, Roberto; Lucignani, Giovanni


    New high-precision radiotherapy (RT) techniques, such as intensity-modulated radiation therapy (IMRT) or hadrontherapy, allow better dose distribution within the target and spare a larger portion of normal tissue than conventional RT. These techniques require accurate tumour volume delineation and intrinsic characterization, as well as verification of target localisation and monitoring of organ motion and response assessment during treatment. These tasks are strongly dependent on imaging technologies. Among these, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US) and positron emission tomography (PET) have been applied in high-precision RT. For tumour volume delineation and characterization, PET has brought an additional dimension to the management of cancer patients by allowing the incorporation of crucial functional and molecular images in RT treatment planning, i.e. direct evaluation of tumour metabolism, cell proliferation, apoptosis, hypoxia and angiogenesis. The combination of PET and CT in a single imaging system (PET/CT) to obtain a fused anatomical and functional dataset is now emerging as a promising tool in radiotherapy departments for delineation of tumour volumes and optimization of treatment plans. Another exciting new area is image-guided radiotherapy (IGRT), which focuses on the potential benefit of advanced imaging and image registration to improve precision, daily target localization and monitoring during treatment, thus reducing morbidity and potentially allowing the safe delivery of higher doses. The variety of IGRT systems is rapidly expanding, including cone beam CT and US. This article examines the increasing role of imaging techniques in the entire process of high-precision radiotherapy.

  12. Intraoperative radiotherapy:principles and prospects

    Omar Abdel-Rahman


    Intraoperative radiotherapy (IORT) in its broadest sense refers to the delivery of radiation at the time of an opera-tion. It includes multiple techniques, namely intraoperative electron irradiation, intraoperative brachytherapy and intraopera-tive photon irradiation. It has a wide range of existing and potential y enlarging clinical applications. We wil discuss in this review the rationale for and use of intraoperative irradiation in conjunction with surgical exploration with or without external-beam irradiation (EBRT) and chemotherapy.

  13. Solid Mesh Registration for Radiotherapy Treatment Planning

    Noe, Karsten Østergaard; Sørensen, Thomas Sangild


    We present an algorithm for solid organ registration of pre-segmented data represented as tetrahedral meshes. Registration of the organ surface is driven by force terms based on a distance field representation of the source and reference shapes. Registration of internal morphology is achieved usi...... to complete. The proposed method has many potential uses in image guided radiotherapy (IGRT) which relies on registration to account for organ deformation between treatment sessions....

  14. À l’aube des dieux

    Pascal Semonsut


    Full Text Available De l’avis même des préhistoriens, la Préhistoire assiste à la naissance du sentiment religieux. Cette religion des origines, quelle image en ont les Français ? Telle est la question que cet article aborde à partir de l’étude des manuels scolaires et des œuvres de fiction (littérature, cinéma et bande dessinée de la seconde moitié du XXe siècle. Si l’enseignement et la fiction n’accordent pas la même place à ce thème, en revanche tous deux font des préhistoriques des polythéistes adorant le soleil, construisant des mégalithes et prenant le plus grand soin de leurs morts. Ce mélange d’obscurantisme et de vraie spiritualité n’a qu’un but : montrer que notre espèce ne pouvait être que victorieuse dans ce combat qu’est l’humanisation.

  15. Radiotherapy in the treatment of ameloblastoma

    Gardner, D.G.


    There is a lack of well-documented evidence in the literature concerning the relative radioresponsiveness or radioresistance of ameloblastomas, although they are generally considered radioresistant. Most of the previous papers reffering to this subject lack acceptable histopathologic proof of the diagnosis, adequate radiotherapeutic data, and/or follow-up information; many predate the use of megavoltage irradiation. The present article reports 5 cases of ameloblastoma that were treated by radiotherapy, 3 by megavoltage irradiation. All have been confirmed histologically by an oral pathologist, all have adequate radiotherapeutic data and, with one exception, adequate follow-up information. In addition, the reasons for our present lack of knowledge of this subject are discussed; objective criteria are presented for evaluating the results of radiotherapy on ameloblastomas; the only other series of ameloblastomas treated by megavoltage irradition is analyzed. Although radiotherapy can reduce the size of an ameloblastoma, primarily that part of the tumor which has expanded the jaw or broken into the soft tissues, it does not appear to be an appropriate treatment for an operable ameloblastoma. Its main use is in inoperable cases, primarily in the posterior maxilla.

  16. Palliative radiotherapy in plasma cell myeloma

    Adamietz, I.A.; Schoeber, C.; Schulte, R.W.M.; Renner, K. (Medizinische Hochschule Hannover (Germany, F.R.). Klinik fuer Strahlentherapie und Spezielle Onkologie); Peest, D. (Medical School, Hannover (Germany). Department of Immunology and Transfusion Medicine)


    Pain symptoms caused by bone lesions of multiple myeloma can be relieved by a local irradiation treatment. To estimate the influence of systemic treatment on the palliative effect of local radiotherapy the records of 70 myeloma patients treated with chemotherapy combined with or followed by local irradiation were reviewed. The local response rate, defined as complete pain relief at the irradiated site, was 80 percent in patients receiving irradiation during chemotherapy (melphalan and prednisone) and this palliative effect endured 31.8+-3.6 months. If irradiation was started in the period without systemic treatment the local response rate was 39.6 percent and lasted 24.8+-17.9 months. In sites treated with more than one radiotherapy course 94 percent response after the 1st treatment, 56 percent after the 2nd and no response after the 3rd was achieved. The duration of local pain control was positively related to the applied radiation dose. It is concluded that irradiation during concomitant chemotherapy is superior to radiotherapy performed in a period without systemic treatment. Local long-term palliation can only be achieved by a sufficient high radiation dose. (author). 24 refs.; 2 figs.; 2 tabs.

  17. Radiotherapy of epidermoid anal canal cancer.

    Dobrowsky, W


    Forty-eight patients with anal canal cancers were treated with surgery and irradiation or irradiation alone during the period 1970-1982. All cases were treated by external megavoltage equipment. The overall 5-year survival was 50%, and the local recurrence rate 33%. According to the therapy, four major groups were analysed: radical surgery followed by post-operative irradiation (5-year survival 43%, local recurrence rate 38%), incomplete major surgery and post-operative irradiation with very inferior prognosis (none of the patients surviving beyond 52 months). Two groups of patients had sphincter-saving procedures: local surgery followed by irradiation (5-year survival 78%, local recurrence rate 22%) and primary irradiation (5-year survival 57%, local recurrence rate 14%). Lymph node positive patients showed a median survival of 24.5 months against 52 months in N0 cases (5-year survival 21% against 50%). Side-effects of radiotherapy were transient and mild, and no late severe sequelae were seen. The data indicate that post-operative external radiotherapy seems insufficient and unable to decrease the local recurrence rate, especially when surgery is incomplete. Both spincter-saving surgery and radiotherapy, as well as primary irradiation, are effective treatment modalities. These data are analysed and future aspects considering combined radiochemotherapy are discussed.

  18. Clinico-statistical study on radiotherapy prostheses

    Inoue, Takaaki; Taniguchi, Hisashi; Sunahara, Yuichi; Shinozuka, Osamu; Suzuki, Ruri; Ohyama, Takashi; Takeda, Masamune [Tokyo Medical and Dental Univ. (Japan). School of Dentistry


    Various radiotherapy prostheses, including spacer, protector, carrier and mold, are frequently used for oral and maxillofacial cancer patients because they enhance the treatment efficacy of radiotherapy and protect adjacent normal tissue from irradiation. Therefore a clinical investigation was carried out on 310 cases of radiotherapy prostheses applied in our clinic from 1981 to 1995. The results were as follows: Sex ratio (male: female) of patients was 1.67: 1 and the number of the patients at the age of 60-69 was the largest. Spacer accounted for 81.0% of prostheses, followed by mold (10.6%), protector (5.5%) and carrier (2.9%). As for the site of malignant tumor, the tongue was 77.1% of all cases. External irradiation was already performed on 23.3% of all cases. Abutment teeth remained in 85.9% of 304 cases in which the prostheses were applied intraorally. The average time to make the prostheses was 12.4 days. As for the retention of the prosthesis to the mouth, a ball clasp was used most frequently in spacer and carrier, and overlay type was applied most frequently in mold and protector. As for the retention of shield to carrier in mold cases, mechanical interlocking of the resin parts of carrier and shield was 75.8% of the cases. (author)

  19. Big Data Analytics for Prostate Radiotherapy.

    Coates, James; Souhami, Luis; El Naqa, Issam


    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose-volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the "RadoncSpace") in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches.

  20. Sacral plexus injury after radiotherapy for carcinoma of cervix

    Stryker, J.A.; Sommerville, K.; Perez, R.; Velkley, D.E. (Pennsylvania State Univ., Hershey (USA))


    A 42-year-old woman developed lower extremity weakness and sensory loss 1 year after external and intracavitary radiotherapy for Stage IB carcinoma of cervix. She has been followed for 5 years posttreatment, and the neurologic abnormalities have persisted, but no evidence of recurrent carcinoma has been found. We believe this to be a rare case of sacral plexus radiculopathy developing as a late complication after radiotherapy. Suggestions are made for improving the radiotherapy technique to prevent this complication in future cases.

  1. 75 caracteristiques et evolution des operations de fusions ...

    Nous décrivons dans un premier temps l'évolution de l'économie tunisienne et ..... grossistes, a réalisé en 2004 près de 88 % du chiffre d'affaires des transactions .... d'actions reste une opération soumise au droit commun des contrats et au droit des ..... tairement des opérations horizontales mettant en relation des entrepri-.

  2. L'espace mondial des grandes manifestations sportives internationales

    Daniel MATHIEU


    Full Text Available La carte des grandes manifestations sportives mondiales montre une forte concentration des épreuves dans un petit nombre de pays développés, en particulier l'Europe occidentale. L'examen des nations concernées par les tournois majeurs du tennis et par le cyclisme professionnel soulignent, avec les nuances propres à chacun des sports, l'étroitesse des espaces intéressés.

  3. Radiotherapy care experience: an anthropological study; Approche anthropologique du vecu de la radiotherapie

    Hoarau, H.; Hubert, A. [Centre National de la Recherche Scientifique, CNRS-UPRES A5036, Anthropologue, 33 - Bordeaux (France); Kantor, G.; Dilhuydy, J.M.; Germain, C.; Barreau, C. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Dilhuydy, J.M. [Federation Nationale des Centres de Lutte Contre le Cancer, FNCLCC, 75 - Paris (France)


    An anthropological study has been carried out in order to evaluate the need expressed by patients undergoing radiotherapy treatment. The study was mostly qualitative and based on the radiotherapy experiences of 13 women with breast cancer and six men with head and neck cancer. A 24-year-old female anthropologist spent one year in the department of radiotherapy at the Bergonie Institute in Bordeaux. She collected data on patients' needs through the observation of their experience of treatment and personal interviews. These were put in context, analyzed both by qualitative and quantitative methods. The results pointed out the need for more information on the different steps of treatment and the patient's need 'for a smile'front the medical team; in other words, emphatic support. (author)

  4. De la manipulation des images 3D

    Geneviève Pinçon


    Full Text Available Si les technologies 3D livrent un enregistrement précis et pertinent des graphismes pariétaux, elles offrent également des applications particulièrement intéressantes pour leur analyse. À travers des traitements sur nuage de points et des simulations, elles autorisent un large éventail de manipulations touchant autant à l’observation qu’à l’étude des œuvres pariétales. Elles permettent notamment une perception affinée de leur volumétrie, et deviennent des outils de comparaison de formes très utiles dans la reconstruction des chronologies pariétales et dans l’appréhension des analogies entre différents sites. Ces outils analytiques sont ici illustrés par les travaux originaux menés sur les sculptures pariétales des abris du Roc-aux-Sorciers (Angles-sur-l’Anglin, Vienne et de la Chaire-à-Calvin (Mouthiers-sur-Boëme, Charente.If 3D technologies allow an accurate and relevant recording of rock art, they also offer several interesting applications for its analysis. Through spots clouds treatments and simulations, they permit a wide range of manipulations concerning figurations observation and study. Especially, they allow a fine perception of their volumetry. They become efficient tools for forms comparisons, very useful in the reconstruction of graphic ensemble chronologies and for inter-sites analogies. These analytical tools are illustrated by the original works done on the sculptures of Roc-aux-Sorciers (Angles-sur-l’Anglin, Vienne and Chaire-à-Calvin (Mouthiers-sur-Boëme, Charente rock-shelters.

  5. Genome-wide transcription responses to synchrotron microbeam radiotherapy.

    Sprung, Carl N; Yang, Yuqing; Forrester, Helen B; Li, Jason; Zaitseva, Marina; Cann, Leonie; Restall, Tina; Anderson, Robin L; Crosbie, Jeffrey C; Rogers, Peter A W


    The majority of cancer patients achieve benefit from radiotherapy. A significant limitation of radiotherapy is its relatively low therapeutic index, defined as the maximum radiation dose that causes acceptable normal tissue damage to the minimum dose required to achieve tumor control. Recently, a new radiotherapy modality using synchrotron-generated X-ray microbeam radiotherapy has been demonstrated in animal models to ablate tumors with concurrent sparing of normal tissue. Very little work has been undertaken into the cellular and molecular mechanisms that differentiate microbeam radiotherapy from broad beam. The purpose of this study was to investigate and compare the whole genome transcriptional response of in vivo microbeam radiotherapy versus broad beam irradiated tumors. We hypothesized that gene expression changes after microbeam radiotherapy are different from those seen after broad beam. We found that in EMT6.5 tumors at 4-48 h postirradiation, microbeam radiotherapy differentially regulates a number of genes, including major histocompatibility complex (MHC) class II antigen gene family members, and other immunity-related genes including Ciita, Ifng, Cxcl1, Cxcl9, Indo and Ubd when compared to broad beam. Our findings demonstrate molecular differences in the tumor response to microbeam versus broad beam irradiation and these differences provide insight into the underlying mechanisms of microbeam radiotherapy and broad beam.

  6. Dysphagia after radiotherapy: state of the art and prevention.

    Servagi-Vernat, S; Ali, D; Roubieu, C; Durdux, C; Laccourreye, O; Giraud, P


    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.

  7. Biomarkers for DNA DSB inhibitors and radiotherapy clinical trials.

    Liu, Stanley K; Olive, Peggy L; Bristow, Robert G


    Major technical advances in radiotherapy, including IMRT and image-guided radiotherapy, have allowed for improved physical precision and increased dose delivery to the tumor, with better sparing of surrounding normal tissue. The development of inhibitors of the sensing and repair of DNA double-strand breaks (DSBs) is exciting and could be combined with precise radiotherapy targeting to improve local control following radiotherapy. However, caution must be exercised in order that DSB inhibitors are combined with radiotherapy in such a manner as to preserve the therapeutic ratio by exploiting repair deficiencies in malignant cells over that of normal cells. In this review, we discuss the rationale and current approaches to targeting DSB sensing and repair pathways in combined modality with radiotherapy. We also describe potential biomarkers that could be useful in detecting functional inhibition of DSB repair in a patient's tissues during clinical radiotherapy trials. Finally, we examine a number of issues relating to the use of DSB-inhibiting molecular agents and radiotherapy in the context of the tumor microenvironment, effects on normal tissues and the optimal timing and duration of the agent in relation to fractionated radiotherapy.

  8. Mécanique des fluides fondamentale

    Zeytounian, Radyadour K


    Ce cours de mecanique des fluides est avant tout un cours theorique qui repond aux questions fondamentales de ce sujet de recherche. Les quatre premiers chapitres presentent les equations propres a determiner l'ecoulement de fluide considere et diverses solutions. Les chapitres 5 et 6sont consacres aux problemes lies la stabilite, aux bifurcations et aux comportements chaotiques. Le livre donne un vision globale des questions traitees en mecanique des fluides qui sont a la base de toute la recherche, de la modelisation et de toutes les applications dans ce domaine.

  9. Écriture scientifique et évolution des croyances, des connaissances ou des conceptions des enseignants en reprise d’étude

    Delarue-Breton Catherine


    Full Text Available Si l’on s’accorde assez unanimement – c’est à dire aux plans simultanément scientifique et institutionnel – à reconnaitre que l’initiation à la recherche est devenue nécessaire dans la formation des enseignants, les modalités de cette initiation, ses visées et ses effets font cependant peu l’objet, encore, d’un consensus, et dans certains cas, divisent. Nous avons pu étudier à diverses reprises, à partir de différentes versions des mémoires, le rôle de l’écriture scientifique dans l’appropriation des concepts théoriques par les étudiants de master MEEF (Métiers de l’Enseignement, de l’Éducation, de la Formation en formation initiale, autrement dit par les étudiants issus de licence, se destinant au métier de professeur des écoles. Nous avons ainsi pu mettre au jour d’une part la diversité de ces modes d’appropriation conceptuelle, et, en corrélation avec celle-ci, la diversité des modes d’analyse des situations scolaires, et d’autre part des formes d’évolution ou de stagnation des croyances, connaissances, conceptions de ces futurs enseignants sur le métier, sur les élèves, sur les disciplines, sur l’apprentissage. Notre propos est ici de nous poser des questions comparables, concernant le rapport entre appropriation théorique et évolution des conceptions non pas d’enseignants en formation initiale, mais d’enseignants titulaires en reprise d’étude, parfois eux-mêmes formateurs, inscrits en master MEEF avec validation des acquis. Nous questionnons ainsi le rôle de la recherche et de l’écriture scientifique dans la formation continue des enseignants.


    Renaud, Angèle; Berland, Nicolas


    International audience; L'engagement des entreprises dans le développement durable consiste à conjuguer performance et responsabilité. La performance financière ne suffit plus à apprécier la performance d'une entreprise. Dès lors, les entreprises doivent mesurer leurs progrès à partir d'une performance plus globale incluant, en dehors de la dimension économique, des dimensions sociale et environnementale. A présent, comment mesurer cette performance globale ? Existe-il des outils de mesure gl...

  11. A l'écoute des professionnels

    Lebre-Peytard, Monique


    Cet ouvrage s'adresse aux étudiants de niveau moyen ou avancé en français. Il propose un travail d'écoute, de réflexion et d'expression autour d'interview authentiques. Des professionnels parlent de leur métier, des entreprises où ils travaillent, des fonctions qu'ils occupent... Ils appartiennent à divers secteurs de l'économie : banque, mode, tourisme, agriculture, télécommunications, etc.

  12. Fatigue and radiotherapy. A literature review; Fatigue et radiotherapie. Revue de la litterature

    Dilhuydy, J.M.; Ouhtatou, F.; Laporte, C.; Nguyen, T.V.F.; Vendrely, V. [Institut Bergonie Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Dilhuydy, J.M. [Federation Nationale des Centres de Lutte Contre le Cancer, FNCLCC, Groupe Rehabilitation, 75 - Paris (France); Dilhuydy, M.S. [Hopital Saint-Andre, Service de Medecine Interne, 33 - Bordeaux (France)


    Fatigue is a common complaint for the cancer patient during and after radiotherapy, according to the published studies. Fatigue is a subjective symptom mostly underestimated by oncologists and other care givers. Etiology is complex, poorly understood in spite of obvious causes like insomnia, nausea, pain, depression, psychological distress, anemia, hypothyroidism, menopause disturbances, treatment adverse effects. Fatigue presents multi-factorial and multidimensional aspects. To evaluate it, many tools can be used as single-item, unidimensional and multidimensional instruments. Practically, the open discussion with the patient throughout radiotherapy is essential to define it. Taking charge fatigue requires its acknowledgement by radiotherapist, treatment of associated symptoms with a multidisciplinary approach. (authors)

  13. Contrôle des Circuits Auxiliaires des PFW (arrêt machines 2002/2003)

    Ottaviani, J


    Les PFW sont des nappes polaires installées sur les pôles des aimants du PS. Elles sont au nombre de 4 par unité d aimant et constituées d un circuit principal (dans lequel circule le courant désiré selon le cycle magnétique utilisé) et de circuits auxiliaires. Les circuits auxiliaires sont des enroulements de correction (boucles de tour et pick-up brasés sur les enroulements). Pendant la variation du champ magnétique de l aimant PS, on utilise des tensions induites dans ces circuits auxiliaires pour corriger les erreurs de champ dues aux courants de Foucault dans la chambre à vide. Chaque année, pendant l arrêt machine, on vérifie si les caractéristiques des circuits auxiliaires correspondent aux normes (mesures des résistances des boucles de tours, résistances entre pick-up et isolation des circuits) afin de faire un suivi. Les 404 PFW sont ainsi vérifiées. Dans cette note, on ne relèvera que les PFW ayant des défauts (valeurs hors tolérances, boucles ouvertes ou en court-circuit, déf...

  14. Exploitation des connaissances issues des processus de retour d'expérience industriels

    Jabrouni, Hicham


    Depuis plusieurs années, dans le secteur industriel, l’amélioration continue constitue un aspect important de la famille de normes ISO 9000 maintenue par l’organisation ISO (International Organization for Standardization). Elle se concentre sur l’amélioration de la satisfaction du client en passant par des améliorations continues et incrémentales des produits, des services et des processus. Afin de répondre à ces exigences, un point clé consiste à optimiser le processus de résolution de probl...

  15. Des changements concevables pour le secteur des transports dans l'objectif "Facteur 4"

    Raux, Charles


    Au niveau mondial, les transports consomment 20% de l'énergie, dont 80% dans les transports routiers et 10% dans les transports aériens, et 95% de cette énergie est à base de pétrole. Le secteur des transports est l'un des principaux émetteurs de gaz à effet de serre dans la plupart des pays, et notamment du CO2 issu de la combustion des carburants fossiles. Pour que les transports contribuent significativement à l'objectif du « Facteur 4 » en 2050, trois pistes différentes mais complémentair...

  16. Typologie des investisseurs institutionnels et performance des firmes dans le contexte français

    Jean-Michel SAHUT; Othmani Gharbi, Hidaya


    L’objet de cet article est d’analyser la relation entre les investisseurs institutionnels et la performance financière des firmes. Dans ce contexte, nous proposons une nouvelle typologie fondée sur la variété des comportements des institutionnels (passifs ou engagés (actifs)) vis-à-vis de la gestion et du gouvernement des firmes qu’ils détiennent en portefeuille, et identifions les principaux facteurs pouvant influencer ces comportements. Nos résultats corroborent, en général, un impact posit...

  17. Etude structurale des sites de nodulation et induction des nodules caulinaires chez Sesbania pubescens

    TOMEKPE, Kodjo; Traore, A S; Ndiaye, S.; Spencer-Barreto, M.M.; Détrez, C.


    #Sesbania pubescens$ est une légumineuse annuelle voisine de #Sesbania rostrata$ qui se rencontre généralement sur les sols temporairement inondés de l'Afrique de l'Ouest. Des sites de nodulation préformes ont été mis en évidence sur sa tige et ses branches. Ces sites prennent naissance à l'aisselle des cotylédons et des feuilles. Comme chez la plupart des légumineuses à nodules de tige, les sites de nodulation caulinaire de #S. pubescens$ se développent en racines lorsque les tiges sont imme...

  18. Molekularbiologische Untersuchungen des Leitgewebes und der Stressphysiologie des Breitwegerichs (Plantago major L.)

    Pommerrenig, Benjamin


    Die Leitbündel Höherer Pflanzen stellen die wesentlichen Gewebe zur Verteilung von Assimilaten, zum Transport von Wasser und zur Übermittlung von Informationen innerhalb und zwischen den einzelnen pflanzlichen Organen dar. Die Zellen des vaskulären Gewebes unterscheiden sich von denen des Mesophylls nicht nur in ihrer Gestalt und Funktion, sondern vor allem in ihrer Genexpression. In dieser Arbeit wurde zur Untersuchung des vaskulären Transkriptoms des Breitwege-richs (Plantago major) eine cD...

  19. Les lexiques des jeunes dans les discours écrits des blogs : pour une approche descriptive

    Lorenz Paulina


    Full Text Available S’il ne faut pas confondre ce qui est appelé communément « langage SMS » et « langage des jeunes », nous avancerons toutefois que les pratiques langagières écrites des jeunes sur les supports modernes de communication, et notamment dans les blogs, présentent des particularités encore peu étudiées. Les traits observables les plus saillants sont ceux de la morphologie graphique, mais il n’en reste pas moins que certains jeunes utilisent des lexiques particuliers dans les blogs qui méritent une attention particulière. Nous nous proposons donc d’étudier les différents lexiques utilisés par des jeunes de 12 à 22 ans dans les blogs de la plateforme aux niveaux de sa diversité, de ses usages sémantiques variable d’un scripteur à l’autre pour un même mot, et de ses particularités morphosyntaxiques. En effet, nous observerons des lexiques divers allant des lexiques perçus comme relevant des cités à des lexiques perçus comme étant « branchés-jeunes », ou encore à des lexiques propres aux supports modernes de communication. Ainsi, nous analyserons des lexiques variés dans leurs usages écrits tels que bolos, bédave, gérer, ouf, tigen, ou encore des lexiques empruntés tels que mouv, full, etc., ainsi que des emplois particuliers de séquences autonomes comme lol. Quelques questions périphériques complèteront notre analyse telle que celles qui concerne l’influence des usages lexicaux entre pairs et le savoir partagé, la distinction de différentes communautés en fonction des lexiques utilisés, ou encore la variabilité des représentations graphiques d’un même mot.

  20. Incidence of radiation toxicity in cervical cancer and endometrial cancer patients treated with radiotherapy alone versus adjuvant radiotherapy

    Roszak, Andrzej; Wareńczak-Florczak, Żaneta; Bratos, Krystyna; Milecki, Piotr


    Aim The study was made to evaluate early and late toxicity in a diversified group of patients receiving definitive or adjuvant radiotherapy in terms of clinical diagnosis and treatment methods. Background Radiotherapy is a standard way of treatment in cervical and endometrial cancer patients, both as definitive and adjuvant therapy. But every radiation treatment may be involved with toxicity. Materials and methods A detailed analysis was performed of 263 patients with gynaecological cancer treated with definitive (90 patients with cervical cancer received radiochemotherapy or radiotherapy exclusively) and adjuvant radiotherapy (38 with cervical and 135 with endometrial cancer). Results Acute reactions were found in 51.3% and late reactions were found in 14.8% of patients. It was stated that early (p radiotherapy. The analysis of the whole group revealed higher rate of toxicity, both early and late, in the gastrointestinal tract than in the urinary system (p radiotherapy group than in the adjuvant one. The occurrence of side effects was associated with the prolongation of total irradiation time due to necessary interruptions of radiotherapy. The comparison of the subgroups showed that interruptions occurred more frequently in patients receiving definitive rather than adjuvant radiotherapy (17.7–2.9%). Conclusions Definitive radiotherapy compared with adjuvant treatment may by associated with higher percentage of side effects caused by dose of therapy and correlation with chemotherapy. PMID:24377035

  1. Peste des Petits Ruminants Virus.

    Baron, M D; Diallo, A; Lancelot, R; Libeau, G


    Peste des petits ruminants virus (PPRV) causes a severe contagious disease of sheep and goats and has spread extensively through the developing world. Because of its disproportionately large impact on the livelihoods of low-income livestock keepers, and the availability of effective vaccines and good diagnostics, the virus is being targeted for global control and eventual eradication. In this review we examine the origin of the virus and its current distribution, and the factors that have led international organizations to conclude that it is eradicable. We also review recent progress in the molecular and cellular biology of the virus and consider areas where further research is required to support the efforts being made by national, regional, and international bodies to tackle this growing threat. © 2016 Elsevier Inc. All rights reserved.

  2. Utilisation des mousses et des pâtes syntactiques pour combler les lacunes des poteries archéologiques

    Viviane Bechoux


    Full Text Available Filling potteries missing parts with plaster raises now complex problems during the de-restoration treatments. Ceramics restorers have recurrently questions on the use of plaster in the field of archaeological ceramics restoration. Some researches point to the choice of other filling materials. At the present time other methods can be devised by proposing plaster replacement by a lightened composite material: syntactic foams and pastes.Le comblement des lacunes des poteries à partir du plâtre pose actuellement des problèmes complexes lors des traitements de dérestauration. Les restaurateurs de céramiques s'interrogent de manière récurrente sur l'utilisation du plâtre dans le domaine de la restauration des céramiques archéologiques. Des recherches s'orientent vers le choix d'autres matériaux d'obturation. Actuellement, d'autres méthodes peuvent être mises en place en proposant le remplacement du plâtre par un matériau composite allégé, les mousses et les pâtes syntactiques.

  3. Radiotherapy for aneurysmal bone cysts. A rare indication

    Elsayad, Khaled; Kriz, Jan; Eich, Hans Theodor [University Hospital Muenster, Department of Radiotherapy and Radiation Oncology, Muenster (Germany); Seegenschmiedt, Heinrich [Radiotherapy Center Hamburg, Hamburg (Germany); Imhoff, Detlef [Goethe University of Frankfurt, Department of Radiotherapy and Radiation Oncology, Frankfurt (Germany); Heyd, Reinhard [Community Hospital Offenbach, Department of Radiotherapy and Radiation Oncology, Offenbach am Main (Germany); Micke, Oliver [Franziskus Hospital Bielefeld, Department of Radiotherapy and Radiation Oncology, Bielefeld (Germany)


    Aneurysmal bone cysts (ABC) are rapidly growing benign osseous lesions composed of blood-filled channels separated by fibrous septa. Since the value of external beam radiotherapy (EBRT) for ABC has not been well defined, the German Cooperative Group on Radiotherapy for Benign Diseases performed the national register study described herein. Five German institutions collected data regarding clinical features, treatment concepts, and outcome for patients with ABC who had been referred for local EBRT over the past 30 years. Between 1990 and 2015, 10 patients with ABC were irradiated (5 female/5 male). Median age was 23 years (range 14-40 years). Involved sites were: spine (n = 3), sacrum/pelvis (n = 2), shoulder/scapula (n = 2), humerus (n = 1), femur (n = 1), and radius (n = 1). The median EBRT total and fractional doses were 28 Gy (range 5-40 Gy) and 2 Gy (range 1-2 Gy), respectively. Median follow-up was 65 months (range 12-358 months). Persistent pain relief was achieved for all patients. However, long-term follow-up response data were only available for 7/10 patients. All 7 patients exhibited a radiological response and experienced no recurrent disease activity or pain during follow-up. Acute and late radiogenic toxicities ≥ grade 3 and secondary malignancies were also not observed. Primary or adjuvant EBRT seems to be an effective and safe treatment option for persistent or recurrent ABC. Fractionated doses below 30 Gy may be recommended. (orig.) [German] Aneurysmale Knochenzysten (ABC) sind schnell wachsende gutartige Knochenlaesionen, die durch Bindegewebssepten von blutgefuellten Kanaelen getrennt sind. Da die Rolle der Teleradiotherapie (EBRT) fuer ABC nicht gut definiert wurde, fuehrte die Arbeitsgruppe ''Gutartige Erkrankungen'' der Deutschen Gesellschaft fuer Radioonkologie eine nationale Studie durch. Fuenf deutsche Institutionen sammelten Daten in Bezug auf die klinischen Symptome, Behandlungskonzepte und die Ergebnisse fuer

  4. Des Balkans About the Balkans

    Predrag Matvejević


    Full Text Available Les Balkans témoignent de contradictions géographiques et politiques, perceptibles dans le changement d’appellation des lieux au cours de l’Histoire : de la péninsule illyrienne, grecque, byzantine à la « Turquie d’Europe » plus récente. Il est resté une dénomination venue des Turcs, les « Balkans ». Cette presqu’île n’offre pas de frontières naturelles difficiles à franchir. Les délimitations des géographes et historiens sont relatives et souvent arbitraires, et donc contestées. Sa définition est difficile, car, étant associée à la progression des troupes ottomanes, cette « zone de turbulences » garde aux yeux de certains un caractère négatif. Marqués par les bouleversements telluriques et historiques, les Balkans témoignent d’une pluralité et d’une variété démographiques, ce qui pose un grand nombre de questions en termes de rapports ethniques, de constructions identitaires et territoriales. Les revendications s’appuient aussi bien sur le mythe que sur l’Histoire. L’apparition de l’État-nation a constitué dans ces régions de multiples fractures à l’image du schisme chrétien de 1054, divisant Églises et croyances, empires et pouvoirs, styles et écritures. L’islam a engendré de nouvelles oppositions ou intolérances. Les puissances étrangères sont intervenues dans ce jeu pour tenter de le stabiliser tout en déterminant leurs sphères d’influence, figeant par le jeu des traités une multitude de questions irrésolues ou conflictuelles, sans apporter de réponse durable. Cet inachevé, dans une histoire faite de partages, suscite des frustrations, et nécessite une réécriture qui tarde à se faire jour, faute d’apaisement entre les différentes sensibilités. La littérature se fait l’écho de ces situations par l’évocation de la cruauté, sous l’occupation ottomane (cf. Ivo Andrić notamment, mais aussi dans l’actualité récente. « Cet espace qui produit

  5. La reputation scientifique contestee des freres Bogdanov

    Morin, H


    "Les celebres jumeaux sont revenus a la television apres avoir obtenu des theses en mathematiques et physique theorique. Depuis, ils sont la cible de virulentes critiques portant sur la qualite reelle de leurs travaux" (1 page).

  6. The enhancement of existing DES Maplet interface

    Abdullah, Nur Lina; Mutalip, Rasidah Abdull; Abdullah, Kamilah


    This study pertains to the process of Data Encryption Standard, DES. DES consists of encryption and decryption processes linked with mathematical elements such as algebra and number theory. Preliminary, studies revealed that most of mathematics students face a problem in understanding the complicated process of DES. In modern learning methods, learning environment becomes more interesting with the use of computer and a variety of mathematical software packages. Several mathematical softwares such as Maple, Mathematica, Mathlab and Sage were developed in order to fulfill the specific calculation requirements. Correspondingly, motivated from that, this study incorporated with Maple to enhance the existing DES Maplet interface to be more interactive and user-friendly compared to the original version.




    Cette étude prospective succincte nous a permis de réunir les informations suivantes - La grande fréquence des grossesses gémellaires dans le mois de septembre. - L'âge jeune des mamans. - La plupart des jumeaux occupent la première ou la deuxième place dans la fratrie. - Le bon état de santé des mamans avant la grossesse par l'absence d'antécédents pathologiques chez elles. - Un très faible tôt d'antécédent personnel de grossesse gémellaire antérieure contre une...

  8. Pyrotechnie : une évaluation des risques

    Aufauvre, Lionel; Marlair, Guy; Michot, Christian


    Depuis une dizaine d'années, la pyrotechnie tend à se démocratiser, comme en témoigne le développement du marché des artifices de divertissement pour le grand public en France. Elle touche de même l'ensemble de la population dans des applications comme les équipements de sécurité des véhicules automobiles de type airbags ou prétensionneurs de ceinture de sécurité. En effet, ces équipements mettent en oeuvre des matériaux énergétiques adaptés au temps de réaction, extrêmement court, nécessaire...

  9. Wood duck studies : Des Lacs NWR

    US Fish and Wildlife Service, Department of the Interior — This memorandum summarizes wood duck studies on Des Lacs National Wildlife Refuge and provides a brief history on the status of wood ducks on the edge of their...

  10. Table des abréviations


    A Textes juridiques al. : alinéa art. : article A.u.-Com. : Acte uniforme portant droit commercial général A.u.-Compt. : Acte uniforme portant harmonisation des comptabilités des entreprises A.u.-Proc.coll. : Acte uniforme portant organisation des procédures collectives d’apurement du passif A.u.-Soc. : Acte uniforme relatif aux sociétés commerciales et au groupement d’intérêt économique C.ass. : Code des assurances C.civ. : Code civil : Code de commerce C.E.S.D.H. : Convention europée...

  11. L 'Analyse des Organisations en Afrique:

    croissance économique, développement des techniques industrielles, nécessité d'une plus ... légale se caractérise par la consécration des règles de droit et d'un certain nombre ..... mais un système ouvert qui entretient avec son environnement une relation .... C'est l'affaire de tous, que l'on soit supérieur ou subordonné.

  12. Tabanidae (Diptera) des pays-bas

    Leclercq, M.


    INTRODUCTION Cette mise au point des Tabanides des Pays-Bas a été rendue possible grâce à la collaboration de M. V. S. van der Goot, département d'Entomologie, Zoölogisch Museum, Amsterdam, que nous remercions pour son amabilité. Nous avons pu étudier aussi les collections du Rijksmuseum van Natuurl

  13. Probleme des elektiven Mutismus bei Jugendlichen


    Nach einem Exkurs zur Terminologie des Begriffs elektiver Mutismus und zur Symptomatologie dieser Erkrankung wird anhand einer Krankengeschichte die Hauptproblematik der Psychotherapie mit einem jugendlichen Mutisten erörtert. Besondere Erwähnung finden dabei 1. der äußerst schwierige Abschnitt von der Kontaktaufnahme bis zur "regelrechten" Gesprächspsychotherapie und 2. der Konflikt, der in diesem speziellen Fall der Entstehung des Mutismus zugrunde liegt. Hinweise zur Arbeit mit de...

  14. Der Machtmensch: zur Dramatologie des Politikers

    Hitzler, Ronald


    Der Beitrag erörtert das Anforderungsprofil des modernen Politikers, wobei unter anderem folgende Aspekte beleuchtet werden: (1) Die Darstellungskompetenz, (2) Machiavellismus, (3) die typische Persönlichkeit des Politikers (Harold D. Laswell), (4) Politik als Beruf (M. Weber), (5) die wichtigsten Bedingungen für eine erfolgreiche Politikerkarriere, (6) politisches Handeln verstanden als Inszenierungsarbeit, (7) Politik als Ritual (Murray Edelman), (8) die Dramatologie der Politik sowie (9) d...

  15. Analyse de la mobilité des paysages et des systèmes sociaux en Thessalie : l’apport des images Landsat TM

    Bernard Helly


    Full Text Available Une équipe pluridisciplinaire tente d’identifier la répartition des sites observables ou enfouis dans la plaine de Larissa. L’analyse d’image Landsat TM a permis d’identifier l’extension réelle des épandages, des systèmes de failles mais aussi des trames anthropiques qu’aucun autre document n’illustre.

  16. Caracterisation des proprietes acoustiques des materiaux poreux a cellules ouvertes et a matrice rigide ou souple

    Salissou, Yacoubou

    L'objectif global vise par les travaux de cette these est d'ameliorer la caracterisation des proprietes macroscopiques des materiaux poreux a structure rigide ou souple par des approches inverses et indirectes basees sur des mesures acoustiques faites en tube d'impedance. La precision des approches inverses et indirectes utilisees aujourd'hui est principalement limitee par la qualite des mesures acoustiques obtenues en tube d'impedance. En consequence, cette these se penche sur quatre problemes qui aideront a l'atteinte de l'objectif global precite. Le premier probleme porte sur une caracterisation precise de la porosite ouverte des materiaux poreux. Cette propriete en est une de passage permettant de lier la mesure des proprietes dynamiques acoustiques d'un materiau poreux aux proprietes effectives de sa phase fluide decrite par les modeles semi-phenomenologiques. Le deuxieme probleme traite de l'hypothese de symetrie des materiaux poreux selon leur epaisseur ou un index et un critere sont proposes pour quantifier l'asymetrie d'un materiau. Cette hypothese est souvent source d'imprecision des methodes de caracterisation inverses et indirectes en tube d'impedance. Le critere d'asymetrie propose permet ainsi de s'assurer de l'applicabilite et de la precision de ces methodes pour un materiau donne. Le troisieme probleme vise a mieux comprendre le probleme de transmission sonore en tube d'impedance en presentant pour la premiere fois un developpement exact du probleme par decomposition d'ondes. Ce developpement permet d'etablir clairement les limites des nombreuses methodes existantes basees sur des tubes de transmission a 2, 3 ou 4 microphones. La meilleure comprehension de ce probleme de transmission est importante puisque c'est par ce type de mesures que des methodes permettent d'extraire successivement la matrice de transfert d'un materiau poreux et ses proprietes dynamiques intrinseques comme son impedance caracteristique et son nombre d'onde complexe. Enfin, le


    George NICULESCU


    Full Text Available Les activités de services sont difficiles à gérer dans le cadre du marketing-mix traditionnel car, contrairement aux biens tangibles produits la qualité des services est très dépendante de facteurs personnels. De même, la nature intangible des services n’est pas prise en compte dans la plupart des analyses du marketing-mix. Par exemple, la distribution physique ne coïncide pas avec la distribution d’éléments invisibles et la politique de communication de l’approche traditionnelle du marketingmix (4P’s ne reconnaît pas la communication des services établie sur le lieu de rencontre entre le personnel de contact de la firme et les clients. Même si les opinions sont partagées et que le débat n’est pas clos, on peut considérer que des éléments supplémentaires s’imposent pour élaborer un marketing qui permette de satisfaire les attentes des parties contractantes de la façon la plus satisfaisante possible

  18. Postoperative radiotherapy for prevention of heterotopic ossification following total hip arthroplasty; Postoperative Strahlentherapie zur Praevention heterotoper Ossifikationen nach endoprothetischem Hueftgelenkersatz

    Heyd, R. [Abt. fuer Strahlentherapie und Onkologie, Zentrum Radiologie, Klinikum J.-W.-Goethe-Universitaet, Frankfurt am Main (Germany); Strassmann, G. [Abt. fuer Strahlentherapie und Onkologie, Zentrum Radiologie, Klinikum J.-W.-Goethe-Universitaet, Frankfurt am Main (Germany); Kirchner, J. [Abt. fuer Roentgendiagnostik, Zentrum Radiologie, Klinikum J.-W.-Goethe-Universitaet, Frankfurt am Main (Germany); Schopohl, B. [Abt. fuer Strahlentherapie und Onkologie, Zentrum Radiologie, Klinikum J.-W.-Goethe-Universitaet, Frankfurt am Main (Germany); Boettcher, H.D. [Abt. fuer Strahlentherapie und Onkologie, Zentrum Radiologie, Klinikum J.-W.-Goethe-Universitaet, Frankfurt am Main (Germany)


    Inzidenz kann durch eine lokale postoperative Radiotherapie der Hueftregion unter Verwendung verschiedener Dosierungs- und Fraktionierungsregime bei Hochrisikofaellen im Mittel auf etwa 8% reduziert werden. In der vorliegenden retrospektiven Arbeit werden die Behandlungsergebnisse nach konventioneller Fraktionierung und einer zweizeitigen postoperativen Bestrahlung miteinander verglichen. 50 Hueftgelenke (46 Patienten) aus zwei verschiedenen Risikogruppen wurden nachbeobachtet. Bei Gruppe I (n=40 Gelenke [80,0%]) erfolgte die Indikationsstellung nach Exzision vorbestehender hoehergradiger heterotoper Ossifikationen, bei Gruppe II (n=10 Gelenke [20,0%]) aufgrund des Vorliegens verschiedener Risikofaktoren (kontralaterale heterotope Ossifikationen [n=7], hypertrophe Osteoarthritis [n=2], Spondylosis hyperostotica [n=1]). Bei 28/50 Hueftgelenken (56,0%) wurden konventionell fraktionierte Bestrahlungsserien mit Gesamtreferenzdosen zwischen 12,0 und 20,0 Gy appliziert, 22/50 Gelenke (44,0%) wurden mittels einer zweizeitigen postoperativen Bestrahlung mit jeweils 5,0 Gy an den ersten beiden postoperativen Tagen behandelt. Nach einem Nachbeobachtungszeitraum von mindestens sechs Monaten (Median 22 Monate, Spannbreite: Sechs bis 56 Monate) wurden die Roentgenbefunde anhand des modifizierten Brooker-Schemas ausgewertet. Es fanden sich bei zwei Gelenken aus Gruppe I hoehergradige Ossifikationen der Stadien IIIA und IVB. In einem Fall entwickelte sich ein Feldrandrezidiv (IVB). In Gruppe II bestand bei neun Patienten ein Stadium 0 und einmal ein Stadium IA. Die statistische Analyse mittels des Wilcoxon-Test zeigte fuer beide Fraktionierungsgruppen eine hochsignifikante Verminderung des Auspraegungsgrades vorbestehender heterotoper Ossifikationen (p<0,0001). (orig.)

  19. Practical recommendations for breathing-adapted radiotherapy; Bonnes pratiques pour la radiotherapie asservie a la respiration

    Simon, L.; Giraud, P.; Rosenwald, J.C. [Institut Curie, Dept. d' Oncologie-radiotherapie, 75 - Paris (France); Dumas, J.L.; Lorchel, F. [CHU de Besancon, Hopital Jean-Minjoz, Service Radiotherapie, 25 - Besancon (France); Marre, D. [Institut Claudius-Regaud, Dept. des Radiations, 31 - Toulouse (France); Dupont, S. [Hopital Europeen Georges-Pompidou, Service d' Oncoradiotherapie, 75 - Paris (France); Varmenot, N. [Centre Henri-Becquerel, UnitE de Physique Medicale, 76 - Rouen (France); Ginestet, C. [Centre Leon-Berard, Dept. de Radiotherapie, 69 - Lyon (France); Caron, J. [Institut Bergonie, Dept. de Radiotherapie, 33 - Bordeaux (France); Marchesi, V. [Centre Alexis-Vautrin, Dept. de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Ferreira, I. [Institut Gustave-Roussy, Dept. d' Oncologie Radiotherapie, 94 - Villejuif (France); Garcia, R. [Institut Sainte-Catherine, Service de Radiotherapie, 84 - Avignon (France)


    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience. (authors)

  20. Histomorphological changes of vessel structure in head and neck vessels following preoperative or postoperative radiotherapy; Histomorphologische Strukturveraenderungen von Kopf-Hals-Gefaessen nach prae- oder postoperativer Radiotherapie

    Schultze-Mosgau, S.; Wehrhan, F.; Wiltfang, J. [Klinik und Poliklinik fuer Mund-, Kiefer-, Gesichtschirurgie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany); Grabenbauer, G.G.; Sauer, R.; Roedel, F. [Klinik und Poliklinik fuer Strahlentherapie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany); Radespiel-Troeger, M. [Inst. fuer Medizinische Informatik, Biometrie und Epidemiologie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany)


    dose of 40-50 Gy and chemotherapy given at a median interval of 1.5 months prior to operation did not lead to significant histological changes to the recipient vessels. (orig.) [German] Im Zeitraum von Oktober 1995 bis Maerz 2002 wurden insgesamt 348 Patienten mit 356 freien mikrovaskulaeren Hart- und Weichgewebetransplantaten primaer oder sekundaer rekonstruiert. In Abhaengigkeit von der strahlentherapeutischen Vorbehandlung wurde folgende Gruppeneinteilung vorgenommen: Gruppe 1 = Patienten (n = 27) mit ausschliesslich chirurgischer Behandlung. Gruppe 2 = Patienten (n = 29) mit einer neoadjuvanten Radiochemotherapie (40-50 Gy; 800 mg/m{sup 2} 5-Fluorouracil [5-FU] und 20 mg/m{sup 2} Cisplatin) und primaerer Rekonstruktion. Gruppe 3 = Patienten (n = 20) mit vorausgegangener Radiotherapie, (60-70 Gy) und sekundaerer Rekonstruktion. 209 Gefaessproben der Anschluss- und Transplantatgefaesse wurden qualitativ histologisch auf Veraenderungen der Media und Intima sowie quantitativ histomorphometrisch (NIH-Image) auf eine anteilige Zu- oder Abnahme der Media, der Intima oder des Lumens am Gesamtquerschnitt des Gefaesses untersucht (ANOVA SPSS V9). Ergebnisse: Die Ergebnisse zeigten ein signifikantes Ueberwiegen von Gefaessveraenderungen des Grades II (Hyalinose der Media und Intima und eine Intimaabloesung, p = 0,009) an den Anschlussarterien in der Gruppe 3 (praeoperative Radiotherapie mit 60-70 Gy). An Transplantatarterien (p = 0,127), Anschluss- (p = 0,43) und Transplantatvenen (p = 0,54) wurden keine signifikanten qualitativen Gefaesswandveraenderungen zwischen einer vorausgegangenen Radiotherapie und keiner Bestrahlung gesehen. Bei der Analyse der Anschlussarterien war die Ratio Media/Gesamtflaeche in Gruppe 3 (Median 0,51; IQR 0,10) signifikant kleiner als in Gruppe 1 (p = 0,02) (Median 0,61; IQR 0,29) und Gruppe 2 (p = 0,046) (Median 0,58; IQR 0,19). Ein signifikanter Unterschied der Ratio Lumen/Gesamtflaeche zeigte sich zwischen Gruppe 1 und 3 (p = 0,01) (Gruppe 1

  1. Wiktor Stoczkowski, Des hommes, des dieux et des extraterrestres. Ethnologie d’une croyance moderne

    Lepoutre, David


    Voici un ouvrage qui nous fait entrer de plain-pied dans une subculture contemporaine généralement perçue comme marginale et qui s’avère pourtant être d’une importance sociale considérable. Il s’agit de l’univers, exotique s’il en est, des parasciences et de la pensée occultiste. Le lecteur curieux y trouvera un ensemble de développements remarquablement bien documentés et ordonnés sur un certain nombre de sujets et de thèmes liés à cette pensée contemporaine dont les ramifications tentaculai...

  2. Value of intraoperative radiotherapy in locally advanced rectal cancer

    Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, Joost J. M. E.; Graveland, Wilfried J.; Marinelli, Andreas W. K. S.; van der Sijp, Joost R.; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander M. M.; de Wilt, Johannes H. W.


    PURPOSE: This study was designed to analyze the results of a multimodality treatment using preoperative radiotherapy, followed by surgery and intraoperative radiotherapy in patients with primary locally advanced rectal cancer. METHODS: Between 1987 and 2002, 123 patients with initial unresectable an

  3. Radiotherapy for renal cell carcinoma: renaissance of an overlooked approach.

    Siva, Shankar; Kothari, Gargi; Muacevic, Alexander; Louie, Alexander V; Slotman, Ben J; Teh, Bin S; Lo, Simon S


    Conventional radiotherapy previously had a limited role in the definitive treatment of renal cell carcinoma (RCC), owing to the disappointing outcomes of several trials and the perceived radioresistance of this type of cancer. In this context, radiotherapy has been relegated largely to the palliation of symptoms in patients with metastatic disease, with variable rates of response. Following the availability of newer technologies that enable safe delivery of high-dose radiotherapy, stereotactic ablative radiotherapy (SABR) has become increasingly used in patients with RCC. Preclinical evidence demonstrates that RCC cells are sensitive to ablative doses of radiotherapy (≥8-10 Gy). Trials in the setting of intracranial and extracranial oligometastases, as well as primary RCC, have demonstrated excellent tumour control using this approach. Additionally, an awareness of the capacity of high-dose radiation to stimulate antitumour immunity has resulted in novel combinations of SABR with immunotherapies. Here we describe the historical application of conventional radiotherapy, the current biological understanding of the effects of radiation, and the clinical evidence supporting the use of ablative radiotherapy in RCC. We also explore emerging opportunities to combine systemic targeted agents or immunotherapies with radiation. Radiotherapy, although once an overlooked approach, is moving towards the forefront of RCC treatment.

  4. Auger Emitter Based Radiotherapy- A Possible New Treatment for Cancer

    Fredericia, Pil; Groesser, Torsten; Severin, Gregory;


    damage produced by Low-LET radiation used in current radiotherapy (2-3) Considerable efforts have been made in the past twenty years to develop Auger emitter-based radiotherapy However, previous studies lack precise measurement of RBE, which is the fundamental factor defining the relationship between...

  5. The role of image guidance in respiratory gated radiotherapy

    Korreman, Stine Sofia; Juhler-Nøttrup, Trine; Fredberg Persson, Gitte


    Respiratory gating for radiotherapy beam delivery is a widely available technique, manufactured and sold by most of the major radiotherapy machine vendors. Respiratory gated beam delivery is intended to limit the irradiation of tumours moving with respiration to selected parts of the respiratory ...

  6. A rare case of unusual gingival enlargement post radiotherapy

    Vishal Singh


    Full Text Available Oral changes following radiotherapy are not uncommon. Oral mucositis, alteration in salivary gland function, radiation caries, and gingival changes have all been reported following radiotherapy and chemotherapy. The gingival changes seen after radiotherapy may be unusual and often cause diagnostic dilemma. Metastasis to the gingiva has also to be ruled out in these cases. A 30-year-old female patient presented with enlargement of the gingiva of 6 months′ duration and lower lip swelling of 7 months′ duration. She was a known case of carcinoma of nasopharynx and had received radiotherapy and chemotherapy. Based on the history, the clinical appearance of the gingiva, and the other oral changes we considered both post-radiotherapy gingival enlargement and secondary metastasis to gingiva as possibilities. An incisional biopsy was performed (internal bevel gingivectomy. The histopathological report did not reveal any metastatic changes. Thus, we diagnosed post-radiotherapy gingival enlargement. For the multiple carious teeth, extraction and root canal treatment was carried out as necessary. The patient was referred to the department of Oral and Maxillofacial Surgery for management of swelling of the lips, which was diagnosed as lymphedema of the lip. Gingival enlargement is rare post radiotherapy. Such nonplaque-associated gingival enlargement in a patient who has undergone radiotherapy should be subjected to biopsy and histopathological examination to distinguish between secondary metastasis and post-radiation changes.

  7. The place radiotherapy alone with respect to surgery and radiotherapy in locally advanced vulva cancers; Place de la radiotherapie seule par rapport a la chirurgie et la radiotherapie dans les cancers vulvaires localement evolues

    Mansouri, S.; Naim, A.; Moukhlissi, M.; Tawfik, N.; Bouchbika, Z.; Benchekroun, N.; Jouhadi, H.; Sahraoui, S.; Benider, A. [Centre de radiotherapie-oncologie, centre hospitalier universitaire, Ibn-Rochd, Casablanca (Morocco)


    The author report a study which aimed at evaluating the place or radiotherapy associated with surgery and of radiotherapy without surgery when taking into care locally advanced vulva cancers. The study is based on 46 cases. After 24 months, different aspects, such as recurrence and survival, have been assessed. It appears that there is no survival difference without recurrences between both sets. Short communication

  8. Children Undergoing Radiotherapy: Swedish Parents' Experiences and Suggestions for Improvement.

    Ångström-Brännström, Charlotte; Engvall, Gunn; Mullaney, Tara; Nilsson, Kristina; Wickart-Johansson, Gun; Svärd, Anna-Maja; Nyholm, Tufve; Lindh, Jack; Lindh, Viveca


    Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80-90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child's and the parent's view of the procedure. As part of an ongoing multicenter study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents' experience when their child undergoes radiotherapy treatment, and to report parents' suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2-16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people's lives upside down, affecting the entire family. Further, the parents experience the child's suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process.

  9. WEE1 inhibition sensitizes osteosarcoma to radiotherapy

    Helder Marco N


    Full Text Available Abstract Background The use of radiotherapy in osteosarcoma (OS is controversial due to its radioresistance. OS patients currently treated with radiotherapy generally are inoperable, have painful skeletal metastases, refuse surgery or have undergone an intralesional resection of the primary tumor. After irradiation-induced DNA damage, OS cells sustain a prolonged G2 cell cycle checkpoint arrest allowing DNA repair and evasion of cell death. Inhibition of WEE1 kinase leads to abrogation of the G2 arrest and could sensitize OS cells to irradiation induced cell death. Methods WEE1 expression in OS was investigated by gene-expression data analysis and immunohistochemistry of tumor samples. WEE1 expression in OS cell lines and human osteoblasts was investigated by Western blot. The effect of WEE1 inhibition on the radiosensitivity of OS cells was assessed by cell viability and caspase activation analyses after combination treatment. The presence of DNA damage was visualized using immunofluorescence microscopy. Cell cycle effects were investigated by flow cytometry and WEE1 kinase regulation was analyzed by Western blot. Results WEE1 expression is found in the majority of tested OS tissue samples. Small molecule drug PD0166285 inhibits WEE1 kinase activity. In the presence of WEE1-inhibitor, irradiated cells fail to repair their damaged DNA, and show higher levels of caspase activation. The inhibition of WEE1 effectively abrogates the irradiation-induced G2 arrest in OS cells, forcing the cells into premature, catastrophic mitosis, thus enhancing cell death after irradiation treatment. Conclusion We show that PD0166285, a small molecule WEE1 kinase inhibitor, can abrogate the G2 checkpoint in OS cells, pushing them into mitotic catastrophe and thus sensitizing OS cells to irradiation-induced cell death. This suggests that WEE1 inhibition may be a promising strategy to enhance the radiotherapy effect in patients with OS.

  10. From image-guided radiotherapy to dose-guided radiotherapy; De la radiotherapie guidee par l'image a la radiotherapie guidee par la dose

    Cazoulat, G.; Lesaunier, M.; Simon, A.; Haigron, P.; Acosta, O. [Inserm, U642, 35000 Rennes (France); LTSI, universite de Rennes-1, 35000 Rennes (France); Louvel, G.; Chajon, E.; Leseur, J. [Centre Eugene-Marquis, rue de La-Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Lafond, C.; De Crevoisier, R. [Inserm, U642, 35000 Rennes (France); LTSI, universite de Rennes-1, 35000 Rennes (France); Centre Eugene-Marquis, rue de La-Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France)


    Purpose. - In case of tumour displacement, image-guided radiotherapy (IGRT) based on the use of cone beam CT (tomographie conique) allows replacing the tumour under the accelerator by rigid registration. Anatomical deformations require however re-planning, involving an estimation of the cumulative dose, session after session. This is the objective of this study. Patients and methods. - Two examples of arc-intensity modulated radiotherapy are presented: a case of prostate cancer (total dose = 80 Gy) with tomographie conique (daily prostate registration) and one head and neck cancer (70 Gy). For the head and neck cancer, the patient had a weekly scanner allowing a dose distribution calculation. The cumulative dose was calculated per voxel on the planning CT after deformation of the dose distribution (with trilinear interpolation) following the transformation given by a non-rigid registration step (Demons registration method) from: either the tomographie conique (prostate), or the weekly CT. The cumulative dose was eventually compared with the planned dose. Results. - In cases of prostate irradiation, the 'cumulative' dose corresponded to the planned dose to the prostate. At the last week of irradiation, it was above the planned dose for the rectum and bladder. The volume of rectal wall receiving more than 50 Gy (V50) was 20% at the planning and 26% at the end of treatment, increasing the risk of rectal toxicity (NTCP) of 14%. For the bladder wall, V50 were 73% and 82%, respectively. In head and neck, the 'cumulative' dose to the parotid exceeded the planned dose (mean dose increasing from 46 Gy to 54 Gy) from the 5. week of irradiation on, suggesting the need for re-planning within the first 5 weeks of radiotherapy. Conclusion. - The deformable registration estimates the cumulative dose delivered in the different anatomical structures. Validation on digital and physical phantoms is however required before clinical evaluation. (authors)

  11. Big Data Analytics for Prostate Radiotherapy

    Coates, James; Souhami, Luis; El Naqa, Issam


    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose–volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the “RadoncSpace”) in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches. PMID:27379211

  12. Surgery Followed by Radiotherapy Versus Radiotherapy Alone for Metastatic Spinal Cord Compression From Unfavorable Tumors

    Rades, Dirk, E-mail: [Department of Radiation Oncology, University of Lubeck (Germany); Huttenlocher, Stefan [Department of Radiation Oncology, University of Lubeck (Germany); Bajrovic, Amira [Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf (Germany); Karstens, Johann H. [Department of Radiation Oncology, Medical University Hannover (Germany); Adamietz, Irenaeus A. [Department of Radiation Oncology, Ruhr University Bochum (Germany); Kazic, Nadja [Department of Radiation Oncology, University of Sarajevo (Bosnia and Herzegowina); Rudat, Volker [Department of Radiation Oncology, Saad Specialist Hospital Al Khobar (Saudi Arabia); Schild, Steven E. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States)


    Purpose: Despite a previously published randomized trial, controversy exists regarding the benefit of adding surgery to radiotherapy for metastatic spinal cord compression (MSCC). It is thought that patients with MSCC from relatively radioresistant tumors or tumors associated with poor functional outcome after radiotherapy alone may benefit from surgery. This study focuses on these tumors. Methods and Materials: Data from 67 patients receiving surgery plus radiotherapy (S+RT) were matched to 134 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for 10 factors and compared for motor function, ambulatory status, local control, and survival. Additional separate matched-pair analyses were performed for patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS) and patients receiving laminectomy (LE). Results: Improvement of motor function occurred in 22% of patients after S+RT and 16% after RT (p = 0.25). Posttreatment ambulatory rates were 67% and 61%, respectively (p = 0.68). Of nonambulatory patients, 29% and 19% (p = 0.53) regained ambulatory status. One-year local control rates were 85% and 89% (p = 0.87). One-year survival rates were 38% and 24% (p = 0.20). The matched-pair analysis of patients receiving LE showed no significant differences between both therapies. In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred more often after DDSS+RT than RT (28% vs. 19%, p = 0.024). Posttreatment ambulatory rates were 86% and 67% (p = 0.30); 45% and 18% of patients regained ambulatory status (p = 0.29). Conclusions: Patients with MSCC from an unfavorable primary tumor appeared to benefit from DDSS but not LE when added to radiotherapy in terms of improved functional outcome.

  13. Radiotherapy of the periarthritis humeroscapularis. Indication, technique and radiation results; Periarthritis humeroscapularis (PHS). Indikation, Technik und Bestrahlungsergebnisse

    Keilholz, L. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Seegenschmiedt, M.H. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Kutzki, D. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik


    106 patients with clinically evident disease of PHS were treated between January 1987 and May 1991. 73/106 patients had a continuous follow-up. 16/73 patients showed typical symptoms on both shoulders; therefore a total of 89 shoulders were examined in this investigation. A daily dose of 0.5 Gy was given for 3 times a week and a total dose of 3.0 Gy. After 8 weeks a second treatment course was performed. In follow-up the subjective (pain) and objective (limitation of abduction) symptoms were classified in 3 grade scales. A marked pain reduction and an improved mobility (abduction of at least 20 degrees more than before radiation) could be observed in 72/89 shoulders (81%). 44/89 shoulders (49%) showed an excellent response and were competely free of pain and impairment of motion. Radiotherapy of acute or subacute Periarthritis humeroscapularis is a very effective treatment if radiation starts within the first year of symptoms and if it is supported by physiotherapy. (orig.) [Deutsch] Im Zeitraum vom 1.1.1987 bis 1.5.1991 wurden an der Klinik fuer Strahlentherapie, Erlangen, 106 Patienten wegen einer Periarthritis humeroscapularis (PHS) behandelt. 73 Patienten konnten regelmaessig nachuntersucht werden. Von diesen litten 16 an einer beidseitigen PHS, so dass insgesamt 89 Lokalisationen untersucht wurden. Es wurden zwei Bestrahlungsserien (im Abstand von acht Wochen) mit einer Referenzdosis von 3 Gy pro Seite, bei einer Einzeldosis von 0,5 Gy, dreimal woechentlich verabreicht. Die Beurteilung des Therapieerfolges erfolgte nach drei subjektiven Beschwerdegraden und drei objektiven Graden. Eine Besserung der subjektiven Beschwerden um einen Grad und er Schultergelekbeweglichkeit (Abduktion) um mindestens 20 Grad trat bei 72 behandelten Schultergelenken (81%) auf. Bei 44 Schultergelenken (49%) erreichten wir eine komplette Beschwerdefreiheit. Die Radiotherapie der akuten wie subakuten Periarthritis humeroscapularis ist hocheffektiv, insbesondere dann, wenn Bestrahlung

  14. Effects of radiotherapy on human parotid saliva

    Mossman, K.L.; Shatzman, A.R.; Chencharick, J.D.


    Changes in parotide salivary function, as determined by flow rate and protein secretion, were measured in 31 cancer patients given radiotherapy to the head and neck. After the first week of treatment, a 50% decrease in salivary flow rate and a 60% decrease in protein secretion rate were observed. Salivary function remained at or below these levels during the next 3 week of treatment. Proteins in saliva were affected unequally, with the family of glycoproteins exhibiting greater sensitivity than amylase. Chromatography or irradiated (60 Gy) and unirradiated whole parotid saliva suggests that the observed alterations in salivary protein may be due to radiation effects on protein synthesis rather than on the proteins themselves.

  15. Ichthyosiform scaling secondary to megavoltage radiotherapy

    Ross, E.V. (National Naval Medical Center, Bethesda, MD (USA))


    Acquired ichthyosis is a rare dermatosis associated with a number of malignancies. Side effects seen on the skin secondary to megavoltage radiotherapy are uncommon but may include fine dry desquamation and tanning. The authors present a case of ichthyosiform scaling limited to the radiation fields in a patient treated for brain metastases of a primary small cell lung carcinoma. The reader is reminded that side effects of megavoltage treatment do occur on the skin. A brief review of these effects is included. 5 references.

  16. [Quality and safety management for radiotherapy].

    Pourel, N; Meyrieux, C; Perrin, B


    Quality and safety management have been implemented for many years in healthcare structures (hospitals treating cancer, private radiotherapy centres). Their structure and formalization have improved progressively over time. These recommendations aim at describing the link between quality and safety management through its organization scheme based on quality-safety policy, process approach, document management and quality measurement. Dedicated tools, such as experience feedback, a priori risk mapping, to-do-lists and check-lists are shown as examples and recommended as routine practice. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  17. Dupuytren contracture. Radiotherapy of early stages

    Herbst, M.; Regler, G.


    Conventional radiotherapy is the treatment of choice for the early stages of theDupuytren contracture. The conventional semi-deep therapy is more favorable than the soft ray technique and the moulage technique. 62 patients have been treated at Erlangen; 33 out of them (46 irradiated hands) with a minimum observation time of 18 months have been evaluated. The pathologic process was stopped in 98% of the cases. 85% of the patients showed an improvement of troubles by regression of tubercules and cords, pains and sensation of pressure. A recurrence was obseved only in one patient at the edge of the irradiated volume.

  18. Particle radiotherapy with carbon ion beams.

    Ohno, Tatsuya


    Carbon ion radiotherapy offers superior dose conformity in the treatment of deep-seated malignant tumours compared with conventional X-ray therapy. In addition, carbon ion beams have a higher relative biological effectiveness compared with protons or X-ray beams. The algorithm of treatment planning and beam delivery system is tailored to the individual parameters of the patient. The present article reviews the available literatures for various disease sites including the head and neck, skull base, lung, liver, prostate, bone and soft tissues and pelvic recurrence of rectal cancer as well as physical and biological properties.

  19. 127 Impact des rejets urbains et industriels sur la qualité des eaux ...


    rejets industriels et urbains sur l'évolution de la qualité des eaux de surface et ... 1,0205= 11820, sa principale activité est l'agriculture, visible surtout dans la partie Sud là .... Ils sont également indicateurs d'une pollution par des eaux usées.

  20. Marine Traffic Project, un outil d’observation des routes et des ports maritimes

    Hervé Théry


    Full Text Available Le site Marine Traffic fournit, gratuitement et en temps réel, des informations sur les mouvements des navires dans le monde entier. Il fait partie d’un projet universitaire qui a pour but la collecte et la diffusion de ces données en vue de leur exploitation dans divers domaines…

  1. PET/CT Based Dose Planning in Radiotherapy

    Berthelsen, Anne Kiil; Jakobsen, Annika Loft; Sapru, Wendy;


    This mini-review describes how to perform PET/CT based radiotherapy dose planning and the advantages and possibilities obtained with the technique for radiation therapy. Our own experience since 2002 is briefly summarized from more than 2,500 patients with various malignant diseases undergoing...... radiotherapy planning with PET/CT prior to the treatment. The PET/CT, including the radiotherapy planning process as well as the radiotherapy process, is outlined in detail. The demanding collaboration between mould technicians, nuclear medicine physicians and technologists, radiologists and radiology...... technologists, radiation oncologists, physicists, and dosimetrists is emphasized. We strongly believe that PET/CT based radiotherapy planning will improve the therapeutic output in terms of target definition and non-target avoidance and will play an important role in future therapeutic interventions in many...

  2. Application of individual lead shield in radiotherapy of eyelid tumor

    Hashizume, Tadashi; Taniguchi, Hisashi; Inoue, Takaaki; Ohyama, Takashi [Tokyo Medical and Dental Univ. (Japan). Hospital; Oki, Meiko; Takeda, Masamune; Shibuya, Hitoshi


    In the treatment of the maxillofacial tumors, radiotherapy plays an important role in the achievement of good local control and to keep the normal shape and function. For the tumors occurring in or adjacent to the orbit, especially the tumors of eyelids, radiotherapy combined with/without surgery also yields better results than surgery alone, but the lens of the eye is a radiosensitive organ. Loss of vision could occur when radiation beam is directed at the eye, so radiotherapy prostheses must be used in the radiotherapy of eyelid tumor. An individual lead shield for the lens of eye was made for each of the 10 eyelid tumor patients and it was carefully placed in the conjunctival sac after anaesthesia with a few drops of oxybuprocaine (Benoxil) to avoid irradiation of the globe. The lead shield was applied to protect the normal surrounding structures. Excellent cosmetic and functional results were achieved during and after radiotherapy. (author)


    Suresh eDutta


    Full Text Available Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT, and 2-dimensional intracavitary brachytherapy.Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron emission tomography (PET and magnetic resonance imaging (MRI has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT, allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  4. Services de transfert des savoirs

    Albert Simard


    Full Text Available Le présent article décrit un modèle visant à faciliter la compréhension du processus de transfert du contenu depuis sa source jusqu’à son utilisation. Un groupe de travail de Ressources naturelles Canada a étudié la nature du transfert des savoirs à l’aide d’un modèle de services, afin de découvrir et comprendre les modèles et processus sous-jacents. Les services de savoir sont des programmes qui créent et fournissent des produits organisationnels basés sur un contenu et ayant une valeur intégrée. Ces programmes sont destinés à être utilisés en interne ou transférés pour répondre aux souhaits et besoins d’un utilisateur externe. Les critères de conception du modèle sont les suivants : indépendance par rapport au contenu, concentration sur l’organisation, évolutivité, deux pilotes et deux niveaux de résolution. Le modèle est basé sur une chaîne de valeur dans laquelle la valeur est intégrée, déplacée ou extraite. Un système de services de savoir se divise en neuf étapes : générer, transformer, gérer, utiliser en interne, transférer, ajouter de la valeur, utiliser professionnellement, utiliser personnellement et évaluer. Les services de savoir sont fournis par l’intermédiaire d’un spectre de distribution allant de complexe à accessible. À chaque région du spectre de distribution correspond une série d’attributs qui influencent la manière dont les services sont fournis.This paper describes a model intended to increase understanding of how content is transferred from its source to its use. A Natural Resources Canada task group explored the nature of knowledge transfer with a services paradigm to discover and understand underlying patterns and processes. Knowledge Services are programs that produce and pro-vide content-based organizational outputs with embedded value that are intended to be used internally or transferred to meet external user wants or needs. Model design criteria

  5. Hydrogel injection reduces rectal toxicity after radiotherapy for localized prostate cancer

    Pinkawa, Michael; Berneking, Vanessa; Koenig, Liane; Frank, Dilini; Bretgeld, Marilou; Eble, Michael J. [RWTH Aachen University, Department of Radiation Oncology, Aachen (Germany)


    Injection of a hydrogel spacer before prostate cancer radiotherapy (RT) is known to reduce the dose to the rectal wall. Clinical results from the patient's perspective are needed to better assess a possible benefit. A group of 167 consecutive patients who received prostate RT during the years 2010 to 2013 with 2-Gy fractions up to 76 Gy (without hydrogel, n = 66) or 76-80 Gy (with hydrogel, n = 101) were included. The numbers of interventions resulting from bowel problems during the first 2 years after RT were compared. Patients were surveyed prospectively before RT, at the last day of RT, and at a median of 2 and 17 months after RT using a validated questionnaire (Expanded Prostate Cancer Index Composite). Baseline patient characteristics were well balanced. Treatment for bowel symptoms (0 vs. 11 %; p < 0.01) and endoscopic examinations (3 vs. 19 %; p < 0.01) were performed less frequently with a spacer. Mean bowel function scores did not change for patients with a spacer in contrast to patients without a spacer (mean decrease of 5 points) >1 year after RT in comparison to baseline, with 0 vs. 12 % reporting a new moderate/big problem with passing stools (p < 0.01). Statistically significant differences were found for the items ''loose stools'', ''bloody stools'', ''painful bowel movements'' and ''frequency of bowel movements''. Spacer injection is associated with a significant benefit for patients after prostate cancer RT. (orig.) [German] Bei der Radiotherapie (RT) des Prostatakarzinoms kann die Dosis an der Rektumwand durch die Injektion eines Hydrogelabstandhalters gesenkt werden. Klinische Ergebnisse aus der Sicht des Patienten sind zur Einschaetzung eines moeglichen Vorteils erforderlich. Eine Gruppe von 167 konsekutiven Patienten, die in den Jahren 2010-2013 eine Prostata-RT mit Einzeldosen von 2 bis 76 Gy (ohne Hydrogel, n = 66) bzw. 76-80 Gy (mit Hydrogel, n = 101

  6. Sparing of contralateral major salivary glands has a significant effect on oral health in patients treated with radical radiotherapy of head and neck tumors

    Beer, K.T.; Greiner, R.H. [Klinik fuer Radio-Onkologie, Univ. Bern, Inselspital (Switzerland); Zehnder, D.; Lussi, A. [Klinik fuer Zahnerhaltung, Kinder- und Praeventivmedizin, Univ. Bern, Inselspital (Switzerland)


    baseline value, the saliva pH remains basic, and the colonisation with Streptococcus mutans is reduced. (orig.) [German] Hintergrund: Welchen Einfluss hat das bewusste Aussparen der kontralateralen grossen Speicheldruesen (Glandulae parotis, submandibulares und sublinguales) bei radikaler Strahlentherapie von HNO-Tumoren auf das Milieu der Mundhoehle (Speichel-pH, -Pufferkapazitaet, -flussrate und Streptococcus-mutans-Kolonisation)? Patienten und Methoden: 20 konsekutive, zustimmende Patienten mit HNO-Tumoren wurden einmal vor, woechentlich waehrend und 6 Wochen nach Abschluss der Radiotherapie bezueglich Speichelflussrate, pH-Wert, Pufferkapazitaet des Speichels sowie Kolonisierung mit Streptococus mutans untersucht. Bei 13 Patienten waren alle grossen Speicheldruesen im behandelten Volumen eingeschlossen, bei sieben Patienten sparte die Feldanordnung bewusst die kontralateralen Speicheldruesen aus. Ergebnisse: Die stimulierbare Speichelmenge nimmt schon waehrend der 1. Woche der Radiotherapie ab, sinkt exponentiell zur Dosis und reduziert sich in den Wochen nach Abschluss der Therapie weiter. Der Effekt ist bei Patienten mit Schonung der kontralateralen grossen Speicheldruesen deutlich geringer ausgepraegt. Die Mehrzahl der Patienten mit einseitiger Schonung haelt den Ausgangswert de Pufferkapazitaet, waehrend alle Patienten mit Einschluss aller grossen Speicheldruesen schon bei Dosen ab 20 Gy erheblich an Pufferkapazitaet in der Mundhoehle ohne Zeichen der Erholung nach Abschluss der Therapie verlieren. Bei einseitiger Schonung bleibt der Speichel-pH immer basisch; bei beidseitig bestrahlten Patienten sinkt der pH waehrend und nach der Radiotherapie von 7,3 Mittelwert auf 5,8 ab. Die Kolonisierung mit Streptococcus mutans variiert in beiden Patientengruppen waehrend der Radiotherapie wenig; sie ist bei beidseitig bestrahlten Patienten nach Abschluss der Therapie hoeher als bei Patienten mit Schonung einer Parotis. Schlussfolgerungen: Die bewusste Anordnung der Felder

  7. Selection and delineation of lymph node target volume for lung cancer conformal radiotherapy. Proposal for standardizing terminology based on surgical experience

    Kiricuta, I.C. [Inst. of Radiation Oncology, St. Vincenz Hospital, Limburg/Lahn (Germany)


    Purpose: To select and delineate the target volumes for definitive or postoperative radiotherapy for lung cancer. Methods and Materials: The lymphatics of the lung and the dissemination of tumor cells to the intra- and extrathoracic lymph nodes are described. The incidence of involvement of the different lymph node sites in the chest is analyzed. The involvement of the contralateral hilar and/or supraclavicular lymph nodes and the consequences for target volume selection for curative radiotherapy are discussed. CT-based nodal classification and distribution of lymph nodes in the chest in CT-axial slices are presented. The sentinel node concept (SNC) and the preliminary data available for lung cancer are described. Results: A critical review of the current TNM classification for lung cancer and the implications for target volume selection is given. The individual target volume selection and delineation have to be based on clinical and pathological data from large surgical studies and upon the individual pathological and diagnostic patient data. The selection and delineation of the clinical target volumes for definitive and for postoperative radiotherapy, dependent on the lymph node involvement, are presented. Conclusions: Criteria for the selection and delineation of the clinical target volumes for definitive and for postoperative conformal radiotherapy in axial CT slices under consideration of site, size and stage of the lung cancer are described. Recommendations for target volume selection for definitive or postoperative radiotherapy are presented. (orig.) [German] Ziel: Die Selektion und Bestimmung der klinischen Zielvolumina fuer die alleinige oder postoperative Strahlentherapie beim Bronchialkarzinom. Material und Methode: Die Lymphabflusswege der Lunge und das Verteilungsmuster der Tumorzellen in den regionalen Lymphknoten werden beschrieben. Die CT-Klassifikation und die Verteilung der intrathorakalen Lymphknoten werden vorgestellt. Der Befall der einzelnen

  8. Effets perturbateurs endocriniens des pesticides organochlores.

    Charlier, C; Plomteux, G


    Xenoestrogens such organochlorine pesticides are known to induce changes in reproductive development, function or behaviour in wildlife. Because these compounds are able to modify the estrogens metabolism, or to compete with estradiol for binding to the estrogen receptor, it may be possible that these products affect the risk of developing impaired fertility, precocious puberty or some kinds of cancer in man. Le plus ancien récit de lutte contre la pollution remonte à une légende indienne racontant que la divinité Sing-bonga était incommodée par les émanations des fours dans lesquels les Asuras fondaient leurs métaux (1). Evidemment depuis, la problématique n-a cessé de s-accroître et la contamination de la Terre par de nombreux polluants est devenue aujourd-hui un problème majeur de notre Société. La protection de notre environnement est une question capitale qui doit être respectée malgré la pression économique actuelle et qui ne cessera de croître au cours des prochaines années même si l-identification objective et indiscutable de ce qui est essentiel - donc devant être prioritairement garanti sur la planète - est difficile à cerner (2). « Un oiseau en mauvais état ne pond pas de bons oeufs » disait un proverbe grec. Mais ce n-est qu-à partir de la seconde moitié du XXème siècle que les toxicologues ont commencé à identifier les effets qu-avaient entraînés à l-échelle mondiale les pollutions émises aux XIXème siècle sur la faune sauvage et sur le cheptel (3). L-histoire contemporaine des pesticides industriels commence vers 1874 (synthèse des organochlorés) et se poursuit tout au long de ces 2 siècles en passant par la synthèse des organophosphorés (1950), des carbamates (1970) et des pyréthroïdes (1975) (4). Le dichlorodiphényltrichloroéthane (DDT) a été synthétisé pour la première fois par un étudiant en cours de préparation de sa thèse de doctorat : Othmer Zeidler. La production, reprise par les

  9. Micro Blog:un monde des rumeurs%Micro Blog : un monde des rumeurs



    Quel est le divertissement le plus populaire sur Internet depuis ao(u)t 2009 en Chine ? Ce serait le Micro Blog du site web Sina.Avec 100 millions d'utilisateurs,ce Micro Blog est une plate-forme où l'on peut partager,diffuser et obtenir des informations immédiatement.En comparaison d'autres micro blogs tels que twitter et facebook,celui de Sina nous offre plus de services.Avec 140 mots,nous pouvons bien exprimer au moins une idée en chinois.De plus,en diffusant des critiques,des photos,des vidéos et des chansons,chacun devient jourr(n)aliste en observant et enregistrant les nouvelles de la vie.

  10. Sexual dysfunction after radiotherapy for cancer of the cervix uteri

    Ohkawa, R.; Takamizawa, H. (Chiba Univ. (Japan). School of Medicine); Arai, T.; Morita, S.


    Investigations of sexual consciousness and sexual dysfunction after radiotherapy for cancer of the cervix uteri were performed on patients of middle and old ages by questionnaires and questioning by doctors, and the following results were obtained. 1. Before radiotherapy, sexual activity was most prominent in their twenties and thirties. However, patients who were in fifties when this study was performed had most active sexual lives during the ages from 35 to 50 years. 2. Frequencies of sexual intercourse decreased markedly just before radiotherapy, and many patients received radiotherapy when sexual activity fell. 3. 32% of the patients have not experienced sexual intercourse after radiotherapy. 4. Decreases in the sex urge, sexuality, vaginal discharge, and frequency of sexual intercourse after radiotherapy were recognized in 77%, 77%, 70%, and 93% respectively. 5. Patients who became unwilling to maintain sexual lives after radiotherapy because of fear about recurrence or aggravation of cancer were 38% by questionaires and 49% by questioning by doctors. 6. Pains on sexual intercourse were found in 69% by questionaires and 49% by questionning by doctors. Most pains occurred at penis insertion and was thought to be due to atrophy and inflammation of vagina and external genitalia in most cases. 7. Both vaginal damage and sexual dysfunction in patients with radiotherapy following surgery for cancer of the cervix uteri, in patients with radiotherapy alone for cancer of the cervix uteri, and in patients with radiotherapy following surgery for cancer of the ovary and corpus uteri were marked, modest and mild, respectively. 8. Vaginal damage score was higher in patients treated more than 5 years before than those less than 2 years ago, but there were no differences in sexual dysfunction score between both groups.

  11. Anatomo-clinical target volumes (GTV and CTV) in radiotherapy; Volumes cibles anatomocliniques (GTV et CTV) en radiotherapie

    Kantor, G. [Institut Bergonie, Universite Victor-Segalen, Dept. de Radiotherapie, Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Halimi, P. [Hopital Europeen Georges-Pompidou, Service de Radiologie, Faculte de Medecine Paris-5, 75 - Paris (France)


    In this issue will be tackled the development of tools (multi modules scanner and images fusion) and the analysis of volumes for cerebral tumors (head and neck). It seemed necessary to update this theme because of the ever more widespread use of conformation radiotherapy and new constraints of volumes definitions brought by radiotherapy with intensity modulation. (N.C.)

  12. Comparison and Prognostic Analysis of Adjuvant Radiotherapy versus Salvage Radiotherapy for Treatment of Radically Resected Locally Advanced Esophageal Squamous Cell Carcinoma

    Xin Xu


    Full Text Available Objective. To compare adjuvant radiotherapy and salvage radiotherapy after radical resection for treatment of esophageal squamous cell carcinoma (ESCC. Methods. Data from 155 patients with locally advanced ESCC who underwent radical resection and received postoperative radiotherapy from 2005 to 2011 were reviewed. Seventy-nine patients received adjuvant radiotherapy and 76 received salvage radiotherapy after locoregional recurrence. Results. The median disease-free survival (DFS and overall survival (OS were significantly higher in the adjuvant radiotherapy group than the salvage radiotherapy group (DFS 25.73 months versus 10.73 months, P 65 years or with PS ≥ 2. Conclusion. Compared to salvage radiotherapy, postoperative adjuvant radiotherapy can prolong DFS and OS for patients with radically resected local advanced ESCC but cannot improve survival for patients aged > 65 years or with PS ≥ 2.

  13. Vom Bürger zum Kunden. Der Strukturwandel des Bildungssystems und der demokratischen Kultur in Deutschland

    Zymek, Bernd


    Der Artikel analysiert aus einer bildungs- und sozialhistorischen Perspektive die Ursachen und Konsequenzen des auffälligen Begriffswandels und Strategiewechsels in den bildungspolitischen Debatten Deutschlands. die aktuelle Konjunktur ökonomischer Begriffe und betriebswirtschaftlicher Strategien wird im Zusammenhang des langfristigen Strukturwandels des deutschen Bildungssystems, des Funktionsverlusts des Berechtigungswesens und der Expansion kommerzieller Bildungsangebote im Umfeld des staa...

  14. La gestion des eaux souterraines et des steppes en Syrie : une ouverture internationale sous contrôle

    Saadé-Sbeih, Myriam; Jaubert, Ronald; Al-Dbiyat, Mohamed


    À partir de la fin des années 1990, dans un contexte d’ouverture à l’international, les autorités syriennes adoptèrent une posture conforme au discours des organisations internationales de développement en redéfinissant les politiques d’exploitation des eaux souterraines et des parcours steppiques. Si les programmes mis en œuvre semblent dans un premier temps correspondre à l’adoption des principes et instruments de régulation et de gestion des ressources naturelles promus par les organisatio...

  15. Multistatic Surveillance and Reconnaissance: Sensor, Signals and Data Fusion (Surveillance et Reconnaissance Multistatiques : Fusion des capteurs, des signaux et des donnees)


    capteurs , des signaux et des données) Research and Technology Organisation (NATO) BP 25, F-92201 Neuilly-sur-Seine Cedex, France RTO-EN-SET-133...this new paradigm, each radar/sonar can receive and process its own signal and/or the signal of other local sources. The application of bi-/multistatic...Multistatiques : Fusion des capteurs , des signaux et des données) The material in this publication was assembled to support a Lecture Series under the

  16. Chromosomal aberration in peripheral lymphocytes and doses to the active bone marrow in radiotherapy of prostate cancer

    Gershkevitsh, E. [Clinicum of the University of Tartu (Estonia). Dept. of Radiotherapy; Hildebrandt, G.; Wolf, U.; Kamprad, F. [Leipzig Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie; Realo, E. [Lab. of Nuclear Spectroscopy, Inst. of Physics, Tartu (Estonia); Trott, K.R. [Queen Mary and Westfield Coll., London (United Kingdom). St. Bartholomew' s and the Royal London School of Medicine and Dentistry


    Purpose: Radiotherapy plays an important role in the management of prostate cancer. Epidemiological data indicate a small but significant risk of radiation-induced leukemia after radiotherapy which might be related to the high mean bone marrow dose associated with radiotherapy of prostate cancer. The purpose of the study was to investigate the relation between the mean bone marrow dose and unstable chromosome aberrations in peripheral blood lymphocytes in patients undergoing conformal radiotherapy for prostate cancer as a possible indicator of risk. Endometrial cancer patients were also included for comparison. Patients and Methods: Nine patients, six with prostate cancer (60-73 years old) and three with endometrial cancer (61-81 years old) treated with radiotherapy were included in the study. The non-bony spaces inside the pelvic bones were outlined on every CT slice using the treatment planning system and mean doses to the bone marrow calculated. Blood samples of the patients were obtained at different times before, during and at the end of treatment. Lymphocytes were cultured in the usual way and metaphases scored for dicentric aberrations. Results: 46 samples from nine patients were obtained. The mean number of metaphases analyzed per sample was 180 with a range from 52 to 435. The mean bone marrow doses for prostate cancer patients ranged from 2.8 to 4.2 Gy and for endometrial cancer patients from 12.8 to 14.8 Gy. The aberration yield increased with the planning target volume and the mean bone marrow dose. Conclusion: The yield of dicentric aberrations for prostate cancer patients correlated closely with the mean bone marrow dose albeit the induction of dicentrics occurred in mature T lymphocytes most of which were probably in transit through the irradiated volumes. Therefore, the observed relationship between dicentrics and mean bone marrow doses are indirect. (orig.) [German] Hintergrund: Bei der kurativen Behandlung des Prostatakarzinoms besitzt die

  17. Prostate-specific antigen kinetics following hypofractionated stereotactic body radiotherapy boost as post-external beam radiotherapy versus conventionally fractionated external beam radiotherapy for localized prostate cancer

    Phak, Jeong Hoon; Kim, Hun Jung; Kim, Woo Chul


    Background Stereotactic body radiotherapy (SBRT) has emerged as an effective treatment for localized prostate cancer. The purpose of this study was to compare the prostate-specific antigen (PSA) kinetics between conventionally fractionated external beam radiotherapy (CF-EBRT) and SBRT boost after whole pelvis EBRT (WP-EBRT) in localized prostate cancer. Methods A total of 77 patients with localized prostate cancer [T-stage, T1–T3; Gleason score (GS) 5–9; PSA 

  18. Target margins in radiotherapy of prostate cancer.

    Yartsev, Slav; Bauman, Glenn


    We reviewed the literature on the use of margins in radiotherapy of patients with prostate cancer, focusing on different options for image guidance (IG) and technical issues. The search in PubMed database was limited to include studies that involved external beam radiotherapy of the intact prostate. Post-prostatectomy studies, brachytherapy and particle therapy were excluded. Each article was characterized according to the IG strategy used: positioning on external marks using room lasers, bone anatomy and soft tissue match, usage of fiducial markers, electromagnetic tracking and adapted delivery. A lack of uniformity in margin selection among institutions was evident from the review. In general, introduction of pre- and in-treatment IG was associated with smaller planning target volume (PTV) margins, but there was a lack of definitive experimental/clinical studies providing robust information on selection of exact PTV values. In addition, there is a lack of comparative research regarding the cost-benefit ratio of the different strategies: insertion of fiducial markers or electromagnetic transponders facilitates prostate gland localization but at a price of invasive procedure; frequent pre-treatment imaging increases patient in-room time, dose and labour; online plan adaptation should improve radiation delivery accuracy but requires fast and precise computation. Finally, optimal protocols for quality assurance procedures need to be established.

  19. [Technical record in radiotherapy (author's transl)].

    Le Dorze, C; Horiot, J C; Laugier, A


    The term "technical record in radiotherapy" is used to describe collected information relative to treatment using radiation. The subject of this session of the chapter of Radiotherapy of the Société Française de Radiologie was the intrinsic functions of this record and its extrinsic limitations. The extreme diversity of the current state of the record is a known fact. A majority of participants express the desire for uniformisation of the collection of data or even, as a second stage, to have a common record. A library of technical records was set up under the responsibility of the Centre Georges-François Leclerc at Dijon (J.C. Horiot). One broad conclusion was seen to emerge: the creation of a minimum common record including essential information to which could be added the more specific data of each radiotherapist and at each time of use. Prior agreement will be necessary with regard to the standardisation of apparatus and the expression of the dose. This session was of necessity merely a reflection of future needs and it is to be hoped that the good will which was obvious during the course of the discussion may produce concrete results in the months to come.

  20. Hypofractionated whole breast radiotherapy: current perspectives

    Koulis TA


    Full Text Available Theodora A Koulis, Tien Phan, Ivo A Olivotto Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada Abstract: Adjuvant radiotherapy (RT is an important part of breast cancer management but the dose and fractionation schedules used are variable. A total of 50 Gy in 25 daily fractions delivered over 5 weeks is often considered the "standard" adjuvant RT prescription. Hypofractionated regimes such as 42.5 Gy in 16 daily fractions or 40 Gy in 15 daily fractions following breast-conserving surgery have proven to be equally effective and achieve similar or better cosmetic and normal tissue outcomes for both invasive and in situ diseases and when treating the regional nodes. Hypofractionation is more convenient for patients and less costly. However, certain patients at higher risk of RT late effects may benefit from a less intense, even more extended fractionation schedule. This review describes the indications for whole breast hypofractionated adjuvant RT for patients with breast cancer following breast-conserving surgery and proposes that hypofractionation should be the new "standard" for adjuvant breast cancer RT. Keywords: fractionation, breast cancer, cosmesis, radiotherapy

  1. Dose masking feature for BNCT radiotherapy planning

    Cook, Jeremy L.; Wessol, Daniel E.; Wheeler, Floyd J.


    A system for displaying an accurate model of isodoses to be used in radiotherapy so that appropriate planning can be performed prior to actual treatment on a patient. The nature of the simulation of the radiotherapy planning for BNCT and Fast Neutron Therapy, etc., requires that the doses be computed in the entire volume. The "entire volume" includes the patient and beam geometries as well as the air spaces in between. Isodoses derived from the computed doses will therefore extend into the air regions between the patient and beam geometries and thus depict the unrealistic possibility that radiation deposition occurs in regions containing no physical media. This problem is solved by computing the doses for the entire geometry and then masking the physical and air regions along with the isodose contours superimposed over the patient image at the corresponding plane. The user is thus able to mask out (remove) the contour lines from the unwanted areas of the image by selecting the appropriate contour masking region from the raster image.

  2. In vivo dosimetry in external beam radiotherapy

    Mijnheer, Ben [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX (Netherlands); Beddar, Sam [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Izewska, Joanna [Division of Human Health, International Atomic Energy Agency, Vienna 1400 (Austria); Reft, Chester [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois 60637 (United States)


    In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

  3. Aimant PS: controle de l'etat des sertissages internes des PFW mesures effectues surl'ensemble des aimants du PS pendant le grand arret 2004/2006

    Ottaviani, J


    Les sertissages (douilles), utilisés pour raccorder les méplats du circuit principal des PFW à leurs câbles d’alimentation, présentent parfois des défauts de réalisation qui entraînent une résistance électrique anormale. Pour mettre en évidence ces défauts, la résistance des 4 sertissages des nappes polaires est mesurée. Les nappes sont alimentées avec un courant efficace nominal de 80A.Les mesures sont effectuées entre le bornier de connexions des 4 câbles d’alimentation des PFW et les circuits auxiliaires correspondants (Pick-ups brasés sur les enroulements). De ces mesures (câble d’alimentation et une courte partie du circuit principal) est déduite la valeur de la résistance du sertissage qui en assure la liaison. A la mesure des résistances des sertissages des nappes polaires supérieures s’ajoute la résistance des câbles qui assurent la liaison entre borniers. Dans le cadre de la rénovation des aimants du PS, les 100 unités on été mesurées.

  4. Development of evaluation and performance verification technology for radiotherapy radiation

    Kim, J. Y.; Jang, S. Y.; Kim, B. H. and others


    No matter how much the importance is emphasized, the exact assessment of the absorbed doses administered to the patients to treat the various diseases such as lately soaring malignant tumors with the radiotherapy practices is the most important factor. In reality, several over-exposed patients from the radiotherapy practice become very serious social issues. Especially, the development of a technology to exactly assess the high doses and high energies (In general, dose administered to the patients with the radiotherapy practices are very huge doses, and they are about three times higher than the lethal doses) generated by the radiation generators and irradiation equipment is a competing issue to be promptly conducted. Over fifty medical centers in Korea operate the radiation generators and irradiation equipment for the radiotherapy practices. However, neither the legal and regulatory systems to implement a quality assurance program are sufficiently stipulated nor qualified personnel who could run a program to maintain the quality assurance and control of those generators and equipment for the radiotherapy practices in the medical facilities are sufficiently employed. To overcome the above deficiencies, a quality assurance program such as those developed in the technically advanced countries should be developed to exactly assess the doses administered to patients with the radiotherapy practices and develop the necessary procedures to maintain the continuing performance of the machine or equipment for the radiotherapy. The QA program and procedures should induce the fluent calibration of the machine or equipment with quality, and definitely establish the safety of patients in the radiotherapy practices. In this study, a methodology for the verification and evaluation of the radiotherapy doses is developed, and several accurate measurements, evaluations of the doses delivered to patients and verification of the performance of the therapy machine and equipment are

  5. Dans le tourbillon des particules

    Zito, Marco


    Accélérateurs géants, détecteurs complexes, particules énigmatiques... La physique subatomique peut sembler bien intimidante pour le novice. Et pourtant, qui n a jamais entendu parler du boson de Higgs et du CERN, le laboratoire européen où il a été découvert en 2012 ? Nul besoin d être un spécialiste pour comprendre de quoi il s agit. Aujourd hui, une théorie extraordinairement élégante, le Modèle Standard, décrit tous les résultats des expériences dans le domaine. Trente-sept particules élémentaires et quatre forces fondamentales : c est tout ce dont nous avons besoin pour expliquer la matière et l Univers ! Ce livre, destiné à un large public, raconte sans équations le long parcours qui a abouti au Modèle Standard. Ce parcours, parfois sinueux, a été entamé lorsque les Grecs anciens, et peut-être d autres avant eux, ont imaginé que la matière est composée de petites « billes ». Il faudra attendre plusieurs siècles pour qu on réalise que la matière, à l échelle micros...

  6. Running Club - Nocturne des Evaux

    Running club


    Les coureurs du CERN sont encore montés sur les plus hautes marches du podium lors de la course interentreprises. Cette course d’équipe qui se déroule de nuit et par équipe de 3 à 4 coureurs est unique dans la région de par son originalité : départ groupé toutes les 30 secondes, les 3 premiers coureurs doivent passer la ligne d’arrivée ensemble. Double victoire pour le running club a la nocturne !!!! 1ère place pour les filles et 22e au classement général; 1ère place pour l'équipe mixte et 4e au général, battant par la même occasion le record de l'épreuve en mixte d'environ 1 minute; 10e place pour l'équipe homme. Retrouvez tous les résultats sur

  7. Dictionnaire d'analyse et de gestion des risques

    Desroches, Alain


    Ce dictionnaire présente les principaux termes utilisés en analyse et gestion des risques, pour tous les secteurs d'activité industrielle ou de service. Il permet de clarifier des terminologies existantes présentant des variations plus ou moins importantes et parfois des contradictions de sens. Il propose : premièrement, la définition des auteurs, définition correspondant à l'usage le plus courant du terme , deuxièmement, les différences avec les terminologies existantes (essentiellement des normes) , troisièmement, des compléments à la définition, lorsque cela semble nécessaire et notamment lorsqu'il est important de préciser le contexte d'utilisation du terme , en dernier lieu, des exemples pratiques d'application, lorsque cela peut apporter un éclairage complémentaire pertinent.

  8. Refuge development report : Des Lacs Migratory Waterfowl Refuge

    US Fish and Wildlife Service, Department of the Interior — Report on the development of Des Lacs National Wildlife Refuge. This report introduces the physical and biological characteristics of the Des Lacs area. This report...

  9. [Des Lacs National Wildlife Refuge habitat improvement to combat botulism

    US Fish and Wildlife Service, Department of the Interior — This documents discusses the possibilities of ditching the Upper Des Lacs lake as a means of combating botulism on the Des Lacs National Wildlife Refuge.

  10. Stabilisation de la formule des traces tordue

    Moeglin, Colette


    Ce travail en deux volumes donne la preuve de la stabilisation de la formule des trace tordue. Stabiliser la formule des traces tordue est la méthode la plus puissante connue actuellement pour comprendre l'action naturelle du groupe des points adéliques d'un groupe réductif, tordue par un automorphisme, sur les formes automorphes de carré intégrable de ce groupe. Cette compréhension se fait en réduisant le problème, suivant les idées de Langlands, à des groupes plus petits munis d'un certain nombre de données auxiliaires; c'est ce que l'on appelle les données endoscopiques. L'analogue non tordu a été résolu par J. Arthur et dans ce livre on suit la stratégie de celui-ci. Publier ce travail sous forme de livre permet de le rendre le plus complet possible. Les auteurs ont repris la théorie de l'endoscopie tordue développée par R. Kottwitz et D. Shelstad et par J.-P. Labesse. Ils donnent tous les arguments des démonstrations même si nombre d'entre eux se trouvent déjà dans les travaux d'Ar...

  11. Positionsbestimmung des Unternehmens: Interne und externe Analyse

    Bergmann, Lars; Crespo, Isabel; Portmann, Stefan

    Die Initiierung und Lenkung von Maßnahmen zur integrierten Modernisierung zielen auf die Verbesserung der Wettbewerbsfähigkeit eines Unternehmens ab. Damit diese Maßnahmen zielgerichtet die Wettbewerbsfähigkeit verbessern können, ist Wissen über die bestehende Wettbewerbsfähigkeit sowie über die bestehenden Fähigkeiten eine zentrale Voraussetzung. Eine zielgerichtete Auswahl problemadäquater Maßnahmen zur Verbesserung der Wettbewerbsfähigkeit bedarf daher im Vorfeld einer Bewertung der aktuellen Situation des Unternehmens im Sinne einer Positionsbestimmung. Erst wenn die internen Stärken und Schwächen sowie die externen Chancen und Risiken identifiziert sind, kann ein ganzheitliches Bild von der Position eines Unternehmens in seiner Umwelt gewonnen werden. Auf Basis der Kenntnisse über die Position des Unternehmens können anschließend zielgerichtet Maßnahmen ausgewählt werden, die einen Beitrag zur Verbesserung der Wettbewerbsfähigkeit des Unternehmens haben. Damit kommt der Positionsbestimmung als initialer Schritt des Prozesses der strategischen Unternehmensplanung eine zentrale Bedeutung im Rahmen der integrierten Modernisierung zu. Erfolgt die Auswahl von Maßnahmen ohne eine vorherige Positionsbestimmung, also lediglich auf Basis drängender Probleme, so besteht die Gefahr einer unbedachten und nur auf das "hier und heute“ bezogenen Schwerpunktbildung ohne Berücksichtigung der mittel- und langfristigen Ziele des Unternehmens.


    Lachachi, Abdelhaq


    Cette étude traite la problématique de la contribution des savoirs dans la performance d’entreprise. En d’autres termes, quel est l’impact des pratiques du management des connaissances (catalyseurs et processus) dans la performance organisationnelle ? Plusieurs études ont montré que les catalyseurs du management des connaissances (Culture organisationnelle, structure organisationnelle, leadership, stratégie et vision et les technologies de l’information et de la communication) ...

  13. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta [Niigata Univ. (Japan). School of Medicine


    To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

  14. A New Cancer Radiotherapy System Using Multi Robotic Manipulators

    Kim, Seung Ho; Lee, Nam Ho; Lee, Byung Chul; Jeung, Kyung Min; Lee, Seong Uk; Bae, Yeong Geol; Na, Hyun Seok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)


    The CyberKnife system is state-of-the-art cancer treatment equipment that combines an image tracking technique, artificial intelligence software, robot technology, accelerator technology, and treatment simulation technology. The current CyberKnife System has significant shortcomings. The biggest problem is that it takes a longer time to treat a tumor. A long treatment time gives stress to patients. Furthermore it makes the patients uncomfortable with radiation and thus it is difficult to measure the exact radiation dose rate to the tumor in the processing. Linear accelerators for radiation treatment are dependent on imports, and demand high maintenance cost. This also makes the treatment cost higher and prevents the popularization of radiation. To solve the disadvantages of the existing CyberKnife, a radiation treatment robot system applied to several articulated robots is suggested. Essential element techniques for new radiotherapy robot system are investigated and some problems of similar existing systems are analyzed. This paper presents a general configuration of a new radiation robot treatment system including with a quantitative goal of the requirement techniques. This paper described a new radiotherapy robot system to track the tumor using multiple articulated robots in real time. The existing CyberKnife system using a single robot arm has disadvantages of a long radiotherapy time, high medical fee, and inaccurate measurement of the radiotherapy dose. So a new radiotherapy robot system for tumors has been proposed to solve the above problems of conventional CyberKnife systems. Necessary technologies to configure new the radiotherapy robot system have been identified. Quantitative targets of each technology have been established. Multiple robot arms are adopted to decrease the radiotherapy time. The results of this research are provided as a requisite technology for a domestic radiotherapy system and are expected to be the foundation of new technology. The

  15. Testis cancer: role of radiotherapy in 2003; Cancer du testicule: place de la radiotherapie en 2003

    Clippe, S. [Centre de Lutte Contre le Cancer Leon-Berard, Dept. de Radiotherapie, 69 - Lyon (France); Flechon, A.; Droz, J.P. [Centre de Lutte Contre le Cancer Leon-Berard, Dept. de Cancerologie Medicale, 69 - Lyon (France)


    Germ-cell minors of the testis are rare tumors of the young adult. Half of them are seminoma. The majority of patients have disease limited to the testis. Radiotherapy still remains the standard treatment of these patients. Almost all patients are cured by orchidectomy and radiotherapy on the lomboaortic area extended to homolateral iliac area. The dose is 24 to 30 Gy in a standard fractionation. Different studies are ongoing to reduce the irradiation field (omission of the pelvic irradiation), to decrease irradiation dose (to 20 Gy). Other treatment options are strict surveillance and adjuvant carbo-platin based chemotherapy. None of these options are standard treatments. A strict attention must be directed on controlateral germ-cell tumors and second cancers. (author)

  16. Comparison of "sandwich chemo-radiotherapy" and six cycles of chemotherapy followed by adjuvant radiotherapy in patients with stage IIIC endometrial cancer: a single center experience.

    Dogan, Nasuh Utku; Yavas, Guler; Yavas, Cagdas; Ata, Ozlem; Yılmaz, Setenay Arzu; Celik, Cetin


    To compare "sandwich chemo-radiotherapy" with six cycles of chemotherapy followed by adjuvant radiotherapy with respect to tolerability and acute toxicity. Twenty-five women with surgically staged IIIC endometrial cancer were included. Treatment consisted of either three cycles of paclitaxel (175 mg/m²) and carboplatin (AUC 6) on a q21-day schedule followed by irradiation (45-50.4 Gy) or six cycles of the same chemotherapy followed by radiotherapy. Acute toxicity related to either chemotherapy or radiotherapy was evaluated. Median age was 61.5 years (range 36-83 years). Eleven patients had sandwich chemo-radiotherapy, and the other 14 patients had 6 cycles of chemotherapy followed by radiotherapy. Three out of the five patients who could not complete all the cycles in the sandwich chemo-radiotherapy group had pelvic and para-aortic radiotherapy. Acute radiotherapy related grade 1-2 gastrointestinal system (GIS) and genitourinary system (GUS) toxicities were observed in 72.8 and 63.6 % of patients, respectively, for sandwich group. Undesired treatment breaks in the course of radiotherapy were observed in six patients for sandwich chemo-radiotherapy and in one patient receiving six cycles of chemotherapy followed by radiotherapy. All the patients who had undesired treatment breaks in the sandwich chemo-radiotherapy group had pelvic and para-aortic radiotherapy. Sandwich chemo-radiotherapy seems to be more toxic particularly for patients who had pelvic and para-aortic irradiation. Therefore, it might be more convenient to delay radiotherapy after six cycles of chemotherapy for patients with the indication of pelvic para-aortic radiotherapy.

  17. L’impact de la participation bancaire dans le capital des entreprises sur la politique de distribution des dividendes

    Naoel Mezgani


    Full Text Available L’objectif de ce papier est de tester l’incidence de la participation bancaire dans le capital des entreprises non financières sur la politique de distribution des dividendes. En utilisant des données de panel des trente entreprises tunisiennes durant la période de 1999 à 2004, nous vérifions si en détenant le capital et la dette, la banque a la possibilité de contraindre la distribution des dividendes pour garantir le remboursement de ses fonds prêtés. Les résultats empiriques obtenus ne confirment pas l’impact significatif des banques actionnaires majoritaires et principaux créditeurs sur la distribution des dividendes dans les entreprises tunisiennes. Ces dernières soutiennent surtout la stabilité du niveau des dividendes payés d’une année à une autre.

  18. ordination et classification de la vegetation des zones humides du ...


    Ivoire appartiennent à la ... géographiques (Gauch, 1982 ; Kent et Coker, ... Le climat de la région est du type sub-équatorial, .... L'influence des ..... efficaces pour la partition des groupes de relevés ... les changements induits par des facteurs.

  19. Inhibition de Phytophthora palmivora, agent de pourriture brune des ...

    les pratiques culturales, la sélection des variétés résistances et l'utilisation des antagonistes ... will assess for efficacy biocontrol candidates from cacao agrosystems on the evolution of disease. ..... °C. Après 7 jours d'incubation, la lecture des.

  20. Statutes of limitations: the special problem of DES suits.

    Feigin, C A


    In 1971, medical studies determined that DES causes a rare type of vaginal cancer in a small number of daughters of mothers who took DES during pregnancy. Subsequently, medical studies determined that exposure to DES can cause other vaginal abnormalities in the daughters, some of which may be precancerous. As a result of these discoveries, many lawsuits have been filed by these daughters against DES manufacturers. Many DES suits may be barred by statutes of limitations, both because the number of years between the daughters' exposure to DES in utero and the discovery that DES can cause injuries exceeds the statutory period, and because the cancer or other injuries caused by DES may not develop for many additional years. This Note discusses two methods that DES plaintiffs may be able to use to overcome the potential statutes of limitations bar: the discovery rule, and state provisions which toll the statute of limitations for minors. The Note contends that courts should apply an expanded discovery rule to DES suits to avoid the unfair result of barring a claim before the plaintiff could have known that she had a cause of action. In addition, the Note argues that the injury which causes the statute of limitations to begin to run in DES suits should not be rigidly defined. Finally, the Note urges that courts allow eligible DES plaintiffs to take advantage of applicable state provisions that toll the statute of limitations for minors.