The role of radiation therapy in the management of head and neck paragangliomas: impact of quality of life versus treatment response.

Purpose: To assess the impact of radiotherapy in paragangliomas (PGLs) with regard to overall survival, local control, volumetric response and particularly quality of life (QoL).

Materials And Methods: From 1985 to 2010, 130 cases of head and neck (H&N) PGLs were managed at Bordeaux University Hospital. With a median follow-up of 7.

Effectiveness of modified radical neck dissection and postoperative radiotherapy.

Background And Objective: The aim of this study was to evaluate the effectiveness of a modified radical neck dissection with preservation of non-lymphatic structures usually removed in advanced-stage head and neck epidermoid carcinoma associated with postoperative radiotherapy (PORT).

Methods: We analyzed retrospectively the files of 109 patients, presenting with epidermoid carcinoma of the upper digestive/respiratory tract staged N2 or N3, over a 6-year period. The rates of regional control, mortality, and recurrence were analyzed and linked to the kind of neck-dissection (usual radical neck dissection [RND], modified radical neck dissection [MRND], selective neck-dissection [SND]) performed.

Comparison between CT- and FDG-PET-defined target volumes for radiotherapy planning in head-and-neck cancers.

Nine patients with head-and-neck cancer underwent computerized tomography (CT) simulation and [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) to compare the radiotherapy target volumes. The PET volumes were delineated with an automatic segmentation based on the source-to-background ratio. The volume comparison showed a reduction and qualitative discrepancies between the PET- and CT-volumes.

[Prostate carcinoma in the elderly].

Prostate carcinoma is the most frequent cancer in French men. Prostate carcinoma in elderly is the topic of this review. The review included chapters on age as the main factor for prostate carcinoma, the modification of disease presentation or PSA level depending on age, and then the challenge of age in therapeutic decisions.

[Prognostic value of infiltration of squamous cell carcinoma of the floor of the mouth].

Objective: The aim of this preliminary retrospective study was to evaluate the prognostic value of tumor thickness in squamous cell carcinoma of the floor of the mouth.

Materials And Methods: A total of 61 patients with previously untreated T1N0, T2N0 or T3N0 squamous cell carcinoma of the floor of the mouth were included in this preliminary study. An optical micrometer was used to determine the maximum of tumor thickness.

[Role of PET-CT with 18-FDG in the management of UADT squamous-cell carcinomas: a retrospective study of 43 cases].

Introduction: The aim of our retrospective study was to evaluate the role of PET-CT in the management of upper-aerodigestive tract (UADT) squamous-cell carcinomas.

Material And Methods: Our study included 43 patients with UADT squamous-cell carcinomas having undergone PET-CT for: initial staging (n=20), diagnosis of recurrent disease (n=16), and response to treatment (n=7).

Results: PET-CT diagnosed distant metastases missed by conventional imaging in four patients (20%) in initial staging, four patients (25%) in diagnosis of recurrent disease, and two patients (29%) in response to treatment.

[Simultaneous squamous cell carcinomas of the oral cavity and oropharynx].

Introduction: Squamous cell carcinoma of the oral cavity is often a single localization, but the discovery of another or several associated lesions is not exceptional. The goal of our study was a retrospective analysis of patients having 2 simultaneous squamous cell carcinomas of the upper aerodigestive tract (UADT), i.e.

[Treatment of squamous-cell carcinoma of the upper gum and the hard palate].

Purpose: The aim of this retrospective study was to determine a rational of treatment of squamous-cell carcinoma of the upper gum and hard palate.

Patients And Method: We analyzed retrospectively a series of 34 patients treated over a period of 11 years.

Results: There were 19 women (76%); mean age was 67.

[Epidermoid carcinoma of oral cavity in patients less than twenty].

Objective: To analyze a review of literature of patients aged less than 20 years with epidermoid carcinoma of oral cavity.

Patients And Methods: Two sources were used to identify cases. A Medline search was performed as well as a review of our Medlog files where two cases of oral epidermoid carcinoma were identified in patients aged less than 20 years.

[Squamous-cell carcinoma of the tongue: treatment results and prognosis].

Objective: The aim of the study was to assess the results of curative treatment of patients with squamous cell carcinoma of the tongue and to evaluate survival and predictive factors of recurrence.

Patients And Methods: A series of 309 patients with squamous cell carcinoma of the tongue treated with curative intent was studied from January 1988 to December 1999. The percentage of oral tongue cancer was 82.

[Surgical methods of removal of T4 nasopharyngeal malignancies. A preliminary report on 18 cases].

Objectives: To describe the technique and evaluate postoperative sequelae and results of transfacial surgical removal of T4N0 nasopharyngeal malignant neoplasms.

Material And Methods: Eighteen cases of surgically-treated nasopharyngeal cancers, managed between january 1993 and october 2000, were retrospectively studied. Three patients were non-responders to neoadjuvant chemotherapy, 6 suffered local recurrence following standard treatment and 7 were operated first either because of a huge and osteolytic tumor or because of an uncommon histolopathology.

[Conformal therapy of locally advanced cholangiocarcinoma of the main bile ducts].

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 (R0), 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.

[Splenic vascular occlusion in the course of pancreatic cancer].

Introduction: Pancreatic cancer is responsible for 6,000 deaths per year in France. During the course of the disease, venous thrombosis is common. Conversely, arterial thrombosis is rarely described.

[Fractionated radiotherapy of intracranial meningiomas: 15 years' experience at the Bordeaux University Hospital Center].

Purpose: To evaluate the long-term results of external fractionated radiation therapy (RT) in the treatment of intracranial meningiomas.

Patients And Methods: From January 1981 to December 1996, 156 patients with intracranial meningiomas were treated with external fractionated RT. Median age was 57.

Prognostic value of histologic findings in neck dissections for squamous cell carcinoma.

Background: Cervical node involvement is the most significant prognostic factor in head and neck squamous cell carcinoma. When histologic findings show node invasion, the number of positive nodes and the presence of extracapsular spread are commonly accepted as prognostic factors.

Objective: To confirm the findings of recent reports that there is no significant difference in outcome associated with extracapsular spread.

[Practice of virtual simulation at the Saint-André hospital].

Purpose: Prospective evaluation of a virtual simulation technique.

Patients And Methods: From September 1993 to February 1997, 343 patients underwent radiation therapy using this technique. Treated sites were mostly: brain (132), rectum (59), lung (43), and prostate (28).

[Post-radiotherapy cutaneous neuro-endocrine carcinoma].

Introduction: Merkel cell carcinoma or cutaneous neuroendocrine carcinoma is an uncommon severe disease. The carcinogenic effect of ionizing radiations has been suspected in exceptional observations. We report the sixth case of Merkel cell neuroendocrine carcinoma in a patient with prior radiotherapy.

[Routine use of electronic portal imaging. Positioning verification in 922 successive pelvic fields].

Treatment reproducibility is a major criterion of quality assurance in radiation therapy. During each course, the same dose should be delivered in the same volume of irradiation. Today, portal imaging devices can be used routinely to check and correct patient positioning before much of the daily irradiation has been delivered.

[Primary carcinoma of the parotid gland. A retrospective study of 31 cases].

The medical records of 31 patients with histologically proven primary carcinoma of the parotid gland seen between January 1980 and December 1992 were reviewed. The efficiency of combined treatment both on locoregional control and overall survival was assessed. Twenty nine patients underwent extensive surgery and postoperative radiotherapy, two patients underwent extensive surgery alone.

Superior vena cava thrombosis related to catheter malposition in cancer chemotherapy given through implanted ports.

Background: Thrombosis of the central veins is one of the most frequent complications of implanted venous access devices. Among the first cases occurring in our patients, most were associated with left-sided placement of the ports, with catheter tips lying against the external wall in the upper half of the superior vena cava. Some chest radiographs showed lateromediastinal opacities centered on the catheter tip, suggesting a vessel injury.

Radiotoxic model for three-dimensional treatment planning. Part 1: Theoretical basis.

Since recent treatment planning systems calculate volumetric dose distribution, an objective evaluation of potential toxicity in the main critical organs may be helpful in treatment optimization. Modeling the toxicity of radiotherapy must at least account for: (a) specific risks in every critical organ; (b) total dose and dose per fraction; (c) partial irradiation of critical organs; (d) heterogeneous dose distribution. The Radiation Damage Factor formula is aimed at estimating the delayed toxicity of a given treatment plan on every critical organ concerned.

[Titanium plates for mandibular reconstruction and radiotherapy].

Mandibular reconstruction plates are now used after cancer surgery in particular patients. This study assesses the irradiation of Titanium mandibular reconstruction plates in terms of both dosimetry and mid-term tolerance. Twenty patients with mandibular plates underwent radiotherapy (mean dose 60 Gy).