Vulval and vaginal rhabdomyosarcoma in children: update and reappraisal of Institut Gustave Roussy brachytherapy experience.

Purpose: To report the Institut Gustave Roussy brachytherapy (BT) experience in the management of vulval and vaginal rhabdomyosarcoma with special emphasis on long-term outcome.

Patients And Methods: Between 1971 and 2005, the data concerning 39 girls who had undergone BT as a part of their treatment were retrospectively analyzed. Of the 39 girls, 20 had been treated before 1990, when the BT volume encompassed the initial tumor extension.

[Current data on radiochemotherapy and potential of targeted therapies for cervical cancers].

The present review represents an up-to-date focus on the particular topic of cervix carcinoma. An exhaustive description of the actual data and the near-future combination of radiotherapy and drugs with the specific potential of targeted therapies are presented. This approach represents one of the next challenges to improve results.

Therapy Insight: fertility in women after cancer treatment.

Cancer is the second-commonest cause of death in women under 40 years of age in Western Europe and the US. The survival of cancer patients has, nevertheless, improved during the past two decades. During this period, and especially during the last decade, there have been ground-breaking advances in the optimization of the quality of life of patients treated for cancer, in particular by the development of fertility-enhancing and fertility-preserving procedures in young patients treated for cancer.

Exclusive radiotherapy for primary squamous cell carcinoma of the vagina.

Purpose: To retrospectively analyze results of external beam therapy (EBT) with brachytherapy (BT) for primary vaginal squamous cell carcinoma (PVSCC).

Materials And Methods: From 1970 to 2001, 91 patients were included. FIGO stages were: I (29%), II (38%), III (29%) and IVa (4%).

Inverse planning approach for 3-D MRI-based pulse-dose rate intracavitary brachytherapy in cervix cancer.

Purpose: The purpose of this study was to evaluate the inverse planning simulated annealing (IPSA) software for the optimization of dose distribution in patients with cervix carcinoma treated with MRI-based pulsed-dose rate intracavitary brachytherapy.

Methods And Materials: Thirty patients treated with a technique using a customized vaginal mold were selected. Dose-volume parameters obtained using the IPSA method were compared with the classic manual optimization method (MOM).

The role of surgery after chemoradiation therapy and brachytherapy for stage IB2/II cervical cancer.

Objective: The aim of this study was to review the results of completion surgery after chemoradiation therapy in stage IB2/II cervical carcinoma.

Methods: Analysis of series published in the literature about completion surgery in this context.

Results: Stages of the disease included in those series were stage IB2-IVA disease.

Para-aortic involvement and interest of para-aortic lymphadenectomy after chemoradiation therapy in patients with stage IB2 and II cervical carcinoma radiologically confined to the pelvic cavity.

Background: Pelvic radiation therapy with concomitant chemotherapy (PCRT) is the standard treatment of stage IB2/II cervical carcinoma. The impact of concomitant chemotherapy on positive para-aortic nodes (PA+), however, remains unknown. The aim of this study was twofold: to evaluate the rate of histological PA+ after PCRT and to determine the survival of patients with PA+.

Brachytherapy for genital-tract rhabdomyosarcomas in girls: technical aspects, reports, and perspectives.

Rhabdomyosarcoma is a mesenchymal disease that represents 15-20% of childhood cancers and is the most common soft-tissue tumour in children. Most reviews on paediatric brachytherapy have described the experience of expert institutions with different brachytherapy techniques in a heterogeneous set of childhood malignant diseases. Brachytherapy reports focusing on specific types or locations (or both) are scarce.

Common strategy for adult and pediatric medulloblastoma: a multicenter series of 253 adults.

Purpose: To assess prognostic factors for adults with medulloblastoma in a multicenter, retrospective study.

Methods And Materials: Data were collected by file review or mail inquiry for 253 adults treated between 1975 to 2004. Radiologists or surgeons assessed disease characteristics, such as volume and extension.

Chemoradiation therapy in pregnant patients treated for advanced-stage cervical carcinoma during the first trimester of pregnancy: report of two cases.

Two patients treated using chemoradiation therapy (CRT) (with fetus in utero) for advanced-stage squamous cell cervical carcinoma diagnosed during the first trimester of pregnancy are reported. One patient with a stage IVA disease diagnosed at 12 weeks of gestation was treated by exclusive CRT with the fetus in utero. She recurred 20 months after the end of the treatment.

[Innovation in gynaecological brachytherapy: new technologies, pulse dose-rate brachytherapy, image, definition of new volumes of interest and their impact on dosimetry: application in a clinical research programme "STIC"].

Brachytherapy plays a fundamental role in the therapeutic approach of patients with stage I-IV cervical carcinoma. Technical modalities have evolved during the last decades: stepping source technology, imaging modalities development, specially IMN, treatment planning system integrating 3D images. Images from CT-Scan and MRI have contributed to a better knowledge of tumoral extension and critical organs.

Endometrial disorders in patients with peritoneal serous papillary carcinoma.

Background: The purpose of this study was to evaluate the incidence rate of endometrial disease, particularly endometrial carcinoma, in patients with primary peritoneal serous papillary carcinoma (PSPC).

Methods: Retrospective review of clinical and histological data from 32 women undergoing surgery (with hysterectomy) for stage III or IV PSPC.

Results: Six patients underwent primary debulking surgery and 26 underwent interval debulking surgery after 3 or 4 courses of platinum-based chemotherapy.

[Medical treatment of metastatic or recurrent cancer of the cervix].

Cervical cancer is the most frequent gynaecological cancer worldwide. Incidence is decreasing in industrialized countries but remains high in poorest countries. In metastatic or recurrent disease, the treatment is more often palliative.

Intercomparison of treatment concepts for MR image assisted brachytherapy of cervical carcinoma based on GYN GEC-ESTRO recommendations.

Purpose: To perform a multicentre intercomparison study of treatment concepts for MRI assisted brachytherapy of cervix cancer based on recommendations of the Gynaecological GEC-ESTRO Working Group.

Methods: Each participating centre (IGR Paris, University Hospital Leuven, Medical University of Vienna) contributed data of one patient with comparable clinical features. GTV, High Risk CTV (HR CTV), Intermediate Risk CTV (IR CTV) and organ walls of bladder, rectum and sigmoid colon were delineated at the time of each brachytherapy fraction on axial MR images with the applicator in place.

Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology.

The second part of the GYN GEC ESTRO working group recommendations is focused on 3D dose-volume parameters for brachytherapy of cervical carcinoma. Methods and parameters have been developed and validated from dosimetric, imaging and clinical experience from different institutions (University of Vienna, IGR Paris, University of Leuven). Cumulative dose volume histograms (DVH) are recommended for evaluation of the complex dose heterogeneity.

[Concomitant chemoradiation in patients with cervix cancer].

Cervical cancer is the 2nd most common cancer among women, behind breast cancer. Concomitant chemoradiation has been assessed in more than 15 randomised clinical trials. A meta-analysis for overall survival showed a statistically significant difference in favour of chemoradiotherapy: relative risk (RR) = 1.

[Results of the Sainte-Anne - Lyons series of 318 oligodendroglioma in adults].

Introduction: Incidence of cerebral oligodendrogliomas is increasing because of better recognition made possible by improved classifications. We studied a homogeneous series using the Sainte-Anne grading scale in order to better understanding the history of these tumors with or without treatment and to assess prognosis and associated factors.

Patients And Methods: A retrospective series of 318 adult patients with oligodendroglioma (OLG) treated at Hôpital Sainte-Anne, Paris (SA) and Hôpital Neurologique, Lyons (L) between 1984 and 2003 was analyzed: 182 grade A OLG (SA + L), 136 grade B among which a homogenous series of 98 (SA) were included.

Chordomas of the base of the skull and upper cervical spine. One hundred patients irradiated by a 3D conformal technique combining photon and proton beams.

To define the prognostic factors for local control and overall survival among 100 consecutive patients with chordoma of the base of skull or upper cervical spine treated by fractionated irradiation combining proton and photon beams. Between December 1993 and August 2002, 100 patients (median age: 53 years [8 - 85], M/F sex ratio: 3/2) were treated by a combination of high-energy photons and protons. The proton component was delivered at the Centre de Protonthérapie d'Orsay (CPO) by a 201 MeV beam.

[Brachytherapy for prostate cancer: high dose rate or low-dose rate?].

Low-dose brachytherapy for prostate cancer was actually proposed in the first years of the XXth century. Its modern version (iodin 125 or palladium 103 permanent implants) now benefits from some 15 years of experience in a few pioneer centers, with very satisfactory results in term of efficacy/toxicity ratio. More recently, a high-dose rate (HDR) prostate brachytherapy technique has been introduced.

Functional outcome of patients with benign meningioma treated by 3D conformal irradiation with a combination of photons and protons.

Purpose: To evaluate efficacy and tolerance of external fractionated combination of photon and proton radiation therapy (RT) for intracranial benign meningiomas.

Methods And Materials: Between 1994 and 2002, 51 patients with intracranial meningiomas of the base of the skull were treated with a combination of photon and proton RT. Median total dose was 60.

[Chordomas of the base of the skull and upper cervical spine. 100 patients irradiated by a 3D conformal technique combining photon and proton beams].

Objective: To define prognostic factors for local control and survival in 100 consecutive patients treated by fractionated photon and proton radiation for chordoma of the skull base and upper cervical spine.

Patients And Methods: Between December 1995 and August 2002, 100 patients (median age: 53 years, range: 8-85, M/F sex-ratio: 3/2), were treated by a combination of high-energy photons and protons. The proton component was delivered by the 201 MeV proton beam of the Centre de Protonthérapie d'Orsay (CPO).

[Laparoscopic total hysterectomy after radiochemotherapy in an obese woman with neuroendocrine carcinoma of the cervix: surgical and anesthesiological aspects].

Massive obesity is an important risk factor in gynaecologic surgery. The traumatic effect of traditional laparotomy on the parietal wall is responsible for important perioperative morbidity. We describe the first reported case of an obese woman (Body Mass Index = 55 kg/m2) with stage IIA neuroendocrine carcinoma of the cervix treated by laparoscopy after radiochemotherapy.

[Use of the functional imaging modalities in radiation therapy treatment planning in patients with glioblastoma].

Glioblastoma multiforme still remains, at present, the most frequent and deadly primary malignant glioma in adult. Despite safer and larger neurosurgical resections, patients almost always relapse very close or inside the tumor bed. Since more than 20 years, radiation therapy (RT) continue delivering the same dose of 60 Gy in 6 weeks, more precisely guided with CT-scanner and magnetic resonance imaging (MRI) in the treatment position.