[Radiotherapy of carcinomas of the anal canal. Tenon Hospital experience].

Since 1980, curative-intent radiation therapy of epidermoid carcinoma of the anal canal is the standard first line treatment. The combined concomitant chemotherapy and radiation therapy is presently established for locally advanced tumors more than 4 cm in length and/or with nodal involvement. We report the Tenon hospital experience since 1972 concerning the long term results after radiation therapy, the modifications of the radiation technique, and the evolution of treatment strategy.

[Locoregional recurrence of adenocarcinomas of the rectum treated with irradiation combined with or without excision surgery].

Purpose: Retrospective study to analyze the results of external beam radiation treatment with or without surgery for loco-regional recurrence of adenocarcinoma of the rectum following previous surgery without pre- or post-operative radiotherapy.

Patients And Methods: Between March 1973 and November 1991, 211 patients with loco-regional recurrence of rectum cancer were treated with external beam radiation treatment. Radical surgery was the only initial treatment modality.

Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer.

Purpose: To identify predicting factors for local failure and increased risk of distant metastases by statistical analysis of the data after breast-conserving treatment for early breast cancer.

Methods And Materials: Between January 1976 and December 1993, 528 patients with nonmetastatic T1 (tumors < or = 1 cm [n = 197], >1 cm [n = 220]) or T2 (tumors < or = 3 cm [n = 111]) carcinoma of the breast underwent wide excision (n = 435) or quadrantectomy (n = 93) with axillary dissection (negative nodal status [n-]: 396; 1-3 involved nodes: 100; >3 involved nodes: 32). Radiotherapy consisted of 45 Gy to the entire breast via tangential fields.

Total-body irradiation before bone marrow transplantation for acute leukemia in first or second complete remission. Results and prognostic factors in 326 consecutive patients.

Aim: In order to assess the influence of total-body irradiation (TBI) on the outcome and incidence of complication after bone marrow transplantation (BMT), we retrospectively analyzed our patients treated for acute leukemia and conditioned with TBI prior to BMT.

Patients And Methods: Between 1980 and 1993, 326 patients referred to our department with acute non-lymphoblastic leukemia (ANLL, n = 182) and acute lymphoblastic leukemia (ALL, n = 144) in complete remission underwent TBI either in single dose (190 patients: 10 Gy administered to the midplane, and 8 Gy to the lungs [STBI]) or in 6 fractions (136 patients: 12 Gy on 3 consecutive days, and 9 Gy to the lungs [FTBI]) before BMT. The male-to-female ratio was 204/122 (1.

Primary chemotherapy and preoperative irradiation for patients with stage II larger than 3 cm or locally advanced non-inflammatory breast cancer.

Background And Purpose: To evaluate possibility of breast-conserving therapy and outcome for patients with locally advanced non-inflammatory breast cancer (LABC) and stage II >3 cm in diameter after primary chemotherapy (CT) followed by external preoperative irradiation (RT).

Materials And Methods: Between 1982 and 1990, 147 patients were treated by four courses of induction CT (doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil) followed by preoperative RT (45 Gy to the breast and nodal areas) and a fifth course of CT. Three different loco-regional approaches were proposed depending on tumour characteristics and tumour response.

Total body irradiation prior to bone marrow transplantation: efficacy and safety of granisetron in the prophylaxis and control of radiation-induced emesis.

Purpose: Radiation-induced emesis is one of the most disturbing side effects of total body irradiation (TBI). To evaluate the efficacy and to determine the best schedule of granisetron (a selective 5-hydroxytryptamine3 serotonin receptor antagonist) administration in the prevention of radiation-induced nausea and vomiting, we conducted a trial involving patients receiving single-dose TBI before bone marrow transplantation (BMT).

Methods And Materials: Thirty-six patients with non-Hodgkin's lymphoma (n = 12), multiple myeloma (n = 8), acute lymphoblastic leukemia (n = 7), acute nonlymphoblastic leukemia (n = 6), and chronic myeloid leukemia (n = 3) referred to our department between March 1992 and February 1994 were enrolled in this study to assess the efficacy of granisetron during single-dose TBI before autologous BMT (n = 26), allogeneic BMT (n = 8), or syngeneic BMT (n = 2).

Remote instrument telemaintenance.

In the past decade, great technological progress has been made in telemaintenance of mainframe and mini computers. As hardware technology is now available at an acceptable cost, computer aided trouble-shooting can be adapted to laboratory instrumentation in order to significantly improve repair time, avoid instrument downtime by taking advantage of predictive methods, and provide general diagnostic assistance. Depending on the size of the instrument, the telemaintenance facility can be dedicated to a single instrument or alternatively a telemaintenance server can manage multiple distributed small instruments through a Local Area Network.

Cataractogenesis after total body irradiation.

Purpose: To evaluate the prognostic factors and the ophthalmologic follow-up on cataract formation following total body irradiation (TBI) prior to bone marrow transplantation (BMT).

Methods And Materials: Between 1980 and 1992, 494 patients were referred to our department for TBI prior to BMT. The mean age was 32 +/- 11 (median: 32, range: 2-63) years and the male to female ratio was 1.

Possibility of conservative local treatment after combined chemotherapy and preoperative irradiation for locally advanced noninflammatory breast cancer.

Purpose: The aims of this prospective study were to evaluate the outcome and the possibility of breast conservation therapy for patients with locally advanced noninflammatory breast cancer after primary chemotherapy followed by external preoperative irradiation.

Methods And Materials: Between April 1982 and June 1990, 97 patients with locally advanced nonmetastatic and noninflammatory breast cancer were treated. The median follow-up was 93 months from the beginning of treatment.

Interstitial pneumonitis following autologous bone-marrow transplantation conditioned with cyclophosphamide and total-body irradiation.

Purpose: To assess the influence of different total-body irradiation (TBI) regimens on interstitial pneumonitis (IP), we retrospectively analyzed our clinical data concerning an homogeneous group of patients conditioned with cyclophosphamide (CY) alone and single-dose or fractionated TBI before autologous bone-marrow transplantation (ABMT).

Methods And Materials: One hundred eighty-six patients with acute nonlymphoblastic leukemia (n = 101), acute lymphoblastic leukemia (n = 62), chronic myeloid leukemia (n = 11), non-Hodgkin's lymphoma (n = 10), and multiple myeloma (n = 2) referred to our department between May 13, 1981 and September 16, 1992, underwent TBI before ABMT. The male-to-female ratio was 123:63 (1.

[Radiation injury of the small intestine. Radiobiological, radiopathological aspects; risk factors and prevention].

Small bowel radiolesions are a dose-limiting factor in radiotherapy of the abdomen ether administered alone or in combination with surgery and/or chemotherapy. Acute radiolesions on the small intestine are frequent and related to the rapid turnover of mucosal cells. The acute effects of radiation are rapidly regressive after completion of radiation therapy.

[The first century of radiotherapy in France].

The first X-ray treatment ever given to a patient was done by Victor Despeignes of Lyon, five months after Roentgen's discovery. The first brachytherapies with radium emanation (radon) were performed a few years after the discovery (March 1st, 1896) of natural radioactivity by Becquerel and that of radium by the Curies (December 28, 1898). Marie Curie organised the Radium Institute and personally calibrated more than five thousand sources of radium disseminated in various French cancer departments.

Is veno-occlusive disease incidence influenced by the total-body irradiation technique?

Background: In order to assess the influence of total-body irradiation technique on veno-occlusive disease (VOD) incidence, we retrospectively analyzed our leukemia patients treated with bone-marrow transplantation conditioned using total-body irradiation and high-dose chemotherapy.

Patients And Methods: Between 1980 and 1992, 305 patients with acute non-lymphoblastic leukemia (ANLL; n = 170) and acute lymphoblastic leukemia (ALL; n = 135) were treated with bone-marrow transplantation in their first complete remission (CR; n = 223) or in second CR (n = 82). All patients underwent total-body irradiation either in single dose (n = 176; 10 Gy to L4, 8 Gy to the lungs) or in 6 fractions (n = 129; 12 Gy in 3 consecutive days to L4, 9 Gy to the lungs) before bone-marrow transplantation.

Epidermoid carcinoma of the anal margin: 17 cases treated with curative-intent radiation therapy.

Between 1973 and 1991, 17 patients with epidermoid carcinoma of the anal margin without evidence of distant metastasis were treated with curative-intent radiation therapy (RT). There were nine T1-tumors, six T2-, one T3- and one T4-tumor; two patients presented with inguinal node involvement: one N1 and one N3. Nine patients underwent prior incomplete local excision (six with microscopic involvement of surgical margins and two with macroscopic residual disease).

[Which equipment for proton therapy of the future?].

The success of proton therapy depends on its cost. Hospital based equipment in fabrication for the Massachusetts General Hospital in Boston costs in the excess of 17 millions dollars, the accelerator being only a fraction of the cost. We think that price can be significantly decreased.

Synchronous and metachronous head and neck carcinomas.

Background: The incidence of head and neck cancer is increasing. To improve the survival of head and neck cancer patients, an effective program of screening and/or chemoprevention of second malignancies is essential. An analysis of the incidence, time to development, and risk factors of second malignant tumors in head and neck cancer patients can contribute to the design of effective screening and chemoprevention programs.

Morbidity After Total Body Irradiation.

High-dose chemotherapy and total body irradiation with either allogeneic or autologous bone-marrow rescue has been used successfully in the treatment of various hematologic malignancies. Total body irradiation, despite its acute and late side effects, combined with cyclophosphamide remains one of the best conditioning regimens before bone marrow transplantation. Interstitial pneumonitis and veno-occlusive disease are major and lethal complications following bone marrow transplantation.

Epidermoid carcinoma of the anal canal. Results of curative-intent radiation therapy in a series of 270 patients.

Background: Epidermoid carcinoma of the anal canal is an uncommon disease, and most institutions have only a small series of patients. The current study of a large series of patients treated with radiation therapy in a single institution evaluates the outcome, prognostic factors, and the late complications for these patients.

Methods: From 1972 to 1991, 270 patients with anal canal epidermoid carcinoma without evident distant metastasis were irradiated with curative intent in the Radiotherapy Department of Tenon Hospital.

[Cancer of the anal canal; role of radiotherapy and combinations of chemotherapy and radiotherapy].

Carcinoma of the anal canal is a rare disease, more common in women than in men. The mean age distribution at presentation is about 60 years. The natural history is mainly loco-regional, distant metastases being uncommon.

Multidisciplinary treatment approach to locally advanced non-inflammatory breast cancer using chemotherapy and radiotherapy with or without surgery.

Between April 1982 and December 1987, 82 locally advanced non-metastatic and non-inflammatory breast cancers were treated (42 stage IIIA, 40 stage IIIB). The median follow-up is 70 months from the beginning of the treatment. The initial treatment consisted of 4 courses of chemotherapy (doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil) followed by irradiation (45 Gy to the breast and nodal area).