Image-mode performance characterisation of a positron emission tomography subsystem designed for Biology-guided radiotherapy (BgRT).

Objectives: In this study, we characterise the imaging-mode performance of the positron emission tomography (PET) subsystem of the RefleXion X1 machine using the NEMA NU-2 2018 standard.

Methods: The X1 machine consists of two symmetrically opposing 90 arcs of PET detectors incorporated into the architecture of a ring-gantry linear accelerator rotating up to 60 RPM. PET emissions from a tumour are detected by the PET detectors and used to guide the delivery of radiation beam.

Manual vs. automated implantation of seeds in prostate brachytherapy: Oncologic results from a single-center study.

Purpose: The objective of this study was to study survival and tolerance of prostate cancer patients treated with I permanent interstitial brachytherapy by automated vs. manual implantation of seeds.

Methods And Materials: Between 2002 and 2010, 349 selected patients were treated with I brachytherapy by the same team: from 2002 to April 2005, 65 patients with linked seeds and then 284 patients treated using Nucletron First System automated implantation.

Post-Prostatectomy Image-Guided Radiotherapy: The Invisible Target Concept.

In the era of intensity-modulated radiation therapy, image-guided radiotherapy (IGRT) appears crucial to control dose delivery and to promote dose escalation while allowing healthy tissue sparing. The place of IGRT following radical prostatectomy is poorly described in the literature. This review aims to highlight some key points on the different IGRT techniques applicable to prostatic bed radiotherapy.

Repeated Thrombosis After Synthetic Cannabinoid Use.

Background: Synthetic cannabinoids are swiftly gaining popularity and have earned a reputation of being relatively safer than other illicit drugs. However, there is a growing body of literature associating thromboembolic events with their use.

Case Report: A 32-year-old woman presented on four separate occasions with a new thromboemoblic event after smoking synthetic cannabinoids.

Role of Adjuvant Radiation Therapy After Surgery for Abdominal Desmoplastic Small Round Cell Tumors.

Purpose: To identify the prognostic role of adjuvant abdominal radiation therapy (RT) on oncologic outcomes as a part of multimodal treatment in the management of desmoplastic small round cell tumor (DSRCT) and to determine its impact according to the quality of surgical resection.

Methods And Materials: All patients treated for primary abdominal DSRCT in 8 French centers from 1991 to 2014 were included. Patients were retrospectively staged into 3 groups: group A treated with adjuvant RT after cytoreductive surgery, group B without RT after cytoreductive surgery, and group C by exclusive chemotherapy.

PIK3CA Pathway Mutations Predictive of Poor Response Following Standard Radiochemotherapy ± Cetuximab in Cervical Cancer Patients.

Purpose: EGFR is frequently overexpressed in cervical cancer, suggesting EGFR blockade as a promising treatment approach. Cetuximab, an anti EGFR antibody, used conjointly with radiochemotherapy, was feasible in first-line treatment of cervix carcinoma limited to the pelvis.

Experimental Design: This randomized phase II trial enrolled 78 FIGO stage IB2-IIIB cervical cancer patients to either cisplatin-based radiochemotherapy alone (arm B, n = 38) or conjointly with a 6-week course of weekly cetuximab (arm A, n = 40).

Progress in survival outcomes in patients with advanced ovarian cancer treated by neo-adjuvant platinum/taxane-based chemotherapy and late interval debulking surgery.

Background: Steady progress in outcomes has been observed after standard treatment by surgery and chemotherapy in patients with advanced ovarian cancer (AOC), but little is known about outcomes after alternative neoadjuvant chemotherapy (NAC) proposed to primary inoperable patients. We assessed whether NAC offers comparable survival to standard treatment, whether survival rates have progressed over time, and what the optimal extent of surgery at late interval debulking surgery (IDS) should be.

Methods: This was a retrospective data analysis of prospectively recorded patients with poor prognosis AOC treated by platinum/taxane NAC and late IDS (after six cycles).

Pulsed-dose-rate brachytherapy for uterine cervix carcinoma: 10 years of experience with 226 patients at a single institution.

Purpose: To analyze the long-term results of pulsed-dose-rate (PDR) brachytherapy (BT) in cervical carcinoma patients treated at a single institution.

Methods And Materials: All patients with histopathologically proven Stages IB-IVA cervical carcinoma, treated at our institution with PDR intracavitary BT between April 1996 and November 2007, were included in this retrospective analysis. All patients underwent primary pelvic radiotherapy (45 Gy) with concomitant chemotherapy from 1999 and PDR intracavitary BT (16 Gy to the clinical target volume), followed by hysterectomy in 124 patients.

A large retrospective multicenter study of vaginal melanomas: implications for new management.

The outcome of patients presenting with vaginal melanoma has been assessed in a large multicentric retrospective study. The databases of 12 French institutions were searched for primary vaginal melanomas managed between 1990 and 2007. Among the 54 patients recorded, 46 were managed with a curative intent and included in the study.

Ewing's sarcoma: A case report of a 52-year-old woman with recurrent tumor and literature review.

Ewing's sarcoma is the second most common primary sacral tumor. Ewing's sarcomas are rare, aggressive tumors with a tendency towards recurrence following resection and early metastasis. Although peak incidences are between the ages of 10 and 20 years, patients of younger or older age account for almost 30% of the cases.

Impact of dosimetric and clinical parameters on clinical side effects in cervix cancer patients treated with 3D pulse-dose-rate intracavitary brachytherapy.

Background And Purpose: To assess the association between dosimetric/clinical parameters and gastrointestinal/urinary grade 2-4 side effects in cervix cancer patients treated with 3D pulse dose rate brachytherapy.

Materials And Methods: Three hundred and fifty-two patients received brachytherapy associated with external-beam radiotherapy (EBRT) for 266 of them; 236 patients underwent surgery. The doses for the most exposed 2, and 0.

Impact of 3D image-based PDR brachytherapy on outcome of patients treated for cervix carcinoma in France: results of the French STIC prospective study.

Purpose: In 2005 a French multicentric non randomized prospective study was initiated to compare two groups of patients treated for cervix carcinoma according to brachytherapy (BT) method: 2D vs 3D dosimetry. The BT dosimetric planning method was chosen for each patient in each center according to the availability of the technique. This study describes the results for 705 out of 801 patients available for analysis.

[Advanced endometrial carcinoma: primary debulking surgery or neoadjuvant chemotherapy?].

Endometrial cancers with peritoneal spread are stage IVB of FIGO classification. Their pattern is similar to that of ovarian cancer. Optimal debulking surgery and chemotherapy are predictor of better overall and disease free survival.

Cardiac arrhythmias and sudden unexpected death in epilepsy (SUDEP).

Sudden unexpected death in epilepsy (SUDEP) is a major clinical problem in epilepsy patients in the United States, especially those with chronic, uncontrolled epilepsy. Several pathophysiological events contributing to SUDEP include cardiac arrhythmias, respiratory dysfunction, and dysregulation of systemic or cerebral circulation. There is a significant body of literature suggesting the prominent role of cardiac arrhythmias in the pathogenesis of SUDEP.

Optimal timing of interval debulking surgery in advanced ovarian cancer: yet to be defined?

Objectives: Interval debulking surgery (IDS) following neo-adjuvant chemotherapy (NAC) is a treatment option in advanced ovarian cancer. It is recommended to perform IDS early, after 3 cycles of NAC, but late IDS (after 6 cycles) may yield better results. Delaying IDS, however, harbours the risk of loosing the opportunity for debulking surgery.

Clinical practice guidelines for the management of patients with endometrial cancer in France: recommendations of the Institut National du Cancer and the Société Française d'Oncologie Gynécologique.

Introduction: Endometrial cancer is the most common gynecological malignancy in France, with more than 6500 new cases in 2010. The French National Cancer Institute has been leading a clinical practice guidelines (CPG) project since 2008. This project involves the development and updating of evidence-based CPG in oncology.

High-dose-rate brachytherapy for non-small-cell lung carcinoma: a retrospective study of 226 patients.

Purpose: To evaluate the efficacy and toxicity of high-dose-rate (HDR) brachytherapy in patients with inoperable endobronchial carcinoma.

Methods And Materials: We retrospectively reviewed the records (April 1991-May 2004) of patients with non-small-cell carcinoma, with no extrabronchial spread on computed tomography scans, who underwent HDR brachytherapy because of contraindications to surgery and external beam radiation therapy. Kaplan-Meier survival curves were compared by the log-rank test.

Lymph node involvement in epithelial ovarian cancer: sites and risk factors in a series of 355 patients.

Objectives: To perform a cartography of lymph node metastases in epithelial ovarian cancer and to determine predictive factors of lymph node metastases.

Method: The charts of 355 patients with epithelial ovarian cancer who underwent lymphadenectomy during a primary (n = 252) or secondary debulking surgery (n = 103) were analyzed. The topography of the lymph node metastases was notified for the whole group according to the stage of the disease, the histological type, and the moment of surgery.

Prognostic factors in early-stage leiomyosarcoma of the uterus.

Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas.

A review of risk factors for stroke in patients with chronic kidney disease.

Background: Patients with chronic kidney disease (CKD) are at higher risk for stroke because of higher prevalence of traditional and non-traditional cardiovascular risk factors.

Methods: We performed an extensive literature review with pre-defined keywords. We summarized the results of the studies evaluating for risk factors predisposing to stroke in CKD patients.

Treatment of squamous cell anal canal carcinoma (SCACC) with pulsed dose rate brachytherapy: a retrospective study.

Background And Purpose: To evaluate the results of pulsed dose rate brachytherapy (PDR) in SCACC.

Material And Methods: From 1996 to 2002, 71 patients (pts) with SCACC were treated with PDR brachytherapy. The median age was 61.

Low-dose intraoperative brachytherapy in soft tissue sarcomas involving neurovascular structure.

Background And Purpose: To evaluate intraoperative brachytherapy in the management of soft tissue sarcomas involving neurovascular structures, its impact on local control and complications.

Patients And Methods: Between 01/1989 and 12/2002, 98 patients received an intraoperative implant in conjunction with conservative surgery. Brachytherapy was part of the initial treatment (79 cases) or performed in recurrent disease (19 cases).

Management of soft tissue sarcomas (STS) in first isolated local recurrence: a retrospective study of 83 cases.

Purpose: To analyze the management and clinical outcome of patients treated for a first isolated local recurrence of soft tissue sarcomas (trunk or extremities) and to identify prognosis factors.

Methods And Material: Between 1980 and 1999, 83 adult patients were included in the study. Mean age was 61 years.