CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC,RTOG consensus guidelines.

Background And Purpose: The appropriate application of 3-D CRT and IMRT for HNSCC requires a standardization of the procedures for the delineation of the target volumes. Over the past few years, two proposals--the so-called Brussels guidelines from Grégoire et al., and the so-called Rotterdam guidelines from Nowak et al.

Intramural neovascularization and haemorrhages are major long-term effects of intravascular gamma-radiation after stenting.

Structural changes that might influence the structural integrity of the vessel in response to intravascular brachytherapy (IVB) and stenting were examined, focus being on the importance of neovascularization in rabbit stented arteries. Stents were implanted in the infrarenal aortas of rabbits, immediately followed by gamma IVB or a sham radiation procedure, and the arteries harvested at 6 months. Labelling for von Willebrand factor showed an increase in adventitial and medial neovascularization in irradiated versus control arteries group (5.

Outcome and prognostic factors in orbital lymphoma: a Rare Cancer Network study on 90 consecutive patients treated with radiotherapy.

Purpose: To assess the outcome and prognostic factors in patients with orbital lymphoma treated by radiotherapy (RT).

Methods And Materials: Between 1980 and 1999, 90 consecutive patients with primary orbital lymphoma were treated in 13 member institutions of the Rare Cancer Network. A full staging workup was completed in 56 patients.

[Cancer of the rectum: target volumes for preoperative radiotherapy].

Preoperative radiotherapy is the standard treatment for locally advanced resectable rectal adenocarcinoma. The total mesorectal excision leads to a dramatic increase of local control rate. Thus, the mesorectal space is the usual field for the spread of rectal cancers cells.

[Target-volume and critical-organ delineation for conformal radiotherapy of prostate cancer: experience of French dose-escalation trials].

The delineation of target volume and organs at risk depends on the organs definition, and on the modalities for the CT-scan acquisition. Inter-observer variability in the delineation may be large, especially when patient's anatomy is unusual. During the two french multicentric studies of conformal radiotherapy for localized prostate cancer, it was made an effort to harmonize the delineation of the target volumes and organs at risk.

[Target-volume contours in radiotherapy. General principles].

Target volume delineation remains an important medical step for conformal radiotherapy. In this general presentation are discussed: the main difficulties for evaluation of gross tumor (GTV) and clinical target volume (CTV), the main recommendations for representation according to ICRU 62 report, differences observed during inter-observer volume comparisons.

[Adenocarcinomas of the distal esophagus and gastric cardia: non-surgical management].

Dedicated studies to esophageal carcinomas are few. Surgical excision remains the treatment of choice for localised tumours. External beam radiation therapy could be used alone to obtain a quick palliation and to allow the recovery of normal eating.

[Tumors of the facial sinuses].

Nasal cavity and paranasal sinus carcinomas represent a small number of head and neck tumors (3 to 4%). Their management has been improved by modern imaging techniques to define operative procedures and deliver high-precision radiotherapy. Surgery is one of the most important components of treatment.

[Clinical target volume for preoperative radiotherapy of rectal cancers].

The total mesorectal excision allows the marked increase of the local control rate in rectal cancer. Therefore, the mesorectal space is the usual field for the spread of rectal cancer cells. It could therefore be considered as the clinical target volume in the preoperative plan by the radiation oncologist.

[Multicenter study on dose escalation with conformal and conventional radiotherapy for the treatment of localized prostatic cancer. Preliminary results of tolerance and quality of life].

Objective: To study the safety of conformal radiotherapy dose escalation up to 80 Gy for curative treatment of prostate cancer.

Material And Methods: A multicentre trial sponsored by the PHRC include 164 patients under the age of 75 years with stage T1b-T3 N0 M0 prostatic adenocarcinoma, between 1995 and 1998. The prostate was treated at 5 dose levels: 18 patients at 66 Gy, 28 at 70 Gy, 49 at 74 Gy, 48 at 78 Gy, 21 at 80 Gy.

[Secondary effects of brachytherapy in the treatment of coronary restenosis].

Brachytherapy is proposed for the treatment or prevention of coronary restenosis with encouraging results, especially in intra-stent restenosis. The results of the first clinical studies show benefit, for example those of the American SCRIPPS trial with a 3 year follow-up. However, recent reports in the literature have described secondary effects associated with this technique: 1) stenoses occurring at the limits of the irradiated segments which are attributed to a proliferative effect of low doses on damaged tissue; 2) late occlusions at the irradiated site: their incidence is estimated at 9% at 6 months.

[Assessment of the use of electronic portal imaging].

Improvement in the accuracy of the positioning of the patient during external irradiation is one of the most important issues of the last decades, due to the detrimental impact of the misplacements on treatment outcome. Since 1990, the evolution of the technologic environment has led to a full integration of the portal imaging devices into linac technology. It offers a real on-line verification tool for "high-dose, high-accuracy" treatments.

[Patient positioning and its verification: justification, state of the art of the classical practices].

Patient immobilization is considered an important part of the quality control program in radiation therapy. The need for patient immobilization according to the symptoms, ensuring both reproducibility and comfort, is described in the recommendations for level 1 published by the SFPM (Société française de physique médicale) and the SFRO (Société française de radiothérapie oncologique). A customized device, associated with regular controls, is required for level 2.

Changes in the practice of adjuvant radiotherapy in resectable rectal cancer within a French well-defined population.

Background And Purpose: To assess the use of adjuvant radiotherapy in treating rectal cancers at a population level.

Materials And Methods: From 1976 to 1996, the influence of the period of diagnosis, sex, age, type of surgical resection, place of surgical resection on the use of radiotherapy was studied. A non-conditional logistic regression was performed to obtain the odds radio for each studied period adjusted for the other variables.

Dose escalation with 3D-CRT in prostate cancer: French study of dose escalation with conformal 3D radiotherapy in prostate cancer-preliminary results.

Purpose: To evaluate the feasibility of dose escalation in a multi-institutional study in prostate cancer patients.

Methods And Materials: Between October 1995 and October 1998, 164 patients with localized adenocarcinoma of the prostate were treated with 3-dimensional conformal radiotherapy at one of five French institutions. The dose of radiation was escalated from 66 to 80 Gy (ICRU point).

Impact on treatment outcome and late effects of customized treatment planning in cervix carcinomas: baseline results to compare new strategies.

Purpose: The aim of the study was to determine the predictive factors of complications, to evaluate the impact of customized treatment planning on late normal tissue effects per stage, and to report disease-free survival (DFS) and local control (LC) rates.

Methods And Materials: From 1970 to 1994, 642 patients were treated with radiotherapy alone for carcinoma of the intact uterine cervix. According to the International Federation of Gynecology and Obstetrics (FIGO) substaging, 34% were Stage I, 39% Stage II, and 27% Stage III.

[Complications of treatments of invasive cancers of the uterine cervix with intact uterus: results and prevention].

The prospective record of acute and late toxicity after treatment of cervix carcinomas is a part of the description of treatment outcome as well as local control and survival. Due to the large number of scales and glossaries used, the comparison of the results from one study to another is often difficult. The French-Italian syllabus seems to be the most reliable scale, providing implementation of quality of life assessments.

[Evolution of the use of the portal imaging device: prospective study over three years].

Purpose: To describe the evolution of the use of the electronic portal imaging device (EPID) over three periods.

Material And Methods: From 1990, as part of the quality assurance research programs, the radiotherapy department of the G.-F.

A survey on staging and treatment in uterine cervical carcinoma in the Radiotherapy Cooperative Group of the European Organization for Research and Treatment of Cancer.

Background: The treatment outcome of advanced stage uterine cervical carcinoma remains unsatisfactory. In order to elaborate a novel trial within The Radiotherapy Cooperative Group (RCG) of the European Organization for Research and Treatment of Cancer (EORTC), we conducted a survey in 1997-1998 to determine the variability of pre-treatment assessment and treatment options. The variability of choosing surgery, defined radiation therapy techniques and chemotherapy are investigated, as well as the center's choices of future treatment strategies.

Radiotherapy of advanced mycosis fungoides: indications and results of total skin electron beam and photon beam irradiation.

Background: The goals of this retrospective study of advanced mycosis fungoides are (1) to describe the indications of a combination of total skin electron beam and photon beam irradiation and (2) to analyze the results of total body or segmental photon irradiation for patients with extension beyond the skin.

Methods: From January 1975 to December 1995, 45 patients with pathologically-confirmed mycosis fungoides or Sézary syndrome received a combination of TSEB and photon beam irradiation for advanced disease: 34 males and 11 females, mean age 61 years (range 27-87 years). The mean follow-up was 111 months (range 18-244 months, median 85 months).

Preoperative radiochemotherapy in rectal cancer: long-term results of a phase II trial.

Purpose: To assess toxicity and long-term results of preoperative chemoradiotherapy in rectal cancer.

Methods And Materials: Between 1989 and 1997, as a phase II study, 66 patients with T3 M0, rectal cancer received preoperatively a 45 Gy dose pelvic radiotherapy (XRT) combined with two 5-day chemotherapy courses (CT) of 5-Fluorouracil (5-FU) and Leucovorin (LV) delivered the first and fifth week of XRT. For each CT course, LV:20 mg/m2/d1-d5,.