[Treatment of soft tissue sarcomas of the extremities and the trunk by conservative surgery and postoperative irradiation. Apropos of a series of 96 patients].

Aim Of Study: Retrospective study of a series of 96 patients presenting with soft tissues sarcoma. Homogeneous treatment between 1980-1992 with conservative surgery and post operative irradiation.

Patients And Methods: Median age of the 96 patients was 58 years.

[Sensitivity to etoposide of human malignant glioma cell lines. Mechanisms of action].

Aim Of The Study: Etoposide, a Topoisomerase II inhibitor agent, is currently being explored as a therapeutic agent for brain tumors. The aim of this experimental study was to compare the in vitro etoposide sensitivity of human glioma cells vs human squamous cell carcinoma (SCC) cells.

Material And Methods: Twelve human cell lines (six malignant glioma cell lines and six head and neck SCC cell lines) were used for this comparative study.

[Concomitant chemoradiotherapy in the therapeutic strategy of adenocarcinoma of the exocrine pancreas and stomach].

The prognosis of pancreatic adenocarcinoma remains poor, with a 5-year survival rate lower than 5%. Resection, the gold standard treatment, can be performed in less than 10% of patients. Following surgery, the median survival is 12 months for the most favorable cancer patients.

[Biological principles of chemoradiotherapy].

Radio-chemotherapy combinations, especially their concomitant associations, are widely used in the treatment of cancer. The development of these associations has been so far related more to clinical research than to laboratory experiments. The biological basis of the use of these agents relies on their complementarity which concerns the cellular and molecular mechanisms involved in lethality (hypoxia, sensitivity throughout the cycle, DNA repair, apoptosis), spatial and temporal cooperation, etc.

[Radiotherapy for non-small-cell bronchial cancers: definitions of volumes, patient selection. Recommendations of the International Association for the Study of Lung Cancer (IASLC)].

Chemoradiation is the standard treatment of unresectable, locally advanced non-small cell lung cancer, with a mean dose of 60-66 Gy, excluding escalation dose schemes. The standard treated volume includes primary tumor, ipsilateral hilar and mediastinal nodes, supraclavicular and contralateral nodes as well, regardless of the node status. This work tries to answer the question of the optimal volume to be treated.

[Radiotherapy of cancer of the anal canal. 15 years experience at the Lyon civil hospices and brief review of the literature].

Aim: Retrospective analysis of a series of 287 anal canal carcinomas seen during a 15-year period in the Department of Radiotherapy Oncology of Hospices Civils de Lyon.

Material And Method: Between 1980 and 1995, 287 patients were managed in the radiotherapy department of Hospices Civils de Lyon. In 25 cases, the patients were referred for recurrence.

[Limitations and perspectives of postoperative radiotherapy in bronchial cancer].

The role of postoperative irradiation for lung cancer remains a controversial issue. The available data suggest a reduction in local relapse in cases of positive mediastinal lymph node, but how this benefit translates into survival is not known. The current indications include tumors with positive mediastinal lymph node and incomplete resection with micro- or macroscopical residue.

The role of radiotherapy in the conservative treatment of rectal carcinoma--the Lyon experience.

The purpose of this study was to present the Lyon experience using radiotherapy alone or with surgery, with intent to cure rectal cancer and to avoid rectal amputation. Two groups of patients were treated between 1980 and 1996: Group I with radiotherapy alone with contact x-ray for T1 N0 (101 patients) or with a combination of external beam radiation therapy (EBRT), contact x-ray and 192 iridium implant in inoperable T2-3 N0-1 patients (43 patients); Group II with preoperative EBRT either as a pilot study (158 patients) or in a randomized trial (210 patients). With contact x-ray alone it was possible to control T1 N0 in 90% of cases, and with the combined approach 70% of the inoperable patients were controlled.

Role of radiation therapy in the treatment of primary tracheal carcinoma.

Purpose: The objective of this work is to investigate the role of radiation therapy in the treatment of primary tracheal carcinoma.

Methods And Materials: From 1963 to 1993, 106 patients presenting with a tracheal carcinoma received a radiation course as part of their treatment in three institutions. Eighty-four patients were treated with megavoltage radiation only, receiving doses ranging from 30 to 70 Gy, with a median dose of 56 Gy.

Treatment of anal canal carcinoma with high dose radiation therapy and concomitant fluorouracil-cisplatinum. Long-term results in 95 patients.

Purpose: To evaluate the long-term results of the treatment of anal canal carcinoma (ACC) with a combined concomitant radiochemotherapy (CCRT) treatment using fluorouracil (5 FU) and cisplatinum (CDDP) with a high dose of radiation therapy.

Patients And Methods: Between 1982 and 1993 a series of 95 patients were treated. Staging showed a majority of advanced squamous ACC, i.

Sphincter preservation in rectal cancer. Endocavitary radiation therapy.

Endocavitary radiation therapy (Endo RT) is performed mainly with a contact x-ray tube. Interstitial brachytherapy is a supplementary method to boost the tumor bed. Only strictly selected patients can be treated for cure by Endo RT.

[Radiation- and chemically-induced respiratory manifestations].

There are frequently respiratory complications with cancer particularly in primary lung carcinoma. Among these are bronchopulmonary infections with or without endobronchial obstruction, carcinomatous lymphangitis, thromboembolic disease and haemorrhagic disease as well. Radiotherapy and chemotherapy may induce various respiratory complications which diagnosis can be of varying shades of difficulty.

Etoposide sensitivity of radioresistant human glioma cell lines.

Purpose: Malignant gliomas display aggressive local behavior and are not cured by existing therapy. Etoposide, a topoisomerase-II-inhibitor agent, is one of the most active and useful antineoplastic agents. However, etoposide is not usually used on these tumors.

[Assessment of procarbazine, vincristine and lomustine association (PCV protocol) in oligodendroglioma and mixed glioma].

Effective chemotherapy using PCV (procarbazine, lomustine and vincristine) has been documented in anaplastic oligodendrogliomas and oligoastrocytomas. A pilot study using PCV was conducted for relapsing patients with anaplastic oligodendrogliomas and oligoastrocytomas. Preliminary results are reported.

[Uterine sarcoma treated by surgery and postoperative radiation therapy. Patterns of relapse, prognostic factors and role of radiation therapy].

The objective was to evaluate the results of a combination of surgery and postoperative radiotherapy in patients with uterine sarcoma, to describe the patterns of relapse and to define prognostic factors. From 1980 to 1993, 29 patients (median age: 56 years) presenting with uterine sarcoma have been treated with surgery and postoperative irradiation. The histology was: leiomyosarcoma: 11; carcinosarcoma: 12; stromal sarcoma: 6.

[Late effects of radiations on mature and growing bone].

The physiopathology of radiation-induced bone damage is no completely elucidated. Ionizing radiation may induce an inhibition or an impairment of growing bone. This fact is of particular importance in children, and represents one of the most important dose-limiting factors in the radiotherapeutic management of children with malignant diseases.

[Late effects of radiations on the liver].

Until recently, the liver was classified as a radioresistant organ, although it is in fact highly radiosensitive. The realization that the whole liver could be treated safely only with low doses of radiation led to the conclusion that radiation therapy had an extremely limited role in the treatment of intrahepatic malignancies. A resurgence of interest has been observed with the advent of conformal radiotherapy and the introduction of bone marrow transplantation with total body irradiation.

[Late effects of ionizing radiations on central nervous system, spinal cord and peripheral nerves].

Despite the lack of characteristic features, demyelination is the dominant feature of radiation induced late effects observed in cerebral nervous system and spinal cord. Acute, subacute and chronic changes are described in terms of pathological, clinical and radiological observations. Brain necrosis in adults is rarely noted below 60 Gy in conventional fractionation, while imaging changes are observed with lower doses.

[Biological mechanisms of late effects of ionizing radiations].

The daily practice of radiation oncology is increasingly influenced by the late tolerance of normal tissues. The treatment decision must be based on detailed arguments and the physician's duty to extensively inform his patients is emphasised every day. The incidence and severity of radiation-induced sequelae and late complications can be reduced by decreasing the total dose to the normal tissues, and by decreasing the dose protraction, provided that the interval between fractions remains longer than 6 to 8 hours.