Cancer Radiotherapie最新文献

{"title":"Bronchiolite oblitérante avec organisation pneumonique secondaire à la radiothérapie : revue de la littérature et rapport de cas clinique","authors":"Antoine Ailloud ,&nbsp;Mael Morfin ,&nbsp;Valérie Grangeon ,&nbsp;Laurent Bertoletti ,&nbsp;Jean-Philippe Suchaud ,&nbsp;Amel Rehailia-Blanchard","doi":"10.1016/j.canrad.2024.05.004","DOIUrl":"10.1016/j.canrad.2024.05.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Bronchiolitis obliterans with pneumonic organization, or organizing pneumonia (OP), is an inflammatory disorder of the lungs, which can be triggered following pulmonary attacks of infectious or non-infectious origin. The non-infectious origins of OP include various entities including connective tissue diseases, exposure to toxic substances, medications, autoimmune diseases, and thoracic radiotherapy. The objective of this article is to summarize the literature on post-radiotherapy organized pneumonia, its etiologies, its clinical and radiological characteristics, as well as its treatment.</div></div><div><h3>Materials and methods</h3><div>A systematic review was performed in Medline database using the search engine PubMed. Keywords for the search included cryptogenic organizing pneumonia, bronchiolitis obliterans organizing pneumonia (BOOP), idiopathic organizing pneumonia and radiation, radiotherapy, breast cancer. The selected articles had to study the link between bronchiolitis obliterans with pneumonic organization and radiotherapy.</div></div><div><h3>Results</h3><div>A total of 96 articles were identified. Of these 96 articles, 49 fulfilled the defined selection criteria. Fourteen epidemiological studies were found in the literature. These epidemiological studies have published incidences of post-radiotherapy organizing pneumonia of less than 2.9% for patients treated for breast cancer. The predictive risk factors for bronchiolitis obliterans with pneumonic organization syndrome were age, smoking and the volume of irradiated lung. In a post-radiation context, bronchiolitis obliterans with pneumonic organization could be diagnosed several months, or even up to a year, after the end of irradiation. Treatment was based on the prescription of long-term corticosteroid therapy. Bronchiolitis obliterans with pneumonic organization should not be confused with post-radiation pulmonary fibrosis, which is inflammatory, dose-dependent, non-immunological, and localized in the irradiation area.</div></div><div><h3>Conclusion</h3><div>Organized pneumonia secondary to radiotherapy is a syndrome affecting approximately 1.4 to 3% of patients treated with radiotherapy for breast cancer. The main risk factors found are age, smoking and the volume of lung irradiated. Post-radiotherapy organized pneumonia needs to be known to all radiotherapists to improve patient care.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages 707-718"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformative clinical trials in gynaecologic radiation oncology in 2023–2024: Shaping modern treatment practices","authors":"Zineb El Ayachi ,&nbsp;Alexandra Gabro ,&nbsp;Guillaume Camprodon ,&nbsp;Supriya Chopra ,&nbsp;Philippe Maingon ,&nbsp;Cyrus Chargari","doi":"10.1016/j.canrad.2024.10.002","DOIUrl":"10.1016/j.canrad.2024.10.002","url":null,"abstract":"<div><div>The field of gynaecologic oncology has evolved rapidly in recent years, largely driven by advances in both radiotherapy and systemic therapies. These innovations have reshaped the management of key gynaecologic cancers, including cervical, endometrial, vaginal, and vulvar cancers, leading to more personalized and effective treatment approaches. This review explores pivotal clinical trials conducted between 2023 and 2024 that have potentially modified current practices. Through an extensive analysis of randomized controlled trials and meta-analyses, we examine the evolving role of radiotherapy, the integration and sequencing of immunotherapy, and the refinement of neoadjuvant and adjuvant treatments based on molecular classifications. The combination of immunotherapy with chemoradiotherapy has shown promising outcomes, particularly in patients with locally advanced cervical cancer. For endometrial cancer, molecular profiling has enabled a more precise classification of tumour subtypes, leading to better-targeted adjuvant therapies that reduce unnecessary interventions and increase treatment efficacy. In parallel, radiotherapy has advanced with the increasing use of modern techniques such as intensity-modulated radiotherapy and more recently the developments of adaptive treatments in order to minimize exposure to healthy tissue, thereby reducing toxicity and enhancing patient quality of life. Integration of image-guided brachytherapy and expansion of capabilities with newer generation of brachytherapy applicators have also increased possibilities to achieve efficient local treatments, including in very advanced cases. However, despite progress in common gynaecologic cancers, the management of rare cancers such as vulvar and vaginal cancers continues to face challenges due to limited clinical research and treatment data. This review highlights the transformative potential of these innovations and emphasizes the need for continued research and personalized treatment strategies to optimize patient outcomes in gynaecologic oncology.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages 719-726"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the future of uterovaginal brachytherapy in private practice in France?","authors":"Fabien Mignot ,&nbsp;Antoine Bruna ,&nbsp;Rebecca Msika ,&nbsp;Céline Legrand-Hamon ,&nbsp;Érik Monpetit ,&nbsp;Olivier Bleichner","doi":"10.1016/j.canrad.2024.06.004","DOIUrl":"10.1016/j.canrad.2024.06.004","url":null,"abstract":"<div><div>Private radiotherapy centres treat almost one in two patients in France. However, very few of these centres perform uterovaginal brachytherapy. In this short communication, we look at the reasons for the underdevelopment of uterovaginal brachytherapy in private practice. In our opinion, there are three factors limiting its development: the lack of doctors trained in brachytherapy, the complex and human resource-heavy organisation, and the inadequate and insufficient reimbursement of uterovaginal brachytherapy. This last point seems to be shared by the entire community of radiation oncologist in France, and it is vital that brachytherapy is given its due value, otherwise it will continue to decline.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages 699-702"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Contents","authors":"","doi":"10.1016/S1278-3218(24)00210-5","DOIUrl":"10.1016/S1278-3218(24)00210-5","url":null,"abstract":"","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages e13-e14"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electron radiation therapy: Back to the future?","authors":"Sophie Renard ,&nbsp;Laure Parent ,&nbsp;Ludovic de Marzi ,&nbsp;Pelagia Tsoutsou ,&nbsp;Youlia Kirova","doi":"10.1016/j.canrad.2024.07.013","DOIUrl":"10.1016/j.canrad.2024.07.013","url":null,"abstract":"<div><div>Electron radiotherapy has long been preferred to photons for the treatment of superficial lesions because of its physical characteristics (high dose at the surface, rapid decrease in depth). Other characteristics (penumbra, heterogeneity on an oblique or irregular surface) make them difficult to use. In most indications (skin cancers, head and neck, medulloblastoma), with technical progress, in some cases they have been replaced by intensity-modulated conformal radiotherapy, brachytherapy and contact therapy. Other indications (drainage of mesotheliomas or irradiation of benign lesions) have disappeared. The low frequency of use leads to problems of safety and cost-effectiveness. However, modern photon radiotherapy techniques are still less effective than electrons in specific indications such as total skin irradiation (mycosis fungoides) or certain thin chest wall irradiations after total mastectomy, reirradiation or paediatric treatments without protons. Flash therapy, initiated by electrons, has been developed over the last 10 years, providing high-dose irradiation in an extremely short time. Initial results show good efficacy, with fewer side effects than with conventional radiotherapy. These results are leading to clinical technological developments on a larger scale. Although it has been replaced in most indications by more modern techniques, electron radiotherapy remains essential for targeted indications in specialised centres. The emergence of flash therapy will lead to new indications, on machines equipped with this new technology, which have yet to be defined and are currently the responsibility of specialised teams.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 6","pages":"Pages 553-559"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Études qui changent les pratiques en oncoradiothérapie digestive","authors":"Anouchka Modesto ,&nbsp;Audrey Keller ,&nbsp;Rosine Guimbaud ,&nbsp;Véronique Vendrely","doi":"10.1016/j.canrad.2024.09.004","DOIUrl":"10.1016/j.canrad.2024.09.004","url":null,"abstract":"<div><div>Current events in radiotherapy oncology are marked by the results of strategic trials, particularly for esophageal and rectal cancers. For resectable esophageal adenocarcinoma, results of the ESOPEC study showed a benefit in overall survival from the perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin and docetaxel compared to chemoradiotherapy (41.4<!--> <!-->Gy radiotherapy and carboplatin/paclitaxel chemotherapy). In definitive setting, the CONCORDE study did not show any benefit from dose escalation and the standard dose remains 50<!--> <!-->Gy. For resectable pancreatic cancer, the NRG/RTOG0848 study that compared adjuvant chemotherapy with or without chemoradiotherapy found a significant increase of the 5-year disease-free survival rate in the subgroup of node-negative patients. For rectal cancers, the 7-year update of PRODIGE 23 study confirmed the benefit in disease-free- and overall survival of neoadjuvant folinic acid, fluorouracil, irinotecan and oxaliplatin chemotherapy before chemoradiotherapy of T3, T4 or N+ adenocarcinoma, while the update of the RAPIDO study revealed an unacceptable local recurrence rate in the experimental arm. The update of the OPRA study shows a significantly higher 5-year organ preservation rate in favor of the chemoradiotherapy arm followed by consolidation chemotherapy compared to induction chemotherapy followed by CRT. A phase 2 study, including 41 patients with mismatch repair deficient, locally advanced rectal cancer reported that exclusive treatment with anti-PDL1 immunotherapy (dostarlimab) for 6 months resulted in complete clinical response without the need of additional treatment (neither radiotherapy nor surgery). For anal carcinoma, the analysis of survival and toxicity profiles of patients treated for a small stage T1 or T2 tumor were compared depending on whether they received exclusive radiotherapy or chemoradiotherapy. The addition of chemotherapy to radiotherapy did not show any survival benefit but significantly increased toxicity and the risk of radiotherapy disruption.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 6","pages":"Pages 519-522"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actualités réglementaires en radiothérapie en France en 2024 : enjeux de qualité et sécurité des soins","authors":"Céline Bourgier ,&nbsp;Christophe Hennequin ,&nbsp;Thomas Leroy ,&nbsp;Fabrice Lorchel","doi":"10.1016/j.canrad.2024.08.003","DOIUrl":"10.1016/j.canrad.2024.08.003","url":null,"abstract":"<div><div>With numerous clinical, technological or strategic innovations, radiation therapy is constantly evolving, contributing to major quality and safety issues, in a context where new regulatory standards are required. In this article, we will describe the conditions for implementing and applying the requirements for accreditation, periodic certification and peer audit in France.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 6","pages":"Pages 523-526"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice-changing trials on breast cancer","authors":"Youlia Kirova,&nbsp;Jihane Bouziane,&nbsp;Pierre Loap","doi":"10.1016/j.canrad.2024.07.004","DOIUrl":"10.1016/j.canrad.2024.07.004","url":null,"abstract":"<div><div>There is new data in the fractionation modalities and these are the really the practice-changing trials of last years: can we use hypo fractionated whole breast radiotherapy in patients presented with ductal carcinoma in situ? Can we realize hypofractionated whole breast radiotherapy with simultaneous integrated boost? What about hypofractionated irradiation after mastectomy with reconstruction? Can we do hypofractionation to lymph nodes without risk of increased toxicity? The purpose of this work is to respond with the last evidence-based recently presented or published data.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 6","pages":"Pages 510-512"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of stereotactic radiotherapy in the management of small-cell lung cancer","authors":"François Lucia ,&nbsp;Delphine Antoni ,&nbsp;Loïg Vaugier ,&nbsp;Loïg Duvergé ,&nbsp;Sébastien Thureau ,&nbsp;Vincent Bourbonne","doi":"10.1016/j.canrad.2024.07.015","DOIUrl":"10.1016/j.canrad.2024.07.015","url":null,"abstract":"<div><div>Small-cell lung cancer is the most aggressive form of lung neoplasia, treated in recent decades with chemoradiotherapy in case of limited stage and chemotherapy alone at the metastatic stage. In the last few years, the advent of immunotherapy has changed the landscape in the treatment of non-small-cell lung cancer, and to a lesser degree in small-cell lung cancer. Despite the recent advances in research, small-cell lung cancer is still considered an aggressive and lethal disease characterized by high recurrence or metastatic potential. As stereotactic radiotherapy has established itself as the standard of care in the early stage of inoperable non-small-cell lung cancer and in metastatic disease to treat brain and extracranial metastases, these same issues now arise in the management of small-cell lung cancer. This article aims to review the current knowledge and the potential of stereotactic radiotherapy in small-cell lung cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 6","pages":"Pages 628-632"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survenue d’un évènement ou d’une erreur en oncologie radiothérapie : concilier les perspectives pour préserver le soin","authors":"Thibaud Haaser ,&nbsp;Yannis Constantinides ,&nbsp;David Osman ,&nbsp;Lucien Lahmi ,&nbsp;Catherine Durdux ,&nbsp;Vincent Bourbonne ,&nbsp;Véronique Cheval ,&nbsp;Renaud de Crevoisier ,&nbsp;Catherine Dejean ,&nbsp;Angélique Ducteil ,&nbsp;Alexandre Escande ,&nbsp;Cédric Gesbert ,&nbsp;Youssef Ghannam ,&nbsp;Claire Lemanski ,&nbsp;Sébastien Thureau ,&nbsp;Jean-Léon Lagrange ,&nbsp;Florence Huguet ,&nbsp;Commission éthique de la Société française de radiothérapie oncologique (SFRO)","doi":"10.1016/j.canrad.2024.07.017","DOIUrl":"10.1016/j.canrad.2024.07.017","url":null,"abstract":"<div><div>The term “event” covers a wide range of concrete situations in radiation oncology, from particularly intense radiation-related side effects to the possibility of technical or human error. Although quality procedures are an integral part of radiotherapy oncology department operations ensuring the analysis and prevention of such events, their occurrence during radiation treatment still has a significant impact on patients and their experience of the treatment process, as well as on health professionals. These practical, emotional and symbolic impacts are all the greater when the event occurs in the aftermath of an error. The ethical approach therefore comprises three essential stages: recognizing the event as such, informing those involved of the event and, finally, creating conditions for the continuation of care. Each of these stages is marked by specific issues and questions, requiring a complex ethical approach that constantly involves reconciling the possible divergent perceptions of patients and health professionals. The occurrence of an event can also lead to a genuine crisis of confidence with multiple dimensions, which health professionals will also have to face and to support. Finally, the occurrence of an event calls into question not only our responsibility towards patients, but also our ideal of control. We need to criticize our culture of performance, rethink our approach to events and errors, and see them also as opportunities for positive change.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 6","pages":"Pages 527-533"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}