No abstract available

[en] Between June 1970 and April 1982, 592 patients with unilateral T1 and small T2 breast cancers were managed conservatively at the Institut Gustave-Roussy. The treatment policy for the axilla was to perform a lower axillary dissection and to proceed to axillary clearance ( +/- radiotherapy) in patients with axillary invasion by tumor (N+). Some N+ patients had only lower axillary dissection and radiotherapy. Five hundred fifty-eight patients underwent axillary surgery which was a lower axillary dissection in 374 patients (67%) and axillary clearance in 184 patients (33%). There was axillary invasion in 198 cases (36%). Only five patients relapsed in the axilla and the probability of axillary relapse at 5 years was 1.2%. There were no axillary relapses in N+ patients who had had an axillary clearance whether irradiated or not. The incidence of upper limb complications was significantly greater in patients undergoing axillary surgery and radiotherapy compared with axillary surgery alone. It is concluded that a lower axillary dissection accurately identifies N-patients and an axillary clearance in N+ patients ensures good local control and avoids the morbidity associated with axillary irradiation

[en] To evaluate the long-term effects of skin angioma irradiation, a recall programme was established which included the systematic recalculation of the radiation dose to the skin and the thyroid. 22% of the 6229 patients contacted had a dermatological examination which revealed cutaneous dystrophy in 81% of the 1137 exposed angiomas and in 39% of the 208 unexposed angiomas. The risk of dystrophy was 12.1 higher among patients who had received a surface skin dose above 20 Gy than among those who had received a dose of 10 Gy or less. The relative risk for each dystrophy component increased significantly with surface skin dose. Furthermore, 14 basal cell carcimonas (BBC) were observed in 12 patients from the exposed group for all quantities of radiation, with a mean latency period of 22 years. No BBC was observed for a surface skin dose below 10 Gy. Thyroid testing was done on a subgroup of 431 patients whose thyroid gland had been particularly exposed during angioma irradiation. After recalculation, the dose delivered to the gland was below 1 Gy in 98% of patients. Only 13 thyroid nodules were discovered. Although no morphological abnormality was found in 98% of the tested patients, most (92%) had a thyroid iodine content below 15 mg while a raised serum thyroglobulin level was observed in 17%. This might confer a higher risk of subsequently developing thyroid nodules. (author)

[en] Published in summary form only

No abstract available

[en] The efficiency of the two irradiation modes are similar, but the hyperfractionated irradiation seems superior in term of global and specific survival. The incidence rates of pneumopathies are not different between the two groups but the incidence rate of the liver vein-occlusive illness is superior in the group treated by non fractionated whole body irradiation. The cost of the hyperfractionated whole body irradiation is superior to this one of the non fractionated whole body irradiation around a thousand dollars. (N.C.)

[en] Between 1970 and April 1982, 592 women, with T/sub 1/, small T/sub 2/, N/sub 0/, N/sub 1/, M/sub 0/ breast cancer were managed by lumpectomy, axillary dissection and radiotherapy at the Institut Gustave Roussy (IGR). The overall cosmetic result and the degree of assymetry, fibrosis and telangiectasia of the treated breast were assessed by the radiation oncologist at each follow-up visit. The changes in these cosmetic parameters with time are shown. At 5 years the overall cosmetic result was excellent in 58%, good in 38% and fair or poor in 8%. A multivariate analysis was performed of the factors associated with a cosmetic defect. The most significant factors were tumour size, the presence of defect after surgery and the daily applied dose per fraction to the breast. Surgical and radiotherapy technique (especially alternate day fractionation) can significantly affect the cosmetic result obtained

[en] At the Institut Gustave-Roussy (IGR), from January 1982 to December 1986, 54 patients received total body irradiation (TBI) as a part of the conditioning regimen before allogeneic bone marrow transplantation. The patients were non-randomly assigned to either single dose TBI (STBI) (31 patients receiving 10 Gy at a 4.5 cGy/min dose rate, 8 Gy to the lungs) or to a hyperfractionated scheme (HTBI) (23 patients receiving 13.2 Gy in 11 fractions, 3 fractions per day, 9 Gy to the lungs). Relapse rate and overall survival were not significantly different in the two STBI and HTBI groups, in spite of a larger number of 2nd and 3rd remission patients in the HTBI subset. The incidence of interstitial pneumonitis (IP) was significantly reduced in the HTBI group (13%, versus 45% after STBI, p = 0.02). Lethality by IP was also lower after HTBI (4%, versus 26% after STBI, p = 0.08). There was no case of venoocclusive disease of the liver in the HTBI group, whereas three cases were observed after STBI. Based on these results, the IGR activated, in January 1987, a randomized trial comparing the single dose 10 Gy TBI (8 Gy to the lung) to a new hyuperfractionated schedule (11 fractions of 1.35 Gy, 3 fractions per day, 9 Gy to the lungs). (author). 67 refs.; 1 fig.; 5 tabs

[en] The objective of this clinical trial is to compare four strategies of management of postoperative radioiodine ablation in a 2*2 factorial design, each strategy combining a method of TSH stimulation and an activity of ¹³¹I. The primary endpoint is the rate of thyroid ablation. 753 patients who gave written informed consent were included in the study between April 2007 and February 2010 and currently data on radioiodine ablation are available for 693 patients (92%) who form the basis of the present report. Data on the follow-up control are currently available for 477 patients. Neck-US (ultra-sound exam) was normal in 444 patients (93%) and suspicious or abnormal in 33 (7%). Preliminary results are only global: thyroid ablation was considered complete in 417 patients (87%), incomplete or doubtful in 58 patients (12%) and non-evaluable in 2 patients. Results of ablation according to the treatment group will be available later