[en] As the occurrence of malignant gliomas and brain metastases is increasing in elderly people, the authors report the definition of an optimal therapeutic strategy for these patients. For patients in good health condition, a prospective randomized showed a modest benefit of radiotherapy alone with respect to support cares in terms of survival. The radiotherapy scheme is discussed in terms of dose and number of fractions. It seems that the physiological age is a strong prognosis factor. Short communication

[en] The acute effects of radiations on normal tissues are linked to known parameters. These parameters are the nature and function of the irradiated organ, and the technical characteristics of the treatment (treated volume, beam energy, fractionation). The intensity and time course of the clinical reactions depend on these parameters. All clinical reactions will be recorded with appropriate systems. Some examples of acute reactions are given. (authors). 14 refs

No abstract available

[en] Short communication

[en] From 1986 to 1990, 60 patients with unresectable esophageal carcinomas were treated by bifractionated accelerated irradiation, alone or after neoadjuvant chemotherapy (39 patients). Mean age was 62 years, poor performance status was the first cause of non resectability (32 patients), then locoregional extension (20 patients) and finally second concomitant head and neck cancers (eight patients). A weight loss exceeding 10% was noted in 21 cases and 43 tumours exceeded 5 cm in length. The accelerated irradiation delivered a mean dose of 66 Gy in 29 days, and 87% of patients fully completed the planned treatment without interruption. Grade III radioepithelitis were observed in 12% of cases. For patients with a tumour of less than 5 cm, the local control rate at 2 years is 70%; survival excluding deaths due to intercurrent diseases and overall survival are respectively 63 and 40%. For patients with a tumour exceeding 5 cm, the local control rate at 2 years is 20%; overall survival and survival excluding deaths due to intercurrent disease at 2 years is 10%. This study suggests that bifractionated accelerated irradiation is feasible in these patients, with acceptable acute toxicity. Although follow-up is limited (20-50 months), local control seems to have been improved, especially for tumours of less than 5 cm. These encouraging results should be confirmed by randomized trials evaluating accelerated irradiation

[en] The functional nuclear magnetic resonance imaging brings complementary information, specific to each clinical and radiological situation allowing a high precision encephalic radiotherapy. (N.C.)

[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] The development of conformal radiotherapy techniques (CRT) and intensity modulated CRT requires an accurate delineation of target structures and organs at risk. Thus, additional information provided by anatomical and/or functional imaging modalities can be used for volume of interest determination combined with traditionally used Computed Tomography imaging (CT): for instance, functional or morphological Magnetic Resonance Imaging (f MRI or m MRI) or Positron Emission Tomography (PET). A prerequisite to the simultaneous use of this information is image registration. Due to the differences between the images and the information they provide, a quality control of image registration process for radiotherapy is mandatory. The purpose of this article is to present the difficulties in implementing such controls and to show the necessity for a clinical validation on patient's images. The last part of this work presents the possible interest in using f MRI to help radio-oncologists in the treatment planning for gliomas associated to image co-registration and quality control considerations. (authors)

[en] Nuclear magnetic resonance imaging before radiotherapy in the prostate cancer and different technique after radiotherapy to evaluate the side effects, the complications and the recurrence in ear- nose-throat cancers are tackled in two articles. (N.C.)

[en] This part is devoted to neurology and the treatment of tumors inside the skull. Radiotherapy, fractionated irradiation, implants, are such treatments developed and reported. (N.C.)