No abstract available

[en] EGF-receptor (EGFR) is a transmembrane protein, which was implicated in the progression of many epithelial cancer types. Its activation induce some transduction pathways inside the cell, and contribute to many cellular processes as cell proliferation, inhibition of apoptosis and angiogenesis. Monoclonal antibodies directed against EGFR or small molecules inhibiting its tyrosine-kinase function could block all these pathways. By modulating these cellular functions, these molecules enhance the antitumor activity of ionizing radiation. Several mechanisms have been discussed (alteration of DNA damage repair, facilitation of apoptosis, inhibition of tumour repopulation) and justify the current clinical trials combining these drugs and radiotherapy. (author)

No abstract available

[en] The present review represents an up-to-date focus on the particular topic of cervix carcinoma. An exhaustive description of the actual data and the near-future combination of radiotherapy and drugs with the specific potential of targeted therapies are presented. This approach represents one of the next challenges to improve results. Studies conducted in 1999, 2000, and 2002 reported the results of six large-scale prospective randomized trials using concomitant chemo radiation with a significant progression-free and overall survival rate improvement compared to radiotherapy only. These results were confirmed by the two last meta-analyses. Nowadays, the concurrent radio chemotherapy schedule used in the treatment of high risk cervical cancer is a standard practice. More growing evidences suggest that intracellular signal pathways play a significant role in radiation response. Several prognostic factors on tumoral radiosensitivity have been identified, including intracellular signal pathways, in the particular case of cervix carcinoma. Promising results have been obtained in experimental studies assessing the combined use of specific inhibitors and radiotherapy. Based on these data, a number of clinical trials have been started to enhance tumor responses and thus, to decrease the rate of recurrences. (authors)

[en] The population over than seventy years old increases considerably as well as the incidence of cancer among old people. The objective of this study was to analyse the complications rate and the efficiency of brachytherapy among patients over seventy and reached by an uterine cervix carcinoma. The brachytherapy is well tolerated among old patients reached by an uterine cervix carcinoma with excellent local control rate and survival. The age does not influence the efficiency of the brachytherapy in the group of old patients. (N.C.)

No abstract available

[en] In hadron therapy centers that have only fixed horizontal beams (i.e. most carbon ions centers and protons centers of first generation), the angulations of the beam remain technically limited, especially for the treatment of children under general anaesthesia with posterior-oblique (40 degrees C or so) beams in supine position. We have been developing recently an original positioning system allowing for treatment with posterior-oblique beams, either from right or left directions, by keeping the child in the adequate position. (authors)

[en] Patients suffering from locally advanced unresectable squamous cell carcinoma of the oropharynx and hypopharynx treated with radiotherapy alone have a poor prognosis. More than 70% of patients die within 5 years mainly due to local recurrences. The aim of this study was to evaluate retrospectively the Antoine Lacassagne Cancer Center's experience in a treatment by concomitant bid radiotherapy and chemotherapy. Evaluation was based on analysis of the toxicity, the response rates, the survival, and the clinical prognostic factors. From 1992 to 2000, 92 consecutive patients were treated in our single institution. All of them had stage IV, unresectable squamous cell carcinoma of the pharynx and they received continuous bid radiotherapy (two daily fractions of 1.2 Gy, 5 days a week, with a 6-h minimal internal between fractions). Total radiotherapy dose was 80.4 Gy on the oropharynx and 75.6 Gy on the hypopharynx. Two or three chemotherapy courses of cisplatin (CP)-5-fluorouracil (5FU) were given during radiotherapy at 21 -day intervals (third not delivered after the end of the radiotherapy). CP dose was 100 mg/m² (day 1) and 5-FU was given as 6-day continuous infusion (750 mg/m²/day at 1. course; 430 mg/m²/day at 2. and 3. courses). Special attention was paid to supportive care, particularly in terms of enteral nutrition and mucositis prevention by low-level laser energy. Acute toxicity was marked and included WHO grade III/IV mucositis (89%, 16% of them being grade IV), WHO grade III dermatitis (72%) and grade III/IV neutropenia (61%). This toxicity was significant but manageable with optimised supportive care, and never led to interruption of treatment for more than 1 week, although there were two toxic deaths. Complete global response rate at 6 months was 74%. Overall global survival at 1 and 3 years was 72% and 50% respectively, with a median follow-up of 17 months. Prognostic factors for overall were the Karnofsky index (71% survival at 3 years for patients with a Karnofsky index of 90-100% versus 30% for patients with a Karnofsky index of 80% versus 0% for patients with a Karnofsky index of 60-70%, p = 0.0001) and tumor location (55% at years for oropharynx versus 37% for pan-pharynx versus 28% for hypopharynx, p=0.009). These results confirm the efficacy of concomitant bid radiotherapy and chemotherapy in advanced unresectable tumor of the pharynx. The improvement in results will essentially depend on our capacity to restore in a good nutritional status the patients before beginning this heavy treatment. (author)

[en] Radiation recall refers to a tissue reaction produced by a chemotherapeutic agent in a previously irradiated field that would not occur in a nonirradiated field. Docetaxel is a member of the taxane group of antineoplastic agents that cause disruption of cell division by enhancing microtubule assembly and inhibiting tubulin depolymerization. As well as in breast cancer and lung cancer treatment, its association in a chemo-radiation planned treatment becomes frequent and effective. Most of radiation recall dermatitis (RDD) reported in literature concerned Paclitaxel or other drugs. We report two particularly striking cases of RDD with Docetaxel and radiotherapy. Even if etiology remains undetermined, a number of hypotheses can be formulated. Familiarity with this phenomenon and potential complications of chemotherapy following tumor irradiation may expedite early diagnosis and appropriate life saving treatment. (authors)

[en] To initiate Intensity-Modulated Radiation Therapy (IMRT) in our department, theoretical cases were used as a training, to define methods of measurements and to verify the software by comparing results of calculation and measurement on a PMMA phantom. Irradiation was performed with 6 and 25 MV X-rays from a linear accelerator. For measurements, films and ionization chambers have been chosen. The comparison between calculations and measurements shows some discrepancies at the level of junctions and also in areas of low doses especially when many segments were used. These theoretical cases provide a first step on the way towards treatments with intensity modulation. (author)