[en] Published in summary form only

[en] Short communication

[en] Differentiated thyroid cancer, when adequately treated, has an overall good prognosis. However, 10-15% of patients develop distant metastases. The presence of metastases is an important prognostic factor that negatively affects survival. For ¹³¹I-avid distant metastases, ¹³¹I therapy is a very effective treatment modality that induces complete remission in about a third of patients. These figures may be even higher in case of early diagnosis, when tumor burden is still limited. Additional measures may include surgery and/or external beam radiation therapy. Cytotoxic chemotherapy is largely ineffective in patients with progressive, poorly differentiated cancer. These patients should be candidates for trials with new molecularly targeted therapeutic agents. In this paper, a review of diagnostic modalities, prognostic factors and therapeutic options for patients with distant metastases is proposed. In particular, the prognostic value of the early discovery of metastatic disease will be underlined. (authors)

[en] There is an increasing interest for targeting of tumor hypoxia and our paper aimed to emphasize the main points of this topic. We review new insights at cellular level and focus on the leading part of hypoxia inducible factor one alpha and its connections with angio genesis. We shortly describe different methods to assess tissue hypoxia then zoom on to positron emission tomography and its acknowledged tracers ¹⁸F-fluoro misonidazole and ¹⁸F-fluoro-erythro-nitroimidazole. Recent studies concerning two new promising tracers Cu(II)-di-acetyl-bis(N(4)-methyl-thio-semicarbazone) and FAZA are reviewed, and the respective value of the tracers is discussed. (N.C.)

No abstract available

[en] The clinical usefulness of FDG-PET has been recognised by the French Medicine Agency since 1998. A PET centre equipped with a dedicated camera suited for oncological routine examination has been opened at the beginning of the year 2000, associating 5 hospitals and their network of oncologists. The present article has several aims. It reports quantitatively, monthly and indication by indication on the number of examinations performed during the opening year, to give possibly helpful information to the future PET centres in France. During the year 2000, 656 FDG-PET examination has been performed in 605 patients, who dwelt in Paris for 28% of them, in the rest of Ile de France region for 47 %, in other French regions or even abroad for 25%. 83% of the patients came has out-patients. The article also briefly enumerates the clinical study protocols that have been designed and approved by the Scientific Committee and started during the year 2000, the inclusions being still underway. Finally, the article includes the main results of our study on the clinical impact of FDG-PET. Such results have been already published outside France: in a meta-analysis involving more than 5000 patients, the modification rate of patients' management was calculated to be 30%. However, the evaluation of this impact from the referring clinician's perspective that seems more impartial has only been performed recently by two Californian teams by means of a questionnaire retrospective survey. We used the same questionnaire (translated into French language) and the same methodology. One questionnaire was sent to the referring physician for each of the 476 who underwent a routine FDG-PET study for a registered clinical indication during the year 2000. 348 responses (73%) were received and included in the study. Globally, the disease was upstaged in 26% of the cases and down-staged in 9%. Inter-modality management changes (change from a scheduled therapeutic modality for a different one) were reported in 37% of the cases and intra-modality changes in 9%. When comparing with the similar studies performed in California in 1999, there were no significant differences between the rates of inter-modality management changes. In contrast, intra-modality management changes were less frequent in our survey, except for lymphoma. Globally the clinical impact of FDG PET was similar, with a higher response rate in our study (73% versus 35%); it was slightly higher than the rate derived from a recent meta-analysis in more than 5000 patients. (author)

[en] Oral communications relative to radiotherapy are presented here. Evaluation of radioimmunotherapy by 90-Y-Ibrittumomab tiuxetan by PET FDG, treatment against pain in bone metastases, estimation of personnel exposure during radiotherapy ( iodine 131, samarium 153, yttrium 90), dosimetry evaluation and response of brachytherapy are the principal subjects of these communications. (N.C.)

[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