[en] A fifty seven years woman received ten years ago, a radiotherapy with iodine for a Basedow hyperthyroidism. In 2001 she was damaged bu an epidermoid carcinoma of the anal canal. Radiotherapy, then chemotherapy, then brachytherapy. During three years noting special to declare. In 2004, respiratory insufficiency leads her to consult. A PET scanography shows an inter-aortic-pulmonary hyper-metabolism. Cortico-therapy and radiotherapy by X rays are delivered. In front of the positive response a new chemoradiotherapy and three cycles of chemotherapy are made. After twenty five months the patient is in complete remission of her metastases after this remedial treatment. This observation illustrates the radiosensitivity of the anal canal cancers of including metastases situation, the interest of the PET scanography and utility of a remedial treatment with curative goal. (N.C.)

[en] The authors discuss the comparison of the treatment plans of eleven patients treated either by conformational irradiation for seven of them, or by intensity-modulated conformational irradiation (IMRT) for four of them. The IMRT results in a good target volume coverage, can better protect the intestine than the conventional irradiation, and therefore is very promising, notably in terms of digestive toxicity. Short communication

[en] The initiated discussion about formalizing of the companionship has created a simple educational tool, reproducible and transferable to other services. The newcomer is well supported in all stages of acquisition of operating rules and safe operation. The registration of acquired data on portfolio allows final and objective validation of the department head. (N.C.)

[en] The authors report a prospective comparison, for a same patient, of delivered doses for the coverage of target volumes and for the protection of organs at risk within the frame of an intensity-modulated conformational irradiation (IMRT) with respect to a conventional conformational radiotherapy for an anal canal cancer. The tumour conformity indexes are compared for the different target volumes. The average received doses are also compared for different organs and bones about the treated area. IMRT ensures a better protection of organs. The authors are developing a dynamic arc therapy approach. Short communication

[en] The authors report the dosimetric comparison of two techniques used for the treatment of cervical cancers: the intensity-modulated conformational radiotherapy (IMRT) with static beams and modulated arc-therapy with RapidArc. The treatment plans of 15 patients have been compared. The clinical target volume (CTV) comprises the gross target volume, the cervix, the upper third of the vagina, and ganglionary areas. The previsional target volume comprises the clinical target volume and a one centimetre margin. Organs at risk are rectum, bladder, intestine and bone marrow. Arc-therapy seems to provide a better sparing of intestine that IMRT, while maintaining a good coverage of the previsional target volume and decreasing treatment duration. Short communication

[en] The authors comment the evolution observed for three cases of sarcomas in a previously irradiated sus-clavicular area. The three patients initially presented different cancers before the appearance of this sarcoma. The authors outline the exceptional characteristic of these sarcomas for their location in the sus-clavicular ganglionary area. Treatment is difficult. The authors suspect the existence of a genetic fragility. Short communication

[en] Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this 'complex U shaped' volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control. (authors)

[en] This case report presents a 57 years-old woman treated for a squamous cell carcinoma of the anal canal by radio chemotherapy and brachytherapy. The particularity of this case lays on the fact that she presented a mediastinal and pleural metastatic evolution three years later, which was also treated by radio chemotherapy, leading to a complete remission of 50 months. This observation is interesting for its curative treatment in metastatic cancer of the anal canal. It also illustrates the radio sensibility of anal canal cancers, including metastatic situations, and raises the contribution of PET-scanner to evaluate the response to treatment and detect a recurrence. (authors)

[en] Four years after the irradiation, the patient was in situation of complete forgiveness: the child was normal, there was neither a deformation nor a mental disorder, but the neoplastic risk persists, thus long-term surveillance is imperative. If the pregnancy is known, we have to arrest the foetal risks incurred in order to propose a termination of pregnancy; therefore, are made the measures on phantoms of the dose that he would receive, according to the tumoral localization, to the dose necessary to eradicate the tumor, to the field and the possible masks for an optimal tumoral control. (N.C.)

[en] The use of three-dimensional breast radiotherapy after a conservative treatment allowed cardiotoxicity as well as the dose delivered to lungs to be significantly reduced. However several bibliographic references give different dose constraints. Based on the constraints given by the Oncological radiotherapy French Society (SFRO), the authors analysed whether these recommendations could be actually respected within a daily practice. Based on a sample of 91 patients, the authors collected the following data: mammary gland volumes receiving respectively 95 and 107% of the dose before the boost calculation, heart and pulmonary volumes receiving different dose levels. Coverage constraints are indicated. It appears that the present technique does not allow the constraints to be respected in a majority of cases. Short communication