[Combined radiation therapy and androgen deprivation in the management of prostate cancer: Where do we stand?]. / Association de radiothérapie et d'hormonothérapie dans la prise en charge des cancers localisés de la prostate: où en est-on?

Radiotherapy and androgen deprivation therapy play a major role in the management of prostate cancer. Indeed, radiotherapy and hormone therapy are combined in a neoadjuvant and concomitant setting for intermediate risk cancers but also in an adjuvant setting in high risk or locally advanced prostate cancer. The benefice of this association was suggested by preclinical studies and demonstrated later by several randomized trials. However, as these trials were conducted before the era of dose escalation the role of androgen deprivation therapy in this case is less clear. Moreover, as hormonal therapy can lead to a significant morbidity and a decrement in quality of life its indications must be carefully weighed especially in case of intermediate risk cancer witch represent a heterogeneous group with distinct prognostic subgroups.

RapidArc for centrally recurrent cervical cancer in the vaginal cuff following primary surgical therapy: a case report.

BACKGROUND: Pelvic recurrences of cervical cancer after primary surgical treatment can be potentially cured with radical hysterectomy or chemoradiation therapy. Combined radio-chemotherapy is believed to improve results compared to other option. Currently, RapidArc radiotherapy is considered an excellent technological advance that shows great potential for producing highly conformal doses to treatment volumes. CASE PRESENTATION: We present a case of a 67-year-old woman with history of early cervical cancer initially treated by radical laparoscopic hysterectomy. More than 5 years later, the patient presented with a central pelvic vaginal cuff recurrence that is histologically confirmed. Salvage radiotherapy using RapidArc with concurrent cisplatin-based chemotherapy was indicated. A high dose of 70 Gy was delivered to the gross recurrent disease with simultaneous integrated boost (SIB) to the subclinical disease and good sparing of organs at risk especially the rectum and sigmoid. CONCLUSIONS: This case clearly demonstrates a large benefit for salvage RapidArc radiotherapy to central pelvic recurrences of gynecological cancers with an excellent rate of local control and less rate of toxicity.

[Efficacy of first-line radiation for non-resectable carotid paraganglioma]. / Efficacité de la radiothérapie en première intention d'un paragangliome carotidien non résécable.

BACKGROUND: Carotid paragangliomas are rare. Surgical resection is the primary treatment. However, when surgery is impossible, radiation therapy is an alternative potentially enabling local control with less morbidity. We report a case of good local control of an unresectable paraganglioma after external beam radiation. CASE REPORT: A 72-year-old-woman, had a 4-year history of right facial palsy associated with pulsatile tinnitus, episodic ear bleeding and ipsilateral hearing loss. Physical examination revealed a retro-mandibular and sub-mastoid pulsatile mass. Magnetic resonance imaging showed a large carotid paraganglioma involving the temporal bone. Since surgical resection was impossible, our patient was given external beam radiation therapy at a dose of 60 Gy. At 12 months follow-up, local control was good without significant toxicity. CONCLUSION: External beam radiation therapy seems to be a good alternative therapy for local control of carotid paragangliomas if surgical resection is impossible.