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1.
Sci Rep ; 10(1): 19951, 2020 Nov 17.
Article in English | MEDLINE | ID: mdl-33204008

ABSTRACT

The results obtained by using an existing model to estimate global solar radiation (GHI) in three different locations in Tunisia. These data are compared with GHI meteorological measurements and PV_Gis satellite imagery estimation. Some statistical indicators (R, R2, MPE, AMPE, MBE, AMBE and RMSE) have been used to measure the performance of the used model. Correlation coefficient for the different stations was close to 1.0. The meteorology and satellite determination coefficient (R2) were also near 1.0 except in the case of Nabeul station in which the meteorology measurements (R) were equals to 0.5848 because of the loss of data in this location due to meteorological conditions. This numerical model provides the best performance according to statistical results in different locations; therefore, this model can be used to estimate global solar radiation in Tunisia. The R square values are used as a statistical indicator to demonstrate that the model's results are compatible with those of meteorology with a percentage of error less than 10%.

2.
Appl Opt ; 58(27): 7472-7488, 2019 Sep 20.
Article in English | MEDLINE | ID: mdl-31674397

ABSTRACT

This paper reports on progress in the analysis of time-domain optical coherence tomography (OCT) applied to the dimensional metrology of through-silicon vias (TSVs), which are vertical interconnect accesses in silicon, enabling three-dimensional (3D) integration in microelectronics, and estimates the deviations from earlier, simpler models. The considered TSV structures are 1D trenches and circular holes etched into silicon with a large aspect ratio. As a prerequisite for a realistic modeling, we work with spectra obtained from reference interferograms measured at a planar substrate, which fully includes the dispersion of the OCT apparatus. Applying a rigorous modal approach, we estimate the differences to a pure ray tracing technique. Accelerating our computations, we focus on the relevant fundamental modes and apply a Fabry-Perot model as an efficient approximation. Exploiting our results, we construct and present an iterative procedure based on the minimization of a merit function, which concludes TSV heights reliably, accurately, and rapidly from measured interferograms.

3.
J Opt Soc Am A Opt Image Sci Vis ; 36(4): 686-704, 2019 Apr 01.
Article in English | MEDLINE | ID: mdl-31044992

ABSTRACT

Optical resonators are widely used in modern photonics. Their spectral response and temporal dynamics are fundamentally driven by their natural resonances, the so-called quasinormal modes (QNMs), with complex frequencies. For optical resonators made of dispersive materials, the QNM computation requires solving a nonlinear eigenvalue problem. This raises a difficulty that is only scarcely documented in the literature. We review our recent efforts for implementing efficient and accurate QNM solvers for computing and normalizing the QNMs of micro- and nanoresonators made of highly dispersive materials. We benchmark several methods for three geometries, a two-dimensional plasmonic crystal, a two-dimensional metal grating, and a three-dimensional nanopatch antenna on a metal substrate, with the perspective to elaborate standards for the computation of resonance modes.

4.
Cancer Radiother ; 22(1): 45-51, 2018 Feb.
Article in French | MEDLINE | ID: mdl-29290555

ABSTRACT

PURPOSE: The aim of this work is to determine experimentally the correction factors [Formula: see text] for four active commercial dosimeters: two microchambers and two diode detectors based on the output factor measured with radiochromic film for a radiotherapy linear accelerator equipped with circular cones. MATERIALS AND METHODS: Initially, a radiochromic film dosimetry measurement protocol with an accuracy of 2% was developed to approach the "reference output factor". Afterwards, the corrective factors of four detectors were determined for two ionization chambers (PinPoint PTW 31016 3D, Micropoint Extradin A16) and two diodes (PTW T60017 Diode, PTW-60019 Micro-Diamond). These measurements were carried out under conical BrainLAB® collimators defining circular fields with diameters equal to 7.5mm, 10mm, 12.5mm, 15mm, 17.5mm, 20mm, 25mm, 30mm, 35mm and 45mm of a 6MV X-ray beam generated by the ClinaciX linear accelerator (Varian®). These factors are weakly dependent on the type of accelerator, whether the model and the collimation type. This allowed their comparisons with those published for the same type of detector and for an accelerator with the same index of beam quality. RESULTS: The correction factors obtained experimentally were comparable in maximum deviation of 1.9% with published ones of the works using the same type of detector (mark and model) and an accelerator delivering the same beam quality for the same field size at the measurement point. CONCLUSION: The measurement protocol using the EBT3 film, which was used as a passive dosimeter to determine the "reference output factor", was validated by comparing measured and published data of active detector correction factors.


Subject(s)
Radiometry/instrumentation , Humans , Monte Carlo Method , Particle Accelerators , Radiosurgery , Radiotherapy Planning, Computer-Assisted , Software
5.
Tunis Med ; 96(10-11): 731-736, 2018.
Article in English | MEDLINE | ID: mdl-30746666

ABSTRACT

OBJECTIVES: To determine the prevalence of Healthcare-Associated Infection (HAI) in medical Intensive Care Unit (ICU), risk factors for these infections and identify the predominant infecting organisms. METHODS: A 1-day point-prevalence study within all medical ICUs in Tunisia, all patients occupying an ICU bed over a 48-hour period were included. Rates of HAI, resistance patterns of microbiological isolates and potential risk factors for HAI were recorded. RESULTS: One hundred and three patients were collected from 15 Tunisian medical ICUs. HAI prevalence was 25.2% CI 95% [15-35].The most frequent HAIs were hospital acquired pneumonia in 19 cases (59%) and catheter related infection in 5 cases (15%). Independent factors associated with HAI occurrence were SAPSII score ≥ 33 with OR 1.047; CI 95% [1.015-1.077], p=0.003 and recent hospitalization with OR 4.14 CI 95% [1.235-13.889], p=0.021. Non-fermenting pathogens were the most frequent microorganisms reported in ICUs ecology, prior colonization and HAIs of the screened patients. CONCLUSION: HAIs are frequent in medical ICUs in Tunisia, which emphasize the importance of specific measures for surveillance and infection control in critically ill patients. Implementing a national monitoring system of HAI should be a major priority of public health in Tunisia.


Subject(s)
Cross Infection/epidemiology , Intensive Care Units/statistics & numerical data , Adult , Aged , Bacterial Infections/epidemiology , Catheter-Related Infections/epidemiology , Catheter-Related Infections/microbiology , Comorbidity , Critical Care/statistics & numerical data , Cross Infection/microbiology , Female , Humans , Iatrogenic Disease/epidemiology , Male , Middle Aged , Prevalence , Risk Factors , Tunisia/epidemiology
6.
Phys Rev Lett ; 116(23): 233601, 2016 Jun 10.
Article in English | MEDLINE | ID: mdl-27341230

ABSTRACT

We measure the coherent scattering of light by a cloud of laser-cooled atoms with a size comparable to the wavelength of light. By interfering a laser beam tuned near an atomic resonance with the field scattered by the atoms, we observe a resonance with a redshift, a broadening, and a saturation of the extinction for increasing atom numbers. We attribute these features to enhanced light-induced dipole-dipole interactions in a cold, dense atomic ensemble that result in a failure of standard predictions such as the "cooperative Lamb shift". The description of the atomic cloud by a mean-field model based on the Lorentz-Lorenz formula that ignores scattering events where light is scattered recurrently by the same atom and by a microscopic discrete dipole model that incorporates these effects lead to progressively closer agreement with the observations, despite remaining differences.

7.
Opt Lett ; 40(15): 3512-5, 2015 Aug 01.
Article in English | MEDLINE | ID: mdl-26258345

ABSTRACT

The successes of nonlinear photonics and hybrid silicon photonics with a growing variety of functional materials entail ever-enlarging bandwidths. It is best exemplified by parametric comb frequency generation. Such operation challenges the dielectric channel waveguide as the basis for guidance, because of the adverse advent of higher order modes at short wavelengths. Surprisingly, the popular mechanism of endlessly single-mode guidance [Opt. Lett.22, 961 (1997).] operating in photonic crystal fibers has not been transposed within silicon photonics yet. We outline here the strategy and potential of this approach within planar and hybrid silicon photonics, whereby in-plane and vertical confinement are shown to be amenable to near-single-mode behavior in the typical silicon band, i.e., λ=1.1 µm to ∼5 µm.

8.
Bull Soc Pathol Exot ; 108(3): 191-6, 2015 Aug.
Article in French | MEDLINE | ID: mdl-26141497

ABSTRACT

This study is the first one that describes the situation of Legionnaires' disease (LD) in Tunisia, with its clinical and epidemiological characteristics and investigates the risk factors associated with Legionella infections in our country. We conducted a retrospective multicentric study during 5 years (2008-2012) concerning all confirmed LD cases in Tunisia and we investigated risk factors for infection. The total of confirmed LD cases was 14. Incidence was 0.03. Mean age: 53.1, sex ratio (M/F): 2.6. Summer-autumnal peak was noted. Risk factors for infection were: the great humidity at home (n=4), living in community (n=3) and practice ablutions (before prayer) in public places (n=4). Community acquired legionellosis (n=9) and nosocomial (n=2). Pulmonary symptoms (n=11)+/-gastrointestinal (n=6) and/or neurological signs (n=4). Beta lactams therapy failed (n=11). CXR showed bilateral lesions (n=6). Abnormalities in laboratory values were noted: hyponatremia (n=9), high CPK levels (n=9). Diagnosis was confirmed by positive urinary Legionella antigens test (n=10) and by direct immunofluorescence (n=1). Treatment was based on bitherapy (n=10). Five patients died. The incidence of LD appears lower than other countries. Some risk factors, as ablutions, are different from that reported in Western countries and seem to be specific to our society. Given the seriousness of its consequences, it is strongly recommended to improve the national surveillance system up and register LD as notifiable disease.


Subject(s)
Intensive Care Units/statistics & numerical data , Legionnaires' Disease/epidemiology , Aged , Anti-Bacterial Agents/therapeutic use , Antigens, Bacterial/urine , Baths , Bronchoalveolar Lavage Fluid/microbiology , Community-Acquired Infections/epidemiology , Comorbidity , Cross Infection/epidemiology , Disease Susceptibility , Female , Hospitals, University/statistics & numerical data , Housing , Humans , Humidity , Incidence , Legionella/isolation & purification , Legionnaires' Disease/diagnosis , Legionnaires' Disease/drug therapy , Legionnaires' Disease/transmission , Length of Stay/statistics & numerical data , Male , Middle Aged , Retrospective Studies , Risk Factors , Seasons , Smoking/epidemiology , Socioeconomic Factors , Tunisia , Water Microbiology
9.
Ann Cardiol Angeiol (Paris) ; 62(3): 149-54, 2013 Jun.
Article in French | MEDLINE | ID: mdl-23721985

ABSTRACT

AIM OF THE STUDY: To valorize fish by-products oil by investigating its effects on dyslipidemia, hyperglycemia, reverse cholesterol transport and paraoxonase-1 activity in obese rat. METHODS: Sixteen male Wistar rats were fed a high fat diet. At 400 ± 10 g, obese rats were randomly divided into two groups: the first received 20% of sardine by-products oil and the second 20% of the edible portion oil. At d28, glycemia and serum lipids concentrations were estimated. High density lipoproteins (HDL2 and HDL3) were separated and their contents and composition in lipids and apolipoproteins were analyzed. Lecithin: cholesterol acyltransferase and paraoxonase-1 activities were assessed. RESULTS: In group which consumed sardine by-products oil, serum cholesterol and triacylglycerols were reduced (-8% and -36%, respectively). However, glycemia was similar. HDL3-phospholipids, HDL3-unesterified cholesterol and HDL3-apolipoproteins were decreased by 56%, 10% and 12%, respectively. Lecithin: cholesterol acyltransferase activity was increased by 35% and the content of HDL2-cholesteryl esters was elevated by 12%. Serum paraoxonase-1 activity was increased by 25%. CONCLUSION: In obese rat, sardine by-products oil may have a protective effect against cardiovascular risk by improving the anti-atherogenic metabolic pathway of cholesterol and triacylglycerols. This anti-atherogenic action is particularly enhanced by the increase in paraoxonase-1 activity which protects lipoproteins from oxidation.


Subject(s)
Aryldialkylphosphatase/blood , Dyslipidemias/blood , Dyslipidemias/drug therapy , Fish Oils/administration & dosage , Obesity/blood , Obesity/drug therapy , Animals , Biomarkers/blood , Blood Glucose/metabolism , Cardiovascular Diseases/prevention & control , Cholesterol/blood , Cholesterol, HDL/blood , Disease Models, Animal , Hyperlipidemias/blood , Lecithins/blood , Male , Oils/administration & dosage , Random Allocation , Rats , Rats, Wistar , Sterol O-Acyltransferase/blood , Treatment Outcome , Triglycerides/blood
10.
Arch Inst Pasteur Tunis ; 90(1-4): 55-60, 2013.
Article in English | MEDLINE | ID: mdl-26012211

ABSTRACT

Pneumocystis pneumonia is a severe opportunistic infection in immunocompromised patients, caused by Pneumocystis jirovecii (P. jirovecii). The co-infection with community-acquired P. jirovecii and Mycobacterium tuberculosis (M. tuberculosis) is exceptionally described in non immunocompromised patients. We herein report the case of a young woman, with no medical history, who developed an acute respiratory failure due to P. jirovecii pneumonia associated with miliary tuberculosis. An extensive immunological investigation ruled out any acquired or primary immunodeficiency, suggesting that she was most likely immunocompetent. This report shows that such infections are not restricted to immunocompromised hosts. Moreover, it is tempting to speculate that the development of M. tuberculosis infection in this patient could be a risk factor for transition from colonization status of respiratory tract by P. jirovecii to pneumocystosis.


Subject(s)
Pneumocystis carinii , Pneumonia, Pneumocystis/complications , Tuberculosis/complications , Coinfection , Female , Humans , Immunocompetence , Young Adult
11.
Phys Rev Lett ; 105(18): 180502, 2010 Oct 29.
Article in English | MEDLINE | ID: mdl-21231093

ABSTRACT

A novel metal-coated nanocylinder-cavity architecture fully compatible with III-V GaInAs technology and benefiting from a broad spectral range enhancement of the local density of states is proposed as an integrated source of nonclassical light. Because of a judicious selection of the mode volume, the cavity combines good collection efficiency (≈45%), large Purcell factors (≈15) over a 80 nm spectral range, and a low sensitivity to inevitable spatial mismatches between the single emitter and the cavity mode. This represents a decisive step towards the implementation of reliable solid-state devices for the generation of entangled photon pairs at infrared wavelengths.

12.
Cancer Radiother ; 14(1): 69-73, 2010 Jan.
Article in French | MEDLINE | ID: mdl-19695937

ABSTRACT

PURPOSE: Measurement of absorbed dose in target volume is widely considered to be an important tool for quality assurance in external radiotherapy. The aims of this work were to measure the entrance dose for patient treated for head and neck tumors and to compare this measured dose with the dose calculated. PATIENTS AND METHODS: Twenty patients were evaluated. Initially, the measurements were performed on a polystyrene phantom in order to calibrate diodes in terms of entrance dose and to determinate appropriate correction factors. In vivo entrance dosimetry check was performed for these patients treated for head and neck tumors in (60)Co gamma-rays. RESULTS: For the entrance dose evaluation over 100 field measurements, the mean deviation between the measured dose and the calculated dose was equal to 0.12% and the standard deviation was 1.84%. The deviation was less than 3% in 95% of measurements. Large deviation (more than 5%) was observed in one case. CONCLUSION: Simple in vivo dose measurements are an additional safeguard against major set-up errors and calculation or transcription errors that were missed during pretreatment chart check.


Subject(s)
Head and Neck Neoplasms/radiotherapy , Radiometry/standards , Humans , Quality Control , Radiation Dosage
13.
Cancer Radiother ; 14(1): 29-33, 2010 Jan.
Article in French | MEDLINE | ID: mdl-19897396

ABSTRACT

PURPOSE: The objective of this work was the study of in vivo dosimetry performed in a series of 54 patients receiving total body irradiation (TBI) at the Salah-Azaiz Institute of Tunis since 2004. In vivo dosimetry measurements were compared to analytically calculated doses from monitor units delivered. PATIENTS AND METHOD: The irradiation was conducted by a linear accelerator (Clinac 1800, Varian, Palo Alto, USA) using nominal X-rays energies of 6 MV and 18 MV, depending on the thickness of the patient at the abdomen. The dose was measured by semi-conductors p-type EPD-20. These diodes were calibrated in advance with an ionization chamber "PTW Farmer" type of 0.6cm(3) and were placed on the surface of plexiglas phantom in the same TBI conditions. A study of dosimetric characteristics of semi-conductors EPD-20 was carried out as a function of beam direction and temperature. Afterwards, we conducted a comparative analysis of doses measured using these detectors during irradiation to those calculated retrospectively from monitor units delivered to each patient conditioned by TBI. RESULTS: Experience showed that semi-conductors are sensitive to the angle of beam radiation (0-90 degrees ) and the temperature (22-40 degrees C). The maximum variation is respectively 5 and 7%, but in our irradiation conditions these correction factors are less than 1%. The analysis of the results of the in vivo dosimetry had shown that the ratio of the average measured doses and analytically calculated doses at the abdomen, mediastina, right lung and head are 1.005, 1.007, 1.0135 and 1.008 with a standard deviation "type A" respectively of 3.04, 2.37, 7.09 et 4.15%. CONCLUSION: In vivo dosimetry by semi-conductors is in perfect agreement with dosimetry by calculation. However, in vivo dosimetry using semiconductors is the only technique that can reflect the dose actually received instantly by the patient during TBI given the many factors that calculation can not take into account: patient and organs motions and the heterogeneity of the targets.


Subject(s)
Radiometry/methods , Whole-Body Irradiation/methods , Humans , Neoplasms/radiotherapy , Radiotherapy Dosage
14.
Cancer Radiother ; 13(1): 30-6, 2009 Jan.
Article in French | MEDLINE | ID: mdl-18790660

ABSTRACT

PURPOSE: The aim of this study is to analyze the results and the complications of radiotherapy in the treatment of retinoblastoma. PATIENTS AND METHODS: Between 1994 and 2004, 40 children received radiotherapy for a retinoblastoma in Salah Azaiz Institute. The average age of the patients was 36 months (four to 132 months). There were 16 girls and 24 boys. Sixteen children presented a bilateral disease and 24 children a unilateral disease. Twenty eyes and thirty-six orbital cavities in 40 children with retinoblastoma were treated by radiotherapy. One child with a unilateral anterior retinoblastoma was treated with 106 ruthenium brachytherapy. External radiotherapy has been used to treat the 39 patients. In 20 cases the irradiation was conservative and in 36 cases postoperatively. The latter (n=36) presented at least one risk factor of relapses noted in the histological examination. The average dose was 44 Gy (1.8 to 2 Gy per fraction, five fractions weekly). This radiotherapy was associated with chemotherapy in 24 cases. RESULTS: Thirty-five children were followed with an average follow-up of 53 months (3-108 months). The average delay of relapses was of 10 months (two to 26 months). We found four orbital relapses and seven metastasis in nine children. The conservation of the eye with a useful visual field was noted in 18 cases among the 20 conservative irradiated eyes. The major therapeutic complication was the growth defect of the bones face. A femoral bone sarcoma was noted five years after the end of the irradiation and chemotherapy in one case. CONCLUSION: If the radiotherapy offers the advantage of the functional conservation and the improvement of the local control, its indications are more and more restricted in favor of the other therapeutic methods (chemotherapy, thermochemotherapy) and this considering the iatrogene risk. The development of new techniques of brachytherapy and the progresses of the conformational radiotherapy appear to reduce considerably this risk.


Subject(s)
Retinal Neoplasms/radiotherapy , Retinoblastoma/radiotherapy , Brachytherapy , Cataract/epidemiology , Cataract/etiology , Chemotherapy, Adjuvant , Child , Child, Preschool , Consanguinity , Cranial Irradiation , Eye Enucleation , Female , Humans , Infant , Male , Neoplasm Recurrence, Local/epidemiology , Neoplasm Staging , Patient Selection , Radiotherapy/adverse effects , Radiotherapy/methods , Radiotherapy Dosage , Radiotherapy, Adjuvant , Radiotherapy, Conformal , Restraint, Physical/methods , Retinal Neoplasms/etiology , Retinal Neoplasms/mortality , Retinoblastoma/etiology , Retinoblastoma/mortality , Retrospective Studies , Treatment Outcome , Tunisia/epidemiology
16.
Opt Lett ; 33(14): 1590-2, 2008 Jul 15.
Article in English | MEDLINE | ID: mdl-18628807

ABSTRACT

For the sake of numerical performance, we hybridize two common approaches often used in electromagnetic computations, namely the finite-element method and the aperiodic Fourier modal method. To that end, we propose an extension of the classical S-matrix formalism to numerical situations, which requires handling different mathematical representations of the electromagnetic fields. As shown with a three-dimensional example, the proposed G-matrix formalism is stable and allows for an enhanced performance in terms of numerical accuracy and efficiency.

17.
Cancer Radiother ; 12(8): 860-2, 2008 Dec.
Article in French | MEDLINE | ID: mdl-18571966

ABSTRACT

Medulloblastoma is a common paediatric brain tumor. Its prognosis is improved since the use of radiotherapy after surgery. This radiotherapy, so widely and complex, has one purpose: tumor control with less toxicity. Frontal relapse of medulloblastoma is not rare. Two hypothesis were proposed to explain this failure pattern: a geographic miss in cribriform plate due to targeting deviation and the migration of tumor cells to the cribriform plate caused by the "face down position" of the patient during surgery. We report the case of a 10-year-old boy who was treated in 1998 for a medulloblastoma with surgery and radiotherapy of the craniospinal axis (24 Gy) and the posterior fossa (54 Gy). Four years later, tumor relapsed only in the frontal area. A new surgery and chemotherapy were used with a complete response. A second frontal relapse associated with posterior fossa recurrence was detected after one year of the second treatment and treated by chemotherapy. Frontal relapse in medulloblastoma is an avoidable failure pattern when surgical and radiotherapeutic procedures are well controlled.


Subject(s)
Brain Neoplasms/radiotherapy , Brain Neoplasms/surgery , Cerebellar Neoplasms/diagnostic imaging , Medulloblastoma/radiotherapy , Medulloblastoma/surgery , Neoplasm Recurrence, Local/diagnostic imaging , Cerebellar Neoplasms/drug therapy , Cerebellar Neoplasms/surgery , Child , Combined Modality Therapy , Humans , Ifosfamide/therapeutic use , Male , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/surgery , Radiography , Treatment Outcome
18.
Cancer Radiother ; 12(2): 73-7, 2008 Mar.
Article in French | MEDLINE | ID: mdl-18243752

ABSTRACT

PURPOSE: This study aims to evaluate local failure patterns in node negative breast cancer patients treated with post-mastectomy radiotherapy including internal mammary chain only. PATIENTS AND METHODS: Retrospective analysis of 92 internal or central-breast node-negative tumours with mastectomy and external irradiation of the internal mammary chain at the dose of 50 Gy, from 1994 to 1998. RESULTS: Local recurrence rate was 5 % (five cases). Recurrence sites were the operative scare and chest wall. Factors associated with increased risk of local failure were age < or = 40 years and tumour size greater than 20mm, without statistical significance. CONCLUSION: Post-mastectomy radiotherapy should be discussed for a sub-group of node-negative patients with predictors factors of local failure such as age < or = 40 years and larger tumour size.


Subject(s)
Breast Neoplasms/prevention & control , Mastectomy , Neoplasm Recurrence, Local/prevention & control , Adult , Aged , Female , Humans , Middle Aged , Radiotherapy , Retrospective Studies , Thoracic Wall
19.
Cancer Radiother ; 11(5): 234-40, 2007 Sep.
Article in French | MEDLINE | ID: mdl-17631405

ABSTRACT

PURPOSE: To study the clinical, radiological, therapeutic and progressive aspects of brain radionecrosis after treatment for nasopharyngeal carcinoma. PATIENTS AND METHODS: Nine patients (seven men and two women) of mean age 47.7 years old (extremes: 18-57 years old) were treated for UCNT (undifferentiated carcinoma of the nasopharynx) between 1989 and 2003 and developed cerebral radionecrosis. All patients were treated with radical radiotherapy. The mean total dose was 73.5 Gy (70-75 Gy). Dose per fraction was 2 to 2.5 Gy, one fraction daily. One patient received adjuvant brachytherapy to the dose of 8 Gy and four patients also received chemotherapy. RESULTS: Brain radionecrosis was authenticated by brain imaging (CT scan+/-MRI): the imaging was ordered in seven cases to elucidate non-specific neurological signs and two cases were discovered fortuitously. The time to the appearance of neurological signs was 40.3 months (10 to 108 months). The localization was temporal in six cases, parieto-occipital (one case) and bulbomedullar (two cases). After a mean follow-up period of 30.6 months (12-84 months), clinical outcomes were favorable in all cases receiving medical treatment (corticoids), with a stabilization of the radiological lesions in eight cases and complete radiological regression in one patient. CONCLUSION: Brain radionecrosis is a late complication rarely occurring in patients irradiated for UCNT. Imaging techniques (CT scan but more so MRI) play a major role in the diagnosis. Corticotherapy resulted in a durable objective response in all patients and, in most cases, resulted in radiological stabilization.


Subject(s)
Brain/pathology , Nasopharyngeal Neoplasms/radiotherapy , Radiation Injuries/pathology , Radiotherapy/adverse effects , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Age Factors , Analgesics/therapeutic use , Blood-Brain Barrier , Brachytherapy , Dose Fractionation, Radiation , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nasopharyngeal Neoplasms/pathology , Nasopharynx/pathology , Necrosis , Neoplasm Staging , Radiation Injuries/diagnosis , Radiation Injuries/diagnostic imaging , Radiation Injuries/drug therapy , Radiation Injuries/etiology , Radiotherapy Dosage , Remission Induction , Risk Factors , Time Factors , Tomography, X-Ray Computed
20.
Cancer Radiother ; 11(3): 117-21, 2007 May.
Article in English | MEDLINE | ID: mdl-17293150

ABSTRACT

PURPOSE: Nasopharyngeal cancer is the commonest head and neck cancer in Tunisia treated with radiotherapy. A dose effect relationship is established in this tumor. The aim of this study is to describe our Low-dose-rate endocavitary brachytherapy using a personalized mold called Tunis applicator. PATIENTS AND METHODS: Seven patients (4 males and 3 females) with histologically confirmed undifferentiated nasopharyngeal carcinoma (UCNT) were treated between 2002 and 2005. Five patients with primary cancer and 2 with recurrent disease received external beam radiation followed by endocavitary brachytherapy. The mean applied dose of endocavitary brachytherapy was 5.5 Gy for primary site after external beam radiation (70-74 Gy) and 30 Gy for recurrent disease after external beam radiation (38 Gy). We have developed a personalized applicator with a balloon to optimize the placement of sources and a better conformity using the computer tomography scanning. Critical normal structures were identified on orthogonal radiographs and the dose was optimized to avoid excessive doses to these structures. RESULTS: With a follow up of 18 months (8-41), only one local failure was observed, 3 years after external beam radiation therapy for a recurrent disease. Moderate grade mucositis was seen in most patients. One patient was diagnosed with bulb necrosis. CONCLUSION: Endobrachytherapy can provide effective treatment for nasopharyngeal carcinoma with an easy application of the brachytherapy procedure.


Subject(s)
Brachytherapy/methods , Carcinoma/radiotherapy , Nasopharyngeal Diseases/radiotherapy , Neoplasm Recurrence, Local/radiotherapy , Adult , Brachytherapy/instrumentation , Female , Humans , Male , Middle Aged , Mucositis/etiology , Radiotherapy Dosage , Treatment Outcome
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