ABSTRACT
PURPOSE: Surgery is the main treatment of early stage non small cell lung cancer. However, in inoperable patients, the treatment is usually conventional radiotherapy. Results are poor and acute toxicity is severe. Stereotactic body radiation therapy provides better results in terms of local control and toxicity. Our purpose was to evaluate the clinical outcomes of patients with primary lung tumours treated by stereotactic body radiation therapy using a stereotactic body frame at the Orléans Regional Hospital. PATIENTS AND METHODS: Between June 2000 and December 2007, 33 patients with stage I and II non small cell lung cancer were treated by stereotactic body radiation therapy. Breathing control was obtained by passive diaphragm control. Two CT-scans were performed 1 week apart to determine the accuracy of patient repositioning and define target volumes. Five or six fields were set up to achieve a conformal dose distribution. According to tumour size, a total of 50 or 40 Gy was delivered in 10 fractions. RESULTS: Mean patient age was 70 years. Median follow-up was 25 months. Ten patients with a complete response are still alive. Eight patients have died from local progression, eight from metastasis, and six from comorbidity. Median disease-free survival was 22.6 months. No acute toxicity up to grade II (CTC AE 3.0) was observed. None of the patients still alive has developed any complications. CONCLUSION: In patients who cannot undergo radical surgery, stereotactic body radiation therapy using a sterotactic body frame is well-tolerated and seems to be an efficient treatment method.
Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Radiosurgery , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/pathology , Esophagus/radiation effects , Female , Follow-Up Studies , Humans , Lung/radiation effects , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Radiation Injuries/etiology , Radiosurgery/adverse effects , Radiosurgery/instrumentation , Remission Induction , Skin/radiation effects , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Anal canal epidermoid carcinomas represent 1.2% of digestive cancers and 6% of ano-rectal cancers. For localized diseases, the treatment is based on radiotherapy with or without chemotherapy (5-FU and cisplatin or mitomycin), according to tumour and nodal extension. The recommended treatment dose is 45 Gy in the anal canal, the mesorectum, pararectal lymph nodes, and inguinal lymph nodes. An additional dose of 15 to 20 Gy is delivered in the initial tumour for good responders. Salvage surgery is necessary in case of poor response. The organs at risk to be considered are bladder, femur heads, small intestine and vulva. The objective of this work is to summarize the epidemiological and radio-anatomic and prognostic characteristics of this tumour. The conformal radiotherapy technique is illustrated by a case report.
Subject(s)
Anus Neoplasms/radiotherapy , Carcinoma, Squamous Cell/radiotherapy , Radiotherapy Dosage , Anus Neoplasms/epidemiology , Anus Neoplasms/surgery , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , France , Humans , Incidence , PrognosisABSTRACT
Primary angiosarcoma is a rare type of breast cancer, the diagnosis is difficult to establish and it has the worst prognostic of all breast malignancies. Two cases of primary breast angiosarcoma have been observed at the centre Henry Kaplan of Tours and at the hospital La Source of Orleans since 2001. Based on a literature review, we analyse the epidemiological, pathological, clinical, diagnostic and treatment aspect of this type of cancer. Mastectomy is the reference treatment and the benefit of radiotherapy and chemotherapy remains to be demonstrated.