Prevalence of burnout, depression and job satisfaction among French senior and resident radiation oncologists.

PURPOSE: Cancer caregivers are at high risk of burn-out, with potential severe consequences on professionals' health and on patients' care. We have investigated the prevalence of burn-out and its impact in terms of psychological morbidity among French radiation oncologists. METHODS AND MATERIALS: An anonymous online questionnaire was advertised in all French senior radiation oncologists and residents, including demographical data, job-related stress factors, drug use, the Maslach Burn-out Inventory (MBI) and the General Health Questionnaire (GHQ-12). RESULTS: The response rates were 37% (76 out of 204) for radiation oncologists and 22% (166 out of 751) for residents. Sixty-four (84%) radiation oncology residents and 104 (63%) radiation oncologists met criteria for moderate/severe burn-out (odd ratio 2.1 [95% confidence interval 1.0-4.8], P=0.03). Radiation oncology residents were more prone to depersonalization (P<0.001) and lower personal accomplishment (P<0.001). Burn-out was more frequent in radiation oncologists working for public facilities. Symptoms of depression (GHQ-12≥4) were reported by 42% of residents and 36% of radiation oncologists (P=0.40). Psychological morbidity, suicidal ideation and anxiolytic consumption were more frequent in burnt out responders. CONCLUSION: Our figures are in the highest range of published data. Active screening and prevention of burn-out should be implemented and particularly aimed at radiation oncology residents.

[Why is brachytherapy still essential in 2017?] / Pourquoi la curiethérapie reste-t-elle indispensable en 2017 ?

These recent years, brachytherapy has benefited from imaging modalities advances. A more systematic use of tomodensitometric, ultrasonographic and MRI images during brachytherapy procedures has allowed an improvement in target and organs at risk assessment as well as their relationship with the applicators. New concepts integrating tumor regression during treatment have been defined and have been clinically validated. New applicators have been developed and are commercially available. Optimization processes have been developed, integrating hypofractionation modalities leading to tumor control improvement. All these opportunities led to further development of brachytherapy, with indisputable ballistic advantages, especially compared to external irradiation.

[Clinical target volume delineation for radiotherapy of the esophagus]. / Définition du volume cible anatomoclinique pour l'irradiation des cancers de l'œsophage.

The dense lymphatic network of the esophagus facilitates tumour spreading along the cephalo-caudal axis and to locoregional lymph nodes. A better understanding of microscopic invasion by tumour cells, based on histological analysis of surgical specimens and analysis of recurrence sites, has justified a reduction in radiotherapy target volumes. The delineation of the clinical target volume (CTV) depends on tumour characteristics (site, histology) and on its spread as assessed on endoscopic ultrasonography and ((18)F)-fluorodeoxyglucose positron-emission tomography (FDG-PET). We propose that positive and negative predictive values for FDG-PET should be used to adapt the CTV according to the risk of nodal involvement.

[Experimental studies concerning the exact determination of the etiopathogenesis of pneumoconiosis of coal miners]. / Cercetari experimentale privind precizarea etiopatogeniei pneumoconiozei minerilor din exploatarile carbonifere (PMC).

The effects have been studied of some pure charcoal powder, and of mixed "coal pit" powder which are representative for the basin in the Jiu Valley. A total of 48 samples have been studied as such and after addition of quartz graduated to contain 5, 10, 15, 20 and 25% quartz. The aim of the study was to determine the type of pneumoconioses induced by the various powders, to establish the role of quartz particles and the threshold at which quartz addition will impart silicogenic properties to the dust particles. A total of 300 Wistar rats have received intra-tracheal doses of an unique amount of 50 mg suspension as such and with added quartz. The rats were distributed in 12 groups. Three animals in each group were sacrificed at 6 and 12 months after instillation and histopathologic studies of the lungs were performed. Addition of 10% quartz dust to the charcoal powder, and of 15% to the "coal pit" powder imparted silicogenic properties to the samples. Both powders have masked to a certain extent the effects of the added quartz, the protective effects being exerted by minerals associated to charcoal (silicates, metallic oxides, etc.). In the mining area investigated pneumoconioses and silicosis represent two distinct pathological entities, and the role of the quartz particles in the genesis of pneumoconioses in this particular area appears to be limited.