[Spinal stereotactic body radiotherapy: French assessment in 2016]. / État des lieux de la radiothérapie en conditions stéréotaxiques vertébrale en France en 2016.

PURPOSE: Stereotactic body radiotherapy to vertebral column remains uncommon practice and only relevant in selected group of patients. The main objective of the study was to describe the current state of medical practices of stereotactic body radiotherapy to vertebral column in France in 2016 and to assess the diversity of practices to identify areas for improvement and establish a common database set for this technique. MATERIALS AND METHODS: A questionnaire was written with contribution of a medical physicist, a radiation oncologist, an information technologist and a radiotherapy resident. The questionnaire was distributed online to a radiation oncologists and a medical physicists partner of selected French radiotherapy specialized centres that provide stereotactic body radiotherapy to vertebral metastasis from April to June 2016. The questionnaire surveyed the following topics: patients' selection, simulation, targeted volume and organs at risk delineation, prescription, dosimetric implementation and image guidance. RESULTS: A total of 31 centres were surveyed. Seventy eight per cent of centres (n=21) completed the questionnaire. The "ideal" patient for spine stereotactic radiotherapy according to these institutions has a good performance status, a long life expectancy, controlled primary tumour with oligometastatic spread. The most prescribed protocol was 30Gy in three fractions. For clinical target volume delineation, about two thirds of centres used the International Spine Radiosurgery Consortium (ISRC) recommendations (Noël G et al.,2006). CONCLUSION: This study identified some consistency of practices in some aspects despite the lack of consensus guidelines. Nevertheless, further studies are needed to establish consensus of planning and treatment.

[French radiotherapy database: results of a survey of French radiation oncology centers in 2007]. / Observatoire national de la radiothérapie: rapport de l'enquête conduite en 2008 sur l'année 2007.

For the second year, the French Radiotherapy Database presents information from French radiation oncology centers. Among 179 centers, 159 have participated (90 %). The number of accelerators increased from 371 to 384 between 2006 and 2007, 11 % of these machines are more than 15 years old. On average, centers are open 50 hours per week for treatment and 9.5 % more for maintenance. The lack of dedicated CT remains a difficulty: 158 from 159 centers have an access to a CT, but only 50 % have a dedicated scanner. There is no progress compared to 2006. The proportion of centers having a MU double calculation system has increased from 51 to 58 %. Two thirds of centers do not implement in vivo dosimetry. The activity is stable around 190 000 treatments per year. Three-dimension conformal radiotherapy is used for more than half of treatments in 77.2 % of private centers and 50 % of public hospitals. Intensity modulated radiotherapy remains rarely used. The number of radiation oncologists and technologists remains stable. The number of radiophysicists has increased from 7.6 %. Despite some progress, the difficulties of this speciality persist in France and are equally distributed across all regions, and between private and public centers. In 2009, the French Society for Radiation Oncology and the associated partners will continue this survey, which interest is recognized by both professionals and health administrations.

[The place of conformal radiotherapy in routine practice: national survey of SFRO members]. / Place de la radiothérapie de conformation dans la pratique quotidienne: enquête nationale auprès des membres de la SFRO.

National French investigation of the using of conformal radiotherapy in routine work, has been made in 2001, in 180 radiotherapeutic centers. Eighty responses have been obtained and analyzed. Conformal radiotherapy is used in 88% and virtual simulation in 60% of these centers. There is a heterogeneity in the equipment of these institutions, most of them have one or two machines. The accelerator equipment differs, and the disponibility of multileaf collimators and electronic portal imaging is limited. Actually only eleven centers have IMRT, eight have projects to install. Only six centers have CT-scans, used mainly for simulation. In 75% of centers, conformal radiotherapy have been used in the treatment of CNS-tumors, head and neck cancers, prostate, and non-small cell lung carcinoma. If there are more equipment and human facilities to use conformal radiotherapy, this treatment can be proposed to patients with breast cancer, rectal and gynecological tumors. According 90% of responses, all prostatic cancers need conformal radiotherapy. The analysis of routine use of conformal radiotherapy in France shows an important heterogeneity but it seems that there is an agreement with objectives of this treatment.

Post-radiation severe xerostomia relieved by pilocarpine: a prospective French cooperative study.

BACKGROUND AND PURPOSE: The aim of the study was: (1) to confirm the action of pilocarpine hydrochloride (Salagen) against xerostomia: (2) to correlate the response to dose/volume radiotherapy parameters. MATERIALS AND METHODS: From June 1995 to February 1996, 156 patients with severe radiation induced xerostomia received pilocarpine hydrochloride orally. IS mg per day with a 5 mg optional increase at S weeks up to a daily dose of 25 mg beyond 9 weeks. RESULTS: One hundred and forty five patients are fully evaluable. Treatment compliance was 75%. Thirty eight patients (26%) stopped treatment before week 12 for acute intolerance (sweating, nausea, vomiting) or no response. No severe complication occurred. Ninety ses en patients (67%) reported a significant relief of symptoms of xerostomia at 12 weeks. Within 12 weeks, the size of the subgroup ith normal food intake almost doubled (13-24 patients) while the size of the subgroup with (nearly) impossible solid food ingestion decreased by 38% (47 vs. 29 patients). The impact on quality of life was considered important or very important by 77% of the responders. CONCLUSIONS: No difference was found according to dose/volume radiotherapy parameters suggesting that oral pilocarpine hydrochloride: (1) acts primarily by stimulating minor salivary glands: (2) can be of benefit to patients suffering of severe xerostomia regardless of radiotherapy dose/volume parameters: (3) all responders are identified at 12 weeks.

Changes in testicular fluid production and plasma hormones in the adult rat after testicular 60Co irradiation.

Adult Wistar rats exposed to testicular radiocobalt irradiation (0.8 Gy) were alloted to four groups: sham control, protected control, unilaterally irradiated and bilaterally irradiated. The rats of each group were killed 30, 45, 60, 75 and 105 days after gamma-ray exposure and/or general anaesthesia. Tubular fluid (TF) production, estimated by ligature of the efferent ducts of both unilaterally and bilaterally irradiated testes, 24h prior to sacrifice, was transiently increased 30 and 45 days after irradiation (P less than 0.001); there was no increment in the interstitial fluid (or lymph) collected compared to sham and protected control testes. At 30 and 45 days, irradiated testis weight decreased significantly. From 60 to 105 days after gamma-ray exposure, TF gradually returned to control levels, while the testicular weight increased. The plasma FSH, LH, PRL and testosterone of the irradiated rats did not change significantly compared to the controls. Consequently, it is presumed that TF secretion was regulated locally by a germ cell-Sertoli cell interrelationship.

[Sympathetic paraganglioma. Scintigraphic detection using a new labeled molecule, meta-iodobenzylguanidine]. / Paragangliomes sympathiques. Détection scintigraphique par une nouvelle molécule marquée, la méta-iodobenzylguanidine.

Two cases of sympathetic paraganglioma are reported: one, benign, in a 20-years old woman with arterial hypertension and attacks of excessive sweating; the other, malignant and with bone metastases, in a 44-years old woman. Both were diagnosed by scintigraphy, using meta-iodobenzylguanidine as radionuclide. This new radiopharmaceutic agent has recently been introduced for the detection of phaeochromocytomas, but it seems to be a general tissue marker of catecholamine uptake and storage. Its use as a therapeutic compound may also be envisaged.