Radiotherapy alone for oropharyngeal carcinomas: the role of fraction size (2 Gy vs 2.5 Gy) on local control and early and late complications.

This retrospective study involved 150 patients treated for oropharyngeal carcinoma by external radiotherapy alone at the Institut Gustave-Roussy. The midplane tumor dose was 70 Gy delivered in 7 weeks. During 1981, 63 patients were treated with 5 fractions (5 F) of 2 Gy per week. The following year, 87 patients, were treated with 4 fractions (4 F) of 2.5 Gy per week. Prognostic factors were equally distributed in both groups. The locoregional tumor control was 83% for the 4 F patients and 83% for the 5 F patients. Degree and incidence of acute reactions with both fractionation regimens were similar. Necrosis of the oropharyngeal mucosa and trismus were significantly more severe and more frequent in the 4 F group (23% and 20% respectively) than in the 5 F group (10% and 5% respectively) (p = 0.03 and p = 0.01). Other late effects such as skin necrosis (6% in the 4 F group versus 0% in the 5 F group) and severe cervical sclerosis (12 vs 5%) were also more frequent in the 4 F group than in the 5 F group but the difference was not significant. The results suggest a greater sensitivity of late compared to early normal tissue effects and of tumor response to an increase in dose per fraction (from 2 Gy to 2.5 Gy) in oropharyngeal carcinoma.

An alternating chemotherapy and radiotherapy combination for non-Hodgkin's lymphomas of unfavourable histologies: feasibility and preliminary results.

In 1980, on the basis of fundamental and clinical data, a protocol was developed at the Institut Gustave-Roussy, alternating eight monthly courses of chemotherapy (CHVP) and two or three radiotherapy sequences (15 Gy in 6 fractions of 10 days, each), to treat non-Hodgkin's lymphomas of unfavourable histologies, mainly stage II, presenting bulky tumours. Systemic, haematological and digestive tolerances were satisfactory. For 19 previously untreated stage II patients, overall survival and relapse-free survival after 30 months were 85 and 65%, respectively. Three of the relapses were observed in patients who did not receive the alternating schedule in an optimal way; this suggests that these results can be further improved.

[Cancer of the prostate: value of x-ray computed tomography in the preradiotherapeutic evaluation. Apropos of 49 cases reviewed at the Gustave-Roussy Institute]. / Cancer de la prostate: intérêt du scanner dans le bilan pré-radiothérapique. A propos de 49 cas revus à l'Institut Gustave-Roussy.

Fourty nine patients having a prostatic carcinoma had a CT examination. CT should be used only if bone metastasis lack and if a curative treatment is possible. Study of local extension is misleading and ultrasound, especially transrectal, is a better method to appreciate the volume of the tumor. On the contrary, CT detects quite often nodes metastasis which will modify the treatment. If CT is negative, lymphangiogram must be done because it is a more precise method to evaluate the node structure. Percutaneous node biopsy may confirm node metastasis.

[Multiple chemotherapy (MOPP) followed by either focal or selective radiotherapy in clinical stages IA and II2A of Hodgkin's disease: results after four years of the use of prospective schedule (H 7701) in 79 patients (author's transl)]. / La séquence polychimiothérapie MOPP-radiothérapie sélective ou focale dans la maladie de Hodgkin, stades cliniques IA, II2A: résultats à 4 ans d'un protocole prospectif (H 7701) incluant 79 patients.

Seventy-nine patients with clinical stages IA, or II2A of Hodgkin's disease were treated from January 1977 to April 1980 by a multiple therapy schedule, H 7701. Three courses of MOPP chemotherapy were first given to all patients. They were then randomly allocated to two groups: group 7701 S (38 patients) was treated by mantle irradiation, excluding the mediastinum when this was not initially involved, or inverted Y radiotherapy; group 7701 F (41 patients) was treated by focal irradiation only. After follow-up for 9-48 months (median: 26 months), overall survival was 98,6 p. cent and relapse-free duration 94,9 p cent. No statistical difference exists between the two randomized groups. Four patients relapsed; three are now free of disease after further treatment, while one patient has since died. With this chemotherapy-radiotherapy selective of focal sequence, staging laparotomy is not indicated. Results and side effects of this treatment schedule are compared with those of other treatment strategies.