Comparison of four-year toxicities and local control of ultra-hypofractionated vs moderate-hypofractionated image guided prostate radiation with HDR brachytherapy boost: A phase I-II single institution trial.

Purpose/Objectives: To analyze the long term efficacy and safety of an ultra-hypofractionated (UHF) radiation therapy prostate treatment regimen with HDR brachytherapy boost (BB) and compare it to moderate-hypofractionated regimens (MHF). Materials/Methods: In this single arm, prospective monocentric study, 28 patients with intermediate risk prostate cancer were recruited in an experimental treatment arm of 25 Gy in 5 fractions plus a 15 Gy HDR BB. They were then compared to two historical control groups, treated with either 36 Gy in 12 fractions or 37.5 Gy in 15 fractions with a similar HDR BB. The control groups included 151 and 311 patients respectively. Patient outcomes were reported using the International Prostate Symptom Score (IPSS) and Expanded Prostate Index Composite (EPIC-26) questionnaires at baseline and at each follow-up visit. Results: Median follow-up for the experimental arm was 48.5 months compared to 47 months and 60 months compared to the 36/12 and 37,5/15 groups respectively. The IPSS and EPIC scores did not demonstrate any significant differences in the gastrointestinal or genitourinary domains between the three groups over time. No biochemical recurrence occurred in the UHF arm as defined by the Phoenix criterion. Conclusion: The UHF treatment scheme with HDR BB seems equivalent to standard treatment arms in terms of toxicities and local control. Randomized control trials with larger cohorts are ongoing and needed to further confirm our findings.

Poster - Thurs Eve-39: Full 3D dose calculation for total body irradiation: A comparison study between treatment planning systems in homogeneous and heterogeneous conditions.

PURPOSE: To perform full 3D heterogeneous dose calculations for total body irradiation (TBI) cases and compare different treatment planning softwares (TPS). METHOD: A retrospective study was performed on 7 patients. Dose distributions obtained with Pinnacle3 v.7.9u (Philips Medical Systems) were compared with the ones calculated using our actual TBI planning system Theraplan Plus (TPP) by MDS Nordion/Nucletron. Two different Pinnacle3 models were studied: standard beam commissioning (std_Pinnacle3 ) and TBI commissioning (TBI_Pinnacle3 ). For the later case, commissioning was adapted for the special TBI conditions (extended SSD of 190cm, large field, acrylic beam spoiler, and out of field dose (OFD)). RESULTS: Significant differences are found between the TPP, std_Pinnacle3 and TBI_Pinnacle3 dose distributions. For the relative mid-line doses, differences up to 12% were observed. Systematic overestimations of 5% were found in patients extremities between TPP and TBI_Pinnacle3 . Average dose underestimation of 3% was observed between std_Pinnacle3 and TBI_Pinnacle3 . Differences in patient extremities are attributed to the OFD contribution which is not correctly computed in TPP and std_Pinnacle3 . Dose comparison outside the patient's mid-line showed greater differences (up to 20%) between models. Accurate 3D heterogeneous dose calculations with TBI_Pinnacle3 model show major differences (homogeneous versus heterogeneous) in high and low density regions. Dose overestimation of 5% was observed in bony regions and dose underestimation of 5% to 10% was observed in lung regions. CONCLUSION: Those results are of major interest since they show a strong dependence of the dose calculation outcome on both TPS and commissioning used, potentially leading to significant dose misevaluation.

[Validation of a questionnaire of physical sensations in a French-Canadian population]. / Validation du questionnaire des sensations physiques auprès de la population canadienne-française.

The objectives of this study are three-fold. The first objective is to present the aspects of reliability and validity of a self-reported questionnaire that evaluates a specific facet of Panic Disorder with Agoraphobia (PDA) for the francophone population of Quebec, mainly the fear of fear. The Body Sensations Questionnaire (17), translated as the Questionnaire des Sensations Physiques (QSP) evaluates the degree to which individuals fear somatic symptoms commonly associated with panic. A second objective is to determine the factorial validity of the QSP and to investigate the dimensionality of the construct as assessed by the questionnaire. The third objective is to establish a reference database for the agoraphobic (N = 141 and N = 70) and the non-clinical population (N = 223). Results suggest that both questionnaires have similar internal consistency, temporal stability, construct validity, and discriminative validity. While the factorial solution of the present study uncovered a three-factor model (somatic, cardiac, and psychosensorial), which points to the multidimensional nature of the construct evaluated by the QSP, it greatly differs from the one obtained by Arrindel's study (5). Nevertheless, the extraction of the three principal components is supported by the results of the screen test and by two different implementations of parallel analysis, i.e., the computation of random eigen values and the use of an interpolation table of eigen values. Finally, it can be concluded that the psychometric properties of the French-Canadian translation of the BSQ are indications that it is an appropriate instrument to use in clinical research and in clinical practice to assess the fear of bodily sensations associated with the fear of fear.

Expression of common acute lymphoblastic leukemia-associated antigen on germ cell tumor.

A mediastinal germ cell tumor is described that reacts with the anti-common acute lymphoblastic leukemia-associated antigen antibody J5 using both immunofluorescence and immunoperoxidase techniques. This antigen has been reported recently on various cell lines including melanoma, colon, and breast. It has also been seen on normal fibroblasts and peripheral granulocytes. This is believed to be the first description of a solid nonlymphoid neoplasm possessing this antigen, and the implications regarding prognosis and therapy are discussed.