BMC Cancer

BACKGROUND: Although some countries have observed a stabilization in the incidence of CNS, an increasing incidence has been reported from multiple studies. Recent observations point out to the heterogeneity of incidence trends according to histological subtypes, gender and age-groups. Using a high-quality regional CNS tumor registry, this article describes the trends of CNS tumor incidence for main histological subtypes, including benign and malignant tumors, in the French department of Gironde from 2000 to 2012. METHODS: Crude and age-standardized incidence rates were calculated globally, by histological subtypes, malignant status, gender and age groups. For trends, annual percent changes (APC) were obtained from a piecewise log-linear model. RESULTS: A total of 3515 CNS tumors was registered during the period. The incidence of overall CNS tumors was 19/100000 person-years (8.3/100000 for neuroepithelial tumors and 7.3/100000 for meningeal tumors). An increased incidence of overall CNS tumors was observed from 2000 to 2012 (APC = + 2.7%; 95%-confidence interval (CI): 1.8-3.7). This trend was mainly explained by an increase in the incidence of meningiomas over the period (APC = + 5.4%, 95%-CI: 3.8-7.0). The increased incidence rate of CNS tumors was more pronounced in female and in older patients even though the incidence rate increased in all age groups. CONCLUSIONS: Part of the temporal variation may be attributed to improvement in registration, diagnosis and clinical practices but also to changes in potential risk factors. Thus, etiological studies on CNS tumors are needed to clarify this rising trend

Place de la radiothérapie des paragangliomes de la tête et du cou (à propos d'une série de 30 patients traités au CHU de Bordeaux entre 1987 et 2010)

OBJECTIFS : Mise en évidence de l'effet à long terme des radiations sur le tissu paraganglionnaire. Evaluation de l'efficacité et de la place de la radiothérapie dans la prise en charge des paragangliomes de la tête et du cou. Estimation de la qualité de vie post-thérapeutique MATERIELS ET METHODES : Analyse rétrospective d'une série de 30 patients traités par radiothérapie pour un paragangliome cervico-céphalique. Analyse volumétrique de la réponse à la radiothérapie. Etude des taux de survie et du contrôle local pour l'échantillon, analyse de sous groupes en fonction du type de traitement et la dose reçue. Evaluation de la qualité de vie post-thérapeutique par les questionnaires de l'EORTC QLQ-C30 et H&N35. RESULTATS : Avec un suivi moyen de 7,6 ans, 70 % des patients soit 21/30 sont en vie à l'issue de l'étude. La régression tumorale après radiothérapie à deux (p = 0,018) est significative. La survie globale et le contrôle local sont respectivement de 95 % et 96 % à 5 ans. Une différence concernant la survie (p = 0,04) et le contrôle tumoral (p = 0,03) est retrouvée selon le traitement réalisé. L'hypothèse d'un comportement tumoral différent suivant le terrain et/ou la forme génétique pourrait expliquer ce résultat. La qualité de vie post-thérapeutique est altérée et nécessite d'être considérée comme un critère de jugement au même titre que la réponse tumorale et la survie des patients. CONCLUSION : La radiothérapie et la radiochirurgie sont des alternatives thérapeutiques dans la prise en charge des paragangliomes. La poursuite de ce travail permettra d'optimiser la stratégie thérapeutique en fonction du terrain du patient.BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Effet volume en radiothérapie, présentation des modèles descriptifs (illustration des économies potentielles de volume au travers d'un échantillon de 10 dossiers de planification thérapeutique d'un adénocarcinome prostatique)

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Inflammatory Myofibroblastic Tumour of the Skull Base

Inflammatory myofibroblastic tumors (IMTs) are rare benign clinical and pathological entities. IMTs have been described in the lungs, abdomen, retroperitoneum, and extremities but rarely in the head and neck region. A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of the right sphenoid and clivus. MR imaging showed a large tumor of the skull base which was invading the sella turcica, right cavernous sinus, and sphenoidal sinus. A biopsy was performed and revealed an IMT. Corticosteroids were given for 3 months but were inefficient. In the framework of our pluridisciplinary consultation, fractionated conformal radiotherapy (FRT) was indicated at a low dose; 20 Gy in 10 fractions of 2 Gy over 12 days were delivered. Clinical response was complete 3 months after FRT. Radiological response was subtotal 6 months after FRT. Two years later, the patient is well

Interval between planning and frameless stereotactic radiotherapy for brain metastases: are our margins still accurate?

International audienceAbstractBackgroundAdvances in intracranial stereotactic radiosurgery (SRS) have led to dramatically reduced planning target volume (PTV) margins. However, tumor growth between planning and treatment may lead to treatment failure. Our purpose was to assess the kinetics of tumor growth before SRS for brain metastases.MethodsThis retrospective, monocentric study included all consecutive patients (pts) treated for brain metastases secondary to melanoma (ML) and non-small cell lung cancer (NSCLC) between June 2015 and May 2016. All pts underwent diagnostic brain imaging and a radiosurgery planning MRI, during which gross tumor volume (GTV) was delineated. Linear and exponential models were used to extrapolate a theoretical GTV at first day of treatment, and theoretical time to outgrow the PTV margins.ResultsTwenty-three ML and 31 NSCLC brain metastases (42 pts, 84 brain imaging scans) were analyzed. Comparison of GTV at diagnosis and planning showed increased tumor volume for 20 ML pts (96%) and 22 NSCLC pts (71%). The shortest time to outgrow a 1 mm margin was 6 days and 3 days for ML and 14 and 8 days for NSCLC with linear and exponential models, respectively.ConclusionsPhysicians should bear in mind the interval between SRS planning and treatment. A mathematical model could screen rapidly progressing tumors

Hypofractionated stereotactic body radiation therapy (SBRT) in pediatric patients: preliminary toxicity results of a national prospective multicenter study.

While hypofractionated stereotactic body radiotherapy (SBRT) has been largely adopted in the adult setting, its use remains limited in pediatric patients. This is due, among other factors, to fear of potential toxicities of hypofractionated regimens at a young age. In this context, we report the preliminary acute (<3 months from SBRT) and middle-term (3-24 months) toxicity results of a national prospective study investigating SBRT in pediatric patients. Between 2013 and 2019, 61 patients were included. The first 40 patients (median age: 12 y, range: 3-20) who completed a 2-year-follow-up were included in the present analysis. SBRT was used for treating lung, brain or (para)spinal lesions, either as first irradiation (35%) or in the reirradiation setting (65%). Acute and middle-term grade ≥2 toxicities occurred in 12.5 and 7.5% of the patients, respectively. No grade ≥4 toxicities occurred. Almost all toxicities occurred in the reirradiation setting. SBRT showed a favorable safety profile in young patients treated for lung, brain, and (para)spinal lesions. SBRT appeared to be safe in pediatric patients treated for multiple oncology indications. These results support further evaluation of SBRT, which may have a role to play in this patient population in the future

Additional file 1: of Increasing incidence of central nervous system (CNS) tumors (2000–2012): findings from a population based registry in Gironde (France)

Table S1. Distribution and standardized incidence rates (reference populations Europe, US, world) by age, sex and histological type, Gironde CNS registry, 2000–2012. (DOCX 18 kb

Réunions nationales de cas complexes en radiothérapie pédiatrique : retour sur six années d’expérience

International audienc

Prognostic and predictive values of diffusion and perfusion MRI in paediatric intracranial ependymomas in a large national study

International audienc

Neuroepidemiology

BACKGROUND: The Gironde Central Nervous System (CNS) Tumor Registry, in collaboration with the French National Cancer Institute, is the largest population-based registry focused exclusively on primary CNS tumors in France and represents a population of 1.62 million. This report focuses on ependymal tumors to refine current knowledge and provide up-to-date data on the epidemiology of these rare tumors. MATERIAL AND METHODS: All of the ependymal tumors were extracted from the Gironde CNS Tumor Registry for the years 2000-2018. Demographic and clinical characteristics, incidence rates, and time trends as well as survival outcomes were analyzed. RESULTS: One hundred forty-four ependymal tumors were retrieved, which represented 2.3% of all the CNS tumors recorded in the same period. Histological subtype was significantly dependent on age and topography in the CNS. The median age at diagnosis was 46 years. The annual incidence rates varied between 0.15/100,000 (2004) and 0.96/100,000 (2016), with a significant increase over the study period by 4.67% per year. Five-year and 10-year OS rates were 87% and 80%, respectively. CONCLUSION: An increase in the incidence of ependymal tumors was observed over the past two decades. Further studies are needed to confirm this result and provide etiological clues