The EPTN consensus-based atlas for CT- and MR-based contouring in neuro-oncology

Biological, physical and clinical aspects of cancer treatment with ionising radiatio

Head and neck proton therapy in France: A missed opportunity or a challenge in front of us?

International audienceFollowing major advances of the best of photon-techniques such as intensity-modulated radiotherapy (IMRT), stereotactic body radiotherapy (SBRT) and, to arrive soon, magnetic resonance (MR)-linac radiotherapy, there are still substantial opportunities in the treatment of head and neck cancers to further reduce the toxicity burden. Proton therapy represents another attractive option in this high-quality and highly competitive precision radiotherapy landscape. Proton therapy holds promises to reduce toxicities and to escalate the dose in radioresistant cases or cases where dose distribution is not satisfactory with photons. However, the selection of patients for proton therapy needs to be done using evidence-based medicine to build arguments in favor of personalized precision radiation therapy. Referral to proton therapy versus IMRT or SBRT should be registered (ProtonShare® platform) and envisioned in a formalized clinical research perspective through randomized trials. The use of an enrichment process using a model-based approach should be done to only randomize patients doomed to benefit from proton. To tackle such great opportunities, the French proton therapy challenge is to collaborate at the national and international levels, and to demonstrate that the extra-costs of treatment are worth clinically and economically in the short, mid, and long-term. In parallel to the clinical developments, there are still preclinical issues to be tackled (e.g., proton FLASH, mini-beams, combination with immunotherapy), for which the French Radiotransnet network offers a unique platform. The current article provides a personal view of the challenges and opportunities with a focus on clinical research and randomized trial requirements as well as the needs for strong collaborations at the national and international levels for PT in squamous cell carcinomas of the head and neck to dat

Anomaluos Phsophenes in Ocular Protontherapy

We have undertaken a clinical ground study of proton-induced light flashes (phosphenes). Patients treated at the Institut Curie – Centre de Protonthérapie in Orsay, France, received radiation therapy to cure ocular and skull-base cancers. Sixty percent of the patients treated for choroidal melanomas using 73 MeV protons report anomalous phosphenes. Delivering a radiation dose on the retina only is not sufficient to trigger the light flash. The present study may be the first indication of phosphenes triggered by protons of few tens of MeV

Review of clinical applications of radiation-enhancing nanoparticles

International audienceBut: Des preuves cliniques des effets d’amélioration des rayonnements des nanoparticules ont émergé.Matériaux et méthodes: Nous avons effectué des recherches dans la littérature en anglais et Français sur PubMed jusqu’en octobre 2019. Le terme de recherche était « nanoparticule » ET « radiothérapie », donnant 1270 résultats.Résultats: Les deux principaux NP utilisés dans les essais cliniques étaient l’oxyde de hafnium et le gadolinium impliquant un total de 229 patients. L’oxyde de hafnium NP a été utilisé dans trois essais de phase 1/2 sur le sarcome, le carcinome épidermoïde de la tête et du cou ou le cancer du foie et dans un essai de phase 2/3. Six essais cliniques de phase 1/2 sont en cours pour évaluer la combinaison de NP et de RT à base de gadolinium pour le traitement des métastases cérébrales et du cancer du col de l’utérus.Conclusion: Jusqu’à présent, les nanoparticules d’oxyde de hafnium intratumorales étaient sûres et amélioraient leur efficacité dans le sarcome localement avancé