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

Assessment of two synthesized curdlan derivatives as possible antioxidants and/or modulators of human PMN cells respiratory burst

Abstract β-glucans are described as active compounds with immune activity. These polymers demonstrated positive effects on the immune syste

The novel arthritis-drug substance MCS-18 attenuates the antibody production in vivo

Influence of the novel arthritis drug-substance MCS-18 on the antibody (Ab) production against tetanus toxoid (TT) and diphtheria toxoid (DT) antigens was tested in vivo . Possible involvement of MCS-18 in Toll-like receptor (TLR) signalling pathway was further considered.Materials and methods: Immunization of male CD1 mice was done with subcutaneous injection of TT emulsified in Freund’s Complete (FCA) or Incomplete Adjuvant (FIA) and mixed diversly with MCS-18 and different test substances. To investigate the influence of TLR activation Pam3Cys and lipopolysaccharide (LPS) emulsified in FIA were tested in combinations with MCS-18. Antibody production was analysed in vivo by tetanus-or diphtheria-toxin neutralization test.Results: Immunogenicity of TT was significantly enhanced if administered together with FCA or TLR agonists Pam3Cys or LPS emulsified in FIA. It was shown that MCS-18 attenuated strongly the production of anti-TT Ab if administered together with the Ab elicitor FCA or TLR agonists in various combinations. MCS-18 was also active via oral administration.Discussion: These findings suggest that MCS-18 could be a potent, non-toxic antagonist or a down-regulator of TLR signalling pathway. Investigations on further models are needed to establish if MCS-18 may influence particularly the production of RA-specific auto-antibodies, too

Nouvelles indications de protonthérapie et essais cliniques en cours : tumeurs intracrâniennes

CERVOXY CLINInternational audienceConsidering intracranial tumours, only few indications of protontherapy, such as chordoma, chondrosarcoma or uveal melanoma, are uniformly approved in the world. Other indications, excluding paediatric pathologies, are still debated. The aim of this article is to describe the rationale for the use of protonbeam irradiation for meningioma, pituitary adenoma, craniopharyngioma, paraganglioma, glioma, and schwannoma, and to inform the radiation oncologists if prospective studies or randomized studies are opened for inclusions. This article deals only with indications for adults.En dehors de l’oncopédiatrie, et des indications dites « indiscutables » de protonthérapie, validées par l’Institut national du cancer (INCa) et de la Haute autorité de santé (HAS) (chordome, chondrosarcome, et mélanome oculaires), les indications potentielles de protonthérapie en population adulte restent très débattues. L’objectif de cet article de synthèse est donc de décrire le rationnel de la protonthérapie pour les indications intracrâniennes « en dehors de celles validées par l’INCa et la HAS », de rapporter les résultats thérapeutiques pour ces indications, s’ils existent, et d’informer l’oncologue-radiothérapeute si des études cliniques sont ouvertes ou en cours d’ouverture. Cet article de synthèse se limite aux indications pour la population adulte

État des lieux de la protonthérapie en France en 2019

International audienceAmong over 100 proton therapy centres worldwide in operation or under construction, French proton therapy is coming to full maturity with the recent opening of the Nice (1991, upgrade in 2016) and Caen (2018) facilities next to the Orsay (1991, upgrade in 2010) centre. Proton therapy is a national priority for children and young adults in all three centres. The patient-related activity of the three French centres is coordinated via the Protonshare portal to optimise referral by type of indication and available expertise in coordination with the French society of radiation oncology SFRO and French radiotherapy centres. The centres are recognised by the French Health Care excellence initiative, promoted by the ministry of Foreign Affairs. The three centres collaborate structurally in terms of clinical research and are engaged at the international level in the participation to European databases and research initiatives. Concerted actions are now also promoted in preclinical research via the Radiotransnet network. Ongoing French developments in proton therapy are well presented in international hadron therapy meetings, including European Proton Therapy Network and Particle Therapy Cooperative Oncology Group. Proton therapy teaching in France is offered at several levels and is open to colleagues from all radiation oncology centres, so that they are fully informed, involved and trained to facility recognition of possible indications and thereby to contribute to appropriate patient referral. This close collaboration between all actors in French radiation oncology facilitates the work to demonstrate the required level of medical and scientific evidence for current and emerging indications for particle therapy. Based on that, the future might entail a possible creation of more proton therapy facilities in France.Il existe plus de 100 centres de proton thérapie dans le monde, et trois en France. La protonthérapie française est en phase de structuration et de montée en charge, avec l’ouverture récente des centres de Nice (2016) et Caen (2018) en plus du centre d’Orsay (2010) pour les indications corps entier. La prise en charge des enfants et adolescents-jeunes adultes est une priorité nationale partagée par les trois centres. L’action des trois centres français est coordonnée en termes d’adressage via le portail Protonshare sous l’égide de la Société Française de radiothérapie oncologique (SFRO). Les trois centres ont aussi une dynamique coordonnée d’offre de soin à des patients étrangers dans le cadre du réseau French Health Care du ministère des Affaires étrangères. Ils sont inscrits dans une démarche nationale et internationale (en particulier, en Europe, via l’European Proton Therapy Network) de participation à des essais thérapeutiques et des bases de données. Des actions concertées sont désormais favorisées en recherche préclinique via le réseau Radiotransnet. Dans ses développements, la protonthérapie française est bien représentée dans les congrès internationaux d’hadronthérapie. L’enseignement de la protonthérapie en France est proposé à plusieurs niveaux et ouvert aux centres photons, potentiellement adresseurs. La participation de l’ensemble des acteurs de la radiothérapie française est ainsi encouragée pour favoriser la participation de tous à la construction du niveau de preuve médicoscientifique requis pour une éventuelle extension future du parc de protonthérapie français