Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB) has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow-up was 8.0 years. Five year local control was 85% . Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity

European Lung Cancer Working Party Clinical Practice Guidelines. Non-Small Cell Lung Cancer: III. Metastatic disease

The present guidelines on the management of advanced non-small cell lung cancer (NS CLC) were formulated by the ELCWP in October 2006. They are designed to answer the following twelve questions: 1) What benefits can be expected from chemotherapy and what are the treatment objectives? 2) What are the active chemotherapeutic drugs for which efficacy has been shown? 3) Which are the most effective platinum-based regimens? 4) Which is the indicated dosage of cisplatin? 5) Can carboplatin be substituted for cisplatin? 6) Which is the optimal number of cycles to be administered? 7) Can non-platinum based regimens be substituted for platinum based chemotherapy as first-line treatment? 8) Is there an indication for sequential chemotherapy? 9) What is the efficacy of salvage chemotherapy and which drugs should be used in that indication? 10) What is the place of targeted therapies? 11) What is the place of chemotherapy in the management of a patient with brain metastases? 12) Which specific drugs can be used for the patient with bone metastases

Comment optimiser la radiothérapie dans le traitement des carcinomes bronchiques à petites cellules?

The most important progress made during the last years in the management of small cell lung cancer is certainly the recognition of the impact of chest radiotherapy for limited disease and prophylactic cranial irradiation (PCI) for patients in complete response. How to optimize chemotherapy and radiotherapy is the topic of this paper. The current trend is to deliver thoracic radiation concurrently with the first cycles of chemotherapy (cisplatine and etoposide). The total dose is still not defined and the subject of phase III trials. PCI is delivered at the end of the chemotherapy with moderate doses. The place of PCI in extensive disease is still debate even if there is a clear benefit in quality of life.English AbstractJournal Articleinfo:eu-repo/semantics/publishe

How to integrate radiation in the therapeutic management of SCLC

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Advances in radiotherapy for small cell lung cancer

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Place de la radiothérapie médiastinale postopératoire dans les cancers pulmonaires non à petites cellules.

Postoperative radiotherapy remains controversial in non-small cell lung cancer. The conclusions of several meta-analysis are still questioned, partly because of flaws in the randomized trials taken into account. The technological improvements of modern radiotherapy and several clinical observations have led to the launch of a new phase III trial.English AbstractJournal ArticleReviewSCOPUS: sh.jinfo:eu-repo/semantics/publishe

Is chest radiation now a classical practice for extensive small cell lung cancer?

The recent phase III published by Slotman et al. addressed the question of additional chest radiation showing a benefit mainly in local control. A critical analysis of this trial point out all the limitations and in view of other studies, the real benefit of chest radiation for extensive small cell lung cancer (SCLC) remains unclear.SCOPUS: ed.jinfo:eu-repo/semantics/publishe

External radiotherapy and prostate cancer

Objectives: To update the results of modern radiation therapy to treat Prostate Cancer (PCa). Methods: The authors review in the recent international literature the papers dealing with radiation therapy for PCa. They notably report on the results obtained with 3-D conformal radiotherapy, heavy ions and image guided radiotherapy (IGRT). Results: Several series have suggested a higher control rate with an increasing radiation dose: 81% for doses above 72 Gy in patients with PSA between 10 and 20 ng/ml. In 3-D conformal radiotherapy, margins are added around the clinical target volume to take into account movement of the tumour and uncertainties in the clinical target volume delineation process. IGRT allows treatment of concave forms and therefore protection of the rectal wall. Using conformal techniques, the rate of grade 2 gastrointestinal toxicity decreased from 15% to 5% and grade 3 toxicities have become rare events in the most modern series. Protons or heavy ions offer a significant advantage in dose distribution compared to photon beams but must be considered so far as investigative. At last, several randomized trials have shown that adjuvant androgen deprivation can improve the results of radical radiotherapy, especially in locally advanced PCa. Conclusions: External radiotherapy is very effective to treat localized PCa and even more locally advanced disease, especially using a conformal 3-D approach. But further improvements have still to be made for a more individualized approach. © 2006 Elsevier B.V. All rights reserved.SCOPUS: cp.jinfo:eu-repo/semantics/publishe

Adjuvant treatments for non-small cell lung cancer

Surgery remains the cornerstone for the curative treatment of non-small cell lung cancer (NSCLC). Long-term survival depends on different prognostic factors including the tumour extent (the T and N stage) and the quality of the surgical resection (complete vs. incomplete resection, the type of mediastinal exploration). Nevertheless, only one-third of all operated patients will be metastases alive 5 years after the surgical resection. Failures are due to a loco-regional relapse, distant metastases or a second primary cancer related to the long story of tobacco abuse. The pattern of failure analysis should decide on the type of adjuvant treatment: a loco regional modality or a form of systemic treatment such as chemotherapy or immunotherapy.SCOPUS: ar.jinfo:eu-repo/semantics/publishe