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Nancy, France

Niewald M.,Saarland University | Seegenschmiedt M.H.,Radiotherapy Center | Micke O.,Franziskus Hospital | Graeber S.,Saarland University | And 6 more authors.
International Journal of Radiation Oncology Biology Physics

Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4-to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, PZ.001; Calcaneodynia score, PZ.027; SF12, PZ.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were re-irradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year. © 2012 Elsevier Inc. Source

Tian F.,Radiotherapy Center
Nan fang yi ke da xue xue bao = Journal of Southern Medical University

To evaluate the value of CT common rail technique for application in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC). Twenty-seven NPC patients underwent Somatom CT scans using the Siemens CTVision system prior to the commencement of the radiotherapy sessions. The acquired CT images were registered with the planning CT images using the matching function of the system to obtain the linear set-up errors of 3 directions, namely X (left to right), Y (superior to inferior), and Z (anterior to posterior). The errors were then corrected online on the moving couch. The 27 NPC patients underwent a total of 110 CT scans and the displacement deviations of the X, Y and Z directions were -0.16∓1.68 mm, 0.25∓1.66 mm, and 0.33∓1.09 mm, respectively. CT common rail technique can accurately and rapidly measure the space error between the posture and the target area to improve the set-up precision of intensity-modulated radiotherapy for NPC. Source

Taillandier L.,Nancy University Hospital Center | Bernier V.,Radiotherapy Center | Baron M.-H.,Besancon University Hospital Center | Baron M.-H.,French Institute of Health and Medical Research
Neurosurgical Review

Grade II gliomas grow slowly and linearly (at rates about 4 mm/year) before undergoing anaplastic transformation. In order to analyze how surgery may affect radiological grade II glioma kinetics, we restrospectively reviewed our national database searching for patients operated on for a supratentorial grade II glioma between 1997 and 2007. We selected patients with at least two postoperative MRI with a minimal delay of 6 months. For each patient, postoperative residues were segmented on successive MRIs. Velocities of diameter expansion were estimated by linear regression of mean diameter evolution for each patient. Fifty-four patients fulfilled inclusion criteria. Median postoperative follow-up was 1.6 years with, on average, 3.4 MRI examinations per patient. Postoperative growth rates of mean diameter were normally distributed, around a mean value of 4.3 mm/year (SD∈=∈3.2 mm/year). Statistical analysis showed no difference between this distribution and the distribution of preoperative growth rates in a previous series of 143 grade II gliomas. For a subset of 23 patients, delay between first MRI and surgery made it possible to estimate also preoperative growth rates. Intrapatient comparison revealed that growth rates were grossly unchanged for 80% of cases. In summary, inter- and intrapatient comparison of pre- and postoperative growth rates proves that surgery does not change grade II glioma dynamics, thus, acting as a cytoreduction. © 2009 Springer-Verlag. Source

Zhang D.-F.,ishui Center Hospital | Fang R.-Y.,Radiotherapy Center | Ma D.-L.,ishui Center Hospital
Zhongguo shi yan xue ye xue za zhi / Zhongguo bing li sheng li xue hui = Journal of experimental hematology / Chinese Association of Pathophysiology

OBJECTIVE: To investigate the clinical efficacy of L-asparginasum, ASP) combined with CHOP for treating patients with extranodal natural killer/T-cell lymphoma.METHODS: A total of 68 patients with extranodal natural killer/T-cell lymphoma in our hospital from August 2007 to May 2009 were enrolled in this study, out of them 34 patients received CHOP regimen (CHOP group) and other 34 patients received CHOP regimen combined with L-Asparaginasum (ASP+CHOP group). The clinical efficacy of both groups was analyzed and compared after treatment.RESULTS: In CHOP group 16 patients achieved CR+PR, the total remission rate (TRR) was 47.06%; in ASP+CHOP group 24 patients achieved CR+PR, the TRR was 70.58%, and the TRR in ASP+CHOP group was higher than that in CHOP group, there was statistical significance between these 2 groups (X(2) = 3.886, P < 0.05). The time of PFS in CHOP group was 24.7 months, and the time of PFS in ASP+CHOP group was 47.5 months which was significantly longer than that in CHOP group, and there was statistical siguificance between these 2 groups (P < 0.05). The incidence of anemia with grade I-II and III-IV blood cell reduction in ASP+CHOP group was higher than that in CHOP group (P < 0.05). The incidence of fever with grade I-II and albumin decrease in ASP+CHOP group was higher than that in CHOP group (P < 0.05). The abnormality of coagulation function in ASP+CHOP group was higher than that in CHOP group (P < 0.05). The anaphylactic reaction was found in 6 cases. The increase of serum amylase was observed in 1 case of aggressive NK/T cell lymphoma, the acute pancreatitis occured in 1 case who was inproved after treatment, but this patients died due to rapid progression of disease caused by poor general condition and untolerance to chemotherapy. The incomplete intestinal obstruction was found in 3 patients who recovered after conservative treatment. The grade II serum creatinine was elevated in 2 cases of ASP+CHOP group and in 1 case of CHOP group who was inproved after symptomatic therapy.CONCLUSION: L-Asparaginasum combined with CHOP for treating patients with extranodal natural killer/T-cell lymphoma is effective, and may be used in clinic. Source

Lettmaier S.,Friedrich - Alexander - University, Erlangen - Nuremberg | Kreppner S.,Friedrich - Alexander - University, Erlangen - Nuremberg | Lotter M.,Friedrich - Alexander - University, Erlangen - Nuremberg | Walser M.,Radiotherapy Center | And 3 more authors.
Radiotherapy and Oncology

Background and purpose: Accelerated partial breast irradiation by means of multicatheter brachytherapy shows great promise in the modern treatment of early breast cancer combining high efficacy in preventing tumour recurrence with low levels of toxicity. The present work attempts a dosimetric comparison between this treatment modality and conventional whole breast external beam radiotherapy by looking at differences in risk organ exposure to radiation. Patients and methods: The planning CT data sets of 16 consecutive patients with left-sided breast cancer who received external beam radiotherapy to the whole breast followed by a boost to the tumour bed using multicatheter interstitial brachytherapy after breast conserving surgery were used to create two independent physical treatment plans - one for an external radiotherapy, one for sole partial breast brachytherapy in each case assuming a total reference dose of 50 Gy for each patient. Dose-volume parameters D 0.1cc, D 0.5cc, D 1cc, D 2cc, D 5cc, D 10cc, D 25cc, D 50cc, V 100, V 90, V 50, V 10, V 5 for the ipsilateral lung, the heart and the adjacent skin were calculated and compared between the two treatment modalities. Results: All organs at risk showed a substantially lower radiation exposure in the brachytherapy plan. This was most pronounced for the heart with values differing by a factor of four. Although somewhat less marked this was also true for the ipsilateral lung and the adjacent skin with exposure ratios of three and two, respectively. Conclusions: With the use of multicatheter interstitial brachytherapy substantial reductions in the radiation exposure of risk organs can be achieved in comparison to whole breast external beam radiotherapy. These are likely to translate into profound clinical benefits. © 2011 Elsevier Ireland Ltd. All rights reserved. Source

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