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Freiburg, Germany

Ferrarini A.,Service de genetique medicale | Auteri-Kaczmarek A.,Fondation du Center Pluridisciplinaire dOncologie | Pica A.,Service de radio oncologie | Boesch N.,University of Basel | And 6 more authors.
Familial Cancer | Year: 2011

We report a 26-year-old female patient who was diagnosed within 4 years with chest sarcoma, lung adenocarcinoma, and breast cancer. While her family history was unremarkable, DNA sequencing of TP53 revealed a germline de novo non-sense mutation in exon 6 p.Arg213X. One year later, she further developed a contralateral ductal carcinoma in situ, and 18 months later a jaw osteosarcoma. This case illustrates the therapeutic pitfalls in the care of a young cancer patient with TP53 de novo germline mutations and the complications related to her first-line therapy. Suggestion is made to use the less stringent Chompret criteria for germline TP53 mutation screening. Our observation underlines the possibly negative effect of radiotherapy in generating second tumors in patients with a TP53 mutation. We also present a review of six previously reported cases, comparing their cancer phenotypes with those generally produced by TP53 mutations. © 2011 Springer Science+Business Media B.V.

Dulguerov N.,Unite de Chirurgie Cervico Faciale | Caparrotti F.,Service de radio oncologie | Mach N.,Service dOncologie | Dulguerov P.,Unite de Chirurgie Cervico Faciale
Revue Medicale Suisse | Year: 2015

We compared the treatment modalities as well as the oncologic outcome between young elderly (65-79 years old), elderly (L 80 years old) and the reference population (l 65 years old.) We reviewed 1047 patients treated between 2002 and 2012. Tumor sites, TNM stages, type of treatment, and the oncologic results are compared with survival statistics. The elderly group was associated with an increase in palliative treatment, more women and advanced T stages. For the 947 patients treated with curative intent, 5 year recurrence free survival was comparable. The overall-survival decreases with the age because of intercurrent deaths. Nevertheless, the treatment efficacy is similar. In conclusion, an advanced age is associated with worse survival, without a decrease in loco-regional control. The chronological age should not be used as a predictive factor for treatment response.

Vlastos G.,Service de Gynecologie | Monnier S.,Service de Gynecologie | Vinh-Hung V.,Service de radio oncologie
Revue Medicale Suisse | Year: 2010

Breast conserving therapy including breast conserving surgery followed by radiation therapy is the treatment of choice for early breast cancer. Sentinel lymph node biopsy is a minimally approach that allows to evaluate the axilla with less morbidity and avoid an axillary lymph node biopsy. This surgical technique is now evaluated in more specific situations. Modem surgical techniques such as oncoplastic surgery allow to excise larger tumors and obtain better cosmetic results. In a near future it is expected that intraoperative radiation therapy will remplace classicals approaches of radiotherapy for selected patients.

Boujelbene N.,University of Sfax | Boujelbene N.,University of Lausanne | Elloumi F.,University of Sfax | Kamel M.E.,Service de radiologie | And 4 more authors.
Swiss Medical Weekly | Year: 2013

Surgery has historically been the standard of care for operable stage I non-small cell lung cancer (NSCLC). However, nearly one-quarter of patients with stage I NSCLC will not undergo surgery because of medical comorbidity or other factors. Stereotactic ablative radiotherapy (SABR) is the new standard of care for these patients. SABR offers high local tumour control rates rivalling the historical results of surgery and is generally well tolerated by patients with both peripheral and centrally located tumours. This article reviews the history of SABR for stage I NSCLC, summarises the currently available data on efficacy and toxicity, and describes some of the currently controversial aspects of this treatment.

Volonte F.,Service de Chirurgie Viscerale | Roth A.,Unite dOncochirurgie | Betz M.,Service de radio oncologie | Huber O.,Service de Chirurgie Viscerale
Revue Medicale Suisse | Year: 2010

Despite recent progresses, the prognosis of oesophageal cancer is still bad, mostly because of frequent late diagnosis. In early cases, radical surgery alone is able to cure 60-70% of the patients. In locally-advanced cases, on the other hand, surgical results are considerably worse and combined therapies are contemplated. In these cases, neoadjuvant therapy (induction chemotherapy followed by radiotherapy and surgical resection) is often proposed, but without formal proof of superiority. These combined therapies are heavy for the patient and complex for the team. They can only be decided and managed in the frame of intensive multidisciplinary collaboration. Future progresses will come at the same time from larger studies and from the efforts of the medical community towards earlier diagnosis of this disease.

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