Service de radio oncologie

Freiburg, Germany

Service de radio oncologie

Freiburg, Germany
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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.


Frambati L.,Drs Alessandra Canuto et Joao Flores Alves Dos Santos | Weber K.,Drs Alessandra Canuto et Joao Flores Alves Dos Santos | Canuto A.,Drs Alessandra Canuto et Joao Flores Alves Dos Santos | Miralbell R.,Service de radio oncologie | And 5 more authors.
Revue Medicale Suisse | Year: 2013

Prostate cancer and androgen deprivation : benefits of psychological counseling Androgen deprivation is a therapeutic option for patients with prostate cancer, however with a range of side effects that negatively affects their physical and psychological condition. A multidisciplinary care program, ADAPP (Androgenic deprivation in prostate cancer patients), has been created with a special focus on managing these side effects. This article describes the intervention of the liaison psychiatry within this program, with care options ranging from psychological support to intensive psychotherapy to address patients' intrapsychic dynamics throughout this care program. Clinical cases are reported to illustrate the relevance and the necessity of this specialized counselling.


Gorthi S.,Ecole Polytechnique Federale de Lausanne | Duay V.,University of Applied Sciences and Arts Western Switzerland | Bresson X.,University of California at Los Angeles | Cuadra M.B.,Ecole Polytechnique Federale de Lausanne | And 5 more authors.
Medical Image Analysis | Year: 2011

This paper presents a new and original variational framework for atlas-based segmentation. The proposed framework integrates both the active contour framework, and the dense deformation fields of optical flow framework. This framework is quite general and encompasses many of the state-of-the-art atlas-based segmentation methods. It also allows to perform the registration of atlas and target images based on only selected structures of interest. The versatility and potentiality of the proposed framework are demonstrated by presenting three diverse applications: In the first application, we show how the proposed framework can be used to simulate the growth of inconsistent structures like a tumor in an atlas. In the second application, we estimate the position of nonvisible brain structures based on the surrounding structures and validate the results by comparing with other methods. In the final application, we present the segmentation of lymph nodes in the Head and Neck CT images, and demonstrate how multiple registration forces can be used in this framework in an hierarchical manner. © 2011 Elsevier B.V.


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.,Service de radio oncologie | Prior J.O.,Service de medecine nucleaire | Boubaker A.,Service de medecine nucleaire | Azria D.,Service de radio oncologie | And 8 more authors.
Cancer/Radiotherapie | Year: 2011

Positron emission tomography is a functional imaging technique that allows the detection of the regional metabolic rate, and is often coupled with other morphological imaging technique such as computed tomography. The rationale for its use is based on the clearly demonstrated fact that functional changes in tumor processes happen before morphological changes. Its introduction to the clinical practice added a new dimension in conventional imaging techniques. This review presents the current and proposed indications of the use of positron emission/computed tomography for prostate, bladder and testes, and the potential role of this exam in radiotherapy planning. © 2011 Société française de radiothérapie oncologique (SFRO).


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.


Boujelbene N.,Service de radio oncologie | Ozsahin M.,Service de radio oncologie | Khanfir K.,Service de radio oncologie | Azria D.,Service de radio oncologie | And 3 more authors.
Cancer/Radiotherapie | Year: 2011

Pure testicular seminoma is a rare disease with an excellent prognosis. Its management is controversial. In stage I disease, several treatment options are considered. Those are radiation therapy alone, chemotherapy alone or active surveillance, which is becoming increasingly popular. For more advanced stages, treatment is based on chemotherapy with or without radiation therapy. In this article, we review thoroughly the existing literature and recent recommendations the various treatment options, their advantages and disadvantages in different stages of the disease. © 2010 Société française de radiothérapie oncologique (SFRO).


Lemarignier C.,Center Henri Becquerel | Kraft J.,Service de radio oncologie | Modzelewski R.,CNRS Informatics Systems Laboratory | Fechter T.,Service de radio oncologie | And 5 more authors.
Medecine Nucleaire | Year: 2014

Purpose: (1) Evaluate the reproducibility of segmentation methods depending on the preselection region for tumour volume determination on 18F-fluoro-ethyl-tyrosine (FET) PET. (2) Evaluate the intra and inter-operator reproducibility of the manual delineation. (3) Compare this delineation with the segmentation methods. Materials and methods: Eighteen FET PET of patients with glioblastoma were analysed. Preselection regions were determined prior to any segmentation. Two physicians delineated the tumour volume manually. The tumour volume was also delineated with a threshold method (40 and 70% of SUVmax), and a random walk based method. Pearson coefficient (r) (P<0.05 for r>0.468) and Jaccard indices (JI) were used to compare the volumes. Results: Manual delineation was reproducible with r = 0.97 and IJ = 0.65 for intra-operator, and r = 0.76 and IJ = 0.45 for inter-operator reproducibility. The preselection regions for a given lesion were different and the segmentation varied with the preselection region: r = 0.55 JI = 0.58; r = 0.85 JI = 0.83; r = 0.70 JI = 0.39 respectively for the threshold of 40%, 70% and the random walk. The segmentation differed form de manual delineation with r = 0.37 and JI = 0.16; r = 0.54 and JI = 0.42; r = 0.43 and JI = 0.37 respectively for the threshold of 40%, 70% and the random walk. Conclusion: The reproducibility of the segmentation methods depends extensively on the preselection region. The intra-operator reproducibility of cerebral lesion delineation on FET PET is satisfactory. The inter-operator reproducibility could be improved. © 2014 Elsevier Masson SAS.


PubMed | Service de radio oncologie
Type: Journal Article | Journal: Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique | Year: 2011

Pure testicular seminoma is a rare disease with an excellent prognosis. Its management is controversial. In stage I disease, several treatment options are considered. Those are radiation therapy alone, chemotherapy alone or active surveillance, which is becoming increasingly popular. For more advanced stages, treatment is based on chemotherapy with or without radiation therapy. In this article, we review thoroughly the existing literature and recent recommendations the various treatment options, their advantages and disadvantages in different stages of the disease.

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