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Menzel Bourguiba, Tunisia

Farhat L.,Service de radiotherapie carcinologique | Besbes M.,Institute Salah Azaiz | Bridier A.,Institute Gustave Roussy | Daoud J.,Service de radiotherapie carcinologique
EPJ Applied Physics | Year: 2011

The aims of this work were to measure the entrance and exit dose for patient treated for head and neck tumors. The target absorbed dose was determined from the exit and entrance dose measurement. Twenty patients were evaluated. The results were compared to the calculated values and the midline dose was determinate and compared with the prescribed dose. 80 entrance doses and 80 exit doses measurements were performed. The average difference from expected values was 1.93% for entrance dose (SD 1.92%) and -0.34% for exit dose (SD 4.1%). The target absorbed dose differed from prescribed dose values by 2.94% (1.97%) for the results using the Noël method and 3.34% (SD: 2.29%) with the Rizzotti method. The total uncertainty budget in the measurement of the absorbed entrance and exit dose with diode, including diode reading, correction factors and diode calibration coefficient, is determined as 3.02% (1 s). Simple in vivo dose measurements are an additional safeguard against major setup errors and calculation or transcription errors that were missed during pre-treatment chart check. © EDP Sciences, 2011.

Elloumi F.,Service de radiotherapie carcinologique | Ben Amor M.,Service de radiotherapie carcinologique | Ghorbel L.,Service de radiotherapie carcinologique | Mnif H.,Service dAnatomie Pathologique | And 4 more authors.
Cancer/Radiotherapie | Year: 2013

Metastasis to the central nervous system, either through a hematogenous route or through the cerebrospinal fluid, is extremely rare in nasopharynx cancer. We aim to expose clinical aspects, therapeutic features and prognosis of nasopharyngeal carcinoma with brain metastases. We retrospectively reviewed the medical history of about 420patients with nasopharyngeal carcinoma treated during 17years at the university hospital of Sfax (Tunisia). Among them, three patients had brain metastasis. We excluded patients with direct extension to the brain. Tumours of the nasopharynx were locally advanced. The first patient had brain metastases at the initial diagnosis. The two other patients had brain metastases at 10and 16months during the follow-up. Ocular signs were the symptoms. Lesions were unique in two patients. Synchronous bone metastases were recorded in the three cases. All patients had whole brain radiation therapy and palliative chemotherapy. All patients had a progression of the disease and died. Brain metastases in nasopharynx cancer represent a rare event. Prognosis is poor, depending on age, surgical excision and synchronous metastases. Survival does not exceed 6months. © 2013 Société française de radiothérapie oncologique (SFRO).

Ben Salah H.,Service de radiotherapie carcinologique | Bahri M.,Service de radiotherapie carcinologique | Jbali B.,Service de radiotherapie carcinologique | Guermazi M.,Service de gynecologie obstetrique | And 2 more authors.
Cancer/Radiotherapie | Year: 2012

Purpose: To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods: It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51. years (27-92. years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68. months (12-120). Results: Lymphedema appeared in 23% of cases (51 patients), 14. months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion: Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. © 2012 Société française de radiothérapie oncologique (SFRO).

Siala W.,Service de radiotherapie carcinologique | Mnejja W.,Service de radiotherapie carcinologique | Abid M.,Service dendocrinologie | Ghorbel A.,Service dORL | And 2 more authors.
Annales d'Endocrinologie | Year: 2011

Objectives: To analyze retrospectively the risk factors for occurrence of thyroid toxicity after radiotherapy for nasopharyngeal cancer and to demonstrate the necessity of a long-term post-therapeutic screening. Patients and methods: Between 1993 and 2004, 239 patients with non-metastatic nasopharyngeal carcinoma were treated by conventional radiotherapy with or without chemotherapy. Radiotherapy was delivered by a standard fractionation (2. Gy/fraction, 5. fractions/week) for 157 patients and hyperfractionation (1.6. Gy/fraction, 2. fractions/day, 5. days/week) for 82 patients. An evaluation of thyroid late toxicity was performed according to tumor stage, age, gender, time after treatment, irradiation method and association or not with chemotherapy. Results: After a median follow up of 111 months, 72 patients (30%) had primitive and/or pituitary thyroid dysfunction. Fifty-seven patients (24%) experienced hypothyroidism, peripheral in 92% of cases (biological 73%, clinical 19%) and central in 8% of cases. Hypothyroidism was detected at a mean 37 months follow up. All patients received replacement treatment with l-thyroxin. The actuarial rate of hypothyroidism was 18.1%, 24.3% and 35% at respectively 3, 5 and 10 years. Only female gender was found as a risk factor for occurrence of hypothyroidism in univariate analysis. However, younger age and advanced tumor stage were associated with a higher risk but the difference was not significant (P= 0.08 for each). There was no difference for other factors: nodal stage, modality of radiation and chemotherapy treatment. The multivariate analysis did not show any risk factor. Conclusion: Thyroid dysfunction after radiotherapy for nasopharyngeal carcinoma is frequent and requires systematic screening to begin adequate treatment earlier. Only gender has been identified as risk factor in univariate analysis in this study. © 2010 Elsevier Masson SAS.

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