[en] The two studies, carried out for one at the 'M.D. Anderson Cancer Center (Houston)' and the other in France show that a distended rectum on the planning scan increases the risk of biochemical recurrence, local recurrence (histologic evidence) and of metastatic recurrence. This risk factor for recurrence, in multivariate analysis appears significant, compared to conventional risk factors (T stage, Gleason score and P.S.A.) and justifies either not opacify the rectum during the scan planning, or to use an image-guided radiotherapy. (N.C.)

[en] We have established a protocol for integration of a prostate tumor volume defined from a parameter image determined by MRI in the planning scanning. A dose escalation in this volume by conformal irradiation with Intensity modulation may increase local control at the condition to include a image-rate-guided radiotherapy, so that the expected dose corresponds to the delivered dose. (N.C.)

[en] Curie-therapy conventionally comes before surgery in the treatment of cervical cancer, either alone or after a concomitant chemotherapy. The authors report a study of the impact of a reverse sequence (surgery before curie-therapy) on the exeresis quality and on the evolution of operable tumours. Among women treated between 2004 and 2009, 40 have been identified who had surgery before curie-therapy. Ages, tumour stages, average doses, and treatment procedures are discussed. The notably high rate of vaginal sections could be reduced or avoided by using the conventional protocol (curie-therapy before surgery). Short communication

[en] The development of sophisticated conformal radiation therapy techniques for prostate cancer, such as intensity-modulated radiotherapy, implies precise and accurate targeting. Inter- and intra-fraction prostate motion can be significant and should be characterized, unless the target volume may occasionally be missed. Indeed, bony landmark-based portal imaging does not provide the positional information for soft-tissue targets (prostate and seminal vesicles) or critical organs (rectum and bladder). In this article, we describe various prostate localization systems used before or during the fraction: rectal balloon, intra-prostatic fiducials, ultrasound-based localization, integrated CT/linear accelerator system, megavoltage or kilo-voltage cone-beam CT, Calypso 4D localization system tomo-therapy, Cyberknife and Exactrac X-Ray 6D. The clinical benefit in using such prostate localization tools is not proven by randomized studies and the feasibility has just been established for some of these techniques. Nevertheless, these systems should improve local control by a more accurate delivery of an increased prescribed dose in a reduced planning target volume. (author)

[en] The authors report a clinic assessment of the 'involved node' irradiation concept in case of localized Hodgkin's diseases and delivered either with intensity modulation (IMRT) or with the deep-inspiration breath-hold technique. Thirty two patients have been irradiated with intensity modulation, and eighteen in breath-hold. They were suffering from the disease with different grades. Survival rates and survival rates without relapse by four years have been assessed. The 'involved node' concept can be efficiently applied with both techniques. Short communication

[en] More than 400 patients have been treated by conformational radiation therapy for a localized prostate adenocarcinoma and some have been selected according to the availability of dose-volume histograms. Predictive models of rectal and bladder toxicity have been compared: LKB, Logit EUD and Poisson EUD for rectal toxicity, LKB, Logit EUD, Poisson EUD and Schultheiss for bladder toxicity. Results suggest that these models could be used during the inverse planning of intensity-modulated radiation therapy in order to decrease toxicity. Short communication

[en] The accelerators equipped with a three-dimensional imaging system allow to consider an approach of the image guided radiotherapy based on a quantitative analysis of already existing treatment techniques. Our first approach thus allows us to assess with three conical tomographies completed the first three sessions of treatment, the systematic error positioning of the patient seems assessable, but its correction must include a new scanning ballistic. While remaining cautious with respect to our initial results based on a comparison of CT scanning and conical ballistic tomography, it seems possible to quantify the movement of the target and at risk organs. The evaluation of a gating based on soft tissue remains in evaluation. (N.C.)

[en] Purpose: The objective of this work was the study of in vivo dosimetry performed in a series of 54 patients receiving total body irradiation (T.B.I.) at the Salah-Azaiz Institute of Tunis since 2004. In vivo dosimetry measurements were compared to analytically calculated doses from monitor units delivered. Patients and method: The irradiation was conducted by a linear accelerator (Clinac 1800, Varian, Palo Alto, USA) using nominal X-rays energies of 6 MV and 18 MV, depending on the thickness of the patient at the abdomen. The dose was measured by semi-conductors p-type E.P.D.-20. These diodes were calibrated in advance with an ionization chamber 'P.T.W. Farmer' type of 0.6 cm³ and were placed on the surface of plexiglas phantom in the same T.B.I. conditions. A study of dosimetric characteristics of semi-conductors E.P.D.-20 was carried out as a function of beam direction and temperature. Afterwards, we conducted a comparative analysis of doses measured using these detectors during irradiation to those calculated retrospectively from monitor units delivered to each patient conditioned by T.B.I.. Results: Experience showed that semi-conductors are sensitive to the angle of beam radiation (0-90 degrees) and the temperature (22-40 Celsius degrees). The maximum variation is respectively 5 and 7%, but in our irradiation conditions these correction factors are less than 1%. The analysis of the results of the in vivo dosimetry had shown that the ratio of the average measured doses and analytically calculated doses at the abdomen, mediastinum, right lung and head are 1.005, 1.007, 1.0135 and 1.008 with a standard deviation 'type A' respectively of 3.04, 2.37, 7.09 et 4.15%. Conclusion: In vivo dosimetry by semi-conductors is in perfect agreement with dosimetry by calculation. However, in vivo dosimetry using semiconductors is the only technique that can reflect the dose actually received instantly by the patient during T.B.I. given the many factors that calculation can not take into account: patient and organs motions and the heterogeneity of the targets. (authors)

[en] The objective of this work is to study in-vivo dosimetry performed in a series of 54 patients receiving total body irradiation (TBI) at the Salah AZAIZ Institute (ISA) of Tunis since 2004. In-vivo dosimetry measurements were compared to calculated doses from monitor units delivered