Pub Date : 2024-01-04DOI: 10.1016/j.canrad.2023.08.009
J. Dumont, J. Bou-Gharios, A. Keller, I. Chambrelant, G. Pamart, C. Mascaux, P.-E. Falcoz, D. Antoni, A. Olland, G.A. Pietta, G. Noël
Purpose
Thymoma is a rare tumour. The most common treatment for thymoma is surgical resection, while the use of radiotherapy and chemotherapy remains controversial.
Patients and methods
We conducted a monocentric observational study of 31 patients diagnosed with thymoma from June 2004 to July 2020 at cancer centre in Strasbourg, France. We analysed the outcomes of the patients.
Results
The 2- and 5- year locoregional relapse-free survival rates were 96.3% (95% confidence interval [CI]: 76.5–99.5%) and 68.0% (95% CI: 43.8–83.5%), respectively. Radiotherapy and chemotherapy significantly improved local tumour control (P = 0.0008 and 0.04, respectively), while a larger initial tumour size significantly worsened local control rates (P = 0.04). The 5- and 10-year overall survival rates were 87.1% (95% CI: 69.2–95%) and 81.7% (95% CI: 60.3–92.2%), respectively. The median overall survival was not reached, and no favourable factor was retrieved. For relapsed patients, the median overall survival after relapse was 115 months.
Conclusion
Despite the inherent limitations of retrospective studies with a limited patient sample size, we demonstrated that chemotherapy and radiotherapy in addition to surgery were effective in achieving local control and contributed to improving patient outcomes in thymoma. Notably, an aggressive treatment strategy at the time of relapse resulted in favourable outcomes for retreated patients.
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Pub Date : 2023-12-09DOI: 10.1016/j.canrad.2023.06.031
M. Cuenin, J. Salleron, D. Peiffert, É. Meknaci, P. Gallet, Y. Abushama, J.-F. Py, S. Renard
Purpose
Low-dose-rate (LDR) and high-dose-rate (HDR) interstitial brachytherapy are known to be effective in the treatment of lip carcinomas. The aim of this study was to retrospectively compare oncologic and toxicity outcomes between the two techniques.
Patients and methods
From 2007 to 2018, patients at the Institut de cancérologie de Lorraine (France) who received exclusive or adjuvant interstitial brachytherapy for lip squamous carcinomas were studied. Two groups were defined: the LDR/PDR group, including patients treated with iridium-192 wires, or pulsed-dose rate technique, and the high-dose-rate group, with patients treated by high-dose-rate technique. The dose ranged between 50 Gy and 65 Gy (depending on previous surgery) for low-dose-/pulsed-dose rate treatments, and 39 Gy for high-dose-rate (twice a day). Early, late toxicity events and oncologic control were reported.
Results
Among the 61 patients whose data were analyzed retrospectively, 36 received the low-dose-/pulsed-dose rate treatment (59%) and 25 the high-dose-rate brachytherapy (41%). The median follow-up time was 44 months. At 36 months, the local control rates were 96.3% for LDR/PDR group and 100% for HDR (P = 0.180). The regional control rates were 85.9% and 92% without any difference according to the two groups (P = 0.179). The specific overall survival rate was 95.5% with no difference between groups. There were more grade 2 or higher mucositis in the HDR group than in LDR/PDR group (40% versus 16.7%, P = 0.042). One case of grade 3 mucositis was recorded in each group. No grade 3 late complications were recorded. High-dose-rate brachytherapy reduced the length of hospitalization by 2 days (P < 0.001).
Conclusion
High-dose- or low-dose-/pulsed-dose rate brachytherapy seemed to be as effective and well tolerated in our experience of 61 patients.
{"title":"Interstitial brachytherapy for lip carcinomas: Comparison between Ir-192 low-dose-rate and high-dose-rate treatment","authors":"M. Cuenin, J. Salleron, D. Peiffert, É. Meknaci, P. Gallet, Y. Abushama, J.-F. Py, S. Renard","doi":"10.1016/j.canrad.2023.06.031","DOIUrl":"https://doi.org/10.1016/j.canrad.2023.06.031","url":null,"abstract":"<h3>Purpose</h3><p>Low-dose-rate (LDR) and high-dose-rate (HDR) interstitial brachytherapy are known to be effective in the treatment of lip carcinomas. The aim of this study was to retrospectively compare oncologic and toxicity outcomes between the two techniques.</p><h3>Patients and methods</h3><p>From 2007 to 2018, patients at the Institut de cancérologie de Lorraine (France) who received exclusive or adjuvant interstitial brachytherapy for lip squamous carcinomas were studied. Two groups were defined: the LDR/PDR group, including patients treated with iridium-192 wires, or pulsed-dose rate technique, and the high-dose-rate group, with patients treated by high-dose-rate technique. The dose ranged between 50<!-- --> <!-- -->Gy and 65<!-- --> <!-- -->Gy (depending on previous surgery) for low-dose-/pulsed-dose rate treatments, and 39<!-- --> <!-- -->Gy for high-dose-rate (twice a day). Early, late toxicity events and oncologic control were reported.</p><h3>Results</h3><p>Among the 61 patients whose data were analyzed retrospectively, 36 received the low-dose-/pulsed-dose rate treatment (59%) and 25 the high-dose-rate brachytherapy (41%). The median follow-up time was 44 months. At 36 months, the local control rates were 96.3% for LDR/PDR group and 100% for HDR (<em>P</em> <!-- -->=<!-- --> <!-- -->0.180). The regional control rates were 85.9% and 92% without any difference according to the two groups (<em>P</em> <!-- -->=<!-- --> <!-- -->0.179). The specific overall survival rate was 95.5% with no difference between groups. There were more grade 2 or higher mucositis in the HDR group than in LDR/PDR group (40% versus 16.7%, <em>P</em> <!-- -->=<!-- --> <!-- -->0.042). One case of grade 3 mucositis was recorded in each group. No grade 3 late complications were recorded. High-dose-rate brachytherapy reduced the length of hospitalization by 2 days (<em>P</em> <!-- --><<!-- --> <!-- -->0.001).</p><h3>Conclusion</h3><p>High-dose- or low-dose-/pulsed-dose rate brachytherapy seemed to be as effective and well tolerated in our experience of 61 patients.</p>","PeriodicalId":501615,"journal":{"name":"Cancer/Radiothérapie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138568530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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