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Cervix cancer ; Cancer du col uterin. Pointreau, Y. Cervix cancers declined in most developed countries in recent years, but remain, the third worldwide leading cause of cancer death in women. A precise staging, based on clinical exam, an abdominal and pelvic MRI, a possible PET-CT and a possible lymph node sampling is necessary to adapt the best therapeutic strategy.

In France, the treatments of tumors of less than 4 cm without nodal involvement are often based on radiotherapy followed by surgery and, whereas tumors larger than 4 cm and involved nodes are treated with concurrent chemoradiotherapy. Based on an illustrated clinical case, indications, delineation, dosimetry and complications expected with radiotherapy are demonstrated. Birba, D. Ouattara, A. Lamien-Sanou, M. Bambara, B. Difficultes d'une campagne de depistage du cancer du col uterin en Concomitant chemo radiation in the treatment of advanced cervical carcinoma; Radiotherapie et chimiotherapie concomitante dans le traitement des cancers avances du col uterin.

Resbeut, M. The study of non randomized radio chemotherapy in the cervix cancer treatment are cheering and clinically the answers are faster. However only some randomized studies using hydroxyurea showed a benefit in survival term. Cervix carcinomas: place of intensity-modulated radiotherapy; Les cancers du col uterin: place de la radiotherapie avec modulation d'intensite.

Barillot, I. While indications of modulated intensity radiation therapy I. The implementation of conformal three dimensional radiotherapy in the late has been the first important step for optimisation of treatment of cervix carcinomas, Nude personals in Sainte-Croix-En-Jarez it permitted a better target coverage with a ificant reduction of the bladder dose.

However, this technique often le to an irradiation of a larger volume of rectum in locally advanced stages and could only spare a limited amount of intestine. The aim of this literature review is to provide the arguments supporting this hypothesis, and to define the place of this technique for dose escalation.

Evidence based of chemoradiotherapy in cervix carcinoma; Chimioradiotherapie concomitante dans les cancers du col de l'uterus: quels niveaux de preuve? Joly-Lobbedez, F. Since 10 Nude personals in Sainte-Croix-En-Jarez, the combination of chemoradiotherapy has become a standard of treatment of the advanced localized cervical cancer. Two systematic reviews of the literature including the of the different clinical trials have already been published.

The aim of this article is to present the of the recent meta-analysis based on individual patient data and to discuss the perspectives. This meta-analysis was rigorously deed: trials selected had the same control arm with the same radiotherapy without concomitant chemotherapy, the definition of the primary outcome overall survival was homogeneous and analysis was made in intent to treat. Interestingly, even if cisplatin seems to be the most active drug, a ificant advantage is also observed with no platinum chemotherapy. A polychemotherapy is not more active than a mono chemotherapy and there was a suggestion of a difference in the size of the survival benefit with tumor stage.

Larger benefits were seen for the few trials in which additional chemotherapy was administered after chemoradiotherapy, but have to be confirmed by other clinical trials. Late toxicity was not well evaluated and a long-term follow-up of the patients is important to assess the real incidence of long-term side effects of the chemoradiotherapy and the impact on quality of Nude personals in Sainte-Croix-En-Jarez.

New strategies combining new chemotherapy protocols or targeted therapy with radiation are promising but have to be evaluated in comparative clinical trials before use in routine. Positron emission tomography in the management of cervix cancer patients; Tomographie par emission de positons dans la prise en charge des cancers du col de l'uterus. Bonardel, G. For cervix carcinoma, F. The metabolic dimension of the technique provides additional prognostic information. Ongoing studies now concentrate on more advanced clinical applications, such as the planning of radiotherapy, the response evaluation after the induction of therapy, the early detection of recurrence.

From the point of view of biological metabolism, new radiopharmaceutical probes are being developed. Those hold promise for future refinements in this field. This article reviews the current applications of F. Dosimetric comparison of IMRT and modulated arc-therapy techniques in the treatment of cervical cancers ; Comparaison dosimetrique des techniques de RCMI et d'arctherapie modulee dans le traitement des cancers du col uterin.

Renard-Oldrini, S. The authors report the dosimetric comparison of two techniques used for the treatment of cervical cancers : the intensity-modulated conformational radiotherapy IMRT with static beams and modulated arc-therapy with RapidArc. The treatment plans of 15 patients have been compared. The clinical target volume CTV comprises the gross target volume, the cervix, the upper third of the vagina, and ganglionary areas. The previsional target volume comprises the clinical target volume and a one centimetre margin. Organs at risk are rectum, bladder, intestine and bone marrow. Arc-therapy seems to provide a better sparing of intestine that IMRT, while maintaining a good coverage of the previsional target volume and decreasing treatment duration.

Short communication. Current data on radio chemotherapy and potential of targeted therapies for cervical cancers ; Donnees actuelles des associations chimioradiotherapeutiques et place potentielle des therapies ciblees dans les cancers du col uterin. Magne, N. The present review represents an up-to-date focus on the particular topic of cervix carcinoma.

An exhaustive description of the actual data and the near-future combination of radiotherapy and drugs with the specific potential of targeted therapies are presented.

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This approach represents one of the next challenges to improve. Studies conducted in, and reported the of six large-scale prospective randomized trials using concomitant chemo radiation with a ificant progression-free and overall survival rate improvement compared to radiotherapy only. These were confirmed by the two last meta-analyses.

Nowadays, the concurrent radio chemotherapy schedule used in the treatment of high risk cervical cancer is a standard practice. More growing evidences suggest that intracellular al pathways play a ificant role in radiation response. Several prognostic factors on tumoral radiosensitivity have been identified, including intracellular al pathways, in the particular case of cervix carcinoma. Promising have been obtained in experimental studies assessing Nude personals in Sainte-Croix-En-Jarez combined use of specific inhibitors and radiotherapy.

Based on these data, a of clinical trials have been started to enhance tumor responses and thus, to decrease the rate of recurrences. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers : Practical methodology; La pratique de la technique du ganglion sentinelle dans diverses indications: sein, col uterin, prostate, vulve et verge. Methodologie pratique. Brenot-Rossi, I. The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node S. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.

The S. The purpose of this article is to give some practical details about the S. Overexpression of COL 11A1 by cancer -associated fibroblasts: clinical relevance of a stromal marker in pancreatic cancer. Directory of Open Access Journals Sweden. The expression of COL 11A1 protein could be involved in desmoplastic events in pancreatic cancerbut an antibody that specifically stains the COL 11A1 protein is not currently available. Normal human pancreas tissue samples were obtained through a cadaveric organ donation program.

Unlike other available antibodies commonly used to detect CAFs, anti-pro COL 11A1 is negative in stromal cells of the normal pancreas and almost absent in benign inflammation. These strongly suggest that pro COL 11A1 is a specific marker for.

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Introduction Pancreatic ductal adenocarcinoma PDA is a highly lethal disease in which a prominent desmoplastic reaction is a defining Nude personals in Sainte-Croix-En-Jarez. Fibrillar collagens, such as collagen I and to a lesser extent, collagen III and V comprise the majority of this stromal fibrosis. The expression of COL 6 has been linked to inflammation and survival. Importantly, tumor-specific alternative splicing in COL 6A3 has been identified in several cancers by genome exon arrays. We evaluated the expression and localization of COL 6A3 in PDA and premalignant lesions and explored the presence of alternative splicing events.

Western blot analysis and immunohistochemistry were used to analyze the expression levels and localization of COL 6A3 protein in the different lesions, and in two animal models of PDA. COL 6A3 was mainly present in the desmoplastic stroma of PDA, with high deposition around the malignant ducts and in between the sites of stromal fatty infiltration. Inclusion of exon 4 was exclusively tumor-specific, with barely detectable expression in the adjacent tissues. IPMN and pancreatic cystadenomas showed no expression of any of the examined exons.

Clinical and dosimetric of three-dimensional image-guided and pulsed dose rate curie-therapy in locally advanced cervical cancers ; Resultats cliniques et dosimetriques de la curietherapie de debit de dose pulse guidee par imagerie tridimensionnelle dans les cancers du col de l'uterus localement evolues. Mazeron, R. The authors report a review of data obtained between and on women who had been treated by optimized pulsed-rate curie-therapy for a locally advanced cervical cancer.

are discussed in terms of cancer stage, treatment with or without concomitant chemotherapyplanning method MRI, scanographydelivered doses in Nude personals in Sainte-Croix-En-Jarez clinical target volumes, surgery, relapse occurrence and localizations, global survival probability, local control, undesirable side effects, occurrence of intestine or urinary toxicity. It appears that the association of a concomitant chemo-radiotherapy and optimized curie-therapy in a good local-regional control and a low toxicity level.

Three-dimensional brachytherapy optimization techniques in the treatment of patients with cervix cancer ; Apport des techniques de curietherapie optimisee grace a l'imagerie tridimensionnelle dans la prise en charge des patientes atteintes d'un cancer du col uterin.

Haie-Meder, C. Traditionally, prescription and treatment planning in intracavitary brachytherapy for cervix cancer have used either reference points mainly points A and B or reference isodoses 60 Gy according to ICRU recommendations to report doses to the target volume. Doses to critical organs were reported at bladder and rectum ICRU points.

This practice has been supported by a long-standing clinical experience that has yielded an acceptable therapeutic ratio. The recent development of imaging has contributed to the improvement in target and organs at risk knowledge.

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These recommendations have been validated with intercomparison delineation studies. With the concomitant development of remote after-loading projectors, provided with miniaturized sources, it is now possible to plan radiation doses by adjusting dwell Nude personals in Sainte-Croix-En-Jarez and relative dwell time values.

These procedures allow better coverage of the targets while sparing O. The recent literature data evidence a ificant improvement in local control with no increase in complications. Further studies are needed to better define the dose recommended in both tumour and organs at risk. This is one of the goals of the European study on MRI-guided brachytherapy in locally advanced cervical cancer E.

Standards, options and recommendations: concomitant radio chemotherapy for cancer of the cervix: a critical analysis of the literature and update of SOR; Radiochimiotherapie concomitante dans les cancers du col de l'uterus: analyse critique des donnees et mise a jour des Standards, options et recommandations.

The main objective is the development of clinical practice guidelines to improve the quality of health and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. To update, according to the methodology of SOR, the Standards, Options and Recommendations for the management of patients with cancer of the cervix, and in particular, the place of concomitant radio-chemotherapy.

Data have been identified by a literature search using Medline to April and the personal reference lists of experts. Once the guidelines were defined, the document was submitted for review to independent national and international reviewers and to the medical committees of the CRCC.

The principle recommendations concerning the place of radio-chemotherapy in the treatment of cancer of the cervix are 1 the available data shows a ificant increase in local control level of evidence A and of overall survival level of evidence B1 following concomitant radio-chemotherapy as compared to radiotherapy alone or the combination of radiotherapy-hydroxyurea.

Contrast ultrasound using SonoVue for pelvic radiation with concurrent chemotherapy monitoring in stage I B-II cervical cancer ; Apport de l'echographie Doppler avec injection de contraste pour la prise en charge des cancers du col de l'uterus de stades IB et II par chimioradiotherapie concomitante. Marret, H.

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