Recent events concerning blood transfusion (BT) have led to the number of BT being drastically re... more Recent events concerning blood transfusion (BT) have led to the number of BT being drastically reduced and to more rigorous checking of blood donations before their use for transfusion. Very few developing countries have been able to set up BT organizations that are both self-sufficient and capable of ensuring a high quality of blood testing. A central blood bank (CBB) was set up in Kabul (Afghanistan) during the 1980s. From 1992 onwards, its activities were curtailed due to the political turmoil, lack of funds and the fact that no blood collection policy was being implemented. A partnership between a development aid agency (Avicen), French public institutions and the local authorities has resulted in the rebirth of this CBB by the injection of financial resources and technical and scientific expertise. An independent committee of BT specialists was responsible for assessing the scientific validity and ethical acceptability of the project. In 1996, the objectives of the project, whi...
International Journal of Radiation Oncology*Biology*Physics, 2014
Purpose/Objective(s): Radiochemotherapy for cervical cancer may have a high risk of acuteand late... more Purpose/Objective(s): Radiochemotherapy for cervical cancer may have a high risk of acuteand late side effects, and hence be considered too toxic for many elderly patients. The purpose was to evaluate treatment-, side effects and survival after radiotherapy (RT) alone, for patients age 80+. Materials/Methods: Consecutive cervical cancer patients, age 80+, treated between January 1, 2000 and December 31, 2011, receiving curative intended RT were included. Patient characteristics, toxicities and survival data were retrieved from our in-department patient database and retrospectively evaluated. Patients received external RT either 46 Gy in 23 fractions (4 pelvic field conformal RT or Volumetric Modulated Arc Therapy (Rapid Arc)) or 64 Gy in 32 fractions (5-field intensity modulated RT (IMRT)) depending on the presence of lymph nodes metastases. Patients were also planned for PDR brachytherapy either intracavitary 17.5 Gy x 2 to point A or interstitial 30 Gy. Results: Twenty-five patients were included. The median age was 82(range 80-88) and the histology of the primary tumors was: Squamous cell carcinoma (64%), Adenocarcinoma (16%), Undifferentiated (4%), Rare types (8%), and Unknown (8%). Primary FIGO stages were: IIA (4%), IIB (56%), IIIA (4%), IIIB (32%), and IVA (4%). Two patients experienced acute side effects of RTOG grade 3 to bladder and vagina respectively. Other two experienced late side effect grade 4 due to vesicoand/or recto-vaginal fistulas. Six patients had had a relapse of their disease (31% actuarial (C.I. 10-52%)). Conclusions: With a relapse rate of 31% and little severe toxicity, our results show that using RT without Cisplatin to 80+ years old cervical cancer patients is safe and provides a good disease control. Author Disclosure: H. Hansen: None. C. Hogdall: None. S. Engelholm: None.
American journal of clinical oncology, Jan 23, 2017
Urethral cancer is a rare malignancy, representing <1% of all malignancies. Optimal management... more Urethral cancer is a rare malignancy, representing <1% of all malignancies. Optimal management, due to its rarity, presents as a treatment dilemma for physicians. There is a lack of consensus regarding treatment as large randomized trials cannot be performed; thus, optimal management decisions rely on study of retrospective cases. This is a review of our institutional experience with urethral cancer treated with various treatment modalities. A retrospective chart review was performed on 31 patients treated for primary cancer of the urethra from 1958 to 2008. The patients were stratified by sex, histologic type, stage, date of diagnosis, type of treatment, and last follow-up. Early stage cases were designated as Tis-T2N0M0 and advanced cases were designated as T3-4, N+ or M+. Analysis was performed based on clinical stage, treatment modalities and outcomes. Fourteen early stage cases and 17 advanced stage cases of urethral cancer were analyzed. The majority of early stage cases oc...
International Journal of Radiation Oncology*Biology*Physics, 2004
To ascertain the potential for dose reduction to bladder and rectal points by using intravaginal ... more To ascertain the potential for dose reduction to bladder and rectal points by using intravaginal Foley balloon catheters as a mechanism for structural displacement during tandem and ovoid high-dose-rate intracavitary brachytherapy of the uterine cervix. In 22 patients, two Foley balloons were placed intravaginally, with one balloon placed anterior to the tandem and one posterior, as close to the flange as patient geometry allowed. A series of 57 consecutive digitized treatment plans was assessed with and without liquid contrast inflation of Foley catheter balloons. Planning X-rays were acquired and digitized. Software calculated dose was then defined for two bladder and two rectal points, both with and without Foley balloon inflation. Results were then assessed using parametric statistical analysis. Collectively and between equivalent points, a statistically significant (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.01) diminution in calculated dose was observed with inflation of intracavitary balloon catheters, with a mean reduction in calculated dose of 16% and 17.6% for bladder and rectal points, respectively. The potential advantages available from dose reduction using intracavitary balloon catheters include decreased high-dose-rate-induced organ toxicity, case-by-case customizability, and low cost of implementation. As such, further exploration of this technique is warranted.
L’evolution de la transfusion sanguine (TS) au cours de ces dernieres annees a conduit a assurer ... more L’evolution de la transfusion sanguine (TS) au cours de ces dernieres annees a conduit a assurer une validation biologique rigoureuse du don et a limiter de facon drastique les indications de la transfusion. Peu de pays en developpement ont pu mettre en œuvre une transfusion auto-suffisante et capable d’assurer un controle biologique de qualite. A Kaboul en Afghanistan, une banque centrale de sang (BCS) a ete implantee dans les annees 80. Elle se trouvait paralysee depuis 1992 dans un environnement de troubles politiques, par manque de moyens financiers et par l’arret de la politique de collecte. Un partenariat entre un organisme de developpement (Avicen), des institutions publiques francaises et les autorites locales a permis de reactiver cette BCS par l’injection de moyens financiers et l’apport d’une expertise technique et scientifique. Un comite scientifique independant reunissant en France des experts de la TS a ete charge de suivre l’evolution, de juger la qualite scientifique...
Recent events concerning blood transfusion (BT) have led to the number of BT being drastically re... more Recent events concerning blood transfusion (BT) have led to the number of BT being drastically reduced and to more rigorous checking of blood donations before their use for transfusion. Very few developing countries have been able to set up BT organizations that are both self-sufficient and capable of ensuring a high quality of blood testing. A central blood bank (CBB) was set up in Kabul (Afghanistan) during the 1980s. From 1992 onwards, its activities were curtailed due to the political turmoil, lack of funds and the fact that no blood collection policy was being implemented. A partnership between a development aid agency (Avicen), French public institutions and the local authorities has resulted in the rebirth of this CBB by the injection of financial resources and technical and scientific expertise. An independent committee of BT specialists was responsible for assessing the scientific validity and ethical acceptability of the project. In 1996, the objectives of the project, whi...
International Journal of Radiation Oncology*Biology*Physics, 2014
Purpose/Objective(s): Radiochemotherapy for cervical cancer may have a high risk of acuteand late... more Purpose/Objective(s): Radiochemotherapy for cervical cancer may have a high risk of acuteand late side effects, and hence be considered too toxic for many elderly patients. The purpose was to evaluate treatment-, side effects and survival after radiotherapy (RT) alone, for patients age 80+. Materials/Methods: Consecutive cervical cancer patients, age 80+, treated between January 1, 2000 and December 31, 2011, receiving curative intended RT were included. Patient characteristics, toxicities and survival data were retrieved from our in-department patient database and retrospectively evaluated. Patients received external RT either 46 Gy in 23 fractions (4 pelvic field conformal RT or Volumetric Modulated Arc Therapy (Rapid Arc)) or 64 Gy in 32 fractions (5-field intensity modulated RT (IMRT)) depending on the presence of lymph nodes metastases. Patients were also planned for PDR brachytherapy either intracavitary 17.5 Gy x 2 to point A or interstitial 30 Gy. Results: Twenty-five patients were included. The median age was 82(range 80-88) and the histology of the primary tumors was: Squamous cell carcinoma (64%), Adenocarcinoma (16%), Undifferentiated (4%), Rare types (8%), and Unknown (8%). Primary FIGO stages were: IIA (4%), IIB (56%), IIIA (4%), IIIB (32%), and IVA (4%). Two patients experienced acute side effects of RTOG grade 3 to bladder and vagina respectively. Other two experienced late side effect grade 4 due to vesicoand/or recto-vaginal fistulas. Six patients had had a relapse of their disease (31% actuarial (C.I. 10-52%)). Conclusions: With a relapse rate of 31% and little severe toxicity, our results show that using RT without Cisplatin to 80+ years old cervical cancer patients is safe and provides a good disease control. Author Disclosure: H. Hansen: None. C. Hogdall: None. S. Engelholm: None.
American journal of clinical oncology, Jan 23, 2017
Urethral cancer is a rare malignancy, representing <1% of all malignancies. Optimal management... more Urethral cancer is a rare malignancy, representing <1% of all malignancies. Optimal management, due to its rarity, presents as a treatment dilemma for physicians. There is a lack of consensus regarding treatment as large randomized trials cannot be performed; thus, optimal management decisions rely on study of retrospective cases. This is a review of our institutional experience with urethral cancer treated with various treatment modalities. A retrospective chart review was performed on 31 patients treated for primary cancer of the urethra from 1958 to 2008. The patients were stratified by sex, histologic type, stage, date of diagnosis, type of treatment, and last follow-up. Early stage cases were designated as Tis-T2N0M0 and advanced cases were designated as T3-4, N+ or M+. Analysis was performed based on clinical stage, treatment modalities and outcomes. Fourteen early stage cases and 17 advanced stage cases of urethral cancer were analyzed. The majority of early stage cases oc...
International Journal of Radiation Oncology*Biology*Physics, 2004
To ascertain the potential for dose reduction to bladder and rectal points by using intravaginal ... more To ascertain the potential for dose reduction to bladder and rectal points by using intravaginal Foley balloon catheters as a mechanism for structural displacement during tandem and ovoid high-dose-rate intracavitary brachytherapy of the uterine cervix. In 22 patients, two Foley balloons were placed intravaginally, with one balloon placed anterior to the tandem and one posterior, as close to the flange as patient geometry allowed. A series of 57 consecutive digitized treatment plans was assessed with and without liquid contrast inflation of Foley catheter balloons. Planning X-rays were acquired and digitized. Software calculated dose was then defined for two bladder and two rectal points, both with and without Foley balloon inflation. Results were then assessed using parametric statistical analysis. Collectively and between equivalent points, a statistically significant (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.01) diminution in calculated dose was observed with inflation of intracavitary balloon catheters, with a mean reduction in calculated dose of 16% and 17.6% for bladder and rectal points, respectively. The potential advantages available from dose reduction using intracavitary balloon catheters include decreased high-dose-rate-induced organ toxicity, case-by-case customizability, and low cost of implementation. As such, further exploration of this technique is warranted.
L’evolution de la transfusion sanguine (TS) au cours de ces dernieres annees a conduit a assurer ... more L’evolution de la transfusion sanguine (TS) au cours de ces dernieres annees a conduit a assurer une validation biologique rigoureuse du don et a limiter de facon drastique les indications de la transfusion. Peu de pays en developpement ont pu mettre en œuvre une transfusion auto-suffisante et capable d’assurer un controle biologique de qualite. A Kaboul en Afghanistan, une banque centrale de sang (BCS) a ete implantee dans les annees 80. Elle se trouvait paralysee depuis 1992 dans un environnement de troubles politiques, par manque de moyens financiers et par l’arret de la politique de collecte. Un partenariat entre un organisme de developpement (Avicen), des institutions publiques francaises et les autorites locales a permis de reactiver cette BCS par l’injection de moyens financiers et l’apport d’une expertise technique et scientifique. Un comite scientifique independant reunissant en France des experts de la TS a ete charge de suivre l’evolution, de juger la qualite scientifique...
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