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We demonstrate that a multiply connected superconducting structure in combination with a perpendicularly magnetized magnetic dot can be used as a current source for superconducting elements and as an external phase shifter. The concept has been tested by measuring the superconducting Tc(B) phase boundary and critical current of an Al superconducting loop placed on the top of a micron-sized Co/Pd magnetic dot. A pronounced asymmetry in the voltage–current characteristic of the loop with respect to the polarity of the external magnetic field, as well as a shift of the Tc(B) phase boundary along the field axis indicate the presence of a persistent current in the loop. [ABSTRACT FROM AUTHOR]

Purpose Intensity-modulated radiation therapy (IMRT) has shown its interest for head and neck cancer treatment. In parallel, cetuximab has demonstrated its superiority against exclusive radiotherapy. The objective of this study was to assess the acute toxicity, local control and overall survival of cetuximab associated with different IMRT modalities compared to platinum-based chemotherapy and IMRT in the ARTORL study ( NCT02024035 ). Patients and method This prospective, multicenter study included patients with epidermoid or undifferentiated nasopharyngeal carcinoma, epidermoid carcinoma of oropharynx and oral cavity (T1–T4, M0, N0–N3). Acute toxicity, local control and overall survival were compared between groups (patients receiving cetuximab or not). Propensity score analysis at the ratio 1:1 was undertaken in an effort to adjust for potential bias between groups due to non-randomization. Results From the 180 patients included in the ARTORL study, 29 patients receiving cetuximab and 29 patients treated without cetuximab were matched for the analysis. Ten patients (34.5%) reported acute dermal toxicity of grade 3 in the cetuximab group versus three (10.3%) in the non-cetuximab group obtained after matching ( P = 0.0275). Cetuximab was not significantly associated with more grade 3 mucositis ( P = 0.2563). There were no significant differences in cutaneous or oral toxicity for patients treated with cetuximab between the different IMRT modalities ( P = 1.000 and P = 0.5731, respectively). There was no significant difference in local relapse-free survival ( P = 0.0920) or overall survival ( P = 0.4575) between patients treated with or without cetuximab. Conclusion Patients treated with cetuximab had more cutaneous toxicities, but oral toxicity was similar between groups. The different IMRT modalities did not induce different toxicity profiles. [ABSTRACT FROM AUTHOR]

Résumé: Les données de la littérature économique concernant la curiethérapie sont relativement pauvres et hétérogènes, avec peu d’études prospectives contrôlées, et une perspective le plus souvent limitée à celle du payeur (assurance maladie). De plus, ces observations et conclusions sont difficilement transposables en France. Les études médico-économiques prospectives conduites en France dans le cadre du programme de soutien aux thérapeutiques innovantes et coûteuse (Stic) sous l’égide de l’institut national du cancer (Inca) sont donc particulièrement intéressantes. À l’exception de la curiethérapie de prostate par implants permanents de grains d’iode, la valorisation des actes de curiethérapie par l’assurance maladie en France ne prend pas en compte le degré de complexité et les coûts réels supportés par les établissements (i.e. pas de valorisation spécifique pour la dosimétrie et l’optimisation de la distribution de la dose sur imagerie tridimensionnelle et pour l’emploi de projecteurs de source pour la curiethérapie de débit pulsé). [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The main objective of the economical study was to prospectively and randomly assess the additional costs of daily versus weekly patient positioning quality control in image-guided radiotherapy (IGRT), taking into account the modalities of the 3D-imaging: tomography (CBCT) or gold seeds implants. A secondary objective was to prospectively assess the additional costs of 3D versus 2D imaging with portal imaging for patient positioning controls. Patients and methods: Economics data are issued from a multicenter randomized medico-economics trial comparing the two frequencies of patient positioning control during prostate IGRT. A prospective cohort with patient positioning control with PI (control group) was constituted for the cost comparison between 3D (IGRT) versus 2D imaging. The economical evaluation was focused to the radiotherapy direct costs, adopting the hospital''s point of view and using a microcosting method applied to the parameters that may lead to cost differences between evaluated strategies. Results: The economical analysis included a total of 241 patients enrolled between 2007 and 2011 in seven centres, 183 in the randomized study (128 with CBCT and 55 with fiducial markers) and 58 in the control group. Compared to weekly controls, the average additional cost per patient of daily controls was €847 (CBCT) and €179 (markers). Compared to PI, the average additional cost per patient was €1392 (CBCT) and €997 (fiducial markers) for daily controls; €545 (CBCT) and €818 (markers) in case of weekly controls. Conclusion: A daily frequency for image control in IGRT and 3D images patient positioning control (IGRT) for prostate cancer lead to significant additional cost compared to weekly control and 2D imaging (PI). Long-term clinical assessment will permit to assess the medico-economical ratio of these innovative radiotherapy modalities. [Copyright &y& Elsevier]

Abstract: Purpose: Our study aims at evaluating the cost of pulsed dose-rate (PDR) brachytherapy with optimized dose distribution versus traditional treatments (iridium wires, cesium, non-optimized PDR). Issues surrounding reimbursement were also explored. Materials and methods: This prospective, multicentre, non-randomised study conducted in the framework of a project entitled “Support Program for Costly Diagnostic and Therapeutic Innovations” involved 21 hospitals. Patients with cervix carcinoma received either classical brachytherapy or the innovation. The direct medical costs of staff and equipment, as well as the costs of radioactive sources, consumables and building renovation were evaluated from a hospital point of view using a microcosting approach. Subsequent costs per brachytherapy were compared between the four strategies. Results: The economic study included 463 patients over two years. The main resources categories associated with PDR brachytherapy (whether optimized or not) were radioactive sources (1053€) and source projectors (735€). Optimized PDR induced higher cost of imagery and dosimetry (respectively 130€ and 367€) than non-optimized PDR (47€ and 75€). Extra costs of innovation over the less costly strategy (iridium wires) reached more than 2100€ per treatment, but could be reduced by half in the hypothesis of 40 patients treated per year (instead of 24 in the study). Conclusion: Aside from staff, imaging and dosimetry, the current hospital reimbursements largely underestimated the cost of innovation related to equipment and sources. [Copyright &y& Elsevier]

Abstract: The aim of this study is to assess the effects of Positron Emission Tomography (PET) associated with computed tomography (CT) on resource allocation (costs and savings) of the following treatment in radiotherapy for non small cell lung cancers (NSCLC) and Hodgkin''s diseases. A national prospective study was conducted in nine hospitals. Two treatment decisions made on the basis of CT only or on PET associated with, were compared in a before-after design. The direct medical cost of using PET was assessed by micro-costing. The costs of new exams and the costs and savings associated with changes in the chosen treatment were calculated on the basis of reimbursement rates. The economic study was conducted over 2 years and included 209 patients (97 patients with Hodgkin''s disease and 112 with NSCLC). The mean cost of using PET, corresponding to an extra cost, was approximately 800€ (50% for the radionuclide FDG). Radiotherapy treatments were modified for only 10% of patients with Hodgkin''s disease with a minor impact on treatment costs versus 40% of patients with lung cancer with a reduction in mean treatment cost of more than 500€. [Copyright &y& Elsevier]

Abstract: Purpose: Our study aims to evaluate the impact of the implementation of respiratory gating (RG) on the production cost of radiotherapy, as compared to conformational radiotherapy without RG (comparator) in patients with lung or breast cancers. Issues surrounding reimbursement were also explored. Materials and methods: A prospective, multicenter, non-randomised study was conducted in the framework of a project entitled “Support Program for Costly Diagnostic and Therapeutic Innovations”. Of the 20 hospitals involved in the clinical study, eight reference centers participated to the medico-economic study evaluating the costs of staff and equipment, as well as the costs of maintenance and consumables. Results: Three hundred and sixty-five patients were enrolled over two years in the economic study, corresponding to 197 radiotherapy treatments without RG and 168 with RG. Patients treated during the learning phase (n =27) were excluded from the comparison with the control group. The use of RG in routine practice induced a cost increase of respectively €1256 and €996 per treatment for lung and breast cancer patients treated with breath-hold techniques, versus €1807 and €1510 for lung and breast cancer patients treated with synchronized gating techniques. Overcosts were mainly due to extra working time of medical staff and medical technicians and to extra use of equipments during treatment sessions. Conclusion: The results of the full cost estimation suggested that medical reimbursements largely underestimate the costs related to innovation. [Copyright &y& Elsevier]

Classical multi-wavelength optical orthogonal code (MWOOC) constructions impose several conditions on the code parameters. These limit the optical code division multiple access (OCDMA) system potentialities in terms of performance and practical implementation. A modified MWOOC construction is used to overcome these limitations. Indeed, this method permits the design of 2D codes with a low temporal code length value and a low number of wavelengths. Considering a multi-user receiver named parallel interference cancellation, the number of users and the data rate per user the system can provide for a low bit error rate value are evaluated. For a given performance, it is shown that the spectral efficiency using the modified MWOOC is significantly improved. Thus, the simplicity of the modified code design and the spectral efficiency increase constitute an advantage for practical implementation of OCDMA network. [ABSTRACT FROM AUTHOR]

Objectives To examine the effect of maternal origin and distance between maternal residence and the nearest maternity ward with a neonatal surgical center in the same hospital, on prenatal diagnosis, elective termination of pregnancy, delivery in an adequate place and neonatal mortality for pregnancies with severe malformations requiring neonatal surgery, and to examine the effect of the place of delivery on neonatal mortality. Methods This was a retrospective study, through the France Central-East malformation registry, of 706 fetuses with omphalocele (n = 123), gastroschisis (n = 99), diaphragmatic hernia (n = 222), or spina bifida (n = 262), but without chromosomal anomalies. Maternal origin was classified as Western European and non- Western European. Adequate place for delivery was defined as birth in a Level-Ill maternity ward with a neonatal surgical center in the same hospital. Results The prenatal diagnosis rate was 67.7% in 1990-1995 and 80.2% in 1996-2001 (odds ratio (OR), 2.07 (95% CI, 1.24-3.45)). On multivariate analysis, the rate was significantly lower for women living 11-50 km (adjusted OR, 0.49 (95% CI, 0.25-0.94)), or > 50 km (adjusted OR, 0.39 (0.20-0.74)) from the closest adequate place of delivery, compared with those living <11 km from it, but there was no difference for maternal origin. Non-Western European women had fewer elective terminations of pregnancy (adjusted OR, 0.34 (95% CI, 0.14-0.81)) and fewer deliveries in an adequate place (adjusted OR, 0.40 (95% CI, 0.18-0.89)). Neonatal mortality was lower in the case of delivery in an adequate place (adjusted OR, 0.22 (95% CI, 0.07-0.72)) and was not associated with maternal origin and distance from nearest maternity ward with a neonatal surgical center. Conclusion Rate of prenatal diagnosis decreases with increasing distance between parental residence and referral center. Non-Western European women are diagnosed prenatally as often as are Western Europeans, but terminate their pregnancy less often, perhaps for cultural reasons. Non-Western European women with malformed fetuses deliver in adequate centers less often, probably because of the way the perinatal care system is run. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports on the use of PIXE and RBS (resonant and non-resonant RBS) implemented with proton beams to simultaneously analyse light and heavy elements in materials of cultural heritage significance, as exemplified by Russian icons or in lead seals. It is shown that in spite of its poor mass resolution RBS with protons can provide useful information when combined with PIXE. In the case of Russian icons, it is possible to discriminate between an Au–Ag bilayer and an alloy of these metals in the gilds. However, when applied to lead seals RBS with protons encounters a significant limitation due to some deficiency in the available computer programs used for spectrum processing. [Copyright &y& Elsevier]

Nucleation of superconductivity and vortex patterns have been studied in mesoscopic samples providing the crossover between square and rectangular geometries. The measured nucleation line,Tc(H), has been analyzed in the framework of the linearized Ginzburg-Landau theory. A very good agreement has been found between the theoreticalTc(H) boundary and the experimental data for rectangles with different aspect ratios. The superconductor/ferromagnet hybrids, such as magnetic Co/Pd dot in a superconducting loop and the dot on top of a superconducting disk have also been investigated. Pronounced effects of the dot on theTc(H) boundary have been found, including strong asymmetry with respect to the field polarity. [ABSTRACT FROM AUTHOR]

We have analysed the onset of superconductivity in an Al mesoscopic disk, with a perpendicularly magnetized magnetic dot on the top. An insulating Si spacer layer between the Al disk and magnetic dot ensures that the interaction between them occurs only through the stray field of the magnetic dot. The superconducting Tc(B) phase boundary is asymmetric with respect to the polarity of the applied magnetic field. The maximum critical temperature is achieved for a finite value of the perpendicular applied magnetic field, which is parallel to the magnetization of the magnetic dot. [Copyright &y& Elsevier]

We report experimental results of a superconducting Pb disk and triangle of the intermediate size, i.e. between the mesoscopic and the macroscopic regime. The magnetization is measured by Hall magnetometry. A comparison of the stability of different vortex configurations in the two different geometries is done. The experimental results for the disk are compared with theoretical predictions. There is a reasonable agreement between the theory and the experiment. [Copyright &y& Elsevier]

The nucleation of superconductivity in a mesoscopic equilateral triangle is studied experimentally by transport measurements and theoretically by using the linearized Ginzburg–Landau equation. The voltage and current leads, intrinsic to transport measurements, give rise to a broadening of the resistive transition R(T). However, by choosing the right resistance criterion to determine the experimental superconducting/normal phase boundary Tc(H) and by reducing the coupling between the triangle and the contacts, achieved by changing the shape of the contacts, this influence can be minimized. From the theoretical study, we found that the trigonal symmetry of the sample has a profound effect on the superconducting state in the presence of a magnetic field H leading, in particular, to the formation of antivortices in symmetry-consistent states. A good agreement between the theory and the experimental Tc(H) data is observed. [Copyright &y& Elsevier]

A superconducting microtriangle is proposed to be used as a field-dependent diode. A dc voltage generated by the triangle induced by an applied ac drive is observed close to the superconducting/normal phase boundary. This effect is due to the superposition of the asymmetric screening currents in the triangle and the ac drive. The sign of the dc voltage is an alternating function of the applied magnetic field that reflects switching of the direction of the screening currents in the structure. [ABSTRACT FROM AUTHOR]

We have studied a system consisting of a superconducting Al strip placed close to a perpendicularly magnetized Co/Pd rectangle. The stray fields of the rectangle produce a nonhomogeneous magnetic field in the superconductor. These stray fields can efficiently compensate the self-field inside the current-carrying superconductor. We have observed a current-polarity dependence of the critical current. The compensation effects are strongly dependent on the current in the superconductor and also on the temperature. The studied configuration is easily tunable for a large range of applied currents. [ABSTRACT FROM AUTHOR]

Efficiency and toxicity of hypofractionated Stereotactic Body Radiation Therapy (SBRT) in pediatric situations need to be assessed. We conducted a prospective multicentric National study on SBRT in young patients (1.5-20 y.) Indications of SBRT had to be approved by a multi-disciplinary tumor board. SBRT indications were either locally relapsed ependymoma after complete surgery (randomization between 24 Gy/3 fr or 25 Gy/5 fr, isodose 80%), or brain, lung or spinal metastases of any origin after incomplete or no resection in first-line, or in re-irradiation (re-RT) situations The main objective was to evaluate the 6-month local control (LC) rate (RECIST 1.1). Secondary objectives were to evaluate 1 and 2-year LC rates, acute (< 3 months) and medium-term toxicities (3-24 months) using NCI-CTC-v-4.0. Sixty-one patients, median age 13y., (range 3-20) were included in 10 institutions (12/2013-12/2019). Four patients did finally not receive SBRT and were excluded from the analysis. Eighteen patients (32%) were irradiated in first intention (5 brain, 5 lung, 8 spinal lesions, median dose 35 Gy/5fr, isodose 80%. Thirty-nine patients (68 %) were included for re-RT: 14 patients (7 patients/randomization arm) for post-operative SBRT for locally relapsed ependymoma, 25 patients for re-RT in other situations (brain, spine, lung...) (median dose 25 Gy/5 fr, isodose 80%). No pt required general anesthesia. Median follow-up was 24 months (22-28 months). Six-month, 1- and 2-year local control rates will be reported during the congress (undergoing analysis). Gr.2 and 3 acute RT toxicities were observed in 7 and 1 (epilepsy) patients respectively. Medium-term RT toxicity was identified in 4 patients (gr.2) and 1 patients (gr.3, brain radio-necrosis). No grade 4/5 was reported. SBRT is feasible and safe in childhood in selected brain, lung and spine treatment or in selected cases of re-RT. More details (especially efficiency) will be available for the congress. [ABSTRACT FROM AUTHOR]

The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires ( n = 132), longitudinal interviews ( n = 47) and observations of consultations ( n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. [ABSTRACT FROM AUTHOR]

The verification regime of the comprehensive test ban treaty (CTBT) is based on a network of three different waveform technologies together with global monitoring of aerosols and noble gas in order to detect, locate and identify a nuclear weapon explosion down to 1 kt TNT equivalent. In case of a low intensity underground or underwater nuclear explosion, it appears that only radioactive gases, especially the noble gas which are difficult to contain, will allow identification of weak yield nuclear tests. Four radioactive xenon isotopes, Xe, Xe, Xe and Xe, are sufficiently produced in fission reactions and exhibit suitable half-lives and radiation emissions to be detected in atmosphere at low level far away from the release site. Four different monitoring CTBT systems, ARIX, ARSA, SAUNA, and SPALAX™ have been developed in order to sample and to measure them with high sensitivity. The latest developed by the French Atomic Energy Commission (CEA) is likely to be drastically improved in detection sensitivity (especially for the metastable isotopes) through a higher sampling rate, when equipped with a new conversion electron (CE)/X-ray coincidence spectrometer. This new spectrometer is based on two combined detectors, both exhibiting very low radioactive background: a well-type NaI(Tl) detector for photon detection surrounding a gas cell equipped with two large passivated implanted planar silicon chips for electron detection. It is characterized by a low electron energy threshold and a much better energy resolution for the CE than those usually measured with the existing CTBT equipments. Furthermore, the compact geometry of the spectrometer provides high efficiency for X-ray and for CE associated to the decay modes of the four relevant radioxenons. The paper focus on the design of this new spectrometer and presents spectroscopic performances of a prototype based on recent results achieved from both radioactive xenon standards and air sample measurements. Major improvements in detection sensitivity have been reached and quantified, especially for metastable radioactive isotopes Xe and Xe with a gain in minimum detectable activity (about 2 × 10 Bq) relative to current CTBT SPALAX™ system (air sampling frequency normalized to 8 h) of about 70 and 30 respectively. [ABSTRACT FROM AUTHOR]

An approach to the Ginzburg–Landau problem for superconducting regular polygons is developed making use of an analytical gauge transformation for the vector potential A which gives An=0 for the normal component along the boundary line of different symmetric polygons. As a result the corresponding linearized Ginzburg–Landau equation reduces to an eigenvalue problem in the basis set of functions obeying Neumann boundary condition. Such basis sets are found analytically for several symmetric structures. The proposed approach allows for accurate calculations of the order parameter distributions at low calculational cost (small basis sets) for moderate applied magnetic fields. This is illustrated by considering the nucleation of superconductivity in squares, equilateral triangles and rectangles, where vortex patterns containing antivortices are obtained on the Tc–H phase boundary. The calculated phase boundaries are compared with the experimental Tc(H) curves measured for squares, triangles, disks, rectangles, and loops. The stability of the symmetry consistent solutions against small deviations from the phase boundary line deep into the superconducting state is investigated by considering the full Ginzburg–Landau functional. It is shown that below the nucleation temperature symmetry-switching or symmetry-breaking phase transitions can take place. The symmetry-breaking phase transition has the same structure as the pseudo-Jahn-Teller instability of high symmetry nuclear configurations in molecules. The existence of these transitions is predicted to be strongly dependent on the size of the samples. [ABSTRACT FROM AUTHOR]

We have studied the nucleation of superconductivity in a mesoscopic Al disk with a Co/Pd magnetic dot placed on the top by measuring the normal/superconducting phase boundary T[sub c](B). The measurements have revealed a pronounced asymmetry in the phase boundary with respect to the direction of the applied magnetic field, indicating an enhancement of the critical field when an applied magnetic field is oriented parallel to the magnetization of the magnetic dot. The theoretical T[sub c](B) curve is in a good agreement with the experimental data. © 2003 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Objectifs ART-ORL est un essai multicentrique qui a évalué d’une part les coûts de la mise en œuvre de la radiothérapie conformationnelle avec modulation d’intensité (RCMI) par différentes techniques d’arcthérapie volumétrique modulée en France et d’autre part l’efficacité et la toxicité de ce traitement. Les implications de l’utilisation du cétuximab chez des patients recevant une arcthérapie volumétrique modulée ne sont pas encore bien décrites. Cette étude est une analyse exploratoire à partir des données prospectives et multicentriques de cet essai soutenu par l’Institut national du cancer (Inca). Patients et méthodes Les critères d’inclusion étaient les patients atteints d’un carcinome épidermoïde ou indifférencié du cavum, de l’oropharynx ou de la cavité buccale, de stade I à IV, sans métastase, non opéré, avec une irradiation des aires ganglionnaires cervicales bilatérale. Résultats Cent quatre-vingt patients ont été inclus. L’âge médian était de 56 ans. Cent dix-huit patients étaient pris en charge pour un carcinome épidermoïde de l’oropharynx (67,8 %), 38 pour un carcinome indifférencié du cavum (21,8 %), 17 pour un carcinome épidermoïde de la cavité buccale (9,8 %) et un pour une double localisation oro- et nasopharyngée. Vingt neuf patients ont reçu du cétuximab. Ces patients étaient plus âgés ( p < 0,001), avec un indice de performance plus élevé ( p = 0,002) et des stades tumoraux plus importants. La survie globale n’était pas significativement différente entre les patients traités par cetuximab et les autres (71,1 % contre 86,6 % ; p = 0,0607). Le taux de contrôle local était de 54,9 % pour le groupe traité par cétuximab contre 82,5 % ( p = 0,0033). La toxicité de grade supérieur ou égal à 3 n’était pas significativement plus importante chez les patients traités par cétuximab ( p = 0,2944 pour la toxicité aiguë et p = 1,0 pour la toxicité tardive). Conclusion Aucune différence significative de survie ou de toxicité n’a été mise en évidence entre les patients traités par une technique d’arcthérapie volumétrique modulée, avec ou sans cétuximab. Ces résultats doivent être interprétés en tenant compte du faible nombre de patients traités par cétuximab dans l’essai ART-ORL. [ABSTRACT FROM AUTHOR]

Introduction et but de l’étude Chez les patientes atteintes d’un cancer du sein, la prise de poids et la perte de condition physique sont des facteurs pronostiques péjoratifs. En revanche, une alimentation saine et une activité physique (AP) régulière pourraient réduire les comorbidités et améliorer la survie. L’étude contrôlée randomisée PASAPAS ( www.clinicaltrials.gov , numéro d’enregistrement NCT01331772) a été conçue pour évaluer la faisabilité d’un programme d’AP adaptée concomitant à une chimiothérapie adjuvante chez les femmes atteintes d’un cancer du sein de stade précoce. Les données évolutives biologiques, morphologiques et de composition corporelle sont présentées. Matériel et méthodes Entre juin 2011 et juin 2013, 61 patientes ont été incluses et randomisées entre un bras interventionnel et un bras témoin (ratio 2:1). Toutes les participantes ont bénéficié de conseils diététiques. Le bras interventionnel a bénéficié d’un programme d’AP aérobie de deux à trois séances hebdomadaires, collectives et supervisées pendant 6 mois. Un prélèvement sanguin, des mesures anthropométriques, la composition corporelle mesurée par impédancemétrie bioélectronique et un questionnaire d’AP ont été obtenus à l’inclusion et à 6 mois. Des statistiques descriptives ont été effectuées et des analyses de corrélation ont évalué les effets potentiels de l’AP. Résultats et Analyse statistique 60 (98 %) patientes ont terminé l’étude et une l’a abandonnée après randomisation. À l’inclusion, les bras interventionnel (n = 41) et témoin (n = 19) étaient comparables. Dans le groupe interventionnel, l’adhésion médiane au programme était de 85 % du nombre de séances prévues ; les raisons de non compliance étaient principalement d’ordre logistique ou liées à une chirurgie complémentaire ou réparatrice. À 6 mois, les bras étaient comparables en termes d’anthropométrie, de composition corporelle et de niveau d’AP. Cependant, la majorité (> 70 %) des participantes ont maintenu ou diminué leur poids, leur tour de taille ou leur masse grasse et ont maintenu ou augmenté leur masse maigre. De plus, l’AP d’intensité modérée à soutenue (> 4 MET) était inversement corrélée aux variations de poids (p = 0,04) et de masse grasse (p = 0,01). La sédentarité était positivement corrélée aux variations de glycémie à jeun (p = 0,04) et de cholestérolémie totale (p = 0,03). Conclusion Cet essai a montré que la mise en œuvre d’un programme d’AP adaptée de 6 mois est réalisable pendant la chimiothérapie adjuvante du cancer du sein dans une population française. Il servira de base pour de futures études randomisées d’efficacité. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To compare respiratory-gated conformal radiotherapy versus conventional conformal radiotherapy for the irradiation of non-small cells lung cancer and breast cancer. Patients and methods: The STIC 2003 project was a comparative, non-randomized, multicenter and prospective study that included in 20 French centers between April 2004 and June 2008, 634 evaluable patients, 401 non-small cells lung cancer and 233 breast cancers. Results: The final results confirmed the feasibility and good reproducibility of the various respiratory-gated conformal radiotherapy systems regardless of tumour location. The results of this study demonstrated a marked reduction of dosimetric parameters predictive of pulmonary, cardiac and esophageal toxicity, especially for non-small cells lung cancer, as a result of the various respiratory gating techniques. These dosimetric benefits were mainly observed with deep inspiration breath-hold techniques (ABC and SDX), which markedly increased the total lung volume compared to the inspiration-synchronized system based on tidal volume (RPM). For non-small cells lung cancer, these theoretical dosimetric benefits were correlated with a significant reduction in clinically acute and late toxicities, especially the pulmonary. For breast cancer, although less clear due to the lower total dose, there was a decrease in the dose delivered to the heart, potentially reducing the risk of cardiac toxicity in the long-term, especially during the irradiation of the left breast, and a reduction in dose to the contra lateral breast. Conclusion: Respiratory-gated radiotherapy appears to be essential to reduce the risk of acute and late toxicities, especially for lungs and heart, during irradiation of non-small cells lung cancer and breast cancers. [Copyright &y& Elsevier]