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F Baillet

Publications and source records attributed to F Baillet.

At least 19 recordsLinked to original sources
PubMed2004

[Results of salvage stereotactic radiosurgery in 14 patients with grade III or IV gliomas].

AIMS: To determine local control and overall survival rates of 14 patients treated for a grade III or IV glioma relapsing in a previously irradiated area and re-irradiated by stereotactic radiosurgery. PATIENTS AND METHODS: From January 1997 to October 2001, 14 patients (median age 52 Years, age range 49-58 Years, Karnofski performance score 80 to 100) received radiosurgery for a relapse of grade III (3 patients) and or grade IV (10 patients) malignant gliomas. Before relapse, all patients had undergone surgery and had been given with a classical radiation protocol. Median maximum diameter and Volume of the tumors were 38.5mm (24-86mm) and 7cm3 (2-35cm3), respectively. RESULTS: Median maximal dose at the isocenter and median minimal dose at the periphery of the lesion were 21Gy (16-38Gy) and 13Gy (9-17Gy), respectively. Mean follow-up was 8.5 Months (1-29). Median overall survival was 11.6 Months; 6-Month, 1- and 2-Year overall survival rates were 85p.100, 36p.100 and 12p.100, respectively. At univariate analysis, only histological grade was a significant prognostic factor of overall survival (p=0.03). Median disease-free survival was 8.2 Months while 6-Month and 1-Year disease-free survival rates were 69p.100 and 14p.100, respectively. According to univariate analysis, histological grade (p=0.033) and minimal dose delivered at the margin of the target Volume (p=0.02) were prognostic factors for disease-free survival. Two patients developed a symptomatic radionecrosis. CONCLUSION: Radiosurgery of relapsed primitive high-grade brain tumors is efficient and overall survival rates were encouraging.

Brain Neoplasms↗
PubMed2003

[Epstein-Barr virus associated central nervous system leiomyosarcoma occurring after renal transplantation: case report and review of the literature].

Central nervous system leiomyosarcomas are extremely rare, however, they became more frequent among immunodeficient patients, either in a patients infected with human immunodeficiency virus (HIV), or after organ transplantation. The data of the literature indicate that the infection by Epstein-Barr virus (EBV) plays a causal role in the development of these tumours but its precise role in the oncogenesis remains unresolved. We report a new case of EBV associated leiomyosarcoma of the left cavernous sinus occurring after renal transplantation. The epidemiological, clinical, pathological and therapeutic characteristics of these tumours are discussed.

Adult↗
PubMed2002

[The organization of psycho-oncology].

Many specialists are acting for psychological support: oncologists, psychologists, psychiatrists. Their respective role and the necessary good adjustment between actors are discussed. Quantitative requirements depends on number of patients and dispersion of medical units. The insufficient number of oncological staff cannot be compensated by the psycho-oncological team whose action is complementary of the technical staff support. The psycho-oncological team may be integrated in the oncology unit or autonomous. A network organisation is still uncommon. The intervention of external units of psychiatry, not specialised in oncology, is a less satisfying solution. Actually, 25% of the 94 French centres have neither psychiatrist nor psychologist. The same investigation has shown that 20% of patients request a consultation with a psychiatrist or a psychologist, but only half of them obtain it. There is also a need of formation as well for psychiatrists and psychologists as for oncologists. All that is necessary to satisfy the demand of support of patients and of their family.

Burnout, Professional↗
PubMed2002

[Comparison with dose-volume histograms of two conformal irradiation techniques used for the treatment of T2N0M0 nasopharyngeal cancer, one with association of photons and protons and another with photons alone].

Purpose- There is a relationship between the local control rate of the nasopharyngeal cancer and the total dose delivered within the tumoral volume. In contrast, the relation between the dose and the irradiated volume and the risk of complication is not clearly defined. That is why, in patients presenting with a locally advanced nasopharyngeal cancer, we compared the dose-volume distribution of irradiated tissues, obtained from two 3D conformal irradiation techniques. Patients and methods- Between January 2000 and June 2001, 5 patients, 3 males and 2 females, with a median age of 32 years and presenting with a T4N0M0 nasopharyngeal cancer received a chemoradiotherapy. Radiotherapy combined photons and protons beams and the platin-based chemotherapy was delivered in three intravenous injections at d1, 22, 43 of the irradiation. To calculate the dosimetry, a CT scan and a MRI were performed in all the patients. The gross tumor volume (GTV) was delineated from the imagery, three clinical tumor volumes were defined, the CTV1 was the GTV and the whole nasopharynx, the CTV2 was the CTV plus a 10 mm-margin and the CTV3 was the CTV2 and the nodes areas (cervical and subclavicular). Prophylactic dose within node areas was 44 Gy. Prescribed doses within CTV2 and GTV or CTV1 were 54 Gy/CGE (Cobalt Gy Equivalent, for an EBR = 1,1) and 70 Gy/CGE, respectively. Irradiation was delivered with fractions of 1.8 or 2.0 Gy/CGE, with 44 Gy or 54 Gy by photons and with 16 or 26 CGE by protons. According to dose-volume histograms obtained from the dosimetry planning by protons and photons and from the theoretical dosimetry by photons lonely, for the different volumes of interest, GTV, CTV2, and organs at risk (optic nerves, chiasm, internal ears, brainstem, temporal lobes), we compared the averages of the maximum, minimum and mean doses and the averages of the volumes of organs of interest encompassed by different isodoses.Results- Calculated averages of minimum, maximum and mean doses delivered within GTV were superior for the treatment with combined photons and protons than with photons alone. The average GTV encompassed by the 70 Gy/CGE isodose was larger by 65% with the association compared to photons alone. The conformation ratio (tissue volume encompassed by the 95% isodose/GTV encompassed by the 95% isodose) was 3.1 with the association compared to 5.7 with photons alone. For the CTV2, there were no differences in different criteria according to the both irradiation techniques. For the critical, radiosensitive organs, the comparison of the majority of the criteria was in favour of the association of protons and photons. Overall, 78% of the criteria were in favour of the association.Conclusion- For locally advanced nasopharyngeal cancer without clinical adenopathy, irradiation by photons and protons increases the tumor volume irradiated at the prescribed dose and decreases the volume or critical organs irradiated and the total dose delivered within them.

Adult↗
PubMed2002

Cancer: the role of extracellular disease.

Invasive carcinoma originates from the epithelial cells lining the lumen of an organ. It is often preceded by metaplasia, dysplasia or carcinoma in situ. The purpose of this review is to suggest that this disease of the epithelium may be, in part, the result of underlying tissue-based disorganization. Human cancer is frequently associated with pre-existing tissue disease. For example, hepatocellular carcinoma usually occurs in patients with a macronodular cirrhotic liver. Most lung cancers arise among patients with chronic lung disease (bronchitis, emphysema, and chronic infection). Mechanical forces appear to play a major role in regulating normal and cancer cell growth. The loss of cell polarity by neoplastic cells, coupled to an otherwise normal growth rate is enough to explain the cancer star-shaped pattern. By changing the plane of cell division, tumor cells may escape physical constraints from surrounding cells and divide. Loss of cell polarity and the resulting cell proliferation appears to be a consequence of either tissue-based disorganization (chronic inflammation, fibrosis) or of direct carcinogenic insult. The multiple mutations frequently described in cancer may be, in part, secondary to physical stress and not primary events. Several animal and clinical trials have shown that tissue disruption (i.e. radiation-induced fibrosis or liver cirrhosis) can be successfully treated. It is possible that treatment targeted at tissue disruption would delay or reduce cancer incidence regardless of the precise biological mechanism of carcinogenesis.

Adult↗
PubMed2002

[The influence of age on radiation-induced cognitive deficit:experimental studies on brain irradiation of 30 gy in 10 sessions and 12 hours in the Wistar rat at 1 1/2, 4 and 18 months age].

The objective of this study was to determine the influence of age on the learning and memory dysfunction induced by cranial radiation in the male Wistar rat. Ninety-six 45-day-old, 70 4-month-old, and 78 18-month-old male rats were divided in two equal groups: (i) irradiated and (ii) control. A course of whole-brain radiation therapy (30 Gy in 10 fractions over 12 days) was administered to the irradiated group, while the control group received sham irradiation. Sequential behavioral studies including one and two-way avoidance tests were undertaken before and after the 7 months following radiation. The results suggest that radiation induced progressive and irreversible memory dysfunction in elderly (18-month-old) rats, but this effect was partial or almost reversible in the 4-month-old and 45-day-old rats, respectively. In return, the learning dysfunction was age non-dependent despite the fact that is occurs more rapidly in the young (45 days, 4 months) rats.

Aging↗
PubMed2001

Pulsed dose rate brachytherapy in head and neck cancers. Feasibility study of a French cooperative group.

PURPOSE: To prospectively evaluate the feasibility of pulsed dose rate (PDR) brachytherapy to mimic the continuous low dose rate (cLDR) iridium wire technique in head and neck carcinomas. MATERIALS AND METHODS: A series of 30 patients were included from June 1995 to May 1998. The primaries were located in the oral cavity (four T1, seven T2 and two T3), the velotonsillar arch (eight T1 and eight T2) and the posterior wall (one T3). Thirteen were irradiated by exclusive brachytherapy (dose, > or =45 Gy). The PDR delivered 0.5 Gy/pulse, one pulse/h, day and night, to mimic cLDR irradiation. RESULTS: The implantation was feasible for all the patients, usually easy and of good quality. The mean duration/pulse was 13 min, with a mean source activity of 171 mCi. Patient tolerance was poor in nine cases. Sixteen patients could receive the whole PDR treatment with a total ranging from 30 to 120 pulses without any problem. Seven had short breakdowns (< or =6 h). Seven had definitive breakdowns, but could end the irradiation by manual afterloading of iridium 192 wires. The radioprotection was better (or complete), except for one patient. Most of the breakdowns were related to kinking or flattering of the tube. CONCLUSIONS: PDR is feasible in head and neck carcinomas, but necessitates improvement of the quality and control of the plastic tubes.

Brachytherapy↗
PubMed2001

Radiosurgery for re-irradiation of brain metastasis: results in 54 patients.

PURPOSE: To evaluate in terms of probabilities of local-regional control and survival, as well as of treatment-related toxicity, results of radiosurgery for brain metastasis arising in previously irradiated territory. PATIENTS AND METHODS: Between January 1994 and March 2000, 54 consecutive patients presenting with 97 metastases relapsing after whole brain radiotherapy (WBRT) were treated with stereotactic radiotherapy. Median interval between the end of WBRT and radiosurgery was 9 months (range 2-70). Median age was 53 years (24-80), and median Karnofski performance status (KPS) 70 (60-100). Forty-seven patients had one radiosurgery, five had two and two had three. Median metastasis diameter and volume were 21 mm (6-59) and 1.2 cc (0.1-95.2), respectively. A Leksell stereotactic head frame (Leksell Model G, Elektra, Instrument, Tucker, GA) was applied under local anesthesia. Irradiation was delivered by a gantry mounted linear accelerator (linacs) (Saturne, General Electric). Median minimal dose delivered to the gross disease was 16.2 Gy (11.8-23), and median maximal dose 21.2 Gy (14- 42). RESULTS: Median follow-up was 9 months (1-57). Five metastases recurred. One- and 2-year metastasis local control rates were 91.3 and 84% and 1- and 2-year brain control rates were 65 and 57%, respectively. Six patients died of brain metastasis evolution, and three of leptomeningeal carcinomatosis. One- and 2-year overall survival rates were 31 and 28%, respectively. According to univariate analysis, KPS, RPA class, SIR score and interval between WBRT and radiosurgery were prognostic factors of overall survival and brain free-disease survival. According to multivariate analysis, RPA was an independent factor of overall survival and brain free-disease survival, and the interval between WBRT and radiosurgery longer than 14 months was associated with longer brain free-disease survival. Side effects were minimal, with only two cases of headaches and two of grade 2 alopecia. CONCLUSION: Salvage radiosurgery of metastasis recurring after whole brain irradiation is an effective and accurate treatment which could be proposed to patients with a KPS>70 and a primary tumour controlled or indolent. We recommend that a dose not exceeding 14 Gy should be delivered to an isodose representing 70% of the maximal dose since local control observed rate was similar to that previously published in literature with upper dose and side effects were minimal.

Adult↗
PubMed2000

Post-radiation severe xerostomia relieved by pilocarpine: a prospective French cooperative study.

BACKGROUND AND PURPOSE: The aim of the study was: (1) to confirm the action of pilocarpine hydrochloride (Salagen) against xerostomia: (2) to correlate the response to dose/volume radiotherapy parameters. MATERIALS AND METHODS: From June 1995 to February 1996, 156 patients with severe radiation induced xerostomia received pilocarpine hydrochloride orally. IS mg per day with a 5 mg optional increase at S weeks up to a daily dose of 25 mg beyond 9 weeks. RESULTS: One hundred and forty five patients are fully evaluable. Treatment compliance was 75%. Thirty eight patients (26%) stopped treatment before week 12 for acute intolerance (sweating, nausea, vomiting) or no response. No severe complication occurred. Ninety ses en patients (67%) reported a significant relief of symptoms of xerostomia at 12 weeks. Within 12 weeks, the size of the subgroup ith normal food intake almost doubled (13-24 patients) while the size of the subgroup with (nearly) impossible solid food ingestion decreased by 38% (47 vs. 29 patients). The impact on quality of life was considered important or very important by 77% of the responders. CONCLUSIONS: No difference was found according to dose/volume radiotherapy parameters suggesting that oral pilocarpine hydrochloride: (1) acts primarily by stimulating minor salivary glands: (2) can be of benefit to patients suffering of severe xerostomia regardless of radiotherapy dose/volume parameters: (3) all responders are identified at 12 weeks.

Administration, Oral↗
PubMed2000

[Postoperative radiotherapy in lung cancer: comments on several randomized trials or the contribution of well-conducted radiotherapy].

Postoperative radiotherapy is classically proposed after surgical resection in case of a high risk of local recurrence (incomplete resection and nodal invasion especially mediastinal). Its interest was shown by non-randomized trials. Nevertheless, several randomized trials and one meta-analysis of them have recently questioned the contribution of radiotherapy. We analyze here these trials then the meta-analysis, emphasizing certain methodology problems such as the noninclusion of certain therapeutic trials and differences in radiotherapy dosages and techniques. In our opinion, excessive toxicity observed in certain trials can be attributed to technical errors; if well conducted, postoperative radiotherapy improves survival in operated patients when there is a high risk of local reccurence. This affirmation is based on a comparison of long term results of 347 non randomized cases with Port Meta-Analysis randomized cases and GETCB trial randomized cases.

Clinical Trials as Topic↗
PubMed1999

Treatment of malignant gliomas in the elderly.

The benefit of standard treatment of malignant glioma in older patients is debated. In order to assess the effect of a combination of surgery, radiotherapy and chemotherapy on survival of elderly patients with high grade gliomas, 30 consecutive patients older than 70 years with malignant supratentorial gliomas were studied between 9/93 and 9/96. Median age was 73 years (70-79). The mean Karnofsky performance status (KPS) was 66 (30-100). Patients underwent maximum possible surgery, followed by a course of radiotherapy (45 Gy/25 fractions/5 weeks) with 3 or 4 orthogonal beams and a 2 cm margin around the tumor bed. The administration of chemotherapy was left at the discretion of the responsible physician and 12 patients received reduced dose nitrosourea-based chemotherapy. The overall median survival was 36 weeks. The median time to progression was 26 weeks. Three months after surgery, 26 patients were alive, 5 were in complete response, 2 in partial response and 10 were stabilized. Preradiotherapy KPS was the only significant prognostic factor with a median survival of 40 weeks in patients with KPS > or = 70 and 25 weeks when KPS was < 70 (logrank test, p = 0.05). In responding and stable patients (57% of the group) the median KPS was 68 and 66 at 1 and 3 months after the completion of radiotherapy. There was no case of radiotherapy-induced dementia with this regimen. Four out of 12 patients who received chemotherapy, experienced WHO grade 3/4 hematotoxicity. This study suggest that some patients older than 70 years with KPS > or = 70 may benefit from the treatment of malignant gliomas with surgery followed by reduced dose of limited field radiotherapy. Further studies are needed to define the most appropriate dose of radiotherapy and to evaluate further the risk/benefit ratio of a reduced dose chemotherapy in this population.

Aged↗
PubMed1998

An experimental model of acute encephalopathy after total body irradiation in the rat: effect of liposome-entrapped Cu/Zn superoxide dismutase.

PURPOSE: To develop an experimental model of acute encephalopathy following total body irradiation in rats and to define the therapeutic effect of liposome-entrapped Cu/Zn superoxide dismutase. METHODS AND MATERIALS: A total of 120 4-month-old rats received 4.5 Gy total body irradiation (TBI) while 120 rats received sham irradiation. A behavioral study based on a conditioning test of negative reinforcement, the one-way avoidance test, was performed 5 hours before irradiation and repeated the following days. Subcutaneous treatment was started 1 hour after irradiation and repeated daily for 2 weeks. In both the irradiated and sham group, three subgroups were defined according to the treatment received: liposome-entrapped Cu/Zn superoxide dismutase (0.5 mg/kg), liposomes only, normal saline. RESULTS: This work comprised two consecutive studies. In study A (90 rats) the one-way avoidance test was administered daily from day 0 to day 4 with a recall session at day 14. In study B (validation phase in 150 rats) the behavioral test was performed only from day 0 to day 6. Before irradiation, all rats showed a similar behavioral response. Study A (6 groups of 15 rats): Following TBI, irradiated rats treated with liposomes only or saline demonstrated a significant delay in learning the one-way avoidance test in comparison with sham-irradiated rats (0.05 < p <0.001 depending upon the day of evaluation and the subgroup type). In contrast, irradiated rats treated with liposome-entrapped Cu/Zn superoxide dismutase did not differ from sham-irradiated rats. Study B (6 groups of 25 rats): The results were the same as those in study A, demonstrating a significant delay in the learning of the test in the liposome and saline-treated irradiated rats in comparison with sham-irradiated rats (0.02 < p < 0.001). The irradiated rats, treated with liposome-entrapped Cu/Zn superoxide dismutase did not differ from the sham-irradiated controls. CONCLUSION: This study indicates that a relatively low dose of total body irradiation induces a substantial acute learning dysfunction in the rat. This effect is prevented by the administration of liposome-entrapped Cu/Zn superoxide dismutase.

Animals↗
PubMed1998

[Concurrent radio-chemotherapy in infiltrating cancer of the bladder: a new therapeutic approach?].

Until now, radical cystectomy has been considered the most effective treatment for invasive bladder cancer. However, it fails to cure more than 50% of patients and can result in a mediocre quality of life. In an effort to improve cure rates, combined modality regimens have been investigated. Despite the preliminary results of early clinical trials, randomized trials have most often failed to show any benefit from neoadjuvant or adjuvant chemotherapy or radiotherapy. One of the major progress brought by radiotherapy has been the wide use of conservative treatment in several cancer, and in the recent years promising results with concomitant radiochemotherapy have been published. Use of the conservative approach in bladder cancer now appears to be a tangible reality for selected patients, but these combined modalities have not yet been tested in randomized trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

[Radiotherapy-induced cognitive dysfunction in 4-months-old male Wistar rats]].

PURPOSE: Behavioral dysfunction of memory process arising 4 months after whole brain irradiation (30 Gy/10 fractions/12 days) has been demonstrated in 16-27 month old rats, as compared with non irradiated rats. This study was therefore aimed at delivering the same irradiation in young rats and comparing results with those previously obtained in old rats. MATERIAL AND METHODS: Thirty-three 4-month old rats were included into the study. Eighteen received whole brain irradiation (30 Gy/10 fractions/12 days), and 18 were given sham irradiation. Sequential behavior studies were done before irradiation and during the 7 months following irradiation. RESULTS: Significant decrease in memory function was observed in irradiated rats 1 month (p < 0.001), 3 months (p < 0.013), and 6 months (p = 0.007) post-irradiation. This was accompanied by learning deficit 1 month (p = 0.01), 4.5 months (p = 0.03), and 7 months (p = 0.009) post-irradiation. CONCLUSION: Response to radiation therapy observed in young rats differed from that observed in old rats. Young rats showed earlier decrease in memory function than old rats, but this deficit was followed by partial recovery. Learning deficits also arised earlier in young rats than in old rats. In two cases this deficit was permanent.

Age Factors↗
PubMed1997

[Radiotherapy in locoregional treatment of inoperable non-small cell lung cancer: results from a series of 381 patients].

PURPOSE: The prognosis of inoperable non-small cell lung cancer (NSCLC) is poor and thoracic radiation therapy is usually the main step of the therapeutic approach. The results of a retrospective analysis of a series of 381 patients treated from 1977 to 1990 for an inoperable NSCLC are reported. PATIENTS AND METHODS: Three hundred and twenty two men and 59 women were included into the study. Their mean age was 66 years. A squamous cell carcinoma was observed in 276 cases (72%). A superior vena cava syndrome or a Pancoast's syndrome were present in 21 and 26 patients, respectively. Fifty-two per cent of the patients had a WHO performance status > or = 2. According to the TNM classification, the tumor distribution was as follows: 11 T1, 153 T2, 175 T3, and 42 T4. The mediastinum was involved in 174 patients. All patients were treated by external radiation therapy with a total dose of 60-65 Gy. Classical fractionation of the irradiation dose was done in 217 patients and hypofractionation was used for 164 patients. RESULTS: After treatment, improvement of the superior vena and Pancoast's syndromes was observed in 90% of the patients. Radiological complete response was obtained in 177 patients (47%). The 5-year overall survival rate was 6.2%. No significant differences in survival according to the initial tumor size, the mediastinum status or the fractionation scheme were noted. The 5-year survival rate was 13% in patients with a tumor that completely responded to irradiation. Death was mainly due to local failure (231 patients, 69%) and metastatic disease (107 patients, 32%). The radiotherapy tolerance was acceptable. CONCLUSION: Although irradiation provides good palliation and a 10%-survival rate at 3 years, the results relating to radiation therapy were disappointing.

Adult↗
PubMed1997

[Postoperative radiotherapy in non-small cell lung cancer. Apropos of a series of 374 cases].

PURPOSE: Several randomized trials have led us to address the usefulness of post-surgical external beam therapy (EBT) in non-oat cell bronchial carcinoma. Results that were obtained in a group of 374 patients submitted between 1977 and 1994 to identical therapy-the follow-up being done by the same team-and results of six randomized trials are analyzed. PATIENTS AND METHODS: The tumor stages were the following: T1, 13%; T2, 56%; T3, 29%; and T4, 2%; N0, 31%; N1, 34%; and N2, 35%. There were 85% histologically complete resections. EBT was administered according to either the classical irradiation scheme (C) or as an 'equivalent hypofractionated dose' (H) in the case of complete resection. When resection was not complete, 60 to 65 Gy were administered according to a C or an H irradiation scheme. The irradiation scheme was C in 73% of the cases and H in 27%. The EBT technique has been chosen to ensure maximum lung sparing. Following a 45 Gy-irradiation with anteroposterior beams, orthogonal or, when necessary, oblique beams were used. Non homogeneity of the lungs was taken into account in establishing the treatment planning. The treatment file was collectively checked by the medical staff in 75% of the cases. EBT was indicated for N+(N1+N2), T3 and incomplete resections. RESULTS: The overall survival was 42% at 5 years and 27% at 10 years. The 5-year survival was 52% for stage I cancer (T1N0-T2N0), 60% for stage II cancer (T1N1-T2N1), 31% for stage IIIa cancer (T3N0, T1-3N2), 45% for complete resection and 30% when resection was not complete. CONCLUSION: Regarding the benefits of post-surgical radiotherapy, the analysis of the six randomized trials does not allow any conclusion. This might be due to either the insufficient number of cases, a follow-up time not long enough, incorrect radiotherapy, or insufficient available data. Comparison of the results pertaining to the six trials with those of our series shows an advantage for the current series, indicating that survival is likely to be improved if EBT is correctly done with regard to the dose, volume and technique used.

Actuarial Analysis↗
PubMed1997

[Discussion on the role of radiotherapy in non-small cell lung cancer apropos of 137 non-metastatic cases].

PURPOSE: Retrospective analysis of 137 patients with limited stage small cell lung carcinoma who received radiotherapy between 1978 and 1990 and literature review. MATERIALS AND METHODS: The population was divided into two groups according to the total dose of radiation delivered to the thorax: 45 Gy (1.8 Gy by fraction) or the equivalent irradiation dose administered by hypofractionation (group 1, 29 patients) and 65 Gy (1,8 Gy by fraction) or the equivalent irradiation dose administered by hypofractionation (group 2, 96 patients). RESULTS: The actuarial survival rate was 20% at 2 years and 9% at 5 years. It was 25% at 2 years and 17% at 5 years for 12 patients with surgical resection. For patients who did not undergo surgical resection, it was 20% at 2 years and 9% at 5 years for 96 patients belonging to group 2, while it was 14% at 2 years and 3.5% at 5 years for group 1. Deaths due to local relapse reached 48% in the group treated with 45 Gy and 33% in the group treated with 65 Gy (NS). For the 33 patients who were more than 70 years old at the time of treatment, the actuarial survival rate was 18% at 2 years and 6% at 5 years with death from other causes twice as high as that of patients who were less than 70 years old at the time of treatment. For the 59 patients who were less than 70 years old at the time of treatment, in whom supraclavicular node, pleural effusion or superior vena cava syndrome were not depicted and who were treated with the highest dose (4% of the total number of patients), the actuarial survival rate was 20% at 2 years and 14% at 5 years. Literature analysis shows that treatment of limited small cell lung cancer with chemotherapy and thoracic irradiation increased the overall survival rate from 16.5% to 23% at 2 years and the local control from 23% to 48%, in comparison with chemotherapy alone. CONCLUSION: Although these results are modest, they seem to be improved with more effective chemotherapy, especially with the association of radiotherapy and concomitant chemotherapy.

Actuarial Analysis↗