[Comparative study of a series of ionization chambers within 20 and 10 MeV electron fluxes].
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Biomedical subjects
Publications and source records attributed to J Dutreix.
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In 1981, a protocol was developed at the Institut Gustave-Roussy, combining interstitial hyperthermia and brachytherapy. Twenty-nine implantations were performed in 23 patients. All the lesions except three were located in previously irradiated areas. The protocol consisted of interstitial hyperthermia, 44 degrees C for 45 min, immediately followed by iridium-192 brachytherapy, delivering a dose of 30 Gy in the first 17 implantations, and a dose of 40 Gy in the next 12 (the dose was increased because of two local relapses in the first 17 cases). Special 'metal-plastic' tubes have been designed to heat the tumour specifically and to spare the surrounding healthy tissues. Among the 25 implantations for which a complete thermal mapping was available, a minimum temperature of 44 degrees C was reached in 16 cases, 43 degrees C in 5 cases and 42 degrees C in 4. The temperature inhomogeneity within the treated volume was less than 1 degrees C in 16 cases, and up to 4 degrees C in only one instance. Short-term clinical results (at two months) are available for 23 implantations: a 100 per cent response rate and a 83 per cent complete regression rate was observed. Follow-up is still short for most patients and long-term local control cannot be evaluated. Treatment has been generally well tolerated despite prior irradiation. Thus, technically satisfactory hyperthermia could be obtained in most cases, short-term clinical results are encouraging, and the technique merits further study.
The authors discuss the management in radiotherapy of bony tumours of the thoracic wall: necessity of accepting the risk due to the volume of healthy tissue which is inevitably irradiated, the technics of irradiation which limit these risks. Limited hope of improvement of the still modest results with new technics of radiotherapy. They emphasize the difference which exists between the idea of radiosensitivity and radiocurability.
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