Objective:To assess the applicability degree of the international guidelines by Moroccan radiotherapists,in order to improve the management of cervical cancer(CC),since CC is the second most common cancer for women in...Objective:To assess the applicability degree of the international guidelines by Moroccan radiotherapists,in order to improve the management of cervical cancer(CC),since CC is the second most common cancer for women in Morocco.Methods:This cross-sectional study was carried out using a questionnaire sent online to Moroccan radiotherapists.The questionnaire covered participants'characteristics,initial assessment and treatment preparation,techniques and indications for radiotherapy and brachytherapy,dose and indications,as well as on the protocol adopted in the intermediate stages and the location of adjuvant treatments and assessments'follow-up.Results:74 radiotherapists out of 300 have responded to the survey.Only 27.0%of practitioners reported discussing patient records systematically in a multidisciplinary consultation meeting(MCM).For the initial assessment,77.0%requested pelvic magnetic resonance imaging(MRI).It is significantly less requested in regional oncology centers(ROCs)than in university hospital centers(UHCs)or the private sector(P<0.001).Furthermore,Clinicians in ROCs do not have access to new techniques of radiotherapy.In 83.8%of cases,the most prescribed radiotherapy protocols were 45–46 Gy in 1.8–2 Gy per fraction.Three-dimensional gynaecological brachytherapy high-throughput dose guided by dosimetric scanner was available in 75.5%of structures while interstitial gynaecological brachytherapy was only available in 23%of centers.The two most prescribed dose protocols were 47 Gy and 37 Gy in 74.4%and 21.6%of cases,respectively.Finally,monitoring during the first two years was based mainly on pelvic MRI(82.2%)while PET/CT was recommended by only less than 10%.Conclusions:The findings obtained show that our radiotherapists generally comply with international guidelines for the cervical cancer management.However,they should still enhance their practices for the first staging evaluation,the use of systematic MCMs,the doses and treatment techniques used,and the follow-up evaluation.展开更多
The aim of this review was to examine the theoretical,preclinical and clinical bases of the combination radiotherapy immunotherapy in the management of non-small cell lung cancer(NSCLC).Preclinical studies have shown ...The aim of this review was to examine the theoretical,preclinical and clinical bases of the combination radiotherapy immunotherapy in the management of non-small cell lung cancer(NSCLC).Preclinical studies have shown that in addition to its well-established tumoricidal effects,radiotherapy can activate the host immune system and modify the tumor microenvironment.Immunotherapy is currently part of the therapeutic arsenal of the NSCLC given its capacity to restore the host's immune system's ability to recognize and destroy tumor cells.The combination of radiotherapy and immunotherapy seems to be synergistic,particularly with inhibitors of immune checkpoints.This association has become standard in the metastatic stages and especially in consolidation after radiochemotherapy in the locally advanced,unresectable and stable stages.Several questions remain unanswered including the optimal sequence of this combination,the type of radiotherapy(hypo-fractionated or normofractionated),the association of several immunotherapies and the cross-toxicity of the combination.The association of radiotherapy and immunotherapy is a promising treatment.展开更多
文摘Objective:To assess the applicability degree of the international guidelines by Moroccan radiotherapists,in order to improve the management of cervical cancer(CC),since CC is the second most common cancer for women in Morocco.Methods:This cross-sectional study was carried out using a questionnaire sent online to Moroccan radiotherapists.The questionnaire covered participants'characteristics,initial assessment and treatment preparation,techniques and indications for radiotherapy and brachytherapy,dose and indications,as well as on the protocol adopted in the intermediate stages and the location of adjuvant treatments and assessments'follow-up.Results:74 radiotherapists out of 300 have responded to the survey.Only 27.0%of practitioners reported discussing patient records systematically in a multidisciplinary consultation meeting(MCM).For the initial assessment,77.0%requested pelvic magnetic resonance imaging(MRI).It is significantly less requested in regional oncology centers(ROCs)than in university hospital centers(UHCs)or the private sector(P<0.001).Furthermore,Clinicians in ROCs do not have access to new techniques of radiotherapy.In 83.8%of cases,the most prescribed radiotherapy protocols were 45–46 Gy in 1.8–2 Gy per fraction.Three-dimensional gynaecological brachytherapy high-throughput dose guided by dosimetric scanner was available in 75.5%of structures while interstitial gynaecological brachytherapy was only available in 23%of centers.The two most prescribed dose protocols were 47 Gy and 37 Gy in 74.4%and 21.6%of cases,respectively.Finally,monitoring during the first two years was based mainly on pelvic MRI(82.2%)while PET/CT was recommended by only less than 10%.Conclusions:The findings obtained show that our radiotherapists generally comply with international guidelines for the cervical cancer management.However,they should still enhance their practices for the first staging evaluation,the use of systematic MCMs,the doses and treatment techniques used,and the follow-up evaluation.
文摘The aim of this review was to examine the theoretical,preclinical and clinical bases of the combination radiotherapy immunotherapy in the management of non-small cell lung cancer(NSCLC).Preclinical studies have shown that in addition to its well-established tumoricidal effects,radiotherapy can activate the host immune system and modify the tumor microenvironment.Immunotherapy is currently part of the therapeutic arsenal of the NSCLC given its capacity to restore the host's immune system's ability to recognize and destroy tumor cells.The combination of radiotherapy and immunotherapy seems to be synergistic,particularly with inhibitors of immune checkpoints.This association has become standard in the metastatic stages and especially in consolidation after radiochemotherapy in the locally advanced,unresectable and stable stages.Several questions remain unanswered including the optimal sequence of this combination,the type of radiotherapy(hypo-fractionated or normofractionated),the association of several immunotherapies and the cross-toxicity of the combination.The association of radiotherapy and immunotherapy is a promising treatment.
