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Abstract
The article deals with the prevention of cancers only directly related to therapeutic radiation which are distinguished from "secondary cancer". The consideration of the risk of radiation-induced cancers after radiation therapy, although it is fortunately rare events, has become indispensable today. With a review of the literature, are detailed the various involved parameters. The age of the irradiated patient is one of the main parameters. The impact of the dose is also discussed based on the model used, and based on clinical data. Other parameters defining a radiation treatment are discussed one after the other: field with the example of Hodgkin's disease, the type of radiation and the participation of secondary neutrons, spreading and splitting. All these parameters are discussed according to each organ whose sensitivity is different. The article concludes with a list of recommendations to reduce the risk of radio-induced cancers. Even with the advent of conformal radiotherapy, intensity modulation, the modulated volume arctherapy, and the development of specific machinery for the extra-cranial stereotactic, the radiation therapist must consider this risk and use of reasonable and justified control imaging. Although they constitute a small percentage of cancers that occur secondarily after a first malignant tumor, radiation-induced cancers, can not and must not be concealed or ignored and justify regular monitoring over the long term, precisely adapted on the described parameters.
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Affiliation(s)
- J-M Cosset
- Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
| | - C Chargari
- Service de curiethérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Institut de recherche biomédicale des armées, 91223 Brétigny-sur-Orge, France
| | - C Demoor
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard J.-Monod, 44800 Saint-Herblain, Nantes, France; Unité Inserm 1018, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - P Giraud
- Hôpital européen Georges-Pompidou, université Paris-Descartes, Paris-Cité Sorbonne, 20, rue Leblanc, 75015 Paris, France
| | - S Helfre
- Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - F Mornex
- Département d'oncologie radiothérapie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, Lyon, France
| | - A Mazal
- Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
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Maalej M, Belaïd A, Laabidi M, Ben Romdhane N, Kochbati L. Myeloma after local external beam radiotherapy jet: Is it a new entity? Cancer Radiother 2013; 17:668-70. [PMID: 24176664 DOI: 10.1016/j.canrad.2013.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 08/21/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
Abstract
Multiple myeloma, also known as Kahler's disease, is a cancer of plasma cells that abnormally accumulate in bone marrow. Radiation therapy may be indicated in multiple myeloma to relieve pain, alleviate spinal cord compression or reduce tumor mass. We report the case of a patient presenting a multiple myeloma, treated with radiation therapy for a spinal cord compression, who developed, eleven months later, an in-field subcutaneous relapse. We called this phenomenon myeloma appearance after local external beam radiotherapy jet (MAALEJ). A review of literature was performed trying to explain this uncommon relapse feature.
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Affiliation(s)
- M Maalej
- Radiation oncology department, Salah-Azaiez Institute, Bab-Saadoun, 1006 Tunis, Tunisia; Medicine university of Tunis, Tunis-El-Manar University, 1068 El-Manar 2, Tunisia
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