Changes in spatial patterns of ammonia dry deposition flux and deposition threshold exceedance according to dispersion model formalism and horizontal resolution

Ammonia (NH₃) emitted into the atmosphere from agricultural sources may affect nearby sensitive ecosystems due to high dry deposition fluxes on vegetation and soil surfaces, contributing to critical load exceedances. Ammonia fluxes near sources are simulated by either short-range atmospheric models or regional models using large grid cell sizes. However, studies are missing on the comparison of the results simulated by these two types of models. This paper presents the effect of model formalism, input factors, especially grid cell size and wind speed and the choice of deposition threshold on the spatial patterns of NH₃ dry deposition fluxes and deposition threshold exceedances. We used the Eulerian chemistry-transport model CHIMERE and the Gaussian plume model OPS-ST on two study domains characterised by contrasting land use. We showed that the average annual NH₃ dry deposition fluxes over each whole domain are similar for both models. By contrast, NH₃ dry deposition fluxes near sources are higher when simulated with OPS-ST that provides analytical solutions that can be sampled with small grid cell sizes (i.e., from 25 to 1600 m in this study), than with CHIMERE, which uses large grid cell sizes (i.e., 800 and 1600 m). As a result, the spatial patterns of deposition threshold exceedance were very different between both models. These patterns depend mainly on grid cell size, the input factors and the choice of the deposition threshold value. We show that the model formalism has a relatively small effect on the results and that the differences result mainly from the spatial resolutions to which they can be applied. Simulation results must therefore be interpreted carefully, taking into account the simulation conditions.

The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The FLUXNET2015 dataset provides ecosystem-scale data on CO₂, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.

Measurement(s)	net ecosystem exchange • carbon dioxide • water • energy
Technology Type(s)	eddy covariance • measurement device
Sample Characteristic - Environment	terrestrial biome • atmosphere
Sample Characteristic - Location	Earth (planet)

Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.12295910

[Role of radiotherapy in the management of node-positive prostate cancer]

Node-positive prostate cancer patients represent a small proportion of all prostate cancers for whom limited prospective information is available. Most retrospective or cohort data strongly suggest however that radiotherapy combined with androgen-depriving therapies is the preferable treatment in this setting. Only randomized clinical trials would be able to better define both radiotherapy (dose? volume? fractionation?) and androgen-depriving therapies (duration? role of novel androgen-depriving therapy?) modalities.

[Use of chemotherapy and radiotherapy in the treatment of urothelial carcinoma of the upper urinary tract]

Urothelial carcinomas of the upper urinary tract are rare entities. Surgery remains the mainstay of the management. The use of others therapeutic modalities is not clearly defined yet. However, the frequency of local recurrence and locoregional encourage us to evaluate the indication of adjuvant therapies. We conducted a synthesis of key data in the literature on the use of chemotherapy and radiotherapy in the treatment of urothelial carcinoma of the renal pelvis and ureter. A literature search on PubMed was performed using the following keywords (MeSH) "urothelial carcinoma", "upper urinary tract", "radiation", "chemotherapy", and adjuvant.

[Recurrence sites following definitive intensity-modulated conformational radiotherapy of squamous-cell carcinomas of the upper aerodigestive tract]

PURPOSE

The implementation of intensity-modulated radiotherapy (IMRT) in a centre requires regular critical review of medical practices and feedback to optimize the subsequent management of patients.

PATIENTS AND METHODS

We reviewed and determined through a retrospective single-centre study recurrence sites of 167 consecutive patients treated for head and neck squamous cell carcinoma excluding skin or sinuses. Patients had mostly stage III or IV locally advanced cancer (n=123).

RESULTS

Locoregional control rates at 1 and 2 years were respectively 87.9% (95% confidence interval [95%CI]: 81.6%-92.1%) and 77.6% (95%CI: 70.1%-83.5). Among 55 relapses, 20 patients (36.4%) had treatment failures. Patients treated with 70 Gy relapsed mainly in high risk volume (78%). Those treated with 66 Gy recurred regionally outside the irradiated volume (n=4) or in the irradiated high risk volume (n=3) or had isolated metastatic failure (n=3). Those irradiated with 50 Gy had regional relapse outside the irradiated volume (n=2) or isolated metastatic relapse (n=2). We noticed respectively 5.4%, 10.2% and 4.2% isolated metastatic, local, cervical lymph node relapse.

CONCLUSION

Our results are consistent with data from the literature. Corrective actions were performed to enhance our practices.

Modeling pesticide volatilization: testing the additional effect of gaseous adsorption on soil solid surfaces

Pesticide volatilization from bare soil exhibits usually a diurnal cycle with a potentially large decrease when the soil surface dries. We assume here that this decrease may be due to the increase in adsorption of gaseous pesticides to soil under dry conditions. Thus, a precise description of the change with time of water content of the soil surface and of additional process such as gaseous adsorption is required. We used the Volt'Air model: we first extended the van Genuchten curve to drier conditions and then inserted a partitioning coefficient of the pesticide between the air-filled pore space and the soil constituents. This coefficient was calculated by a quantum-chemistry-based method with a dependence on the Specific Surface Area of the soil (SSA) and Relative Humidity (RH) of the air-filled pore space. These developments were assessed by comparing with two data sets on volatilization of trifluralin applied to bare soil. The updated Volt'Air model allowed a better description of the volatilization dynamics on a diurnal cycle (increasing efficiency factor from 0.85 to 0.96 and -2.73 to 0.17 and decreasing RMSE from 146 to 78 and 353 to 168 for both scenarios) as well as the effect of a rewetting situation. Recommendations are made for further refining the description of this process together with the soil water conditions.

Fracture incidence after 3 years of aromatase inhibitor therapy

BACKGROUND

The purpose of this study was to describe the fracture incidence and bone mineral density (BMD) evolution in a large cohort of post-menopausal women with breast cancer after 3 years of aromatase inhibitor (AI) therapy.

PATIENTS AND METHODS

A prospective, longitudinal study in real-life setting. Each woman had an extensive medical assessment, a biological evaluation, a BMD measurement, and systematic spinal X-rays at baseline and after 3 years of AI therapy. Women with osteoporosis at baseline (T-score < -2.5 and/or non-traumatic fracture history) were treated by oral weekly bisphosphonates.

RESULTS

Among 497 women (mean age 63.8 ± 9.6 years) included in this study, 389 had a bone evaluation both at baseline and after 3 years of AI therapy: 267 women (mean age 61.2 ± 8.6) with no osteoporosis at baseline and 122 women (mean age 67.2 ± 9.1) with osteoporosis at baseline justifying a weekly oral bisphosphonate treatment. Women without bisphosphonates had a significant decrease in spine BMD (-3.5%, P < 0.01), neck BMD (-2.0%, P < 0.01), and total hip BMD (-2.1%, P < 0.01) over the 3 years but only 15 of them (5.6%) presented an incident vertebral or non-vertebral fracture. In osteoporotic women treated with bisphosphonates, spine and hip BMD were maintained at 3 years but 12 of them (9.8%) had an incident fracture. These fractured women were significantly older (74.1 ± 9.8 versus 66.5 ± 8.8) but also presented BMD loss during treatment suggesting poor adherence to bisphosphonate treatment.

CONCLUSION

This real-life study confirmed that AIs induced moderate bone loss and low fracture incidence in post-menopausal women without initial osteoporosis. In women with baseline osteoporosis and AI therapy, oral bisphosphonates maintain BMD but were associated with a persistent fracture risk, particularly in older women.

Towards a climate-dependent paradigm of ammonia emission and deposition

Existing descriptions of bi-directional ammonia (NH3) land-atmosphere exchange incorporate temperature and moisture controls, and are beginning to be used in regional chemical transport models. However, such models have typically applied simpler emission factors to upscale the main NH3 emission terms. While this approach has successfully simulated the main spatial patterns on local to global scales, it fails to address the environment- and climate-dependence of emissions. To handle these issues, we outline the basis for a new modelling paradigm where both NH3 emissions and deposition are calculated online according to diurnal, seasonal and spatial differences in meteorology. We show how measurements reveal a strong, but complex pattern of climatic dependence, which is increasingly being characterized using ground-based NH3 monitoring and satellite observations, while advances in process-based modelling are illustrated for agricultural and natural sources, including a global application for seabird colonies. A future architecture for NH3 emission-deposition modelling is proposed that integrates the spatio-temporal interactions, and provides the necessary foundation to assess the consequences of climate change. Based on available measurements, a first empirical estimate suggests that 5°C warming would increase emissions by 42 per cent (28-67%). Together with increased anthropogenic activity, global NH3 emissions may increase from 65 (45-85) Tg N in 2008 to reach 132 (89-179) Tg by 2100.

[Adjuvant treatment of keloid scars: electrons or brachytherapy?]

PURPOSE

Evaluation of perioperative treatment of keloid scars with electron beam therapy or iridium 192 low dose rate brachytherapy.

PATIENTS AND METHODS

From 1994 to 2010, 95 patients with 142 keloid scars have been treated by immediate perioperative irradiation and retrospectively reviewed in our institute: 116 scars were treated by electrontherapy and 26 by brachytherapy.

RESULTS

In the electrontherapy group treated locations were: earlobe (n=88, 76%), thorax (n=14, 12%), neck (n=9, 8%), limbs (n=5, 4%). The median size of lesions was 3cm (range [R]: 0.5-18cm). In 95.6% of cases, a dose of 15Gy was delivered in five fractions of 3Gy. The median follow-up was 70 months (R: 7-161 months). The 2-year and 5-year local control were respectively 69% (95% confidence interval [95% CI]: 59-76%) and 55% (95% CI: 45-64%). In the brachytherapy group treated locations were: neck (n=3, 11%), earlobe (n=8, 32%), abdomen (n=3, 11%), thorax (n=2, 8%), limbs (n=10, 38%). The median size of lesions was 6.6cm (R: 1.7-28cm). The median dose delivered at 5mm from the source was 20Gy (R: 15-20.69). The median follow-up was 113 months (R: 21-219 months). The 2-year and 5-year local control were respectively 84.6% (95% CI: 64-94%) and 73.5% (95% CI: 49-87%). So far, no radiation-induced cancer has occurred. A trend to a better local control with brachytherapy was noted (compared to electrontherapy, 2-year relapse is halved with brachytherapy) though this difference did not reach the significance (P=0.0991), probably due to the reduced number of patients in the brachytherapy group.

CONCLUSION

Brachytherapy seems to provide better local control compared to electrontherapy, and should be proposed as first line treatment. However, electrontherapy is an interesting alternative in case of difficulty to realize brachytherapy. There is probably a dose effect: according to published data, 25 to 30Gy should at least be proposed.

Effects of farm heterogeneity and methods for upscaling on modelled nitrogen losses in agricultural landscapes

The aim of this study is to illustrate the importance of farm scale heterogeneity on nitrogen (N) losses in agricultural landscapes. Results are exemplified with a chain of N models calculating farm-N balances and distributing the N-surplus to N-losses (volatilisation, denitrification, leaching) and soil-N accumulation/release in a Danish landscape. Possible non-linearities in upscaling are assessed by comparing average model results based on (i) individual farm level calculations and (ii) averaged inputs at landscape level. Effects of the non-linearities that appear when scaling up from farm to landscape are demonstrated. Especially in relation to ammonia losses the non-linearity between livestock density and N-loss is significant (p > 0.999), with around 20-30% difference compared to a scaling procedure not taking this non-linearity into account. A significant effect of farm type on soil N accumulation (p > 0.95) was also identified and needs to be included when modelling landscape level N-fluxes and greenhouse gas emissions.

Sensitivity analysis for models of greenhouse gas emissions at farm level. Case study of N(2)O emissions simulated by the CERES-EGC model

Modelling complex systems such as farms often requires quantification of a large number of input factors. Sensitivity analyses are useful to reduce the number of input factors that are required to be measured or estimated accurately. Three methods of sensitivity analysis (the Morris method, the rank regression and correlation method and the Extended Fourier Amplitude Sensitivity Test method) were compared in the case of the CERES-EGC model applied to crops of a dairy farm. The qualitative Morris method provided a screening of the input factors. The two other quantitative methods were used to investigate more thoroughly the effects of input factors on output variables. Despite differences in terms of concepts and assumptions, the three methods provided similar results. Among the 44 factors under study, N(2)O emissions were mainly sensitive to the fraction of N(2)O emitted during denitrification, the maximum rate of nitrification, the soil bulk density and the cropland area.

Effect of topography on nitrous oxide emissions from winter wheat fields in Central France

We assessed nitrous oxide (N(2)O) emissions at shoulder and foot-slope positions along three sloping sites (1.6-2.1%) to identify the factors controlling the spatial variations in emissions. The three sites received same amounts of total nitrogen (N) input at 170kgNha(-1). Results showed that landscape positions had a significant, but not consistent effect on N(2)O fluxes with larger emission in the foot-slope at only one of the three sites. The effect of soil inorganic N (NH(4)(+)+NO(3)(-)) contents on N(2)O fluxes (r(2)=0.55, p<0.001) was influenced by water-filled pore space (WFPS). Soil N(2)O fluxes were related to inorganic N at WFPS>60% (r(2)=0.81, p<0.001), and NH(4)(+) contents at WFPS<60% (r(2)=0.40, p<0.01), respectively. Differences in WFPS between shoulder and foot-slope correlated linearly with differences in N(2)O fluxes (r(2)=0.45, p<0.001). We conclude that spatial variations in N(2)O emission were regulated by the influence of hydrological processes on soil aeration intensity.

NitroScape: a model to integrate nitrogen transfers and transformations in rural landscapes

Modelling nitrogen transfer and transformation at the landscape scale is relevant to estimate the mobility of the reactive forms of nitrogen (N(r)) and the associated threats to the environment. Here we describe the development of a spatially and temporally explicit model to integrate N(r) transfer and transformation at the landscape scale. The model couples four existing models, to simulate atmospheric, farm, agro-ecosystem and hydrological N(r) fluxes and transformations within a landscape. Simulations were carried out on a theoretical landscape consisting of pig-crop farms interspersed with unmanaged ecosystems. Simulation results illustrated the effect of spatial interactions between landscape elements on N(r) fluxes and losses to the environment. More than 10% of the total N(2)O emissions were due to indirect emissions. The nitrogen budgets and transformations of the unmanaged ecosystems varied considerably, depending on their location within the landscape. The model represents a new tool for assessing the effect of changes in landscape structure on N(r) fluxes.

Assessing the ability of mechanistic volatilization models to simulate soil surface conditions: a study with the Volt'Air model

Ammonia and pesticide volatilization in the field is a surface phenomenon involving physical and chemical processes that depend on the soil surface temperature and water content. The water transfer, heat transfer and energy budget sub models of volatilization models are adapted from the most commonly accepted formalisms and parameterizations. They are less detailed than the dedicated models describing water and heat transfers and surface status. The aim of this work was to assess the ability of one of the available mechanistic volatilization models, Volt'Air, to accurately describe the pedo-climatic conditions of a soil surface at the required time and space resolution. The assessment involves: (i) a sensitivity analysis, (ii) an evaluation of Volt'Air outputs in the light of outputs from a reference Soil-Vegetation-Atmosphere Transfer model (SiSPAT) and three experimental datasets, and (iii) the study of three tests based on modifications of SiSPAT to establish the potential impact of the simplifying assumptions used in Volt'Air. The analysis confirmed that a 5 mm surface layer was well suited, and that Volt'Air surface temperature correlated well with the experimental measurements as well as with SiSPAT outputs. In terms of liquid water transfers, Volt'Air was overall consistent with SiSPAT, with discrepancies only during major rainfall events and dry weather conditions. The tests enabled us to identify the main source of the discrepancies between Volt'Air and SiSPAT: the lack of gaseous water transfer description in Volt'Air. They also helped to explain why neither Volt'Air nor SiSPAT was able to represent lower values of surface water content: current classical water retention and hydraulic conductivity models are not yet adapted to cases of very dry conditions. Given the outcomes of this study, we discuss to what extent the volatilization models can be improved and the questions they pose for current research in water transfer modeling and parameterization.

High-resolution inventory of NO emissions from agricultural soils over the Ile-de-France region

Arable soils are a significant source of nitric oxide (NO), a precursor of tropospheric ozone, and thereby contribute to ozone pollution. However, their actual impact on ozone formation is strongly related to their spatial and temporal emission patterns, which warrant high-resolution estimates. Here, we combined an agro-ecosystem model and geo-referenced databases to map these sources over the 12,000 km2 administrative region surrounding Paris, France, with a kilometric level resolution. The six most frequent arable crop species were simulated, with emission rates ranging from 1.4 kg N-NO ha(-1) yr(-1) to 11.1 kg N-NO ha(-1) yr(-1). The overall emission factor for fertilizer-derived NO emissions was 1.7%, while background emissions contributed half of the total NO efflux. Emissions were strongly seasonal, being highest in spring due to fertilizer inputs. They were mostly sensitive to soil type, crops' growing season and fertilizer N rates.

Neoadjuvant radiotherapy ± tegafur-uracil plus leucovorin in rectal adenocarcinoma: Final results of a French multicenter phase III study

4104

Background: Neoadjuvant chemoradiotherapy (CRT) with tegafur-uracil (UFT) plus leucovorin (LV) has shown promising results in patients with rectal adenocarcinoma (RAC). We therefore conducted a phase III trial to compare neoadjuvant CRT with UFT/LV versus radiotherapy (RT) alone. Methods: One hundred seventy seven pts with RAC stage T3 (T4 if anal extension) N<2, M0 were randomized to either RT alone (RT) (1.8 Gy/d, 45 G total) 5 days/w for 5 weeks or combined to CT (CRT) with daily UFT 300 mg/m2 plus leucovorin 75 mg for 5 weeks. TME surgery was performed 6–8 weeks after treatment. Adjuvant CT permitted at investigator discretion. Primary endpoint was pathological complete response rate (pCR), secondary endpoints included downstaging, QOL, sphincter preservation, recurrence rates, disease-free and overall survival. Results: Of 177 pts, 87 pts were allocated to RT and 90 to CRT. Compliance: RT dose intensity 98.8 % (n=86) in RT arm vs 95.6 % (n=86) in CRT arm with UFT mean dose 295.7 ± 19.8 mg/m2. 172 pts underwent surgery (97.2%), 5 pts were not resected (4 liver and 1 lung metastases plus 1 CVA). Both RT and CRT were well tolerated. No neutropenia and only 1 grade IV diarrhea in the CRT arm were observed. Treatment related death occurred in 4 patients, 3 in the RT arm and 1 in the CRT arm respectively. With a median follow-up at 22.3 mo, median OS is not yet reached. Conclusions: Neoadjuvant radiotherapy combined with UFT increases significantly the pCR rate with an acceptable toxicity. Further survival data will be presented. This is the first randomized study of neoadjuvant CRT highlighting the improvement of the pCR rate with UFT.

[Table: see text]

[Table: see text]

Relationship between ammonia stomatal compensation point and nitrogen metabolism in arable crops: current status of knowledge and potential modelling approaches

The ammonia stomatal compensation point of plants is determined by leaf temperature, ammonium concentration ([NH4+]apo) and pH of the apoplastic solution. The later two depend on the adjacent cells metabolism and on leaf inputs and outputs through the xylem and phloem. Until now only empirical models have been designed to model the ammonia stomatal compensation point, except the model of Riedo et al. (2002. Coupling soil-plant-atmosphere exchange of ammonia with ecosystem functioning in grasslands. Ecological Modelling 158, 83-110), which represents the exchanges between the plant's nitrogen pools. The first step to model the ammonia stomatal compensation point is to adequately model [NH4+]apo. This [NH4+]apo has been studied experimentally, but there are currently no process-based quantitative models describing its relation to plant metabolism and environmental conditions. This study summarizes the processes involved in determining the ammonia stomatal compensation point at the leaf scale and qualitatively evaluates the ability of existing whole plant N and C models to include a model for [NH4+]apo.

Challenges in quantifying biosphere-atmosphere exchange of nitrogen species

Recent research in nitrogen exchange with the atmosphere has separated research communities according to N form. The integrated perspective needed to quantify the net effect of N on greenhouse-gas balance is being addressed by the NitroEurope Integrated Project (NEU). Recent advances have depended on improved methodologies, while ongoing challenges include gas-aerosol interactions, organic nitrogen and N(2) fluxes. The NEU strategy applies a 3-tier Flux Network together with a Manipulation Network of global-change experiments, linked by common protocols to facilitate model application. Substantial progress has been made in modelling N fluxes, especially for N(2)O, NO and bi-directional NH(3) exchange. Landscape analysis represents an emerging challenge to address the spatial interactions between farms, fields, ecosystems, catchments and air dispersion/deposition. European up-scaling of N fluxes is highly uncertain and a key priority is for better data on agricultural practices. Finally, attention is needed to develop N flux verification procedures to assess compliance with international protocols.

Measurement of trifluralin volatilization in the field: Relation to soil residue and effect of soil incorporation

Volatilization may represent a major dissipation pathway for pesticides applied to soils or crops. A field experiment (September, 2002), consisted in volatilization fluxes measurements during 6 days, covering the periods before and after soil incorporation carried out 24 h after trifluralin spraying on bare soil. Evolution of concentration in soil was measured during 101 days, together with soil physical and meteorological variables. Volatilization fluxes were very high immediately after application (1900 ng m(-2) s(-1)), decreased down to 100 ng m(-2) s(-1) in the following 24 h. Soil incorporation strongly abated trifluralin concentration in the air. 99% of the total volatilization losses recorded over the 6 days following application occurred before incorporation. Volatilization fluxes evidenced a diurnal cycle driven by environmental conditions. Soil trifluralin residues could still be quantified 101 days after application. Our results highlight the caution required when using soil degradation half-life values in the field for volatile compounds.

Toxicity of chemicals to microalgae in river and in standard waters

The influence of the composition of natural waters on the toxicity of chemicals to microalgae was studied on samples representative of western European rivers. Effects of zinc, pentachlorophenol (PCP), 4-nonylphenol (4-NP), phosalone, and 2,4,5-trichloroaniline (TCA) on algal growth were tested in river waters without adding any nutrients or cosolvents, and in the International Standards Organization (ISO) medium for comparison. The mean values of effective concentrations reducing the algal growth by 50% (EC50s) after 72 h based on measured concentrations did not differ significantly in natural waters and in standard medium for 4-NP (0.5 mg/L) and phosalone (0.8-0.9 mg/L). These values were two or three times higher in rivers than in ISO medium for PCP (0.25 vs 0.1 mg/L), TCA (1.69 vs 0.73 mg/L), and zinc (0.20 vs 0.056 mg/L). Although the mean values were of the same order of magnitude, the distribution of the EC50 values ranged over 1.5 and 2 log concentrations in surface waters. Therefore, in view of a refined hazard assessment of a chemical on a local scale, it would be advisable to use the actual river water of the concerned aquatic environment in testing. Correlations between toxicity data and the physicochemical characteristics of the waters identified classic parameters such as water hardness or conductivity as factors that significantly influenced the toxicity of the ionizable compounds PCP and zinc. On the other hand, organic materials or suspended solids, but only at high levels, affected the toxicity of 4-NP, an organic chemical with high adsorption potential. No correlation could be drawn for phosalone and TCA.

[The role of hyperbaric oxygen therapy in radiation-induced digestive disorders. 36 cases]

OBJECTIVES

Study the effect of hyperbaric oxygen on chronic irradiation induced digestive disorders.

PATIENTS AND METHODS

A retrospective study was conducted in 36 patients (mean age 66 +/- 11 years) with chronic digestive tract necrosis which had developed a mean 42 months after irradiation therapy. Hyperbaric oxygen therapy was given a mean 17 months after symptom onset: failing healing (n = 9), rectal bleeding (n = 19), profuse diarrhea (n = 9), recurrent anal abscess (n = 1). The severity of the digestive tract radionecrosis was quantified using the Soma-Lent scale. Hyperbaric oxygen therapy was grade 1 (n = 1), grade 2 (n = 11), grade 3 (n = 16), grade 4 (n = 8).

RESULTS

Thirty-six patients underwent a mean 67 hyperbaric sessions (100% O2, 2.5 atm, 90 min). Three patients died within one month of the first session due to radiation enteritis, a neoplastic process or another concomitant cause. Immediate outcome after hyperbaric oxygen therapy was cure (n = 3) or improvement (n = 16) in 19 patients (53%) and failure in 17 (47%). Long-term results evaluated in 32 subjects with a mean 52 months follow-up were: cure (n = 9) or improvement (n = 12) in 21 patients (66%) and failure in 11 (34%). Nine patients died within a mean 25 months after the end of the hyperbaric sessions. Death was related to digestive tract radionecrosis in 1 case and neoplasia in 5.

CONCLUSION

Hyperbaric oxygen therapy provides clinical relief in 2 out of 3 patients and can be a useful alternative to conventional treatment in patients with chronic radiation-induced necrosis of the digestive tract.

[Parietal tumor seeding after thoracoscopic surgery: apropos of a case]

The authors report one case of port site recurrence 5 months after thoracoscopic resection of a pulmonary metastasis in a 68-year-old woman.