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Desmoplastic small round cell tumor (DSRCT) is an aggressive sarcoma occurring in the young, teenager, and adult populations. The aim of this study is to compare initial tumor presentation, therapeutic management and scalability between pediatric and adult DSRCT patients and investigate the possibility of specific therapeutic approaches. A multicenter retrospective study of 81 Franco-Belgian medical files with DSRCT harboring Ewing sarcoma-Wilm tumor transcript was made. Median age was 17 years (3 to 58) with 42 children (13.5 y [3;17]) and 39 adults (28 y [18;58]). No significant differences were found between the 2 groups regarding initial symptoms and metastasis at diagnosis. The therapeutic approaches were similar for both groups: use of neoadjuvant chemotherapy (78.6% vs. 79.5%, P=1), primary surgery (71.4% vs. 69.2%, P=0.73), adjuvant chemotherapy (54.8% vs. 61.5%, P=0.99), radiotherapy (23.8% and 10.3%, P=0.11) and intraperitoneal chemotherapy (14.3% vs. 2.6%; P=0.11). Median time to recurrence was 12 versus 18 months (P=0.13). Overall survival at 2 years and recurrence free were 46.4% versus 60.1% (P=0.83) and 14.3% versus 16%, respectively (P=0.16). Clinical presentation, initial therapeutics and outcome of DSRCT are equivalent suggesting that similar management should be considered for children and adults with DSRCT.

Resume Introduction L’hypertension arterielle (HTA) est la maladie chronique la plus frequemment retrouvee a travers le monde. Sa prevalence varie selon les regions. Elle est elevee dans la plupart des DOM-ROM (departements et regions d’outre-mer) : 38,2 % a La Reunion, 44 % a Mayotte, 28 % aux Antilles, 18 % en Guyane, 25 % en Polynesie francaises et 28 % a Saint-Martin. Objet Determiner, pour un meme systeme de soin, la differences de la prise en charge de l’HTA entre l’Hexagone et les DOM-ROM. Resultats Differences selon le sexe. A la difference de l’Hexagone, en outre-mer la prevalence de l’HTA est plus elevee chez les femmes, et on a par contre une meilleure prise en charge de l’HTA (un taux plus eleve en Guadeloupe d’HTA « normalise sous traitement » en comparaison avec l’Hexagone). La principale explication quant a cette prevalence de l’HTA en outre-mer : le taux d’obesite et de surpoids bien plus eleve en outre-mer chez les femmes. Particularite socio-economiques de l’HTA en outre-mer. Les differentes etudes epidemiologiques realisees en outre-mer confirment le role majeur des conditions socio-economiques dans la prevalence et la prise en charge de l’HTA en outre-mer, avec pour les couches defavorisees une plus forte prevalence de la sedentarite, de l’obesite de la consommation d’alcool et de sel. Au niveau socio-economique identique, il n’y a plus de difference concernant l’HTA, surtout chez les hommes, entre l’Hexagone et les Antilles. Conclusions Les differences observees entre les DOM-ROM et l’Hexagone concernant la prevalence, la connaissance, le traitement et le controle de l’HTA sont variables en fonction du sexe. Chez les hommes, la prevalence et la prise de l’HTA different tres peu lorsque que l’on s’interesse a une population de travailleurs ou de salaries. En revanche, parmi les femmes, la prevalence de l’HTA est plus elevee aux Antilles-Guyane. Cette difference n’est pas totalement expliquee par la plus forte prevalence de l’obesite observee chez les salariees des Antilles-Guyane. Chez ces dernieres, on observe egalement une meilleure connaissance et un meilleur controle de l’HTA. Les hommes en situation de precarite ou de pauvrete administrative ont un niveau de prise en charge a ameliorer (depistage, adhesion au traitement).

Purpose Evaluate efficacy and toxicity of hypofractionated stereotactic radiotherapy (HSRT) for patients treated for pituitary adenoma (PA) with an alternative HSRT escalating protocol delivering 35 Gy in 5 fractions. Material and methods From June 2007 to March 2017, 29 patients with pituitary adenoma were treated in Antoine Lacassagne Cancer Centre with an alternative HSRT protocol. Prescribed dose was 35 Gy in 5 fractions of 7 Gy. Radiographic responses were assessed by annual MRI. Hormone blood samples were evaluated each year after HSRT. Results A total of 29 patients aged between 23 and 86 years (median 54 years) were included. Twelve patients received HSRT for recurrent cases and 12 received postoperative adjuvant HSRT, 5 patients did not have surgery. After a median follow-up period of 47 months local control rate was 96%. One patient presented an out-field tumor regrowth 73 months after HSRT. The majority of PA were endocrine-active (18 patients, 62%). After HSRT, 8 patients (44%) presented complete response on initial secretion, 4 patients (23%) presented partial response on initial secretion. Four patients (14%) presented grade 2 or more acute radiation toxicities. One grade 4 visual disorder was observed for one patient. Conclusions HSRT delivering 35 Gy in 5 fractions represents a feasible treatment and shows promising results to reduce hormonal overproduction and to improve local control in PA.

Background: Lung cancer is the leading cause of cancer-related death worldwide. Shorter survival has been repeatedly reported for patients of African ancestry. Multivariate analysis demonstrated that this gap could be a consequence of socio-economic disparities instead of genetic specificities. However, those results were obtained in a pre-targeted therapies era and the effect of tyrosine kinase inhibitors targeting EGFR are not known in this population. Objective: In this French West Indies study, we report overall survival (OS) in a frequently mutated population treated for lung adenocarcinoma within an equal-access healthcare system. Patients and Methods: Clinical, demographic, survival, and treatment data have been retrospectively assessed for all patients diagnosed with lung adenocarcinoma in the islands of Martinique and Guadeloupe between 2013 and 2015. Results: Two hundred and forty-one patients (82% African-Caribbean) were included. EGFR mutations were detected in 37% of all tumor specimens and were associated with non-smoker status in multivariate analysis. Median OS was 16.2 months. For patients with advanced disease, median OS was 11.5 months, depending on EGFR mutation (23 vs. 8.3 months for non-mutated patients, p = 0.0012). There was no difference in survival according to ethnicity or island. In multivariate analysis, performance status (PS) and EGFR mutation were the only independent prognostic factors. Conclusions: Despite a higher frequency of EGFR mutations in African-Caribbean patients, ethnicity was not an independent factor of OS in lung adenocarcinoma. Lower initial PS in this mainly non-smoking African-Caribbean population may explain the absence of a difference in OS.[Figure not available: see fulltext.].

Purpose Prostate cancer is the most frequent malignancy in African-Caribbean men, a population sharing common genetic traits with African-American (AA) but presenting also genomic and epidemiologic specificities. Despite socioeconomic disparities with French mainland, all patients were treated within the French state–financed equal-access health care system. In this study, we report biochemical outcomes of patients treated by brachytherapy in our department from 2005 to 2014 in an African-Caribbean population. Methods and Materials Three hundred seventy consecutive patients receiving 125I brachytherapy as a curative treatment for early-stage (localized) disease between 2005 and 2014 were recorded. Selected patients presented with low-risk disease: initial prostate-specific antigen (PSA)

Monitoring and controlling respiratory motion is a challenge for the accuracy and safety of therapeutic irradiation of thoracic tumors. Various commercial systems based on the monitoring of internal or external surrogates have been developed but remain costly. In this article we describe and validate Madibreast, an in‐house‐made respiratory monitoring and processing device based on optical tracking of external markers. We designed an optical apparatus to ensure real‐time submillimetric image resolution at 4 m. Using OpenCv libraries, we optically tracked high‐contrast markers set on patients' breasts. Validation of spatial and time accuracy was performed on a mechanical phantom and on human breast. Madibreast was able to track motion of markers up to a 5 cm/s speed, at a frame rate of 30 fps, with submillimetric accuracy on mechanical phantom and human breasts. Latency was below 100 ms. Concomitant monitoring of three different locations on the breast showed discrepancies in axial motion up to 4 mm for deep‐breathing patterns. This low‐cost, computer‐vision system for real‐time motion monitoring of the irradiation of breast cancer patients showed submillimetric accuracy and acceptable latency. It allowed the authors to highlight differences in surface motion that may be correlated to tumor motion. PACS number(s): 87.55.km

Resume Objectif L’objectif est de decrire la prevalence de l’hypertension arterielle (HTA) et des facteurs de risque cardiovasculaires (FDR) et de preciser les facteurs socioeconomiques associes dans une collective de Saint-Martin. Materiel et methodes CONSANT-SM est une etude descriptive transversale realisee sur un echantillon representatif de 400 personnes. Le recueil des donnees a ete realise par des enqueteurs au domicile. Resultats Le niveau de revenus faibles est associe significativement avec l’obesite abdominale (OR = 2,3), avec le cumul de FDR cardiovasculaires (OR = 3,58). Le faible niveau d’etudes (OR = 2,86) et l’obesite abdominale (OR = 3,73) sont associes significativement avec l’HTA. Discussion Le lien entre FDR cardiovasculaires et precarite (dans notre etude representee par la variable faible niveaux de revenus et d’etudes) est retrouve dans cette etude realisee sur un echantillon representatif de la population de la collectivite de Saint-Martin. Conclusion Le niveau de revenus faibles est associe significativement avec l’obesite abdominale et avec le cumul de FDR cardiovasculaires. Le faible niveau d’etudes et l’obesite abdominale sont associes significativement avec l’HTA. Les donnees de cette etude seront utiles afin de permettre aux tutelles et aux autorites d’ameliorer encore et toujours les programmes d’education therapeutique et de sante publique.

Background: Prostate cancer incidence in the African-Caribbean population ranks among the highest worldwide. We aim to evaluate the prostate-specific antigen (PSA) kinetics after brachytherapy, which so far remains unknown in this population. Methods and Materials: From 2005 to 2013, 371 patients received 125I brachytherapy of 145 Gy for early-stage prostate cancer. Eligibility criteria were cTNM ≤T2c, Gleason score ≤7, and initial PSA ≤15 ng/mL. Pretreatment androgen deprivation therapy was allowed. PSA bounce was defined as an increase of ≥0.4 ng/mL, lasting ≥6 months, followed by a decrease without any anticancer therapy. We examined PSA kinetics during followup. Results: For the 274 patients with at least 24 months followup, median age was 62 years old (range, 45-76). Initial PSA was

Linked to the difference of prognosis, the terms and conditions of the follow-up of low-grade and high-grade gliomas treated by irradiation differ highly. Patients treated for a low-grade glioma have prolonged survival. In this case, monitoring of toxicities linked to the treatment is a major objective. Opportunistic infections and depression are corticosteroids side effects widely underestimated. Radionecrosis search and differentiation with recurrent disease are done by MRI. Perfusion and spectroscopy showing a choline/creatine ratio increase are in favour of disease recurrence. Cognitive status and quality of life must be evaluated during the follow-up. They have to be evaluated by adapted scales. Cognitive rehabilitation improves interestingly the post-treatment cognitive status. Pseudoprogression rates for high-grade gliomas are near 20%. MRI is the benchmark imaging for its diagnosis. Diffusion weight imaging and spectroscopy are actually the most interesting techniques.

Purpose Radiotherapy is a common adjuvant treatment of breast cancer. Acute radiation-induced dermatitis is a frequent side effect. We hypothesized whether it is possible to capture the increase of local temperature as a surrogate of the inflammatory state induced by radiotherapy. We designed a prospective, observational, single-centre study to acquire data on temperature rise in the treated breast during the course of radiotherapy, establish a possible association with the occurrence of dermatitis and investigate the predictive value of temperature increase in future occurrences of radiation-induced dermatitis. Patients and methods All patients presenting for neoadjuvant or adjuvant radiotherapy during the course of breast cancer treatment at the university hospital of Martinique were considered for inclusion. Every week, patients were examined by two trained investigators for the occurrence of radiation-induced dermatitis, graded based on Radiotherapy Oncology Group, Common Terminology Criteria for Adverse Events v.4.0 and Wright scales. A frontal thermal image of torso was taken in strictly controlled conditions, with a calibrated TE-Q1 camera (Thermal Expert, i3systems, Daejeon, Korea). We studied temperature differences between the irradiated breast or thoracic wall and the contralateral area. For each thermal picture, we measured the difference in maximum temperature as well as the difference in minimum temperature and the difference in the average temperature in the considered area. We studied the evolution of these parameters over time week after week, measuring the maximum recorded difference and its correlation to acute radiation dermatitis intensity. Results Sixty-four consecutive patients were included. For all patients, we noticed an increase of temperature during the course of radiotherapy. Difference in maximum, minimum and average temperature was higher between the two breasts of patients with a radiation-induced dermatitis grade 2 or above compared to patients with no or mild dermatitis. Higher temperatures were also significantly associated with an increased sensation of discomfort, as recorded by questionnaire (P Conclusion As expected from the inflammatory phenomena involved in radiation-induced dermatitis, a noticeable increase in temperature during the course of radiotherapy was seen in all patients. Furthermore, high-grade radiation-induced dermatitis was strongly associated with an additional increase in local temperature, which is probably linked to the intense inflammatory reaction. Lastly, with a 1.4 °C threshold set beforehand, it is possible to anticipate the occurrence of radiation-induced dermatitis, with interesting positive and negative predictive values of 70% and 77%, respectively in our population. We note that these results need to be confirmed in a dedicated study.

ResumeContexte et objectif Les caracteristiques epidemiologiques de l’hypertension et de l’obesite n’ont jamais ete comparees entre les territoires francais d’Outre-mer (TFO). Methodes Cette enquete transversale a inclus des echantillons representatifs de la population composes de 602, 601, 620 et 605 hommes et femmes âges de plus de 15 ans dans quatre TFO, respectivement la Guadeloupe, la Martinique, la Guyane francaise et la Polynesie francaise. L’hypertension etait definie par une tension arterielle (TA) d’au moins 140/90 mmHg ou par l’utilisation actuelle d’un traitement antihypertenseur. Resultats La prevalence de l’hypertension etait de 29,2 % en Guadeloupe, 17,9 % en Guyane francaise, 27,6 % en Martinique et 24,5 % en Polynesie francaise. Si on considere la population de Guadeloupe comme groupe de reference, la prevalence de l’hypertension etait significativement inferieure en Guyane francaise (p

Background Desmoplastic Small Round Cell Tumor (DSRCT) is a rare disease affecting predominantly children and young adults and for which the benefit of hyperthermic intraperitoneal chemotherapy (HIPEC) after complete cytoreductive surgery (CCRS) remains unknown. Methods To identify patients with DSRCT without extraperitoneal metastases (EPM) who underwent CCRS between 1991 and 2015, a retrospective nation-wide survey was conducted by crossing the prospective and retrospective databases of the French Network for Rare Peritoneal Malignancies, French Reference Network in Sarcoma Pathology, French Sarcoma Clinical Network and French Pediatric Cancer Society. Results Among the 107 patients with DSRCT, 48 had no EPM and underwent CCRS. The median peritoneal cancer index (PCI) was 9 (range: 2–27). Among these 48 patients, 38 (79%) had pre- and/or postoperative chemotherapy and 23 (48%) postoperative whole abdominopelvic radiotherapy (WAP-RT). Intraperitoneal chemotherapy was administered to 11 patients (23%): two received early postoperative intraperitoneal chemotherapy (EPIC) and nine HIPEC. After a median follow-up of 30 months, the median overall survival (OS) of the entire cohort was 42 months. The 2-y and 5-y OS were 72% and 19%. The 2-y and 5-y disease-free survival (DFS) were 30% and 12%. WAP-RT was the only variable associated with longer peritoneal recurrence-free survival and DFS after CCRS. The influence of HIPEC/EPIC on OS and DFS was not statistically conclusive. Conclusion The benefit of HIPEC is still unknown and should be evaluated in a prospective trial. The value of postoperative WAP-RT seems to be confirmed.

To identify the prognostic role of adjuvant abdominal radiation therapy (RT) on oncologic outcomes as a part of multimodal treatment in the management of desmoplastic small round cell tumor (DSRCT) and to determine its impact according to the quality of surgical resection.All patients treated for primary abdominal DSRCT in 8 French centers from 1991 to 2014 were included. Patients were retrospectively staged into 3 groups: group A treated with adjuvant RT after cytoreductive surgery, group B without RT after cytoreductive surgery, and group C by exclusive chemotherapy. Peritoneal progression-free survival (PPFS), progression-free survival (PFS), and overall survival (OS) were evaluated. We also performed a direct comparison between groups A and B to evaluate RT after cytoreductive surgery. Radiation therapy was also evaluated according to completeness of surgery: complete cytoreductive surgery (CCS) or incomplete cytoreductive surgery (ICS).Thirty-seven (35.9%), thirty-six (34.9%), and thirty (28.0%) patients were included in groups A, B, and C, respectively. Three-year OS was 61.2% (range, 41.0%-76.0%), 37.6% (22.0%-53.1%), and 17.3% (6.3%-32.8%) for groups A, B, and C, respectively. Overall survival, PPFS, and PFS differed significantly among the 3 groups (P.001, P.001, and P.001, respectively). Overall survival and PPFS were higher in group A (RT group) compared with group B (no RT group) (P=.045 and P=.006, respectively). Three-year PPFS was 23.8% (10.3%-40.4%) for group A and 12.51% (4.0%-26.2%) for group B. After CCS, RT improved PPFS (P=.024), but differences in OS and PFS were not significant (P=.40 and P=.30, respectively). After ICS, RT improved OS (P=.044). A trend of PPFS and PFS increase was observed, but the difference was not statistically significant (P=.073 and P=.076).Adjuvant RT as part of multimodal treatment seems to confer oncologic benefits for patients treated for abdominal DSRCT after cytoreductive surgery and perioperative chemotherapy.

The design of modern scientific experiments requires the control and monitoring of many parallel data streams. However, the serial execution of programming instructions in a computer makes it a challenge to develop software that can deal with the asynchronous, parallel nature of scientific data. Here we present Bonsai, a modular, high-performance, open-source visual programming framework for the acquisition and online processing of data streams. We describe Bonsai's core principles and architecture and demonstrate how it allows for flexible and rapid prototyping of integrated experimental designs in neuroscience. We specifically highlight different possible applications which require the combination of many different hardware and software components, including behaviour video tracking, electrophysiology and closed-loop control of stimulation parameters.

Objectifs L'objectif est de decrire la prevalence de l'Hypertension Arte-rielle (HTA) et des facteurs de risque cardiovasculaires (FDR), et de preciser les connaissances et croyances des personnes en matiere de prevention cardiovasculaire. Methodes CONSANT-SM est une etude descriptive transversale realisee sur un echantillon representatif de 400 personnes. Le recueil des donnees a ete realise par des enqueteurs au domicile sous forme d’un questionnaire anonyme compose de 362 questions, associe a des mesures anthropometriques et trois mesures de pression arterielle. Les analyses seront uni-variees, multi-variees si possibles, avec test du Khi 2 et de Student, par le logiciel Stata. Resultats La prevalence de l'HTA est de 17 % pour les personnes avec un IMC normal, et de 38,7 % pour les obeses (IMC > 30). Pour les femmes, on passe de 13 % a 40,6 %, et pour les hommes de 20 % a 35 %. Cette forte association HTA et obesite abdominale est aussi notee dans cette etude. L'obesite abdominale (OR = 3,73, IC 95 % [1.64 – 8,49], p = 0,002) est associee significativement a l'HTA. La prevalence de l'HTA passe de 15 % pour ceux avec un tour de taille dans les normes (TT 88 cm chez la femme et > 102 cm chez l'homme). Chez les femmes cette prevalence passe de 14 % a 40 % (p a 102 cm. Conclusion L'obesite est un des principaux facteurs d'HTA, expliquant la forte prevalence de l'HTA dans cette population de la collectivite de Saint-Martin. Le lien entre obesite et HTA et precarite (dans notre etude representee par la variable faible niveaux de revenus et d'etudes) est retrouve dans cette etude realisee sur un echantillon representatif de la population de la collectivite de Saint-Martin. Les donnees de cette etude seront utiles afin de permettre aux tutelles et aux autorites d'ameliorer encore et toujours les programmes d'education therapeutique et de sante publique.