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Resume Objectif de l'etude Analyse retrospective des resultats de la radiotherapie de l'adenocarcinome non metastatique de la prostate a l'exclusion des complications. Patients et methodes Les 610 cas de stade T1-T2 repertories ont ete traites par irradiation externe dans 19 instituts, entre janvier 1983 et janvier 1988. Le recul moyen etait de 10,4 ans, la moyenne d'âge au debut du traitement de 68,5 ans. Resultats Un controle local a 10 ans a ete obtenu pour 86 % des cancers classes T1-T2 (81,4 % dans le cas des T2). Le taux de rechute metastatique etait a 5 et 10 ans respectivement de 25,3 et 30 % (29 et 38,1 % pour les T2). A 10 ans, 62,4 % des tumeurs de stade T1-T2 n'avaient pas recidive; par ailleurs, le taux de survie globale etait de 45,8 % et celui de survie specifique de 70,5 %; 29,9 % des patients etaient vivants sans signe de recidive. Il y avait une correlation entre le stade (TNM), le grade, le statut ganglionnaire pelvien, le controle tumoral local, la presence d'une obstruction ureterale, et la survie. L'irradiation pelvienne, la dose, l'etalement, le traitement hormonal neoadjuvant et la resection transuretrale n'avaient pas d'influence sur le pronostic. Conclusion Il n'y a pas de difference entre les deux etudes francaises (1975–1982 et 1983–1988) sur le plan du recrutement et du pronostic. Les resultats releves dans la litterature sont voisins des notres. Cette etude souligne l'importance des facteurs de pronostic inherents a la tumeur et au malade.

The rationale for dose intensity is based on pre-clinical observations in experimental model systems of cancer as well as upon retrospective studies correlating the impact of dose intensity upon response rates and survival.

Allogeneic hematopoietic stem cell transplantation is often used to treat hematologic malignancies. The efficacy of this procedure is due to both myeloablative conditioning and graft-versus-leukemia (GVL). However, the disadvantages of allogeneic transplantation include graft-versus-host disease (GVHD), relapse from the original tumor, and patient susceptibility to opportunistic infections. Lately, allogeneic transplantation has been developed to treat solid tumors, with the expectation that graft-versus-tumor (GVT), like GVL, will have a significant anti-tumor effect. This effect has been demonstrated in renal carcinomas, and with less evidence in breast cancers. Five patients with malignant ovarian tumors resistant to chemotherapy underwent allogeneic transplantation, four from bone marrow, and one from peripheral blood stem cells. All donors were HLA-identical siblings. One patient received a myeloablative conditioning regimen, while the other four received a non-myeloablative regimen. Two patients received donor lymphocyte infusions (DLI). Four of the patients presented with acute or chronic GVHD associated with tumor regression of at least 50%. These tumor regressions were measured by CA-125 levels and CT scans. The fifth patient died of rapid progression just after transplantation. Of the four transplantation survivors, three received a non-myeloablative regimen which did not seem to reduce treatment effectiveness. While it did reduce toxicity, one of these patients died of GVHD after 127 days. DLI was administered to two patients. These infusions seemed to promote GVHD which was able to control disease progression for one patient and had no apparent effect on the other. Allograft of hematopoietic stem cells might be of interest in ovarian cancer. The results in one patient also suggest that DLI may be an effective immunotherapy, although doses and timing need to be determined. The number of cases presented is small, however, and clinical experience on a larger scale will be required to determine the real clinical efficacy of graft versus cancerous ovarian cells.

In order to avoid modified radical mastectomy, a neoadjuvant approach was adopted in our institute for operable bulky breast cancers. From January, 1982, to December, 1995, 288 patients received primary chemotherapy with 3 different regimens (all doses mg/m2): (1) AVCF/AVCFM, 167 patients (adriamycin 30, vincristine 1 d1, cyclophosphamide 300, fluorouracil 400 d2-d5 and methotrexate 20 d2 and d4, every 28 days); (2) NEM, 78 patients (vinorelbine 25, epirubicin 35, methotrexate 20 d1 and d8, every 28 days); and (3) TNCF, 43 patients (THP-adria 20, d1-d3, vinorelbine 25 d1 and d4, cyclophosphamide 300, fluorouracil 400 d1-d4, every 21 days). Evaluation of the response comprised 3 methods: clinical (C), echographic (E), mammographic (M). The overall objective response rate (C: 63/90/93; E: 49/61/85; M: 53/65/83%) is higher with regimens (2) and (3). The complete response rate was increased 2-fold with TNCF but the hematologic toxicity was very superior with this combination. Patients were all operated for (2) and (3), only several for (1), and the breast conservation rate (68/83/79%) was quite similar in the 3 regimens. The pathological complete response rate reached 23% with TNCF. However the impact on patient survival has to be confirmed.