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Le terme d'évènement recouvre un large éventail de situations concrètes en oncologie radiothérapie, de l'effet secondaire particulièrement intense en lien avec l'irradiation à la possibilité d'une erreur technique ou humaine. Si les démarches qualité font désormais partie intégrante du fonctionnement des services d'oncologie radiothérapie pour l'analyse et la prévention de ces évènements, leur survenue au cours d'une irradiation conserve un impact significatif sur les personnes soignées et leur vécu du parcours de soin, mais aussi sur les professionnels de santé. Ces impacts pratiques, émotionnels et symboliques sont d'autant plus importants quand l'évènement survient dans les suites d'une erreur. La démarche éthique comprend alors trois temps essentiels : reconnaître l'évènement en tant que tel, informer les personnes impliquées de l'évènement et enfin créer les conditions favorables au maintien du soin. Chacune de ses étapes est marquée d'enjeux et de questionnements spécifiques nécessitant une approche éthique complexe amenant à considérer constamment la conciliation de perceptives parfois divergentes entre personnes soignées et professionnels de santé. La survenue d'un évènement peut aussi déboucher sur une authentique crise de confiance aux multiples dimensions que les professionnels de santé auront aussi à accompagner. Enfin, la survenue d'un évènement interroge notre responsabilité vis-à-vis des personnes que nous prenons en soin, mais aussi notre idéal de maîtrise. Critiquer notre culture de la performance, repenser profondément notre approche de l'évènement et de l'erreur pour y voir aussi une opportunité d'évolution positive sont autant de pistes à déployer au sein de nos unités de soin. The term "event" covers a wide range of concrete situations in radiation oncology, from particularly intense radiation-related side effects to the possibility of technical or human error. Although quality procedures are an integral part of radiotherapy oncology department operations ensuring the analysis and prevention of such events, their occurrence during radiation treatment still has a significant impact on patients and their experience of the treatment process, as well as on health professionals. These practical, emotional and symbolic impacts are all the greater when the event occurs in the aftermath of an error. The ethical approach therefore comprises three essential stages: recognizing the event as such, informing those involved of the event and, finally, creating conditions for the continuation of care. Each of these stages is marked by specific issues and questions, requiring a complex ethical approach that constantly involves reconciling the possible divergent perceptions of patients and health professionals. The occurrence of an event can also lead to a genuine crisis of confidence with multiple dimensions, which health professionals will also have to face and to support. Finally, the occurrence of an event calls into question not only our responsibility towards patients, but also our ideal of control. We need to criticize our culture of performance, rethink our approach to events and errors, and see them also as opportunities for positive change. [ABSTRACT FROM AUTHOR]

Simple Summary: We aimed to evaluate the diagnostic performance, impact on patient disease management, and therapy efficacy prediction of [68Ga]Ga-PSMA-11 PET/CT on 294 patients with biochemical recurrence of prostate cancer. We established a composite standard of truth for the imaging based on all clinical data available collected during the follow-up period with a median duration of follow-up of 17 months. Using this methodology, we found that the overall per-patient sensitivity and specificity were both 70%, the patient disease management was changed in 68% of patients, and that [68Ga]Ga-PSMA-11 PET/CT impacted this change in 86% of patients. The treatment carried out on the patient was considered effective in 78% of patients; in 89% of patients when guided by [68Ga]Ga-PSMA-11 PET/CT versus 61% of patients when not guided by [68Ga]Ga-PSMA-11 PET/CT. Background: Detection rates of [68Ga]Ga-PSMA-11 PET/CT on the restaging of prostate cancer (PCa) patients presenting with biochemical recurrence (BCR) have been well documented, but its performance and impact on patient management have not been evaluated as extensively. Methods: Retrospective analysis of PCa patients presenting with BCR and referred for [68Ga]Ga-PSMA-11 PET/CT. Pathological foci were classified according to six anatomical sites and evaluated with a three-point scale according to the uptake intensity. The impact of [68Ga]Ga-PSMA-11 PET/CT was defined as any change in management that was triggered by [68Ga]Ga-PSMA-11 PET/CT. The existence of a PCa lesion was established according to a composite standard of truth based on all clinical data available collected during the follow-up period. Results: We included 294 patients. The detection rate was 69%. Per-patient sensitivity and specificity were both 70%. Patient disease management was changed in 68% of patients, and [68Ga]Ga-PSMA-11 PET/CT impacted this change in 86% of patients. The treatment carried out on patient was considered effective in 89% of patients when guided by [68Ga]Ga-PSMA-11 PET/CT versus 61% of patients when not guided by [68Ga]Ga-PSMA-11 PET/CT (p < 0.001). Conclusions: [68Ga]Ga-PSMA-11 PET/CT demonstrated high performance in locating PCa recurrence sites and impacted therapeutic management in nearly two out of three patients. [ABSTRACT FROM AUTHOR]