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The impact of curative radiotherapy depends mainly on the total dose delivered homogenously in the target volume. Tumor sensitivity to radiotherapy may be particularly inconstant depending on location, histology, somatic genetic parameters and the capacity of the immune system to infiltrate the tumor. In addition, the dose delivered to the surrounding healthy tissues may reduce the therapeutic ratio of many radiation treatments. In a same population treated in one center with the same technique, it appears that individual radiosensitivity clearly exists, namely in terms of late side effects that are in principle non-reversible. This review details the different radiobiological approaches that have been developed to better predict the tumor response but also the radiation-induced late effects.

Randomized trials demonstrated similar overall survival between mastectomy and breast-conservative surgery followed by adjuvant radiation therapy. Breast-conservative surgery, with adjuvant radiation therapy, with or without neoadjuvant systemic therapy has become the standard of care for women with early or locally advanced breast cancer. Nevertheless, certain cardiac, lung or cutaneous toxicities may alter the long-term body image and the quality of life of a limited number of patients who consider having had "overtreatment" or treatment outside the best knowledge of science. In case of low-risk breast cancer, several trials have evaluated the carcinologic outcome in absence of radiation therapy after breast-conservative surgery. Local recurrences increased in case of breast-conservative surgery alone but without impact on overall survival. Multiple debates have emerged in order to select the most appropriate evaluation criteria. Finally, a large consensus has considered that reducing local recurrences is important but with modern technologies and after identifying patients of individual radiosensitivity. Indeed, in case of a low absolute risk of local recurrence, radiation therapy techniques have been developed to allow a focal treatment especially for patients with high risk of developing late effects. This kind of compromise takes into account the reduction risk of local recurrences but also the probability of developing radiation-induced cutaneous sequelae. In the same way, for patients considered at high risk of recurrence, the huge volumes need specific techniques to better cover the targets while protecting the surrounding critic organs such as heart and lung. Intensity-modulated radiation therapy and the local high boost may help to decrease local recurrences of these more extended and aggressive diseases while considering the individual radiosensitivity that paves the way of long-term sequelae. In this article, we detail a personalized approach of breast radiation therapy considering the absolute risk of local recurrences and the probability of radiation-induced toxicity appearance.

Locally advanced oesophageal cancer treatment requires a multidisciplinary approach with the combination of chemotherapy and radiotherapy for preoperative and definitive strategy. Preoperative chemoradiation improves the locoregional control and overall survival after surgery for locally advanced oesophageal cancer. Definitive chemoradiation can also be proposed for non-resectable tumours or medically inoperable patients. Besides, definitive chemoradiation is considered as an alternative option to surgery for locally advanced squamous cell carcinomas. Chemotherapy regimen associated to radiotherapy consists of a combination of platinum derived drugs (cisplatinum or oxaliplatin) and 5-fluorouracil or a weekly scheme combination of carboplatin and paclitaxel according to CROSS protocol in a neoadjuvant strategy. Radiation doses vary from 41.4Gy to 45Gy for a preoperative strategy or 50 to 50.4Gy for a definitive treatment. The high risk of lymphatic spread due to anatomical features could justify the use of an elective nodal irradiation when the estimated risk of microscopic involvement is higher than 15% to 20%. An appropriate delineation of the gross tumour volume requires an exhaustive and up-to-date evaluation of the disease. Intensity-modulated radiation therapy represents a promising approach to spare organs-at-risk. This critical review of the literature underlines the roles of radiotherapy for locally advanced oesophageal cancers and describes doses, volumes of treatment, technical aspects and dose constraints to organs-at-risk.

Resume Les cancers de l’œsophage localement evolues relevent d’une prise en charge pluridisciplinaire ou la chimioradiotherapie occupe une place essentielle. La chimioradiotherapie neoadjuvante permet d’ameliorer les taux de controle locoregional et de survie globale des cancers de l’œsophage localement evolues operes. La chimioradiotherapie exclusive a egalement une place pour les lesions non resecables et/ou pour les patients non operables et est consideree comme une alternative a la chirurgie dans la prise en charge initiale des carcinomes epidermoides de l’œsophage localement evolues. La chimiotherapie associee consiste en une combinaison de sels de platine (cisplatine ou oxaliplatine) et de 5-fluoro-uracile le plus souvent, ou de carboplatine et de paclitaxel hebdomadaire selon le protocole CROSS en situation neoadjuvante. Les doses varient de 41,4 Gy (protocole CROSS) a 45 Gy en situation neoadjuvante. En traitement exclusif, une dose de 50 a 50,4 Gy est preconisee selon les recommandations francaises et americaines. Les volumes cibles tiennent compte des particularites anatomiques de l’œsophage et de son drainage lymphatique. Ainsi, une irradiation ganglionnaire prophylactique interesse classiquement les aires ganglionnaires presentant un risque d’envahissement de plus de 15 % a 20 %. L’utilisation de la radiotherapie conformationnelle avec modulation d’intensite represente une approche prometteuse susceptible de diminuer la toxicite dans les organes a risque adjacents. Cet article decrit, a partir d’une revue critique de la litterature, la place de la chimioradiotherapie dans la strategie therapeutique, les volumes anatomiques d’interet, les doses de prescription, les contraintes de doses dans les organes a risque et les techniques de radiotherapie adaptees.

Radiation-induced lung disease (RILD) is common after radiation therapy and represents cornerstone toxicities after treatment of thoracic malignancies. From a review of literature, the objective of this article was to summarize clinical and non-clinical parameters associated with the risk of RILD in the settings of normo-fractionated radiotherapy and stereotactic body radiation therapy (SBRT). For the treatment of lung cancers with a normo-fractionated treatment, the mean lung dose (MLD) should be below 15-20Gy. For a thoracic SBRT, V20Gy10% and MLD6Gy are recommended. One should pay attention to central tumors and respect specific dose constraints to the bronchial tree. The recent technological improvements may represent an encouraging way to decrease lung toxicities. Finally, our team developed a calculator in order to predict the risk of radiation pneumonitis.

Yaykasli, Emine/0000-0001-6471-0106; Yaykasli, Kursat/0000-0001-7550-6370; Hatipoglu, Omer Faruk/0000-0002-1012-001X WOS: 000407091600002 PubMed: 28766346 OBJECTIVE: A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), comprising of 19 members is a family of peptidases. They have several vital functions in physiological and pathological processes in organisms. ADAMTS-9 has aggrecanolytic activity and is responsible for degradation of aggrecan mainly in articular cartilage. It is known that adiponectin is the most abundantly secreted adipokine (adipocytokines), and the characteristics of adiponectin have not been elucidated yet. It was assumed that adiponectin has anti-inflammatory effect before. However, an inflammatory feature of adiponectin was shown in researches. In our study, the effect of adiponectin on ADAMTS-9 gene expression in primary human chondrocytes was investigated. METHODS: Primary human chondrocytes were exposed to adiponectin at 1, 4, 8 and 12 mu g/ml doses for certain time period. Total RNA was isolated and reverse-transcribed by random primer after incubation. ADAMTS-9 and beta-actin genes expression levels were determined using real-time polymerase chain reaction (qRT-PCR). RESULTS: The highest upregulation of ADAMTS-9 gene expression level was found at 12 mu g/ml dose of adiponectin and 48 h incubation. CONCLUSION: Adiponectin is the key element in the maintenance of cartilage homeostasis. Similarly, the involvement of adiponectin in articular inflammatory diseases was demonstrated in detail. These findings bring adiponectin into central place in the research to develop adiponectin based new therapy methods for arthritic diseases. Together with these findings, our results suggest that adiponectin may be involved in the degradation of articular cartilage by increasing ADAMTS-9 gene expression (Tab. 1, Fig. 3, Ref. 35). Text in PDF www.elis.sk. TUBITAK (The Scientific and Technical Research Council of Turkey)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [SBAG/111S218] This study was supported by TUBITAK (The Scientific and Technical Research Council of Turkey), (Project Number: SBAG/111S218).

Strategic decision-making processes necessitate a significant amount of experience and the consideration of a wide range of factors associated with the decision problem. Determination of applicant credit score and loan decisions are such decisions that subjective judgement of loan officers can produce poor results with substantial losses. This study is triggered as a result of an industrial consultancy project with a partner providing technological solutions for financial services. Anticipated requirement for an e-payment system that connects financial lenders, credit applicants and retailers digitally through a system is the main motivation of the study. Another focus of the study is on providing immediate loan access to retail customers which has necessitated automated processes and a decision-support system to assist the analysis of loan applications. The proposed system automatically evaluates a credit application as soon as the relevant information is inputted to the system at the end of the shopping process. The decision-making process should be supported with appropriate systems performing computerized credit assessment processes for quick and accurate decisions. The main complementary tools for the proposed system include a fraud detection module and credit risk assessment module which runs credit scoring algorithms. The proposed system will make loan or credit line decisions faster by eliminating paper work, easier by eliminating bureaucracy, and more accurate by newly integrated algorithms and approaches. (c) 2017 Published by Future Academy www.FutureAcademy.org.UK

Objectif de l’etude Nous presentons l’analyse retrospective d’une cohorte de patients atteints d’un cancer du rectum localement evolue pris en charge par chimioradiotherapie delivree avec la tomotherapie helicoidale, par une technique de simultaneous integrated boost (SIB) et un controle quotidien de la position du patient, suivie par une chirurgie. Materiel et methode Quatre-vingt-six patients ont recu 45 Gy (1,8 Gy par fraction) au niveau du rectum, du mesorectum et des ganglions de drainage pelviens (presacres, iliaques internes et obturateurs jusqu’a L5-S1), delivres avec un SIB jusqu’a la dose totale de 50 Gy (2 Gy par fraction) dans le volume tumoral macroscopique (GTV) rectal et ganglionnaire, et avec une chimiotherapie concomitante (capecitabine, 825 mg/m2, deux fois par jour). La marge entre les volumes cibles anatomoclinique et previsionnel (CTV-PTV) a ete de 5 mm pour les deux volumes. Tous les patients ont ete operes apres la chimioradiotherapie (resection R0 : 84/86 patients). Quarante-cinq patients ont recu une chimiotherapie adjuvante. Le degre de regression tumorale (TRG) a ete evalue avec le score de Mandard. Resultats Le temps de suivi median etait de 54 mois (extremes : 4–91 mois). Trois et six patients ont souffert, respectivement, d’une toxicite de grade 3 ou plus aigue ou tardive. Vingt et un pour cent et 30 % des patients etaient, respectivement, en situation de reponse pathologique complete (TRG = 1) ou quasi complete. Les taux de controle local, de survie globale, et de survie sans rechute a 5 ans etaient, respectivement, de 78 %, 84 % et 66 %. Les patients avec un TRG 1–2 avaient des meilleurs taux de controle local (94 % contre 78 %, p = 0,01) et de survie globale (94 % contre 33 %, p Conclusion Un SIB delivre avec une tomotherapie et un controle quotidien de la position du patient est bien tolere et efficace. Un TRG 1–2 apres la chimioradiotherapie est un facteur pronostique de controle local et de survie globale.

IEEE Conference on Standards for Communications and Networking, CSCN 2015 -- 28 October 2015 through 30 October 2015 -- 119154 Purpose: In experimental and clinical trials, tamoxifen (TAM) has been shown to increase radiation-induced lung fibrosis (RILF). Furthermore, aromatase inhibitors (AI) have been shown to be superior to TAM in the adjuvant setting and preclinical data suggest that letrozole (LET) sensitizes breast cancer cells to ionizing radiation in other studies. In this experimental study, we evaluated whether AI have any impact on the development of RILF in rats. Materials and methods: 60 female wistar- albino rats were divided into 6 groups: Control (group A), RT alone (group B), RT + TAM (group C), RT + anastrozole (ANA group D), RT + LET (group E), and RT + exemestane (EXE, group F). RT consisted of 30 Gy in 10 fractions to both lungs with an anterior field at 2 cm depth. Equivalent doses for 60 kg adult dose per day of TAM, ANA, LET, and EXE were calculated according to the mean weight of rats and orally administrated with a feeding tube. Percentage of lung with fibrosis was quantified with image analysis of histological sections of the lung. The mean score values were calculated for each group. the significance of the differences among groups were calculated using one way ANOVA test and Tukey HSD post-hoc test. Results: Mean values of fibrosis were 1.7, 5.9, 6.7, 2.5, 2 and 2.2 for groups A, B, C, D, E, and F, respectively (p = 0.000). TAM increased RT-induced lung fibrosis but without statistical significance. Groups treated with RT + AI showed significantly less lung fibrosis than groups treated with RT alone or RT + TAM (p = 0.000). RT + AI groups showed nearly similar RT-induced lung fibrosis than control group. Conclusions: In this study, we found that AI decreased RT-induced lung fibrosis to the control group level suggesting protective effect.

Focusing on digital marketing brand managers have to focus on current and future customer demands and need to find new ways of penetrating into the lives of consumers, offering the 'right' advertisement at the 'right' time. In order to promote the e-commerce or the brand image of the company, the marketing strategy has moved to digital marketing. Branding can be defined as an outgoing process, where the outputs are a brand and a brand identity for differentiating products, services, divisions, companies, industries, or target groups. Branding is an output-generating process, with a brand and brand identity for differentiating products, services, and corporations, as outputs. Brands are critical marketing and communication assets, and it is important to invest time in researching, developing, and implementing a brand. In this study a four level brand management dashboard was developed focusing on the dimensions stakeholder, market, media sources and internal dimension. The dashboard was then implemented in a company operating the telecommunications market, having one master brand and several sub brands. Objectives of the project were to deliver better brand briefs, establish a clear internal communication hierarchy, get a greater visibility of projects in the pipeline. Indicators to evaluate brand effectiveness and the whole strategic brand management process after the brand performance dashboard has been implemented are the accuracy of branded materials, on time delivery, preservation of brand values and equity. The evaluation of the strategic brand management process with the dashboard applied and the new set of indicators implemented gives after one year in use the following results: values for already implemented indicators, such as brand development index, close rate and brand equity improved in the 1 year study period. Newly implemented indicators, such as brand penetration index, master brand influence rate, stakeholder value, sub brand sales rate, brand cross index, customer index, employee index and market penetration index, have all values within the pre-defined ranges. The developed brand performance dashboard offers an opportunity to analyze brands, brand dimensions and the brand environment in a structured way. (C) 2016 The Authors. Published by Elsevier Ltd.

Recently, there have been several efforts to develop ranking systems for universities. Increasing competititon and need for competitiveness as a result of globalization, knowledge based economy and growing interest of information related to higher education institutions due to increasing mobility of people all served for the remarkable popularity of ranking systems. Many researchers and organizations have put effort into developing a ranking framework by focusing on different criteria and following various methodologies. These ranking systems produce different ranks for the same institution due to methodological differences which stem from selection of indicators, weights, data collection and analysis. Thus, this study analyzes conceptual and methodological differences in university ranking systems and concentrates on the situation in Turkey. Literature review demonstrates that there is a larger than expected need for a national ranking system for Turkey so as to identify the position of a specific university compared to others. In strategic management context, it is especially important for policy makers to develop and deploy strategies associated with the higher education system. In this aspect, this study concentrates on developing a ranking system which provides information transparency for the strategic management of higher education institutions. Moreover, this study's focus is more specific and the case of ranking of management departments is examined so as to construct a foundation for a national field based ranking system. In this regard, a framework for ranking of management departments in Turkey is proposed. (C) 2016 The Authors. Published by Elsevier Ltd.

The phenomenon of corporate social responsibility "CSR" has stimulated lots of debates and disagreement among the business scholars. One of the most howling sounds comes from strategy and CSR thinkers. Strategic thinkers of this debate believe that CSR is not only an accountability action but also it is countability action. Due to this countability action heavily based on profit, scholar of strategy field stated that the phenomenon of CSR and the result of its activities should be revised by strategic thinking lens. To this end in this study we examine the CSR activities, especially philanthropy activities (sports, art sponsorships etc.) from strategy perspectives. And the question of this study is "How the process of the strategic CSR activities works on private hospitals?" In the study private hospitals and their CSR activity reports used as the cases of the study. We make qualitative content analysis and the documents in this study are analyzed with qualitative analysis software (MAXQDA). (C) 2016 The Authors. Published by Elsevier Ltd.

Le lymphome testiculaire primaire est une forme rare de lymphome malin non hodgkinien (LMNH). C’est une maladie grave touchant essentiellement le sujet âge. Le traitement des stades precoces (I et II) repose sur l’orchidectomie suivie par la chimiotherapie (CT) associee a un anticorps monoclonal dirige contre l’antigene CD20 et a l’irradiation scrotale (site sanctuaire) associee ou non a la radiotherapie (RT) ganglionnaire iliaque et/ou para-aortique. Dans les stades avances (III et IV), la chimio-immunotherapie est le traitement de choix. Le role de la RT scrotale est sujet a controverses. La CT intrathecale (IT) est justifiee quel que soit le stade de la maladie, et ce, afin de prevenir les rechutes au niveau du systeme nerveux central (SNC). De nouvelles approches moleculaires et des therapies agressives sont en voie d’exploration dans cette maladie rare.

Positron emission tomography is a functional imaging technique that allows the detection of the regional metabolic rate, and is often coupled with other morphological imaging technique such as computed tomography. The rationale for its use is based on the clearly demonstrated fact that functional changes in tumor processes happen before morphological changes. Its introduction to the clinical practice added a new dimension in conventional imaging techniques. This review presents the current and proposed indications of the use of positron emission/computed tomography for prostate, bladder and testes, and the potential role of this exam in radiotherapy planning.

Objectif de l’etude La radiotherapie stereotaxique d’ablation est une technique emergente dans la prise en charge des tachycardies ventriculaires refractaires aux traitements medicamenteux et a l’ablation par catheter. Nous rapportons ici les resultats des premiers patients traites dans notre centre. Materiel et methode Les patients inclus souffraient de tachycardies ventriculaires ou d’une tempete rythmique refractaires aux traitements classiques. Avant chaque traitement, afin de localiser le substrat de la tachycardie ventriculaire, une cartographie tridimensionnelle a ete realisee durant une exploration electrophysiologique endocavitaire. Pour chaque patient, le cardiologue a delimite le substrat de la tachycardie ventriculaire sur la scanographie de radiotherapie grâce aux informations de la cartographie. L’electrode de defibrillation du defibrillateur automatique implantable a servi de fiduciel pour assurer le suivi en temps reel (tracking). Une dose de 25 Gy a ete delivree sur le substrat de la tachycardie ventriculaire grâce a un accelerateur lineaire robotise Cyberknife® M6. Resultats Depuis septembre 2017, trois patients ont ete pris en charge : deux patients electifs et un patient hospitalise en reanimation en raison d’une tempete rythmique a l’origine de nombreux chocs electriques delivres par le defibrillateur automatique implantable, et necessitant une anesthesie generale. Le tracking de l’electrode du defibrillateur automatique implantable a permis de delivrer avec succes la radiotherapie stereotaxique chez tous les patients. Le volume des substrats de la tachycardie ventriculaire etait pour chaque patient de 19 cm3, 21 cm3 et 35 cm3. Apres un suivi median de cinq mois, les patients electifs n’ont pas souffert de recidive rythmique. Le patient en reanimation a ete extube trois jours apres la radiotherapie stereotaxique et sans recidive de tempete rythmique pendant quatre mois, avant de presenter un nouvel episode a 19 semaines. Cet episode a ete impute a un nouveau substrat de la tachycardie ventriculaire, distant du premier, confirme par cartographie tridimensionnelle et traite par ablation par catheter. Il n’y a eu aucune complication imputable a la radiotherapie stereotaxique. Conclusion La radiotherapie stereotaxique apparait comme un traitement prometteur des tachycardies ventriculaires et tempete rythmiques refractaires aux traitements classiques. Un suivi des effets secondaires a long terme reste indispensable.

Par leur caractere irreversible et leur impact sur la qualite de vie, les effets secondaires tardifs des tissus sains constituent un facteur limitant de la radiotherapie. L’irradiation est a l’origine de dereglements biologiques multiples aboutissant a la destruction des cellules souches, a des atteintes vasculaires et a la constitution progressive d’une fibrose interstitielle qui s’aggrave avec le temps. Parmi une population soumise a des techniques de radiotherapie identiques, certains patients vont avoir une toxicite augmentee suggerant l’existence d’une radiosensibilite intrinseque differente des tissus sains. Des outils predictifs, bases sur l’etude de l’apoptose lymphocytaire et sur la modification de certains genes impliques dans la reponse a l’irradiation, ont alors ete developpes pour identifier ces patients radiosensibles. Ainsi, il a ete montre qu’un taux d’apoptose lymphocytaire CD8 radio-induite bas etait correle aux complications radio-induites de grade eleve et correspondait a plus de quatre alterations de type SNP (single nucleotide polymorphisms) sur les genes candidats de type ATM, SOD2, TGFB1, XRCC1 et XRCC3.

The impact of curative radiotherapy depends mainly on the total dose delivered homogenously in the targeted volume. Nevertheless, the dose delivered to the surrounding healthy tissues may reduce the therapeutic ratio of many radiation treatments. Two different side effects (acute and late) can occur during and after radiotherapy. Of particular interest are the radiation-induced sequelae due to their irreversibility and the potential impact on daily quality of life. In a same population treated in one centre with the same technique, it appears that individual radiosensitivity clearly exists. In the hypothesis that genetic is involved in this area of research, lymphocytes seem to be the tissue of choice due to easy accessibility. Recently, low percentage of CD4 and CD8 lymphocyte apoptosis were shown to be correlated with high grade of sequelae. In addition, recent data suggest that patients with severe radiation-induced late side effects possess four or more single nucleotide polymorphisms (SNP) in candidate genes (ATM, SOD2, TGFB1, XRCC1, and XRCC3) and low radiation-induced CD8 lymphocyte apoptosis in vitro. On-going studies are being analyzing the entire genome using a Genome-wide association study (GWAS) analysis.

Background and purpose To evaluate the feasibility and dosimetric optimization potential of a unilateral two-field intensity-modulated radiotherapy (IMRT) technique in the curative treatment of lateralized tonsil cancer. Materials and methods Six patients with lateralized tonsillar carcinoma were treated unilaterally with a two-field IMRT technique (oblique-anterior and oblique-posterior fields, with or without collimator and couch rotation). Alternative IMRT plans using seven non-opposed coplanar fields were compared with the two-field plans for each patient. Results Planning target volume (PTV) coverage was excellent with the two-field technique, using a relatively low number of monitor units (MU) (median, 441; range, 309–550). Dose constraints were respected for all organs at risk (OAR). Mean doses to contralateral parotid and submandibular glands were 3.9 and 17.7Gy, respectively. Seven-field IMRT provided similar PTV coverage, with statistically significant better dose homogeneity and conformality. However, the mean delivered dose to the contralateral parotid (3.9 vs . 9.0Gy, p =0.001) as well as the mean number of MU (437 vs . 814, p =0.002) and consequently machine time were lower with two-field IMRT. Conclusions Unilateral two-field IMRT is a simple and feasible technique providing excellent tumor coverage and optimal OAR sparing while reducing the number of MU and treatment time.

While enterprises are struggling to go on existing in the intensive competitive environment, unexpected breakdowns occur at unexpected times, thereby leading to the emergence of halts in production and to hitches in production plans. As a result, enterprises suffer from the loss of revenue as they fail to hit the production quantity that they have aimed at. The fact that the maintenance plans have been made well is an important issue in the prevention of the losses due to breakdowns within an enterprise. This gains more importance particularly when the production system grows and the production quantity increases. It is necessary to plan the activities to be carried out to ensure that the machines and plants of enterprises are working continuously. All management activities concerning the practices including such issues as the determination of maintenance priorities as well as preparation and supervision of maintenance plans are carried out with maintenance management. This study described the implementation of maintenance management and lean manufacturing techniques at the maintenance workshop in order to eliminate the losses due to breakdowns and to enhance productivity and the motivation of employees at an enterprise which produced dairy products. (C) 2015 Published by Elsevier Ltd.

In this study, the term strategic orientation that was developed within the scope of competitive advantage theories in the literature is analysed through the case of ASEM (Furniture Market of Sakarya). Throughout the study, the status of ASEM members is defined and the relationship of the strategic orientation of the firms with their innovation strategies is determined. This study has been conducted for defining the status of strategic orientation of the firms (market orientation, entrepreneurial orientation and technology orientation) in using innovation capabilities. Within the study, a model has been developed under the assumption that strategic orientations have positive effects on market performance and creating costumer value through innovation capabilities. The data is collected through a survey that tests strategic orientations, innovation types and market performance for SMEs in ASEM. The findings suggest that proactive market orientation, proactive entrepreneurial orientation and technology orientation are positively related in innovation capabilities. In addition, innovation capabilities play a key role between strategic orientation and market performance. (C) 2015 The Authors. Published by Elsevier Ltd.

Locally advanced non-small-cell lung carcinoma (NSCLC) is a very heterogeous disease, the role of postoperative radiation therapy (PORT) in pN2 patients with completly resected NSCLC remains controversial. Although an improvment in local control has been described in several studies, the effect on survival has been contradictory or inconclusive. Retrospective evaluation suggest a positive effect of PORT in high risk patients with pN2 disease: RI-resected NSCLC, bulky and multilevel N2. However further evaluation of PORT in prospectively randomized studies in completely resected pN2 NSCLC is needed.

En 1901, six ans apres la decouverte des rayons X par Wilhelm Rontgen, Henri Becquerel et Pierre Curie publient une note officielle a l’Academie des sciences sur l’action physiologique des rayons du radium [1]. En reproduisant l’experience de Friedrich Giesel, Pierre Curie decrit les diverses rougeurs, brulures et plaies qu’a provoquees l’exposition, durant une dizaine d’heures, de chlorure de baryum radifere sur son avant-bras. Les symptomes decrits sont les memes que ceux de Marie Curie et d’Henri Becquerel, lorsque ces derniers transportent dans une poche de leur gilet un petit tube metallique scelle avec quelques centigrammes de cette meme matiere active. Ces diverses observations conduisent rapidement a la conclusion de l’existence d’un effet biologique des rayonnements ionisants sur les tissus.

The impact of curative radiotherapy depends mainly on the total dose delivered homogenously in the targeted volume. Nevertheless, the dose delivered to the surrounding healthy tissues may reduce the therapeutic ratio of many radiation treatments. In a same population treated in one center with the same technique, it appears that individual radiosensitivity clearly exists, namely in terms of late side effects that are in principle non-reversible. This review details the different radiobiological approaches that have been developed to better understand the mechanisms of radiation-induced late effects. We also present the possibilities of clinical use of predictive assays in the close future.

Breast cancer is currently the most common carcinoma among women. Adjuvant radiotherapy (RT) plays an important role in the treatment of early breast cancer after lumpectomy and in selected cases after mastectomy. Adjuvant RT has traditionally been delivered using two tangential fields with or without direct fields for regional lymph node treatment after two-dimensional planning. Recently, new treatment planning and delivery options have emerged aiming to improve the dose distribution, reduce inhomogeneities, and clinically confer better locoregional control with reduced toxicities. Even more advanced RT techniques, such as helical intensity modulated radiotherapy (IMRT) (tomotherapy), might offer new solutions to further improve treatment planning and therefore, possibly clinical outcomes in comparison with traditional RT techniques. In this chapter, the current literature about applications of tomotherapy in breast cancer patients is being reviewed and our breast tomotherapy practice at the University of Lausanne, CHUV, Switzerland is being presented.

Background: Mammary adenoid cystic carcinoma (ACC) is a rare breast cancer. The aim of this retrospective study was to assess prognostic factors and patterns of failure, as well as the role of radiation therapy (RT), in ACC. Methods: Between January 1980 and December 2007, 61 women with breast ACC were treated at participating centers of the Rare Cancer Network. Surgery consisted of lumpectomy in 41 patients and mastectomy in 20 patients. There were 51(84%) stage pN0 and 10 stage cN0 (16%) patients. Postoperative RT was administered to 40 patients (35 after lumpectomy, 5 after mastectomy). Results: With a median follow-up of 79 months (range, 6–285), 5-year overall and disease-free survival rates were 94% (95% confidence interval [CI], 88%–100%) and 82% (95% CI, 71%–93%), respectively. The 5-year locoregional control (LRC) rate was 95% (95% CI, 89%–100%). Axillary lymph node dissection or sentinel node biopsy was performed in 84% of cases. All patients had stage pN0 disease. In univariate analysis, survival was not influenced by the type of surgery or the use of postoperative RT. The 5-year LRC rate was 100% in the mastectomy group versus 93% (95% CI, 83%–100%) in the breast-conserving surgery group, respectively (p = 0.16). For the breast-conserving surgery group, the use of RT significantly correlated with LRC (p = 0.03); the 5-year LRC rates were 95% (95% CI, 86%–100%) for the RT group versus 83% (95% CI, 54%–100%) for the group receiving no RT. No local failures occurred in patients with positive margins, all of whom received postoperative RT. Conclusion: Breast-conserving surgery is the treatment of choice for patients with ACC breast cancer. Axillary lymph node dissection or sentinel node biopsy might not be recommended. Postoperative RT should be proposed in the case of breast-conserving surgery. 2012 Elsevier Inc. Adenoid cystic carcinoma, Breast cancer, Radiotherapy, Surgery.

Strategic planning in higher education institution is a systematic planning process designed to guide decisions about the improvement of education and training, research and development, and application and service processes. It also provides the allocation of financial and other resources, and the procurement of new resources. There are two fundamental regulations in Turkey which oblige universities to prepare strategic plans and set methods of preparation. These regulations have some points in common as well as differences. This paper aims to analyze these two approaches by addressing differences and similarities, and discuss jointly applicability of them. Preparing reports according to both DPT YODEK models causes trouble in practice for universities. Therefore, a single model to be prepared jointly by relevant ministries and the Council of Higher Education should be formed instead of implementation two distinctive models. This integrated model also facilitates benchmarking by determining common targets and indicators for higher education institutions. (C) 2012 Published by Elsevier Ltd. Selection and/or peer-review under responsibility of The 8th International Strategic Conference

The oncologic outcome and the total dose are highly correlated with the treatment by ionizing radiation. The dose increase (total or per fraction) may provoke late-side effects that are potentially irreversible. The radiation-induced CD8 lymphocyte apoptotic value and the molecular modifications within the lymphocyte are capable of predicting the level of risk of developing late-side effects after curative intent radiotherapy. In this review, we present the different blood assays in this setting and discuss the current possibilities of researches, namely those involving the proteomic process.

TPS197 Background: The clinical outcome of patients (pts) with resected HNSCC at high risk of recurrence remains poor. Disease free survival (DFS) at 5 years is around 40% after standard adjuvant chemoradiation (CRT). The use of anti-EGFR monoclonal antibodies combined with radiotherapy was shown to be effective in pts with HNSCC, and combination with CRT showed to be safe.METHODS: This open-label phase III randomized trial will investigate whether the addition of the anti-EGFR antibody panitumumab to adjuvant CRT significantly prolongs DFS in HNSCC at high risk of recurrence. Pts with high-risk HNSCC, due to the presence of close resection margins (