| 1. |
- Chargari, Cyrus, et al.
(författare)
-
Brachytherapy for Pediatric Patients at Gustave Roussy Cancer Campus : A Model of International Cooperation for Highly Specialized Treatments
- 2022
-
Ingår i: International Journal of Radiation Oncology Biology Physics. - : Elsevier BV. - 0360-3016. ; 113:3, s. 602-613
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Childhood cancer is rare, and treatment is frequently associated with long-term morbidity. Disparities in survival and long-term side effects encourage the establishment of networks to increase access to complex organ-conservative strategies, such as brachytherapy. We report our experience of an international cooperation model in childhood cancers. Methods and Materials: We examined the outcome of all children referred to our center from national or international networks to be treated according to a multimodal organ-conservative approach, including brachytherapy. Results: We identified 305 patients whose median age at diagnosis was 2.2 years (range, 1.4 months to 17.2 years). Among these patients, 99 (32.4%) were treated between 2015 and 2020; 172 (56.4%) were referred from national centers; and 133 (43.6%) were international patients from 31 countries (mainly Europe). Also, 263 patients were referred for primary treatment and 42 patients were referred for salvage treatment. Genitourinary tumors were the most frequent sites, with 56.4% bladder/prostate rhabdomyosarcoma and 28.5% gynecologic tumors. In addition to brachytherapy, local treatment consisted of partial tumor resection in 207 patients (67.9%), and 39 patients (13%) had additional external radiation therapy. Median follow-up was 58 months (range, 1 month to 48 years), 93 months for national patients, and 37 months for international patients (P < .0001). Five-year local control, disease-free survival, and overall survival rates were 90.8% (95% confidence interval [CI], 87.3%-94.4%), 84.4% (95% CI, 80.1%-89.0%), and 93.3% (95% CI, 90.1%-96.5%), respectively. Patients referred for salvage treatment had poorer disease-free survival (P < .01). Implementation of image guided pulse-dose-rate brachytherapy was associated with better local control among patients with rhabdomyosarcoma referred for primary treatment (hazard ratio, 9.72; 95% CI, 1.24-71.0). At last follow-up, 16.7% patients had long-term severe treatment-related complications, and 2 patients (0.7%) had developed second malignancy. Conclusions: This retrospective series shows the feasibility of a multinational referral network for brachytherapy allowing high patient numbers in rare pediatric cancers. High local control probability and acceptable late severe complication probability could be achieved despite very challenging situations. This cooperation model could serve as a basis for generating international reference networks for high-tech radiation such as brachytherapy to increase treatment care opportunities and cure probability.
|
|
| 2. |
- Darve, Christine, et al.
(författare)
-
The ESS Elliptical Cavity Cryomodules
- 2014
-
Ingår i: Advances in Cryogenic Engineering: Transactions of the Cryogenic Engineering Conference - CEC (AIP Conference Proceedings). - : AIP Publishing LLC. - 1551-7616 .- 0094-243X. ; 1573, s. 639-646
-
Konferensbidrag (refereegranskat)abstract
- The European Spallation Source (ESS) is a multi-disciplinary research centre under design and construction in Lund, Sweden. This new facility is funded by a collaboration of 17 European countries and is expected to be up to 30 times brighter than today's leading facilities and neutron sources. The ESS will enable new opportunities for researchers in the fields of life sciences, energy, environmental technology, cultural heritage and fundamental physics. A 5 MW long pulse proton accelerator is used to reach this goal. The pulsed length is 2.86 ms, the repetition frequency is 14 Hz (4 % duty cycle), and the beam current is 62.5 mA. The superconducting section of the Linac accelerates the beam from 80 MeV to 2.0 GeV. It is composed of one string of spoke cavity cryomodule and two strings of elliptical cavity cryomodules. These cryomodules contain four elliptical Niobium cavities operating at 2 K and at a frequency of 704.42 MHz. This paper introduces the thermo-mechanical design, the prototyping and the expected operation of the ESS elliptical cavity cryomodules. An Elliptical Cavity Cryomodule Technology Demonstrator (ECCTD) will be built and tested in order to validate the ESS series production.
|
|
