Predictive Factors for Local Control in Primary and Metastatic Lung Tumours after Four to Five Fraction Stereotactic Ablative Body Radiotherapy: A Single Institution's Comprehensive Experience

AIMS: We report the outcomes of a large lung stereotactic ablative body radiotherapy (SABR) programme for primary non-small cell lung cancer (NSCLC) and pulmonary metastases. The primary study aim was to identify factors predictive for local control.

MATERIALS AND METHODS: In total, 311 pulmonary tumours in 254 patients were treated between 2008 and 2011 with SABR using 48-60 Gy in four to five fractions. Local, regional and distant failure data were collected prospectively, whereas other end points were collected retrospectively. Potential clinical and dosimetric predictors of local control were evaluated using univariate and multivariate analyses.

RESULTS: Of the 311 tumours, 240 were NSCLC and 71 were other histologies. The 2 year local control rate was 96% in stage I NSCLC, 76% in colorectal cancer (CRC) metastases and 91% in non-lung/non-CRC metastases. Predictors of better local control on multivariate analysis were non-CRC tumours and a larger proportion of the planning target volume (PTV) receiving ≥100% of the prescribed dose (higher PTV V100). Among the 45 CRC metastases, a higher PTV V100 and previous chemotherapy predicted for better local control.

CONCLUSIONS: Lung SABR of 48-60 Gy/four to five fractions resulted in high local control rates for all tumours except CRC metastases. Covering more of the PTV with the prescription dose (a higher PTV V100) also resulted in superior local control.

Achieving optimal dose intensity with adjuvant chemotherapy in elderly breast cancer patients:A 10-year retrospective study in a UK institution

The study was to determine if breast cancer patients aged 65 and above could be given adjuvant chemotherapy safely while achieving an acceptable relative dose intensity of at least 85%. We identified all patients aged 65 and over who received adjuvant chemotherapy over the 10 year period, November 1999 to October 2009, and determined the proportion that achieved a relative dose intensity of at least 85% as well as the tolerability of their treatment. A total of 101 patients were identified, with a median age of 69 years (range 65-78).Of these, 25.7% of patients had at least one major comorbidity, 84.2% had a tumor size of 5 cm or less, 73.3% were node positive and 58.4% were hormone receptor positive. The chemotherapy regimens used were AC (Doxorubicin and Cyclophosphamide), FEC (Fluorouracil, Epirubicin, and Cyclophosphamide), CMF (Cyclophosphamide, Methotrexate, and Fluorouracil) and ECMF (Epirubicin followed by CMF). Seventy-nine patients (78.2%) achieved the relative dose intensity of at least 85%. With respect to toxicity, 11.9% of patients developed febrile neutropenia and 23.8% of patients required hospital admission during the treatment period, but there were no treatment-related deaths in the group. A significant proportion of patients aged 65 and above achieved the intended dose intensity of at least 85% over this 10-year period, with manageable toxicity levels. This supports the use of these regimens as adjuvant chemotherapy for breast cancer in this age group. © 2011 Wiley Periodicals, Inc.

Création littéraire sous contexte médiatisé: l'œuvre de Michel Houellebecq, Amélie Nothomb et Jacques Chessex

Partindo da análise dos processos de legitimação e de consagração que regem, a partir da segunda metade do século XX, a mediatização do campo literário, propomo-nos estudar os peri-fenómenos consequentes, tal como a correlação possível entre essa circunstância e a própria criação. O objeto deste estudo focaliza-se na produção de três escritores paradigmáticos das letras de expressão francesa europeias contemporâneas, cuja mediatização acompanha a popularidade: o francês Michel Houellebecq, a belga Amélie Nothomb e o suíço romando Jacques Chessex. Interrogamo-nos sobre as relações possíveis entre os instrumentos dessa mediatização e os seus efeitos nas opções de escrita destes três escritores. Atenta à projeção transfronteiriça de autores e de obras, resultado de uma convergência de alguns fatores de mediatização, mas também às particularidades da memória cultural e literária onde se inscrevem as literaturas respectivas (num percurso de legitimação progressiva das literaturas de periferia face à centralidade franco-francesa), a nossa reflexão visa também contribuir para uma recontextualização do cânone da literatura francesa no contexto globalizado da sociedade mediática contemporânea na qual os autores visados estão comprometidos.

Les Lionel Groulx : la pseudonymie comme stratégie littéraire et jeu institutionnel (1900-1966)

De 1900 à 1966, Lionel Groulx, prêtre, historien, écrivain, conférencier, professeur, a signé 176 textes d'une vingtaine de pseudonymes différents. Le premier chapitre du mémoire résume d'abord les positions théoriques qu'ont adoptées des chercheurs comme Genette, Laugaa et Jeandillou en ce qui concerne la pseudonymie. Le récit de l'aventure pseudonyme de Groulx commence au deuxième chapitre, alors que le jeune professeur du College de Valleyfield, surtout pour éviter les représailles de son évêque, recourra à la pseudonymie pour signer des textes patriotiques. En 1915, Groulx quitte Valleyfield pour Montréal. Dès 1917, il collabore à l'Action française, dont il devient le directeur en 1920. Sans contredit, l'étude de la pseudonymie de Groulx de 1917 a 1929 prouve qu'il est bel et bien "L'Homme à tout faire" de la revue, comme le démontre le troisième chapitre. Le quatrième et dernier chapitre analyse la période 1930 à 1966. [Résumé abrégé par UMI]

Dispositif didactique pour développer la lecture littéraire au deuxième cycle du secondaire

Cet article fait état d’une recherche s’inscrivant dans la foulée des travaux sur la didactique de la lecture littéraire, sur l’établissement d’un rapport vivant entre le sujet lecteur et le texte littéraire. Cette recherche, qui prend la forme d’une recherche-développement, vise à élaborer un dispositif didactique en trois volets (le questionnement réciproque, l’écrit de travail et l’écriture d’invention) susceptible de développer la lecture littéraire chez des élèves du secondaire. La première version du dispositif didactique a été évaluée par cinq experts, soit des enseignants de français et des didacticiens. L’analyse de contenu de leurs commentaires a permis de procéder à l’amélioration du dispositif didactique. L’analyse a également permis de relever que le développement de la lecture littéraire effectué par des outils validés par des experts et créés en adéquation avec les avancées de la recherche et les besoins des enseignants s’avère encore crucial et nécessaire, avant même de songer à une mise en œuvre en salle de classe.

Prognostic value of sentinel node biopsy in 327 prospective melanoma patients from a single institution

AIM: To confirm the accuracy of sentinel node biopsy (SNB) procedure and its morbidity, and to investigate predictive factors for SN status and prognostic factors for disease-free survival (DFS) and disease-specific survival (DSS). MATERIALS AND METHODS: Between October 1997 and December 2004, 327 consecutive patients in one centre with clinically node-negative primary skin melanoma underwent an SNB by the triple technique, i.e. lymphoscintigraphy, blue-dye and gamma-probe. Multivariate logistic regression analyses as well as the Kaplan-Meier were performed. RESULTS: Twenty-three percent of the patients had at least one metastatic SN, which was significantly associated with Breslow thickness (p<0.001). The success rate of SNB was 99.1% and its morbidity was 7.6%. With a median follow-up of 33 months, the 5-year DFS/DSS were 43%/49% for patients with positive SN and 83.5%/87.4% for patients with negative SN, respectively. The false-negative rate of SNB was 8.6% and sensitivity 91.4%. On multivariate analysis, DFS was significantly worsened by Breslow thickness (RR=5.6, p<0.001), positive SN (RR=5.0, p<0.001) and male sex (RR=2.9, p=0.001). The presence of a metastatic SN (RR=8.4, p<0.001), male sex (RR=6.1, p<0.001), Breslow thickness (RR=3.2, p=0.013) and ulceration (RR=2.6, p=0.015) were significantly associated with a poorer DSS. CONCLUSION: SNB is a reliable procedure with high sensitivity (91.4%) and low morbidity. Breslow thickness was the only statistically significant parameter predictive of SN status. DFS was worsened in decreasing order by Breslow thickness, metastatic SN and male gender. Similarly DSS was significantly worsened by a metastatic SN, male gender, Breslow thickness and ulceration. These data reinforce the SN status as a powerful staging procedure

Understanding academics' popular science publishing : institution culture and management style effects

Most universities and higher education systems have formally taken up a third mission, which involves various public outreach and engagement activities. Little is known regarding how higher education institutions' organisations interact with academic's level of public outreach. This article examines to which extent the perceptions academics have of their institutions' culture and management style, as well as some of their own individual and statutory characteristics interact with their level of public outreach. Using the Academic Profession in Europe comparative and quantitative research database, this article focuses on two countries on the extremities of the spectrum - Switzerland and the United Kingdom.

Le Réveil littéraire et artistique : journal hebdomadaire

1875/11/27 (A1,N5).

Le Réveil littéraire et artistique : journal hebdomadaire

1875/11/20 (A1,N4).

Le Réveil littéraire et artistique : journal hebdomadaire

1876/01/01 (A2,N10).