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Giraud P, Fleury B, Le Prince C, Falk AT, Rousse C, Hance H, Santini JJ, Bicheron D, Palisson J, Hannoun-Lévi JM, Tack K, Marchesi V, Azria D. [Interprofessional recommendations on behalf of Société française de radiothérapie oncologique for the prevention, protection and management of cyberattacks in radiation oncology]. Cancer Radiother 2023; 27:683-688. [PMID: 37839920 DOI: 10.1016/j.canrad.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
Cybersecurity is currently a major issue. Large hospitals are no longer the only main targets of attacks, but all healthcare organizations and establishments, without distinction of size or activities. The information system is defined as all the resources needed to collect images, store and process them with general distribution of multiple information within an organization. Systems are therefore crucial for the functioning of a medical department. Radiation oncology is one of the specialties most dependent on digital resources, for imaging, data transfer, dosimetry, treatment and so on.. Radiation oncology departments are therefore a prime target for ransomware attacks, which have increased significantly in recent years. Cybersecurity can be likened to a viral or bacterial attack. It is based on the two usual pillars of antimicrobial protection : hygiene and prophylaxis. In this article, we will detail by analogy the three classic levels of prevention of a bacillary attack: "primary prevention", which acts upstream of the infection; "secondary prevention", which acts at an early stage of its evolution; and "tertiary prevention", which acts on complications and risks of recurrence. This article is the result of an interprofessional group on behalf of SFRO, the French society of radiation oncology, with the aim of helping all teams to implement safety adapted to the specificities of a radiation oncology department in France.
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Affiliation(s)
- P Giraud
- Université de Paris Cité, Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France.
| | - B Fleury
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - C Le Prince
- Service de physique médicale, Centre de la Baie, 1, avenue du Quesnoy, 50307 Avranches cedex, France
| | - A T Falk
- Centre azuréen de cancérologie, 1, place Dr-Jean-Luc-Broquerie, 06250 Mougins, France
| | - C Rousse
- Autorité de sûreté nucléaire, 15, rue Louis-Lejeune, CS 70013, 92541 Montrouge cedex, France
| | - H Hance
- Service qualité, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - J-J Santini
- Institut régional du cancer de Montpellier ICM, parc Euromédecine, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - D Bicheron
- Centre azuréen de cancérologie, 1, place Dr-Jean-Luc-Broquerie, 06250 Mougins, France
| | - J Palisson
- Service de physique médicale, Centre de la Baie, 1, avenue du Quesnoy, 50307 Avranches cedex, France
| | - J-M Hannoun-Lévi
- Centre Antoine-Lacassagne, université Côte d'Azur, 33, avenue de Valombrose, 06189 Nice, France
| | - K Tack
- Autorité de sûreté nucléaire, 15, rue Louis-Lejeune, CS 70013, 92541 Montrouge cedex, France
| | - V Marchesi
- Service de physique médicale, Institut de cancérologie de Lorraine, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; Société française de physique médicale, centre Antoine-Béclère, 47, rue de la Colonie, 75013, Paris, France
| | - D Azria
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Institut régional du cancer de Montpellier ICM, parc Euromédecine, 208, avenue des Apothicaires, 34090 Montpellier, France; Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, université de Montpellier, Inserm, U1194 IRCM, 34000 Montpellier, France
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Falk AT, Thyss A, Thariat J. Metastatic Ablation for Sarcomas: Methodological and Ethical Dilemmas for Prospective Studies. Clin Oncol (R Coll Radiol) 2015; 27:429-30. [PMID: 25869259 DOI: 10.1016/j.clon.2015.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 11/27/2022]
Affiliation(s)
- A T Falk
- Centre Antoine Lacassagne, Nice, France
| | - A Thyss
- Centre Antoine Lacassagne, Nice, France
| | - J Thariat
- Centre Antoine Lacassagne, Nice, France
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Trone JC, Mengue Ndong S, Falk AT, Annede P, Rivoirard R, Guy JB, Langrand-Escure J, Méry B, Espenel S, Ben Mrad M, Vallard A, Auberdiac P, Moncharmont C, Assouline A, de Laroche G, Chargari C, Magné N. Skin cancers in nonagenarian patients: special focus on radiotherapy. Clin Oncol (R Coll Radiol) 2015; 27:371. [PMID: 25681870 DOI: 10.1016/j.clon.2015.01.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 01/27/2015] [Indexed: 12/01/2022]
Affiliation(s)
- J-C Trone
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - S Mengue Ndong
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - A T Falk
- Radiation Oncology, Centre Antoine Lacassagne, Nice, France
| | - P Annede
- Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, France
| | - R Rivoirard
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - J-B Guy
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - J Langrand-Escure
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - B Méry
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - S Espenel
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - M Ben Mrad
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - A Vallard
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - P Auberdiac
- Radiation Oncology, Clinique Claude Bernard, Albi, France
| | - C Moncharmont
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - A Assouline
- Radiation Oncology, Centre Clinique de la Porte de Saint Cloud, Boulogne-Billancourt, France
| | - G de Laroche
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - C Chargari
- Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, France
| | - N Magné
- Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
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Falk AT, Moureau-Zabotto L, Ouali M, Penel N, Italiano A, Bay JO, Olivier T, Sunyach MP, Boudou-Roquette P, Salas S, Le Maignan C, Ducassou A, Isambert N, Kalbacher E, Pan C, Saada E, Bertucci F, Thyss A, Thariat J. Effect on survival of local ablative treatment of metastases from sarcomas: a study of the French sarcoma group. Clin Oncol (R Coll Radiol) 2015; 27:48-55. [PMID: 25300878 DOI: 10.1016/j.clon.2014.09.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 07/31/2014] [Accepted: 09/04/2014] [Indexed: 01/08/2023]
Abstract
AIMS Recent data suggest that patients with pulmonary metastases from sarcomas might benefit from ablation of their metastases. Some data are available regarding osteosarcomas/angiosarcomas and lung metastases. The purpose of this study was to assess the efficacy of local ablative treatment on the survival of patients with oligometastases (one to five lesions, any metastatic site, any grade/histology) from sarcomas. MATERIALS AND METHODS A multicentric retrospective study of the French Sarcoma Group was conducted in sarcoma patients with oligometastases who were treated between 2000 and 2012. Survival was analysed using multivariate sensitivity analyses with propensity scores to limit bias. RESULTS Of the 281 patients evaluated, 164 patients received local treatment for oligometastases between 2000 and 2012. The groups' characteristics were similar in terms of tumour size and remission of the primary tumours. The median follow-up was 25.7 months; 129 (45.9%) patients had died at this point. The median overall survivals were 45.3 (95% confidence interval = 34-73) months for the local treatment group and 12.6 for the other group (95% confidence interval = 9.33-22.9). Survival was better among patients who received local treatment (hazard ratio = 0.47; 95% confidence interval = 0.29-0.78; P < 0.001). Subgroup analyses revealed similar findings in the patients with single oligometastases (hazard ratio = 0.48; 95% confidence interval = 0.28-0.82; P = 0.007); a significant benefit was observed for grade 3, and a trend was observed for grade 2. CONCLUSION Local ablative treatment seemed to improve the overall survival of the patients who presented with oligometastatic sarcomas, including soft tissue and bone sarcomas. The survival benefit remained after repeated local treatments for several oligometastatic events. Surgery yielded the most relevant results, but alternative approaches (i.e. radiofrequency ablation and radiotherapy) seemed to be promising. The relevance of these results is strengthened by our analysis, which avoided biases by restricting the population to patients with oligometastatic disease and used propensity scores.
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Affiliation(s)
- A T Falk
- Centre Antoine Lacassagne, Nice, France
| | | | - M Ouali
- Centre Claudius Regaud, Toulouse, France
| | - N Penel
- Centre Oscar Lambret, Lille, France
| | | | - J-O Bay
- Centre Jean Perrin, Clermont Ferrand, France; Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - T Olivier
- Institut régional du cancer de Montpellier, Montpellier, France
| | | | | | - S Salas
- Paris Descartes University, Paris, France
| | | | | | - N Isambert
- Centre Georges-François Leclerc, Dijon, France
| | - E Kalbacher
- Centre Hospitalier Universitaire, Besançon, France
| | - C Pan
- CHU Henri Mondor, Creteil, France
| | - E Saada
- Centre Antoine Lacassagne, Nice, France
| | - F Bertucci
- Institut Paoli-Calmettes, Marseille, France
| | - A Thyss
- Centre Antoine Lacassagne, Nice, France
| | - J Thariat
- Centre Antoine Lacassagne, Nice, France.
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Falk AT, Fenoglietto P, Azria D, Bourgier C. [New external radiotherapy technologies for breast cancer]. Cancer Radiother 2014; 18:480-5. [PMID: 25182528 DOI: 10.1016/j.canrad.2014.06.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 06/24/2014] [Accepted: 06/26/2014] [Indexed: 10/24/2022]
Abstract
The purpose of new radiotherapy techniques is to better deliver dose conformation in the tumour volume while diminishing organs at risk exposition. Their development is soaring in the breast cancer field in the adjuvant setting with intensity-modulated radiation therapy but also in cerebral and extracerebral oligometastastic presentation. Their usage is still being debated for breast cancer care. The objective of this narrative review is to list and discuss clinical data at our disposal for these news technologies.
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Affiliation(s)
- A T Falk
- Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2, France; Université de Nice Sophia-Antipolis, BP 2135, 06103 Nice cedex 2, France
| | - P Fenoglietto
- Département de radiothérapie oncologique, centre régional de lutte contre le cancer, 208, rue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 05, France
| | - D Azria
- Département de radiothérapie oncologique, centre régional de lutte contre le cancer, 208, rue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 05, France; Inserm U896, institut de recherche en cancérologie de Montpellier, 208, rue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 05, France; Université de Montpellier 1, CS 19044, 34967 Montpellier cedex 2, France
| | - C Bourgier
- Département de radiothérapie oncologique, centre régional de lutte contre le cancer, 208, rue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 05, France; Inserm U896, institut de recherche en cancérologie de Montpellier, 208, rue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 05, France; Université de Montpellier 1, CS 19044, 34967 Montpellier cedex 2, France.
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