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Background: Whole breast radiation therapy (WBRT) is the standard of care for early breast cancer after lumpectomy, but it has side effects. For elderly women with good prognostic cancer, intra-operative radiotherapy (IORT) is an alternative. We report our results with IORT. Methods: We performed a retrospective cohort study to observe clinical outcomes after IORT, between 2012 and 2017. Patients had inclusion criteria for RIOP INCA (French national institute of cancer) (group A) or for TARGIT E (group B).Results: Ninety women were included (91 tumors). The mean age was 73.1 years (range, 56.0-87.0 years) and 95.6% of tumors were under 20 mm. After a median follow-up of 27.4 months (range, 3.0-51.0 months), overall survival was 100%, with two local recurrences out of the 84 tumors followed at least 3 months (2.4%).After IORT, 34.1% of patients had adjuvant WBRT; 70.2% of tumors had fibrosis at least once in the followup, 47.6% had cystosteatonecrosis, 25.8% had breast pain grades 1-2, 6% had over grade 2 toxicities, with no grade 4, and 94.0% had good to very good subjective global aspect. Conclusions:IORT is a good alternative to WBRT when ASTRO's guidelines indications are respected, with promising results, but need carry on following up with patients.

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Résumé -Introduction :La radiothérapie est une modalité thérapeutique utilisée de manière systématique dans le traitement des cancers des voies aéro-digestives supérieures. L'ostéoradionécrose (ORN) représente son principal effet secondaire ; elle peut survenir tout au long de la vie du patient et compromettre le pronostic vital. Le but de ce travail est de mettre au point un modèle d'irradiation de la mandibule chez le lapin afin de mieux connaître la pathogénie de l'ORN et de proposer une meilleure prévention et un traitement plus efficace. Matériel et méthodes : Un groupe contrôle de 7 lapins a permis de connaître l'anatomie et l'histologie de la mandibule de lapin. Un premier groupe de 14 lapins a été irradié à raison d'une séance hebdomadaire de 5,5 Gy pendant 5 semaines, soit un équivalent de dose de 46,8 Gy. Ils ont été sacrifiés 1, 4, 12 et 24 semaines après la fin de la radiothérapie. L'analyse statistique n'ayant pas montré de différences significatives avec le groupe contrôle, un second groupe de 3 lapins a été irradié avec une séance hebdomadaire de 8,0, 8,5 et 9,0 Gy pendant 5 semaines. Résultats : Les premiers résultats histologiques ont montré une altération vasculaire, une diminution du nombre de cellules osseuses et des modifications de l'architecture osseuse. Discussion : Le rôle des éponges collagéniques intra-alvéolaires, du PRF®, des ultrasons et des cellules souches sera étudié ultérieurement. Abstract -A model of mandibular irradiation in the rabbit: preliminary results. Introduction: Radiotherapy is widely used in the treatment of head and neck cancers. Its major adverse effect is osteoradionecrosis, which can occur during the whole life of the patient, involving the vital prognosis. The aim of the study was to develop a model for irradiation of the rabbit mandible in order to have a better knowledge of radiotherapy-induced bone alterations and thus a better prevention and treatment of osteoradionecrosis. Material and methods: The control group consisted in 7 rabbits and was used to assess anatomical and histological parameters of the rabbit's mandible. A first group of 14 rabbits was weekly irradiated at doses of 5.5 Gy during 5 weeks, at a total dose of 46.8 Gy. Sacrifices were done at 1 week, 4 weeks, 12 weeks and 24 weeks. As histological analysis did not reveal statistical differences with the control group, a second group (3 rabbits) was weekly irradiated at 8.0, 8.5 and 9 Gy during 5 weeks. Results: The first histological results seem to show vascular alterations, bone cells decrease and alterations of bone architecture. Discussion: The role of intra alveolar collagen sponges, PRF®, ultrasounds and stem cells in bone regeneration after radiotherapy will be further studied.Dans la prise en charge des cancers des voies aéro-digestives supérieures, le recours à la radiothérapie est presque systématique. Les effets secondaires de cette modalité théra-peutique concernent l'ensemble des tissus oro-faciaux. L'ostéoradionécrose (ORN) constitue l'un des effets les plus redoutables. L'ORN es...