OBJECTIVE: The main objective of this study was to assess inter- and intrafraction errors for two patient immobilisation devices in the context of lung stereotactic body radiation therapy: a vacuum cushion and a simple arm support.
METHODS: Twenty patients who were treated with lung stereotactic body radiation therapy in supine position with arms above their head were included in the study. Ten patients were setup in a vacuum cushion (Bluebag™, Elekta) and ten other patients with a simple arm support (Posirest™, Civco). A pretreatment four-dimensional cone-beam computed tomography and a post-treatment three-dimensional cone-beam computed tomography were acquired to compare positioning and immobilisation accuracy. Based on a rigid registration with the planning computed tomography on the spine at the target level, translational and rotational errors were reported.
RESULTS: The median number of fractions per treatment was 5 (range: 3-10). Mean interfraction errors based on 112 four-dimensional cone-beam computed tomographies were similar for both setups with deviations less than or equal to 1.3mm in lateral and vertical direction and 1.2° in roll and yaw. For longitudinal translational errors, mean interfraction errors were 0.7mm with vacuum cushion and -3.9mm with arm support. Based on 111 three-dimensional cone-beam computed tomographies, mean lateral, longitudinal and vertical intrafraction errors were -0.1mm, -0.2mm and 0.0mm respectively (SD: 1.0, 1.2 and 1.0mm respectively) for the patients setup with vacuum cushion, and mean vertical, longitudinal and lateral intrafraction errors were -0.3mm, -0.7mm and 0.1mm respectively (SD: 2.3, 1.8 and 1.4mm respectively) for the patients setup with arm support. Intrafraction errors means were not statistically different between both positions but standard deviations were statistically larger with arm support.
CONCLUSIONS: The results of our study showed similar inter and intrafraction mean deviations between both positioning but a large variability in intrafraction observed with arm support suggested a more accurate immobilization with vacuum cushion.

In recent years, the development of both medical imaging and new systemic agents (targeted therapy and immunotherapy) have revolutionized the field of oncology, leading to a new entity: oligometastatic disease. Adding local treatment of oligometastases to systemic treatment could lead to prolonged survival with no significant impact on quality of life. Given the high prevalence of lung oligometastases and the new systemic agents coming with increased pulmonary toxicity, this article provides a comprehensive review of the current state-of-art for radiotherapy of lung oligometastases. After reviewing pretreatment workup, the authors define several radiotherapy regimen based on the localization and size of the oligometastases. A comment on the synergistic combination of medical treatment and radiotherapy is also made, projecting on future steps in this specific clinical setting.

BACKGROUND: Pediatric cancers are a major public health problem in sub-Saharan Africa. However, they are seldom studied, especially as regards in their extensive forms.
METHODS: An eight-year retrospective and descriptive study was carried out so as to specify the epidemiological and clinical characteristics of cancers with pleural and pulmonary involvement in children of 0 to 14years of age in the pediatric oncology unit at the University Hospital of Treichville, Côte d\'Ivoire (Ivory Coast).
RESULTS: The frequency of pleural and pulmonary involvement in pediatric cancers was 13.8%. Children\'s average age was 7.2years, with sex ratio at 2.11. Solid tumors were predominant, with a predominance of Burkitt\'s lymphoma (39.3%) and nephroblastoma (35.7%). The most affected age groups were 10 to 15years (Burkitt\'s lymphoma) and 0 to 5years (nephroblastoma). Time to diagnosis ranged from 31 and 60days in 40.4% of cases, and time to treatment was at most 30 days, for the overwhelming majority (97.1%) of the children. Chemotherapy was initiated in 67.9% of patients. Hospital mortality was 73.2%.
CONCLUSIONS: Through this study, the authors established the profile of childhood cancers with pleural and pulmonary involvement. Comparative studies of mortality in pediatric cancers with and without pleural and pulmonary involvement could further underline the importance of early management before dissemination.

Unlike the well-documented effects of tobacco smoke on the lung, the effects of cannabis smoke remain controversial, the main bias consisting in co-consumption of tobacco. That said, the composition of joint smoke is close to that of cigarettes, containing many compounds that are carcinogenic and/or alter the respiratory epithelium. Confirmed respiratory effects in chronic cannabis smokers include aggravated chronic bronchitis symptoms, a cumulative effect with tobacco on COPD and emphysema occurrence, an increased risk of bullous emphysema, and pneumothorax with heightened risk of recurrence after pleural symphysis. Recent prospective studies have shown a negative impact on lung function, with not only damage to the airways, but also DLCO alteration and an accelerated drop in FEV1. Finally, cannabis smoking is very common among young patients with lung cancer. Its consumption could lead to a different lung cancer profile, potentially more undifferentiated and less accessible to targeted therapy. Questioning about cannabis consumption must be systematic and targeted medical care should be offered.

OBJECTIVE: Although three-dimensional conformal radiotherapy (3D-CRT) remains the gold standard as a curative treatment for NSCLC when surgery is not possible, intensity modulated radiotherapy (IMRT) is increasingly used routinely. The purpose of this study was to assess the clinical (immediate toxicities) and dosimetric impact of IMRT compared to 3D-CRT in the treatment of locally advanced (stages IIIA to IIIC) non-small cell lung cancer (NSCLC) treated with concomitant radiochemotherapy, while IMRT in lung cancer was implemented in the radiotherapy department of the Jean-Perrin Center.
METHODS: Between March 2015 and October 2019, 64 patients treated with concomitant radiochemotherapy were retrospectively included. Thirty-two received 3D-CRT and 32 IMRT. The radiotherapy prescription was 66Gy in 33 fractions of 2Gy.
RESULTS: IMRT has improved coverage of target volumes (V95 increased by 14.81% in IMRT; P<0.001) without increasing doses to OARs and reducing dysphagia (RR=0.67; P=0.027). Low doses to the lung were not significantly increased in IMRT (pulmonary V5 increased by 7.46% in IMRT).
CONCLUSIONS: Intensity modulated radiotherapy, compared with the standard RC3D technique, improve the coverage of target volumes without increasing the dose to the OARs. It also improves the immediate tolerance of the treatment by reducing the number of dysphagia.

BACKGROUND: Asthma is a common disease whose diagnosis does not typically rely on the results of imaging. However, chest CT has gained a key place over the last decade to support the management of patients with difficult to treat and severe asthma.
BACKGROUND: Bronchial wall thickening and mild dilatation or narrowing of bronchial lumen are frequently observed on chest CT in people with asthma. Bronchial wall thickening is correlated to the degree of obstruction and to bronchial wall remodeling and inflammation. Diverse conditions which can mimic asthma should be recognized on CT, including endobronchial tumours, interstitial pneumonias, bronchiectasis and bronchiolitis. Ground-glass opacities and consolidation may be related to transient eosinophilic infiltrates, infection or an associated disease (vasculitis, chronic eosinophilic pneumonia). Hyperdense mucous plugging is highly specific for allergic bronchopulmonary aspergillosis.
CONCLUSIONS: Airway morphometry, air trapping and quantitative analysis of ventilatory defects, with CT or MRI, can help to identify different morphological subgroups of patients with different functional or inflammatory characteristics. These imaging tools could emerge as new biomarkers for the evaluation of treatment response.
CONCLUSIONS: Chest CT is indicated in people with severe asthma to search for additional or alternative diagnoses. Quantitative imaging may contribute to phenotyping this patient group.

BACKGROUND: Indications for pulmonary excision are dominated by infectious pulmonary pathologies in developing countries. We conducted this study to describe the indications and results of pulmonary resections in the thoracic surgery department of the Mali hospital.
METHODS: This is a retrospective and descriptive study from January 2012 to December 2019, carried out in the thoracic surgery department of the Mali hospital. It involved 76 patients who had a pulmonary resection. The variables studied were the epidemiological data, the operating indications, the therapeutic data and the prognosis.
RESULTS: The mean age of the patients was 35.5 years. The sex ratio was 1.7. The average consultation time in thoracic surgery was 11.6 months with extremes of 7 days and 96 months. A history of pulmonary tuberculosis was noted in 46.1% of patients. The main indications for pulmonary resection were infectious parenchymal destruction in 64.5%, bullous dystrophy in 14.5%, bronchopulmonary cancer in 11.8% and thoracic trauma in 4% of the cases. The procedures performed were: a lobectomy (39.5%), atypical resection (36.8%), culminectomy (7.9%) and pneumonectomy (15.8%). Morbidity was dominated by thoracic empyema (9.2%) postoperative hemorrhage (5.2%), parietal suppuration (7.8%) and bronchopleural fistula (1.3%). The average length of hospital stay was 14.3 days. Mortality was 10.5%. There was a statistically significant correlation between pneumonectomy and deaths (P=0.01).
CONCLUSIONS: Infectious lung destruction is the main indication for pulmonary resection in Mali. The consultation period is quite long. Morbidity and mortality remains high.

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BACKGROUND: This paper reviews the technique used for thoracic -ultrasonography of the bovine lower respiratory tract and the ultrasonographic findings in calves with -bronchopneumonia. Studies that compare the results of auscultation with those of ultrasonography and postmortem examination are included as are studies that examine the relationship between ultrasonographic findings and bacterial lung infection and prognosis. Lesions associated with bronchopneumonia, pleuropneumonia, pneumothorax and lung abscesses are -easily imaged ultrasonographically and characterised in calves.
BACKGROUND: Die vorliegende Arbeit gibt einen Überblick über die sonographische Untersuchung der Lunge des Kalbes sowie die bei verschiedenen Erkrankungen des unteren Atemapparats bei Kälbern sonographisch möglichen Befunde. Im Weiteren werden die Untersuchungen, welche die Auskultations- und Ultraschallbefunde sowie die Ultraschall- und die pathologisch-anatomischen Befunde miteinander vergleichen, dargestellt. Schliesslich werden die Arbeiten besprochen, welche die Be­ziehungen zwischen Infektionen und den Ultraschallbefunden sowie die Beziehungen zwischen den Ultraschallbefunden und der Prognose untersuchen. Zusammenfassend erlaubt die Ultraschalluntersuchung der Lunge, die bei Kälbern mit Bronchopneumonie, Pleuropneumonie, Pneumothorax und Lungenabszessen vorhandenen Befunde zu erfassen und zu beschreiben sowie Hinweise auf die Prognose und die pathologisch-anatomischen Befunde zu geben.
BACKGROUND: Cet article passe en revue la technique utilisée pour l’échographie des voies respiratoires inférieures des bovins et les résultats de l’échographie chez les veaux atteints de bronchopneumonie. Les études qui comparent les résultats de l’auscultation à ceux de l’échographie et de l’examen post mortem sont incluses, tout comme les études qui étudient la relation entre les résultats de l’échographie et l’infection pulmonaire bactérienne ainsi que le pronostic. Les lésions associées à la bronchopneumonie, à la pleuropneumonie, au pneumothorax et aux abcès pulmonaires sont facilement imagées par échographie et caractérisées chez les veaux.
BACKGROUND: Il presente studio fornisce una panoramica dell’esame ecografico dei polmoni del vitello e dei risultati ecografici possibili nel caso di varie malattie dell’apparato respiratorio inferiore. Inoltre, vengono esposte le ricerche che mettono a confronto i risultati dell’auscultazione e degli ultrasuoni, nonché gli ultrasuoni e i risultati patologico-anatomici. Infine, vengono discussi gli studi che esplorano la relazione tra infezioni e risultati degli ultrasuoni e la relazione tra risultati degli ultrasuoni e prognosi. In sintesi, l’esame ecografico dei polmoni permette di individuare e descrivere i reperti riscontrati nei vitelli affetti da broncopolmonite, pleuropolmonite, pneumotorace e ascessi polmonari, oltre a fornire informazioni sulla prognosi e sui reperti patologico-anatomici.

The management of metastatic lung cancers, either of the small-cell (SCLC) or the non-small cell (NSCLC) subtype, largely based on systemic treatments so far, has been the subject of breakthrough advances over the past few years, with notably the wide use of immunotherapy changing the landscape of these harmful prognosis diseases. In parallel with this major progress, the increasing use of radiotherapy (RT) for the treatment of the primary thoracic lesion±the distant lesions, may contribute to improving the condition of these metastatic patients, both in terms of progression-free survival (PFS) and overall survival (OS). This review proposes to summarize and explain the findings provided by the different studies published in the last years experiencing RT of the primary tumor in metastatic lung cancers, either associated or not with the local ablative treatment of a low number of distant lesions. It will also expose the respective limits encountered in these studies and, in the light of all these elements, suggests various promising issues and fields of research for the future.