Editorial

Radiotherapy for Benign Disease: Current Evidence, Benefits and Risks

Deux enquêtes précédentes ont été réalisées en 1995 et 1999 pour évaluer l’utilisation de la radiothérapie dans le traitement d’affections bénignes non-tumorales. En 2016, le même questionnaire a été utilisé et envoyé aux 24 centres du pays : 22 centres ont répondu. Une diminution très importante du nombre de patients a été observée : 360 patients pour l’année 2016 contre 954 en 1999 et 1113 en 1995. Les indications les plus fréquentes restent la prévention des chéloïdes, des formations osseuses hétérotopiques et de la gynécomastie. Une nouvelle indication est apparue : les névralgies du trijumeau traitées par radiochirurgie. La prévention des sténoses coronariennes et le traitement de la dégénérescence maculaire, indications fréquentes dans les enquêtes antérieures, ne sont plus retenus. Un grand consensus est observé concernant les indications potentielles mais aussi dans la non utilisation de la radiothérapie pour les maladies inflammatoires.

Two prior surveys were carried out in 1995 and 1999 to evaluate the use of radiotherapy in the treatment of non-malignant disease. In 2016, the same questionnaire was used and sent to the 24 centers of the country: 22 responded. A major decrease was observed in the number of patients treated: 360 in 2016 in contrast to 954 in 1999 and 1113 in 1995. The most frequent indications remain the prevention of heterotopic bone formation, keloids or gynecomastia. A new indication was observed: trigeminal nevralgia treated with radiosurgery. Two frequent indications in the past disappeared: the prevention of coronary restenosis and the macular degeneration. A great agreement was observed regarding the possible indications for radiotherapy but also to avoid it for inflammatory pathologies.

To evaluate feasibility of left gastric artery (LGA) yttrium-90 (⁹⁰Y) radioembolization as potential treatment for obesity in a porcine model.

This study included 8 young female pigs (12–13 weeks, 21.8–28.1 kg). Six animals received infusions of ⁹⁰Y resin microspheres (46.3–105.1 MBq) into the main LGA and the gastric artery arising from the splenic artery. Animal weight and serum ghrelin were measured before treatment and weekly thereafter. Animals were euthanized 69–74 days after treatment, and histologic analyses of mucosal integrity and ghrelin immunoreactive cell density were performed.

Superficial mucosal ulcerations < 3.0 cm² were noted in 5 of 6 treated animals. Ghrelin immunoreactive cell density was significantly lower in treated versus untreated animals in the stomach fundus (13.5 vs 34.8, P < .05) and stomach body (11.2 vs 19.8, P < .05). Treated animals gained less weight than untreated animals over the study duration (40.2 kg ± 5.4 vs 54.7 kg ± 6.5, P = .053). Average fundic parietal area (165 cm² vs 282 cm², P = .067) and average stomach weight (297.2 g vs 397.0 g, P = .067) were decreased in treated versus untreated animals. Trichrome staining revealed significantly more fibrosis in treatment animals compared with control animals (13.0 vs 8.6, P < .05). No significant differences were identified in plasma ghrelin concentrations (P = .24).

LGA ⁹⁰Y radioembolization is promising as a potential treatment for obesity. A larger preclinical study is needed to evaluate the safety and efficacy of this procedure further.