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Basse C, Khalifa J, Thillays F, Le Pechoux C, Maury JM, Bonte PE, Coutte A, Pourel N, Bourbonne V, Pradier O, Belliere A, Le Tinier F, Deberne M, Tanguy R, Denis F, Padovani L, Zaccariotto A, Molina T, Chalabreysse L, Brioude G, Delatour B, Faivre JC, Cao K, Giraud P, Riet FG, Thureau S, Antoni D, Massabeau C, Keller A, Bonnet E, Lerouge D, Martin E, Girard N, Botticella A. Recommendations for Post-Operative Radiotherapy after complete resection of Thymoma - a French DELPHI consensus initiative. J Thorac Oncol 2024:S1556-0864(24)00161-8. [PMID: 38608932 DOI: 10.1016/j.jtho.2024.04.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Thymomas are rare intrathoracic malignancies that can relapse after surgery. Whether or not Post-Operative Radiotherapy (PORT) should be delivered after surgery remains a major issue. RADIORYTHMIC is an ongoing, multicenter, randomized phase 3 trial addressing this question in patients with completely R0 resected Masaoka-Koga stage IIb/III thymoma. Experts in the field met to develop recommendations for PORT. METHODS A scientific committee from the RYTHMIC network identified key issues regarding the modalities of PORT in completely resected thymoma. A DELPHI-method was used to question 24 national experts, with 115 questions regarding: 1/ Imaging techniques, 2/ Clinical Target Volume (CTV) and margins, 3/ Dose constraints to Organs At Risk, 4/ Dose and fractionation, 5/ Follow-up and records. Consensus was defined when opinions reached ≥ 80% agreement. RESULTS We established the following recommendations: pre-operative contrast-enhanced CT-scan is recommended (94% agreement); optimization of radiation delivery includes either a 4D-CT based planning (82% agreement), a breath-holding inspiration breath-hold-based planning, or daily control CT-imaging (81% agreement); imaging fusion based on cardiovascular structures of pre-operative and planning CT-scan is recommended (82% agreement); right coronary and left anterior descending coronary arteries should be delineated as cardiac substructures (88% agreement); rotational RCMI/VMAT is recommended (88% agreement); total dose is 50Gy (81% agreement) with 1.8-2Gy per fraction (94% agreement); cardiac evaluation, and follow-up for patients with history of cardiovascular disease is recommended (88% agreement) with EKG and evaluation of LVEF at 5 years and 10 years. CONCLUSION This is the first consensus for PORT in thymoma. Implementation will help to harmonize practices.
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Affiliation(s)
- Clémence Basse
- Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; Paris Saclay Campus, Versailles Saint Quentin University, Versailles, France
| | - Jonathan Khalifa
- Department of Radiotherapy, Institut Claudius Rigaud, Institut Universitaire du Cancer de Toulouse Oncopole, France
| | - François Thillays
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest Centre René Gauducheau, Nantes, France
| | - Cécile Le Pechoux
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Jean-Michel Maury
- Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; IVPC UMR754 INRA, Univ Lyon, Université Claude Bernard Lyon 1, EPHE, Lyon, France
| | | | | | - Nicolas Pourel
- Radiation department, Institut Sainte Catherine, Avignon, France
| | - Vincent Bourbonne
- Department of Radiotherapy, University Hospital of Brest, Brest, France
| | - Olivier Pradier
- Department of Radiotherapy, University Hospital of Brest, Brest, France
| | - Aurélie Belliere
- Department of Radiotherapy, Centre Jean Perrin, Clermont-Ferrand, France
| | | | - Mélanie Deberne
- Department of Radiotherapy, Hospices Civils Lyonnais, Lyon, France
| | - Ronan Tanguy
- Department of Radiotherapy, Hospices Civils Lyonnais, Lyon, France
| | - Fabrice Denis
- Department of Radiotherapy, Centre de Cancérologie de la Sarthe, ELSAN, Le Mans, France
| | - Laetitia Padovani
- Department of Radiotherapy, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Audrey Zaccariotto
- Department of Radiotherapy, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Thierry Molina
- Pathology Department, Necker Enfants Malades Hospital, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Lara Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron Cedex Lyon, France
| | - Geoffrey Brioude
- Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantations, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Bertrand Delatour
- Department of Thoracic and Cardiovascular Surgery, Rennes University Hospital Center, 2 rue Henri le Guilloux, 35000 Rennes, France
| | | | - Kim Cao
- Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France
| | - Philippe Giraud
- Paris City University, Department of Radiation Oncology, Hopital Européen Georges Pompidou, Paris, France
| | | | | | - Delphine Antoni
- Department of Radiotherapy, ICANS, Institut de Cancérologie de Strasbourg, France
| | - Carole Massabeau
- Department of Radiotherapy, Institut Claudius Rigaud, Toulouse, France
| | - Audrey Keller
- Department of Radiotherapy, Institut Claudius Rigaud, Toulouse, France
| | | | | | - Etienne Martin
- Department of Radiotherapy, Centre Georges-François-Leclerc, Dijon, France
| | - Nicolas Girard
- Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; Paris Saclay Campus, Versailles Saint Quentin University, Versailles, France.
| | - Angela Botticella
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
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Guillemin F, Blanchard P, Boisselier P, Brahimi Y, Calugaru V, Coutte A, Gillon P, Graff P, Liem X, Modesto A, Pointreau Y, Racadot S, Sun XS, Bellini R, Pham Dang N, Saroul N, Bourhis J, Thariat J, Biau J, Lapeyre M. [Proposal for the delineation of postoperative primary clinical target volumes in maxillary sinus and nasal cavity cancers]. Cancer Radiother 2024; 28:218-227. [PMID: 38599940 DOI: 10.1016/j.canrad.2023.12.001] [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: 11/20/2023] [Accepted: 12/31/2023] [Indexed: 04/12/2024]
Abstract
In this article, we propose a consensus delineation of postoperative clinical target volumes for the primary tumour in maxillary sinus and nasal cavity cancers. These guidelines are developed based on radioanatomy and the natural history of those cancers. They require the fusion of the planning CT with preoperative imaging for accurate positioning of the initial GTV and the combined use of the geometric and anatomical concepts for the delineation of clinical target volume for the primary tumour. This article does not discuss the indications of external radiotherapy (nor concurrent systemic treatment) but focuses on target volumes when there is an indication for radiotherapy.
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Affiliation(s)
- F Guillemin
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - P Blanchard
- Département de radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - P Boisselier
- Département de radiothérapie, Institut régional cancer de Montpellier, parc Euromedecine, 208, rue des Apothicaires, 34090 Montpellier, France
| | - Y Brahimi
- Département de radiothérapie, institut de cancérologie Strasbourg Europe (ICANS), 13, rue Albert-Calmette, 67200 Strasbourg, France
| | - V Calugaru
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - A Coutte
- Département de radiothérapie, CHU d'Amiens-Picardie, 30, avenue de la Croix-Jourdain, 80054 Amiens cedex 1, France
| | - P Gillon
- Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
| | - P Graff
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - X Liem
- Pôle de radiothérapie curiethérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59020 Lille cedex, France
| | - A Modesto
- Département de radiothérapie, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Y Pointreau
- Département de radiothérapie, institut interrégional de cancérologie (ILC), centre Jean-Bernard, centre de cancérologie de la Sarthe (CCS), 64, rue de Degré, 72000 Le Mans, France
| | - S Racadot
- Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - X S Sun
- Département de radiothérapie, hôpital Nord Franche-Comté de Montbéliard, CHRU de Besançon, 1, rue Henri-Becquerel, 25200 Montbéliard, France
| | - R Bellini
- Département de radiodiagnostic, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - N Pham Dang
- Département de chirurgie maxillofaciale, centre hospitalier universitaire Estaing, 63003 Clermont-Ferrand cedex 1, France
| | - N Saroul
- Département de chirurgie ORL, centre hospitalier universitaire Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France
| | - J Bourhis
- Département de radiothérapie, centre hospitalier universitaire vaudois (CHUV), rue du Bugnon 46, 1005 Lausanne, Suisse
| | - J Thariat
- Département de radiothérapie, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - J Biau
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - M Lapeyre
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France.
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Dworczak M, Bielinyte G, Coutte A, Mirabel X, Lartigau É, Lemoine P, Rivera S, Pasquier D. [Five-fraction radiotherapy for breast cancer]. Cancer Radiother 2023; 27:531-534. [PMID: 37537026 DOI: 10.1016/j.canrad.2023.07.004] [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: 06/14/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 08/05/2023]
Abstract
Extreme hypofractionation in adjuvant breast radiotherapy currently generates a lot of interest. We propose here a synthesis of hypofractionation trials and present the DESTHE COL and DESTHE GR projects, encouraged by the French National Cancer Institute (INCa), which experiment care pathways in order to deploy effective strategies to de-escalate the therapeutics and to reduce sequelae after cancer treatment.
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Affiliation(s)
- M Dworczak
- Département de radiothérapie, centre Oscar-Lambret, Lille, France.
| | - G Bielinyte
- Département de radiothérapie, institut Gustave-Roussy, Villejuif, France
| | - A Coutte
- Département de radiothérapie, centre hospitalier universitaire d'Amiens Picardie, Amiens, France
| | - X Mirabel
- Département de radiothérapie, centre Oscar-Lambret, Lille, France
| | - É Lartigau
- Département de radiothérapie, centre Oscar-Lambret, Lille, France; Cristal UMR 9189, université de Lille, école Centrale de Lille, CNRS, Lille, France
| | - P Lemoine
- Département de radiothérapie, centre Oscar-Lambret, Lille, France
| | - S Rivera
- Département de radiothérapie, institut Gustave-Roussy, Villejuif, France; Laboratoire de radiothérapie moléculaire et d'innovation thérapeutique, université Paris-Saclay, U1030, Inserm, Villejuif, France
| | - D Pasquier
- Département de radiothérapie, centre Oscar-Lambret, Lille, France; Cristal UMR 9189, université de Lille, école Centrale de Lille, CNRS, Lille, France
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Martz N, Salleron J, Dhermain F, Vogin G, Daisne JF, Mouttet-Audouard R, Tanguy R, Noel G, Peyre M, Lecouillard I, Jacob J, Attal J, Charissoux M, Veresezan O, Hanzen C, Huchet A, Latorzeff I, Coutte A, Doyen J, Stefan D, Feuvret L, Garcia GCTE, Royer P. Target volume delineation for radiotherapy of meningiomas: an ANOCEF consensus guideline. Radiat Oncol 2023; 18:113. [PMID: 37408055 DOI: 10.1186/s13014-023-02300-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/18/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE Radiotherapy is, with surgery, one of the main therapeutic treatment strategies for meningiomas. No prospective study has defined a consensus for the delineation of target volumes for meningioma radiotherapy. Therefore, target volume definition is mainly based on information from retrospective studies that include heterogeneous patient populations. The aim is to describe delineation guidelines for meningioma radiotherapy as an adjuvant or definitive treatment with intensity-modulated radiation therapy and stereotactic radiation therapy techniques. This guideline is based on a consensus endorsed by a multidisciplinary group of brain tumor experts, members of the Association of French-speaking Neuro-oncologists (ANOCEF). MATERIALS AND METHODS A 3-step procedure was used. First, the steering group carried out a comprehensive review to identify divergent issues on meningiomas target volume delineation. Second, an 84-item web-questionnaire has been developed to precisely define meningioma target volume delineation in the most common clinical situations. Third, experts members of the ANOCEF were requested to answer. The first two rounds were completed online. A third round was carried out by videoconference to allow experts to debate and discuss the remaining uncertain questions. All questions remained in a consensus. RESULTS Limits of the target volume were defined using visible landmarks on computed tomography and magnetic resonance imaging, considering the pathways of tumor extension. The purpose was to develop clear and precise recommendations on meningiomas target volumes. CONCLUSION New recommendations for meningiomas delineation based on simple anatomic boundaries are proposed by the ANOCEF. Improvement in uniformity in target volume definition is expected.
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Affiliation(s)
- Nicolas Martz
- Academic Department of Radiation Therapy & Brachytherapy, Institut de Cancérologie de Lorraine - Alexis-Vautrin Cancer Center, 6 avenue de Bourgogne - CS 30 519, Vandoeuvre Les Nancy, France.
| | - Julia Salleron
- Cellule Data-biostatistiques, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandœuvre-lés-Nancy, France
| | - Frédéric Dhermain
- Department of Radiation Oncology, Gustave Roussy University Hospital, Villejuif, France
| | - Guillaume Vogin
- Academic Department of Radiation Therapy & Brachytherapy, Institut de Cancérologie de Lorraine - Alexis-Vautrin Cancer Center, 6 avenue de Bourgogne - CS 30 519, Vandoeuvre Les Nancy, France
- Department of Radiation Therapy, Baclesse Radiation Therapy Centre, Esch/Alzette, Luxembourg
| | - Jean-François Daisne
- Department of Radiation Oncology, University Hospitals Leuven, Catholic University of Leuven (KU Leuven), Leuven, Belgium
| | | | - Ronan Tanguy
- Department of Radiotherapy, Léon Bérard Cancer Centre, Lyon, France
| | - Georges Noel
- Radiation Oncology Department, Paul Strauss Cancer Centre, Strasbourg, France
| | - Matthieu Peyre
- Department of Neurosurgery, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | | | - Julian Jacob
- Department of Radiation Oncology, Hôpital Pitié-Salpêtrière Charles Foix, APHP, Paris, France
| | - Justine Attal
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Marie Charissoux
- Radiation Oncology Department, Centre Val d'Aurelle, Montpellier, France
| | - Ovidiu Veresezan
- Department of Radiation Oncology, Cancer Centre Henri Becquerel, Rouen, France
| | - Chantal Hanzen
- Department of Radiation Oncology, Centre Hospitalier et Universitaire, Bordeaux, France
| | - Aymeri Huchet
- Department of Radiation Oncology, Centre Hospitalier et Universitaire, Bordeaux, France
| | - Igor Latorzeff
- Department of Radiotherapy, Groupe ONCORAD Garonne and Clinique Pasteur, Toulouse, France
| | | | - Jérôme Doyen
- Department of Radiation Therapy, Antoine Lacassagne Cancer Center, University of Nice- Sophia, Nice, France
| | - Dinu Stefan
- Department of Radiation Oncology, François Baclesse Cancer Centre, Caen, France
| | - Loic Feuvret
- Department of Radiation Oncology, Hôpital Pitié-Salpêtrière Charles Foix, APHP, Paris, France
| | | | - Philippe Royer
- Academic Department of Radiation Therapy & Brachytherapy, Institut de Cancérologie de Lorraine - Alexis-Vautrin Cancer Center, 6 avenue de Bourgogne - CS 30 519, Vandoeuvre Les Nancy, France
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Thomas-Joulié A, Houillier C, Antoni D, Créhange G, Jouglar E, Colin P, Benchalal M, Lang P, Alfonsi M, Hamidou H, Coutte A, Ahrweiller F, Dadoun N, Pointreau Y, Ammarguellat H, Bernier-Chastagner V, Belkacemi Y, Vieillot S, Hoang-Xuan K, Soussain C, Jacob J, Feuvret L. Brain radiotherapy in patients treated for a newly diagnosed primary central nervous system lymphoma: professional practice evaluation in 19 French centers. Acta Oncol 2023; 62:648-656. [PMID: 37338525 DOI: 10.1080/0284186x.2023.2225146] [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: 01/12/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION The objective of this study was a multicentric evaluation of professional practices, analyzing the irradiation technique itself and its impact on survival and recurrence sites, in primary central nervous system lymphomas (PCNSLs). METHODS We retrospectively analyzed the technical and clinical records of 79 PCNSL patients included in the database of the national expert network for oculocerebral lymphoma ('LOC') who were treated with brain radiotherapy as first-line treatment for newly diagnosed primary central nervous system lymphoma between 2011 and 2018. RESULTS The number of patients treated with brain radiotherapy gradually decreased over time. The heterogeneity of radiotherapy prescriptions was significant, and 55% of them did not comply with published recommendations in terms of irradiation dose and/or volume. The proportion of complete responders to induction chemotherapy treated with reduced-dose radiotherapy increased over time. Partial brain radiotherapy was associated with significantly lower overall survival in univariate analysis. In partial responders to induction chemotherapy, increasing the total dose to the brain >30 Gy and adding a boost to the WBRT induced a trend toward improved progression-free and overall survival. Five recurrences (13%) occurred exclusively in the eyes, all in patients whose eyes had been excluded from the irradiation target volume and including 2 patients without ocular involvement at diagnosis. CONCLUSION The visibility of recommendations for prescribing brain radiotherapy for the treatment of newly diagnosed primary central nervous system lymphoma needs to be improved to harmonize practices and improve their quality. We propose an update of the recommendations.
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Affiliation(s)
- Alice Thomas-Joulié
- Department of Radiation Oncology, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
- Department of Radiation Oncology, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France
| | - Caroline Houillier
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Paris, France
| | - Delphine Antoni
- Department of Radiation Oncology, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Gilles Créhange
- Department of Radiation Oncology, Institut Curie, PSL Research University, Paris, France
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest, Nantes-Saint-Herblain, France
| | - Emmanuel Jouglar
- Department of Radiation Oncology, Institut Curie, PSL Research University, Paris, France
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest, Nantes-Saint-Herblain, France
| | - Philippe Colin
- Department of Radiation Oncology, Institut du Cancer Courlancy, Rouen, France
| | - Mohamed Benchalal
- Department of Radiation Oncology, Centre Eugène Marquis, Rennes, Bretagne, France
| | - Philippe Lang
- Federation Universitaire d'oncologie radiothérapie d'Occitanie, ICG CHU Caremeau, Nîmes, France
| | | | - Hadji Hamidou
- Department of Radiation Oncology, ICO Cancer Center, Centre Paul Papin, Angers, France
| | - Alexandre Coutte
- Department of Radiation Oncology, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Flora Ahrweiller
- Institut de cancérologie et radiothérapie bretillien, Saint Malo, France
| | - Nathalie Dadoun
- Department of Radiation Oncology, Centre de la Baie, Avranches, France
| | - Yohan Pointreau
- Department of Radiation Oncology, Centre Jean Bernard, Le Mans, France
| | - Hanifa Ammarguellat
- Department of Radiation Oncology, Centre Hospitalier Simone Veil, Beauvais, France
| | | | - Yazid Belkacemi
- Department of Radiation Oncology, Hôpital Universitaire Henri Mondor, Créteil, France
| | - Sabine Vieillot
- Department of Radiation Oncology, Centre Catalan d'Oncologie, Perpignan, France
| | - Khê Hoang-Xuan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Paris, France
| | - Carole Soussain
- Department of Hematology, Institut Curie site de Saint-Cloud, Paris, France
- INSERM U932 Institut Curie, PSL Research University, Paris, France
| | - Julian Jacob
- Department of Radiation Oncology, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France
| | - Loïc Feuvret
- Department of Radiation Oncology, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France
- Department of Radiation Oncology, Centre Hospitalier Universitaire Lyon Sud, Lyon, France
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Harrington KJ, Ferris RL, Gillison M, Tahara M, Argiris A, Fayette J, Schenker M, Bratland Å, Walker JWT, Grell P, Even C, Chung CH, Redman R, Coutte A, Salas S, Grant C, de Azevedo S, Soulières D, Hansen AR, Wei L, Khan TA, Miller-Moslin K, Roberts M, Haddad R. Efficacy and Safety of Nivolumab Plus Ipilimumab vs Nivolumab Alone for Treatment of Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck: The Phase 2 CheckMate 714 Randomized Clinical Trial. JAMA Oncol 2023; 9:779-789. [PMID: 37022706 PMCID: PMC10080406 DOI: 10.1001/jamaoncol.2023.0147] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/10/2022] [Indexed: 04/07/2023]
Abstract
Importance There remains an unmet need to improve clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Objective To evaluate clinical benefit of first-line nivolumab plus ipilimumab vs nivolumab alone in patients with R/M SCCHN. Design, Setting, and Participants The CheckMate 714, double-blind, phase 2 randomized clinical trial was conducted at 83 sites in 21 countries between October 20, 2016, and January 23, 2019. Eligible participants were aged 18 years or older and had platinum-refractory or platinum-eligible R/M SCCHN and no prior systemic therapy for R/M disease. Data were analyzed from October 20, 2016 (first patient, first visit), to March 8, 2019 (primary database lock), and April 6, 2020 (overall survival database lock). Interventions Patients were randomized 2:1 to receive nivolumab (3 mg/kg intravenously [IV] every 2 weeks) plus ipilimumab (1 mg/kg IV every 6 weeks) or nivolumab (3 mg/kg IV every 2 weeks) plus placebo for up to 2 years or until disease progression, unacceptable toxic effects, or consent withdrawal. Main Outcomes and Measures The primary end points were objective response rate (ORR) and duration of response between treatment arms by blinded independent central review in the population with platinum-refractory R/M SCCHN. Exploratory end points included safety. Results Of 425 included patients, 241 (56.7%; median age, 59 [range, 24-82] years; 194 males [80.5%]) had platinum-refractory disease (nivolumab plus ipilimumab, n = 159; nivolumab, n = 82) and 184 (43.3%; median age, 62 [range, 33-88] years; 152 males [82.6%]) had platinum-eligible disease (nivolumab plus ipilimumab, n = 123; nivolumab, n = 61). At primary database lock, the ORR in the population with platinum-refractory disease was 13.2% (95% CI, 8.4%-19.5%) with nivolumab plus ipilimumab vs 18.3% (95% CI, 10.6%-28.4%) with nivolumab (odds ratio [OR], 0.68; 95.5% CI, 0.33-1.43; P = .29). Median duration of response for nivolumab plus ipilimumab was not reached (NR) (95% CI, 11.0 months to NR) vs 11.1 months (95% CI, 4.1 months to NR) for nivolumab. In the population with platinum-eligible disease, the ORR was 20.3% (95% CI, 13.6%-28.5%) with nivolumab plus ipilimumab vs 29.5% (95% CI, 18.5%-42.6%) with nivolumab. The rates of grade 3 or 4 treatment-related adverse events with nivolumab plus ipilimumab vs nivolumab were 15.8% (25 of 158) vs 14.6% (12 of 82) in the population with platinum-refractory disease and 24.6% (30 of 122) vs 13.1% (8 of 61) in the population with platinum-eligible disease. Conclusions and Relevance The CheckMate 714 randomized clinical trial did not meet its primary end point of ORR benefit with first-line nivolumab plus ipilimumab vs nivolumab alone in platinum-refractory R/M SCCHN. Nivolumab plus ipilimumab was associated with an acceptable safety profile. Research to identify patient subpopulations in R/M SCCHN that would benefit from nivolumab plus ipilimumab over nivolumab monotherapy is warranted. Trial Registration ClinicalTrials.gov Identifier: NCT02823574.
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Affiliation(s)
- Kevin J. Harrington
- Royal Marsden Hospital/The Institute of Cancer Research National Institute for Health and Care Research Biomedical Research Centre, London, United Kingdom
| | | | - Maura Gillison
- The University of Texas MD Anderson Cancer Center, Houston
| | | | - Athanasios Argiris
- Hygeia Hospital, Marousi, Greece
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jérôme Fayette
- Centre Léon Bérard, Lyon, France
- Hôpital Saint-André, Bordeaux, France
| | | | | | | | - Peter Grell
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | | | | | - Rebecca Redman
- University of Louisville, Brown Cancer Center, Louisville, Kentucky
| | | | - Sébastien Salas
- Assistance Publique–Hôpitaux de Marseille, Marseille, France
| | | | | | | | - Aaron R. Hansen
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Li Wei
- Bristol Myers Squibb, Princeton, New Jersey
| | | | | | | | - Robert Haddad
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Delaby N, Barateau A, Chiavassa S, Biston MC, Chartier P, Graulières E, Guinement L, Huger S, Lacornerie T, Millardet-Martin C, Sottiaux A, Caron J, Gensanne D, Pointreau Y, Coutte A, Biau J, Serre AA, Castelli J, Tomsej M, Garcia R, Khamphan C, Badey A. Practical and technical key challenges in head and neck adaptive radiotherapy: The GORTEC point of view. Phys Med 2023; 109:102568. [PMID: 37015168 DOI: 10.1016/j.ejmp.2023.102568] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/15/2023] [Accepted: 03/18/2023] [Indexed: 04/05/2023] Open
Abstract
Anatomical variations occur during head and neck (H&N) radiotherapy (RT) treatment. These variations may result in underdosage to the target volume or overdosage to the organ at risk. Replanning during the treatment course can be triggered to overcome this issue. Due to technological, methodological and clinical evolutions, tools for adaptive RT (ART) are becoming increasingly sophisticated. The aim of this paper is to give an overview of the key steps of an H&N ART workflow and tools from the point of view of a group of French-speaking medical physicists and physicians (from GORTEC). Focuses are made on image registration, segmentation, estimation of the delivered dose of the day, workflow and quality assurance for an implementation of H&N offline and online ART. Practical recommendations are given to assist physicians and medical physicists in a clinical workflow.
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8
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Tao Y, Sun XS, Pointreau Y, Le Tourneau C, Sire C, Kaminsky MC, Coutte A, Alfonsi M, Calderon B, Boisselier P, Martin L, Miroir J, Ramee JF, Delord JP, Clatot F, Rolland F, Villa J, Magne N, Elicin O, Gherga E, Nguyen F, Lafond C, Bera G, Calugaru V, Geoffrois L, Chauffert B, Damstrup L, Crompton P, Ennaji A, Gollmer K, Nauwelaerts H, Bourhis J. Extended follow-up of a phase 2 trial of xevinapant plus chemoradiotherapy in high-risk locally advanced squamous cell carcinoma of the head and neck: a randomised clinical trial. Eur J Cancer 2023; 183:24-37. [PMID: 36796234 DOI: 10.1016/j.ejca.2022.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 10/10/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION We report long-term efficacy and overall survival (OS) results from a randomised, double-blind, phase 2 study (NCT02022098) investigating xevinapant plus standard-of-care chemoradiotherapy (CRT) vs. placebo plus CRT in 96 patients with unresected locally advanced squamous cell carcinoma of the head and neck (LA SCCHN). METHODS Patients were randomised 1:1 to xevinapant 200 mg/day (days 1-14 of a 21-day cycle for 3 cycles), or matched placebo, plus CRT (cisplatin 100 mg/m2 every 3 weeks for 3 cycles plus conventional fractionated high-dose intensity-modulated radiotherapy [70 Gy/35 F, 2 Gy/F, 5 days/week for 7 weeks]). Locoregional control, progression-free survival, and duration of response after 3 years, long-term safety, and 5-year OS were assessed. RESULTS The risk of locoregional failure was reduced by 54% for xevinapant plus CRT vs. placebo plus CRT but did not reach statistical significance (adjusted hazard ratio [HR] 0.46; 95% CI, 0.19-1.13; P = .0893). The risk of death or disease progression was reduced by 67% for xevinapant plus CRT (adjusted HR 0.33; 95% CI, 0.17-0.67; P = .0019). The risk of death was approximately halved in the xevinapant arm compared with placebo (adjusted HR 0.47; 95% CI, 0.27-0.84; P = .0101). OS was prolonged with xevinapant plus CRT vs. placebo plus CRT; median OS not reached (95% CI, 40.3-not evaluable) vs. 36.1 months (95% CI, 21.8-46.7). Incidence of late-onset grade ≥3 toxicities was similar across arms. CONCLUSIONS In this randomised phase 2 study of 96 patients, xevinapant plus CRT demonstrated superior efficacy benefits, including markedly improved 5-year survival in patients with unresected LA SCCHN.
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Affiliation(s)
- Yungan Tao
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Xu-Shan Sun
- Department of Radiation Oncology, Nord Franche-Comté de Montbéliard and CHRU de Besançon, Besançon, France
| | - Yoann Pointreau
- Oncologie-Radiothérapie, Institut Inter-Régional de Cancérologie, Centre Jean Bernard, Le Mans, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris-Saclay University, Paris, France
| | - Christian Sire
- South Brittany Hospital Center, Hôpital du Scorff Radiothérapie, Lorient, France
| | - Marie-Christine Kaminsky
- Institut Cancérologie de Lorraine - Alexis Vautrin, Oncologie Médicale, Vandoeuvre-lès-Nancy, France
| | | | - Marc Alfonsi
- Institut Sainte Catherine, Radiothérapie, Avignon, France
| | | | - Pierre Boisselier
- Institut du Cancer de Montpellier, Val d'Aurelle, Oncologie-Radiothérapie, Montpellier, France
| | - Laurent Martin
- Centre de Radiothérapie Guillaume le Conquérant, Le Havre, France
| | - Jessica Miroir
- Jean Perrin Center, Radiothérapie, Clermont-Ferrand, France
| | | | - Jean-Pierre Delord
- Medical Oncology Dept, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Florian Clatot
- Henri Becquerel Centre, Service Oncologie Médicale rue d'Amiens, Rouen, France
| | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - Julie Villa
- CHU Grenoble, Radiothérapie, Pôle de Cancérologie, Grenoble, France
| | - Nicolas Magne
- Institut de Cancérologie Lucien Neuwirth, Radiothérapie, Saint-Priest-en-Jarez, France
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Elisabeta Gherga
- Department of Radiation Oncology, Nord Franche-Comté de Montbéliard and CHRU de Besançon, Besançon, France
| | - France Nguyen
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Cédrik Lafond
- Oncologie-Radiothérapie, Institut Inter-Régional de Cancérologie, Centre Jean Bernard, Le Mans, France
| | - Guillaume Bera
- South Brittany Hospital Center, Hôpital du Scorff Radiothérapie, Lorient, France
| | - Valentin Calugaru
- Radiotherapy Oncology Department, Institut Curie, Paris-Saclay University, Paris, France
| | - Lionnel Geoffrois
- Institut Cancérologie de Lorraine - Alexis Vautrin, Oncologie Médicale, Vandoeuvre-lès-Nancy, France
| | - Bruno Chauffert
- CHU Amiens Picardie, Oncologie-Radiothérapie, Amiens, France
| | | | | | | | | | | | - Jean Bourhis
- CHUV, Radiation Oncology Department, Bâtiment Hospitalier, Lausanne, Switzerland.
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Belkacemi Y, Gabelle-Flandin I, Deley MCL, Petit A, Guilbert P, Geffrelot J, Carrie C, Campo ERD, Hanzen C, Charra-Brunaud C, Lecouillard I, Magne N, Tallet A, Leduc N, Belgadi B, Fourneret P, Coutte A, Capelo E, Darloy F, Ramirez MG, Dudouet P, Clavere P, Suchaud JP, Auzac G, Lacornerie T, Lemonnier J, Bourgier C, Lartigau E. Abstract PD3-05: Early results of the French multicenter, randomized SHARE trial comparing whole breast irradiation versus accelerated partial breast irradiation in postmenopausal women with early-stage breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd3-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Purpose: The aim of current analyses is to report toxicity and cosmetic outcomes at 3 and up to 9 years of follow-up of post-menopausal patients randomized to receive either standard external beam whole breast radiotherapy (WBI), including hypofractionated options, versus accelerated partial breast irradiation (APBI). Methods and materials: From December 2010 to July 2015, 1006 patients were enrolled in 34 French centers (503 in each arm). Among the whole population, 28 patients who did not meet the final selection criteria or withdrew consent were excluded leading to a modified intention to treat analysis dataset of 978 patients (WBI: n=488; APBI: n=490). Median age (65y) and tumor stage pT1 (99%) rates were similar in both arms. Patients had conservative surgery with clip placement in the tumor bed. Clear margins (> 2mm) were observed in 99% of the patients. In both arms, 96-97% of the patients had negative sentinel lymph node biopsy (SLNB; median number: 4 in WBI arm and 5 in APBI), luminal BC. Ductal histology was observed 82%. Only 2% and 1% of patients had grade III and pN(i+) disease. The median time interval between surgery and radiotherapy was 57d in WBI vs 62d in APBI. WBI schedules consisted of: 50Gy in 25fr + 16Gy boost (n=212) or 40Gy in 15fr (n=156) or 42.5Gy in 16fr (n=120), while APBI arm consisted of 38.5Gy or 40Gy in 10fr. Overall, 94 patients from the APBI arm finally received standard WBI. For statistical considerations, SHARE trial, sponsored by UNICANCER (NCT01247233) is a non-inferiority randomized controlled trial comparing APBI versus WBI in terms of local control as primary objective. Secondary endpoints were severe toxicity (NCI-CTCAE v4 grade ≥ 2), and cosmetic results, evaluated by doctors and by patients, over the entire follow-up. For both outcomes, we estimated the cumulative incidences (CI) using Kalbfleish and Prentice method, considering disease relapse, secondary cancer or death as competing events. Treatment effect (APBI vs WBI) was estimated by cause-specific Hazard Ratios (cs-HR) from Cox models adjusted on stratification factors. Results: Median follow-up was 5.8y (range, 0.13-9.5). The number of deaths was 27, and the number of local relapses was 8. Among the 978 patients, 582 and 396 had finally WBI and APBI, respectively. The rates of post-operative hematoma, edema and infection were low: 8-9%, 2%, 3-2%, respectively. When considering any type of severe toxicity, we observed a significant reduction rate in APBI compared to WBI: cs-HR=0.73 (95% confidence interval: 0.61-0.88); p=0.001, and 3-year cumulative incidence (CI) of severe toxicity at 45% (41-49) in WBI vs 36% (32-40) in APBI arm. The difference was also in favor of APBI when considering breast skin toxicity alone: cs-HR=0.55 (0.44-0.70), p< 0.001 and 3-year CI at 36% (32-40) in WBI vs 21% (18-25) in APBI arm. Conversely, for breast other toxicities, WBI was found less toxic than APBI: cs-HR= 2.10 (1.51-2.91), p< 0.001, and 3-year CI at 8% (5-10) vs 15% (12-19), respectively. When considering cosmetic results according to the investigator, we observed no significant difference between the two arms: cs-HR=1.04 (0.81-1.33), p=0.26 and 3-year probability of remaining with good to excellent cosmetic results at 77% (73-81) in WBI arm and 78% (74-81) in APBI arm. Findings were similar when considering results according to the patient: cs-HR=1.07 (0.85-1.37), p=0.23, and 3-year probability at 74% (70-78) and 75% (70-79), respectively. Conclusions Historically SHARE is the first APBI trial that included hypofractionated schedules in the standard arm. We reported increased risk of severe toxicity and skin breast toxicity in standard arm as compared with APBI arm without any difference in terms of cosmetic results. Longer follow-up is needed.
Citation Format: Yazid Belkacemi, Isabelle Gabelle-Flandin, Marie-Cécile Le Deley, Adeline Petit, Philippe Guilbert, Julien Geffrelot, Christian Carrie, Eleonor Rivin Del Campo, Chantal Hanzen, Claire Charra-Brunaud, Isabelle Lecouillard, Nicolas Magne, Agnès Tallet, Nicolas Leduc, Blaha Belgadi, Philippe Fourneret, Alexandre Coutte, Esther Capelo, Franck Darloy, Muriel Garcia Ramirez, Philippe Dudouet, Pierre Clavere, Jean-Philippe Suchaud, Guillaume Auzac, Thomas Lacornerie, Jérôme Lemonnier, Céline Bourgier, Eric Lartigau. Early results of the French multicenter, randomized SHARE trial comparing whole breast irradiation versus accelerated partial breast irradiation in postmenopausal women with early-stage breast cancer. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD3-05.
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10
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Tao Y, Biau J, Sun XS, Sire C, Martin L, Alfonsi M, Prevost JB, Modesto A, Lafond C, Tourani JM, Miroir J, Kaminsky MC, Coutte A, Liem X, Chautard E, Vauleon E, Drouet F, Ruffier A, Ramee JF, Waksi G, Péchery A, Wanneveich M, Guigay J, Aupérin A, Bourhis J. Pembrolizumab versus cetuximab concurrent with radiotherapy in patients with locally advanced squamous cell carcinoma of head and neck unfit for cisplatin (GORTEC 2015-01 PembroRad): a multicenter, randomized, phase II trial. Ann Oncol 2023; 34:101-110. [PMID: 36522816 DOI: 10.1016/j.annonc.2022.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [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: 06/28/2022] [Revised: 10/01/2022] [Accepted: 10/13/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND To evaluate potential synergistic effect of pembrolizumab with radiotherapy (RT) compared with a standard-of-care (SOC) cetuximab-RT in patients with locally advanced-squamous cell carcinoma of head and neck (LA-SCCHN). PATIENTS AND METHODS Patients with nonoperated stage III-IV SCC of oral cavity, oropharynx, hypopharynx, and larynx and unfit for receiving high-dose cisplatin were enrolled. Patients received once-daily RT up to 69.96 Gy in 33 fractions with weekly cetuximab (cetuximab-RT arm) or 200 mg Q3W pembrolizumab during RT (pembrolizumab-RT arm). The primary endpoint was locoregional control (LRC) rate 15 months after RT. To detect a difference between arms of 60%-80% in 15-month LRC, inclusion of 66 patients per arm was required to achieve a power of at least 0.85 at two-sided significance level of 0.20. RESULTS Between May 2016 and October 2017, 133 patients were randomized to cetuximab-RT (n = 66) and pembrolizumab-RT (n = 67). Two patients (one in each arm) were not included in the analysis (a consent withdrawal and a progression before treatment start). The median age was 65 years (interquartile range 60-70 years), 92% were smokers, 60% were oropharynx (46% of oropharynx with p16+) and 75% were stage IV. Median follow-up was 25 months in both arms. The 15-month LRC rate was 59% with cetuximab-RT and 60% with pembrolizumab-RT ]odds ratio 1.05, 95% confidence interval (CI) 0.43-2.59; P = 0.91]. There was no significant difference between arms for progression-free survival (hazard ratio 0.85, 95% CI 0.55-1.32; P = 0.47) and for overall survival (hazard ratio 0.83, 95% CI 0.49-1.40; P = 0.49). Toxicity was lower in the pembrolizumab-RT arm than in the cetuximab-RT arm: 74% versus 92% patients with at least one grade ≥3 adverse events (P = 0.006), mainly due to mucositis, radiodermatitis, and rash. CONCLUSION Compared with the SOC cetuximab-RT, pembrolizumab concomitant with RT did not improve the tumor control and survival but appeared less toxic in unfit patients with LA-SCCHN.
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Affiliation(s)
- Y Tao
- Gustave-Roussy Institute, Villejuif, France
| | - J Biau
- Centre Jean Perrin, Clermont Ferrand, France
| | - X S Sun
- Hôpital Nord Franche-Comté, Montbéliard and CHU Besançon, Montbéliard, France
| | - C Sire
- Centre Hospitalier de Bretagne Sud, Lorient, France
| | - L Martin
- Clinique des Ormeaux, Le Havre, France
| | - M Alfonsi
- Clinique Sainte Catherine, Avignon, France
| | | | - A Modesto
- Institut Claudius Regaud, Toulouse, France
| | - C Lafond
- Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - J M Tourani
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - J Miroir
- Centre Jean Perrin, Clermont Ferrand, France
| | - M C Kaminsky
- Institut de Cancérologie de Lorraine, Nancy, France
| | - A Coutte
- Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - X Liem
- Centre Oscar Lambret, Lille, France
| | - E Chautard
- Centre Jean Perrin, Clermont Ferrand, France
| | - E Vauleon
- Centre Eugène Marquis, Rennes, France
| | - F Drouet
- Clinique Mutualiste de l'estuaire, Saint-Nazaire, France
| | - A Ruffier
- Gustave-Roussy Institute, Villejuif, France; Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - J F Ramee
- Centre Hospitalier Départemental de Vendée, La Roche sur Yon, France
| | | | | | | | - J Guigay
- Centre Antoine Lacassagne, FHU OncoAge, University Côte d'Azur, Nice, France
| | - A Aupérin
- Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France
| | - J Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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Martz N, Salleron J, Dhermain F, Vogin G, Daisne J, Audouard RM, Tanguy R, Noel G, Peyre M, Lecouillard I, Jacob J, Attal J, Charissoux M, Veresezan O, Hanzen C, Huchet A, Latorzeff I, Coutte A, Doyen J, Dinu S, Feuvret L, Garcia G, Royer P. ANOCEF Consensus Guideline on Target Volume Delineation for Meningiomas Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Boisselier P, Coutte A, Martin E, Pointreau Y. [Stereotactic radiotherapy for localized primary lung tumours of stage T1-T2]. Cancer Radiother 2022; 26:755-759. [PMID: 36075829 DOI: 10.1016/j.canrad.2022.07.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/30/2022]
Abstract
The historical treatment for stage I non-small cell lung cancer is surgical. Parenchymal amputation is not always possible due to cardiopulmonary comorbidities and stereotactic radiotherapy is one of the alternatives to an invasive procedure. The excellent results observed for inoperable tumors raised the question of this treatment in operable patients. This article presents the data in these two situations and the future perspectives.
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Affiliation(s)
- P Boisselier
- Service de radiothérapie oncologie, Institut du Cancer de Montpellier (ICM) - Val d'Aurelle, Parc Euromédecine, 208, avenue des Apothicaires, 34090 Montpellier, France.
| | - A Coutte
- Service de radiothérapie oncologie, CHU Amiens Picardie, 1, rond-point du Professeur Christian Cabrol, 80054 Amiens, France
| | - E Martin
- Département de radiothérapie, centre Georges-François Leclerc, 1, rue du Professeur-Marion, 21079 Dijon, France
| | - Y Pointreau
- Institut inter-régionaL de cancérologie (ILC) - centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
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Bourhis J, Le Tourneau C, Calderon B, Martin L, Sire C, Pointreau Y, Ramee JF, Coutte A, Boisselier P, Kaminsky-Forrett MC, Delord JP, Clatot F, Sun X, Villa J, Magne N, Elicin O, Damstrup L, Gollmer K, Crompton P, Tao Y. LBA33 5-year overall survival (OS) in patients (pts) with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) treated with xevinapant + chemoradiotherapy (CRT) vs placebo + CRT in a randomized, phase II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Zhou Y, Larnaudie A, Ghannam Y, Ollivier L, Gounane Y, Laville A, Coutte A, Huertas A, Maroun P, Chargari C, Bockel S. Interactions of radiation therapy with common and innovative systemic treatments: Antidiabetic treatments, antihypertensives, lipid-lowering medications, immunosuppressive medications and other radiosensitizing methods. Cancer Radiother 2022; 26:979-986. [PMID: 36028416 DOI: 10.1016/j.canrad.2022.06.030] [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: 06/02/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022]
Abstract
The invention and approval of innovative anticancer therapies in the last decade have revolutionized oncology treatment. Radiotherapy is one of the three traditional pillars in oncology treatment with surgery and systemic therapies. Some standard-of-care combinations of chemoradiotherapy widened the therapeutic window of radiation, while some other chemotherapies such as gemcitabine caused unacceptable toxicities when combined with radiation in lung cancers. Fast-paced progress are specially focused on immunotherapies, targeted-therapies, anti-angiogenic treatment, DNA repair inhibitors, hormonotherapy and cell cycle inhibitors. New anticancer therapeutic arsenals provided new possibilities of combined oncological treatments. The interactions of the radiotherapy with other systemic treatments, such as non-anticancer immunomodulatory/immunosuppressive medications are sometimes overlooked even though they could offer a real therapeutic benefit. In this review, we summarize the new opportunities and the risks of historical and novel combined therapies with radiation: non-anticancer immunomodulatory/immunosuppressive drugs, systemic reoxygenation, new therapies such as nanoparticles and SMAC mimetics. Key biological mechanisms, pre-clinical and available clinical data will be provided to demonstrate the promising opportunities in the years to come.
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Affiliation(s)
- Y Zhou
- Department of Radiation Oncology, CHU d'Amiens-Picardie, 80000 Amiens, France; Institut de radiothérapie du sud de l'Oise, 60100 Creil, France
| | - A Larnaudie
- Department of Radiation Oncology, centre hospitalier universitaire Dupuytren, 87000 Limoges, France
| | - Y Ghannam
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest centre Paul-Papin, 49100 Angers, France
| | - L Ollivier
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest centre René-Gauducheau, 44880 Nantes, France
| | - Y Gounane
- Department of Radiation Oncology, hôpital La Source, 45100 Orléans, France
| | - A Laville
- Department of Radiation Oncology, CHU d'Amiens-Picardie, 80000 Amiens, France
| | - A Coutte
- Department of Radiation Oncology, CHU d'Amiens-Picardie, 80000 Amiens, France
| | - A Huertas
- Institut de radiothérapie du sud de l'Oise, 60100 Creil, France
| | - P Maroun
- Institut de radiothérapie du sud de l'Oise, 60100 Creil, France
| | - C Chargari
- Department of Radiation Oncology, Gustave-Roussy, 94800 Villejuif, France
| | - S Bockel
- Department of Radiation Oncology, Gustave-Roussy, 94800 Villejuif, France.
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Coutte A, Pointreau Y. [Hematological pathologies: the most successful model of de-escalation in radiotherapy]. Cancer Radiother 2022; 26:925-930. [PMID: 35965244 DOI: 10.1016/j.canrad.2022.06.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 10/15/2022]
Abstract
The proportion of patients irradiated in the context of malignant hematological pathologies decreased over the last decades. The main causes are the late side effects of the historical series and the new therapeutic strategies aiming to relay radiotherapy to the rank of option. At the same time, radiotherapy has been modernised, target volumes and total doses have been drastically reduced. Hodgkin's lymphomas, indolent follicular lymphomas and primary cerebral lymphomas are the main witnesses of this therapeutic deflation.
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Affiliation(s)
- A Coutte
- Service de radiothérapie, CHU Amiens Picardie, 1, rond-point du Professeur Christian Cabrol, 80054 Amiens, France.
| | - Y Pointreau
- Institut inter-régionaL de Cancérologie (ILC) - Centre Jean Bernard, 9, Rue Beauverger, 72000 Le Mans, France; Service de radiothérapie, centre régional universitaire de cancérologie Henry-S.-Kaplan, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; COLIB, Club des Oncologues LIBéraux, 72000 Le Mans, France
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Boussida S, François Y, Heintz A, Saidak Z, Dakpé S, Coutte A, Chauffert B, Devauchelle B, Galmiche A, Testelin S, Goudot P, Constans JM. Evaluation of Proton MR Spectroscopy for the Study of the Tongue Tissue in Healthy Subjects and Patients With Tongue Squamous Cell Carcinoma: Preliminary Findings. Front Oral Health 2022; 3:912803. [PMID: 35924279 PMCID: PMC9339644 DOI: 10.3389/froh.2022.912803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/20/2022] [Indexed: 12/24/2022] Open
Abstract
PurposeTo noninvasively assess spectroscopic and metabolic profiles of healthy tongue tissue and in an exploratory objective in nontreated and treated patients with tongue squamous cell carcinoma (SCC).MethodsFourteen healthy subjects (HSs), one patient with nontreated tongue SCC (NT-SCC), and two patients with treated tongue SCC (T-SCC) underwent MRI and single-voxel proton magnetic resonance spectroscopy (1H-MRS) evaluations (3 and 1.5T). Multi-echo-times 1H-MRS was performed at the medial superior part (MSP) and the anterior inferior part (AIP) of the tongue in HS, while 1H-MRS voxel was placed at the most aggressive part of the tumor for patients with tongue SCC. 1H-MRS data analysis yielded spectroscopic metabolite ratios quantified to total creatine.ResultsIn HS, compared to MSP and AIP, 1H-MRS spectra revealed higher levels of creatine, a more prominent and well-identified trimethylamine-choline (TMA-Cho) peak. However, larger prominent lipid peaks were better differentiated in the tongue MSP. Compared to HS, patients with NT-SCC exhibited very high levels of lipids and relatively higher values of TMA-Cho peak. Interestingly, patients with T-SCC showed almost nonproliferation activity. However, high lipids levels were measured, although they were relatively lower than lipids levels measured in patients with NT-SCC.ConclusionThe present study demonstrated the potential use of in-vivo1H-MRS to noninvasively assess spectroscopic and metabolic profiles of the healthy tongue tissue in a spatial location-dependent manner. Preliminary results revealed differences between HS and patients with tongue NT-SCC as well as tongue T-SCC, which should be confirmed with more patients. 1H-MRS could be included, in the future, in the arsenal of tools for treatment response evaluation and noninvasive monitoring of patients with tongue SCC.
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Affiliation(s)
- Salem Boussida
- Radiology Department, University Hospital of Amiens Picardie, Amiens, France
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
| | - Yvener François
- Faculty of Medicine, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
| | - Adrien Heintz
- Radiology Department, University Hospital of Amiens Picardie, Amiens, France
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
| | - Zuzana Saidak
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- Department of Biochemistry, University Hospital of Amiens, Amiens, France
| | - Stéphanie Dakpé
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- Department of Maxillofacial Surgery and Stomatology, University Hospital of Amiens, Amiens, France
| | - Alexandre Coutte
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- Department of Radiotherapy, University Hospital of Amiens, Amiens, France
| | - Bruno Chauffert
- Department of Medical Oncology, University Hospital of Amiens, Amiens, France
| | - Bernard Devauchelle
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- Department of Maxillofacial Surgery and Stomatology, University Hospital of Amiens, Amiens, France
| | - Antoine Galmiche
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- Department of Biochemistry, University Hospital of Amiens, Amiens, France
| | - Sylvie Testelin
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- Department of Maxillofacial Surgery and Stomatology, University Hospital of Amiens, Amiens, France
| | - Patrick Goudot
- Faculty of Medicine, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
| | - Jean-Marc Constans
- Radiology Department, University Hospital of Amiens Picardie, Amiens, France
- CHIMERE UR 7516 Research Team for Head & Neck, Institute Faire Faces, University of Picardie Jules Verne, Amiens, France
- *Correspondence: Jean-Marc Constans
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Beddok A, Guzene L, Coutte A, Thomson D, Yom SS, Calugaru V, Blais E, Gilliot O, Racadot S, Pointreau Y, Corry J, Jensen K, Porceddu S, Khalladi N, Bastit V, Lasne-Cardon A, Marcy PY, Carsuzaa F, Nioche C, Bourhis J, Salleron J, Thariat J. International assessment of interobserver reproducibility of flap delineation in head and neck carcinoma. Acta Oncol 2022; 61:672-679. [PMID: 35139735 DOI: 10.1080/0284186x.2022.2036367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/11/2021] [Accepted: 01/23/2022] [Indexed: 11/01/2022]
Abstract
Background: Several reports have suggested that radiotherapy after reconstructive surgery for head and neck cancer (HNC), could have deleterious effects on the flaps with respect to functional outcomes. To predict and prevent toxicities, flap delineation should be accurate and reproducible. The objective of the present study was to evaluate the interobserver variability of frequent types of flaps used in HNC, based on the recent GORTEC atlas.Materials and methods: Each member of an international working group (WG) consisting of 14 experts delineated the flaps on a CT set from six patients. Each patient had one of the five most commonly used flaps in HNC: a regional pedicled pectoralis major myocutaneous flap, a local pedicled rotational soft tissue facial artery musculo-mucosal (FAMM) (2 patients), a fasciocutaneous radial forearm free flap, a soft tissue anterolateral thigh (ALT) free flap, or a fibular free flap. The WG's contours were compared to a reference contour, validated by a surgeon and a radiologist specializing in HNC. Contours were considered as reproducible if the median Dice Similarity Coefficient (DSC) was > 0.7.Results: The median volumes of the six flaps delineated by the WG were close to the reference contour value, with approximately 50 cc for the pectoral, fibula, and ALT flaps, 20 cc for the radial forearm, and up to 10 cc for the FAMM. The volumetric ratio was thus close to the optimal value of 100% for all flaps. The median DSC obtained by the WG compared to the reference for the pectoralis flap, the FAMM, the radial forearm flap, ALT flap, and the fibular flap were 0.82, 0.40, 0.76, 0.81, and 0.76, respectively.Conclusions: This study showed that the delineation of four main flaps used for HNC was reproducible. The delineation of the FAMM, however, requires close cooperation between radiologist, surgeon and radiation oncologist because of the poor visibility of this flap on CT and its small size.
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Affiliation(s)
- Arnaud Beddok
- Department of Radiation Oncology, Institut Curie, Paris - Orsay, France
- Laboratoire d'Imagerie Translationnelle en Oncologie (LITO), U1288 Université Paris Saclay/Inserm/Institut Curie, Orsay, France
| | - Leslie Guzene
- Department of Radiation Oncology, University Hospital of Amiens, Amiens, France
| | - Alexandre Coutte
- Department of Radiation Oncology, University Hospital of Amiens, Amiens, France
| | - David Thomson
- Department of Radiation Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, USA
| | - Valentin Calugaru
- Department of Radiation Oncology, Institut Curie, Paris - Orsay, France
| | - Eivind Blais
- Department of Radiation Oncology, Polyclinique Marzet, Pau, France
| | - Olivier Gilliot
- Department of Radiation Oncology, Polyclinique Marzet, Pau, France
| | - Séverine Racadot
- Department of Radiation Oncology, Centre Léon Bérard Lyon, France
| | - Yoann Pointreau
- Department of Radiation Oncology, Centre Jean Bernard, Le Mans, France
| | - June Corry
- Department of Radiation Oncology, GenesisCare. St Vincent's Hospital, Fitzroy, Australia
| | - Kenneth Jensen
- Department of Radiation Oncology, Aarhus University Hospital, Aarhus, Danemark
| | - Sandro Porceddu
- Department of Radiation Oncology, Princess Alexandra Hospital Southside Clinical Unit, Australia
| | - Nazim Khalladi
- Department of Radiation Oncology, Centre François Baclesse, Caen, France
| | - Vianney Bastit
- Department of Head and Neck Surgery, Centre François Baclesse, Caen, France
| | | | | | - Florent Carsuzaa
- Department of Head and Neck Surgery, University Hospital of Poitiers, Poitiers, France
| | - Christophe Nioche
- Laboratoire d'Imagerie Translationnelle en Oncologie (LITO), U1288 Université Paris Saclay/Inserm/Institut Curie, Orsay, France
| | - Jean Bourhis
- Department of Radiation Oncology, University Hospital of Vaudois, Lausanne, Swiss
| | - Julia Salleron
- Department of Statistics, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France
- Laboratoire de physique Corpusculaire IN2P3/ENSICAEN/CNRS UMR 6534 - Normandie Université, Caen, France
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Zhou Y, Rassy E, Coutte A, Achkar S, Espenel S, Genestie C, Pautier P, Morice P, Gouy S, Chargari C. Current Standards in the Management of Early and Locally Advanced Cervical Cancer: Update on the Benefit of Neoadjuvant/Adjuvant Strategies. Cancers (Basel) 2022; 14:cancers14102449. [PMID: 35626051 PMCID: PMC9139662 DOI: 10.3390/cancers14102449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Cervical cancers is a human papillomavirus infection-induced gynecologic cancer. Due to the uneven access to prevention measures in the world, it is still a leading cause of cancer death in women in low- and middle-income countries. The mainstay of treatment for early-stage cervical cancers is upfront surgery. Clinical trials confirmed the place of adjuvant radiotherapy to improve disease control, but also highlighted the need for a careful selection of patients prior to surgery, in order to avoid the cumulative morbidities of each treatment. In locally advanced cervical cancers, the standard of care remains concurrent pelvic chemoradiotherapy followed by an image-guided adaptive brachytherapy boost allowing for dose escalation and leading to a very high probability of local control. Systemic failures remain a major concern, and neoadjuvant or adjuvant approaches in this context are discussed in the light of recent literature. Abstract Globally, cervical cancers continue to be one of the leading causes of cancer-related deaths. The primary treatment of patients with early-stage disease includes surgery or radiation therapy with or without chemotherapy. The main challenge in treating these patients is to maintain a curative approach and limit treatment-related morbidity. Traditionally, inoperable patients are treated with radiation therapy solely and operable patients undergo upfront surgery followed by adjuvant (chemo) radiotherapy in cases with poor histopathological prognostic features. Patients with locally advanced cervical cancers are treated with concurrent chemoradiotherapy followed by an image-guided brachytherapy boost. In these patients, the main pattern of failure is distant relapse, encouraging intensification of systemic treatments to improve disease control. Ongoing trials are evaluating immunotherapy in locally advanced tumours following its encouraging efficacy reported in the recurrent and metastatic settings. In this article, clinical evidence of neoadjuvant and adjuvant treatments in cervical cancer patients is reviewed, with a focus on potential strategies to improve patients’ outcome and minimize treatment-related morbidity.
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Affiliation(s)
- Yuedan Zhou
- Department of Radiation Oncology, Centre Hospitalier Universitaire, 80000 Amiens-Picardie, France; (Y.Z.); (A.C.)
| | - Elie Rassy
- Department of Medical Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France; (E.R.); (P.P.)
| | - Alexandre Coutte
- Department of Radiation Oncology, Centre Hospitalier Universitaire, 80000 Amiens-Picardie, France; (Y.Z.); (A.C.)
| | - Samir Achkar
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France; (S.A.); (S.E.)
| | - Sophie Espenel
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France; (S.A.); (S.E.)
| | - Catherine Genestie
- Department of Pathology, Gustave Roussy Comprehensive Cancer Center, 94800 Villejuif, France;
| | - Patricia Pautier
- Department of Medical Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France; (E.R.); (P.P.)
| | - Philippe Morice
- Department of Surgery, Gustave Roussy Comprehensive Cancer Center, 94800 Villejuif, France; (P.M.); (S.G.)
| | - Sébastien Gouy
- Department of Surgery, Gustave Roussy Comprehensive Cancer Center, 94800 Villejuif, France; (P.M.); (S.G.)
| | - Cyrus Chargari
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Centre, 94800 Villejuif, France; (S.A.); (S.E.)
- Correspondence:
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Bourhis J, Tao Y, Sun X, Sire C, Martin L, Liem X, Coutte A, Pointreau Y, Thariat J, Miroir J, Rolland F, Kaminsky MC, Borel C, Maillard A, Sinigaglia L, Guigay J, Saada-Bouzid E, Even C, Aupérin A. LBA35 Avelumab-cetuximab-radiotherapy versus standards of care in patients with locally advanced squamous cell carcinoma of head and neck (LA-SCCHN): Randomized phase III GORTEC-REACH trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2112] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Leleu T, Bastit V, Doré M, Kammerer E, Florescu C, Alfonsi M, Troussier I, Bensadoun RJ, Biau J, Blais E, Coutte A, Deberne M, Wiazzane N, Dupin C, Faivre JC, Giraud P, Graff P, Guihard S, Huguet F, Janoray G, Liem X, Pointreau Y, Racadot S, Schick U, Servagi-Vernat S, Sun XS, Thureau S, Villa J, Vulquin N, Wong S, Patron V, Thariat J. Histosurgical mapping of endoscopic endonasal surgery of sinonasal tumours to improve radiotherapy guidance. Cancer Radiother 2021; 26:440-444. [PMID: 34175228 DOI: 10.1016/j.canrad.2021.06.014] [Citation(s) in RCA: 1] [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: 02/03/2021] [Revised: 05/21/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Endoscopic endonasal surgery (EES) is becoming a standard for most malignant sinonasal tumours. Margin analysis after piecemeal resection is complex and optimally relies on accurate histosurgical mapping. Postoperative radiotherapy may be adapted based on margin assessment mapping to reduce the dose to some sinonasal subvolumes. We assessed the use of histosurgical mapping by radiation oncologists (RO). MATERIAL AND METHODS A French practice survey was performed across 29 ENT expert RO (2 did not answer) regarding integration of information on EES, as well as quality of operative and pathology reportsto refine radiotherapy planning after EES. This was assessed through an electronic questionnaire. RESULTS EES was ubiquitously performed in France. Operative and pathology reports yielded accurate description of EES samples according to 66.7% of interviewed RO. Accuracy of margin assessment was however insufficient according to more than 40.0% of RO. Additional margins/biopsies of the operative bed were available in 55.2% (16/29) of the centres. In the absence of additional margins, quality of resection after EES was considered as microscopically incomplete in 48.3% or dubious in 48.3% of RO. As performed, histosurgical mapping allowed radiotherapy dose and volumes adaptation according to 26.3% of RO only. CONCLUSIONS Standardized histosurgical mapping with margin and additional margin analysis could be more systematic. Advantages of accurate EES reporting could be dose painting radiotherapy to further decrease morbidity in sinonasal tumours.
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Affiliation(s)
- T Leleu
- Department of radiation oncology, centre François-Baclesse, Caen, France
| | - V Bastit
- Department of surgery, centre François-Baclesse, Caen, France
| | | | - E Kammerer
- Department of radiation oncology, centre François-Baclesse, Caen, France
| | - C Florescu
- Department of radiation oncology, centre François-Baclesse, Caen, France
| | | | | | | | - J Biau
- CJP, Clermont-Ferrand, France
| | - E Blais
- AP-HP, Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - X S Sun
- CHU, Besançon Montbéliard, France
| | | | | | | | | | - V Patron
- Department of ENT surgery, CHU Caen, Caen, France
| | - J Thariat
- Department of radiation oncology, centre François-Baclesse, Caen, France; Unicaen, Normandie Université, Caen, France; GORTEC, France.
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21
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Carsuzaa F, Lapeyre M, Gregoire V, Maingon P, Beddok A, Marcy PY, Salleron J, Coutte A, Racadot S, Pointreau Y, Graff P, Beadle B, Benezery K, Biau J, Calugaru V, Castelli J, Chua M, Di Rito A, Dore M, Ghadjar P, Huguet F, Jardel P, Johansen J, Kimple R, Krengli M, Laskar S, Mcdowell L, Nichols A, Tribius S, Valduvieco I, Hu C, Liem X, Moya-Plana A, D'onofrio I, Parvathaneni U, Takiar V, Orlandi E, Psyrri A, Shenouda G, Sher D, Steuer C, Shan Sun X, Tao Y, Thomson D, Tsai MH, Vulquin N, Gorphe P, Mehanna H, Yom SS, Bourhis J, Thariat J. Recommendations for postoperative radiotherapy in head & neck squamous cell carcinoma in the presence of flaps: A GORTEC internationally-reviewed HNCIG-endorsed consensus. Radiother Oncol 2021; 160:140-147. [PMID: 33984351 DOI: 10.1016/j.radonc.2021.04.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/07/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Head and neck reconstructive surgery using a flap is increasingly common. Best practices and outcomes for postoperative radiotherapy (poRT) with flaps have not been specified. We aimed to provide consensus recommendations to assist clinical decision-making highlighting areas of uncertainty in the presence of flaps. MATERIAL AND METHODS Radiation, medical, and surgical oncologists were assembled from GORTEC and internationally with the Head and Neck Cancer International Group (HNCIG). The consensus-building approach covered 59 topics across four domains: (1) identification of postoperative tissue changes on imaging for flap delineation, (2) understanding of tumor relapse risks and target volume definitions, (3) functional radiation-induced deterioration, (4) feasibility of flap avoidance. RESULTS Across the 4 domains, international consensus (median score ≥ 7/9) was achieved only for functional deterioration (73.3%); other consensus rates were 55.6% for poRT avoidance of flap structures, 41.2% for flap definition and 11.1% for tumor spread patterns. Radiation-induced flap fibrosis or atrophy and their functional impact was well recognized while flap necrosis was not, suggesting dose-volume adaptation for the former. Flap avoidance was recommended to minimize bone flap osteoradionecrosis but not soft-tissue toxicity. The need for identification (CT planning, fiducials, accurate operative report) and targeting of the junction area at risk between native tissues and flap was well recognized. Experts variably considered flaps as prone to tumor dissemination or not. Discrepancies in rating of 11 items among international reviewing participants are shown. CONCLUSION International GORTEC and HNCIG-endorsed recommendations were generated for the management of flaps in head and neck radiotherapy. Considerable knowledge gaps hinder further consensus, in particular with respect to tumor spread patterns.
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Affiliation(s)
| | - Michel Lapeyre
- Department of Radiation Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Vincent Gregoire
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Philippe Maingon
- Department of Radiation Oncology, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Arnaud Beddok
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Pierre-Yves Marcy
- Department of Radiology, Clinique du Cap d'Or, La Seyne-sur-mer, France
| | - Julia Salleron
- Department of Biostatistics, Institut de cancérologie de Lorraine, France
| | - Alexandre Coutte
- Department of Radiation Oncology, Amiens Picardie University Medical Center, Amiens, France
| | - Severine Racadot
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Yoann Pointreau
- Department of Radiation Oncology, Centre Jean Bernard, Le Mans, France
| | - Pierre Graff
- Department or Radiation Oncology, Institut C. Regaud, Toulouse, France
| | - Beth Beadle
- Department of Radiation Oncology, Stanford University Medical Center, Stanford University Medical Center, USA
| | - Karen Benezery
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France
| | - Julian Biau
- Department of Radiation Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | | | - Joel Castelli
- Department of Radiation Oncology, Centre Eugène Marquis, Rennes, France
| | - Melvin Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - Alessia Di Rito
- Department of Radiation Oncology, OC Radioterapia Ospedale "Mons. A.R. Dimiccoli" di Barletta, Rome, Italy
| | - Melanie Dore
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest, St Herblain, France
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité, Berlin, Germany
| | - Florence Huguet
- Department of Radiation Oncology, Hospital de Tenon, Paris, France
| | - Pauline Jardel
- Department of Radiation Oncology, CHU de la Milétrie, Poitiers, France
| | - Jorgen Johansen
- Department of Radiation Oncology, Odense University Hospital, Denmark
| | - Randall Kimple
- Department of Medical Oncology, University of Wisconsin-Madison, WI, USA
| | - Marco Krengli
- Department of Translational Medicine University of Piemonte Orientale, Novara, Italy
| | | | - Lachlan Mcdowell
- Department of Radiation Oncology, Peter McCallum Cancer Center, Melbourne, Australia
| | - Anthony Nichols
- Department of Head and Neck surgery, London Health Sciences Center, Ontario, Canada
| | - Silke Tribius
- Department of Radiation Oncology, Hermann-Holthusen-Institute for Radiation Oncology, Asklepios Hospital St. Georg, Hamburg, Germany
| | | | - Chaosu Hu
- Department of Radiation Oncology, Fundan University, Shanghai, China
| | - Xavier Liem
- Department of Radiation Oncology, Centre Oscar Lambret, Lille, France
| | | | - Ida D'onofrio
- Department of Radiation Oncology, Hospital Naples, Italy
| | | | - Vinita Takiar
- Department of Radiation Oncology, University of Cincinaty, USA
| | - Ester Orlandi
- Department of Radiation Oncology, CNAO, Milan, Italy
| | - Amanda Psyrri
- Department of Medical Oncology, Attikon University Hospital, Athens, Greece
| | - George Shenouda
- Department of Radiation Oncology, McGill University Health Centre, Montreal, Canada
| | - David Sher
- Department of Radiation Oncology, UT Southwestern, Dallas, USA
| | - Conor Steuer
- Department of Head and Neck Surgery, Winship Cancer Institute, Atlanta, USA
| | - Xu Shan Sun
- Department of Radiation Oncology, University hospital CHBM, Montbéliard, France
| | - Yungan Tao
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - David Thomson
- Department of Radiation Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Mu-Hung Tsai
- Department of Radiation Oncology, National Cheng Kung University Hospital, Tïnan, Taiwan
| | - Noemie Vulquin
- Department of Radiation Oncology, Centre Georges François Leclerc, Dijon, France
| | - Philippe Gorphe
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Hisham Mehanna
- Department of Radiation Oncology, Institute for Global Innovation, Birmingham, UK
| | - Sue S Yom
- Department of Radiation Oncology, NRG Oncology Cancer Research Group, USA
| | - Jean Bourhis
- Department of Radiation Oncology, UNIL-CHUV, Lausanne, Switzerland
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François-Baclesse, Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534. Normandie University, Caen, and GORTEC, France.
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22
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Guillemin F, Miroir J, Piram L, Bellini R, Saroul N, Pham Dang N, Boisselier P, Bourhis J, Calugaru V, Coutte A, Graff P, Pointreau Y, Racadot S, Sun XS, Thariat J, Biau J, Lapeyre M. [Proposal for the delineation of postoperative primary clinical target volumes in ethmoid cancers]. Cancer Radiother 2021; 25:200-205. [PMID: 33546996 DOI: 10.1016/j.canrad.2020.04.015] [Citation(s) in RCA: 1] [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: 11/12/2019] [Revised: 03/20/2020] [Accepted: 04/10/2020] [Indexed: 11/30/2022]
Abstract
It is proposed to delineate the anatomo-clinical target volumes of primary tumor (CTV-P) in ethmoid cancers treated with post-operative radiotherapy. This concept is based on the use of radioanatomy and the natural history of cancer. It is supported by the repositioning of the planning scanner with preoperative imaging for the replacement of the initial GTV and the creation of margins around it extended to the microscopic risk zones according to the anatomical concept. This article does not discuss the indications of external radiotherapy but specifies the volumes to be delineated if radiotherapy is considered.
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Affiliation(s)
- F Guillemin
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - J Miroir
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - L Piram
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - R Bellini
- Département de radiodiagnostic, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - N Saroul
- Département de chirurgie ORL, centre hospitalier universitaire Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France
| | - N Pham Dang
- Département de chirurgie maxillofaciale, centre hospitalier universitaire Estaing, 63003 Clermont-Ferrand cedex 1, France
| | - P Boisselier
- Département de radiothérapie, Institut régional cancer de Montpellier, parc Euromédecine, 208 rue des Apothicaires, 34090 Montpellier, France
| | - J Bourhis
- Département de radiothérapie, Centre hospitalier universitaire vaudois, rue du Bugnon 46, 1005 Lausanne, Suisse
| | - V Calugaru
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - A Coutte
- Département de radiothérapie, CHU Amiens-Picardie, 30, avenue de la Croix-Jourdain, 80054 Amiens cedex 1, France
| | - P Graff
- Département de radiothérapie, Institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Y Pointreau
- Département de radiothérapie, Institut inter-régional de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - S Racadot
- Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - X S Sun
- Département de radiothérapie, hôpital Nord Franche-Comté de Montbéliard, CHRU de Besançon, 1 rue Henri-Becquerel, 25200 Montbéliard, France
| | - J Thariat
- Département de radiothérapie, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - J Biau
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - M Lapeyre
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France.
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Tao Y, Aupérin A, Sun X, Sire C, Martin L, Coutte A, Lafond C, Miroir J, Liem X, Rolland F, Even C, Nguyen F, Saada E, Maillard A, Colin-Batailhou N, Thariat J, Guigay J, Bourhis J. Avelumab-cetuximab-radiotherapy versus standards of care in locally advanced squamous-cell carcinoma of the head and neck: The safety phase of a randomised phase III trial GORTEC 2017-01 (REACH). Eur J Cancer 2020; 141:21-29. [PMID: 33125944 DOI: 10.1016/j.ejca.2020.09.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 04/15/2020] [Revised: 08/18/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Based on the hypothesis of synergistic effect of avelumab with cetuximab and radiotherapy, this new combination is tested in a randomised trial against two well-established standard of care (SOC) in locally advanced squamous-cell carcinoma of the head and neck (LA-SCCHN). METHODS This phase III trial comprises two cohorts of patients deemed fit to receive cisplatin (100 mg/m2 Q3W) (cohort 1) or unfit to cisplatin (cohort 2). The SOC was Intensity Modulated Radiation Therapy (IMRT) with cisplatin in cohort 1 (arm A) and with weekly cetuximab in cohort 2 (arm D). In both cohorts, experimental arms (arms B and C) were IMRT with cetuximab and avelumab (10 mg/kg day 7 and every 2 weeks) followed by avelumab every two weeks for 12 months. A safety phase was planned among the first 41 patients in experimental arms by monitoring grade ≥IV adverse events (AEs) with an unacceptable rate of 35%. RESULTS Between September 2017 and August 2018, 82 patients with LA-SCCHN were randomised including 41 patients in experimental arms. All patients of experimental arms except one (arm C) received entire radiotherapy as planned. Most common grade ≥III AEs were mucositis, radio-dermatitis, and dysphagia. Grade ≥IV AEs occurred in 5/41 (12%) patients, all in arm C (no grade V). This rate was acceptable according to the hypotheses of the safety phase. In the SOC arms, grade ≥IV AEs occurred in 3/21 patients (14%) in arm A and 2/20 (10%) in arm D. One grade V haemorrhage occurred in arm A. CONCLUSION The avelumab-cetuximab-RT combination was tolerable for patients with LA-SCCHN, and the approval was given for continuing the trial without modification. CLINICALTRIAL.GOV: NCT02999087.
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Affiliation(s)
- Yungan Tao
- Gustave-Roussy Institute, Villejuif, France
| | | | - Xushan Sun
- Hopital Nord Franche-Comté de Montbéliard & CHRU de Besançon, France
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24
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Le Guevelou J, Bastit V, Marcy P, Guzène L, Gérard M, Larnaudie A, Coutte A, Beddok A, Calugaru A, Johnson A, Géry B, Lasne-Cardon A, Thariat J. Radiothérapie postopératoire des cancers ORL : recommandations de délinéation des lambeaux. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Houessinon A, Moreira A, Bettoni J, Schoonaker M, Sauzay C, Galmiche A, Coutte A, Biet A, Krzisch C, Chauffert B. Resensitization to Nivolumab after Intratumoral Chemotherapy in Recurrent Head and Neck Squamous Cell Cancer: A Report of 2 Cases. Case Rep Oncol 2020; 13:835-842. [PMID: 32884527 PMCID: PMC7443634 DOI: 10.1159/000507986] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 11/19/2022] Open
Abstract
The survival of patients with head and neck squamous cancer with locoregional recurrence is short if salvage surgery or radiation cannot be performed. Systemic chemotherapy based on platinum salts and cetuximab produces only partial and transient responses. Immune checkpoint inhibitors (i.e., nivolumab) lead to a low complete response rate of only about 10%, but in some cases the effects can be long-lasting. Intratumoral chemotherapy (ITC) has been proposed for patients with local recurrence of head and neck squamous cell carcinoma with an objective response rate of 27-50%. However, it often leads to peritumoral tissue necrosis, and the duration of local control is limited. Here, we present 2 patients with head and neck squamous cell cancer whose local recurrences were refractory to intravenous chemotherapy and nivolumab. ITC using nonnecrotizing molecules, associated with nivolumab, led to complete stable local and distant response. ITC seems to trigger tumor resensitization to previously ineffective immunotherapy. This combination deserves an evaluation in the framework of a prospective trial.
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Affiliation(s)
- Aline Houessinon
- Department of Medical Oncology, University Hospital, Amiens, France.,EA7516 CHIMERE, Picardie Jules Verne University, Amiens, France
| | - Aurélie Moreira
- Department of Medical Oncology, University Hospital, Amiens, France
| | - Jérèmie Bettoni
- Department of Maxillo-Facial Surgery, University Hospital, Amiens, France.,EA7516 CHIMERE, Picardie Jules Verne University, Amiens, France
| | - Marine Schoonaker
- EA7516 CHIMERE, Picardie Jules Verne University, Amiens, France.,Laboratory of Biochemistry, University Hospital, Amiens, France
| | - Chloé Sauzay
- EA7516 CHIMERE, Picardie Jules Verne University, Amiens, France.,Laboratory of Biochemistry, University Hospital, Amiens, France
| | - Antoine Galmiche
- EA7516 CHIMERE, Picardie Jules Verne University, Amiens, France.,Laboratory of Biochemistry, University Hospital, Amiens, France
| | | | - Aurélie Biet
- Department of ENT and Cervico-Facial Surgery, University Hospital, Amiens, France
| | - Claude Krzisch
- Department of Radiotherapy, University Hospital, Amiens, France
| | - Bruno Chauffert
- Department of Medical Oncology, University Hospital, Amiens, France.,EA7516 CHIMERE, Picardie Jules Verne University, Amiens, France
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Laville A, Coutte A, Blanchard P, Sun R, Deutsch E, Latorzeff I. [Treatment of primary disease for synchronous metastatic prostate cancer]. Cancer Radiother 2020; 24:547-553. [PMID: 32855028 DOI: 10.1016/j.canrad.2020.06.011] [Citation(s) in RCA: 1] [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: 05/15/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 11/30/2022]
Abstract
The management of early metastatic prostate cancer is based on systemic treatment by androgen deprivation therapy with or without chemotherapy or next-generation anti-androgen therapies. Local treatment of the prostate was initially used only to alleviate local symptoms. However, local radiotherapy of the prostate has been the subject of retrospective and prospective studies in patients with better prognostic factors, particularly in oligometastatic status. The results of these studies support that prostate radiotherapy can prolong the survival of patients with a low metastatic burden. This article states the biological bases, the main published and future published studies aimed to embed this strategy to optimize therapeutic management.
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Affiliation(s)
- A Laville
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Département de radiothérapie, CHU d'Amiens, 1, rue du Professeur-Christian-Cabrol, 80050, France.
| | - A Coutte
- Département de radiothérapie, CHU d'Amiens, 1, rue du Professeur-Christian-Cabrol, 80050, France
| | - P Blanchard
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - R Sun
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - E Deutsch
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Inserm, UMR 1030 « radiosensibilité des tumeurs et tissus sains », 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - I Latorzeff
- Département de radiothérapie-oncologie, bâtiment Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
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Laville A, Coutte A, Capel C, Maroote J, Lefranc M. Dosimetric and volumetric outcomes of combining cyst puncture through an Ommaya reservoir with index-optimized hypofractionated stereotactic radiotherapy in the treatment of craniopharyngioma. Clin Transl Radiat Oncol 2020; 23:66-71. [PMID: 32490217 PMCID: PMC7256109 DOI: 10.1016/j.ctro.2020.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/26/2022] Open
Abstract
Large cystic craniopharyngioma management combining cyst puncture through an Ommaya reservoir with hypofractionated stereotactic radiotherapy was evaluated. The planning optimization was focused on the gradient and selectivity. Punctured and filled cyst treatment plans were compared with a retrospective analysis of volumetric and functional outcomes.
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Affiliation(s)
- Adrien Laville
- Department of Radiation Oncology, University Hospital, Amiens, France
| | - Alexandre Coutte
- Department of Radiation Oncology, University Hospital, Amiens, France
| | - Cyrille Capel
- Department of Neurosurgery, University Hospital, Amiens, France
| | - Justine Maroote
- Department of Radiation Oncology, University Hospital, Amiens, France
| | - Michel Lefranc
- Department of Neurosurgery, University Hospital, Amiens, France
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Jarebi M, Coutte A, Bartier F, Khormi Y, Peltier J, Lefranc M. A Novel, Hybrid, Stereotactic Approach (Radiosurgery and Dual Ommaya Reservoirs) for the Treatment of Mixed (Polycystic and Solid) Craniopharyngioma. Stereotact Funct Neurosurg 2019; 97:266-271. [DOI: 10.1159/000503690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 09/25/2019] [Indexed: 11/19/2022]
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29
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Bourhis J, Sun X, Pointreau Y, Sire C, Le Tourneau C, Coutte A, Kaminsky-Forrett MC, Alfonsi M, Boisselier P, Martin L, Delord JP, Clatot F, Miroir J, Rolland F, Crompton P, Brienza S, Szyldergemajn S, Even C, Tao Y. Double-blind randomized phase II results comparing concurrent high-dose cisplatin chemorradiation (CRT) plus debio 1143 or placebo in high-risk patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN): A GORTEC study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Etienne-Selloum N, Prades J, Bello Roufai D, El Azumi F, Boone M, Sevestre H, Trudel S, Coutte A, Desenclos C, Constans J, Chauffert B, Dontenwill M. P14.122 Integrin α5 is a poor prognostic factor in patients with glioblastoma treated by the Stupp protocol. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Integrin α5β1 was suggested to be involved in glioblastoma (GBM) aggressiveness through preclinical studies and genomic analysis of several cohorts of patients. However, protein expression data are still missing to confirm this hypothesis. Our aim was to investigate the prognostic value of integrin α5 protein expression level in GBM.
MATERIAL AND METHODS
We retrospectively determined the protein expression level of integrin α5 using immunochemistry in tumors from patients treated in 6 French centers. Paraffin sections of GBM were labeled by immunofluorescence and analyzed by confocal microscopy. The corresponding clinical and survival data have been identified and analyzed. The primary end-point was overall survival (OS).
RESULTS
Out of 297 patients newly diagnosed with GBM between 2006 and 2013, 152 met the inclusion criteria (scheduled for initial treatment with the Stupp protocol, age > 18 years) and 95 tumor samples were suitable for immunohistochemical analysis. The median age is 58 years, (64 men, 34 women). Most of patients received macroscopic (43%) or partial (36%) surgery. In univariate analysis using the Log Rank test, high integrin α5 expression level was associated with poor prognosis (PFS: hazard ratio (HR) = 1,696, p=0,0355; OS: HR=1,598, p = 0,0508). Corresponding median OS were 15,6 versus 19,2 months. Similarly, OS was significantly reduced with age (> 60 years), lower resection degree, higher RPA (recursive partitioning analysis) score and non-methylated MGMT (O-6-methylguanine-DNA methyltransferase) promoter. In the subgroup of patients who received the full initial protocol (temozolomide treatment together with radiotherapy and later as adjuvant treatment; n=58) mean OS was strongly reduced when integrin α5 expression level was high (15,6 versus 22,8 months, p=0,0162) suggesting an impact of integrin signaling on temozolomide response in GBM.
CONCLUSION
Our study validates for the first time that the high protein level expression of α5 integrin is associated with poor prognosis in GBM. It also confirms its potential as a therapeutic target and its likely role in resistance to temozolomide as previously shown in preclinical study.
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Affiliation(s)
- N Etienne-Selloum
- UMR 7021 CNRS/Unistra, Laboratoire de Bioimagerie et Pathologies, Faculté de pharmacie, Illkirch-Graffenstaden, France
- Service de Pharmacie, Centre de Lutte contre le Cancer Paul Strauss, Strasbourg, France
| | - J Prades
- Service d’oncologie médicale, CHU Amiens-Picardie, Amiens, France
| | - D Bello Roufai
- Service d’oncologie médicale, CHU Amiens-Picardie, Amiens, France
| | - F El Azumi
- UMR 7021 CNRS/Unistra, Laboratoire de Bioimagerie et Pathologies, Faculté de pharmacie, Illkirch-Graffenstaden, France
| | - M Boone
- Service d’oncologie médicale, CHU Amiens-Picardie, Amiens, France
| | - H Sevestre
- Service d’anatomie et cytologie pathologique, CHU Amiens-Picardie, Amiens, France
| | - S Trudel
- Laboratoire d’oncobiologie moléculaire, CHU Amiens-Picardie, Amiens, Amiens, France
| | - A Coutte
- Service de radiothérapie, CHU Amiens Picardie, Amiens, France
| | - C Desenclos
- Service de neurochirurgie, CHU Amiens-Picardie, Amiens, France
| | - J Constans
- Service de radiologie et imagerie médicale, CHU Amiens-Picardie, Amiens, France
| | - B Chauffert
- Service d’oncologie médicale, CHU Amiens-Picardie, Amiens, France
| | - M Dontenwill
- UMR 7021 CNRS/Unistra, Laboratoire de Bioimagerie et Pathologies, Faculté de pharmacie, Illkirch-Graffenstaden, France
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Heintz A, Chombar J, Boussida S, Saidak Z, Lefranc M, Deleval N, Coutte A, Chauffert B, Boone M, Constans J. P14.92 Study of Glutaminergic and Glutamatergic Metabolism in 1H-MRS Monovoxel in the Most Aggressive Part of 62 Glioblastoma Before and After 18 months Treatment. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
To study the relationships between glutaminergic metabolism (Glx/tCr), tumor proliferation (tCho/tCr) and other metabolic activities in patients with glioblastoma (GBM).
MATERIAL AND METHODS
Patients: 62 patients with glioblastoma, all having a STUPP Protocol (radiotherapy and concomitant chemotherapy), were selected and separated into 2 groups: Biopsies (30) and resections (32). In total, 269 NMR spectra (PRESS at GE 1.5T and 3T; multi-TEs TE=35ms and TE=144ms) were acquired. Processing: MRS data were processed with jMRUI software and quantitated using HLSVD and QUEST algorithms. Statistical analysis of longitudinal MRS data (every 3 months)
RESULTS
Glx/tCr and Lac/tCr ratios are correlated with the tumoral proliferation (tCho/tCr) before the beginning of treatment. This correlations decreases over time in biopsied and resected patients. In biopsied patients, the evolution of lactate (Lac/tCr) and Glx (Glx/tCr) ratios is similar along the follow-up with a progressive decrease in tumor proliferation (tCho/tCr). However, in resected patients, the evolution of lactate (Lac/tCr) and Glx (Glx/tCr) ratios is similar until 6 months and differ above: a progressive decrease of Lac/tCr and Glx/tCr until 18 months with a higher level of Glx/tCr.
CONCLUSION
Despite the difficulties to separate glutamine from glutamate (post-processing improvement is ongoing), spectroscopic measurements of Glx changes before clinical deterioration. The increase of Glx is longer (in time) than the Lactate increase after 6 months of treatment in the resected patients could be predictive of the observed increase of tumor proliferation at 12 months of treatment.The study of glutaminergic metabolism in the GBM could be used to evaluate the response to treatment. Being able to predict the increase of tumor proliferation in resected patients could allow a faster treatment adaptation.
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Affiliation(s)
- A Heintz
- CHU Amiens Picardie, Amiens, France
| | | | | | - Z Saidak
- CHU Amiens Picardie, Amiens, France
| | | | | | - A Coutte
- CHU Amiens Picardie, Amiens, France
| | | | - M Boone
- CHU Amiens Picardie, Amiens, France
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Bondue C, Racadot S, Coutte A, Dupuis P, Biston MC, Grégoire V. Volumetric and dosimetric comparison of two delineation guidelines for the radiation treatment of laryngeal squamous cell carcinoma. Clin Transl Radiat Oncol 2019; 19:1-11. [PMID: 31334365 PMCID: PMC6614748 DOI: 10.1016/j.ctro.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/31/2019] [Accepted: 06/09/2019] [Indexed: 11/24/2022] Open
Abstract
The delineation of target volumes for Head and Neck IMRT is complex. There have been several approaches for the delineation of the primary tumor clinical target volume: the anatomical guidelines, the geometric guidelines and more recently the international guidelines.
Purpose Three methods have been recently proposed for the delineation of the primary tumor clinical target volume (CTV-P) in Head and Neck Cancers: the anatomic method popularized in the French literature by Lapeyre et al. the geometric methods proposed by the DAHANCA group, and more recently the international guidelines promoted by Grégoire et al. integrating the latter two. The aim of this study was to perform a volumetric and dosimetric comparison of the French and the International consensus methods in laryngeal SCC. Patients and methods Two radiation oncologists independently delineated the high dose and low dose primary tumor CTV in four patients with T2 or T3 N0-M0 laryngeal SCC following either the so-called French guidelines or the International guidelines. For the 4 cases, the GTV was delineated by a single radiation oncologist. Nodal CTVs were delineated by one radiation oncologist for the 4 cases using International guidelines. Dose optimization was then performed with VMAT (MONACO version 5.11) using 6 MeV photons. Differences in target volumes and dose distributions in OARs and PTVs were then evaluated with various metrics such as the DICE Similarity Coefficient and the homogeneity index. Results Major differences were observed in the CTV delineation between the 2 delineation methods for the low dose volumes and to a lower extend for the high dose volumes. These differences translated into variations in dose distribution favoring the International guidelines for decreasing dose to various OARs. Such differences toned down when dose distribution on the primary tumors PTVs and nodal PTVs were combined. Conclusion This study demonstrated large differences in CTV delineation between the 2 delineation guidelines. Such differences translated into differences in dose distribution.
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Affiliation(s)
- C Bondue
- Department of Radiation Oncology, University Hospital, Amiens, France
| | - S Racadot
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - A Coutte
- Department of Radiation Oncology, University Hospital, Amiens, France
| | - P Dupuis
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - M C Biston
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - V Grégoire
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
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Beddok A, Faivre J, Coutte A, Le Guévelou J, Welmant J, Clavier J, Guihard S, Janoray G, Calugaru V, Pointreau Y, Lacout A, Salleron J, Lefranc M, Hasboun D, Duvernoy H, Thariat J. PO-0754 Radiation-induced nausea and vomiting: how to delineate the Dorsal Vagal Complex ? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31174-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pflumio C, Troussier I, Sun XS, Salleron J, Petit C, Caubet M, Beddok A, Calugaru V, Servagi-Vernat S, Castelli J, Miroir J, Krengli M, Giraud P, Romano E, Khalifa J, Doré M, Blanchard N, Coutte A, Dupin C, Sumodhee S, Pointreau Y, Patel S, Rehailia-Blanchard A, Catteau L, Bensadoun RJ, Tao Y, Roth V, Geoffrois L, Faivre JC, Thariat J. Unilateral or bilateral irradiation in cervical lymph node metastases of unknown primary? A retrospective cohort study. Eur J Cancer 2019; 111:69-81. [PMID: 30826659 DOI: 10.1016/j.ejca.2019.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 02/17/2018] [Revised: 01/02/2019] [Accepted: 01/06/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Patients with cervical lymphadenopathy of unknown primary carcinoma (CUP) usually undergo neck dissection and irradiation. There is an ongoing controversy regarding the extent of nodal and mucosal volumes to be irradiated. We assessed outcomes after bilateral or unilateral nodal irradiation. METHODS This retrospective multicentre study included patients with CUP and squamous cellular carcinoma who underwent radiotherapy (RT) between 2000 and 2015. RESULTS Of 350 patients, 74.5% had unilateral disease and 25.5% had bilateral disease. Of 297 patients with available data on disease and irradiation sides, 61 (20.5%) patients had unilateral disease and unilateral irradiation, 155 (52.2%), unilateral disease and bilateral irradiation and 81 (27.3%), bilateral disease and bilateral irradiation. Thirty-four (9.7%) and 217 (62.0%) patients received neoadjuvant and/or concomitant chemotherapy, respectively. Median follow-up was 37 months. Three-year local, regional, locoregional failure rates and CUP-specific survival were 5.6%, 11.7%, 15.0% and 84.7%, respectively. In patients with unilateral disease, the 3-year cumulative incidence of regional/local relapse was 7.7%/4.3% after bilateral irradiation versus 16.9%/11.1% after unilateral irradiation (hazard ratio = 0.56/0.61, p = 0.17/0.32). The cumulative incidence of CUP-specific deaths was 9.2% after bilateral irradiation and 15.5% after unilateral irradiation (p = 0.92). In multivariate analysis, mucosal irradiation was associated with better local control, whereas no neck dissection, ≥N2b and interruption of RT for more than 4 days were associated with poorer regional control. Toxicity was higher after bilateral irradiation (p < 0.05). No positron-emission tomography-computed tomography, largest node diameter, ≥N2b, neoadjuvant chemotherapy and interruption of RT were associated with poorer cause-specific survival. CONCLUSION Bilateral nodal irradiation yielded non-significant better nodal and mucosal control rates but was associated with higher rates of severe toxicity.
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Affiliation(s)
- Carole Pflumio
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Idriss Troussier
- Department of Radiation Therapy, CHU Pitié Salpêtrière, Assistance Publique, Hôpitaux de Paris, Paris, France
| | - Xu Shan Sun
- Department of Radiation Therapy, Hôpital de Montbéliard, Montbéliard, France
| | - Julia Salleron
- Department of Biostatistics and Data Management, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Claire Petit
- Department of Radiation Therapy, Institut Gustave Roussy, Villejuif, France
| | - Matthieu Caubet
- Department of Radiation Therapy, CHU de Besançon, Besançon, France
| | - Arnaud Beddok
- Department of Radiation Therapy, Institut Curie, Paris, France
| | | | | | - Joël Castelli
- Department of Radiation Therapy, Institut Eugène Marquis, Rennes, France
| | - Jessica Miroir
- Department of Radiation Therapy, Institut Jean Perrin, Clermont-Ferrand, France
| | - Marco Krengli
- Department of Radiation Therapy, University of Piemonte Orientale, Pavia, Italy
| | - Paul Giraud
- Department of Radiation Therapy, Hôpital Tenon, Assistance Publique, Hôpitaux de Paris, Paris, France
| | - Edouard Romano
- Department of Radiation Therapy, Hôpital Tenon, Assistance Publique, Hôpitaux de Paris, Paris, France
| | - Jonathan Khalifa
- Department of Radiation Therapy, Institut Universitaire du Cancer, Toulouse, France
| | - Mélanie Doré
- Department of Radiation Therapy, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Nicolas Blanchard
- Department of Radiation Therapy, Clinique les Dentellières, Valenciennes, France
| | | | - Charles Dupin
- Department of Radiation Therapy, Centre Antoine Lacassagne, Nice, France
| | - Shakeel Sumodhee
- Department of Radiation Therapy, Centre Antoine Lacassagne, Nice, France
| | - Yoann Pointreau
- Department of Radiation Therapy, Clinique Victor Hugo, Le Mans, France
| | - Samir Patel
- Department of Radiation Therapy, Mayo Clinic, Arizona, USA
| | | | - Ludivine Catteau
- Department of Radiation Therapy, CHU de Poitiers, Poitiers, France
| | | | - Yungan Tao
- Department of Radiation Therapy, Institut Gustave Roussy, Villejuif, France
| | | | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Jean-Christophe Faivre
- Academic Department of Radiation Therapy, Lorraine Institute of Cancerology, Vandoeuvre-lès-Nancy, France
| | - Juliette Thariat
- Department of Radiation Therapy, Centre Francois Baclesse, Advanced Resource Center for Hadrontherapy in Europe, Caen, France, Unicaen-Normandie Universite.
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Thariat J, Troussier I, Sun X, Salleron J, Petit C, Pflumio C, Arnaud B, Stephanie S, Castelli J, Miroir J, Krengli M, Giraud P, Khalifa J, Dore M, Blanchard N, Coutte A, Sumodhee S, Calugaru V, TAO Y, Dupin C, Pointreau Y, Patel S, rehalia-Blanchard A, Catteau L, Bensadoun R, Roth V, Christophe FJ. Uni or bilateral Irradiation in Cervical Lymph Node Metastases of Unknown Primary? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Geoffrois L, Martin L, De Raucourt D, Sun XS, Tao Y, Maingon P, Buffet J, Pointreau Y, Sire C, Tuchais C, Babin E, Coutte A, Rolland F, Kaminsky MC, Alfonsi M, Lapeyre M, Saliou M, Lafond C, Jadaud E, Gery B, Zawadi A, Tourani JM, Khoury C, Henry AR, Hasbini A, Guichard F, Borel C, Meert N, Guillet P, Calais MH, Garaud P, Bourhis J. Induction Chemotherapy Followed by Cetuximab Radiotherapy Is Not Superior to Concurrent Chemoradiotherapy for Head and Neck Carcinomas: Results of the GORTEC 2007-02 Phase III Randomized Trial. J Clin Oncol 2018; 36:3077-3083. [DOI: 10.1200/jco.2017.76.2591] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Both concurrent chemoradiotherapy (CT-RT) and cetuximab radiotherapy (cetux-RT) have been established as the standard of care for the treatment of locally advanced squamous cell carcinoma of the head and neck. It was not known whether the addition of induction chemotherapy before cetux-RT could improve outcomes compared with standard of care CT-RT. Patients and Methods The current trial was restricted to patients with nonmetastatic N2b, N2c, or N3 squamous cell carcinoma of the head and neck and fit for taxotere, cisplatin, fluorouracil (TPF). Patients were randomly assigned to receive three cycles of TPF followed by cetux-RT versus concurrent carboplatin fluorouracil and RT as recommended in National Comprehensive Cancer Network guidelines. The trial was powered to detect a hazard ratio (HR) of 0.66 in favor of TPF plus cetux-RT for progression-free survival at 2 years. The inclusion of 180 patients per arm was needed to achieve 80% power at a two-sided significance level of .05. Results Between 2009 and 2013, 370 patients were included. All patients and tumors characteristics were well balanced between arms. There were more cases of grade 3 and 4 neutropenia in the induction arm, and the induction TPF was associated with 6.6% treatment-related deaths. With a median follow-up of 2.8 years, 2-year progression-free survival was not different between both arms (CT-RT, 0.38 v TPF + cetux-RT, 0.36; HR, 0.93 [95% CI, 0.73 to 1.20]; P = .58). HR was 0.98 (95% CI, 0.74 to 1.3; P = .90) for locoregional control and 1.12 (95% CI, 0.86 to 1.46; P = .39) for overall survival. These effects were observed regardless of p16 status. The rate of distant metastases was lower in the TPF arm (HR, 0.54 [95% CI, 0.30 to 0.99]; P = .05). Conclusion Induction TPF followed by cetux-RT did not improve outcomes compared with CT-RT in a population of patients with advanced cervical lymphadenopathy.
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Affiliation(s)
- Lionnel Geoffrois
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Laurent Martin
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Dominique De Raucourt
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Xu Shan Sun
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Yungan Tao
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Philippe Maingon
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Joëlle Buffet
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Yoann Pointreau
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Christian Sire
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Claude Tuchais
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Emmanuel Babin
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Alexandre Coutte
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Frédéric Rolland
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Marie-Christine Kaminsky
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Marc Alfonsi
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Michel Lapeyre
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Marie Saliou
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Cédric Lafond
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Eric Jadaud
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Bernard Gery
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Ayman Zawadi
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Jean-Marc Tourani
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Cédric Khoury
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Anne Rose Henry
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Ali Hasbini
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - François Guichard
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Christian Borel
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Nicolas Meert
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Pierre Guillet
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Marie-Hélène Calais
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Pascal Garaud
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
| | - Jean Bourhis
- Lionnel Geoffrois, Marie-Christine Kaminsky, Institut de Cancérologie de Lorraine, Vandoeuvre Lès Nancy; Laurent Martin, Centre Guillaume le Conquérant; Dominique De Raucourt, Bernard Gery, Centre François Baclesse; Emmanuel Babin, Hopital Universitaire, Caen; Xu Shan Sun, Joëlle Buffet, Centre Hospitalier Universitaire de Besançon, Besançon; Hôpital de Mulhouse, Mulhouse; Yungan Tao, Gustave-Roussy Institute, Villejuif; Philippe Maingon, Centre François Leclercq, Leclercq; Yoann Pointreau, Cédric Lafond
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Loriguet L, Morisse MC, Dremaux J, Collet L, Attencourt C, Coutte A, Boone M, Sevestre H, Galmiche A, Gubler B, Chauffert B, Trudel S. Combining genomic analyses with tumour-derived slice cultures for the characterization of an EGFR-activating kinase mutation in a case of glioblastoma. BMC Cancer 2018; 18:964. [PMID: 30305059 PMCID: PMC6180520 DOI: 10.1186/s12885-018-4873-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/28/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) gene alterations and amplification are frequently reported in cases of glioblastoma (GBM). However, EGFR-activating mutations that confer proven sensitivity to tyrosine kinase inhibitors (TKIs) in lung cancer have not yet been reported in GBM. CASE PRESENTATION Using next-generation sequencing, array comparative genomic hybridization and droplet digital PCR, we identified the p.L861Q EGFR mutation in a case of GBM for the first time. The mutation was associated with gene amplification. L861Q may be a clinically valuable mutation because it is known to sensitize non-small-cell lung cancers to treatment with the second-generation EGFR TKI afatinib in particular. Furthermore, we used slice culture of the patient's GBM explant to evaluate the tumour's sensitivity to various EGFR-targeting drugs. Our results suggested that the tumour was not intrinsically sensitive to these drugs. CONCLUSIONS Our results highlight (i) the value of comprehensive genomic analyses for identifying patient-specific, targetable alterations, and (ii) the need to combine genomic analyses with functional assays, such as tumour-derived slice cultures.
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Affiliation(s)
- Lea Loriguet
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Service d’Oncologie médicale, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Mony Chenda Morisse
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Service d’Oncologie médicale, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Julie Dremaux
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Laboratoire d’Oncobiologie moléculaire, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Louison Collet
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
| | - Christophe Attencourt
- Service d’Anatomie et de cytologie pathologiques, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Alexandre Coutte
- Service d’Oncologie radiothérapique, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Mathieu Boone
- Service d’Oncologie médicale, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Henri Sevestre
- Service d’Anatomie et de cytologie pathologiques, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Antoine Galmiche
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Laboratoire de Biochimie, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Brigitte Gubler
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Laboratoire d’Oncobiologie moléculaire, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Bruno Chauffert
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Service d’Oncologie médicale, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Stephanie Trudel
- EA4666, LNPC, Université de Picardie Jules Verne, Amiens, France
- Laboratoire d’Oncobiologie moléculaire, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
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Troussier I, Pflumio C, Sun X, Salleron J, Petit C, Caubet M, Beddock A, Calugaru V, Servagi Vernat S, Castelli J, Miroir J, Giraud P, Khalifa J, Doré M, Blanchard N, Coutte A, Dupin C, Sumodhee S, Rehailia-Blanchard A, Catteau L, Tao Y, Pointreau Y, Bensadoun RJ, Roth V, Faivre JC, Thariat J. Irradiation uni- ou bilatérale des métastases ganglionnaires cervicales de cancer primitif inconnu ? Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Beddok A, Faivre JC, Coutte A, Guévelou JL, Welmant J, Clavier JB, Guihard S, Janoray G, Calugaru V, Pointreau Y, Lacout A, Salleron J, Lefranc M, Hasboun D, Duvernoy HM, Thariat J. Practical contouring guidelines with an MR-based atlas of brainstem structures involved in radiation-induced nausea and vomiting. Radiother Oncol 2018; 130:113-120. [PMID: 30172454 DOI: 10.1016/j.radonc.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/06/2018] [Revised: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this project was to define consensus guidelines for delineating brainstem substructures (dorsal vagal complex, including the area postrema) involved in radiation-induced nausea and vomiting (RINV). The three parts of the brainstem are rarely delineated, so this study was also an opportunity to find a consensus on this subject. MATERIALS AND METHODS The dorsal vagal complex (DVC) was identified on autopsy sections and endoscopic descriptions. Anatomic landmarks and boundaries were used to establish radio-anatomic correlations on CT and Magnetic Resonance Imaging (MRI). Additionally, delineation of RINV structures was performed on MRI images and reported on CT scans. Next, guidelines were provided to eight radiation oncologists for delineation guidance of these RINV-related structures on DICOM-RT images of two patients being treated for a nasopharyngeal carcinoma. Interobserver variability was computed. RESULTS The DVC and the three parts of the brainstem were defined with a concise description of their main anatomic boundaries. The interobserver analysis showed that the DVC, the midbrain, the pons, and the medulla oblongata delineations were reproducible with KI = 0.72, 0.84, 0.94 and 0.89, respectively. The Supplemental Material section provides an atlas of the consensus guidelines projected on 1-mm MR axial slices. CONCLUSIONS This RINV-atlas was feasible and reproducible for the delineation of RINV structures on planning CT using fused MRI. It may be used to prospectively assess dose-volume relationship for RINV structures and occurrence of nausea vomiting during intracranial or head and neck irradiation.
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Affiliation(s)
- Arnaud Beddok
- Department of Radiation Oncology, University Hospital of Amiens, France; Department of Radiation Oncology, Curie Institute, Paris, France.
| | - Jean-Christophe Faivre
- Lorraine Institute of Cancerology - Alexis-Vautrin Comprehensive Cancer Center, Academic Radiation Oncology & Brachytherapy Department, Vandœuvre-lès-Nancy, France
| | - Alexandre Coutte
- Department of Radiation Oncology, University Hospital of Amiens, France
| | | | - Julien Welmant
- Department of Radiation Oncology, Montpellier Institute of Cancer, France
| | - Jean-Baptiste Clavier
- Department of Radiation Oncology, Strasbourg Insitute of Cancerology - Paul Strauss Cancer Center, Strasbourg Cedex, France
| | - Sébastien Guihard
- Department of Radiation Oncology, Strasbourg Insitute of Cancerology - Paul Strauss Cancer Center, Strasbourg Cedex, France
| | - Guillaume Janoray
- Department of Radiation Oncology, Tours Regional University Center, France
| | | | - Yoann Pointreau
- Jean Bernard Radiation Oncology Center, Le Mans, France; CORad Department, Henry S Kaplan - Bretonneau Regional University Hospital Center, Tours, France; CNRS, UMR 7292 "Génétique, Immunothérapie, Chimie et Cancer", Tours, France
| | - Alexis Lacout
- Department of Radiology, Centre médico - chirurgical - ELSAN, Aurillac, France
| | - Julia Salleron
- Lorraine Institute of Cancerology - Alexis-Vautrin Comprehensive Cancer Center, Academic Radiation Oncology & Brachytherapy Department, Vandœuvre-lès-Nancy, France
| | - Michel Lefranc
- Department of Neurosurgery, University Hospital of Amiens, France
| | - Dominique Hasboun
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France; Department of Neuroanatomy, Pitié-Salpêtrière University Hospital, Paris, France
| | - Henri M Duvernoy
- Besançon Regional University Hospital Center, laboratoire de pathology, Centre Hospitalier Régional Universitaire de Besançon (Besançon), France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France; Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534 - Unicaen - Normandie Université Boulevard du Marechal Juin 14050 Caen, France
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Tao Y, Auperin A, Sire C, Martin L, Khoury C, Maingon P, Bardet E, Kaminsky MC, Lapeyre M, Chatellier T, Alfonsi M, Pointreau Y, Jadaud E, Géry B, Zawadi A, Tourani JM, Laguerre B, Coutte A, Racadot S, Hasbini A, Malaurie E, Borel C, Meert N, Cornely A, Ollivier N, Casiraghi O, Sun XS, Bourhis J. Improved Outcome by Adding Concurrent Chemotherapy to Cetuximab and Radiotherapy for Locally Advanced Head and Neck Carcinomas: Results of the GORTEC 2007-01 Phase III Randomized Trial. J Clin Oncol 2018; 36:JCO2017762518. [PMID: 29878867 DOI: 10.1200/jco.2017.76.2518] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Purpose To investigate the effect of adding concurrent chemotherapy (CT) to cetuximab plus radiotherapy (RT; CT-cetux-RT) compared with cetuximab plus RT (cetux-RT) in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Patients and Methods In this phase III randomized trial, patients with N0-2b, nonoperated, stage III or IV (nonmetastatic) LA-SCCHN were enrolled. Patients received once-daily RT up to 70 Gy with weekly cetuximab or with weekly cetuximab and concurrent carboplatin and fluorouracil (three cycles). To detect a hazard ratio (HR) of 0.64 for progression-free survival (PFS) with 85% power at a two-sided significance level of P = .05, 203 patients needed to be included in each arm. Results Four hundred six patients were randomly assigned to either CT-cetux-RT or cetux-RT. Patient and tumor characteristics were well balanced between arms, including p16 status. With a median follow-up of 4.4 years, the HR for PFS favored the CT-cetux-RT arm (HR, 0.73; 95% CI, 0.57 to 0.94; P = .015), with 3-year PFS rates of 52.3% and 40.5% and median PFS times of 37.9 and 22.4 months in the CT-cetux-RT and cetux-RT arms, respectively. The HR for locoregional control was 0.54 (95% CI, 0.38 to 0.76; P < .001) in favor of CT-cetux-RT. These benefits were observed regardless of p16 status for oropharynx carcinomas. Overall survival (HR, 0.80; P = .11) and distant metastases rates (HR, 1.19; P = .50) were not significantly different between the two arms. The CT-cetux-RT arm, compared with cetux-RT, had a higher incidence of grade 3 or 4 mucositis (73% v 61%, respectively; P = .014) and of hospitalizations for toxicity (42% v 22%, respectively; P < .001). Conclusion The addition of concurrent carboplatin and fluorouracil to cetux-RT improved PFS and locoregional control, with a nonsignificant gain in survival. To our knowledge, this is the first evidence of a clinical benefit for treatment intensification using cetux-RT as a backbone in LA-SCCHN.
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Affiliation(s)
- Yungan Tao
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Anne Auperin
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Christian Sire
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Laurent Martin
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Cedric Khoury
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Philippe Maingon
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Etienne Bardet
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Marie-Christine Kaminsky
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Michel Lapeyre
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Thierry Chatellier
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Marc Alfonsi
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Yoann Pointreau
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Eric Jadaud
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Bernard Géry
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Ayman Zawadi
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Jean-Marc Tourani
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Brigitte Laguerre
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Alexandre Coutte
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Séverine Racadot
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Ali Hasbini
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Emanuelle Malaurie
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Christian Borel
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Nicolas Meert
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Alexandre Cornely
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Nathalie Ollivier
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Odile Casiraghi
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Xu Shan Sun
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
| | - Jean Bourhis
- Yungan Tao, Anne Auperin, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, and Jean Bourhis, Gustave-Roussy Institute, Villejuif; Christian Sire, Centre Hospitalier de Lorient, Lorient; Laurent Martin, Centre Guillaume le Conquérant, Le Havre; Cedric Khoury, Centre Hospitalier de Toulon, Toulon; Philippe Maingon, Centre Georges-François Leclerc, Dijon; Etienne Bardet, Centre René Gauducheau, Nantes; Marie-Christine Kaminsky, Centre Alexis Vautrin, Nancy; Michel Lapeyre, Centre Jean Perrin, Clermont; Thierry Chatellier, Clinique Mutualiste, Saint Nazaire; Marc Alfonsi, Clinique Sainte Catherine, Avignon; Yoann Pointreau, Centre Jean Bernard, Le Mans; Yoann Pointreau, Centre Hospitalier Universitaire (CHU) de Tours, Tours; Eric Jadaud, Centre Paul Papin, Angers; Bernard Géry, Centre François Baclesse, Caen; Ayman Zawadi, Centre Hospitalier de La Roche-sur-Yon, La Roche-sur-Yon; Jean-Marc Tourani, CHU, Poitiers; Brigitte Laguerre, Centre Eugène Marquis, Rennes; Alexandre Coutte, CHU, Amiens; Séverine Racadot, Centre Léon Bérard, Lyon; Ali Hasbini, Clinique Armoricaine, Saint-Brieuc; Emanuelle Malaurie, Centre Hospitalier Intercommunal de Créteil, Créteil; Christian Borel, Centre Paul Strauss, Strasbourg; Xu Shan Sun, Hopital Nord Franche-Comté de Montbéliard, Montbéliard; Xu Shan Sun, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; Nicolas Meert, Centre Hospitalier de Charleroi, Charleroi, Belgium; and Jean Bourhis, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland
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Sun XS, Sire C, Tao Y, Martin L, Alfonsi M, Prevost JB, Rives M, Lafond C, Tourani JM, Biau J, Geoffrois L, Coutte A, Liem X, Vauleon E, Drouet F, Ramee JF, Waksi G, Sinigaglia L, Auperin A, Bourhis J. A phase II randomized trial of pembrolizumab versus cetuximab, concomitant with radiotherapy (RT) in locally advanced (LA) squamous cell carcinoma of the head and neck (SCCHN): First results of the GORTEC 2015-01 “PembroRad” trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.6018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Yungan Tao
- Institut Gustave Roussy, Villejuif, France
| | | | | | | | - Michel Rives
- Institut Claudius Regaud, IUCT-Oncopole, CRCT, Inserm, Toulouse, France
| | | | | | - Julian Biau
- Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-Lès-Nancy, France
| | | | | | | | | | | | | | | | | | - Jean Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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42
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Tao Y, Auperin A, Sun XS, Sire C, Martin L, Bera G, Coutte A, Miroir J, Lafond C, Colin-Batailhou N, Maillard A, Gibel L, Michel C, Guigay J, Bourhis J. Avelumab-cetuximab-radiotherapy (RT) versus standards of care (SoC) in locally advanced squamous cell carcinoma of the head and neck (SCCHN): Safety phase of the randomized trial GORTEC 2017-01 (REACH). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.6076] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yungan Tao
- Institut Gustave Roussy, Villejuif, France
| | | | | | | | | | - G Bera
- Centre Hospitalier Bretagne Sud, Lorient, France
| | | | | | | | | | - Aline Maillard
- Pole de Santé Publique, Service d’Information Médicale, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, CHU de Bordeaux, Bordeaux, France
| | | | | | - Joel Guigay
- Department of Medical Oncology, Antoine Lacassagne Comprehensive Cancer Centre, FHU Oncoage, Nice, France
| | - Jean Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Abstract
Size perception is known to influence our usual interactions with environment. Numerous studies highlighted that during the visual presentation of an object, the properties of manual actions vary as a function of this object's size. In order to better understand the dynamic variations of relationships between size perception and action, we used an experimental paradigm consisting in two phases. During a previous implicit learning phase, a manual response (right or left) was specifically associated with the appearance of a large or small stimulus. During further test phase, participants were required to prepare a response while discriminating the color of a stimulus (GO/No GO task). We observed that the response execution was faster when the size of the stimulus was congruent with the size that had been associated to this response (during implicit learning phase). These results suggest that when a response usually co-occurs with visual stimuli characterized by a specific size pattern, the response and the size pattern become integrated. Any subsequent preparation and execution of this action are therefore influenced by the reactivation of this visual pattern. This result brings out new insights on how sensorimotor interactions may modulate the ability to anticipate perceptive size variations in the environment.
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Affiliation(s)
- Alexandre Coutte
- Centre de Recherche sur le Sport et le Mouvement (CeRSM), Université Paris Nanterre; Laboratoire d'Anthropologie et de Psychologie Cliniques, Cognitives et Sociales (LAPCOS), Université de Nice Sophia Antipolis, France
| | - Thomas Camus
- Laboratoire Epsylon, Université Paul Valery Montpellier 3, France
| | - Loïc Heurley
- Centre de Recherche sur le Sport et le Mouvement (CeRSM), Université Paris Nanterre, France
| | - Denis Brouillet
- Laboratoire Epsylon, Université Paul Valery Montpellier 3, France
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44
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Tao Y, Geoffrois L, Martin L, De Raucourt D, Miny J, Maingon P, Lafond C, Tuchais C, Sire C, Babin E, Coutte A, Rolland F, Girard-Calais MH, Casiraghi O, Garaud P, Bourhis J. Impact of p16 expression on induction taxotere-cisplatin-5 FU (TPF) followed by cetuximab-radiotherapy in N2b-N3 head and neck squamous cell carcinoma (HNSCC): Results of GORTEC 2007-02 phase III randomized trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.6070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6070 Background: TPF is a reference induction chemotherapy regimen in non-operated locally advanced (LA) HNSCC. GORTEC 2007-02 phase III randomized trial was restricted to HNSCC patients with large nodal spread (N2b-N3). Results showed no benefit of 3 cycles of induction TPF followed by cetuximab-radiotherapy (RT), as compared to concurrent chemoradiotherapy (CRT) (Geoffrois et al ASCO 2016). Methods: Patients were randomized to receive concurrent CRT (arm A) or induction TPF followed by cetuximab-RT (arm B). RT was 70 Gy/35F/7 weeks. Concurrent chemotherapy was 3 cycles of carboplatin-5FU as previously described (Calais JNCI 1999). About 2/3 of patients had oropharyngeal cancers (OPC) and HPV status was determined in these patients using p16 expression as a surrogate (immunohistochemistry). Smoking status was also collected. Primary endpoint was progression free survival (PFS). Results: Between May 2009 and Aug 2013, 360 eligible patients were randomized including 231 (64%) OPC. Overall, p16 expression could be assessed in 172 / 231 OPC patients (74%) with 84 in arm A and 88 in arm B. 26 patients were found p16+ in arm A (31%) and 19 in arm B (22%). Only 8 out 45 (18%) p16+ patients were non-smokers showing that the large majority of OPC patients randomized were p16- (127/172) and smokers (117/129). A significant improvement in PFS was found in p16+ compared to p16- OPC (p < 0.0001). The absence of benefit in PFS associated with TPF + cetux-RT compared with CRT was suggested both in p16+ (HR: 0.78, 95% CI: 0.28 – 2.20) and in p16- OPC (HR: 1.28, 95% CI: 0.84 – 1.93), and the interaction between p16 and treatment modality was not significant (p = 0.35). A significant benefit was observed in favor of arm B regarding distant metastasis, but this effect was not different between the p16+ and p16- OPC, while there was no benefit of TPF + cetux-RT compared with CRT for loco-regional control, regardless of p16 status. Conclusions: The OPC p16 subpopulations were small. No benefit of induction TPF chemotherapy followed by cetuximab-RT compared with CRT in OPC patients regardless of p16 status. Clinical trial information: NCT01233843.
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Affiliation(s)
- Yungan Tao
- Gustave Roussy Cancer Campus, Villejuif, France
| | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-Lès-Nancy, France
| | | | | | - Joelle Miny
- Besancon University Hospital, Besancon, France
| | - Philippe Maingon
- Georges-François Leclerc Center, Radiotherapy Department, Dijon, France
| | | | - Claude Tuchais
- Institut De Cancérologie De L'ouest - Site Paul Papin, Angers, France
| | | | | | | | - Frederic Rolland
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | | | - Odile Casiraghi
- Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | | | - Jean Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Darmon I, Morisse MC, Coutte A, Blonski M, Le Rhun E, Taillandier L, Roufai DB, Desenclos C, Trudel S, Faivre JC, Blanchard N, Chauffert B, Boone M. Temozolomide and Bevacizumab Induction before Chemoradiotherapy in Patients with Bulky Glioblastoma and/or with Severe Neurological Impairment. J Cancer 2017. [PMID: 28638456 PMCID: PMC5479247 DOI: 10.7150/jca.18339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background.New approaches are needed for patients newly diagnosed with bulky glioblastoma (GB) and/or with severe neurological impairment that cannot benefit from first line temozolomide (TMZ)-based chemoradiotherapy. Bevacizumab (BEV), an antiangiogenic anti-VEGF-R monoclonal antibody, has a rapid impact on tumor-related brain edema in recurrent GB. The present study reports the feasibility and efficacy of an induction treatment with TMZ and BEV to alleviate the initial neurological impairment and/or to reduce the tumor volume before a delayed chemoradiotherapy. Methods.We retrospectively analyzed tumor and target volumes and clinical neurological status in 39 patients with bulky GB and/or with severe neurological impairment after an induction treatment combining TMZ and BEV. Neurological and radiological responses were assessed according to RANO criteria. Calculating gross tumor and clinical target volumes (GTV and CTV) was done at diagnosis and before radiotherapy. Progression-free survival (PFS) and overall survival (OS) were determined by Kaplan Meier methods. Safety was reported according to NCTCAE. Results. A cohort of 39 patients was analyzed between December 2010 and April 2014. Upfront standard TMZ-based chemoradiotherapy was recused due either to tumor volume or impairment of neurological status and/or performance status. After TMZ/BEV induction (median time of 3 months), 6 (15%) patients achieved a partial response (PR), and 17 (44%) had a stable disease. 24 patients (62%) received a radical-intent chemoradiotherapy. TMZ-BEV induced median reduction of the clinical target volume (CTV) was 25.9% [-84.4%; - 4.8%]. The median PFS and OS were 8.4 months [95% CI: (6.6 - 9.9)] and 11.0 months [95% CI: (9.3 - 13.7)], respectively in the whole cohort and 10.8 [95% CI: (9.3 - 12.9)] and 15.0 [95% CI: (13.2 - 17.8)] for irradiated patients. Induction treatment led to corticosteroid dose reduction or cessation in 21 patients (54%). KPS improvement was observed in 38% of patients. Toxicity was mild with only 7/39 (18%) grade III-IV toxicity, including 1 digestive bleeding and 1 epistaxis. Conclusion.TMZ-BEV induction led to CTV reduction allowing for optimal chemoradiotherapy in a majority (62%) of patients for which radiotherapy was initially recused. A clinical benefit was obtained with improved KPS and a decrease in steroid dose.
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Affiliation(s)
- Ilan Darmon
- Department of Radiotherapy, University Hospital, Amiens, France
| | | | | | - Marie Blonski
- Department of Neuro-Oncology, University Hospital, Nancy, France
| | - Emilie Le Rhun
- Department of Neuro-Oncology, University Hospital, Lille, France
| | - Luc Taillandier
- Department of Neuro-Oncology, University Hospital, Nancy, France
| | | | | | - Stéphanie Trudel
- Laboratory of Molecular Oncology, University Hospital, Amiens, France
| | - Jean-Christophe Faivre
- Department of Radiotherapy, Centre Alexis Vautrin, Nancy, France.,Department of Radiotherapy, Hospital of Metz-Thionville, France
| | - Nicolas Blanchard
- Department of Radiotherapy, Clinique des Dentellières, Valenciennes, France
| | - Bruno Chauffert
- Department of Medical Oncology , University Hospital, Amiens, France
| | - Mathieu Boone
- Department of Medical Oncology , University Hospital, Amiens, France
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Seloi O, Heintz A, Hanafi R, Laborde R, Dou W, Ruan S, Prades J, Le Gars D, Deramond H, Lefranc M, Coutte A, Toussaint P, Desenclos C, Chauffert B, Boone M, Constans J. Intérêt des séquences avancées en IRM dans l’évaluation à la réponse au Bevacizumab. Suivi multimodal de 20 glioblastomes. J Neuroradiol 2017. [DOI: 10.1016/j.neurad.2017.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Constans JM, Heintz A, Seloi O, Deleval N, Beauvois M, Hanafi R, Dallery F, Dou W, Ruan S, Prades J, Le Gars D, Baledent O, Deramond H, Houessinon A, Fichten A, Lefranc M, Coutte A, Toussaint P, Desenclos C, Chauffert B, Boone M. Importance des variations spectrales durant 36 mois de suivi longitudinal IRM et SRM de 80 patients atteints de glioblastomes traités. J Neuroradiol 2017. [DOI: 10.1016/j.neurad.2017.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Geoffrois L, Martin L, Garaud P, De Raucourt D, Miny J, Maingon P, Lafond C, Tuchais C, Sire C, Babin E, Coutte A, Tao Y, Rolland F, Girard-Calais MH, Bourhis J. Induction docetaxel platinum 5-FU (TPF) followed by cetuximab-radiotherapy (cetux-RT) versus concurrent chemo-radiotherapy (CT/RT) in patients with N2b/c-N3 non operated stage III-IV squamous cell cancer of the head and neck (SCCHN): Results of the GORTEC 2007-02 phase III randomized trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.6000] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Joelle Miny
- Besancon University Hospital, Besancon, France
| | - Philippe Maingon
- Georges-François Leclerc Center, Radiotherapy Department, Dijon, France
| | | | - Claude Tuchais
- Institut De Cancérologie De L'ouest - Site Paul Papin, Angers, France
| | | | | | | | | | | | | | - Jean Bourhis
- Lausanne University Medical Center, , Lausanne,, Switzerland
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Denamps J, Brigant F, Caudron A, Chaby G, Dadban A, Arnault JP, Coutte A, Lok C. Nævus et radiothérapie : analyse dermoscopique des nævus après un traitement par radiothérapie externe. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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50
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Darmon I, Boone M, Blonski M, Le Rhun E, Taillandier L, Chauffert B, Coutte A. Upfront treatment with temozolomide and bevacizumab (TEMOBEVA) in patients with bulky, multifocal glioblastoma and/or with severe neurological impairmen. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ilan Darmon
- Department of Radiotherapie, CHU Amiens, Amiens, France
| | - Mathieu Boone
- Department of Medical Oncology, CHU Amiens, Amiens, France
| | | | - Emilie Le Rhun
- Centre Hospitalier Régional et Universitaire, Lille, France
| | | | - Bruno Chauffert
- University Hospital (CHU) - Department of medical oncology, Amiens, France
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