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Carrie C, Kieffer V, Figarella-Branger D, Masliah-Planchon J, Bolle S, Bernier V, Laprie A, Supiot S, Leseur J, Habrand JL, Alapetite C, Kerr C, Dufour C, Claude L, Chapet S, Huchet A, Bondiau PY, Escande A, Truc G, Nguyen TD, Pasteuris C, Vigneron C, Muracciole X, Bourdeaut F, Appay R, Dubray B, Colin C, Ferlay C, Dussart S, Chabaud S, Padovani L. Exclusive Hyperfractionated Radiation Therapy and Reduced Boost Volume for Standard-Risk Medulloblastoma: Pooled Analysis of the 2 French Multicentric Studies MSFOP98 and MSFOP 2007 and Correlation With Molecular Subgroups. Int J Radiat Oncol Biol Phys 2020; 108:1204-1217. [PMID: 32768563 DOI: 10.1016/j.ijrobp.2020.07.2324] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/03/2020] [Accepted: 07/29/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE Medulloblastoma has recently been characterized as a heterogeneous disease with 4 distinct molecular subgroups: wingless (WNT), sonic hedgehog (SHH), group 3, and group 4, with a new definition of risk stratification. We report progression-free survival, overall survival, and long-term cognitive effects in children with standard-risk medulloblastoma exclusively treated with hyperfractionated radiation therapy (HFRT), reduced boost volume, and online quality control, and we explore the prognostic value of biological characteristics in this chemotherapy-naïve population. METHODS AND MATERIALS Patients with standard-risk medulloblastoma were enrolled in 2 successive prospective multicentric studies, MSFOP 98 and MSFOP 2007, and received exclusive HFRT (36 Gy, 1 Gy/fraction twice daily) to the craniospinal axis followed by a boost at 68 Gy restricted to the tumor bed (1.5 cm margin), with online quality assurance before treatment. Patients with MYC or MYCN amplification were not excluded at the time of the study. We report progression-free survival and overall survival in the global population, and according to molecular subgroups as per World Health Organization 2016 molecular classification, and we present cognitive evaluations based on the Wechsler scale. RESULTS Data from 114 patients included in the MSFOP 98 trial from December 1998 to October 2001 (n = 48) and in the MSFOP 2007 from October 2008 to July 2013 (n = 66) were analyzed. With a median follow-up of 16.2 (range, 6.4-19.6) years for the MSFOP 98 cohort and 6.5 (1.6-9.6) years for the MSFOP 2007 cohort, 5-year overall survival and progression-free survival in the global population were 84% (74%-89%) and 74% (65%-81%), respectively. Molecular classification was determined for 91 patients (WNT [n = 19], SHH [n = 12], and non-WNT/non-SHH [n = 60]-including group 3 [n = 9], group 4 [n = 29], and not specified [n = 22]). Our results showed more favorable outcome for the WNT-activated subgroup and a worse prognosis for SHH-activated patients. Three patients had isolated extra-central nervous system relapse. The slope of neurocognitive decline in the global population was shallower than that observed in patients with a normofractionated regimen combined with chemotherapy. CONCLUSIONS HFRT led to a 5-year survival rate similar to other treatments combined with chemotherapy, with a reduced treatment duration of only 6 weeks. We confirm the MSFOP 98 results and the prognostic value of molecular status in patients with medulloblastoma, even in the absence of chemotherapy. Intelligence quotient was more preserved in children with medulloblastoma who received exclusive HFRT and reduced local boost, and intelligence quotient decline was delayed compared with patients receiving standard regimen. HFRT may be appropriate for patients who do not consent to or are not eligible for prospective clinical trials; for patients from developing countries for whom aplasia or ileus may be difficult to manage in a context of high cost/effectiveness constraints; and for whom shortened duration of RT may be easier to implement.
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Affiliation(s)
- Christian Carrie
- Department of Radiotherapy, Leon Berard Cancer Center, and University of Lyon, CNRS UMR 5220, INSERM U1044, INSA, Lyon, France.
| | - Virginie Kieffer
- Neuropsychologue CSI (Saint-Maurice hospital)/Gustave Roussy, Département de cancérologie de l'enfant et de l'adolescent, Gustave Roussy, Villejuif, France
| | - Dominique Figarella-Branger
- Aix Marseille Univ, CNRS, INP, Institute of Neurophysiopathology, Marseille, France; Department of AnatomoPathology and Neuropathology, AP-HM, University Hospital Center la Timone, Marseille, France
| | | | - Stéphanie Bolle
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Valérie Bernier
- Department of Radiotherapy, Alexis Vautrin Cancer Center, Vandoeuvre-les-Nancy, France
| | - Anne Laprie
- Department of Radiotherapy, University Institute of Cancer Toulouse-Oncopôle, France
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest (ICO), Nantes-Saint-Herblain, France
| | - Julie Leseur
- Department of Radiotherapy, Centre Eugène Marquis, Rennes, France
| | - Jean-Louis Habrand
- Department of Radiotherapy, François Baclesse Cancer Center, Caen, France
| | | | - Christine Kerr
- Department of Radiotherapy, Institut regional du Cancer, Val d'Aurelle, Montpellier, France
| | | | - Line Claude
- Department of Radiotherapy, Leon Berard Cancer Center, and University of Lyon, CNRS UMR 5220, INSERM U1044, INSA, Lyon, France
| | - Sophie Chapet
- Department of Radiotherapy, University Hospital Center of Tours, Tours, France
| | - Aymeri Huchet
- Department of Radiotherapy, University Hospital Center of Bordeaux, Bordeaux, France
| | | | | | - Gilles Truc
- Department of Radiotherapy, Georges-François Leclerc Cancer Center, Dijon, France
| | - Tan Dat Nguyen
- Department of Radiotherapy, Jean Godinot Institute, Reims, France
| | - Caroline Pasteuris
- Department of Radiotherapy, University Hospital Center of Grenoble, Grenoble, France
| | - Céline Vigneron
- Department of Radiotherapy, Centre Paul Strauss, Strasbourg, France
| | | | - Franck Bourdeaut
- SIREDO Pediatric Cancer Center, Institut Curie, Paris-Sciences-Lettres, Paris, France
| | - Romain Appay
- Aix Marseille Univ, CNRS, INP, Institute of Neurophysiopathology, Marseille, France; Department of AnatomoPathology and Neuropathology, AP-HM, University Hospital Center la Timone, Marseille, France
| | - Bernard Dubray
- Department of Radiotherapy, Henri Becquerel Cancer Center, Rouen, France
| | - Carole Colin
- Aix Marseille Univ, CNRS, INP, Institute of Neurophysiopathology, Marseille, France; Department of AnatomoPathology and Neuropathology, AP-HM, University Hospital Center la Timone, Marseille, France
| | - Céline Ferlay
- Department of Clinical Research and Innovation, Leon Berard Cancer center, Lyon, France
| | - Sophie Dussart
- Department of Clinical Research and Innovation, Leon Berard Cancer center, Lyon, France
| | - Sylvie Chabaud
- Department of Clinical Research and Innovation, Leon Berard Cancer center, Lyon, France
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Negrier S, Rioux-Leclercq N, Ferlay C, Gross-Goupil M, Gravis G, Geoffrois L, Chevreau C, Boyle H, Rolland F, Blanc E, Ravaud A, Dermeche S, Flechon A, Albiges L, Pérol D, Escudier B. Axitinib in first-line for patients with metastatic papillary renal cell carcinoma: Results of the multicentre, open-label, single-arm, phase II AXIPAP trial. Eur J Cancer 2020; 129:107-116. [DOI: 10.1016/j.ejca.2020.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/08/2020] [Accepted: 02/02/2020] [Indexed: 01/08/2023]
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Carrie C, Magné N, Burban-Provost P, Sargos P, Latorzeff I, Lagrange JL, Supiot S, Belkacemi Y, Peiffert D, Allouache N, Dubray BM, Servagi-Vernat S, Suchaud JP, Crehange G, Guerif S, Brihoum M, Barbier N, Graff-Cailleaud P, Ruffion A, Dussart S, Ferlay C, Chabaud S. Short-term androgen deprivation therapy combined with radiotherapy as salvage treatment after radical prostatectomy for prostate cancer (GETUG-AFU 16): a 112-month follow-up of a phase 3, randomised trial. Lancet Oncol 2019; 20:1740-1749. [DOI: 10.1016/s1470-2045(19)30486-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 12/22/2022]
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Carrie C, Kieffer V, Figarella-Branger D, Masliah-Planchon J, Bolle S, Leseur J, Supiot S, Laprie A, Bernier V, Dufour C, Huchet A, Coche-Dequeant B, Truc G, Vigneron C, Alapetite C, Habrand J, Dubray B, Colin C, Ferlay C, Padovani L. Medulloblastoma Molecular Subgroup and Hyperfractionated Radiation Therapy Alone for Standard Risk Medulloblastoma : Results of the Pool Data of MSFOP 1998 and 2007 Studies. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.600] [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: 11/24/2022]
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Peyrat P, Blanc E, Guillermet S, Chen Y, Ferlay C, Perol D, Basso V, Rivoire M, Dupré A. HEPATOFLUO: A prospective monocentric study assessing the benefits of indocyanine green (ICG) fluorescence for hepatic surgery. J Surg Oncol 2018; 117:922-927. [DOI: 10.1002/jso.25011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/15/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Patrice Peyrat
- Department of Surgery; Centre Léon Bérard; Lyon France
- Experimental Surgical Unit; Centre Léon Bérard; Lyon France
| | - Ellen Blanc
- Clinical Research and Innovation; Centre Léon Bérard; Lyon France
| | | | - Yao Chen
- Experimental Surgical Unit; Centre Léon Bérard; Lyon France
| | - Céline Ferlay
- Clinical Research and Innovation; Centre Léon Bérard; Lyon France
| | - David Perol
- Clinical Research and Innovation; Centre Léon Bérard; Lyon France
| | - Valéria Basso
- Department of Surgery; Centre Léon Bérard; Lyon France
| | - Michel Rivoire
- Department of Surgery; Centre Léon Bérard; Lyon France
- Experimental Surgical Unit; Centre Léon Bérard; Lyon France
| | - Aurélien Dupré
- Department of Surgery; Centre Léon Bérard; Lyon France
- Experimental Surgical Unit; Centre Léon Bérard; Lyon France
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Fossard G, Ferlay C, Nicolas-Virelizier E, Rey P, Ducray F, Jouanneau E, Faurie P, Belhabri A, Sunyack MP, Chassagne-Clément C, Thiesse P, Sebban C, Biron P, Blay JY, Ghesquières H. Utility of post-therapy brain surveillance imaging in the detection of primary central nervous system lymphoma relapse. Eur J Cancer 2016; 72:12-19. [PMID: 28012348 DOI: 10.1016/j.ejca.2016.10.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 06/07/2016] [Revised: 09/29/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The optimal follow-up strategy for primary central nervous system lymphoma (PCNSL) patients after first-line therapy is unclear. The goal of this study is to determine the utility of planned brain surveillance imaging in the detection of relapse in a retrospective cohort of PCNSL patients. METHODS Patients were consecutive PCNSL cases treated in Leon Berard Cancer Centre, Lyon, France, from 1985 to 2011. Histology was diffuse large B-cell lymphoma in 94%. Patients were treated by methotrexate (92%) and cytarabine (63%) based-chemotherapy followed by radiotherapy for 108 patients (51%). Clinical records were reviewed for details at relapse and relationship to planned imaging. The imaging follow-up strategy was performed according to each treating physicians. RESULTS Among 209 PCNSL patients, 127 complete response patients entered in post-treatment observation and 63 (50%) subsequently relapsed. Among the 125 evaluable patients, the majority of relapses (N = 49, 80%) was asymptomatic and identified before the planned brain imaging. Surveillance imaging detected relapses before symptoms in 12 patients who entered in post-therapy observation (10%). The median number of brain imaging during the follow-up was 7 (0-13). A total of 819 MRI/CT-scan were performed leading to the detection of 12 asymptomatic relapses. The one year OS rates were 41% and 58% for symptomatic and non-symptomatic relapses, respectively (P = 0.21). CONCLUSION The majority of PCNSL relapses occurred outside planned follow-up with no difference in patient outcome between symptomatic and asymptomatic relapses. The role of brain imaging for the detection of relapses in the follow-up of PCNSL patients remains to be clarified.
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Affiliation(s)
- Gaëlle Fossard
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - Céline Ferlay
- Centre Léon Bérard, Department of Statistics, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Philippe Rey
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - François Ducray
- Hopital Neurologique, Department of Neurology, Université Claude Bernard Lyon 1, Bron, France
| | - Emmanuel Jouanneau
- Hopital Neurologique, Department of Neurosurgery, Université Claude Bernard Lyon 1, Bron, France
| | - Pierre Faurie
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - Amine Belhabri
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie-Pierre Sunyack
- Centre Léon Bérard, Department of Radiotherapy, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Philippe Thiesse
- Centre Léon Bérard, Department of Radiology, Université Claude Bernard Lyon 1, Lyon, France
| | - Catherine Sebban
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Biron
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - Jean-Yves Blay
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France
| | - Hervé Ghesquières
- Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France; Department of Hematology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Bénite, France.
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Fayette J, Digue L, Ferlay C, Treilleux I, Garin G, Wang Q, Hebert C, Even C, Cupissol D, Couchon-Thaunat S, Jaouen L, Guyennon A, Le Tourneau C, Lefebvre G, Mailliez A, Matias M, Degardin M, Tartas S, Clapisson G, Perol D. PIK-ORL: A phase II, multicenter trial aiming to evaluate BKM120 in monotherapy in patients (pts) with metastatic/recurrent head and neck squamous cell carcinoma (HNSCC) after failure of platin and cetuximab or anti-EGFR-based therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Carrie C, Hasbini A, de Laroche G, Richaud P, Guerif S, Latorzeff I, Supiot S, Bosset M, Lagrange JL, Beckendorf V, Lesaunier F, Dubray B, Wagner JP, N'Guyen TD, Suchaud JP, Créhange G, Barbier N, Habibian M, Ferlay C, Fourneret P, Ruffion A, Dussart S. Salvage radiotherapy with or without short-term hormone therapy for rising prostate-specific antigen concentration after radical prostatectomy (GETUG-AFU 16): a randomised, multicentre, open-label phase 3 trial. Lancet Oncol 2016; 17:747-756. [PMID: 27160475 DOI: 10.1016/s1470-2045(16)00111-x] [Citation(s) in RCA: 269] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND How best to treat rising prostate-specific antigen (PSA) concentration after radical prostatectomy is an urgent clinical question. Salvage radiotherapy delays the need for more aggressive treatment such as long-term androgen suppression, but fewer than half of patients benefit from it. We aimed to establish the effect of adding short-term androgen suppression at the time of salvage radiotherapy on biochemical outcome and overall survival in men with rising PSA following radical prostatectomy. METHODS This open-label, multicentre, phase 3, randomised controlled trial, was done in 43 French study centres. We enrolled men (aged ≥18 years) who had received previous treatment for a histologically confirmed adenocarcinoma of the prostate (but no previous androgen deprivation therapy or pelvic radiotherapy), and who had stage pT2, pT3, or pT4a (bladder neck involvement only) in patients who had rising PSA of 0·2 to less than 2·0 μg/L following radical prostatectomy, without evidence of clinical disease. Patients were randomly assigned (1:1) centrally via an interactive web response system to standard salvage radiotherapy (three-dimensional [3D] conformal radiotherapy or intensity modulated radiotherapy, of 66 Gy in 33 fractions 5 days a week for 7 weeks) or radiotherapy plus short-term androgen suppression using 10·8 mg goserelin by subcutaneous injection on the first day of irradiation and 3 months later. Randomisation was stratified using a permuted block method according to investigational site, radiotherapy modality, and prognosis. The primary endpoint was progression-free survival, analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00423475. FINDINGS Between Oct 19, 2006, and March 30, 2010, 743 patients were randomly assigned, 374 to radiotherapy alone and 369 to radiotherapy plus goserelin. Patients assigned to radiotherapy plus goserelin were significantly more likely than patients in the radiotherapy alone group to be free of biochemical progression or clinical progression at 5 years (80% [95% CI 75-84] vs 62% [57-67]; hazard ratio [HR] 0·50, 95% CI 0·38-0·66; p<0·0001). No additional late adverse events occurred in patients receiving short-term androgen suppression compared with those who received radiotherapy alone. The most frequently occuring acute adverse events related to goserelin were hot flushes, sweating, or both (30 [8%] of 366 patients had a grade 2 or worse event; 30 patients [8%] had hot flushes and five patients [1%] had sweating in the radiotherapy plus goserelin group vs none of 372 patients in the radiotherapy alone group). Three (8%) of 366 patients had grade 3 or worse hot flushes and one patient had grade 3 or worse sweating in the radiotherapy plus goserelin group versus none of 372 patients in the radiotherapy alone group. The most common late adverse events of grade 3 or worse were genitourinary events (29 [8%] in the radiotherapy alone group vs 26 [7%] in the radiotherapy plus goserelin group) and sexual disorders (20 [5%] vs 30 [8%]). No treatment-related deaths occurred. INTERPRETATION Adding short-term androgen suppression to salvage radiotherapy benefits men who have had radical prostatectomy and whose PSA rises after a postsurgical period when it is undetectable. Radiotherapy combined with short-term androgen suppression could be considered as a reasonable option in this population. FUNDING French Ministry of Health, AstraZeneca, and La Ligue Contre le Cancer.
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Affiliation(s)
| | - Ali Hasbini
- Department of Radiotherapy, Clinique Armoricaine, Saint-Brieuc, France
| | - Guy de Laroche
- Department of Radiotherapy, Institut de Cancérologie de la Loire, Saint Priest en Jarez, France
| | - Pierre Richaud
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
| | - Stéphane Guerif
- Department of Radiotherapy, Centre Hospitalier Universitaire, Poitiers, France
| | - Igor Latorzeff
- Department of Radiotherapy, Groupe ONCORAD Garonne and Clinique Pasteur, Toulouse, France
| | - Stéphane Supiot
- Department of Radiotherapy, Institut de Cancérologie de l'Ouest René Gauducheau, Saint Herblain, University of Nantes, Nantes, France; INSERM UMR892, Nantes, France
| | - Mathieu Bosset
- Department of Radiotherapy, Centre Marie Curie, Valence, France
| | | | - Véronique Beckendorf
- Department of Radiotherapy, Institut de Cancérologie de Lorraine Alexis Vautrin, Nancy, France
| | | | - Bernard Dubray
- Radiation Oncology and Medical Physics, QuantIF LITIS (EA4108), Centre Henri Becquerel, Rouen, France; Rouen University Hospital, University of Rouen, Rouen, France
| | | | - Tan Dat N'Guyen
- Department of Radiotherapy, Institut Jean Godinot, Reims, France
| | | | - Gilles Créhange
- Department of Radiotherapy, Centre George-François Leclerc, Dijon, France
| | - Nicolas Barbier
- Department of Radiotherapy, Centre Catalan d'oncologie, Perpignan, France
| | | | - Céline Ferlay
- Direction of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Philippe Fourneret
- Department of Radiotherapy, Centre Hospitalier Métropole Savoie, Chambéry, France
| | - Alain Ruffion
- Department of Urology, Hôpital Lyon Sud, Pierre Bénite, Lyon, France; Cancer Research Centre of Lyon, INSERM 1052 CNRS 5286, Lyon 1 University, Lyon, France
| | - Sophie Dussart
- Direction of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
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Kasenda B, Ferreri AJM, Marturano E, Forst D, Bromberg J, Ghesquieres H, Ferlay C, Blay JY, Hoang-Xuan K, Pulczynski EJ, Fosså A, Okoshi Y, Chiba S, Fritsch K, Omuro A, O'Neill BP, Bairey O, Schandelmaier S, Gloy V, Bhatnagar N, Haug S, Rahner S, Batchelor TT, Illerhaus G, Briel M. First-line treatment and outcome of elderly patients with primary central nervous system lymphoma (PCNSL)--a systematic review and individual patient data meta-analysis. Ann Oncol 2015; 26:1305-13. [PMID: 25701456 DOI: 10.1093/annonc/mdv076] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [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: 10/25/2014] [Accepted: 02/10/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To investigate prognosis and effects of first-line therapy in elderly primary central nervous system lymphoma (PCNSL) patients. PATIENTS AND METHODS A systematic review of studies about first-line therapy in immunocompetent patients ≥60 years with PCNSL until 2014 and a meta-analysis of individual patient data from eligible studies and international collaborators were carried out. RESULTS We identified 20 eligible studies; from 13 studies, we obtained individual data of 405 patients, which were pooled with data of 378 additional patients (N = 783). Median age and Karnofsky Performance Score (KPS) was 68 years (range: 60-90 years) and 60% (range: 10%-100%), respectively. Treatments varied greatly, 573 (73%) patients received high-dose methotrexate (HD-MTX)-based therapy. A total of 276 patients received whole-brain radiotherapy (median 36 Gy, range 28.5-70 Gy). KPS ≥ 70% was the strongest prognostic factor for mortality [hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.41-0.62]. After a median follow-up of 40 months, HD-MTX-based therapy was associated with improved survival (HR 0.70, 95% CI 0.53-0.93). There was no difference between HD-MTX plus oral chemotherapy and more aggressive HD-MTX-based therapies (HR 1.39, 95% CI 0.90-2.15). Radiotherapy was associated with an improved survival, but correlated with an increased risk for neurological side-effects (odds ratio 5.23, 95% CI 2.33-11.74). CONCLUSIONS Elderly PCNSL patients benefit from HD-MTX-based therapy, especially if combined with oral alkylating agents. More aggressive HD-MTX protocols do not seem to improve outcome. WBRT may improve outcome, but is associated with increased risk for neurological side-effects. Prospective trials for elderly PCNSL patients are warranted.
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Affiliation(s)
- B Kasenda
- Department of Oncology, University Hospital of Basel, Basel Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - A J M Ferreri
- Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Milan, Italy
| | - E Marturano
- Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Milan, Italy
| | - D Forst
- Partners Neurology Residency Program, Harvard Medical School, Boston, USA
| | - J Bromberg
- Department of Neuro-Oncology, Daniel den Hoed Cancer Center, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - H Ghesquieres
- Department of Hematology, Centre Léon Bérard, University of Lyon, Lyon
| | - C Ferlay
- Department of Hematology, Centre Léon Bérard, University of Lyon, Lyon
| | - J Y Blay
- Department of Hematology, Centre Léon Bérard, University of Lyon, Lyon
| | - K Hoang-Xuan
- Department of Neurology Mazarin, LOC National Expert Center, APHP, IHU, UPMC, CRICM, GH Pitié-Salpêtrière, Paris, France
| | - E J Pulczynski
- Department of Haematology, Nordic Lymphoma Group, University Hospital Aarhus, Aarhus, Denmark
| | - A Fosså
- Norwegian Department of Oncology, Nordic Lymphoma Group, Radium Hospital, Oslo, Norway
| | - Y Okoshi
- Faculty of Medicine, Department of Hematology, University of Tsukuba, Tsukuba, Japan
| | - S Chiba
- Faculty of Medicine, Department of Hematology, University of Tsukuba, Tsukuba, Japan
| | - K Fritsch
- Department of Hematology/Oncology, University Hospital Freiburg, Freiburg, Germany
| | - A Omuro
- Department of Neurology Mazarin, LOC National Expert Center, APHP, IHU, UPMC, CRICM, GH Pitié-Salpêtrière, Paris, France
| | - B P O'Neill
- Department of Neurology, Mayo Medical School, Rochester, USA
| | - O Bairey
- Institute of Hematology, Rabin Medical Center, Beilinson Hospital, Tel Aviv Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Schandelmaier
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - V Gloy
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - N Bhatnagar
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - S Haug
- Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg
| | - S Rahner
- Medical Faculty, University of Freiburg, Freiburg, Germany
| | - T T Batchelor
- Partners Neurology Residency Program, Harvard Medical School, Boston, USA Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, USA
| | - G Illerhaus
- Stuttgart Cancer Center, Eva-Mayr-Stihl Tumor Center, Stuttgart, Germany
| | - M Briel
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
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Berger P, Ferlay C, Poiron L. Traitement de l’acidose 5-oxoprolinique survenue dans un contexte d’intoxication chronique au paracétamol : place de la N-Acétyl-Cystéine ? Toxicologie Analytique et Clinique 2014. [DOI: 10.1016/j.toxac.2014.09.007] [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: 11/24/2022]
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Ghesquières H, Stamatoullas A, Casasnovas O, Morschhauser F, Gyan E, Gabarre J, Malphettes M, Clément L, Ferlay C, Brice P. Clinical experience of bendamustine in relapsed or refractory Hodgkin lymphoma: a retrospective analysis of the French compassionate use program in 28 patients. Leuk Lymphoma 2013; 54:2399-404. [DOI: 10.3109/10428194.2013.776165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hervé Ghesquières
- Service d’Onco-Hématologie Centre Léon Bérard, Université Claude Bernard, Lyon, France
| | | | | | | | - Emmanuel Gyan
- Service d’Hématologie et Thérapie cellulaire, Faculté de Médecine de Tours, CIC INSERM U202, CHU de Tours, France
| | - Jean Gabarre
- Service d’Hématologie Clinique, Hôpital Pitié Salpetrière, AP-HP, Paris, France
| | - Marion Malphettes
- Service d’Immuno-Hématologie Hôpital Saint-Louis, AP-HP, Paris, France
| | | | - Céline Ferlay
- Unité de Biostatistique et d’Evaluation des Thérapeutiques, Centre Léon Bérard, Université Claude Bernard, Lyon, France
| | - Pauline Brice
- Service d’Hématologie Clinique, Hôpital Saint-Louis, AP-HP, Paris, France
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12
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Claude L, Arpin D, Servois V, Ayadi M, Dussart S, Ferlay C, Mahe M. Acute Radiation Pneumonitis in Non-small Cell Lung Cancer: Is Respiratory-gated Control Useful? Results of a French Prospective Randomized Study. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Claude L, Arpin D, Servois V, Ayadi M, Dussart S, Ferlay C, Mahé M. Pneumopathie radique aiguë : intérêt du contrôle respiratoire durant l’irradiation ? Résultats d’une étude prospective randomisée de phase III multicentrique française. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.019] [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: 11/24/2022]
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14
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Sebban C, Lefranc A, Perrier L, Moreau P, Espinouse D, Schmidt A, Kammoun L, Ghesquieres H, Ferlay C, Bay JO, Lissandre S, Pérol D, Michallet M, Quittet P. A randomised phase II study of the efficacy, safety and cost-effectiveness of pegfilgrastim and filgrastim after autologous stem cell transplant for lymphoma and myeloma (PALM study). Eur J Cancer 2012; 48:713-20. [PMID: 22248711 DOI: 10.1016/j.ejca.2011.12.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 12/18/2011] [Indexed: 11/27/2022]
Abstract
AIM To evaluate in a multicentre randomised study the effect on duration of febrile neutropenia (FN), the safety and cost-effectiveness of a single subcutaneous pegfilgrastim injection compared with daily injections of filgrastim after peripheral blood stem cell transplantation in patients receiving high dose chemotherapy for myeloma and lymphoma. METHODS Patients were randomly assigned to a single dose of pegfilgrastim at day 5 (D5) or daily filgrastim from D5 to the recovery of absolute neutrophil count (ANC) to 0.5 G/L. Duration of FN, of neutrophil and platelet recovery, transfusion and antibiotic requirements were the main end-points of the study. Costs were calculated from D0 until transplant unit discharge. The incremental cost-effectiveness ratio was expressed as the cost per day of FN prevented. Probabilistic sensitivity analysis was performed by non-parametric bootstrap methods. RESULTS Between October 2008 and September 2009, 10 centres enrolled 151 patients: 80 patients with lymphoma and 71 patients with myeloma. The mean duration of FN was 3.07 days (standard deviation (SD) 1.96) in the pegfilgrastin arm and 3.29 (SD 2.54) in the filgrastim one. Mean total costs were 23,256 and 25,448 euros for pegfilgrastim and filgrastim patients, respectively. There was a 62% probability that pegfilgrastim strictly dominates filgrastim. CONCLUDING STATEMENT Pegfilgrastim after PBSC transplantation in myeloma and lymphoma is safe, effective when compared with filgrastim and could represent a cost-effective alternative in this setting.
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Affiliation(s)
- C Sebban
- Hematology Department, Cancer Centre Léon Bérard, Lyon, France.
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Montagnac R, Ferlay C, Schendel A, Gérard F, Vuiblet V. Glomérulonéphrite membrano-proliférative (GNMP) : n’oublions pas les infections focales. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.187] [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: 10/17/2022]
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16
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Négrier S, Gravis G, Pérol D, Chevreau C, Delva R, Bay JO, Blanc E, Ferlay C, Geoffrois L, Rolland F, Legouffe E, Sevin E, Laguerre B, Escudier B. Temsirolimus and bevacizumab, or sunitinib, or interferon alfa and bevacizumab for patients with advanced renal cell carcinoma (TORAVA): a randomised phase 2 trial. Lancet Oncol 2011; 12:673-80. [PMID: 21664867 DOI: 10.1016/s1470-2045(11)70124-3] [Citation(s) in RCA: 197] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Combining targeted treatments for renal cell carcinoma has been suggested as a possible method to improve treatment efficacy. We aimed to assess the potential synergistic or additive effect of the combination of bevacizumab, directed against the VEGF receptor, and temsirolimus, an mTOR inhibitor, in metastatic renal cell carcinoma. METHODS TORAVA was an open-label, multicentre randomised phase 2 study undertaken in 24 centres in France. Patients aged 18 years or older who had untreated metastatic renal cell carcinoma were randomly assigned (2:1:1) to receive the combination of bevacizumab (10 mg/kg every 2 weeks) and temsirolimus (25 mg weekly; group A), or one of the standard treatments: sunitinib (50 mg/day for 4 weeks followed by 2 weeks off; group B), or the combination of interferon alfa (9 mIU three times per week) and bevacizumab (10 mg/kg every 2 weeks; group C). Randomisation was done centrally and independently from other study procedures with computer-generated permuted blocks of four and eight patients stratified by participating centre and Eastern Cooperative Oncology Group performance status. The primary endpoint was progression-free survival (PFS) at 48 weeks (four follow-up CT scans), which was expected to be above 50% in group A. Analysis was by intention to treat. The study is ongoing for long-term overall survival. This study is registered with ClinicalTrials.gov, number NCT00619268. FINDINGS Between March 3, 2008 and May 6, 2009, 171 patients were randomly assigned: 88 to the experimental group (group A), 42 to group B, and 41 to group C. PFS at 48 weeks was 29.5% (26 of 88 patients, 95% CI 20.0-39.1) in group A, 35.7% (15 of 42, 21.2-50.2) in group B, and 61.0% (25 of 41, 46.0-75.9) in group C. Median PFS was 8.2 months (95% CI 7.0-9.6) in group A, 8.2 months (5.5-11.7) in group B, and 16.8 months (6.0-26.0) in group C. 45 (51%) of 88 patients in group A stopped treatment for reasons other than progression compared with five (12%) of 42 in group B and 15 (38%) of 40 in group C. Grade 3 or worse adverse events were reported in 68 (77%) of 88 patients in group A versus 25 (60%) of 42 in group B and 28 (70%) of 40 in group C. Serious adverse events were reported in 39 (44%) of 88, 13 (31%) of 42, and 18 (45%) of 40 patients in groups A, B, and C, respectively. INTERPRETATION The toxicity of the temsirolimus and bevacizumab combination was much higher than anticipated and limited treatment continuation over time. Clinical activity was low compared with the benefit expected from sequential use of each targeted therapy. This combination cannot be recommended for first-line treatment in patients with metastatic renal cell carcinoma. FUNDING French Ministry of Health and Wyeth Pharmaceuticals.
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Affiliation(s)
- Sylvie Négrier
- Medical Oncology Department, University of Lyon, Centre Léon Bérard, Lyon, France.
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Chevreau C, Ravaud A, Escudier B, Caty A, Delva R, Rolland F, Oudard S, Herve R, Blanc E, Ferlay C, Lignon N, Negrier S. Phase II trial of sunitinib in renal cell cancer with untreated brain metastases. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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18
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Escudier BJ, Negrier S, Perol D, Gravis G, Delva R, Bay J, Geoffrois L, Legouffe E, Metzger S, Ferlay C. Prognostic factors for progression-free survival (PFS) in patients with metastatic renal cell carcinoma (mRCC): Results from the French randomized phase II study TORAVA. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Provencher S, Ferlay C, Alaoui-Slimani K, Devidas A, Lepretre S, de Prijck B, Sebban C, de la Fouchardiere A, Chassagne-Clement C, Ketterer N, Thyss A, Delannoy A, Tilly H, Biron P, Blay JY, Ghesquières H. Clinical characteristics and outcome of isolated extracerebral relapses of primary central nervous system lymphoma: a case series. Hematol Oncol 2011; 29:10-6. [PMID: 21381074 DOI: 10.1002/hon.944] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is very limited data on isolated systemic relapses of primary central nervous system lymphomas (PCNSL). We retrospectively reviewed the clinical characteristics and outcome of 10 patients with isolated systemic disease among 209 patients with PCNSL mainly treated with methotrexate-based chemotherapy (CT) with or without radiation therapy (RT). Isolated systemic relapse remained rare (4.8%, 10/209 patients). Median time from initial diagnosis to relapse was 33 months (range, 3-94). Sites of relapse were mostly extranodal. Three patients presented with early extra-cerebral (EC) relapse 3, 5 and 8 months from the beginning of initial treatment, respectively, and 7 patients had later relapses (range, 17-94 months). Treatment at relapse included surgery alone, RT alone, CT with or without radiotherapy, or CT with autologous stem cell transplantation (ASCT). Median overall survival (OS) after relapse was 15.5 months (range, 5.8-24.5) compared to 4.6 months (range, 3.6-6.5) for patients with central nervous system (CNS) relapse (p = 0.35). In conclusion, isolated systemic relapses exist but are infrequent. Early EC relapse suggests the presence of systemic disease undetectable by conventional evaluation at initial diagnosis. Patient follow-up must be prolonged because systemic relapse can occur as late as 10 years after initial diagnosis. Whether EC relapses of PCNSL have a better prognosis than CNS relapses needs to be assessed in a larger cohort.
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Affiliation(s)
- Sawyna Provencher
- Department of Medical Oncology, Centre Léon Bérard, Université de Lyon, Lyon, France
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20
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Fléchon A, Pouessel D, Ferlay C, Perol D, Beuzeboc P, Gravis G, Joly F, Oudard S, Deplanque G, Zanetta S, Fargeot P, Priou F, Droz JP, Culine S. Phase II study of carboplatin and etoposide in patients with anaplastic progressive metastatic castration-resistant prostate cancer (mCRPC) with or without neuroendocrine differentiation: results of the French Genito-Urinary Tumor Group (GETUG) P01 trial. Ann Oncol 2011; 22:2476-2481. [PMID: 21436186 DOI: 10.1093/annonc/mdr004] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In the evolution of metastatic castration-resistant prostate cancer (mCRPC), patients present visceral metastases with or without neuroendocrine differentiation in 20% of cases. PATIENTS AND METHODS We assessed the efficacy and toxicity of a platinum-based chemotherapy regimen in mCRPC patients with either neuroendocrine differentiation defined by high serum levels of chromogranin A (CgA) and neuron-specific enolase (NSE) or visceral metastases. Patients received the combination of carboplatin and etoposide every 3 weeks. Efficacy end points included prostate-specific antigen (PSA) and neuroendocrine marker response, objective response and toxicity. RESULTS Of the 60 patients included from April 2005 to January 2008, 78.6% had bone metastases, 46.4% had lymph node involvement and 57.1% had liver and/or lung localizations. The objective response rate was 8.9% in the 46 patients with measurable disease. A neuroendocrine response was observed in 31% of cases for NSE and 7% for CgA. The PSA response rate was 8%. The most common grade 3-4 treatment-related toxic effects were neutropenia (65.5%), thrombocytopenia (32.7%) and anemia (27.3%). There was 7.2% febrile neutropenia, with one toxicity-related death. The median follow-up was 9.3 months [95% confidence interval (CI) 0.2-27.1] and the median overall survival 9.6 months (95% CI 8.7-12.7). CONCLUSION The benefit-risk ratio of this regimen seems unfavorable due to poor response and high toxicity.
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Affiliation(s)
- A Fléchon
- Department of Medical Oncology, Centre Léon Bérard, Lyon.
| | - D Pouessel
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier
| | - C Ferlay
- Department of Biostatistic, Centre Léon Bérard, Lyon
| | - D Perol
- Department of Biostatistic, Centre Léon Bérard, Lyon
| | - P Beuzeboc
- Department of Medical Oncology, Institut Curie, Paris
| | - G Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - F Joly
- Department of Medical Oncology, Centre François Baclesse, Caen
| | - S Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris
| | - G Deplanque
- Department of Medical Oncology, Fondation Hôpital Saint Joseph, Paris
| | - S Zanetta
- Department of Medical Oncology, Centre G.F. Leclerc, Dijon
| | - P Fargeot
- Department of Medical Oncology, Centre G.F. Leclerc, Dijon
| | - F Priou
- Department of Medical Oncology, CHD Les Oudairies, La Roche Sur Yon
| | - J P Droz
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - S Culine
- Department of Medical Oncology, Hôpital Henri Mondor, Créteil, France
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Escudier BJ, Perol D, Ferlay C, Gravis G, Chevreau C, Delva R, Bay J, Geoffrois L, Blanc E, Negrier S. TORAVA trial: Lessons from this trial in the two control arms, sunitinib and bevacizumab in combination with interferon. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.315] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
Abstract
315 Background: The TORAVA trial, reported at ASCO 2010, was a randomized phase II study aimed to determine the efficacy and safety of temsirolimus and bevacizumab combination. Both efficacy and safety were demonstrated as insufficient. Interestingly, 2 control arms were used in this study, sunitinib (arm B) or bevacizumab and a-interferon (arm C). Both PFS and RR were higher in arm C than arm B (16.8 mths and 39% vs. 8.6 mths and 23.8%). Post-hoc analysis were thus performed to determine the predictive factors for better efficacy. Methods: Overall, 171 pts were randomized in this study, 42 in arm B and 41 in arm C. The study was stratified on PS only, 0–1 vs 2. These 83 pts were analyzed regarding baseline characteristics, and dose reduction. Results: Some important differences were detected in the 2 arms, in favor of arm C: DFI>12mths (29 vs. 39%), good MSKCC risk (31 vs. 39%), Fuhrman grade 1–2 (32 vs. 38%), liver metastases (19 vs. 14.6%), high LDH (17.1 vs. 7.9%). Interestingly, pts who had dose reduction of interferon (27/41 pts) had a longer PFS than those who did not reduced the dose. Updated analyses will be presented. Conclusions: Small randomized trials such as randomized phase II trials are not guaranteed to balance predictive/ prognostic factors across treatment arms. Before interpreting RR and PFS in mRCC, careful analysis of pt characteristics should be performed. However, this study will probably help to determine a population more likely to benefit from bevacizumab-interferon combination. [Table: see text]
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Affiliation(s)
- B. J. Escudier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - D. Perol
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - C. Ferlay
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - G. Gravis
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - C. Chevreau
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - R. Delva
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - J. Bay
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - L. Geoffrois
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - E. Blanc
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - S. Negrier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
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Ducassou S, Ferlay C, Bergeron C, Girard S, Laureys G, Pacquement H, Plantaz D, Lutz P, Vannier JP, Uyttebroeck A, Bertrand Y. Clinical presentation, evolution, and prognosis of precursor B-cell lymphoblastic lymphoma in trials LMT96, EORTC 58881, and EORTC 58951. Br J Haematol 2011; 152:441-51. [DOI: 10.1111/j.1365-2141.2010.08541.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [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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Ducassou S, Ferlay C, Bergeron C, Girard S, Laureys G, Pacquement H, Plantaz D, Vannier J, Uyttebroeck A, Lutz P, Bertrand Y. CL097 - Les lymphomes lymphoblastiques pré-B dans les protocoles LMT96, EORTC 58881, et 58951. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70321-3] [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: 10/19/2022]
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Escudier BJ, Negrier S, Gravis G, Chevreau C, Delva R, Bay J, Geoffrois L, Legouffe E, Blanc E, Ferlay C. Can the combination of temsirolimus and bevacizumab improve the treatment of metastatic renal cell carcinoma (mRCC)? Results of the randomized TORAVA phase II trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4516] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ghesquières H, Ferlay C, Sebban C, Perol D, Bosly A, Casasnovas O, Reman O, Coiffier B, Tilly H, Morel P, Van den Neste E, Colin P, Haioun C, Biron P, Blay JY. Long-term follow-up of an age-adapted C5R protocol followed by radiotherapy in 99 newly diagnosed primary CNS lymphomas: a prospective multicentric phase II study of the Groupe d’Etude des Lymphomes de l’Adulte (GELA). Ann Oncol 2010; 21:842-850. [DOI: 10.1093/annonc/mdp529] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Flechon A, Pouessel D, Ferlay C, Perol D, Beuzeboc P, Gravis G, Joly F, Oudard S, Deplanque G, Droz J, Culine S. Results of a phase II study of carboplatin and etoposide in patients with progressive metastatic castration refractory prostate cancer (mCRPC) and neuro-endocrine differentiation. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
e16073 Background: Neuro-endocrine differentiation is often observed in the evolution of mCRPC. We assessed the efficacy and toxicity of a platin-based chemotherapy regimen in patients with mCPRC and neuro-endocrine differentiation defined by: either increased circulating neuro-endocrine markers (chromogranin A: CgA, Neuron Specific Enolase: NSE) more than 1.5 X normal serum values and/or visceral metastases confirmed with immunihistochemical proof of neuro-endocrine differentiation on pathological sample. Methods: Sixty patients were included (Simon optimal two stages design with P0 = 20%, P1 = 40%, α = 5% and power 90% for a total of 54 evaluable patients) and were treated by the combination of carboplatin AUC 4 d1 IV and etoposide 100 mg/m2/d d1–3 IV every 3 weeks for a maximum of 6 cycles. Efficacy endpoints included PSA and neuro-endocrine marker response rate (defined as a decrease of 50% or greater of the baseline serum value), objective response rate (according to RECIST criteria), and toxicity. Results: Sixty patients were included between April 2005 to January 2008, median age was 67 (range: 45–80). Sixty-seven per cent patients received prior chemotherapy. Patients had bone metastases (78%), lymph nodes involvement (49%), lung metastases (35%), hepatic involvement (33%) and other localizations (17%). The objective response rate was 33% in the 48 assessable patients. A neuro-endocrine response was observed in 28% of 32 evaluable patients for neuro-endocrine marker level (CgA 6%, NSE 25% and both 3%). The PSA response rate was 9%. The most common grade 3–4 treatment-related toxicities were neutropenia (67%), thrombocytopenia (31%), anemia (27%), asthenia (14%) nausea and vomiting grade (12%). There were 6% febrile neutropenia, with one related toxic death. The median follow-up is 9 months. The median response duration was 1.8 months (range: 0.2–13.4 months). The median overall survival is 10 months. Conclusions: Despite an absolute response rate in accordance with the study assumptions, the benefit-risk ratio of this regimen seems unfavourable due to observed toxicities. Another trials must be conducted in order to define a group of patients which may benefit of this regimen. No significant financial relationships to disclose.
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Affiliation(s)
- A. Flechon
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - D. Pouessel
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - C. Ferlay
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - D. Perol
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - P. Beuzeboc
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - G. Gravis
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - F. Joly
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - S. Oudard
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - G. Deplanque
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - J. Droz
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
| | - S. Culine
- Centre Léon Bérard, Lyon, France; Centre Val d'Aurelle, Montpellier, France; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; Centre François Baclesse, Caen, France; Hopital Européen Georges Pompidou, Paris, France; Fondation Hopital Saint Joseph, Paris, France; Hopital Henri Mondor, Creteil, France
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Cassier PA, Ray-Coquard I, Sunyach MP, Lancry L, Guastalla JP, Ferlay C, Gomez F, Curé H, Lortholary A, Claude L, Blay JY, Bachelot T. A phase 2 trial of whole-brain radiotherapy combined with intravenous chemotherapy in patients with brain metastases from breast cancer. Cancer 2008; 113:2532-8. [PMID: 18780315 DOI: 10.1002/cncr.23858] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A study was conducted to determine the efficacy, tolerability, and safety of concurrent cisplatin and vinorelbine chemotherapy and radiotherapy in patients with previously untreated brain metastases from breast cancer. METHODS Twenty-five patients with untreated brain metastases from breast cancer were treated with cisplatin (at a dose of 20 mg/m(2)/day, Days 1-5) and vinorelbine (6-mg/m(2) bolus on Day 1 and 6 mg/m(2)/day continuous infusion on Days 1-5) chemotherapy combined with concurrent 30-gray fractionated external-beam radiotherapy. Chemotherapy was given at 3-week intervals for a total of 4 cycles. Primary endpoint was the rate of radiologic response of brain metastases. RESULTS Complete response in the brain was observed in 3 patients, and partial response was noted in 16 patients, yielding a 76% response rate in the brain. The overall systemic response rate was 44%. Progression-free and overall survival were 3.7 months and 6.5 months, respectively. Overall toxicity was acceptable; nonhematologic grade 3-4 events were noted in 5 (20%) patients, and there were no toxic deaths. CONCLUSIONS Concurrent chemoradiation with cisplatin and vinorelbine for brain metastases from breast cancer appears to be active and well tolerated.
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Affiliation(s)
- Philippe A Cassier
- Multidisciplinary Medical Oncology Day Unit, Edouard Herriot Hospital, Lyon, France
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Ghesquières H, Ferlay C, Sebban C, Chassagne C, Carausu L, Gargi T, Favier B, Philip I, Blay JY, Biron P. Combination of rituximab with chemotherapy in diffuse large B-cell lymphoma. Evaluation in daily practice before and after approval of rituximab in this indication. Hematol Oncol 2008; 26:139-47. [PMID: 18383186 DOI: 10.1002/hon.850] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Randomized trials have demonstrated improved outcome from adding rituximab to CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) for patients with diffuse large B-cell lymphoma (DLBCL). This retrospective study compared the outcomes of 224 patients with DLBCL treated in our institution before (Period 1, 1996-2002) and after (Period 2, 2002-2005) approval of rituximab in this indication to evaluate the impact of the drug in daily practice in unselected patients receiving different types of chemotherapy. We treated 131 patients in Period 1 versus 93 in Period 2 (median follow-up, 75 and 29 months, respectively) with no difference in patient characteristics between the two periods. Event-free and overall survivals (EFS and OS) were significantly improved in Period 2 for elderly patients and a significant shift in the selection of regimens was observed at the time when rituximab became available. More patients received the CHOP regimen in Period 2 than in Period 1 (82 vs. 57%, p < 0.007) with CHOP being substituted for epirubicin-based regimens. In younger patients treated mostly with the ACVBP regimen (doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone) these differences were not observed, suggesting that combination of rituximab with dose-dense chemotherapy may deserve further evaluation in this age group.
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Bonnin N, Ceruse P, Bachelot T, Zrounba P, Ramade A, Pommier P, Favrel V, Tartas S, Ferlay C, Fayette J. Efficacy of neoadjuvant TPF (nTPF; docetaxel, T; cisplatin, P; 5FU) in nonselected patients (pts) with head and neck cancer and subsequent radiotherapy (RT) combined with chemotherapy (CT) or cetuximab (Cx). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Le Scodan R, Pommier P, Ardiet JM, Montbarbon X, Malet C, Favrel V, Zrounba P, Poupart M, Céruse P, Ferlay C, Clippe S. Exclusive brachytherapy for T1 and T2 squamous cell carcinomas of the velotonsillar area: Results in 44 patients. Int J Radiat Oncol Biol Phys 2005; 63:441-8. [PMID: 16168837 DOI: 10.1016/j.ijrobp.2005.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 12/06/2004] [Revised: 02/03/2005] [Accepted: 02/03/2005] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the role of interstitial brachytherapy as an exclusive radiotherapy modality for primary T1-T2 squamous cell carcinomas (SCC) of the velotonsillar area. METHODS AND MATERIALS Between 1992 and 2000, 44 patients with T1-T2 SCC of the tonsil (n = 36) and soft palate (n = 8) were treated to the primary with brachytherapy alone (37 patients) or after a limited resection (7 patients). Eight patients had prior external beam radiation therapy (EBRT) for previous head-and-neck carcinoma. Nineteen patients had initial neck dissection. The mean brachytherapy dose was 58.7 Gy, and the mean reference dose rate and Ir-192 linear activity were 58.2 cGy/h and 1.51 mCi/cm respectively. RESULTS With a 75-month median follow-up, 1 patient recurred locally. Isolated nodal relapses occurred in 4 patients, none of whom had initial neck dissection, and salvage therapy was successful in 2. Five-year overall and progression-free survival rates were 76% and 68%, respectively. Full-course radiation therapy was possible in 7 of 12 patients who developed a second primary head-and-neck carcinoma. Late toxicity was limited to 6 mild soft-tissue necroses, and was significantly associated with previous surgery to the primary and high linear activity. CONCLUSIONS Exclusive brachytherapy for T1-T2 velotonsillar carcinomas is safe and effective, and permits definitive reirradiation for a second head-and-neck cancer. Initial neck dissection should be performed for optimal selection for exclusive brachytherapy.
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Affiliation(s)
- Romuald Le Scodan
- Department of Radiation Oncology, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon Cedex 08, France
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