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Allignet B, Merle P, Rode A, Mabrut JY, Mohkam K, Mornex F. Transarterial chemoembolization followed by moderately hypofractionated radiotherapy in hepatocellular carcinoma: Long-term results of RTF3 regimen. Cancer Radiother 2023:S1278-3218(23)00064-1. [PMID: 37150729 DOI: 10.1016/j.canrad.2023.01.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 05/09/2023]
Abstract
PURPOSE In early-stage hepatocellular carcinoma (HCC) patients merely fit for surgery, transarterial chemoembolization (TACE) achieve low long-term disease control. We evaluated the efficacy and safety of its combination with moderately hypofractionated radiotherapy (hRT) using RTF3 regimen. MATERIAL AND METHODS Between 2006 and 2016, 61 consecutive patients treated in our single expert center for a Barcelona Clinic Liver Cancer (BCLC) A HCC by TACE followed by hRT 3Gy/fraction were retrospectively included. RESULTS Sixty of the 61 included presented Child-Pugh A cirrhosis (A5, n=41, 67.2%; A6: n=19, 31.1%). Fourteen patients (22.9%) were already treated for a HCC, mainly by radiofrequency (n=12). All patient received a TACE followed by 3Gy per fraction hRT. Mean radiation dose was 54Gy (range: 48-60). After a median follow-up of 118 months, median time-to-progression, progression-free survival (PFS) and overall survival (OS) was 21.3, 18.1, and 31.5 months, respectively. In univariate analysis, PFS was related to dose > 54Gy (HR: 2, P=0.036), and OS was correlated to Child-Pugh A6 or B7 (HR: 1.93, P=0.03) and overall hRT time (HR: 1.06, P=0.015). At progression, orthotopic liver transplantation was performed in 8 patients (13.1%). Severe symptomatic adverse events occurred in 12 patients (19.7%), mainly ascites (n=7). CONCLUSION In BCLC-A Child-Pugh A HCC patients ineligible to surgery or thermoablation, TACE-hRT is a safe and effective treatment. Prospective studies are needed to compare this association with radioembolization, TACE-stereotactic radiotherapy, and systemic treatments combinations.
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Affiliation(s)
- B Allignet
- Department of Radiotherapy, centre hospitalier Lyon Sud, hospices civils de Lyon, université Claude-Bernard Lyon 1, Pierre-Bénite, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294 Lyon, France.
| | - P Merle
- Hepatology Unit, hôpital de La Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Inserm 1052/CNRS 5286 Unit, Cancer Research Center of Lyon (CRCL), université Claude-Bernard Lyon 1, Lyon, France
| | - A Rode
- Department of Radiology, hôpital de La Croix-Rousse, hospices civils de Lyon, université-Claude Bernard Lyon 1, Lyon, France
| | - J Y Mabrut
- Inserm 1052/CNRS 5286 Unit, Cancer Research Center of Lyon (CRCL), université Claude-Bernard Lyon 1, Lyon, France; Department of General Surgery and Liver Transplantation, hôpital de La Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - K Mohkam
- Inserm 1052/CNRS 5286 Unit, Cancer Research Center of Lyon (CRCL), université Claude-Bernard Lyon 1, Lyon, France; Department of General Surgery and Liver Transplantation, hôpital de La Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - F Mornex
- Department of Radiotherapy, centre hospitalier Lyon Sud, hospices civils de Lyon, université Claude-Bernard Lyon 1, Pierre-Bénite, France
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Evin C, Quéro L, Le Malicot K, Blanchet-Deverly S, François E, Buchalet C, Lemanski C, Baba Hamed N, Rivin del Campo E, Bauwens L, Pommier P, Lièvre A, Tougeron D, Macé V, Sergent G, Diaz O, Zucman D, Mornex F, Locher C, De la Rochefordière A, Vendrely V, Huguet F. MO-0226 Clinical outcomes of HIV-positive patients with anal cancer in the ANABASE multicentric cohort. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02328-3] [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: 11/24/2022]
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Trédaniel J, Barlési F, Le Péchoux C, Lerouge D, Pichon É, Le Moulec S, Moreau L, Friard S, Westeel V, Petit L, Carré O, Guichard F, Raffy O, Villa J, Prévost A, Langlais A, Morin F, Wislez M, Giraud P, Zalcman G, Mornex F. Final results of the IFCT-0803 study, a phase II study of cetuximab, pemetrexed, cisplatin, and concurrent radiotherapy in patients with locally advanced, unresectable, stage III, non-squamous, non-small-cell lung cancer. Cancer Radiother 2022; 26:670-677. [PMID: 35260342 DOI: 10.1016/j.canrad.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/20/2021] [Revised: 11/24/2021] [Accepted: 12/12/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Roughly 20% of patients with non-small-cell lung cancer exhibit locally advanced, unresectable, stage III disease. Concurrent platinum-based chemoradiotherapy is the backbone treatment, which is followed by maintenance immunotherapy, yet with poor long-term prognosis. This phase II trial (IFCT-0803) sought to evaluate whether adding cetuximab to cisplatin and pemetrexed chemoradiotherapy would improve its efficacy in these patients. MATERIALS AND METHODS Eligible patients received weekly cetuximab (loading dose 400mg/m2 day 1; subsequent weekly 250mg/m2 doses until two weeks postradiotherapy). Chemotherapy comprised cisplatin (75mg/m2) and pemetrexed (500mg/m2), both delivered on day 1 of a 21-day cycle of maximally four. Irradiation with maximally 66Gy started on day 22. Disease control rate at week 16 was the primary endpoint. RESULTS One hundred and six patients were included (99 eligible patients). Compliance exceeded 95% for day 1 of chemotherapy cycles 1 to 4, with 76% patients receiving the 12 planned cetuximab doses. Maximal grade 3 toxicity occurred in 63% patients, and maximal grade 4 in 9.6%. The primary endpoint involving the first 95 eligible patients comprised two (2.1%) complete responses, 57 (60.0%) partial responses, and 27 (28.4%) stable diseases. This 90.5% disease control rate (95% confidence interval [95% CI]: 84.6%-96.4%) was achieved at week 16. After median 63.0-month follow-up, one-year and two-year survival rates were 75.8% and 59.5%. Median overall survival was 35.8months (95% CI: 23.5-NR), and median progression-free survival 14.4months (95% CI: 11.2-18.8), with one-year and two-year progression-free survival rates of 57.6% and 34.3%. CONCLUSION These survival rates compare favourably with published data, thus justifying further development of cetuximab-based induction chemoradiotherapy.
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Affiliation(s)
- J Trédaniel
- Department of pneumology, hôpital Saint-Joseph, 75014 Paris, France.
| | - F Barlési
- Multidisciplinary oncology and therapeutic innovations department, centre hospitalier universitaire de Marseille, 13000 Marseille, France
| | - C Le Péchoux
- Department of radiation oncology, Gustave-Roussy, 94805 Villejuif, France
| | - D Lerouge
- Department of radiation oncology, centre François-Baclesse, 14000 Caen, France
| | - É Pichon
- Department of pneumology, centre hospitalier universitaire de Tours, 37000 Tours, France
| | - S Le Moulec
- Department of pneumology, institut Bergonié, 33000 Bordeaux, France
| | - L Moreau
- Department of pneumology, hôpital Louis-Pasteur, 68024 Colmar, France
| | - S Friard
- Department of pneumology, hôpital Foch, 92150 Suresnes, France
| | - V Westeel
- Department of pneumology, centre hospitalier universitaire de Besançon, 25000 Besançon, France
| | - L Petit
- Department of pneumology, centre hospitalier Alpes Léman, 74130 Contamine-sur-Arve, France
| | - O Carré
- Department of pneumology, clinique de l'Europe, 80090 Amiens, France
| | - F Guichard
- Department of oncology, polyclinique, 33000 Bordeaux, France
| | - O Raffy
- Department of pneumology, hôpital de Chartres, 28000 Chartres, France
| | - J Villa
- Department of pneumology, centre hospitalier universitaire de Grenoble, 38000 Grenoble, France
| | - A Prévost
- Department of pneumology, centre de lutte contre le cancer Jean-Godinot, 51100 Reims, France
| | - A Langlais
- Intergroupe francophone de cancérologie thoracique, 75000 Paris, France
| | - F Morin
- Intergroupe francophone de cancérologie thoracique, 75000 Paris, France
| | - M Wislez
- Department of pneumology, hôpital Cochin, 75014 Paris, France
| | - P Giraud
- Department of radiation Oncology, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - G Zalcman
- Department of pneumology, centre hospitalier universitaire de Caen, 14000 Caen, France
| | - F Mornex
- Department of radiation oncology, centre hospitalier universitaire de Lyon, 69000 Lyon, France
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Escande A, Frey P, Lacornerie T, Mervoyer E, Chargari C, Laurans M, Mornex F, Marijon É, Giraud P. Radiotherapy for patient with cardiac implantable electronic device, consensus from French radiation oncology society. Cancer Radiother 2021; 26:404-410. [PMID: 34969621 DOI: 10.1016/j.canrad.2021.11.003] [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] [Indexed: 10/19/2022]
Abstract
Radiotherapy in patients with cardiac implantable electronic device such as pacemakers or defibrillators, is a clinical situation that is becoming increasingly common. There is a risk of interaction between the magnetic field induced by accelerators and the cardiac implantable electronic device, but also a risk of device dysfunction due to direct and/or indirect irradiation if the cardiac implantable electronic device is in the field of treatment. The risk can be dose-dependent, but it is most often independent of the total dose and occurs randomly in case of neutron production (stochastic effect). The presence of this type of device is therefore described as a contraindication for radiotherapy by the French national agency for the safety of medicines and health products (Agence nationale de sécurité du médicament et des produits de santé, ANSM). Nevertheless, since radiotherapy is often possible, it is advisable to respect the recommendations of good practice, in particular the eligibility criteria, the monitoring modalities before, during and after irradiation according to the type of treatment, the dose and the characteristics of the cardiac implantable electronic device. It is sometimes necessary to discuss repositioning the device and/or modifying the treatment plan to minimize the risk of cardiac implantable electronic device dysfunction. We present the update of the recommendations of the French society of oncological radiotherapy on in patients with cardiac implantable electronic device.
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Affiliation(s)
- A Escande
- Département universitaire de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France; Faculté de médecine Henri-Warembourg, université de Lille, 59000 Lille, France; UMR 9189, Centre de recherche en informatique, signal et automatique de Lille (Cristal), 59655 Villeneuve d'Ascq, France.
| | - P Frey
- Département de cardiologie, centre hospitalier Annecy Genevois, 74370 Épagny-Metz-Tessy, France
| | - T Lacornerie
- Département de physique médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - E Mervoyer
- Département de cardiologie, Institut de cancérologie de l'Ouest, 44800 Saint-Herblain, France
| | - C Chargari
- Unité de curiethérapie, département de radiothérapie, Gustave-Roussy, 94805 Villejuif, France
| | - M Laurans
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - F Mornex
- Département de radiothérapie, centre hospitalier Lyon Sud, 69310 Pierre-Bénite, France
| | - É Marijon
- Département de cardiologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Université de Paris, 20, rue Leblanc, 75015 Paris, France
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Abstract
We present an update of the French society of oncological radiotherapy recommendation regarding indication, doses, and technique of radiotherapy for intrathoracic metastases. The recommendations for delineation of the target volumes and critical organs are detailed.
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Affiliation(s)
- A Lévy
- Département d'oncologie radiothérapie, Gustave-Roussy, 94805 Villejuif, France; Université Paris-Saclay, Inserm U1030, radiothérapie moléculaire, 94805, Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France.
| | - J Darréon
- Département d'oncologie radiothérapie, institut Paoli-Calmettes, 13000 Marseille, France; CRCM Inserm U1068, 13000 Marseille, France
| | - F Mornex
- Département d'oncologie radiothérapie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 12, rue de l'École-de-Médecine, 75006 Paris, France
| | - S Thureau
- Département de d'oncologie radiothérapie, centre Henri-Becquerel, 1, rue d'Amiens, 76000 Rouen, France; QuantIf Litis EA4108, université de Rouen, 76000 Rouen, France
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Huguet F, Rivin Del Campo E, Orthuon A, Mornex F, Bessières I, Guimas V, Vendrely V. Radiation therapy of pancreatic cancers. Cancer Radiother 2021; 26:259-265. [PMID: 34953706 DOI: 10.1016/j.canrad.2021.08.010] [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] [Indexed: 11/29/2022]
Abstract
We present the update of the recommendations of the French society of oncological radiotherapy on radiotherapy of pancreatic tumors. Currently, the use of radiation therapy for patients with pancreatic cancer is subject to discussion. In the adjuvant setting, the standard treatment is six months of chemotherapy with 5-fluorouracile, irinotecan and oxaliplatin. Chemoradiation may improve the survival of patients with incompletely resected tumours (R1). This remains to be confirmed by a prospective trial. Neoadjuvant chemoradiation is a promising treatment especially for patients with borderline resectable tumours. For patients with locally advanced tumours, there is no standard. An induction chemotherapy followed by chemoradiation for non progressive patients reduces the rate of local relapse. Whereas in the first trials of chemoradiation large fields were used, the treated volumes have been reduced to improve tolerance. Tumour movements induced by breathing should be taken in account. Intensity modulated radiation therapy allows a reduction of doses to the organs at risk. Whereas widely used, this technique has poor evidence-based recommendation. Stereotactic body radiation therapy is also being studied, as a neoadjuvant or exclusive treatment.
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Affiliation(s)
- F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, hôpitaux universitaires Est Parisien, Sorbonne Université, 4, rue de la Chine, 75020 Paris, France.
| | - E Rivin Del Campo
- Service d'oncologie radiothérapie, hôpital Tenon, hôpitaux universitaires Est Parisien, Sorbonne Université, 4, rue de la Chine, 75020 Paris, France
| | - A Orthuon
- Service d'oncologie radiothérapie, hôpital Tenon, hôpitaux universitaires Est Parisien, Sorbonne Université, 4, rue de la Chine, 75020 Paris, France
| | - F Mornex
- Service de radiothérapie, centre hospitalier Lyon-Sud, hospices civils, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - I Bessières
- Département de physique médicale, centre Georges-François-Leclerc, 1, rue Professeur-Marion, 21000 Dijon, France
| | - V Guimas
- Service d'oncologie radiothérapie, institut de cancérologie de l'Ouest centre René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - V Vendrely
- Service de radiothérapie, CHU de Bordeaux, 33604 Pessac cedex, France
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Abstract
Herein are presented the recommendations from the Société française de radiothérapie oncologique regarding indications and modalities of lung cancer radiotherapy. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Affiliation(s)
- J Khalifa
- Département de radiothérapie, Institut universitaire du cancer de Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - D Lerouge
- Département de radiothérapie, centre François-Baclesse, 3, avenue du General-Harris, 14076 Caen, France
| | - C Le Péchoux
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - N Pourel
- Département de radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, CS80005, 84918 Avignon cedex 9, France
| | - J Darréon
- Service de physique médicale, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - F Mornex
- Service de radiothérapie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
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Abstract
We present the update of the recommendations of the French society of oncological radiotherapy on hepatic tumours. Recent technological progress led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumours, as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. The tumour volume, its liver location close to the organs at risk determine the irradiation technique (repositioning method, total dose delivered, dose fractionation regimens). Tumour (and liver) breathing related motions should be taken into account. Strict dosimetric criteria must be observed with particular attention to the dose-volume histograms of non-tumoral liver as well as of the hollow organs, particularly in case of hypofractionated high dose radiotherapy "under stereotaxic conditions". Stereotactic body radiotherapy is being evaluated and is often preferred to radiofrequency for primary or secondary tumours (usually less than 5cm). An adaptation can be proposed, with a conformal fractionated irradiation protocol with or without intensity modulation, for hepatocellular carcinomas larger than 5cm.
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Affiliation(s)
- E Rio
- Service de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44805 Saint-Herblain, France.
| | - F Mornex
- Département de radiothérapie-oncologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - P Maingon
- Service d'oncologie radiothérapie, groupe hospitalier La Pitié Salpêtrière, Sorbonne université, AP-HP, 47/83, boulevard de l'Hôpital, 75013 Paris, France
| | - D Peiffert
- Service de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - L Parent
- Département d'ingénierie et de physique médicale, institut Claudius-Regaud (ICR), institut universitaire du cancer de Toulouse-Oncopole (IUCT-O), 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
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Evin C, Quéro L, Le Malicot K, Blanchet-Deverly S, François E, Buchalet C, Lemanski C, Baba Hamed N, Rivin Del Campo E, Bauwens L, Pommier P, Lièvre A, Tougeron D, Mace V, Sergent G, Diaz O, Zucman D, Mornex F, Locher C, de La Rochefordiere A, Vendrely V, Huguet F. Efficacité et toxicité de la (chimio)radiothérapie chez les patients séropositifs pour le VIH atteints d’un carcinome épidermoïde du canal anal, analyse en sous-groupe de la cohorte multicentrique Anabase. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.026] [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: 11/26/2022]
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Mesny E, Mornex F, Rode A, Merle P. [Radiation therapy of hepatic haemangiomas: Review from a case report]. Cancer Radiother 2021; 26:481-485. [PMID: 34116947 DOI: 10.1016/j.canrad.2021.05.002] [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: 03/25/2021] [Accepted: 05/09/2021] [Indexed: 11/18/2022]
Abstract
Haemangioma is the most frequent benign hepatic tumour. Haemangioma is generally asymptomatic but it can sometimes cause disabling symptoms depending on its size and location. Surgery and interventional radiology are the cornerstone of the treatment in this situation. Radiation therapy, already used with good efficacy and safety to treat hepatic malignant lesions as hepatocarcinoma and metastases, is a relevant option in case of contraindication to surgery because of multiple or very large lesions. In this context, we report the case of a patient presenting with multiple symptomatic hepatic haemangiomas, successfully treated by radiation therapy in our department. These good results justified a review of the literature to report series of patients treated in this indication and to describe the main treatment regimens used.
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Affiliation(s)
- E Mesny
- Département de radiothérapie oncologie, groupement hospitalier Lyon Sud, Hospices civils de Lyon, Pierre-Bénite, France.
| | - F Mornex
- Département de radiothérapie oncologie, groupement hospitalier Lyon Sud, Hospices civils de Lyon, Pierre-Bénite, France; Université Claude-Bernard Lyon 1, Lyon, France
| | - A Rode
- Département de radiologie, groupement hospitalier Lyon Nord, Hospices civils de Lyon, Lyon, France
| | - P Merle
- Université Claude-Bernard Lyon 1, Lyon, France; Département d'hépatologie, groupement hospitalier Lyon Nord, Hospices civils de Lyon, Lyon, France
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Mazeron JJ, Mornex F, Cosset JM, Eschwège F. [The 30th anniversary of SFRO, the French society of oncological radiotherapy]. Cancer Radiother 2021; 25:411-418. [PMID: 33875367 DOI: 10.1016/j.canrad.2021.03.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The French society of oncological radiotherapy (Société française de radiothérapie oncologique, SFRO) was created in 1990. On the occasion of its thirtieth annual congress, in October 2019, a session was devoted to it, with the objective of exposing its functioning, its actions and its productions during these three decades during which radiotherapy and oncology have undergone unprecedented transformations. We propose in this article to outline the content of this session.
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Affiliation(s)
- J-J Mazeron
- Centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France.
| | - F Mornex
- Centre hospitalier Lyon-sud, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Université Claude-Bernard Lyon 1, 69000 Lyon, France
| | - J-M Cosset
- Centre de radiothérapie Charlebourg, groupe Amethyst, 92250 La Garenne-Colombes, France
| | - F Eschwège
- Centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
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McDonald F, Mornex F, Garassino M, Filippi A, Christoph D, Haakensen V, Agbarya A, Van den Heuvel M, Vercauter P, Chouaid C, Pichon E, Siva S, Steinbusch L, Peretz I, Solomon B, Decoster L, Sawyer W, Allen A, Licour M, Girard N. 79MO PACIFIC-R: Real-world characteristics of unresectable stage III NSCLC patients treated with durvalumab after chemoradiotherapy. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01921-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Azria D, Créhange G, Castan F, Belkacemi Y, Lagrange J, Nguyen T, Chapet O, Mornex F, Noel G, Lartigau E, Pasquier D, Clippe S, Hennequin C, Gourgou S, Brengues M, Fenoglietto P, Farcy-Jacquet M, Ozsahin M. Le taux d’apoptose lymphocytaire radio-induit CD8 prédicteur de la toxicité pelvienne après radiothérapie prostatique : résultats de l’étude prospective multicentrique française. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vokes E, Adjei A, Ahn M, Barlesi F, Felip E, Garon E, Grenga I, Koenig A, Martin C, Mok T, Mornex F, Munshi N, Raben D, Robinson C, Paz-Ares L. P2.18-01 A Multicenter, Double-Blind, Randomized, Controlled Study of Bintrafusp Alfa (M7824) in Unresectable Stage III NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1955] [Citation(s) in RCA: 2] [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: 10/25/2022]
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Avrillon V, Bota Ouchlif S, Merle P, Pichon E, Stancu A, Chouaid C, Sire C, Boudabous H, Lagrange A, Sabatini M, Eberst G, Boisselier P, Gourion A, Lion A, Lahouegue A, Belkhiria K, de La Porte I, Urbieta M, Mornex F, Girard N. First real life data on durvalumab after definitive concomitant chemoradiotherapy (cCRT) in unresectable stage (St) III non-small cell lung cancer (NSCLC) in France: Analysis of 591 patients (pts) enrolled in the French cohort (c) temporary authorization of use (ATU). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz259.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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16
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Kaiss H, Mornex F. [Stereotactic radiotherapy of stage I non-small cell lung cancer. State of the art in 2019 and recommendations: Stereotaxy as an alternative to surgery?]. Cancer Radiother 2019; 23:720-731. [PMID: 31471255 DOI: 10.1016/j.canrad.2019.07.132] [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: 07/19/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 11/24/2022]
Abstract
Stereotactic radiotherapy (or Stereotactic body radiotherapy [SBRT]) is a technique currently well established in the therapeutic arsenal for the management of bronchial cancers. It represents the standard treatment for inoperable patients or who refuses surgery. It is well tolerated, especially in elderly and frail patients, and the current issue is to define its indications in operated patients, based on retrospective and randomized trials comparing stereotactic radiotherapy and surgery, with results equivalents. This work analyzes in detail the different aspects of pulmonary stereotactic radiotherapy and suggests arguments that help in the therapeutic choice between surgery and stereotaxic irradiation. In all cases, the therapeutic decision must be discussed in a multidisciplinary consultation meeting, while informing the patient of the possible therapeutic options.
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Affiliation(s)
- H Kaiss
- Département de radiothérapie oncologie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
| | - F Mornex
- Département de radiothérapie oncologie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
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Girard N, Mornex F, Christoph D, Fietkau R, Filippi A, Field J, Garrido Lopez P, McDonald F, Peters S, Klein A, Licour M, Garassino M. PACIFIC-R: First real-world study of patients with unresectable, stage III NSCLC treated with durvalumab after chemoradiotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz067.017] [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] [Indexed: 11/14/2022] Open
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18
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Chajon E, Pracht M, De Baere T, N’Guyen F, Bronowicki J, Vendrely V, Baumann A, Croisé-Laurent V, Rio E, Rolland Y, Le Sourd S, Gustin P, Perret C, Mornex F, Peiffert D, Merle P, Deutsch E. OC-0281 Phase I/II trial of hafnium oxide nanoparticles activated by SBRT in the treatment of liver cancers. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30701-7] [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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19
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Peters S, Dafni U, Boyer M, De Ruysscher D, Faivre-Finn C, Felip E, Garrido P, Girard N, Guckenberger M, Haanen J, Le Pechoux C, Mornex F, Ozsahin M, Paz-Ares L, Planchard D, Raben D, Ramalingam S, Reck M, Smit E, Stahel R, Stenzinger A, Swanton C, Vallone S, Garassino MC. Position of a panel of international lung cancer experts on the approval decision for use of durvalumab in stage III non-small-cell lung cancer (NSCLC) by the Committee for Medicinal Products for Human Use (CHMP). Ann Oncol 2019; 30:161-165. [PMID: 30624547 DOI: 10.1093/annonc/mdy553] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- S Peters
- Oncology Department, Lausanne University and CHUV, Lausanne, Switzerland.
| | - U Dafni
- Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - M Boyer
- Chris O'Brien Lifehouse, Camperdown, Australia
| | - D De Ruysscher
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Department of Radiation Oncology (Maastro Clinic), Maastricht, The Netherlands
| | - C Faivre-Finn
- Department of Clinical Oncology, The Christie NHS Foundation Trust & University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - E Felip
- Oncology Department, Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - P Garrido
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - N Girard
- Thorax Institute, Institute Curie, Paris, France
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - J Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Le Pechoux
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - F Mornex
- Université Claude Bernard Lyon1, and Hospices Civils de Lyon, Lyon, France
| | - M Ozsahin
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - L Paz-Ares
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, CNIO & Universidad Complutense, Madrid, Spain
| | - D Planchard
- Department of Medical Oncology, Thoracic Group, Gustave Roussy, Villejuif, France
| | - D Raben
- Marsico Family Endowed Chair of Head and Neck Cancer Research, University of Colorado Cancer Center, Aurora, USA
| | - S Ramalingam
- Department of Hematology and Medical Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, USA
| | - M Reck
- LungenClinic, Airway Research Center North (ARCN), German Center for Lung Research, Grosshansdorf, Germany
| | - E Smit
- Egbert Smit, Department Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R Stahel
- Chair Comprehensive Cancer Center Zürich, Universitätspital Zurich, Zurich, Switzerland
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - C Swanton
- Cancer Evolution and Genome Stability Laboratory, The Francis Crick Institute and UCL Cancer Institute, UK
| | - S Vallone
- Lung Cancer Europe (LuCE), Bern, Switzerland
| | - M C Garassino
- Thoracic Oncology, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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20
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Bibault JE, Denis F, Roué A, Gibon D, Fumagalli I, Hennequin C, Barillot I, Quéro L, Paumier A, Mahé MA, Servagi Vernat S, Créhange G, Lapeyre M, Blanchard P, Pointreau Y, Lafond C, Huguet F, Mornex F, Latorzeff I, de Crevoisier R, Martin V, Kreps S, Durdux C, Antoni D, Noël G, Giraud P. [Siriade 2.0: An e-learning platform for radiation oncology contouring]. Cancer Radiother 2018; 22:773-777. [PMID: 30360973 DOI: 10.1016/j.canrad.2018.02.003] [Citation(s) in RCA: 2] [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: 11/17/2017] [Revised: 01/23/2018] [Accepted: 02/08/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE In 2008, the French national society of radiation oncology (SFRO) and the association for radiation oncology continued education (AFCOR) created Siriade, an e-learning website dedicated to contouring. MATERIAL AND METHODS Between 2015 and 2017, this platform was updated using the latest digital online tools available. Two main sections were needed: a theoretical part and another section of online workshops. RESULTS Teaching courses are available as online commented videos, available on demand. The practical section of the website is an online contouring workshop that automatically generates a report quantifying the quality of the user's delineation compared with the experts'. CONCLUSION Siriade 2.0 is an innovating digital tool for radiation oncology initial and continuous education.
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Affiliation(s)
- J-E Bibault
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France
| | - F Denis
- Service de radiothérapie, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - A Roué
- Institut national des sciences et techniques nucléaires, centre CEA de Saclay, D36, 91191 Gif-sur-Yvette, France
| | - D Gibon
- Aquilab, parc Eurasanté, biocentre Fleming, 250, rue Salvador-Allende, 59120 Loos, France
| | - I Fumagalli
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - C Hennequin
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - I Barillot
- Service d'oncologie radiothérapie, centre universitaire de cancérologie Henry-S.-Kaplan, 2, boulevard Tonnellé, 37044 Tours, France; Université François-Rabelais, 2, boulevard Tonnellé, 37044 Tours, France
| | - L Quéro
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - A Paumier
- Service d'oncologie radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Professeur-Jacques-Monod, 44805 Saint-Herblain, France
| | - M-A Mahé
- Service d'oncologie radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Professeur-Jacques-Monod, 44805 Saint-Herblain, France
| | - S Servagi Vernat
- Service d'oncologie radiothérapie, institut Jean-Godinot, 1, rue Koenig, 51100 Reims, France
| | - G Créhange
- Service d'oncologie radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - M Lapeyre
- Service d'oncologie radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63011 Clermont-Ferrand, France
| | - P Blanchard
- Service d'oncologie radiothérapie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Y Pointreau
- Service de radiothérapie, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - C Lafond
- Service de radiothérapie, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires de l'Est parisien, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, 4, rue de la Chine, 75020 Paris, France
| | - F Mornex
- Service d'oncologie radiothérapie, CHU Lyon Sud, 65, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - I Latorzeff
- Service d'oncologie radiothérapie, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
| | - R de Crevoisier
- Service d'oncologie radiothérapie, centre Eugène-Marquis, avenue de la Bataille-Flandre-Dunkerque, 35700 Rennes, France
| | - V Martin
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - S Kreps
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France
| | - C Durdux
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France.
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Pracht M, Chajon E, de Baere T, Nguyen F, Bronowicki JP, Vendrely V, Baumann AS, Croisé-Laurent V, Rio E, Rolland Y, Le Sourd S, Gustin P, Perret C, Mornex F, Peiffert D, Merle P, Deutsch E. Hepatocellular carcinoma and liver metastasis treated by hafnium oxide nanoparticles activated by stereotactic body radiation therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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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22
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Barillot I, Antoni D, Bellec J, Biau J, Giraud P, Jenny C, Lacornerie T, Lisbona A, Marchesi V, Mornex F, Supiot S, Thureau S, Noel G. Bases référentielles de la radiothérapie en conditions stéréotaxiques pour les tumeurs ou métastases bronchopulmonaires, hépatiques, prostatiques, des voies aérodigestives supérieures, cérébrales et osseuses. Cancer Radiother 2018; 22:660-681. [DOI: 10.1016/j.canrad.2018.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 07/26/2018] [Accepted: 08/01/2018] [Indexed: 12/12/2022]
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Chargari C, Maingon P, Mornex F, Haie-Méder C. La curiethérapie : la plus ancienne des techniques modernes d’irradiation. Cancer Radiother 2018; 22:303-304. [DOI: 10.1016/j.canrad.2017.12.004] [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] [Received: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 11/25/2022]
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24
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Darfaoui M, Mornex F, Rode A, Radenne S, Manichon AF, Fares N, Prévost C, Ouziel G, Hartig-Lavie K, Pages-Écochard M, Ducerf C, Lesurtel M, Mabrut JY, Merle P. Carcinome hépatocellulaire unifocal Child A : l’association de radiothérapie et de chémoembolisation transartérielle est-elle équivalente à la résection chirurgicale ? Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.07.010] [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: 12/01/2022]
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Debbi K, Janoray G, Scher N, Deutsch É, Mornex F. [Doses to organs at risk in conformational and stereotactic body radiation therapy: Liver]. Cancer Radiother 2017; 21:604-612. [PMID: 28893525 DOI: 10.1016/j.canrad.2017.07.042] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 07/23/2017] [Indexed: 12/25/2022]
Abstract
The liver is an essential organ that ensures many vital functions such as metabolism of bilirubin, glucose, lipids, synthesis of coagulation factors, destruction of many toxins, etc. The hepatic parenchyma can be irradiated during the management of digestive tumors, right basithoracic, esophagus, abdomen in toto or TBI. In addition, radiotherapy of the hepatic area, which is mainly stereotactic, now occupies a central place in the management of primary or secondary hepatic tumors. Irradiation of the whole liver, or part of it, may be complicated by radiation-induced hepatitis. It is therefore necessary to respect strict dosimetric constraints both in stereotactic and in conformational irradiation in order to limit the undesired irradiation of the hepatic parenchyma which may vary according to the treatment techniques, the basic hepatic function or the lesion size. The liver is an organ with a parallel architecture, so the average tolerable dose in the whole liver should be considered rather than the maximum tolerable dose at one point. The purpose of this article is to propose a development of dose recommendations during conformation or stereotactic radiotherapy of the liver.
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Affiliation(s)
- K Debbi
- Clinique d'oncologie radiothérapie, centre Henry-S.-Kaplan, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France.
| | - G Janoray
- Clinique d'oncologie radiothérapie, centre Henry-S.-Kaplan, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - N Scher
- Clinique d'oncologie radiothérapie, centre Henry-S.-Kaplan, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - É Deutsch
- Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - F Mornex
- Département de radiothérapie oncologie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard-Lyon-1, 69373 Lyon cedex 08, France
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Riou O, Azria D, Mornex F. [Stereotactic body radiotherapy for liver tumors: State of the art]. Cancer Radiother 2017; 21:563-573. [PMID: 28888744 DOI: 10.1016/j.canrad.2017.07.040] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 01/04/2023]
Abstract
Thanks to the improvement in radiotherapy physics, biology, computing and imaging, patients presenting with liver tumors can be efficiently treated by radiation. Radiotherapy has been included in liver tumors treatment guidelines at all disease stages. Liver stereotactic radiotherapy has to be preferred to standard fractionated radiotherapy whenever possible, as potentially more efficient because of higher biological equivalent dose. Liver stereotactic radiotherapy planning and delivery require extensive experience and optimal treatment quality at every step, thus limiting its availability to specialized centres. Multicentre studies are difficult to develop due to a large technical heterogeneity. Respiratory management, image guidance and immobilization are considerations as important as machine type. The use of multimodal planning imaging is compulsory to achieve expected contouring quality. Treatment efficacy is difficult to assess following liver stereotactic radiotherapy, but local control is high and toxicity unusual. As a consequence, liver stereotactic radiotherapy is part of multimodal and multidisciplinary management of liver tumors.
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Affiliation(s)
- O Riou
- Département de cancérologie radiothérapie, ICM-Val d'Aurelle, rue de la Croix-Verte, 34298 Montpellier, France; Institut de recherche en cancérologie de Montpellier (IRCM), avenue des Apothicaires, 34298 Montpellier cedex 05, France; Inserm U1194, avenue des Apothicaires, 34298 Montpellier cedex 05, France; Université de Montpellier 1, avenue des Apothicaires, 34298 Montpellier cedex 05, France.
| | - D Azria
- Département de cancérologie radiothérapie, ICM-Val d'Aurelle, rue de la Croix-Verte, 34298 Montpellier, France; Institut de recherche en cancérologie de Montpellier (IRCM), avenue des Apothicaires, 34298 Montpellier cedex 05, France; Inserm U1194, avenue des Apothicaires, 34298 Montpellier cedex 05, France; Université de Montpellier 1, avenue des Apothicaires, 34298 Montpellier cedex 05, France
| | - F Mornex
- Département de radiothérapie-oncologie, centre hospitalier Lyon sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon-1, domaine Rockefeller, 8, avenue Rockefeller, 69373 Lyon cedex 08, France
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Bockel S, Antoni D, Deutsch É, Mornex F. Immunothérapie et radiothérapie. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.04.003] [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: 11/26/2022]
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Bockel S, Antoni D, Deutsch É, Mornex F. Immunothérapie et radiothérapie. Cancer Radiother 2017; 21:244-255. [DOI: 10.1016/j.canrad.2016.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/09/2016] [Accepted: 12/13/2016] [Indexed: 12/15/2022]
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29
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Bockel S, Antoni D, Deutsch É, Mornex F. Immunothérapie et radiothérapie. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.04.004] [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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Khounigere M, Benmira M, Prévost C, Fontaine-Delaruelle C, Selmaji I, Hassouni A, Girard N, Couraud S, Viart-Ferber C, Mornex F. Irradiation des cancers bronchiques : mesure de la double diffusion du CO et du NO. Résultats matures de l’étude prospective CONORT. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.07.053] [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: 10/21/2022]
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31
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Guigay J, Chamorey E, Céruse P, Mornex F, Degardin M, Alfonsi M, Digue L, Berrier A, Artignan X, Cals L, Faivre S, Vuillemin E, Rolland F, Timochenko A, Babin E, Seronde-Delmas A, Prevost A, Romano O, Peyrade F, Le Tourneau C. Observational study of the cetuximab relative dose intensity (RDI) in the first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Data on the maintenance and every two weeks use (DIRECT study). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.19] [Citation(s) in RCA: 2] [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: 11/14/2022] Open
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Abstract
Thanks to recent advances achieved in oncologic systemic and local ablative treatment, the treatments become more and more efficient in term of local control and overall survival. Thus, the targeted therapies, immunotherapy or stereotactic radiotherapy have modified the management of patients, especially in case of oligometastatic disease. Many questions are raised by these innovations, particularly the diagnosis and management of new side effects or that of the combination of these different treatments, depending on the type of primary tumor. Fundamental data are available, while clinical data are still limited. Ongoing trials should help to clarify the clinical management protocols. This manuscript is a review of the combination of radiotherapy and targeted therapy/immunotherapy.
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Affiliation(s)
- D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, UNICANCER, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 67200 Strasbourg, France
| | - S Bockel
- Département universitaire de radiothérapie, centre Paul-Strauss, UNICANCER, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - E Deutsch
- Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France; UMR 1030 « radiosensibilité des tumeurs et tissus sains », Inserm, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - F Mornex
- Département de radiothérapie oncologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EA 3738, université Claude-Bernard Lyon-1, domaine Rockefeller, 8, avenue Rockefeller, 69373 Lyon cedex 08, France.
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Barillot I, Mazeron R, Mornex F, Giraud P. Patients porteurs d’un stimulateur cardiaque ou d’un défibrillateur implantable. Cancer Radiother 2016; 20 Suppl:S256-8. [DOI: 10.1016/j.canrad.2016.07.022] [Citation(s) in RCA: 6] [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: 11/15/2022]
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Abstract
Indication, doses, and technique of radiotherapy, for intrathoracic metastases are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Affiliation(s)
- P Giraud
- Service d'oncologie radiothérapie, hôpital européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, Paris-Cité Sorbonne, 12, rue de l'École-de-Médecine, 75006 Paris, France.
| | - T Lacornerie
- Service de physique médicale, centre Oscar-Lambret, 3, avenue Frédéric-Combemale, 59000 Lille, France
| | - F Mornex
- EMR 3738, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; Département de radiothérapie-oncologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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Abstract
Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT.
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Affiliation(s)
- E Rio
- Service de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44805 Saint-Herblain, France.
| | - F Mornex
- Département de radiothérapie-oncologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - D Peiffert
- Service de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - A Huertas
- Service de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
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38
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Abstract
The article deals with the prevention of cancers only directly related to therapeutic radiation which are distinguished from "secondary cancer". The consideration of the risk of radiation-induced cancers after radiation therapy, although it is fortunately rare events, has become indispensable today. With a review of the literature, are detailed the various involved parameters. The age of the irradiated patient is one of the main parameters. The impact of the dose is also discussed based on the model used, and based on clinical data. Other parameters defining a radiation treatment are discussed one after the other: field with the example of Hodgkin's disease, the type of radiation and the participation of secondary neutrons, spreading and splitting. All these parameters are discussed according to each organ whose sensitivity is different. The article concludes with a list of recommendations to reduce the risk of radio-induced cancers. Even with the advent of conformal radiotherapy, intensity modulation, the modulated volume arctherapy, and the development of specific machinery for the extra-cranial stereotactic, the radiation therapist must consider this risk and use of reasonable and justified control imaging. Although they constitute a small percentage of cancers that occur secondarily after a first malignant tumor, radiation-induced cancers, can not and must not be concealed or ignored and justify regular monitoring over the long term, precisely adapted on the described parameters.
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Affiliation(s)
- J-M Cosset
- Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
| | - C Chargari
- Service de curiethérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Institut de recherche biomédicale des armées, 91223 Brétigny-sur-Orge, France
| | - C Demoor
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard J.-Monod, 44800 Saint-Herblain, Nantes, France; Unité Inserm 1018, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - P Giraud
- Hôpital européen Georges-Pompidou, université Paris-Descartes, Paris-Cité Sorbonne, 20, rue Leblanc, 75015 Paris, France
| | - S Helfre
- Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - F Mornex
- Département d'oncologie radiothérapie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, Lyon, France
| | - A Mazal
- Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
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Hennequin C, Azria D, Riou O, Castan F, Coelho M, Nguyen TD, Peignaux K, Lemanski C, Lagrange JL, Kirova Y, Lartigau E, Belkacemi Y, Bourgier C, Noel G, Clippe S, Mornex F, Kramar A, Pèlegrin A, Ozsahin M. Abstract P3-12-18: Radiation-induced CD8 T-lymphocyte apoptosis as a predictor of late toxicity after radiotherapy: Results of the prospective multicenter French trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-12-18] [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: 11/16/2022]
Abstract
Abstract
Purpose/Objective(s): We and others showed in retrospective and monocentric studies that radiation-induced CD8-lymphocyte apoptosis (RILA) can significantly predict differences in late toxicity between individuals and can be used as a rapid screening for potential hyper-reactive patients to radiation therapy (RT). We present here the clinical results of the prospective multicenter French trial (NCT00893035) evaluating the predictive role of RILA as a predictor of late effects after RT.
Materials/Methods: A total of 502 consenting breast-cancer patients (pts) treated by conservative surgery and adjuvant RT were included by 10 French centers. Lymphocytes apoptosis was assessed before RT by associated condensation of DNA. The incidence of late toxicities was obtained using CTCAEv3.0 grading scale. Complication-free survival (CFS) and complication-relapse-free survival (CRFS) curves were estimated by the Kaplan-Meier method. The log-rank test was used to identify significant categorical variables for each of the survival curves. Cox model was used for multivariate analysis.
Results: Four hundred and fifty-four pts (90.4%) were included in the final analysis (clinical, biological and dosimetric data available). One hundred and eight pts (24%) received both whole breast (WB) and nodal irradiation (NI). A boost dose of 10-16 Gy was given in 448 pts (99%). Adjuvant hormonotherapy (tamoxifen or aromatase inhibitor) was delivered to 346 pts (76%). Three categories of absolute change in the percent CD8 cells in apoptosis before and after exposure to 8-Gy in vitro RT were constructed around the 33 percent quantiles, <12%, 12-20%, and >20%. In a median follow-up period of 38.5 months, grade 2 and 3 late fibrosis was observed in 54 (12%) and 3 (0.7%) pts, respectively. A decreased percentage of grade 2 or more late toxicity was observed for increasing values of CD8 apoptosis (p=0.001). No grade 3 late toxicity was observed for patients with RILA ≥12%. The 3-year CFS rates were significantly lower for patients with low levels of CD8 radiation-induced apoptosis, 79% (95% confidence interval [CI]: 72–85%), 90% (95% CI: 84–94%), and 93% (95% CI: 87–96%) for CD8 <12%, 12–20%, and >20%, respectively (p=0.001). Similar results were observed for the CRFS rates (p<0.001). In multivariate analyses, prognostic factors for CFS were RILA<12% (p=0.001), smoking history (p<0.001), and adjuvant hormonal treatment (p=0.008). Negative predictive value for grade 2 or more toxicity was equal to 83% for CD8 >20% and positive predictive value was equal to 22% for CD8 <12% where the overall prevalence of grade 2 or more late side effects was estimated at 14%.
Conclusion: RILA significantly predicts differences in radiation-induced late toxicity between individuals. This study validates the use of RILA as a rapid screening for potential hyper-reactive pts to radiotherapy.
Citation Format: Hennequin C, Azria D, Riou O, Castan F, Coelho M, Nguyen TD, Peignaux K, Lemanski C, Lagrange J-L, Kirova Y, Lartigau E, Belkacemi Y, Bourgier C, Noel G, Clippe S, Mornex F, Kramar A, Pèlegrin A, Ozsahin M. Radiation-induced CD8 T-lymphocyte apoptosis as a predictor of late toxicity after radiotherapy: Results of the prospective multicenter French trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-12-18.
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Affiliation(s)
- C Hennequin
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - D Azria
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - O Riou
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - F Castan
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - M Coelho
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - TD Nguyen
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - K Peignaux
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - C Lemanski
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - J-L Lagrange
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Y Kirova
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - E Lartigau
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Y Belkacemi
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - C Bourgier
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - G Noel
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - S Clippe
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - F Mornex
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - A Kramar
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - A Pèlegrin
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - M Ozsahin
- Instiut Cancer Montpellier, Montpellier, France; Institut Jean Godinot, Reims, France; Centre GF Leclerc, Dijon, France; AP-HP Henri Mondor, Créteil, France; Institut Curie, Paris, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Strauss, Strasbourg, France; Centre Marie Curie, Valence, France; Centre Hospitalier Lyon Sud, Pierre-Bénite, France; Hopital Saint-Louis, Paris, France; Institut de Recherche en Cancérologie de Montpellier, Montpellier, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Mornex F, Senan S, Hennequin C, Lartigau E, Brade A, Wang L, Vansteenkiste J, Dakhil S, Biesma B, Martinez Aguillo M, Aerts J, Govindan R, Rubio-Viqueira B, Lewanski C, Gandara D, Choy H, Mok T, Hossain A, Iscoe N, Treat J, Koustenis A, Chouaki N, Vokes E. PROCLAIM : résultats finaux de survie globale de l’essai de phase III : pemetrexed cisplatine ou étoposide cisplatine, plus radiothérapie thoracique suivie d’une chimiothérapie de consolidation dans le CBNPC non épidermoïde localement avancé. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.674] [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: 11/27/2022]
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Mornex F, Fontaine-Delaruelle C, Selmaji I, Prevost C, Girard N, Zarza V, Viart-Ferber C, Couraud S. 421PD Prospective monitoring of lung function tests with CO and NO diffusion during high dose thoracic radiotherapy for lung cancer: The CONORT study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.05] [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: 11/13/2022] Open
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42
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Azria D, Riou O, Castan F, Coelho M, Nguyen T, Peignaux K, Lemanski C, Lagrange J, Kirova Y, Lartigau E, Belkacemi Y, Bourgier C, Noel G, Clippe S, Mornex F, Hennequin C, Kramar A, Pèlegrin A, Ozsahin E. Radiation Induced CD8 T-Lymphocyte Apoptosis as a Predictor of Late Toxicity After Radiation Therapy: Results of the Prospective Multicenter French Trial. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.248] [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: 11/15/2022]
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Huguet F, Thariat J, Antoni D, Mornex F. Place de la radiothérapie (et chimioradiothérapie) dans les cancers localement avancés ou borderline. Quelles perspectives ? ONCOLOGIE 2015. [DOI: 10.1007/s10269-015-2561-9] [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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44
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Bibault JE, Arsène-Henry A, Durdux C, Mornex F, Hamza S, Trouette R, Thureau S, Faivre JC, Boisselier P, Lerouge D, Paragios N, Giraud P. Radiothérapie adaptative du carcinome bronchique non à petites cellules. Cancer Radiother 2015; 19:458-62. [DOI: 10.1016/j.canrad.2015.05.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 05/27/2015] [Indexed: 11/26/2022]
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Janoray G, Mornex F. Suivi après radiothérapie stéréotaxique des tumeurs hépatiques : revue de la littérature et recommandations. Cancer Radiother 2015; 19:573-81. [DOI: 10.1016/j.canrad.2015.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 05/24/2015] [Indexed: 02/08/2023]
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46
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Antoni D, Srour I, Mornex F. Cancer du poumon : radiothérapie en conditions stéréotaxiques et chirurgie. Cancer Radiother 2015; 19:371-6. [DOI: 10.1016/j.canrad.2015.06.014] [Citation(s) in RCA: 3] [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] [Received: 06/10/2015] [Accepted: 06/15/2015] [Indexed: 12/17/2022]
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Dhermain F, Reyns N, Colin P, Métellus P, Mornex F, Noël G. Radiothérapie en conditions stéréotaxiques des métastases cérébrales. Cancer Radiother 2015; 19:25-9. [DOI: 10.1016/j.canrad.2014.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 12/02/2014] [Indexed: 11/17/2022]
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Borg C, André T, Mantion G, Boudghène F, Mornex F, Maingon P, Adenis A, Azria D, Piutti M, Morsli O, Bosset J. Pathological response and safety of two neoadjuvant strategies with bevacizumab in MRI-defined locally advanced T3 resectable rectal cancer: a randomized, noncomparative phase II study. Ann Oncol 2014; 25:2205-2210. [DOI: 10.1093/annonc/mdu377] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Ayadi M, Zahra N, Thariat J, Bouilhol G, Boissard P, Van Houtte P, Claude L, Mornex F. Radiothérapie conformationnelle avec modulation d’intensité dans les carcinomes bronchiques non à petites cellules. Cancer Radiother 2014; 18:406-13. [DOI: 10.1016/j.canrad.2014.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 06/24/2014] [Accepted: 06/29/2014] [Indexed: 12/25/2022]
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Chauvet B, Mornex F, Mahé MA. [Strategy for technical evaluation in radiation oncology: methodological and ethical aspects, the French society for radiation oncology's opinion]. Cancer Radiother 2014; 18:379-82. [PMID: 25195111 DOI: 10.1016/j.canrad.2014.08.002] [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: 07/22/2014] [Revised: 07/28/2014] [Accepted: 08/04/2014] [Indexed: 11/30/2022]
Abstract
Evidence-based medicine is a paradigm founded on a hierarchy of research design, accepted as a dogma. Applied to radiation oncology, and specifically to radiotherapy technical comparisons, evidence-based medicine implies methodological and ethical problems. The concept of "incremental" evolution and the dosimetric evidence are proposed as an acceptable alternative to comparative clinical trials if total dose, time, fractionation, and target volumes are not modified. For other situations, either randomized comparative trials or observational studies are needed. When randomized comparative trials are not possible, observational studies, whose validity can be enhanced by appropriate methodology, must be considered as a valid method.
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Affiliation(s)
- B Chauvet
- Institut Sainte-Catherine, 250, chemin de Baigne-Pieds, CS 80005, 84918 Avignon cedex 9, France.
| | - F Mornex
- Service de radiothérapie-oncologie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - M-A Mahé
- Institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
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