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Chamois J, Septans A, Schipman B, Gross E, Blanchard N, Passerat V, Debelleix C, Hemery C, Latorzeff I, Pointreau Y. Metastases-directed radiotherapy in castration resistant oligo metastatic prostate cancer: A multicentric retrospective study from the French group COLib. Clin Transl Radiat Oncol 2024; 46:100762. [PMID: 38572302 PMCID: PMC10987832 DOI: 10.1016/j.ctro.2024.100762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024] Open
Abstract
Oligometastases are defined as a number of detectable metastases less or equal to 5. In castrate-resistant oligo metastatic prostate Cancer (CR oligoM PC), Metastases-Directed Ablative radiotherapy (MDRT) is poorly investigated. Our study retrospectively reviewed the cases of CR oligoM PC treated with MDRT in 8 French high-volume radiotherapy centers. OS and PFS are defined as the delay between the first day of MDRT and death (OS) or progression according to PCWG criteria (PFS). OS and PFS are evaluated according to Kaplan Meyer, curves are compared with log rank test. Logistic regression was used to identify predictive factors for outcome: bone versus node metastasis, ISUP grade, PSA doubling Time (PSADT) at the time of MDRT, time to castration resistance. 107 patients were included in the study, among those 197 metastases received MDRT. For the overall population, the median follow-up was 25.2 months (1,4-145). OS was 93 % at 2 years and 81,4% at 3 years. At 2 years, 100 % of patients with node-only metastasis were alive versus 88,7% among those who have bone metastases (p = 0,72). The median PFS was 12,6 months (IC 95 % [9,6; 17]), with no difference among patients with node only disease versus the rest of the cohort. The PFS was 18,2 months (10,0; 32,4) in patients with PSADT >6 months versus 10,7 months (8,9; 14,3) when PSADT was inferior to 6 months. However, this difference did not reach significant. We did not find a correlation neither between ISUP grade (1-2 versus 3-4-5) and PFS, nor between hormone-sensitivity duration and PFS. Patients receiving MDRT for CR oligoM PC have a good prognosis with 81,6% OS at 3 years. PSA DT longer than 6 months could be related to better PFS. MDRT strategy could postpone the onset of new systemic treatment with median PFS >1 year.
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Affiliation(s)
- J. Chamois
- Centre Hospitalier privé, Saint Grégoire, France
| | | | - B. Schipman
- Radiotherapie, Institut de Cancerologie de Bourgogne, Dijon, France
| | - E. Gross
- Radiotherapie, Hopital prive Clairval – Ramsay Sante, Marseille, France
| | - N. Blanchard
- Radiotherapie, Centre de Cancerologie les Dentellieres, Valenciennes, France
| | | | - C. Debelleix
- Radiotherapie, Clinique, Bordeaux Tivoli- Ducos, Bordeaux, France
| | | | - I. Latorzeff
- Radiotherapie, Clinique Pasteur, Toulouse, France
| | - Y. Pointreau
- Radiotherapie, Institut Interrégional de Cancerologie, Le Mans, France
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Antoni D, Mesny E, El Kabbaj O, Josset S, Noël G, Biau J, Feuvret L, Latorzeff I. Role of radiotherapy in the management of brain oligometastases. Cancer Radiother 2024; 28:103-110. [PMID: 37802747 DOI: 10.1016/j.canrad.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/27/2023] [Accepted: 03/29/2023] [Indexed: 10/08/2023]
Abstract
The management of patients with brain oligometastases is complex and relies on specific reasoning compared to extracranial oligometastases. The levels of evidence are still low because patients with brain oligometastases are frequently excluded from randomized clinical trials. Stereotactic radiotherapy should be preferred in this indication over whole brain irradiation, both for patients with metastases in place and for those who have undergone surgery. The decision of local treatment and its timing must be a multidisciplinary reflection taking into account the histological and molecular characteristics of the tumor as well as the intracranial efficacy of the prescribed systemic treatments. Great caution must be observed when using stereotactic radiotherapy and concomitant systemic treatments because interactions are still poorly documented. We present the recommendations of the French society of radiation oncology on the management of brain oligometastatic patients with radiotherapy.
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Affiliation(s)
- D Antoni
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe, 67033 Strasbourg, France.
| | - E Mesny
- Radiation Therapy Department, Hospices civils de Lyon, 69000 Lyon, France
| | - O El Kabbaj
- Radiation Therapy Department, hôpital privé Océane, 56000 Vannes, France
| | - S Josset
- Medical Physics, Institut de cancérologie de l'Ouest, 44800 Saint-Herblain, France
| | - G Noël
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe, 67033 Strasbourg, France
| | - J Biau
- Radiation Therapy Department, centre Jean-Perrin, 63011 Clermont-Ferrand, France
| | - L Feuvret
- Radiation Therapy Department, Hospices civils de Lyon, 69000 Lyon, France
| | - I Latorzeff
- Radiation Therapy Department, clinique Pasteur, 31300 Toulouse, France
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3
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Latorzeff I, Camps-Maléa A, Supiot S, de Crevoisier R, Farcy-Jacquet MP, Hannoun-Lévi JM, Riou O, Pommier P, Artignan X, Chapet O, Créhange G, Marchesi V, Pasquier D, Sargos P. Indication and perspectives of radiation therapy in the setting of de-novo metastatic prostate cancer. Cancer Radiother 2024; 28:49-55. [PMID: 37827959 DOI: 10.1016/j.canrad.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 10/14/2023]
Abstract
Prostate cancer is the most common cancer and the third leading cause of cancer mortality in men. Each year, approximately 10% of prostate cancers are diagnosed metastatic at initial presentation. The standard treatment option for de-novo metastatic prostate cancer is androgen deprivation therapy with novel hormonal agent or with chemotherapy. Recently, PEACE-1 trial highlighted the benefit of triplet therapy resulting in the combination of androgen deprivation therapy combined with docetaxel and abiraterone. Radiotherapy can be proposed in a curative intent or to treat local symptomatic disease. Nowadays, radiotherapy of the primary disease is only recommended for de novo low-burden/low-volume metastatic prostate cancer, as defined in the CHAARTED criteria. However, studies on stereotactic radiotherapy on oligometastases have shown that this therapeutic approach is feasible and well tolerated. Prospective research currently focuses on the benefit of intensification by combining treatment of the metastatic sites and the primary all together. The contribution of metabolic imaging to better define the target volumes and specify the oligometastatic character allows a better selection of patients. This article aims to define indications of radiotherapy and perspectives of this therapeutic option for de-novo metastatic prostate cancer.
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Affiliation(s)
- I Latorzeff
- Department of Radiation Oncology, clinique Pasteur, Toulouse, France.
| | - A Camps-Maléa
- Department of Radiation Oncology, hôpital Bretonneau, CHU de Tours, Tours, France
| | - S Supiot
- Department of Radiation Oncology, institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; CNRS, Nantes, France; Université de Nantes, Nantes, France
| | - R de Crevoisier
- Department of Radiation Oncology, centre Eugène-Marquis, Rennes, France
| | - M-P Farcy-Jacquet
- Fédération universitaire d'oncologie radiothérapie, institut de cancérologie du Gard, CHU de Nîmes, Nîmes, France
| | - J-M Hannoun-Lévi
- Department of Radiation Oncology, centre Antoine-Lacassagne, Nice, France
| | - O Riou
- Department of Radiation Oncology, institut du cancer de Montpellier, Montpellier, France; Fédération universitaire d'oncologie radiothérapie de Méditerranée Occitanie, université de Montpellier, Montpellier, France; U1194, Inserm, Montpellier, France; IRCM, Montpellier, France
| | - P Pommier
- Department of Radiation Oncology, institut de cancérologie de l'Ouest, Angers, France
| | - X Artignan
- Department of Radiation Oncology, centre hospitalier privé Saint-Grégoire, Rennes, France
| | - O Chapet
- Department of Radiation Oncology, centre hospitalier Lyon Sud, Pierre-Bénite, France
| | - G Créhange
- Department of Radiation Oncology, institut Curie, Saint-Cloud, France
| | - V Marchesi
- Department of Medical Physics, centre Alexis-Vautrin, Vandœuvre-lès-Nancy, France
| | - D Pasquier
- Academic Department of Radiation Oncology, centre Oscar-Lambret, Lille, France; UMR 9189 - CRIStAL, université de Lille, CNRS, école Centrale Lille, 59000 Lille, France
| | - P Sargos
- Department of Radiotherapy, institut Bergonié, Bordeaux, France
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Sargos P, Le Guevelou J, Khalifa J, Albiges L, Azria D, de Crevoisier R, Supiot S, Créhange G, Roubaud G, Chapet O, Pasquier D, Blanchard P, Latorzeff I. The role of radiation therapy for de novo metastatic bladder and renal cancers. Cancer Radiother 2024; 28:56-65. [PMID: 37286452 DOI: 10.1016/j.canrad.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/21/2023] [Indexed: 06/09/2023]
Abstract
Metastatic bladder and renal cancers account respectively for 2.1% and 1.8% of cancer deaths worldwide. The advent of immune checkpoint inhibitors has revolutionized the management of metastatic disease, by demonstrating considerable improvements in overall survival. However, despite initial sensitivity to immune checkpoint inhibitors for most patients, both bladder and renal cancer are associated with short progression-free survival and overall survival, raising the need for further strategies to improve their efficacy. Combining systemic therapies with local approaches is a longstanding concept in urological oncology, in clinical settings including both oligometastatic and polymetastatic disease. Radiation therapy has been increasingly studied with either cytoreductive, consolidative, ablative or immune boosting purposes, but the long-term impact of this strategy remains unclear. This review intends to address the impact of radiation therapy with either curative or palliative intent, for synchronous de novo metastatic bladder and renal cancers.
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Affiliation(s)
- P Sargos
- Department of Radiation Oncology, institut Bergonié, Bordeaux, France.
| | - J Le Guevelou
- Faculty of Medicine, Geneva, Switzerland; Department of Radiation Oncology, centre Eugène-Marquis, Rennes, France
| | - J Khalifa
- Department of Radiation Oncology, institut Claudius-Regaud, Institut universitaire du cancer de Toulouse - Oncopole, Toulouse, France
| | - L Albiges
- Department of Cancer Medicine, institut Gustave-Roussy, Villejuif, France
| | - D Azria
- Department of Radiation Oncology, Institut du cancer de Montpellier (ICM), IRCM U1194 Inserm, université de Montpellier, Montpellier, France
| | - R de Crevoisier
- Department of Radiation Oncology, centre Eugène-Marquis, Rennes, France
| | - S Supiot
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest, Saint-Herblain, France; CRCINA CNRS, Nantes, France; Inserm, Nantes, France; Université de Nantes et d'Angers, Nantes, France
| | - G Créhange
- Department of Radiation Oncology, institut Curie, Saint-Cloud, France
| | - G Roubaud
- Department of Medical Oncology, institut Bergonié, Bordeaux, France
| | - O Chapet
- Department of Oncology Department, centre hospitalier Lyon Sud, Pierre-Bénite, France
| | - D Pasquier
- Department of Radiation Oncology, centre Oscar-Lambret, Lille, France; Cristal UMR 9189, université de Lille, Lille, France
| | - P Blanchard
- Department of Radiation Oncology, Gustave-Roussy Cancer Campus, université Paris-Saclay, Oncostat U1018 Inserm, Villejuif, France
| | - I Latorzeff
- Department of Radiation Oncology, clinique Pasteur, Toulouse, France
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Latorzeff I, Bayart É, Azria D. Indication of radiotherapy for de novo metastatic cancer. The « Recommendations » Commission first issue. Cancer Radiother 2024; 28:1-2. [PMID: 38307639 DOI: 10.1016/j.canrad.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/04/2024]
Affiliation(s)
- I Latorzeff
- Department of Radiation Oncology, groupe Orion, clinique Pasteur, Toulouse, France.
| | - É Bayart
- Société française de radiothérapie oncologique - RadioTransNet, centre Antoine-Béclère, Paris, France
| | - D Azria
- Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, ICM, Inserm U1194 ICRM, Montpellier, France
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Latorzeff I, Guerif S, Castan F, Meyer E, Supiot S, Lagneau E, Deniaud-Alexandre E, Ronchin P, Benyoucef A, Cartier L, Hamidou H, Crehange G, Pommier P, Magne N, Zibouche M, Gross E, Ploussard G, Salomon L, Sargos P. GETUG-AFU 22 Phase II Randomized Trial Evaluating Outcomes of Post-Operative Immediate Salvage Radiation Therapy with or without ADT for Patients with Persistently Elevated PSA Level. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Benziane-Ouaritini N, Zilli T, Ingrosso G, di Staso M, Trippa F, Francolini G, Meyer E, Achard V, Schick U, Cosset J, Martin E, Penna RR, Ferrari V, Giraud N, Pasquier C, Magne N, Anger E, Aristei C, Perrenec T, Gnep K, Pasquier D, Supiot S, Sargos P, Latorzeff I. Salvage Radiotherapy Guided by Functional Imaging for Macroscopic Local Recurrence Following Radical Prostatectomy: A Multicentric Retrospective Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Martz N, Salleron J, Dhermain F, Vogin G, Daisne J, Audouard RM, Tanguy R, Noel G, Peyre M, Lecouillard I, Jacob J, Attal J, Charissoux M, Veresezan O, Hanzen C, Huchet A, Latorzeff I, Coutte A, Doyen J, Dinu S, Feuvret L, Garcia G, Royer P. ANOCEF Consensus Guideline on Target Volume Delineation for Meningiomas Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vilotte F, Pasquier D, Blanchard P, Supiot S, Khalifa J, Schick U, Lacornerie T, Vieillevigne L, Marre D, Chapet O, Latorzeff I, Magne N, Meyer E, Cao K, Belkacemi Y, Bibault J, Berge-Lefranc M, Faivre J, Gnep K, Guimas V, Hasbini A, Langrand-Escure J, Hennequin C, Graff P. Recommendations for stereotactic body radiation therapy for spine and non-spine bone metastases. A GETUG (French society of urological radiation oncolgists) consensus using a national two-round modified Delphi survey. Clin Transl Radiat Oncol 2022; 37:33-40. [PMID: 36052019 PMCID: PMC9424259 DOI: 10.1016/j.ctro.2022.08.006] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background and purpose The relevance of metastasis-directed stereotactic body radiation therapy (SBRT) remains to be demonstrated through phase III trials. Multiple SBRT procedures have been published potentially resulting in a disparity of practices. Therefore, the french society of urological radiation oncolgists (GETUG) recognized the need for joint expert consensus guidelines for metastasis-directed SBRT in order to standardize practice in trials carried out by the group. Materials and methods After a comprehensive literature review, 97 recommendation statements were created regarding planning and delivery of spine bone (SBM) and non-spine bone metastases (NSBM) SBRT. These statements were then submitted to a national online two-round modified Delphi survey among main GETUG investigators. Consensus was achieved if a statement received ≥ 75 % agreements, a trend to consensus being defined as 65-74 % agreements. Any statement without consensus at round one was re-submitted in round two. Results Twenty-one out of 29 (72.4%) surveyed experts responded to both rounds. Seventy-five statements achieved consensus at round one leaving 22 statements needing a revote of which 16 achieved consensus and 5 a trend to consensus. The final rate of consensus was 91/97 (93.8%). Statements with no consensus concerned patient selection (3/19), dose and fractionation (1/11), prescription and dose objectives (1/9) and organs at risk delineation (1/15). The voting resulted in the writing of step-by-step consensus guidelines. Conclusion Consensus guidelines for SBM and NSBM SBRT were agreed upon using a validated modified Delphi approach. These guidelines will be used as per-protocole recommendations in ongoing and further GETUG clinical trials.
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Affiliation(s)
- F. Vilotte
- Department of Radiation Oncology, Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux, France
| | - D. Pasquier
- Department of Radiation Oncology, Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000 Lille, France
| | - P. Blanchard
- Department of Radiation Oncology, Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - S. Supiot
- Department of Radiation Oncology, Institut de Cancérologie de L'Ouest, Boulevard Professeur Jacques Monod, 44800 Saint Herblain, France
| | - J. Khalifa
- Department of Radiation Oncology, Institut Universitaire du Cancer de Toulouse-Oncopole, 1 AV Irène Joliot Curie, 31059 Toulouse, France
| | - U. Schick
- Department of Radiation Oncology, CHU de Brest, Hôpital Morvan, avenue Foch, 29200 Brest, France
| | - T. Lacornerie
- Division of Radiation Medical Physics, Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000 Lille, France
| | - L. Vieillevigne
- Division of Radiation Medical Physics, Institut Universitaire du Cancer de Toulouse-Oncopole, 1 AV Irène Joliot Curie, 31059 Toulouse, France
| | - D. Marre
- Division of Radiation Medical Physics, Groupe ONCORAD Garonne, Clinique Pasteur, Bât Atrium, 1 rue de la petite vitesse, 31300 Toulouse, France
| | - O. Chapet
- Department of Radiation Oncology, CH Lyon Sud 165 Chemin Du Grand Revoyet, 69310 Pierre-bénite, France
| | - I. Latorzeff
- Department of Radiation Oncology, Groupe ONCORAD Garonne, Clinique Pasteur, Bât Atrium, 1 rue de la petite vitesse, 31300 Toulouse, France
| | - N. Magne
- Department of Radiation Oncology, Institut de cancérologie Lucien Neuwirth, 108 bis AV Albert Raimond, 42270 Saint Priest en Jarez, France
| | - E. Meyer
- Department of Radiation Oncology, Centre François Baclesse, 3 Av. du Général Harris, 14000 Caen, France
| | - K. Cao
- Department of Radiation Oncology, Institut Curie Paris, 26 rue d’Ulm, 75005 Paris, France
| | - Y. Belkacemi
- Department of Radiation Oncology, Hôpital Henri-Mondor, 1 rue Gustave Eiffel, 94000 Créteil, France
| | - J.E. Bibault
- Department of Radiation Oncology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - M. Berge-Lefranc
- Department of Radiation Oncology, Centre Saint Michel, rue du Docteur Schweitzer, 17000 La Rochelle, France
| | - J.C. Faivre
- Department of Radiation Oncology, Institut de Cancérologie de Lorraine, 6 Av. de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - K. Gnep
- Department of Radiation Oncology, Centre Eugène Marquis, AV de la Bataille Flandres Dunkerque, 35000 Rennes, France
| | - V. Guimas
- Department of Radiation Oncology, Institut de Cancérologie de L'Ouest, Boulevard Professeur Jacques Monod, 44800 Saint Herblain, France
| | - A. Hasbini
- Department of Radiation Oncology, Clinique Pasteur, 32 r Auguste Kervern, 29200 Brest, France
| | - J. Langrand-Escure
- Department of Radiation Oncology, Institut de cancérologie Lucien Neuwirth, 108 bis AV Albert Raimond, 42270 Saint Priest en Jarez, France
| | - C. Hennequin
- Department of Radiation Oncology, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - P. Graff
- Department of Radiation Oncology, Institut Curie Saint Cloud, 35 rue Dailly, 92210 Saint Cloud, France
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Burdett S, Fisher D, Parker C, Sydes M, Pommier P, Sargos P, Spratt D, Kishan A, Brihoum M, Catton C, Chabaud S, Clarke N, Cook A, Latorzeff I, Tierney J, Vale C. LBA64 Duration of androgen suppression with post-operative radiotherapy (DADSPORT): A collaborative meta-analysis of aggregate data. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Delpon G, Barateau A, Beneux A, Bessières I, Latorzeff I, Welmant J, Tallet A. [What do we need to deliver "online" adapted radiotherapy treatment plans?]. Cancer Radiother 2022; 26:794-802. [PMID: 36028418 DOI: 10.1016/j.canrad.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022]
Abstract
During the joint SFRO/SFPM session of the 2019 congress, a state of the art of adaptive radiotherapy announced a strong impact in our clinical practice, in particular with the availability of treatment devices coupled to an MRI system. Three years later, it seems relevant to take stock of adaptive radiotherapy in practice, and especially the "online" strategy because it is indeed more and more accessible with recent hardware and software developments, such as coupled accelerators to a three-dimensional imaging device and algorithms based on artificial intelligence. However, the deployment of this promising strategy is complex because it contracts the usual time scale and upsets the usual organizations. So what do we need to deliver adapted treatment plans with an "online" strategy?
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Affiliation(s)
- G Delpon
- Institut de cancérologie de l'Ouest, Saint-Herblain et IMT Atlantique, Nantes université, CNRS/IN2P3, Subatech, Nantes, France.
| | - A Barateau
- Université Rennes, CLCC Eugène-Marquis, Inserm, LTSI-UMR 1099, Rennes, France
| | - A Beneux
- Hospices Civils de Lyon, Lyon, France
| | - I Bessières
- Centre Georges-François Leclerc, Dijon, France
| | | | - J Welmant
- Institut du cancer de Montpellier, Montpellier, France
| | - A Tallet
- Institut Paoli-Calmettes, Marseille, France
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Pointreau Y, Sacier V, Gilard F, Balavoine M, Latorzeff I, Monpetit E. [Clinical research in radiotherapy oncology in private sector: A reality with a possible future?]. Cancer Radiother 2022; 26:818-822. [PMID: 35987810 DOI: 10.1016/j.canrad.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
Clinical research is one of the activities of medical practice, particularly in oncology including radiotherapy. It was developed in the public sector and then in the liberal sector, in compliance with regulatory institutions, resulting in a doubling of inclusions over the last decade. Setting up and developing clinical research in the liberal sector are major axes in terms of interests: improving the proposition of care, access to innovation, to keep patients, intellectual stimulation, encouraging recruitment, activity of scientific publications, financial valorisation, quality of visibility… An inventory on French national territory via the national union of iadiotherapists oncologists (SNRO) and the club of liberal oncologists (Colib) is reported in this article, as well as examples of structuring and organization.
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Affiliation(s)
- Y Pointreau
- Institut interrégionaL de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; Club des oncologues libéraux (Colib), 72000 Le Mans, France; SNRO, 168 A, rue de Grenelle, 75007 Paris, France; Société de recherche clinique en oncologie et hématologie (Sorecoh), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; WeProm, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; Oracle, ILC-centre d'oncologie de Gentilly, 2, rue Marie-Marvingt, 54100 Nancy, France.
| | - V Sacier
- Institut interrégionaL de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; Société de recherche clinique en oncologie et hématologie (Sorecoh), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - F Gilard
- Institut interrégionaL de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; Société de recherche clinique en oncologie et hématologie (Sorecoh), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; WeProm, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; Oracle, ILC-centre d'oncologie de Gentilly, 2, rue Marie-Marvingt, 54100 Nancy, France
| | - M Balavoine
- Institut interrégionaL de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France; WeProm, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - I Latorzeff
- SNRO, 168 A, rue de Grenelle, 75007 Paris, France; Service de radiothérapie, groupe Oncorad Garonne, clinique Pasteur, l'« Atrium », 1, rue de la Petite-Vitesse, 31300 Toulouse, France; Centre régional de radiochirurgie stéréotaxique, CHU Rangueil, avenue Jean-Poulhès, 31052 Toulouse cedex, France
| | - E Monpetit
- SNRO, 168 A, rue de Grenelle, 75007 Paris, France; Centre d'oncologie Saint-Yves, 11, rue du Docteur-Joseph-Audic, 56001 Vannes, France
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13
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Latorzeff I, Sargos P, Saad F. Editorial: Post Operative Radiation Treatment for Prostate Cancer. Front Oncol 2022; 12:959436. [PMID: 35865477 PMCID: PMC9294635 DOI: 10.3389/fonc.2022.959436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- I. Latorzeff
- Department of Radiation Oncology, Clinique Pasteur, Toulouse, France
- *Correspondence: I. Latorzeff,
| | - P. Sargos
- Department of Radiation Oncology, Institut Bergonié, Bordeaux, France
| | - F. Saad
- Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, Canada
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14
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Langé M, Magné N, Zhou K, Bellanger M, Latorzeff I, Pommier P, Martin E, Paumier A, Béra G, Supiot S. [Intermediate-risk prostate cancer treated with exclusive external irradiation: Focus on anatomical sites of recurrence in two French trials]. Cancer Radiother 2022; 26:647-653. [PMID: 35715355 DOI: 10.1016/j.canrad.2021.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Retrospective description of anatomical sites of relapse based on (18F)-choline PET-CT, (68Ga)-prostatic specific-membrane antigen PET-CT, bone scan, and prostate magnetic resonance imaging (MRI) data. MATERIALS AND METHODS From two French prospective cohorts, patients treated with exclusive radiotherapy for an intermediate-risk cancer were identified during their follow-ups. They were included if they presented a rising of the prostate-specific antigen (PSA) associated with the realization of an imaging showing the sites of recurrences. RESULTS Two hundred and sixty-three patients were included. After a median follow-up of 76 months (interquartile range [IQR] 67-95), 65 patients had biochemical recurrence and positive imaging. The median nadir PSA was 0.6ng/mL and the median PSA at recurrence was 3.4ng/mL. A single lesion was found in 48% of cases, 2 to 4 lesions in 43% of cases and more than 4 lesions in 9% of cases. The sites of relapse identified were prostate (37/65), prostate only (19/65), seminal vesicles (9/65) Pelvic nodes (35/65), extrapelvic nodes (15/65) and bone (13/65). CONCLUSIONS The majority of relapses presented as a single lesion localized in the pelvis.
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Affiliation(s)
- M Langé
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - N Magné
- Département de radiothérapie, institut de cancérologie de la Loire, 42270 Saint-Priest-en-Jarez, France
| | - K Zhou
- Département de sciences humaines et sociales, institut de cancérologie de l'Ouest, boulevard J.-Monod, 44800 Saint-Herblain, France
| | - M Bellanger
- Département de sciences humaines et sociales, institut de cancérologie de l'Ouest, boulevard J.-Monod, 44800 Saint-Herblain, France
| | - I Latorzeff
- Département de radiothérapie, Oncorad clinique Pasteur, 31300 Toulouse, France
| | - P Pommier
- Département de radiothérapie, centre Léon-Bérard, 69008 Lyon, France
| | - E Martin
- Département de radiothérapie, centre Georges-François-Leclerc, 21000 Dijon, France
| | - A Paumier
- Département de radiothérapie, institut de cancérologie de l'Ouest, 49000 Angers, France
| | - G Béra
- Département de radiothérapie, hôpital du Scorff, 56322 Lorient, France
| | - S Supiot
- Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44800 Saint-Herblain, France; Centre de recherche en cancérologie Nantes-Angers (CRCNA), UMR 1232 Inserm-6299 CNRS, institut de recherche en santé de l'université de Nantes, 8, quai Moncousu, BP 70721, 44007 Nantes cedex 1, France.
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15
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Mazurier J, Sidorski G, Franceries X, Berry I, Pichon B, Pinel B, Latorzeff I, Gallocher O, Jimenez G, Camilleri J, Connord V, Marty Y, Mathy N, Zarate D. PD-0734 Artificial Intelligence and Multi-Criteria Optimization for automatic treatment plan generation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02929-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Benziane N, Sargos P, Zilli T, Giraud A, Ingrosso G, Di Staso M, Trippa F, Meyer E, Francolini G, Schick U, Cosset J, Martin E, Ferrari V, Achard V, Giraud N, Pasquier C, Magné N, Pasquier D, Supiot S, Latorzeff I, Gnep K, Pommier P, Perennec T, Zaine H. OC-0607 Radiotherapy guided by functional imaging for macroscopic local recurrence following prostatectomy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02629-9] [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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Latorzeff I, Ploussard G, Schick U, Benziane-Ouaritini N, Pasquier D, Sargos P. [Erratum to "Salvage radiotherapy after prostatectomy - what do in case of elevated postoperative PSA or macroscopic relapse?" [Cancer Radiother. 25 (2021) 822-9]]. Cancer Radiother 2022; 26:424. [PMID: 35039241 DOI: 10.1016/j.canrad.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- I Latorzeff
- Département de radiothérapie-oncologie, Bât Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France.
| | - G Ploussard
- Département d'urologie, clinique La Croix du Sud, Quint-Fonsegrives, France
| | - U Schick
- Département de radiothérapie-oncologie, CHU de Brest, Brest, France
| | - N Benziane-Ouaritini
- Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
| | - D Pasquier
- Département universitaire de radiothérapie, centre O.-Lambret, 3, rue F.-Combemale, 59020 Lille, France
| | - P Sargos
- Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
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Abstract
We present the update of the recommendations of the French society for radiation oncology on radiation therapy for the management of brain metastases. It has evolved in recent years and has become more complex. As the life expectancy of patients has increased and retreatments have become more frequent, side effects must be absolutely avoided. Cognitive side effects must in particular be prevented, and the most modern radiation therapy techniques must be used systematically. New prognostic classifications specific to the primary tumour of patients, advances in imaging and radiation therapy technology and new systemic therapeutic strategies, are making treatment more relevant. Stereotactic radiation therapy has supplanted whole-brain radiation therapy both for patients with metastases in place and for those who underwent surgery. Hippocampus protection is possible with intensity-modulated radiation therapy. Its relevance in terms of cognitive functioning should be more clearly demonstrated but the requirement for its use is constantly increasing. New targeted cancer treatment therapies based on the nature of the primitive have complicated the notion of the place and timing of radiation therapy and the discussion during multidisciplinary care meeting to indicate the best sequences is becoming a challenging issue as data on the interaction between treatments remain to be documented. In the end, although aimed at patients in the palliative phase, the management of brain metastases is one of the locations for which technical reflection is the most challenging and treatment become increasingly personalized.
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Affiliation(s)
- I Latorzeff
- Service de radiothérapie, groupe Oncorad Garonne, clinique Pasteur, l'« Atrium », 1, rue de la Petite-Vitesse, 31300 Toulouse, France; Centre régional de radiochirurgie stéréotaxique, CHU Rangueil, avenue Jean-Poulhès, 31052 Toulouse cedex, France.
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - S Josset
- Service de physique médicale, institut de cancérologie de l'Ouest, Unicancer, 44805 Saint-Herblain, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - A Tallet-Richard
- Département universitaire de radiothérapie, institut Paoli-Calmettes, Unicancer, 232, boulevard de Sainte-Marguerite, 13273 Marseille, France
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Latorzeff I, Ploussard G, Schick U, Benziane N, Pasquier D, Sargos P. [Salvage radiotherapy after prostatectomy - what do do in case of elevated post operative PSA or macroscopic relapse?]. Cancer Radiother 2021; 25:822-829. [PMID: 34702645 DOI: 10.1016/j.canrad.2021.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/03/2023]
Abstract
The management of the postoperative biological relapse of prostate cancer is most often based on salvage radiotherapy (RT) and a variable duration of hormone therapy (HT) in addition. The indications for RT±HT become more consensual for the adjuvant postoperative situation or in the event of a rising PSA level after a period where an undetectable PSA level was achieved. On the other hand, in the event of detectable PSA immediately postoperatively or in the event of a biological recurrence with macroscopic relapse in the prostate bed seen on conventional imaging assessment, the treatment options are still being evaluated. This article will describe these 2 situations and their current management but also will come through assessments with the contribution of modern imaging and new treatment options in terms of RT dose and RT±HT combination.
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Affiliation(s)
- I Latorzeff
- Département de radiothérapie-oncologie, Bât Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France.
| | - G Ploussard
- Département d'urologie, clinique La Croix du Sud, Quint-Fonsegrives, France
| | - U Schick
- Département de radiothérapie-oncologie, CHU de Brest, Brest, France
| | - N Benziane
- Département de radiothérapie, institut Bergonié, 229 cours de l'Argonne, 33076 Bordeaux cedex, France
| | - D Pasquier
- Département universitaire de radiothérapie, centre O.-Lambret, 3, rue F.-Combemale, 59020 Lille, France
| | - P Sargos
- Département de radiothérapie, institut Bergonié, 229 cours de l'Argonne, 33076 Bordeaux cedex, France
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20
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Leseur J, Créhange G, Pasquier D, Supiot S, Pommier P, Latorzeff I, Blanchard P, Mahé M, Sargos P, Colliaux J, Huguet F, Haaser T, Clavère P, Peiffert D, Lartigau É, Giraud P, Noël G, Simon JM, Hasbini A, Chauveinc L, Hennequin C, Lagrange J, de Crevoisier R. Évaluation du questionnement éthique en radiothérapie. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.031] [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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21
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Sidorski G, Mazurier J, Berry I, Franceries X, Villain E, Pichon B, Pinel B, Jimenez G, Gallocher O, Chevelle C, Marre D, Camilleri J, Connord V, Marty Y, Mathy N, Zarate D, Latorzeff I. Génération automatique de plans de traitements en radiothérapie externe : apport de l’intelligence artificielle pour la prise en charge des cancers de la prostate. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.019] [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: 10/20/2022]
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22
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Blanchard P, Foulon S, Artignan X, Carles J, Ronchin P, Gizzi M, Villa Freixa S, Valdagni R, Sargos P, Marques Da Costa L, Duberge T, Guillot A, Latorzeff I, Gallardo E, Sáez M, Abadie-Lacourtoisie S, Bennamoun M, Hasbini A, Tantot F, Fizazi K. 646TiP A randomized phase III, factorial design, of cabazitaxel and pelvic radiotherapy in patients with localized prostate cancer and high-risk features of relapse: The PEACE 2 trial from Unicancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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23
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Le Roy T, Baron D, Vandendorpe B, Bataille B, Hannoun-Levi JM, Blanchard P, Lartigau E, Latorzeff I, Pasquier D. [The role of radiotherapy to the primary tumor and metastases in patients with oligometastatic prostate cancer]. Cancer Radiother 2021; 25:526-532. [PMID: 34400086 DOI: 10.1016/j.canrad.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022]
Abstract
Oligometastatic prostate cancer is among the most studied oligometastatic cancers in the literature. However few prospective studies have assessed stereotactic body radiotherapy (SBRT) for prostate cancer oligometastases. Two randomised phase II trials show a progression-free survival benefit compared with observation. Prospective registry data show very good local control and low toxicity too. Inclusion in ongoing trials should be strongly encouraged to define the role of SBRT in addition to systemic therapy. Radiation therapy to the primary tumour has been studied in randomised trials and provides an overall survival benefit in patients with low metastatic burden. The benefit is inversely correlated with the number of bone lesions using conventional imaging, up to three metastases. Radiotherapy to the primary tumour is recommended by the learned societies for patients with low metastatic burden. Its role in combination with second generation anti androgen therapy needs to be clarified.
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Affiliation(s)
- T Le Roy
- Département universitaire de radiothérapie, centre O. Lambret, 3, rue F. Combemale, 59020 Lille, France
| | - D Baron
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, université Côte d'Azur, 33, avenue de Valombrose, 06000 Nice, France
| | - B Vandendorpe
- Département universitaire de radiothérapie, centre O. Lambret, 3, rue F. Combemale, 59020 Lille, France
| | - B Bataille
- Département universitaire de radiothérapie, centre O. Lambret, 3, rue F. Combemale, 59020 Lille, France
| | - J M Hannoun-Levi
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, université Côte d'Azur, 33, avenue de Valombrose, 06000 Nice, France
| | - P Blanchard
- Département de radiothérapie-oncologie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - E Lartigau
- Département universitaire de radiothérapie, centre O. Lambret, 3, rue F. Combemale, 59020 Lille, France; Centre de recherche en informatique, signal et automatique de Lille UMR CNRS 9189, université de Lille, Lille, France
| | - I Latorzeff
- Département de radiothérapie-oncologie, Bât Atrium, clinique Pasteur, 1, rue de la petite vitesse, 31300 Toulouse, France
| | - D Pasquier
- Département universitaire de radiothérapie, centre O. Lambret, 3, rue F. Combemale, 59020 Lille, France; Centre de recherche en informatique, signal et automatique de Lille UMR CNRS 9189, université de Lille, Lille, France.
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24
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Schick U, Latorzeff I, Sargos P. Postoperative radiotherapy in prostate cancer: Dose and volumes. Cancer Radiother 2021; 25:674-678. [PMID: 34400088 DOI: 10.1016/j.canrad.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/05/2021] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Approximately thirty percent of patients experience biochemical recurrence after radical prostatectomy for prostate cancer. Early salvage radiotherapy has recently become a standard of care in this setting. The purpose of this review is first to summarize current knowledge in terms of dose to the prostate bed in light of the recent SAKK 09/10 randomized phase III trial results. The evidence on moderate hypofractionation will also be discussed whereas extreme hypofractionation remains highly investigational. Regarding target volumes, several different guidelines have been published to address the need for standardization of postoperative target delineation. The recent GFRU (Groupe Francophone de Radiothérapie Urologique) recommendations could represent an international consensus.
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Affiliation(s)
- U Schick
- Radiation Oncology Department, University Hospital, Brest, France; LaTIM, UMR 1101, INSERM, University Brest, Brest, France.
| | - I Latorzeff
- Department of Oncology Radiotherapy, Bât Atrium, Clinique Pasteur, Toulouse, France
| | - P Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
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25
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Ploussard G, Sargos P, Beauval JB, Rouprêt M, Latorzeff I. [Recent advances in high-risk prostate cancer surgery]. Cancer Radiother 2021; 25:655-659. [PMID: 34175227 DOI: 10.1016/j.canrad.2021.06.010] [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] [Received: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
The management of high-risk prostate cancer has greatly evolved in recent years. Advances in imaging helps to better define the actual aggressiveness of the disease, to plan the surgical procedure, and to improve the prognostic evaluation of this high-risk of recurrence disease. The information obtained by MRI and by targeted biopsies improves management before surgery. Advances in nuclear medicine and generalization of PSMA-PET scans are beginning to improve the initial stage of diagnosis, thanks to a better detection of lymph node and distant metastases. The oncological interest of these new imaging techniques, which then influence the therapeutic plan, remains to be defined. The curative impact of an extensive lymph node dissection, as currently recommended, remains to be proved, and recently published randomized trials do not provide firm conclusions. The new hormone therapies pave the way for an intensification of perioperative systemic treatment, with a significant action on the tumor tissue, but an impact on survival, which remains to be defined in the context of ongoing randomized trials.
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Affiliation(s)
- G Ploussard
- Service d'urologie Urosud, clinique de la Croix-du-Sud, Quint-Fonsegrives, France; Service d'urologie, institut universitaire du cancer, Toulouse, France.
| | - P Sargos
- Service de radiothérapie, institut Bergonié, Bordeaux, France
| | - J-B Beauval
- Service de radiothérapie, institut Bergonié, Bordeaux, France
| | - M Rouprêt
- Service d'urologie, CHU La Pitié-Salpêtrière, Paris, France
| | - I Latorzeff
- Service de radiothérapie, clinique Pasteur, Toulouse, France
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Belkacemi Y, Latorzeff I, Hasbini A, Coraggio G, Pasquier D, Toledano A, Hennequin C, Bossi A, Chapet O, Crehange G, Guerif S, Duberge T, Allouache N, Clavere P, Gross E, Supiot S, Azria D, Bolla M, Sargos P. Patterns of practice of androgen deprivation therapy combined to radiotherapy in favorable and unfavorable intermediate risk prostate cancer. Results of The PROACT Survey from the French GETUG Radiation Oncology group. Cancer Radiother 2020; 24:892-897. [PMID: 33144063 DOI: 10.1016/j.canrad.2020.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The intermediate-risk (IR) prostate cancer (PCa) group is heterogeneous in terms of prognosis. For unfavorable or favorable IR PCa treated by radiotherapy, the optimal strategy remains to be defined. In routine practice, the physician's decision to propose hormonal therapy (HT) is controversial. The PROACT survey aimed to evaluate pattern and preferences of daily practice in France in this IR population. MATERIALS AND METHODS A web questionnaire was distributed to French radiotherapy members of 91 centers of the Groupe d'Etude des Tumeurs Uro-Genitales (GETUG). The questionnaire included four sections concerning: (i) the specialists who prescribe treatments and multidisciplinary decisions (MTD) validation; (ii) the definition of IR subsets of patients; (iii) radiotherapy parameters; (iv) the pattern of practice regarding cardiovascular (CV) and (iv) metabolic evaluation. A descriptive presentation of the results was used. RESULTS Among the 82 responses (90% of the centers), HT schedules and irradiation techniques were validated by specific board meetings in 54% and 45% of the centers, respectively. Three-fourths (76%) of the centers identified a subset of IR patients for a dedicated strategy. The majority of centers consider PSA>15 (77%) and/or Gleason 7 (4+3) (87%) for an unfavorable IR definition. Overall, 41% of the centers performed systematically a CV evaluation before HT prescription while 61% consider only CV history/status in defining the type of HT. LHRH agonists are more frequently prescribed in both favorable (70%) and unfavorable (98%) IR patients. Finally, weight (80%), metabolic profile (70%) and CV status (77%) of patients are considered for follow-up under HT. CONCLUSION To the best of our knowledge, this is the first survey on HT practice in IR PCa. The PROACT survey indicates that three-quarters of the respondents identify subsets of IR-patients in tailoring therapy. The CV status of the patient is considered in guiding the HT decision, its duration and type of drug.
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Affiliation(s)
- Y Belkacemi
- AP-HP, hôpitaux universitaires Henri-Mondor, Inserm U955 (équipe 21), IMRB, université Paris-Est Créteil, CHU de Henri-Mondor, 51, avenue Mal-De-Lattre-de-Tassigny, 94000 Créteil, France.
| | | | | | - G Coraggio
- AP-HP, hôpitaux universitaires Henri-Mondor, Inserm U955 (équipe 21), IMRB, université Paris-Est Créteil, CHU de Henri-Mondor, 51, avenue Mal-De-Lattre-de-Tassigny, 94000 Créteil, France
| | - D Pasquier
- Centre OscarLambret, CHRU de Lille, Lille, France
| | - A Toledano
- Clinique Hartmann, Neuilly-sur-Seine, France
| | | | - A Bossi
- Institut Gustave-Roussy, Villejuif, France
| | | | - G Crehange
- Institut Curie/René Huguenin, Paris/Saint Cloud, France
| | - S Guerif
- CHU de Poitiers, Poitiers, France
| | - T Duberge
- Croix-Rouge française, Toulon, France
| | | | | | - E Gross
- Ramsay-Générale de santé, hôpital privé Clairval, Marseille, France
| | - S Supiot
- Institut de cancérologie de l'Ouest, Saint-Heblain, France
| | | | - M Bolla
- CHU de Grenoble, Grenoble, France
| | - P Sargos
- Institut Bergonie, Bordeaux, France
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27
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Supiot S, Pasquier D, Buthaud X, Magne N, Becckendorf V, Crehange G, Pommier P, Loos G, Hasbini A, Latorzeff I, Silva M, Denis F, Campion L, Vaugier L, Blanc-Lapierre A. OC-0210: Salvage radiotherapy in oligorecurrent pelvic node relapses of prostate cancer : a phase 2 trial. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00234-6] [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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28
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Sargos P, Chabaud S, Latorzeff I, Magné N, Benyoucef A, Supiot S, Pasquier D, Abdiche S, Gilliot O, Graff-Cailleaud P, Silva M, Bergerot P, Baumann P, Belkacemi Y, Azria D, Brihou M, Soulié M, Richaud P. GETUG-AFU 17 : étude de phase III randomisée comparant la radiothérapie adjuvante à la radiothérapie de rattrapage précoce, combinées à l’hormonothérapie courte, pour les patients présentant un cancer de la prostate traité par prostatectomie radicale. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Sargos P, Chabaud S, Latorzeff I, Magne N, Benyoucef A, Supiot S, Pasquier D, Abdiche S, Gilliot O, Graff P, Silva M, Bergerot P, Baumann P, Belkacemi Y, Azria D, Nenan S, Richaud P. A Phase III Randomized Trial Comparing Adjuvant versus Early Salvage Radiotherapy, Both Combined with Short-term Androgen Deprivation Therapy, following a Radical Prostatectomy: Initial Results of the GETUG-AFU 17 Study [NCT00667069]. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Goupy F, Meyer E, Pommier P, Magné N, Sargos P, Pasquier D, Noël G, Schick U, Hasbini A, Supiot S, Bossi A, Latorzeff I, Riverain J, Duvergé L, Benna M, Benziane N, Le Roy T, Bigot C, Rehn M, Vaugier L, Le Proust B, Barateau A, Campillo-Gimenez B, Castelli J, De Crevoisier R. PH-0117: Radiotherapy of T4M0 prostate cancer : A multicentric retrospective analysis. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00143-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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31
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Lerouge D, Latorzeff I, Mirabel X, Dohan A, Mordant P, Barry De Longchamps N, Giraud P. [Erratum to "Stereotaxic radiotherapy of primary extracranial tumors" [Cancer Radiother. 24 (2020) DOI:10.1016/j.canrad.2020.06.020]]. Cancer Radiother 2020; 24:898. [PMID: 33004297 DOI: 10.1016/j.canrad.2020.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- D Lerouge
- Service d'oncologie radiothérapie, université de Paris, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - I Latorzeff
- Département de radiothérapie, centre François-Baclesse, avenue du Général-Harris, 14076 Caen, France
| | - X Mirabel
- Département de radiothérapie-oncologie, clinique Pasteur, bâtiment Atrium, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
| | - A Dohan
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - P Mordant
- Unité de radiologie abdominopelvienne et interventionnelle, service de radiologie A, université de Paris, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - N Barry De Longchamps
- Unité Inserm U1152, service de chirurgie vasculaire, thoracique, et de transplantation pulmonaire, université de Paris, hôpital Bichat, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | - P Giraud
- Équipe 4, Inserm U1151, service d'urologie, Institut Necker-Enfants-malades, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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Pichon B, Marre D, Pinel B, Chevelle C, Caillot E, Dudouet P, Gallocher O, Jimenez G, Thouveny F, Zarate D, Mazurizer J, Latorzeff I. Radiothérapie en conditions stéréotaxiques de métastases rachidiennes non compressives par technique de dynamic wave arc sur un accélérateur linéaire dédié Vero (Brainlab®). Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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33
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Mazurier J, Sidorski G, Pichon B, Pinel B, Jimenez G, Gallocher O, Camilleri J, Mathy N, Marre D, Zarate D, Marty Y, Connord V, Latorzeff I. Apport d’algorithmes de délination et de planification basés sur l’intelligence artificielle pour la radiothérapie du cancer de la prostate. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.024] [Citation(s) in RCA: 1] [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: 11/24/2022]
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34
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Latorzeff I, Bogart E, Marre D, Le Deley M, Lartigau É, Pasquier D. Étude prospective « BioPro-RCMI » sur l’utilisation du ballonnet Bioprotect® comme espaceur rectal pour la radiothérapie avec modulation d’intensité de l’adénocarcinome prostatique de risque intermédiaire. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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35
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Jumeau R, Pruvot É, Thariat J, Latorzeff I, Milliez PU, Champ-Rigot L, De Crevoisier R, Ferchaud V. Tachycardies ventriculaires réfractaires : quelle place pour la radiothérapie et comment ? Cancer Radiother 2020; 24:534-546. [DOI: 10.1016/j.canrad.2020.06.005] [Citation(s) in RCA: 3] [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] [Received: 05/22/2020] [Accepted: 06/07/2020] [Indexed: 12/31/2022]
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36
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Giraud P, Lerouge D, Latorzeff I, Mirabel X, Dohan A, Mordant P, Barry de Longchamps N. [Stereotaxic radiotherapy of primary extracranial tumors]. Cancer Radiother 2020; 24:513-522. [PMID: 32830055 DOI: 10.1016/j.canrad.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022]
Abstract
Stereotactic radiotherapy is a fundamental change from the conventional fractionated radiotherapy and represents a new therapeutic indication. Stereotactic radiotherapy is now a standard of care for inoperable patients or patients who refuse surgery. The results are encouraging with local control and survival rates very high in selected populations. The rate of late toxicity remains acceptable. Good tolerability makes it appropriate even for elderly and frail patients. In these fragile patients or in certain specific clinical situations, different surgical, radiotherapy or interventional radiology attitudes can be discussed on a case-by-case basis. These situations are considered in this article for the pulmonary, hepatic and prostatic localizations.
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Affiliation(s)
- P Giraud
- Service d'oncologie radiothérapie, université de Paris, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
| | - D Lerouge
- Département de radiothérapie, centre François-Baclesse, avenue du Général-Harris, 14076 Caen, France
| | - I Latorzeff
- Département de radiothérapie-oncologie, bâtiment Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
| | - X Mirabel
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - A Dohan
- Service de radiologie A, université de Paris, unité de radiologie abdominopelvienne et interventionnelle, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - P Mordant
- Service de chirurgie vasculaire, thoracique, et de transplantation pulmonaire, hôpital Bichat, Assistance publique-Hôpitaux de Paris, unité Inserm U1152, université de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | - N Barry de Longchamps
- Service d'urologie, Inserm U1151 - équipe 4/Institut Necker Enfants Malades, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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37
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Laville A, Coutte A, Blanchard P, Sun R, Deutsch E, Latorzeff I. [Treatment of primary disease for synchronous metastatic prostate cancer]. Cancer Radiother 2020; 24:547-553. [PMID: 32855028 DOI: 10.1016/j.canrad.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 11/30/2022]
Abstract
The management of early metastatic prostate cancer is based on systemic treatment by androgen deprivation therapy with or without chemotherapy or next-generation anti-androgen therapies. Local treatment of the prostate was initially used only to alleviate local symptoms. However, local radiotherapy of the prostate has been the subject of retrospective and prospective studies in patients with better prognostic factors, particularly in oligometastatic status. The results of these studies support that prostate radiotherapy can prolong the survival of patients with a low metastatic burden. This article states the biological bases, the main published and future published studies aimed to embed this strategy to optimize therapeutic management.
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Affiliation(s)
- A Laville
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Département de radiothérapie, CHU d'Amiens, 1, rue du Professeur-Christian-Cabrol, 80050, France.
| | - A Coutte
- Département de radiothérapie, CHU d'Amiens, 1, rue du Professeur-Christian-Cabrol, 80050, France
| | - P Blanchard
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - R Sun
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - E Deutsch
- Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Inserm, UMR 1030 « radiosensibilité des tumeurs et tissus sains », 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - I Latorzeff
- Département de radiothérapie-oncologie, bâtiment Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
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38
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Sargos P, Guerif S, Fraisse J, Meyer E, Supiot S, Lagneau E, Deniaud-Alexandre E, Rochin P, Benyoucef A, Cartier L, Hamidou H, Hasbini A, Crehange G, Pommier P, De Laroche G, Pelissier S, Gross E, Fourneret P, Salomon L, Latorzeff I. Late toxicity and quality of life from GETUG-AFU 22 study: A randomized phase II trial comparing 6 months of degarelix in combination with radiotherapy to radiotherapy alone for patients with detectable PSA after radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33522-9] [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: 10/23/2022] Open
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39
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Latorzeff I, Sargos P, Créhange G, Belkacémi Y, Azria D, Hasbini A, Dubergé T, Toledano A, Graff-Cailleaud P, Chapet O, Hennequin C, de Crevoisier R, Supiot S, Pasquier D. Indications et perspectives de l’hormonoradiothérapie des cancers de prostate à haut risque. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.02.002] [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: 10/24/2022]
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40
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Camilleri J, Mazurier J, Angles D, Marre D, Mathy N, Zarate D, Caillot E, Chevelle C, Franck D, Gallocher O, Jimenez G, Latorzeff I, Pichon B, Pinel B. 7 DoseCHECK™ algorithm evaluation used for secondary 3D dose calculation of 3DCRT and VMAT treatment plans. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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41
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Latorzeff I, Guerif S, Fraisse J, Meyer E, Pelissier S, Salomon L, Sargos P. Toxicité tardive et qualité de vie de l’étude GETUG-AFU 22. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.242] [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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42
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Pichon B, Pinel B, Chevelle C, Caillot É, Gallocher O, Jimenez G, Latorzeff I, Mathy N, Mazurier J, Zarate D. Étude de faisabilité du remplacement des points de tatouage par l’utilisation d’un système d’imagerie surfacique pour la radiothérapie externe du cancer du sein. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.046] [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: 11/17/2022]
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43
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Lapierre A, Horn S, Créhange G, Enachescu C, Latorzeff I, Supiot S, Sargos P, Hennequin C, Chapet O. Radiothérapie stéréotaxique extracrânienne : quelle machine pour quelle indication ? Stéréotaxie prostatique. Cancer Radiother 2019; 23:651-657. [DOI: 10.1016/j.canrad.2019.06.009] [Citation(s) in RCA: 3] [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: 06/06/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022]
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44
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Modesto A, Dalmasso C, Chaltiel L, Pagès C, Boulinguez S, Sibaud V, Chira C, Latorzeff I, Lubrano V, Moyal É, Meyer N. Le traitement local intracrânien des métastases cérébrales de mélanome allonge la survie globale des patients pris en charge par immunothérapie ou anti-Braf. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.058] [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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45
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Latorzeff I, Guerif S, Fraisse J, Meyer E, Supiot S, Lagneau E, Deniaud-Alexandre E, Ronchin P, Benyoucef A, Cartier L, Hamidou H, Hasbini A, Crehange G, Pommier P, Magne N, Pelissier S, Gross E, Fourneret P, Salomon L, Sargos P. Late Toxicity and Quality of Life from GETUG-AFU 22 Study: A Multicenter Randomized Phase II Trial Comparing Radiotherapy +/- 6 Months of Degarelix as a Salvage Treatment for Patients with Detectable PSA after Radical Prostatectomy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.123] [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: 11/29/2022]
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46
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Bourdais R, Achkar S, Chauffert-Yvart L, Pasquier D, Sargos P, Blanchard P, Latorzeff I. [Prophylactic nodal radiotherapy in prostate cancer]. Cancer Radiother 2019; 23:688-695. [PMID: 31451356 DOI: 10.1016/j.canrad.2019.07.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 12/30/2022]
Abstract
The risk of lymph node invasion, in case of prostate cancer, increases with the clinical stage of the disease, the Gleason score of prostate biopsies and the value of PSA at diagnosis. Historically, beyond 15% risk of lymph node involvement, irradiation of the pelvic areas was performed with prostate radiotherapy (RT) to take into account the risk of occult lymph node metastasis in patients at risk, but the benefit of this therapeutic approach remains to be demonstrated. The data from surgical lymph node dissection seem to question the risk levels, the escalation of the dose on the prostate increases the survival without relapse, the contribution of image-guided radiotherapy, (IGRT) and modulation of intensity (IMRT), decreases the toxicity of pelvic RT. This article reviews the principles of prophylactic ganglion irradiation for prostate cancer and discusses its relevance, current uncertainties, and prospective trials.
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Affiliation(s)
- R Bourdais
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - S Achkar
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - L Chauffert-Yvart
- Service d'oncologie radiothérapie, GHU La Pitié-Salpêtrière-Charles-Foix, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - D Pasquier
- Département de radiothérapie, Centre Oscar-Lambret, 3, rue Combemale, 59020 Lille cedex; Université de Lille et Centre de Recherche en Informatique Signal et Automatique de Lille CRISTAL UMR CNRS 9189, 59000 Lille, France.
| | - P Sargos
- Département de radiothérapie, Institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
| | - P Blanchard
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - I Latorzeff
- Département de radiothérapie-oncologie, Bât Atrium, Clinique Pasteur, 1, rue de la petite vitesse, 31300 Toulouse, France.
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47
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Brassart C, Basson L, Olivier J, Latorzeff I, De Crevoisier R, Lartigau E, Pasquier D. [The radiation oncologist, one of the actors in the patient's path after cancer. Follow up after prostate cancer]. Cancer Radiother 2019; 23:565-571. [PMID: 31447344 DOI: 10.1016/j.canrad.2019.07.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
Abstract
Prostate cancer is the most common cancer of men over 50 years old. Localized prostatic cancer treatment may be responsible of a decline of patient's quality of life. The main actors of treatment are now focused on minimizing functional consequences of treatments. The radiation oncologist has a central role in patient monitoring. The follow-up is codified by official recommendations of learned societies to enhance the post-cancer period. The main objective of this article is to review the recommendations for clinical and biological follow-up. An inventory of the functional consequences of the various treatments will be detailed, and particularly those caused by androgen deprivation therapy, with a review of precautions before implementation, adverse effects and their management, as well as monitoring recommendations. The analysis of quality of life after curative treatment and suggestions to improve monitoring will also be discussed.
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Affiliation(s)
- C Brassart
- Département universitaire de radiothérapie, Centre Oscar -Lambret, 3, rue Frédéric-Combemale, 59020 Lille
| | - L Basson
- Département universitaire de radiothérapie, Centre Oscar -Lambret, 3, rue Frédéric-Combemale, 59020 Lille
| | - J Olivier
- Service d'urologie, université de Lille, CHU de Lille, 59000 Lille, 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
| | - E Lartigau
- Département universitaire de radiothérapie, Centre Oscar -Lambret, 3, rue Frédéric-Combemale, 59020 Lille; Centre de recherche en informatique, signal et automatique de Lille UMR CNRS 9189, université de Lille, M3, avenue Carl-Gauss, 59650 Villeneuve-d'Ascq, France
| | - D Pasquier
- Département universitaire de radiothérapie, Centre Oscar -Lambret, 3, rue Frédéric-Combemale, 59020 Lille; Centre de recherche en informatique, signal et automatique de Lille UMR CNRS 9189, université de Lille, M3, avenue Carl-Gauss, 59650 Villeneuve-d'Ascq, France.
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48
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Latorzeff I. [Optimizing local control of high-risk prostate cancers through multimodal treatments]. Prog Urol 2019; 29 Suppl 1:S8-S19. [PMID: 31307631 DOI: 10.1016/s1166-7087(19)30166-6] [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
Prostate cancer is a sensitive adenocarcinoma, in more than 80 % of cases, to chemical castration, due to its hormone dependence. Locally advanced and/or high-risk cancer is defined based on clinical stage, initial PSA value or high Gleason score. Hormone therapy associated with radiation therapy is the standard of management and improves local control, reduces the risk of distant metastasis and improves specific and overall survival. Duration of hormone therapy, dose level of radiation therapy alone or associated with brachytherapy are controversial data in the literature. Radical prostatectomy surgery is a therapeutic option that must be performed with extensive lymph node dissection and is often part of a multimodal care sequence. The therapeutic choice, multidisciplinary, depends on the age and co-morbidity of the patient, the prognostic criteria of the pathology and the urinary function of the patient. Current research focuses on optimizing local and distant control of these aggressive forms and incorporates neo-adjuvant or adjuvant chemotherapy and also new hormone therapies.
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Affiliation(s)
- I Latorzeff
- Oncologie-radiothérapie, Bât Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France.
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49
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Bourgier C, Cowen D, Lemanski C, Castan F, Rivera S, De La Lande B, Peignaux K, Le Blanc-Onfroy M, Benyoucef A, Mege A, Douadi-Gaci Z, Racadot S, Latorzeff I, Schick U, Jacquot S, Massabeau C, Guilbert P, Geffrelot J, Ellis S, Lecouillard I, Breton-Callu C, Richard-Tallet A, Bontemps P, Fenoglietto P, Azria D. OC-0594 Acute toxicity results after breast-conserving therapy in “boost vs no boost (BONBIS)” DCIS trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31014-x] [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: 11/29/2022]
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50
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Jimenez G, Mazurier J, Marre D, Mathy N, Zarate D, Camilleri J, Gallocher O, Pinel B, Chevelle C, Franck D, Latorzeff I. 44 Dynamic Tumor Tracking with SBRT dedicated system VERO (Brainlab): Quality control and PTV volume reduction. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.09.057] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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