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Goineau A, Marchand V, Bourdin S, Rio E, Campion L, Lisbona A, Mahé M, Supiot S. Évaluation de la qualité de vie 54 mois après RCMI pour cancer de prostate localisé. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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2
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Goineau A, Marchand V, Bourdin S, Rio E, Campion L, Lisbona A, Mahe M, Supiot S. EP-1129 QUALITY OF LIFE 54 MONTHS AFTER HIGH-DOSE INTENSITY-MODULATED RADIOTHERAPY FOR LOCALIZED PROSTATE CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71462-7] [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: 10/28/2022]
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Dewas S, Cochet A, Talbot J, Supiot S, Brunotte F, Rousseau C, Truc G, Bourdin S, Maingon P, Crehange G. Preliminary Results of Fluorocholine (18F) PET/CT (FCH PET/CT) for Guiding Salvage IG-IMRT in Patients with an Occult Recurrence from a Previously Treated Prostate Cancer. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.794] [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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Dewas S, Cochet A, Talbot JN, Supiot S, Brunotte F, Rousseau C, Truc G, Bourdin S, Maingon P, Créhange G. RCMI avec guidage par l’image de rattrapage et TEP à la 18F choline de patients en situation de récidive biochimique après traitement initial radical de cancer prostatique : résultats préliminaires. Cancer Radiother 2010. [DOI: 10.1016/j.canrad.2010.07.010] [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: 10/19/2022]
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Marchand V, Bourdin S, Charbonnel C, Rio E, Munos C, Campion L, Lisbona A, Mahe M, Supiot S. Health-related Quality of Life after 76 Gy Intensity Modulated Radiotherapy for Localized Prostate Cancer: A Prospective and Longitudinal Study. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.998] [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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Marchand V, Munos C, Bourdin S, Rio E, Campion L, Lisbona A, Mahé MA. RCMI etprostate: évaluation prospective detoxicité etdequalité devie, premiers résultats àsixmois. Cancer Radiother 2007. [DOI: 10.1016/j.canrad.2007.09.096] [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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Delpon G, Boissinot C, Bourdin S, Lisbona A. Repositionnement quotidien parimagerie embarquée debas voltage (kV-kV) danslecas dutraitement delaprostate: comparaison entrerepères anatomiques etmarqueurs implantés. Cancer Radiother 2007. [DOI: 10.1016/j.canrad.2007.09.030] [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: 10/22/2022]
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Beckendorf V, Guerif S, Le Prise E, Cossett J, Le Floch O, Chauvet B, Salem N, Chapet O, Bourdin S, Bey P. Late Toxicity in the GETUG 06 Randomized Trial Comparing 70 Gy and 80 Gy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1382] [Citation(s) in RCA: 5] [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: 10/22/2022]
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Botti M, Bourdin S, Brunet G, Thillays F, Menegalli D, Martin S, Campion L, Mahé MA. Radiochirurgie etradiothérapie stéréotaxique desmétastases cérébrales: résultats d'une série rétrospective de107patients. Cancer Radiother 2007. [DOI: 10.1016/j.canrad.2007.09.047] [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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Brunet G, Delpon G, Bardet E, Bourdin S, Gaudaire S, Munos C, Preuvel P, Mahé MA, Lisbona A. Évaluation par l'imagerie embarquée de la précision de positionnement et de repositionnement en radiothérapie stéréotaxique fractionnée. Cancer Radiother 2006. [DOI: 10.1016/j.canrad.2006.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bensadoun RJ, Dassonville O, Ramaioli A, Magné N, Benezery K, Marcy PY, Poissonnet G, Lemanski C, Bourdin S, Tortochaux J. Phase III multicenter randomized study of concurrent twice-a-day radiotherapy with and without cisplatin-5FU (BiRCF) in unresectable pharyngeal carcinoma. Results at 18 months (FNCLCC-GORTEC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. J. Bensadoun
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - O. Dassonville
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - A. Ramaioli
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - N. Magné
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - K. Benezery
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - P. Y. Marcy
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - G. Poissonnet
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - C. Lemanski
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - S. Bourdin
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - J. Tortochaux
- Centre Antoine Lacassagne, Nice Cedex 2, France; Centre Val d'Aurelle, Montpellier, France; Centre René Gauducheau, Nantes, France; Centre Jean Perrin, Clermont-Ferrand, France
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Beckendorf V, Guerif S, Le Prise E, Bey P, Cosset J, Le Floch O, Chauvet B, Salem N, Chapet O, Bourdin S, Bachaud J, Maingon P. The French 70 Gy versus 80 Gy dose escalation trial for localized prostate cancer: feasibility and toxicity. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)00924-6] [Citation(s) in RCA: 6] [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: 11/30/2022]
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Mornex F, Thomas L, Mohr P, Hauschild A, Delaunay MM, Lesimple T, Tilgen W, Bui BN, Guillot B, Ulrich J, Bourdin S, Mousseau M, Cupissol D, Bonneterre ME, De Gislain C, Bensadoun RJ, Clavel M. A prospective randomized multicentre phase III trial of fotemustine plus whole brain irradiation versus fotemustine alone in cerebral metastases of malignant melanoma. Melanoma Res 2003; 13:97-103. [PMID: 12569292 DOI: 10.1097/00008390-200302000-00016] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The main objective of this prospective multicentre randomized phase III study was to compare a combined regimen of fotemustine plus whole brain irradiation with fotemustine alone in terms of cerebral response and time to cerebral progression in patients with melanoma cerebral metastases. Seventy-six patients were randomized to receive either fotemustine (arm A, n = 39) or fotemustine plus whole brain irradiation (arm B, n = 37). Fotemustine was administered intravenously at 100 mg/m(2) on days 1, 8 and 15, followed by a 5 week rest period, then every 3 weeks in non-progressive patients. In arm B, concomitant whole brain irradiation was performed at a total dose of 37.5 Gy (2.5 Gy/day on days 1-5 for three consecutive weeks). Although patients who received fotemustine alone had worse prognostic factors, there was no significant difference in cerebral response (arm A, 7.4%, arm B, 10.0%) or control rates (objective responses plus stable disease) after 7 weeks (arm A, 30%; arm B, 47%) or in overall survival (arm A, 86 days; arm B, 105 days). However, there was a significant difference in favour of arm B for the time to cerebral progression (P = 0.028, Wilcoxon test). In conclusion, fotemustine plus whole brain irradiation delayed the time to cerebral progression of melanoma cerebral metastases compared with fotemustine alone but without a significant improvement in terms of objective control or overall survival.
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Affiliation(s)
- F Mornex
- Centre Hospitalier Lyon Sud, Service de Radiothérapie-Oncologie, Pierre-Benite Cedex, France.
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Mornex F, Thomas L, Mohr P, Hauschild A, Delaunay MM, Lesimple T, Tilgen W, Nguyen BB, Guillot B, Ulrich J, Bourdin S, Mousseau M, Cupissol D, Bonneterre J, de Gislain C, Bensadoun JR, Clavel M. [Randomised phase III trial of fotemustine versus fotemustine plus whole brain irradiation in cerebral metastases of melanoma]. Cancer Radiother 2003; 7:1-8. [PMID: 12648711 DOI: 10.1016/s1278-3218(02)00284-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE The main objective of this prospective multicenter randomised phase III study was to compare a combined regimen of fotemustine plus whole brain irradiation versus fotemustine alone in terms of cerebral response and time to cerebral progression in patients with melanoma brain metastases. PATIENTS AND METHODS Seventy-six patients (instead of the 106 planned patients; study was stopped after the interim analysis) were randomised receiving either fotemustine (arm A, n = 39) or fotemustine and whole brain irradiation (arm B, n = 37). Fotemustine was administered intravenously at 100 mg m(-2) on day 1, 8 and 15, followed by a 5-week rest period, then every 3 weeks in non-progressive patients. In arm B, a concomitant whole brain irradiation was performed at the total dose of 37.5 Gy (2.5 Gy/d(-1), days 1-5, 3 consecutive weeks). RESULTS Although patients who received fotemustine alone had worse prognostic factors, there was no significant difference in brain response (arm A: 7.4%, B: 10.0%) or control rates (objective response plus stable disease) after seven weeks (arm A: 30%, B: 47%) and overall survival (arm A: 86d, B: 105d). However, there was a significant difference in favour of arm B for the time to brain progression (p = 0.028, Wilcoxon test). CONCLUSION Fotemustine plus whole brain irradiation delayed the time to brain progression of melanoma cerebral metastases compared to fotemustine alone but without a significant improvement in terms of objective control or overall survival.
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Affiliation(s)
- F Mornex
- Centre hospitalier Lyon-Sud, service de radiothérapie-oncologie, EA 643, 69495 cedex, Pierre-Bénite, France.
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Beckendorf V, Bachaud JM, Bey P, Bourdin S, Carrie C, Chapet O, Cowen D, Guérif S, Hay HM, Lagrange JL, Maingon P, Le Prisé E, Pommier P, Simon JM. [Target-volume and critical-organ delineation for conformal radiotherapy of prostate cancer: experience of French dose-escalation trials]. Cancer Radiother 2002; 6 Suppl 1:78s-92s. [PMID: 12587386 DOI: 10.1016/s1278-3218(02)00217-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The delineation of target volume and organs at risk depends on the organs definition, and on the modalities for the CT-scan acquisition. Inter-observer variability in the delineation may be large, especially when patient's anatomy is unusual. During the two french multicentric studies of conformal radiotherapy for localized prostate cancer, it was made an effort to harmonize the delineation of the target volumes and organs at risk. Two cases were proposed for delineation during two workshops. In the first case, the mean prostate volume was 46.5 mL (extreme: 31.7-61.3), the mean prostate and seminal vesicles volume was 74.7 mL (extreme: 59.6-80.3), the rectal and bladder walls varied respectively in proportion from 1 to 1.45 and from 1 to 1.16; in the second case, the mean prostate volume was 53.1 mL (extreme: 40.8-73.1), the volume of prostate plus seminal vesicles was 65.1 mL (extreme: 53.2-89), the rectal wall varied proportionally from 1 to 1, 24 and the vesical wall varied from 1 to 1.67. For participating centers to the french studies of dose escalation, a quality control of contours was performed to decrease the inter-observer variability. The ways to reduce the discrepancies of volumes delineation, between different observers, are discussed. A better quality of the CT images, use of urethral opacification, and consensual definition of clinical target volumes and organs at risk may contribute to that improvement.
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Affiliation(s)
- V Beckendorf
- Radiothérapie, centre Alexis-Vautrin, 54511 Vandoeuvre-lès-Nancy, France.
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Thomas O, Mahé M, Campion L, Bourdin S, Milpied N, Brunet G, Lisbona A, Le Mevel A, Moreau P, Harousseau J, Cuillière J. Long-term complications of total body irradiation in adults. Int J Radiat Oncol Biol Phys 2001; 49:125-31. [PMID: 11163505 DOI: 10.1016/s0360-3016(00)01373-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To report long-term pulmonary, thyroid, and ocular complications in patients who had conditioning regimens including total body irradiation (TBI) before bone marrow transplantation (BMT). METHODS AND MATERIALS Between June 1986 and December 1995, 478 patients received TBI in our institution. The present study includes 186 adult patients who had complete remission lasting one year or more after BMT. There were 108 males and 78 females. Median age was 36.5 years (range 15-60). Initial diagnoses were lymphomas (50%), acute lymphoid leukemias (16%), acute myeloid leukemias (16%), chronic myeloid leukemia (13%), aplastic anemia (3%), and myelodysplasia (2%). At the time of BMT, 43.5% of patients were in complete response and 56.5% in partial response. Treatment consisted of a single dose TBI at 10 Gy in 9% and fractionated TBI delivering 12 to 13.5 Gy in 6 fractions in 91%. From 1986 to October 1991, TBI was performed in lateral position with 9 MV energy (57% of patients) and thereafter in alternate prone and supine positions with 15 MV energy (43%). Chemical conditioning regimen was cyclophosphamide (60 mg/kg at D-4 and D-3) in 69% and CBV (cyclophosphamide 1500 mg/m(2) from D-6 to D-3, BCNU 300 mg/m(2) at D-6, VP-16 200 mg/m(2) from D-6 to D-4) in 25%. Fifty eight percent of patients received autologous and 42% allogeneic BMT. All patients had clinical, biologic, and functional examinations at one-year intervals. RESULTS Median follow-up from BMT was 49 months (range 12-136). Late pulmonary effects were observed only in functional explorations, without clinical effect, including restrictive syndrome in 8% and alteration in the diffusing capacity of carbon monoxide in 12%. No patient showed clinical thyroid symptoms, and 10% developed biologic dysfunction: hypothyroidism (6.5%), thyroiditis (3%), and Basedow disease (0.5%). Ocular complications occurred in 29.5%, including cataract (15%), dry syndrome (13%), and keratitis (1.5%). In univariate and multivariate analysis, pulmonary complications were statistically increased by chronicle graft vs. host disease (GVHD) vs. no (p = 0.02), prone and supine vs. lateral TBI position (p = 0.02), and with 15 MV vs. 9 MV beam energy (p = 0.02). Cataract occurred less frequently with fractionated than with single-dose TBI (p = 0.000002). No differences were observed regarding age, sex, initial diagnosis, status at the time of BMT, conditioning chemotherapy regimen, and total dose of TBI. CONCLUSION From this retrospective study it was shown that long-term complications of TBI were not symptomatic in most patients. The role of parameters of irradiation and especially position of treatment and beam energy should be emphasized and assessed with a longer follow-up.
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Affiliation(s)
- O Thomas
- Department of Radiotherapy, Centre René Gauducheau, Saint-Herblain, Nantes, France.
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Kraeber-Bodéré F, Campion L, Rousseau C, Bourdin S, Chatal JF, Resche I. Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement. Eur J Nucl Med 2000; 27:1487-93. [PMID: 11083537 DOI: 10.1007/s002590000315] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This retrospective study evaluated the toxicity and efficacy of strontium-89 chloride (Metastron, Amersham) in 94 patients with painful bone metastases of prostate cancer (117 injections of 150 MBq) and compared the efficacy of treatment in patients with moderate and extensive bone involvement. The predictive value of flare response with regard to analgesic response was also studied. High-grade leukothrombopenias were observed after only 5% of injections. An improvement in quality of life was obtained in 65% of cases, a decrease in pain in 78% (31% complete response) and a reduction of analgesics in 60%. Efficacy was significantly better for pain decrease (P=0.005) and reduction of analgesics (P=0.018), and response was significantly longer (P<0.0035) in patients with moderate than in patients with extensive bone involvement. The flare response observed in 23% of cases was not predictive of pain response (P=0.919) or reduction of analgesics (P=0.353). A second dose prolonged analgesia in three-quarters of cases without any apparent increase in toxicity. These results confirm the benefit of 89Sr chloride for the treatment of metastatic bone pain and suggest that internal radiotherapy should be started earlier. A bone scan could be proposed at the time of hormonal escape resulting in bone pain, and internal radiotherapy could be initiated when several metastatic foci exist, even if only one is painful. In this way, pain-free follow-up could be prolonged, and the transition to other therapeutic approaches, particularly opioids, delayed.
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Horiot JC, Lipinski F, Schraub S, Maulard-Durdux C, Bensadoun RJ, Ardiet JM, Bolla M, Coscas Y, Baillet F, Coche-Dequéant B, Urbajtel M, Montbarbon X, Bourdin S, Wibault M, Alfonsi M, Calais G, Desprez P, Pene F, Lapeyre M, Vinke J, Maral J. Post-radiation severe xerostomia relieved by pilocarpine: a prospective French cooperative study. Radiother Oncol 2000; 55:233-9. [PMID: 11041775 DOI: 10.1016/s0167-8140(99)00018-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE The aim of the study was: (1) to confirm the action of pilocarpine hydrochloride (Salagen) against xerostomia: (2) to correlate the response to dose/volume radiotherapy parameters. MATERIALS AND METHODS From June 1995 to February 1996, 156 patients with severe radiation induced xerostomia received pilocarpine hydrochloride orally. IS mg per day with a 5 mg optional increase at S weeks up to a daily dose of 25 mg beyond 9 weeks. RESULTS One hundred and forty five patients are fully evaluable. Treatment compliance was 75%. Thirty eight patients (26%) stopped treatment before week 12 for acute intolerance (sweating, nausea, vomiting) or no response. No severe complication occurred. Ninety ses en patients (67%) reported a significant relief of symptoms of xerostomia at 12 weeks. Within 12 weeks, the size of the subgroup ith normal food intake almost doubled (13-24 patients) while the size of the subgroup with (nearly) impossible solid food ingestion decreased by 38% (47 vs. 29 patients). The impact on quality of life was considered important or very important by 77% of the responders. CONCLUSIONS No difference was found according to dose/volume radiotherapy parameters suggesting that oral pilocarpine hydrochloride: (1) acts primarily by stimulating minor salivary glands: (2) can be of benefit to patients suffering of severe xerostomia regardless of radiotherapy dose/volume parameters: (3) all responders are identified at 12 weeks.
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Affiliation(s)
- J C Horiot
- Radiation Therapy Department, Centre Georges-François Leclerc, Dijon, France
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Mahé MA, Bourdin S, Le Pourhiet-Le Mevel A, Moreau P, Campion L, Hamidou M, Milpied N, Moreau A, Gaillard F, Harousseau JL, Cuillière JC. Salvage extended-field irradiation in follicular non-Hodgkin's lymphoma after failure of chemotherapy. Int J Radiat Oncol Biol Phys 2000; 47:735-8. [PMID: 10837958 DOI: 10.1016/s0360-3016(00)00481-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the efficacy of total abdominopelvic (TAI) and total body irradiation (TBI) in heavily pretreated follicular non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS From 1983 to 1998, 34 patients received TAI (n = 22) or TBI (n = 12). All had Stage III or IV, Class B, C, D NHL in the working formulation and failed after receiving 1-5 regimens of chemotherapy. TAI was given at 20 Gy over a 3-week period. TBI was delivered in two successive half-body irradiations of 15 Gy over a 2-week period with a 4-week interval between each. RESULTS Mean follow-up from TAI or TBI was 120 months (range, 6-180). Seventy-six percent of patients achieved complete response and 24% partial response. Median survival was 62 months, 5-year and 10-year overall survival was 59% and 41%, and disease-free survival was 56% and 30%, respectively. Grade III or IV toxicity was gastrointestinal in 38% of patients and hematologic in 30%. No toxic death or delayed complications were observed. CONCLUSION Extended-field irradiation is feasible and efficient after failure of chemotherapy in follicular NHL.
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Affiliation(s)
- M a Mahé
- Centre René Gauducheau, Cedex, France.
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Bourhis J, Lapeyre M, Tortochaux J, Rives M, Bourdin S, Benassi T, Dubois J, Lesaunier F, Geoffrois L, Verrelle P, Daly-Schveitzer N, Bardet E, Wibault P, Eschwege F, Benhamou E. Very accelerated versus conventional radiotherapy in HNSCC: Results of the GORTEC 94-02 randomized trial. Int J Radiat Oncol Biol Phys 2000. [DOI: 10.1016/s0360-3016(00)80019-x] [Citation(s) in RCA: 10] [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: 10/27/2022]
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Mahe M, Bourdin S, Le Mevel A, Moreau P, Campion L, Hamidou M, Milpied N, Lisbona A, Harousseau J, Cuilliere J. 2218 Salvage extended field irradiation in disseminated follicular non-Hodgkin's lymphoma (NHL) after failure of chemotherapy. Int J Radiat Oncol Biol Phys 1999. [DOI: 10.1016/s0360-3016(99)90487-x] [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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Classe JM, Mahé M, Moreau P, Rapp MJ, Maisonneuve H, Lemevel A, Bourdin S, Harousseau JL, Cuillière JC. Ovarian transposition by laparoscopy before radiotherapy in the treatment of Hodgkin's disease. Cancer 1998; 83:1420-4. [PMID: 9762944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND The use of inverted Y irradiation in the treatment of Hodgkin's disease with pelvic lymph node involvement can cause iatrogenic early menopause in young women as a result of ovarian exposure to radiation. Ovarian transposition protects the ovaries by removing them from the irradiation field. This surgical procedure, initially performed by laparotomy, can now be done by laparoscopy. METHODS During the period July 1994 to April 1996, laparoscopic ovarian transposition was performed on 4 young women with Hodgkin's disease 1 week before inverted Y radiotherapy. The surgical procedure, complications, length of hospitalization, and hormonal, clinical, and biologic results were evaluated. RESULTS The mean duration of hospitalization was 4 days, and there were no postoperative complications. Iatrogenic menopause did not occur in any of the patients during the mean follow-up period of 20.75 months (range, 6-35 months; median, 20 months). CONCLUSIONS Laparoscopy offers many advantages over laparotomy for ovarian transposition. This procedure, which can be performed without opening the abdominal wall, is highly efficient, requires only a short period of hospitalization, and leads to few postoperative complications. Laparoscopy is an attractive alternative to laparotomy for ovarian transposition in young women with advanced Hodgkin's disease who require pelvic radiotherapy.
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Affiliation(s)
- J M Classe
- Department of Surgery, Centre René Gauducheau, Saint-Herblain, France
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23
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Bensadoun RJ, Etienne MC, Dassonville O, Chauvel P, Pivot X, Marcy PY, Prevost B, Coche-Dequeant B, Bourdin S, Vallicioni J, Poissonnet G, Courdi A, Teissier E, Lagrange JL, Thyss A, Santini J, Demard F, Schneider M, Milano G. Concomitant b.i.d. radiotherapy and chemotherapy with cisplatin and 5-fluorouracil in unresectable squamous-cell carcinoma of the pharynx: clinical and pharmacological data of a French multicenter phase II study. Int J Radiat Oncol Biol Phys 1998; 42:237-45. [PMID: 9788400 DOI: 10.1016/s0360-3016(98)00235-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE The aim of this phase II study conducted on unresectable squamous cell carcinoma (USCC) of the oro- and hypopharynx was to associate twice-a-day (b.i.d.) continuous nonaccelerated radiotherapy with concomitant cisplatin (CP)-5-fluorouracil (5-FU) chemotherapy, both given at full dose. Feasibility, efficacy, survival, and pharmacokinetic-pharmacodynamic relationships were analyzed. METHODS AND MATERIALS Fifty-four consecutive patients with strictly USCC of oro- and/or hypopharynx received continuous b.i.d. radiotherapy (RT) (2 daily fractions of 1.2 Gy, 5 days a week, with a 6-h minimal interval between fractions). Total RT dose was 80.4 Gy on the oropharynx and 75.6 Gy on the hypopharynx. Three chemotherapy (CT) courses of CP-5-FU were given during RT at 21-day intervals (third not delivered after the end of RT). CP dose was 100 mg/m2 (day 1) and 5-FU was given as 5-day continuous infusion (day 2-day 6: 750 mg/m2/day cycle 1, 750 mg total dose/day cycle 2 and 3). Pharmacokinetics was performed for 5-FU (105 h follow-up) and CP (single sample at 16 h). Special attention was paid to supportive care. RESULTS Good feasibility of RT was observed (85.2% of patients with total dose > 75 Gy). Five patients received 1 CT cycle, 34: 2 cycles, and 15: 3 cycles. The most frequent and severe acute toxicities were mucositis with grade 3-4 occurring in 28% at cycle 1 and 86% at cycle 2, as well as neutropenia (43% at cycle 2). Locoregional control at 6 months was observed in 66.7% of patients. No late toxicity above grade 2 RTOG was noticed. CP dose and 5-FU AUC(0-105h) were significantly linked to grade 3-4 neutropenia (cycle 2). Cumulative total platinum (Pt) concentration and Karnofsky index were the only independent predictors of locoregional control at 6 months. Finally, total RT dose and total Pt concentration were the only independent predictors of specific survival. CONCLUSION This protocol showed good locoregional response with an acceptable toxicity profile. Pharmacokinetic survey is probably an effective approach to further reduce toxicity and improve efficacy. A multicentric randomized phase III study, now underway, should confirm these encouraging results.
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Affiliation(s)
- R J Bensadoun
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France.
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24
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Moreau P, Milpied N, Rapp MJ, Moreau A, Bourdin S, Mahe MA, Dupas B, Le Tortorec S, Hamidou M, Maisoneuve H, Mahe B, Bulabois CE, Morineau N, Jardel H, Harousseau JL. Early intensive therapy with autologous stem cell transplantation in high-risk Hodgkin's disease: long-term follow-up in 35 cases. Leuk Lymphoma 1998; 30:313-24. [PMID: 9713963 DOI: 10.3109/10428199809057544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Thirty-five adult patients with high-risk HD (HD) defined by (1) Ann Arbor stage IV or bulky nodal disease (tumor/thorax ratio > 0.45) and (2) no or partial response (PR) (< 75%) to the initial 3 courses of ABVD, received an early intensive therapy with autologous stem cell transplantation (ASCT). Thirty patients were considered as partial responders and 5 as refractory to initial chemotherapy. Conditioning regimen consisted of chemotherapy alone (CBV in 11 patients before 1993, BEAM in 13 patients since 1993) followed by adjuvant radiotherapy: 40 Gy) on the initial sites of bulky disease, or 12 Gy total body irradiation plus 120 mg/kg cyclophosphamide in 11 patients with disseminated extra-nodal disease. All 30 patients in PR at the time of ASCT experienced prolonged complete remission (CR). One patient died in CR from an acute myocardial infarction 48 months after ASCT. Four out of the 5 patients with refractory disease at the time of ASCT experienced rapid progression of HD leading to death in 3 cases. After 6 years of CR post-ASCT, the last refractory patient died of myelodysplastic syndrome diagnosed 2 years after intensive therapy. With a median follow-up for surviving patients of 51 months (range: 11-111), the cumulative probability of 8-year overall survival is 75.6% for the entire group of patients, 94.1% for the chemosensitive ones, and 0% for the primary refractory (P < .0001). The cumulative probability of 8-year event-free survival is 79.9% for the entire group of patients, 94.1% for the chemosensitive ones, and 0% for the primary refractory (P < .0001). We conclude that early intensive therapy with ASCT is feasible in patients with high-risk HD and induces a high cure rate in chemosensitive patients. In primary refractory patients, new therapeutic approaches are warranted.
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Affiliation(s)
- P Moreau
- Department of Hematology, CHU Hôtel-Dieu, Nantes, France
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25
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Mahé MA, Bourdin S, Le Mevel A, Moreau P, Moreau A, Hamidou M, Gaillard F, Rapp MJ, Milpied N, Harousseau JL. Long-term results of total abdominopelvic irradiation in non-Hodgkin's lymphomas after failure of chemotherapy. Int J Radiat Oncol Biol Phys 1998; 41:117-21. [PMID: 9588925 DOI: 10.1016/s0360-3016(98)00034-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the therapeutic efficacy of moderate-dose total abdominopelvic irradiation (TAI) in a retrospective series of pretreated non-Hodgkin's lymphomas (NHL). METHODS AND MATERIALS From 1977 to 1994, 45 patients received TAI after failure of chemotherapy (CT). According to the Working Formulation, 10 patients were diagnosed with class A (group I), 19 with class B, C, or D (follicular) (group II), and 16 with class E or more severe (group III) NHL. Irradiation consisted of two daily fractions of 0.80 Gy each for a total dose of 20 Gy. RESULTS Mean follow-up after TAI was 102 months (range 8-156). For the entire group, the complete response (CR) rate was 66%, the partial response (PR) rate 29%, 10-year overall survival (OS) 35%, 10-year disease-free survival (DFS) 29%, and median survival 32 months. When results between subgroups were compared, CR was 70% in group I, 84% in group II, and 44% in group III; and survival was statistically higher in group II than in groups I and III: 10-year OS 52% vs. 10% (p < 0.01) and 31% (p < 0.05), respectively, 10-year DFS 37% vs. 10% (p < 0.03) and 19% (p < 0.05), respectively. Grade III or IV complications were gastrointestinal in 27% of patients and hematologic in 25%. CONCLUSION Large-field irradiation in moderate doses could provide an alternative to bone marrow transplantation in refractory NHL, especially in cases showing a follicular growth pattern.
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Affiliation(s)
- M A Mahé
- Centre René Gauducheau, Nantes, France
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26
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Thomas O, Mahé M, Bourdin S, Milpied N, Moreau P, Campion L, Harousseau J, Brunet G, Lishona A, Point C, Cuilliere U. Long-term complications of total body irradiation from a cohort of 186 patients. Int J Radiat Oncol Biol Phys 1998. [DOI: 10.1016/s0360-3016(98)80242-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Resbeut M, Marteau P, Cowen D, Richaud P, Bourdin S, Dubois JB, Mere P, N'Guyen TD. A randomized double blind placebo controlled multicenter study of mesalazine for the prevention of acute radiation enteritis. Radiother Oncol 1997; 44:59-63. [PMID: 9288859 DOI: 10.1016/s0167-8140(97)00064-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Symptoms of acute radiation enteritis (ARE), dominated by diarrhea, occur in more than 70% of patients receiving pelvic irradiation. Eicosanoids and free radicals release have been implicated in the pathogenesis. Mesalazine (5-ASA) is a potent inhibitor of their synthesis in the mucosa and could therefore be of some interest in preventing ARE. PATIENTS AND METHODS The study was performed in six radiotherapy units in France who agreed on standardized irradiation procedures. One hundred and fifty-three patients planned for external beam radiotherapy to the pelvis > or = 45 Gy for prostate (n = 97) or uterus (n = 54) cancer were randomized on a double blind basis to receive prophylactic 5-ASA (4 g/day Pentasa) or placebo. Patients with concomitant chemotherapy were excluded. Prostate and uterus cancers were chosen since these centropelvic tumors require a similar radiotherapy protocol during the first step of treatment and involve a comparable volume of small intestine. The symptoms of ARE and their severity were assessed every week during irradiation, and 1 and 3 months after its end. All patients followed a low fiber and low lactose diet. End points were diarrhea, use of antidiarrheal agents, abdominal pain, and body weight. Effficacy was evaluated using intention to treat. RESULTS (means +/- SD) Groups did not differ for age (mean 64 +/- 9 years), sex, tumor site, or irradiation procedure. During irradiation, diarrhea occurred in 69% and 66% of the 5-ASA and placebo groups, respectively (chi2, P = 0.22). Curves of survival without diarrhea did not differ between groups (logrank P = 0.09). Severity of diarrhea did not differ between groups except at d15 where it was significantly more severe in the 5-ASA group (ANOVA P = 0.006). Duration of diarrhea did not differ (22 +/- 15 days in both groups, P = 0.88). Abdominal pain was less frequently reported in the 5-ASA group at d28 (34% vs. 51%, P = 0.048). Use of antidiarrheal agents and body weight did not differ between groups. CONCLUSION Mesalazine 4 g/day did not decrease the symptoms of ARE.
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Affiliation(s)
- M Resbeut
- Centre de Recherche et de Lutte Contre le Cancer, Institut Paoli-Calmettes, Marseille, France
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28
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Beauvillain C, Mahé M, Bourdin S, Peuvrel P, Bergerot P, Rivière A, Vignoud J, Deraucourt D, Wesoluch M. Final results of a randomized trial comparing chemotherapy plus radiotherapy with chemotherapy plus surgery plus radiotherapy in locally advanced resectable hypopharyngeal carcinomas. Laryngoscope 1997; 107:648-53. [PMID: 9149168 DOI: 10.1097/00005537-199705000-00017] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
After neoadjuvant chemotherapy, a routine conservative approach followed by salvage surgery was evaluated in terms of local control and survival in cases of advanced potentially resectable hypopharyngeal carcinoma. Between 1985 and 1989, 92 patients with T3 or T4-NO,N3 operable squamous cell hypopharyngeal carcinomas received three courses of neoadjuvant chemotherapy every 2 weeks involving a combination of cisplatin, 100 mg/m2, on day 1 and fluorouracil, 1 g/m2, on days 2 to 5, followed by total laryngopharyngectomy plus postoperative radiotherapy in 47 patients (arm A) or radiotherapy alone in 45 patients (arm B). Randomization was always performed prior to chemotherapy. The response rates of tumor and node to chemotherapy were, respectively, 67% in arm A versus 79% in arm B (P > 0.05) and 54% in arm A versus 73% in arm B (P > 0.05). Grade III or IV toxicity was similar, affecting 15% of patients and 7% of cycles in arm A versus 16% of patients and 6% of cycles in arm B. After a mean follow-up of 92 months, survival was statistically better (P = 0.04) in arm A (5-year overall survival, 37%; median survival, 40 months) than in arm B (19% and 20 months) because of a better local control rate (63% versus 39%; P < 0.01). Better results were obtained for mutilant surgery in terms of local control and overall survival, regardless of response to neoadjuvant chemotherapy.
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Affiliation(s)
- C Beauvillain
- Department of Head and Neck Surgery, C.H.U., Nantes, France
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29
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Mahé MA, André MJ, Moyon E, Le Mevel A, Soubeyran P, Hamidou M, Milpied N, Bourdin S, Cuillière JC, Chatal JF. Chromosome aberrations after radiotherapy in patients treated for non Hodgkin's lymphoma. Ann Genet 1997; 40:92-8. [PMID: 9259955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chromosome aberrations were evaluated in the lymphocytes of 30 patients who had undergone radiotherapy several years before for non-Hodgkin's lymphoma. Twelve had received 20 Gy over the entire abdomen (group I), 12 wholebody irradiation at 1.5 Gy (group II) and 6 wholebody irradiation at 15 Gy (group III). Unirradiated patients seen for cytogenetic analysis during the same period served as controls. Overall results for the irradiated population were 13/27 (48%) evaluable patients with chromosome aberrations and 50/710 (7%) abnormal cells for a total of 73 aberrations (unstable: 35, stable: 38). The frequency of aberrations was statistically higher in group I (12% of cells) than in groups II (3.5%, p < 0.0001) and III (2.5%, p < 0.0002). Differences in irradiation dose and volume may account for the variations between groups.
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Affiliation(s)
- M A Mahé
- Service de Radiothérapie, Site Hospitalier Nord de Nantes, Saint-Herblain, France
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30
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Bey P, Wilkinson PM, Resbeut M, Bourdin S, Le Floch O, Hahne W, Claverie N. A double-blind, placebo-controlled trial of i.v. dolasetron mesilate in the prevention of radiotherapy-induced nausea and vomiting in cancer patients. Support Care Cancer 1996; 4:378-83. [PMID: 8883232 DOI: 10.1007/bf01788845] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The aim of this work was to measure the safety and efficacy of single i.v. doses of dolasetron mesilate for the control of emesis caused by single high-dose (at least 6 Gy) radiotherapy to the upper abdomen. The double-blind, placebo-controlled, multicenter study stratified patients on the basis of being naive or nonnaive to radiotherapy. Patients with or without a history of previous chemotherapy were enrolled. Patients were randomized to receive placebo or 0.3, 0.6, or 1.2 mg/kg dolasetron mesilate 30 min before radiotherapy, then monitored for 24 h. Antiemetic efficacy was assessed from the time to the first emetic episode or rescue, from whether there was a complete response (0 emetic episodes /no rescue medication) or a complete-plus-major response (0-2 emetic episodes/no rescue medication), from the severity of nausea (rated by patients and the investigator), and from the investigator's assessment of efficacy. Fifty patients completed the study (owing to changing medical practice, enrollment objectives were not met; consequently, no significant linear dose trend was expected). Pooled dolasetron was superior to the placebo in its effect on the time to first emesis or rescue in radiotherapy-nonnaive patients (P = 0.015). Dolasetron was statistically superior to the placebo in the overall population on the basis of a complete plus major response: 54%, 100%, 93%, and 83% for the placebo and 0.3-, 0.6-, and 1.2-mg/kg doses respectively (P = 0.002). The low response in the highest dose group may be due to an imbalance in the number of chemotherapy-nonnaive patients in that group. Dolasetron was superior to the placebo on the basis of nausea assessed by the investigator (P = 0.024) and administration of rescue medication (P = 0.006). Complete response at the 0.3-mg/ kg dose was superior to results with the placebo (P = 0.050). Treatment-related adverse events were rare, mild to moderate in intensity, and evenly distributed across the four groups. Overall, dolasetron mesilate was effective and well-tolerated in the control of single, high-dose radiotherapy-induced emesis.
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Affiliation(s)
- P Bey
- Centre Alexis Vautrin, Vandoeuvre-Les-Nancy, France
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31
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Horiot J, Lipinski F, Schraub S, Maylin C, Bensadoun R, Gérard J, Bolla M, Coscas Y, Baillet F, Coche-Dequéant B, Urbajtel M, Montbarbon X, Bourdin S, Wibault P, Pene F, Alfonsi M, Calais G, Desprez P, Favre A, Lapeyre M, Vinke J, Labart M, Savary J. 151Can pilocarpine hydrochloride relieve xerostomia regardless of the destruction of major salivary glands? A prospective French cooperative study. Radiother Oncol 1996. [DOI: 10.1016/s0167-8140(96)80160-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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32
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Bensadoun R, Chauvel P, Dassonville O, Laudoyer Y, Bourdin S, Prevost B, Resbeut M, Schneider M, Demard F. 2027 Continuous twice-a-day radiotherapy and concomitant CDDP-5fu chemotherapy (BiRCF) for the treatment of locallyadvanced inoperable pharyngeal carcinomas: Final results of a multicentric phase II study (FNCLCC). Int J Radiat Oncol Biol Phys 1995. [DOI: 10.1016/0360-3016(95)97931-p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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33
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Moreau P, LeTortorec S, Mahé MA, Mahé B, Moreau A, Bourdin S, Bulabois CE, Bureau B, Harousseau JL, Milpied N. Autologous bone marrow transplantation using TBI and CBV for disseminated high/intermediate grade cutaneous non-epidermotropic non-Hodgkin's lymphoma. Bone Marrow Transplant 1994; 14:775-8. [PMID: 7889011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Patients with stage IV high/intermediate grade cutaneous non-epidermotropic lymphoma of skin as first localization of the disease have a poor prognosis. In this setting, autologous bone marrow transplantation (BMT) has rarely been evaluated. We report here on the treatment of four patients with such lymphomas with autologous BMT using 12 Gy total body irradiation (TBI) and CBV (cyclophosphamide, carmustine and etoposide). Using a plexiglass screen, TBI delivered an homogenized dose to the skin. With this conditioning regimen, all patients are still in complete remission 22, 44, 46 and 51, respectively, months after high-dose chemotherapy, TBI and autologous BMT.
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Affiliation(s)
- P Moreau
- Haematology Department, CHU Hôtel-Dieu, Nantes, France
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34
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Wu DP, Milpied N, Moreau P, Mechinaud-Lacroix F, Mahe B, Le Tortorec S, Rapp MJ, Bourdin S, Mahe JM, Harousseau JL. Total body irradiation and high-dose cyclophosphamide, BCNU and VP-16 (CBV) as a new preparatory regimen for allogeneic bone marrow transplantation in patients with advanced hematologic malignancies. Bone Marrow Transplant 1994; 14:751-7. [PMID: 7889008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To increase the cure rate of advanced hematologic malignancies following allogeneic bone marrow transplantation we sequentially evaluated two intensified conditioning regimens. Eleven patients with acute myeloblastic leukemia (AML) beyond the first complete remission or chronic myelogenous leukemia (CML) not in first chronic phase received an association of 13.5 Gy of fractionated total body irradiation (TBI) followed by cyclophosphamide (CY) 120 mg/kg. Following this regimen, the probability of relapse was 47% at 3 years and the non-relapse mortality rate was 27%. Given the acceptable tolerance of this regimen, 13.5 Gy fractionated TBI was associated with intensified chemotherapy consisting of a combination of CY 120 mg/kg, carmustine 300 mg/m2 and etoposide 600 mg/m2 (CBV). This regimen was administered to 22 patients with comparable diseases. Of these patients, 7 received a transplant from a matched unrelated donor and 2 other patients received a second transplant from the original genoidentical donor. For 15 patients with a genoidentical donor, including the 2 second transplant, the 3 year probability of survival, disease-free survival and relapse are 40%, 40% and 14%, respectively. No regimen-related toxic deaths were recorded during the first 100 days. Of 7 patients with matched unrelated donors, 3 died before day 100, one death being directly attributable to the regimen. Early non-fatal regimen-related toxicity consisted mainly in grade II mucositis with no grade III or IV toxicity in recipients of genoidentical marrow. The late deaths were mainly due to chronic GVH-related complications. In conclusion, the association of fractionated 13.5 Gy TBI and CBV carries a high antileukemic activity and an acceptable toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Bone Marrow Transplantation/adverse effects
- Bone Marrow Transplantation/methods
- Carmustine/administration & dosage
- Carmustine/adverse effects
- Child
- Child, Preschool
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Etoposide/administration & dosage
- Etoposide/adverse effects
- Female
- Graft vs Host Disease/etiology
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/radiotherapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/radiotherapy
- Leukemia, Myeloid, Acute/therapy
- Male
- Recurrence
- Time Factors
- Transplantation, Homologous
- Whole-Body Irradiation/adverse effects
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Affiliation(s)
- D P Wu
- Department of Hematology, University Hospital, Nantes, France
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35
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Mahé B, Moreau P, Bonnemain B, Letortorec S, Menegali D, Bourdin S, De Lajartre D, Harousseau JL. Isolated Richter's syndrome of the brain: two recent cases. Nouv Rev Fr Hematol (1978) 1994; 36:383-5. [PMID: 7892133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Two new cases of central nervous system (CNS) large cell lymphoma without evidence of systemic lymphoma in patients with chronic lymphocytic leukaemia (CLL) are reported. This unusual presentation of Richter's syndrome emphasizes the necessity to evoke this diagnosis in the case of neurologic symptoms in CLL.
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MESH Headings
- Aged
- Brain Neoplasms/complications
- Brain Neoplasms/diagnosis
- Brain Neoplasms/therapy
- Combined Modality Therapy
- Frontal Lobe
- Hemianopsia/etiology
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Middle Aged
- Neoplasms, Multiple Primary
- Neurocognitive Disorders/etiology
- Occipital Lobe
- Syndrome
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Affiliation(s)
- B Mahé
- Service d'Hématologie, CHU Hôtel-Dieu, Nantes, France
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36
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Moreau P, Milpied N, Mechinaud-Lacroix F, Mahe B, Rapp MJ, Le Tortorec S, Bourdin S, Dupas B, Harousseau JL. Early intensive therapy with autotransplantation for high-risk Hodgkin's disease. Leuk Lymphoma 1993; 12:51-8. [PMID: 7512854 DOI: 10.3109/10428199309059571] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The purpose of this trial was to evaluate the efficacy and the tolerance of high-dose therapy with autologous stem cell transplantation as part of front-line therapy in Hodgkin's disease for patients with both adverse prognostic factors: high tumor burden at presentation and slow response to initial chemotherapy. In a prospective one-center study, 20 consecutive patients with slow response (tumor reduction < 75%) (16 pts) or refractory (4 pts) to 3-4 courses of conventional HD chemotherapy received high-dose therapy followed with autologous bone marrow (14 pts) or peripheral blood stem cell (6 pts) transplantation. They were 13 males, 7 females, median age 26 years (8-45). At the time of initial diagnosis, all but one of the patients had B symptoms, all had high-risk HD defined as Ann Arbor stage IV (7 pts) or large mediastinal involvement (LMI = tumor/thorax > 0.45 at T5-T6) (6 pts) or both stage IV+LMI (7 pts). Median time between diagnosis and autotransplantation was 5 months. Intensive therapy consisted of either CBV (cyclophosphamide 1.5 g/m2 x 4, BCNU 300 mg/m2, etoposide 200 mg/m2 x 3) (12 pts) or cyclophosphamide 120 mg/kg + 12 Gy total body irradiation for 8 patients with diffuse bone or lung involvement. For pts treated with CBV, 40 Gy involved field radio-therapy was performed after hematological recovery. Median duration of neutropenia was 16 days (9-21). Neither veno-occlusive disease, nor interstitial pneumonitis nor toxic death were observed. Seventeen pts are alive with no progression of the disease (16/16 in partial response after initial chemotherapy, 1/4 with refractory disease).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Moreau
- Hematology Department, CHU Hôtel-Dieu, Nantes, France
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Bensadoun RJ, Chauvel P, Bourdin S, Peuvrel P, Prevost B, Resbeut M, Schneider M, Thyss A, Dassonville O, Demard F, Vallicioni J, Lefebvre JC, Pech-Gourd A. Combined bifractionated radiotherapy and CDDP-5FU chemotherapy (BIRCF) in locally advanced inoperable pharyngeal carcinomas — a phase II study. Eur J Cancer 1993. [DOI: 10.1016/0959-8049(93)91383-v] [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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Maugard-Louboutin C, Fumoleau P, Ibrabim N, Bourdin S, Resche F, Lajat Y, Menegalli-Boggelli D, Brienza S, Gastiaburu J. Preliminary phase II trial of oxaliplatin (L-OHP) in malignant astrocytomas. Eur J Cancer 1993. [DOI: 10.1016/0959-8049(93)91687-g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bourdin S, Karam G, Clemain P, Bouchot O, Peuvrel P, Lacoste J, Auvigne J. Clinical experience with leuprorelin acetate before radiotherapy for prostatic cancer. J Int Med Res 1990; 18 Suppl 1:74-8. [PMID: 2108888 DOI: 10.1177/03000605900180s111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A total of 40 patients with stages A2 to C prostatic cancer were treated with leuprorelin acetate depot once a month for 2 months before being treated by pelvic irradiation or radical prostatectomy. In the 32 patients who were evaluable, seven (22%) were classified as minor responders after leuprorelin treatment and 23 (72%) as major responders when assessed by rectal examination. Prostate-specific antigens also returned to normal concentrations (5 ng/ml) in 26/31 (84%) patients. Leuprorelin acetate depot suppressed plasma testosterone concentrations to castration values during treatment, but concentrations returned to normal 2 months after completion of treatment. Following radical treatment, there were three deaths--one postoperative and two due to recurrent disease--but there was no isolated local relapse. It is concluded that the protocol was locally well tolerated and was effective in the treatment of stages B2 and C prostatic cancer patients.
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Affiliation(s)
- S Bourdin
- Centre René Gauducheau CRLC de Nantes, France
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