1
|
Cuenin M, Salleron J, Peiffert D, Meknaci É, Gallet P, Abushama Y, Py JF, Renard S. Interstitial brachytherapy for lip carcinomas: Comparison between Ir-192 low-dose-rate and high-dose-rate treatment. Cancer Radiother 2024; 28:145-151. [PMID: 38072744 DOI: 10.1016/j.canrad.2023.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 04/22/2024]
Abstract
PURPOSE Low-dose-rate (LDR) and high-dose-rate (HDR) interstitial brachytherapy are known to be effective in the treatment of lip carcinomas. The aim of this study was to retrospectively compare oncologic and toxicity outcomes between the two techniques. PATIENTS AND METHODS From 2007 to 2018, patients at the Institut de cancérologie de Lorraine (France) who received exclusive or adjuvant interstitial brachytherapy for lip squamous carcinomas were studied. Two groups were defined: the LDR/PDR group, including patients treated with iridium-192 wires, or pulsed-dose rate technique, and the high-dose-rate group, with patients treated by high-dose-rate technique. The dose ranged between 50Gy and 65Gy (depending on previous surgery) for low-dose-/pulsed-dose rate treatments, and 39Gy for high-dose-rate (twice a day). Early, late toxicity events and oncologic control were reported. RESULTS Among the 61 patients whose data were analyzed retrospectively, 36 received the low-dose-/pulsed-dose rate treatment (59%) and 25 the high-dose-rate brachytherapy (41%). The median follow-up time was 44 months. At 36 months, the local control rates were 96.3% for LDR/PDR group and 100% for HDR (P=0.180). The regional control rates were 85.9% and 92% without any difference according to the two groups (P=0.179). The specific overall survival rate was 95.5% with no difference between groups. There were more grade 2 or higher mucositis in the HDR group than in LDR/PDR group (40% versus 16.7%, P=0.042). One case of grade 3 mucositis was recorded in each group. No grade 3 late complications were recorded. High-dose-rate brachytherapy reduced the length of hospitalization by 2 days (P<0.001). CONCLUSION High-dose- or low-dose-/pulsed-dose rate brachytherapy seemed to be as effective and well tolerated in our experience of 61 patients.
Collapse
Affiliation(s)
- M Cuenin
- Radiation Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
| | - J Salleron
- Biostatistics Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - D Peiffert
- Radiation Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - É Meknaci
- Radiation Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - P Gallet
- Head and Neck Surgery Department, CHU de Nancy, Nancy, France
| | - Y Abushama
- Head and Neck Surgery Department, CHU de Nancy, Nancy, France
| | - J-F Py
- Radiation Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - S Renard
- Radiation Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| |
Collapse
|
2
|
Trampetti I, Cuenin M, Gérard K, Salleron J, Peiffert D, Charra-Brunaud C. Can we predict the cardiac benefit of deep inspiration breath hold for left breast and regional nodal irradiation? Cancer Radiother 2023; 27:407-412. [PMID: 37541798 DOI: 10.1016/j.canrad.2023.06.004] [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: 05/14/2023] [Accepted: 06/13/2023] [Indexed: 08/06/2023]
Abstract
PURPOSE Deep inspiration breath hold (DIBH) is used to decrease the dose of radiotherapy delivered to the heart. There is a need to define criteria to select patients with the potential to derive a real clinical benefit from DIBH treatment. Our study's main goal was to investigate whether two CT-scan cardiac anatomical parameters, cardiac contact distance in the parasagittal plane (CCDps) and lateral heart-to-chest distance (HCD), were predictive of unmet dosimetric cardiac constraints for left breast and regional nodal irradiation (RNI). MATERIALS AND METHODS This retrospective single-institution dosimetric study included 62 planning CT scans of women with left-sided breast cancer (BC) from 2016 to 2021. Two independent radiation oncologists measured HCD and CCDps twice to assess inter- and intra-observer reproducibility. Dosimetric constraints to be respected were defined, and dosimetric parameters of interest were collected for each patient. RESULTS Mean heart dose was 7.9Gy. Inter-rater reproducibility between the two readers was considered excellent. The mean heart dose constraint<8Gy was not achieved in 25 patients (40%) and was achieved in 37 patients (60%). There was a significant correlation between mean heart dose and HCD (rs=-0.25, P=0.050) and between mean heart dose and CCDps (rs=0.25, P=0.047). The correlation between HCD and CCDps and unmet cardiac dosimetric constraints was not statistically significant. CONCLUSION Our dosimetric analysis did not find that the cardiac anatomical parameters HCD and CCDps were predictive of unmet dosimetric cardiac constraints, nor that they were good predictors for cardiac exposure in left-sided BC radiotherapy comprising RNI.
Collapse
Affiliation(s)
- I Trampetti
- Département de radiothérapie, institut de cancérologue de Lorraine, 6, avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France; Faculté de médecine de Nancy, université de Lorraine, 9, avenue de la Forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France.
| | - M Cuenin
- Département de radiothérapie, institut de cancérologue de Lorraine, 6, avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France
| | - K Gérard
- Département de radiothérapie, institut de cancérologue de Lorraine, 6, avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France
| | - J Salleron
- Unité de biostatistiques, institut de cancérologie de Lorraine, 54519 Vandoeuvre-lès-Nancy, France
| | - D Peiffert
- Département de radiothérapie, institut de cancérologue de Lorraine, 6, avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France
| | - C Charra-Brunaud
- Département de radiothérapie, institut de cancérologue de Lorraine, 6, avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France
| |
Collapse
|
3
|
Jacques J, Renard S, Demogeot N, Faivre JC, Peiffert D. Hypofractionated radiotherapy for invasive squamous cell carcinoma of the scalp in the elderly: Efficacy and tolerance, preliminary results. Cancer Radiother 2023:S1278-3218(23)00063-X. [PMID: 37179219 DOI: 10.1016/j.canrad.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE Skin squamous cells carcinomas (SCC) are frequently tumor, especially in the elderly population. Surgical excision is the standard treatment. But for patients suffering large tumor or/with comorbidity, a conservative approach with irradiation can be proposed. The hypofractionated schedule is used to shorten the overall treatment time with same results and without compromising therapeutic outcomes. The aim of this study is to assess the efficacy and tolerance of hypofractionated radiotherapy for invasive SCC of the scalp in elderly. PATIENTS AND METHODS We included patients suffering from SCC of the scalp and treated by hypofractionated radiotherapy at the Institut de cancérologie de Lorraine or centre Émile-Durkeim d'Épinal, from January 2019 to December 2021. Characteristics of patients, size of the lesion and side effects were collected retrospectively. Tumor size at 6 months corresponded to the primary endpoint. Toxicity was collected for the secondary endpoint. RESULTS Twelve patients with a median age of 85 years old were included. The mean size was 4,5cm with a bone invasion in 2/3 of cases. Radiotherapy was delivered after surgical excision for half of the patient. The dose delivered was 54Gy in 18 daily fractions size. Six months after irradiation: 6/11 patients had no residual lesion, 2/11 had a partial response with a residual lesion of about 1cm. 3 patients presented local recurrence. One patient died within 6 months of radiotherapy because of another comorbidity. In total, 25% had presented a grade 3 acute radiation dermatitis, no grade 4 toxicity. CONCLUSION Short term of moderately hypofractionated schedule radiotherapy was a success with complete or partial response for more than 70% of the patients in squamous cell carcinomas. There is no major side effect.
Collapse
Affiliation(s)
- J Jacques
- Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France.
| | - S Renard
- Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France
| | - N Demogeot
- Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France; Radiation Department, centre Émile-Durkheim, Épinal, France
| | - J C Faivre
- Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France
| | - D Peiffert
- Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France
| |
Collapse
|
4
|
Py JF, Salleron J, Vogin G, Courrech F, Teixeira P, Colnat-Coulbois S, Baumard F, Thureau S, Supiot S, Peiffert D, Oldrini G, Faivre JC. Could conventionally fractionated radiation therapy coupled with stereotactic body radiation therapy improve local control in bone oligometastases? Cancer Radiother 2023; 27:1-10. [PMID: 36641333 DOI: 10.1016/j.canrad.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To describe clinical outcomes of stereotactic body radiation therapy (SBRT) applied alone or as a boost after a conventionally fractionated radiation therapy (CFRT) for the treatment of bone oligometastases. MATERIAL AND METHODS This retrospective cohort study included patients treated with SBRT from January 2007 to December 2015 in the Institut de cancérologie de Lorraine in France. The inclusion criteria involved adults treated with SBRT for one to three bone metastases from a histological proven solid tumor and a primary tumor treated, an Eastern Cooperative Oncology Group (ECOG) score inferior or equal to 2. Local control (LC), overall survival (OS), progression free survival (PFS), bone progression incidence (BPI), skeletal related events free survival (SRE-FS), toxicity and pain response were evaluated. RESULTS Forty-six patients and 52 bone metastases were treated. Twenty-three metastases (44.2%) received SBRT alone mainly for non-spine metastases and 29 (55.8%) a combination of CFRT and SBRT mainly for spine metastases. The median follow-up time was 22months (range: 4-89months). Five local failures (9.6%) were observed and the cumulative incidences of local recurrence at 1 and 2years respectively were 4.4% and 8% with a median time of local recurrence of 17months (range: 4-36months). The one- and two-years OS were 90.8% and 87.4%. Visceral metastasis (HR: 3.40, 95% confidence interval [1.10-10.50]) and a time from primary diagnosis (TPD)>30months (HR: 0.22 [0.06-0.82]) were independent prognostic factors of OS. The 1 and 2years PFS were 66.8% and 30.9% with a median PFS time of 18months [13-24]. The one- and two-years BPI were 27.7% and 55.3%. In multivariate analysis, unfavorable histology was associated with worse BPI (HR: 3.19 [1.32-7.76]). The SRE-FS was 93.3% and 78.5% % at 1 and 2years. The overall response rate for pain was 75% in the evaluable patients (9/12). No grade≥3 toxicity nor especially no radiation induced myelopathy (RIM), two patients developed asymptomatic vertebral compression fractures. CONCLUSION The sole use of SBRT or its association with CFRT is an efficient and well-tolerated treatment that allows high LC for bone oligometastases.
Collapse
Affiliation(s)
- J F Py
- Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
| | - J Salleron
- Department of Biostatistics and Data Management, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - G Vogin
- Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - F Courrech
- Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - P Teixeira
- Guilloz Imaging Department, CHU de Nancy, Nancy, France
| | - S Colnat-Coulbois
- Department of Neurosurgery, CHU de Nancy, Vandœuvre-lès-Nancy, France
| | - F Baumard
- Department of Biostatistics and Data Management, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - S Thureau
- Department of Radiation Oncology, centre Henri-Becquerel, Rouen, France
| | - S Supiot
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest, Saint-Herblain, France
| | - D Peiffert
- Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - G Oldrini
- Department of Radiology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - J C Faivre
- Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| |
Collapse
|
5
|
Vogin G, Pereira S, Cérimele E, Duclos M, Scherrer V, Behm-Ansmant I, Hettal L, Salleron J, François A, Bezdetnaya L, Peiffert D, Chastagner P, Bernier V. Evaluation of a Functional Assay for Radiosensitivity in the Pediatric Prospective Cohort ARPEGE. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.646] [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: 10/31/2022]
|
6
|
Demogeot N, Salleron J, Beckendorf V, Peiffert D, Levitchi M, Charra-Brunaud C, Renard S. Impact of external beam pelvic radiotherapy of endometrial carcinoma: A focus on chronic digestive toxicity. Cancer Radiother 2022; 26:570-576. [PMID: 35172947 DOI: 10.1016/j.canrad.2021.10.012] [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: 04/14/2021] [Revised: 08/27/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The standard treatment for endometrial cancer is surgery, although depending on the risk factors, adjuvant radiation therapy may also be given. It is proposed for high-risk carcinomas for which an improvement in progression-free survival though not overall survival has been shown. However, despite the development of radiotherapy treatments with intensity modulation and image guidance, adjuvant radiation therapy remains toxic to the digestive system. We aimed to investigate the incidence of digestive toxicity and the presence of any predictive factors. MATERIALS AND METHODS Data were retrospectively collected from patients treated with adjuvant radiotherapy for endometrial carcinoma at the Institut de cancérologie de Lorraine and centre hospitalier Émile-Durkheim between January 2010 and October 2016 and analyzed to identify factors associated with chronic digestive toxicity. RESULTS One hundred and thirty-nine patients received a total dose of 50Gy fractionated into 25 sessions, five per week for five weeks. The median follow-up after irradiation completion was 38 months. The incidence of gastrointestinal and rectal toxicity in all patients treated with pelvic irradiation for endometrial carcinoma was 11.1% (95% confidence interval [95%CI]: 5.4-19%) for grade 3-4 and 25.6% (95%CI: 17.0-34.9%) for grade 2-4. No factor was found to be significantly predictive of chronic digestive toxicity. At five years, the overall survival was 74.3%, (95%CI: 65.3-81.4%), progression-free survival was 69.6% (95%CI: 60.1-77.3%) and incidence of pelvic recurrence was 7.9% (95%CI: 3.8-13.9%). CONCLUSION Our results confirmed that pelvic radiotherapy can induce a relatively high rate of digestive toxicity but failed to identify relevant factors able to predict it.
Collapse
Affiliation(s)
- N Demogeot
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France.
| | - J Salleron
- Département de biostatistiques, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| | - D Peiffert
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| | - M Levitchi
- Département de radiothérapie, centre Henri-Becquerel, 76000 Rouen, France
| | - C Charra-Brunaud
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| | - S Renard
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| |
Collapse
|
7
|
Pommier P, Ferré M, Blanchard P, Martin É, Peiffert D, Robin S, Hannoun-Lévi JM, Marchesi V, Cosset JM. Prostate cancer brachytherapy: SFRO guidelines 2021. Cancer Radiother 2021; 26:344-355. [PMID: 34955422 DOI: 10.1016/j.canrad.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Prostate brachytherapy techniques are described, concerning both permanent seed implant and high dose rate brachytherapy. The following guidelines are presented: brachytherapy indications, implant procedure for permanent low dose rate implants and high dose rate with source projector, as well as dose and dose-constraints objectives, immediate postoperative management, post-treatment evaluation, and long-term follow-up.
Collapse
Affiliation(s)
- P Pommier
- Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France.
| | - M Ferré
- Département de physique médicale, institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - P Blanchard
- Département de radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - É Martin
- Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Pr-Marion, BP 77980, 21079 Dijon cedex, France
| | - D Peiffert
- Service universitaire de radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France
| | - S Robin
- Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France
| | - J-M Hannoun-Lévi
- Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - V Marchesi
- Unité de physique médicale, Institut de cancérologie de Lorraine centre Alexis-Vautrin, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - J M Cosset
- Centre de radiothérapie Charlebourg/La Défense, groupe Améthyst, 65, avenue Foch, 92250 La Garenne-Colombes, France
| |
Collapse
|
8
|
Abstract
Penile cancers are uncommon and should be treated in expert center. Radiotherapy indications are mainly limited to exclusive brachytherapy for early stage penile glans cancer. Brachytherapy yields to excellent outcome for disease control and organ and function preservation. Only scarce data are available for external beam radiation therapy. It could be considered as palliative setting for irradiation of the primary tumor. For lymph node irradiation, external beam radiation therapy (with or without chemotherapy) could be discussed either as neoadjuvant approach prior to surgery for massive inguinal lymph node invasion or as adjuvant approach in case of high-risk of relapse. However, these cases should be discussed on an individual basis, as the level of evidence is poor. We present the recommendations of the French Society of Oncological Radiotherapy on the indications and techniques for external beam radiotherapy and brachytherapy for penile glans cancer.
Collapse
Affiliation(s)
- A Escande
- Département de radiothérapie, centre Oscar-Lambret, 3, avenue Frédéric-Combemale, 59000 Lille, France; Faculté de médecine Henri-Warembourg, université de Lille, 59000 Lille, France; Laboratoire Cristal, UMR 9189, 59009 Villeneuve-d'Ascq, France.
| | - D Peiffert
- Département d'oncologie radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - C Dejean
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06000 Nice, France
| | - J-M Hannoun-Lévi
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06000 Nice, France
| | - A Cordoba
- Département de radiothérapie, centre Oscar-Lambret, 3, avenue Frédéric-Combemale, 59000 Lille, France
| | - P Pommier
- Département d'oncologie radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France
| | - C Haie-Méder
- Département d'oncologie radiothérapie, centre de cancérologie, Charlebourg la Défense, 65, avenue Foch, 92250 La Garenne Colombes, France
| | - C Chargari
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France; École du Val-de-Grâce, boulevard de Port-Royal, 75005 Paris, France; Département des effets biologiques des rayonnements, institut de recherche biomédicale des armées, 91223 Brétigny-sur-Orge, France
| |
Collapse
|
9
|
Chargari C, Petit A, Escande A, Peignaux K, Lafond C, Peiffert D, Hannoun-Lévi JM, Durdux C, Haie-Méder C. Role of radiotherapy in the management of vulvar cancer: Recommendations of the French society for radiation oncology. Cancer Radiother 2021; 26:286-291. [PMID: 34953710 DOI: 10.1016/j.canrad.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Primary vulvar carcinomas are rare gynaecological cancers, for which surgery is the mainstay of treatment. There is however a major place for external beam radiotherapy in the situation of inoperable locally advanced tumours and/or as adjuvant therapy, when there are risk factors for locoregional relapse. We present the recommendations of the French society for radiation oncology on the indications and techniques for radiotherapy in the treatment of primary vulvar cancer.
Collapse
Affiliation(s)
- C Chargari
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - A Petit
- Département de radiothérapie, centre régional de lutte contre le cancer institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - A Escande
- Département de radiothérapie, centre Oscar-Lambret, avenue Frédéric-Combemale, 59000 Lille, France
| | - K Peignaux
- Département d'oncologie radiothérapie, centre Georges-François-Leclerc, 1, avenue Professeur-Marion, 21000 Dijon, France
| | - C Lafond
- Département de radiothérapie, centre Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - D Peiffert
- Département de radiothérapie, Institut de cancérologie de Lorraine Alexis-4 Vautrin, 54511 Vandœuvre-lès-Nancy, France
| | - J-M Hannoun-Lévi
- Département de radiothérapie, centre Antoine-Lacassagne, avenue de Valombrose, 06000 Nice, France
| | - C Durdux
- Département d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - C Haie-Méder
- Département d'oncologie radiothérapie, Centre de cancérologie, Charlebourg la Défense, 65, avenue Foch, 92250 La Garenne-Colombes, France
| |
Collapse
|
10
|
Peiffert D, Huguet F, Vendrely V, Moureau-Zabotto L, Rivin Del Campo E, Créhange G, Dietmann AS, Moignier A. Radiotherapy of anal canal cancer. Cancer Radiother 2021; 26:279-285. [PMID: 34955416 DOI: 10.1016/j.canrad.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present the update of the recommendations of the French society for radiation oncology on external radiotherapy and brachytherapy of anal canal carcinoma. The following guidelines are presented: indications, treatment procedure, as well as dose and dose-constraints objectives, immediate postoperative management, post-treatment evaluation, and long-term follow-up.
Collapse
Affiliation(s)
- D Peiffert
- Département de radiothérapie, Institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
| | - F Huguet
- Service de radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - V Vendrely
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France; Inserm U1035, université de Bordeaux, 33000 Bordeaux, France
| | - L Moureau-Zabotto
- Service de radiothérapie, institut Paoli-Calmettes, 13000 Marseille, France
| | - E Rivin Del Campo
- Service de radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - G Créhange
- Département d'oncologie radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - A-S Dietmann
- Département de radiothérapie, Institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - A Moignier
- Service de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, 44805 Saint-Herblain, France
| |
Collapse
|
11
|
Vendrely V, Rivin Del Campo E, Modesto A, Jolnerowski M, Meillan N, Chiavassa S, Serre AA, Gérard JP, Créhanges G, Huguet F, Lemanski C, Peiffert D. Rectal cancer radiotherapy. Cancer Radiother 2021; 26:272-278. [PMID: 34953708 DOI: 10.1016/j.canrad.2021.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/14/2022]
Abstract
We present the updated recommendations of the French society of oncological radiotherapy for rectal cancer radiotherapy. The standard treatment for locally advanced rectal cancer consists in chemoradiotherapy followed by radical surgery with total mesorectal resection and adjuvant chemotherapy according to nodal status. Although this strategy efficiently reduced local recurrences rates below 5% in expert centres, functional sequelae could not be avoided resulting in 20 to 30% morbidity rates. The early introduction of neoadjuvant chemotherapy has proven beneficial in recent trials, in terms of recurrence free and metastasis free survivals. Complete pathological responses were obtained in 15% of tumours treated by chemoradiation, even reaching up to 30% of tumours when neoadjuvant chemotherapy is associated to chemoradiotherapy. These good results question the relevance of systematic radical surgery in good responders. Personalized therapeutic strategies are now possible by improved imaging modalities with circumferential margin assessed by magnetic resonance imaging, by intensity modulated radiotherapy and by refining surgical techniques, and contribute to morbidity reduction. Keeping the same objectives, ongoing trials are now evaluating therapeutic de-escalation strategies, in particular rectal preservation for good responders after neoadjuvant treatment, or radiotherapy omission in selected cases (Greccar 12, Opera, Norad).
Collapse
Affiliation(s)
- V Vendrely
- Service d'oncologie radiothérapie, Hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France; Inserm U1035, université de Bordeaux, 33000 Bordeaux, France.
| | - E Rivin Del Campo
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires Est Parisien, Sorbonne université, 75020 Paris, France
| | - A Modesto
- Service d'oncologie radiothérapie, institut Claudius-Regaud, université de Toulouse, 31000 Toulouse, France
| | - M Jolnerowski
- Service universitaire de radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 54000 Nancy, France
| | - N Meillan
- Service d'oncologie radiothérapie, hôpital Pitié Salpêtrière, APHP, Sorbonne université, 75013 Paris, France
| | - S Chiavassa
- Service de physique médicale, Institut de cancérologie de l'Ouest (ICO) centre René-Gauducheau, 44805 Saint-Herblain, France
| | - A-A Serre
- Service d'oncologie radiothérapie, centre Léon-Bérard, 69000 Lyon, France
| | - J-P Gérard
- Service d'oncologie radiothérapie, centre Antoine-Lacassagne, université Côte d'Azur, 06000 Nice, France
| | - G Créhanges
- Service d'oncologie radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires Est Parisien, Sorbonne université, 75020 Paris, France
| | - C Lemanski
- Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, Institut du cancer de Montpellier, université de Montpellier, 34000 Montpellier, France
| | - D Peiffert
- Service universitaire de radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 54000 Nancy, France
| |
Collapse
|
12
|
Abstract
We present the update of the recommendations of the French society of oncological radiotherapy on hepatic tumours. Recent technological progress led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumours, as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. The tumour volume, its liver location close to the organs at risk determine the irradiation technique (repositioning method, total dose delivered, dose fractionation regimens). Tumour (and liver) breathing related motions should be taken into account. Strict dosimetric criteria must be observed with particular attention to the dose-volume histograms of non-tumoral liver as well as of the hollow organs, particularly in case of hypofractionated high dose radiotherapy "under stereotaxic conditions". Stereotactic body radiotherapy is being evaluated and is often preferred to radiofrequency for primary or secondary tumours (usually less than 5cm). An adaptation can be proposed, with a conformal fractionated irradiation protocol with or without intensity modulation, for hepatocellular carcinomas larger than 5cm.
Collapse
Affiliation(s)
- E Rio
- Service de radiothérapie, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, 44805 Saint-Herblain, France.
| | - F Mornex
- Département de radiothérapie-oncologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - P Maingon
- Service d'oncologie radiothérapie, groupe hospitalier La Pitié Salpêtrière, Sorbonne université, AP-HP, 47/83, boulevard de l'Hôpital, 75013 Paris, France
| | - D Peiffert
- Service de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - L Parent
- Département d'ingénierie et de physique médicale, institut Claudius-Regaud (ICR), institut universitaire du cancer de Toulouse-Oncopole (IUCT-O), 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| |
Collapse
|
13
|
Crehange G, M'vondo C, Bertaut A, Pereira R, Rio E, Peiffert D, Gnep K, Benezery K, Ronchin P, Noel G, Mineur L, Drouillard A, Blanc J, Rouffiac M, Boustani J. Exclusive Chemoradiotherapy With or Without Radiation Dose Escalation in Esophageal Cancer: Multicenter Phase 2/3 Randomized Trial CONCORDE (PRODIGE-26). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
14
|
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]
|
15
|
Crehange G, M’vondo C, Bertaut A, Pereira R, Rio E, Peiffert D, Gnep K, Benezery K, Ronchin P, Noel G, Mineur L, Drouillard A, Blanc J, Rouffiac M, Boustani J. OC-0336 Dose escalated chemoradiotherapy in esophageal cancer : randomized phase 2/3 CONCORDE trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06869-9] [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: 11/24/2022]
|
16
|
Charra-Brunaud C, Salleron J, Menoux I, Peignaux K, Ducassou A, Petit A, Pommier P, Barillot I, Serre AA, Thomas L, Delannes M, Thibouw D, Antoni D, Renard S, Peiffert D. [Dose optimization in 3D pulsed dose rate brachytherapy for patients with locally advanced cervical cancer: A French multicenter phase II trial]. Cancer Radiother 2021; 26:474-480. [PMID: 34301498 DOI: 10.1016/j.canrad.2021.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 06/02/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE We present the results of the PHRC Tridicol, a prospective French phase II study whose objective was to increase the dose delivered to the target volume during brachytherapy for locally advanced cervical cancers. MATERIAL AND METHODS Eight centers included 48 patients, treated with concomitant radiochemotherapy, then uterovaginal brachytherapy. RESULTS The median follow-up was 63 months. The dose of brachytherapy delivered in biological equivalent dose (EQD2) to 90% of the High Risk CTV (D90 CTV HR) was 80Gy in median dose. The 5-year local control rate (LC) was 84%, close to the hypothesis of 86.7%. The rate of severe complications (grade 3-4) was 23% at 5 years. The rectal dose was correlated with the risk of severe complications. CONCLUSION HR CTV dose was below the target (85Gy) due to low use of parametrial interstitial needles, as the centers did not always have an adequate applicator, or were at the time at the beginning of their learning curve. The 5-year LC rate was improved compared to that of the comparable STIC PDR group (78%) but lower than the retroEMBRACE cohort of GEC ESTRO (89%). The complication rate was higher than in the comparable group of STIC PDR but close to that of retroEMBRACE. Training brachytherapy teams in interstitial implantation or referring patients to referral centers should help improve the therapeutic index of cervical cancer.
Collapse
Affiliation(s)
- C Charra-Brunaud
- Service de radiothérapie, Institut de cancérologie de Lorraine, route de Bourgogne, 54519 Vandœuvre-les-Nancy, France.
| | - J Salleron
- Service de biostatistique, Institut de cancérologie de Lorraine, route de Bourgogne, 54519 Vandœuvre-les-Nancy, France
| | - I Menoux
- Service de radiothérapie, Centre Paul-Strauss, 3, rue de la Porte de l'Hôpital, 67000 Strasbourg, France
| | - K Peignaux
- Service de radiothérapie, Centre GF-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - A Ducassou
- Service de radiothérapie, Institut Claudius-Regaud, IUCT-Oncopole, 20-24, rue du Pont Saint-Pierre, 31300 Toulouse, France
| | - A Petit
- Service de radiothérapie, Institut Bergonié, 229, Cours de l'Argonne, 33000 Bordeaux, France
| | - P Pommier
- Service de radiothérapie, Centre Léon-Berard, 28, Prom.-Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - I Barillot
- Service de radiothérapie, CHRU de Tours, Hôpital Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France
| | - A A Serre
- Service de radiothérapie, Centre Léon-Berard, 28, Prom.-Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - L Thomas
- Service de radiothérapie, Institut Bergonié, 229, Cours de l'Argonne, 33000 Bordeaux, France
| | - M Delannes
- Service de radiothérapie, Institut Claudius-Regaud, IUCT-Oncopole, 20-24, rue du Pont Saint-Pierre, 31300 Toulouse, France
| | - D Thibouw
- Service de radiothérapie, Centre GF-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - D Antoni
- Service de radiothérapie, Centre Paul-Strauss, 3, rue de la Porte de l'Hôpital, 67000 Strasbourg, France
| | - S Renard
- Service de radiothérapie, Institut de cancérologie de Lorraine, route de Bourgogne, 54519 Vandœuvre-les-Nancy, France
| | - D Peiffert
- Service de radiothérapie, Institut de cancérologie de Lorraine, route de Bourgogne, 54519 Vandœuvre-les-Nancy, France
| |
Collapse
|
17
|
Bruand M, Renard S, Salleron J, Meknaci E, Charra-Brunaud C, Peiffert D. Interstitial multi-catheter breast brachytherapy: Technical aspects and experience feedback in a comprehensive cancer center. Cancer Radiother 2021; 26:450-457. [PMID: 34147341 DOI: 10.1016/j.canrad.2021.06.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/08/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To focus on technical aspects of the implementation of interstitial high dose rate brachytherapy, with a step-by-step approach. MATERIALS AND METHODS Patients were selected during multidisciplinary tumor boards, according to inclusion criteria adapted from GEC-ESTRO guidelines. A CT scan was performed a few days before implantation. On pre-implant CT, using surgical scar and clips, surgical and pathological reports, and preoperative images, we delineated the tumor bed to be included in the Clinical Target Volume (CTV), according to GEC ESTRO Recommendations. A 3D virtual implant simulation of the best catheter positions was performed in order to cover the target volume. Implantation was then carried out under local anaesthetic using 3D projections of the catheter inlets and outlets. Dosimetry was performed on post-implantation CT scan. A dose of 34Gy was delivered in 10 fractions. Acute and late side effects, and local control were evaluated 2 and 8 months after treatment. RESULTS Between July 2017 and January 2020, 20 patients were treated with accelerated partial breast irradiation. Dose constraints regarding target volume coverage, overdose, dose homogeneity, conformation index and organs at risk were met in 94.7%, 100%, 63.2%, 0% and 89.5% of the treatment plans, respectively. Grade 1-2 acute adverse events were observed in 21% of patients, with no grade 3-4 events. CONCLUSION The first dosimetric results and early clinical tolerance and efficacy achieved by the implementation of breast interstitial multicatheter brachytherapy in routine clinical practice are very encouraging, and confirm the interest of extending this practice.
Collapse
Affiliation(s)
- M Bruand
- Department of radiotherapy, institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France; Faculté de médecine de Nancy, université de Lorraine, 9, avenue de la Forêt de Haye, 54505 Vandœuvre-lès-Nancy, France.
| | - S Renard
- Department of radiotherapy, institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France
| | - J Salleron
- Biostatistic unit, institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France
| | - E Meknaci
- Department of radiotherapy, institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France
| | - C Charra-Brunaud
- Department of radiotherapy, institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France
| | - D Peiffert
- Department of radiotherapy, institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France
| |
Collapse
|
18
|
Py JF, Salleron J, Courrech F, Beckendorf V, Croisé-Laurent V, Peiffert D, Vogin G, Dietmann AS. Long-term outcome of Stereotactic Body Radiation Therapy for patient with unresectable liver metastases from colorectal cancer. Cancer Radiother 2021; 25:350-357. [PMID: 33618909 DOI: 10.1016/j.canrad.2021.01.004] [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: 12/12/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate clinical outcome and predicting factors of local failures in patients with colorectal cancer treated for unresectable liver metastases with stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS We restrospectively reviewed the medical records of 67 patients treated with the Cyberknife SBRT system for 99 hepatic metastases between January 2007 and December 2015 in our center. In total, 37.5 to 54.0Gy in 3 to 5 fractions were prescribed to the 80% isodose line. Local control (LC), intrahepatic progression incidence, Progression-Free Survival (PFS), Overall Survival (OS) and toxicity were evaluated. RESULTS The median follow-up was 47 months (IQR, 28-59 months). The median OS was 53 months, the 2-year OS and PFS rates were 81.4% and 54.0%. The 1- and 2-year LC rates were 86.6% and 72.4%. In the multivariate analysis, the degree of differentiation was the only prognostic factor for LC (HR 0.31, 95% CI, 0.10-0.98, P=0.046). Margin expansion>5mm was not associated with a better LC (HR 0.72, 95% CI, 0.38-1.37, P=0.317). Performans Status≥2 (HR 3.27, 95% CI, 1.07-9.98, P=0.038), chemotherapy for metastases before SBRT (HR 0.36, 95% CI, 0.18-0.75, P=0.006) and regional lymph node at diagnosis (HR 2.19, 95% CI, 1.09-4.43, P=0.029) were independent prognostic factors for OS. We report 2 cases of grade≥3 toxicity (3.0%) - one grade 3 acute nausea and one grade 3 late gastric ulcer. CONCLUSION Stereotactic body radiation therapy is an effective and well-tolerated treatment that allow high LC for liver metastases from colorectal cancer during the first two years. A prescription dose of 45Gy in 3 fractions to the 80% isodose line with a risk adapted schedule to respect Organ At Risk constraints allows a low rate of toxicity.
Collapse
Affiliation(s)
- J F Py
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France.
| | - J Salleron
- Département de biostatistique et data management, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - F Courrech
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - V Beckendorf
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - V Croisé-Laurent
- Département de radiologie, CHU de Nancy, Vandœuvre-les-Nancy, France
| | - D Peiffert
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - G Vogin
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - A S Dietmann
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| |
Collapse
|
19
|
De Baère T, Pracht M, Rolland Y, Durand-Labrunie J, Nguyen F, Bronowicki J, Vendrely V, Cunha AS, Croisé-Laurent V, Rio E, Le Sourd S, Said P, Gustin P, Perret C, Peiffert D, Deutsch E, Chajon E. PH-0159: NANORAY-103: Phase I/II trial of NBTXR3 activated by SBRT in patients with HCC and liver metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Chargari C, Renard S, Espenel S, Escande A, Buchheit I, Ducassou A, Peiffert D, Hannoun-Lévi JM. [Can stereotactic body radiotherapy replace brachytherapy for locally advanced cervical cancer? French society for radiation oncology statement]. Cancer Radiother 2020; 24:706-713. [PMID: 32753238 DOI: 10.1016/j.canrad.2020.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/11/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/30/2022]
Abstract
Brachytherapy is part of the treatment of locally advanced cervical cancers, accounting for about half of the total delivered dose. The benefit of dose escalation is the most important in advanced cases or if the tumor has responded poorly. The use of interstitial implantations makes it possible to reach doses of the order of 85 to 90Gy (including external beam radiotherapy contribution) in most patients, through image-guided approaches. Brachytherapy delivery is one of the quality criteria for patient care. To date, no data allow us to consider as an alternative the use of external boost through intensity-modulated or stereotactic body radiotherapy. Indeed, the doses delivered to the tumor and the capacity to spare normal tissues remains lower, as compared to what is permitted by brachytherapy. It is therefore appropriate for centers that do not have access to the technique to establish networks with centers where brachytherapy is performed, to allow each patient to have access to the technique. It is also necessary to promote brachytherapy teaching. The issue of reimbursement will be crucial in the coming years to maintain expertise that is today insufficiently valued in its financial aspects, but has a very high added value for patients.
Collapse
Affiliation(s)
- C Chargari
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - S Renard
- Département d'oncologie radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - S Espenel
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - A Escande
- Département d'oncologie radiothérapie, centre Oscar-Lambret, 3, rue Fréderic-Combemale, 59020 Lille, France
| | - I Buchheit
- Département d'oncologie radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - A Ducassou
- Département d'oncologie radiothérapie, institut Claudius-Regaud, 1, avenue Joliot-Curie, 31059 Toulouse, France
| | - D Peiffert
- Département d'oncologie radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - J-M Hannoun-Lévi
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06000 Nice, France
| |
Collapse
|
21
|
Hannoun-Lévi JM, Chand MÈ, Blanchard P, Chargari C, Escande A, Pierrat N, Pommier P, Peiffert D. [Brachytherapy in France in 2020: State of the art and perspectives from the Groupe curiethérapie de la SFRO]. Cancer Radiother 2020; 24:876-881. [PMID: 32576437 DOI: 10.1016/j.canrad.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/18/2020] [Accepted: 03/28/2020] [Indexed: 11/18/2022]
Abstract
Because of its principle and its high proof level clinical results, brachytherapy represents a specific irradiation technique for the treatment of primary tumors as well as some local relapses in pre-irradiated area. After a glory period between the 80's and 90's, brachytherapy has progressively lost its attractiveness. In order to provide a practical solution to this deleterious situation, it is important that guardianships, health care payers, patient associations, specialist doctors and radiation oncologists understand the reasons leading to this harmful state as well as the risks concerned. A teaching judged insufficient, non-adapted value and an aging image of brachytherapy represent the three main reasons of this degradation and constitute the three most important challenges conditioning its maintain in the anticancer treatment arsenal. An adapted communication with radiation oncologists themselves but also with the other scientific societies remains crucial as well as with guardianship and patient associations. It is central that brachytherapy could be recognized in order to make it stronger and accessible for all the patients who could need it.
Collapse
Affiliation(s)
- J M Hannoun-Lévi
- Département de radiothérapie oncologique, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06000 Nice, France; Université Côte-d'Azur, 06000 Nice, France.
| | - M-È Chand
- Département de radiothérapie oncologique, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06000 Nice, France; Université Côte-d'Azur, 06000 Nice, France
| | - P Blanchard
- Département de radiothérapie oncologique, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - C Chargari
- Département de radiothérapie oncologique, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - A Escande
- Département de radiothérapie oncologique, centre Oscar-Lambret, 3, rue Fréderic-Combemale, 59020 Lille, France
| | - N Pierrat
- Unité de physique médicale, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - P Pommier
- Département de radiothérapie oncologique, centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France
| | - D Peiffert
- Département de radiothérapie oncologique, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| |
Collapse
|
22
|
Lam Cham Kee D, Peiffert D, Hannoun-Lévi JM. Brachytherapy boost for prostate cancer: A national survey from Groupe curiethérapie – Société française de radiothérapie oncologique. Cancer Radiother 2019; 23:847-852. [DOI: 10.1016/j.canrad.2019.06.003] [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] [Received: 03/19/2019] [Revised: 05/31/2019] [Accepted: 06/07/2019] [Indexed: 01/26/2023]
|
23
|
Lam Cham Kee D, Peiffert D, Hannoun-Lévi JM. Curiethérapie en complément d’irradiation pour le cancer de prostate : enquête nationale du Groupe curiethérapie–Société française de radiothérapie oncologique. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.073] [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]
|
24
|
Rivin del Campo E, Matzinger O, Haustermans K, Bosset JF, Glynne-Jones R, Winter K, Konski A, Ajani J, Peiffert D, Hannoun-Lévi JM, Puyraveau M, Chakravarthy B, Meadows H, Northover J, Collette L, Christiaens M, Maingon P. Analyse des données regroupées de paramètres de radiothérapie externe d’essais de phase II et III de chimioradiothérapie du cancer de canal anal. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.012] [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]
|
25
|
Bruand M, Renard S, Courrech F, Salleron J, Py JF, Meknaci E, Charra-Brunaud C, Peiffert D. Mise en œuvre de la curiethérapie du sein interstitielle multicathéters à l’Institut de cancérologie de Lorraine : aspects méthodologiques et techniques. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.071] [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: 10/26/2022]
|
26
|
Pracht M, Chajon E, Rolland Y, de Baere T, Nguyen F, Bronowicki JP, Vendrely V, Sa Cunha A, Baumann AS, Croisé-Laurent V, Rio E, Said P, Le Sourd S, Gustin P, Perret C, Peiffert D, Deutsch E. Phase I/II trial of NBTXR3 activated by SBRT in patients with hepatocellular carcinoma or liver metastasis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.082] [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: 11/13/2022] Open
|
27
|
Peiffert D. [Anal channel cancer: customization of dose, volume and breaching]. Cancer Radiother 2019; 23:773-777. [PMID: 31471250 DOI: 10.1016/j.canrad.2019.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
The conservative treatment of squamous cell carcinoma of anal canal by irradiation is recommended as first indication. Despite its rarity, significant improvements were obtained by retrospective or prospective clinical studies these 20 past years, evaluating concomitant chemotherapy and IMRT. Nevertheless, the individualisation of the treatment, over dose distribution, has poor data available. Fractionation remains classic (1.8-2.0Gy/Fr), but the optimal dose level remains under discussion. The strategy concerning the volumes and doses for the prophylactic volumes remains under discussion. This paper will describe the data published, and the recommendations of working Groups, and the main options under evaluation. To conclude, today only the absence of gap is recommended, the benefit of a one-step schedule reducing the treatment time, then increasing local control and survival, but personalised schedules remain under investigation.
Collapse
Affiliation(s)
- D Peiffert
- Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandoeuvre-les-Nancy, France.
| |
Collapse
|
28
|
Rodriguez EC, Pracht M, Rolland Y, De Baere T, Nguyen T, Bronowicki J, Vendrely V, Cunha AS, Baumann A, Croisé-Laurent V, Rio E, Le Sourd S, Gustin P, Perret C, Peiffert D, Deutsch E. Hafnium Oxide Nanoparticles Activated by SBRT for the Treatment of Hepatocellular Carcinoma and Liver Metastasis: A Phase I/II Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.605] [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: 11/16/2022]
|
29
|
De Baere T, Pracht M, Rolland Y, Nguyen F, Bronowicki J, Vendrely V, Cunha AS, Baumann A, Croisé-Laurent V, Rio E, Sourd SL, Gustin P, Perret C, Peiffert D, Deutsch E, Chajon E. Hafnium oxide nanoparticles activated by SBRT: a new interventional radiation therapy approach for the treatment of unresectable liver cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.005] [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: 11/12/2022] Open
|
30
|
Boustani J, Rivin Del Campo R, Blanc J, Peiffert D, Benezery K, Pereira R, Rio E, Le Prisé E, Créhange G, Huguet F. OC-0381 Benchmark case in the ongoing PRODIGE 26 trial : quality assurance of dose escalated radiatherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30801-1] [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]
|
31
|
Chajon E, Pracht M, De Baere T, N’Guyen F, Bronowicki J, Vendrely V, Baumann A, Croisé-Laurent V, Rio E, Rolland Y, Le Sourd S, Gustin P, Perret C, Mornex F, Peiffert D, Merle P, Deutsch E. OC-0281 Phase I/II trial of hafnium oxide nanoparticles activated by SBRT in the treatment of liver cancers. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30701-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
32
|
Charret J, Baumann A, Eschwege P, Moreau J, Bernier V, Falk A, Salleron J, Peiffert D. Prostate-specific antigen bounce in patients treated before 60 years old by iodine 125 brachytherapy for prostate cancer is frequent and not a prognostic factor. Brachytherapy 2018; 17:888-894. [DOI: 10.1016/j.brachy.2018.07.011] [Citation(s) in RCA: 5] [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: 06/14/2018] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/01/2022]
|
33
|
Py JF, Salleron J, Vogin G, Courrech F, Baumard F, Peiffert D, Oldrini G, Faivre JC. Évaluation de la radiothérapie stéréotaxique seule ou associée à une radiothérapie conformationnelle de fractionnement standard dans le traitement des oligométastases osseuses. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.094] [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: 11/29/2022]
|
34
|
Pracht M, Chajon E, de Baere T, Nguyen F, Bronowicki JP, Vendrely V, Baumann AS, Croisé-Laurent V, Rio E, Rolland Y, Le Sourd S, Gustin P, Perret C, Mornex F, Peiffert D, Merle P, Deutsch E. Hepatocellular carcinoma and liver metastasis treated by hafnium oxide nanoparticles activated by stereotactic body radiation therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
35
|
Rouard N, Peiffert D, Rio E, Mahé MA, Delpon G, Marchesi V, Falk A, Salleron J, Serre AA. Radiothérapie conformationnelle avec modulation d’intensité des cancers du canal anal : impact de la délinéation sur le risque de récidive. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.028] [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: 11/25/2022]
|
36
|
Peiffert D, Baumann AS, Serre AA, Vendrely V, Rouard N, Faivre JC, Vogin G. [Anal canal cancer: In the era of intensity-modulated radiotherapy, outstanding issues]. Cancer Radiother 2018; 22:509-514. [PMID: 30181029 DOI: 10.1016/j.canrad.2018.07.131] [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: 07/09/2018] [Accepted: 07/15/2018] [Indexed: 02/07/2023]
Abstract
Intensity-modulated radiotherapy makes possible to optimize the irradiation and spare normal tissues. The toxicity remains important with concomitant chemotherapy often associated. The improvement of MRI and PET-CT define more precisely the target volumes, which need a higher dose, but necessitates to respect the rules of contouring. The treatment is uniform whatever the stage but should be individualized based on clinical stage and tumor response. New paradigms concern biology, staging, volumes and doses, fractionation and combined treatments.
Collapse
Affiliation(s)
- D Peiffert
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; EA 4360 Apemac, université de Lorraine, 9, avenue de la Forêt-de-Haye, 54500 Nancy, France.
| | - A S Baumann
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A A Serre
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Vendrely
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France
| | - N Rouard
- Hôpital Édouard-Hériot, 69000 Lyon, France
| | - J C Faivre
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - G Vogin
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| |
Collapse
|
37
|
Abstract
The main indications of the brachytherapy of head and neck cancers are the limited tumours of the lip, the nose, the oral cavity and the oropharynx. Nasopharynx tumours are nowadays treated by intensity-modulated radiotherapy. This technique can be exclusive, associated with external radiotherapy or postoperative. It can also be a salvage treatment for the second primaries in previously irradiated areas. If the low dose rate brachytherapy rules remain the reference, the pulse dose rate technique allows the prescription of the dose rate and the optimisation of the dose distribution. Results of high dose rate brachytherapy are now published. This paper reports the recommendations of the Gec-ESTRO, published in 2017, and takes into account the data of the historical low dose rate series, and is upgraded with the pulsed-dose rate and high dose rate series.
Collapse
Affiliation(s)
- D Peiffert
- Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511, Vandœuvre-lès-Nancy, France.
| | - B Coche-Dequéant
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combenale, BP 307, 59020 Lille cedex, France
| | - M Lapeyre
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63011 Clermont-Ferrand cedex 1, France
| | - S Renard
- Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511, Vandœuvre-lès-Nancy, France
| |
Collapse
|
38
|
Durand-Labrunie J, Jarraya H, Boleslawski E, Cattan S, Lacornerie T, Peiffert D, Mirabel X. PV-0105: Stereotactic body radiotherapy treatment for hepatocellular carcinoma: A phase II study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30415-8] [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]
|
39
|
Crehange G, Cormier L, Bertaut A, Peiffert D, Bolla M, Chapet O, Rio E, De Crevoisier R, Martin E, Cosset J. EP-1581: Salvage brachytherapy and a rectal spacer in locally recurrent prostate cancer after radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31890-5] [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: 10/14/2022]
|
40
|
Mirjolet C, Charon-Barra C, Ladoire S, Arbez-Gindre F, Bertaut A, Ghiringhelli F, Leroux A, Peiffert D, Borg C, Bosset JF, Créhange G. Tumor lymphocyte immune response to preoperative radiotherapy in locally advanced rectal cancer: The LYMPHOREC study. Oncoimmunology 2017; 7:e1396402. [PMID: 29399395 DOI: 10.1080/2162402x.2017.1396402] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 12/22/2022] Open
Abstract
Introduction: Some studies have suggested that baseline tumor-infiltrating-lymphocytes (TILs), such as CD8+ and FoxP3+ T-cells, may be associated with a better prognosis in colorectal cancer. We sought to investigate modulation of the immune response by preoperative radiotherapy (preopRT) and its impact on survival in locally advanced rectal cancer (LARC). Materials & Methods: We analyzed data for 237 patients with LARC who received RT. Density of TILS (CD8+ and FoxP3+) in intraepithelial (iTILs) and stromal compartments (sTILs) were evaluated from surgery pathological specimens and biopsies performed at baseline. The primary endpoint was to assess the impact of infiltration of the tumor or tumor site after preopRT on progression-free survival (PFS) and overall survival (OS). Secondary endpoints were the impact of dose fractionation scheme on TILs. Results: In univariate analysis, several factors significantly correlated (p<0.05) with PFS and/or OS (T-stage, M-stage, the delay between RT and surgery). A high level of post-treatment FoxP3+ TIL density correlated significantly with a better PFS (p = 0.007). In multivariate analysis, a decrease in the CD8+/FoxP3+ iTILs ratio after preopRT correlated with better PFS and OS (p = 0.049 and p = 0.024, respectively). More particularly, patients with a delta CD8+/FoxP3+ <-3.8 had better PFS and OS. Interestingly, the dose fractionation scheme significantly influenced the CD8+/FoxP3+ ratio after treatment (p = 0.027) with a lower ratio with hypofractionated RT (≥2 Gy). Conclusion: Patients with LARC who had a significant decrease in the CD8+/FoxP3+ ratio after preopRT were more likely to live longer. This ratio needs to be validated prospectively to guide physicians in adjuvant treatment decision-making.
Collapse
Affiliation(s)
- C Mirjolet
- Department of Radiation-Oncology, Centre Georges François Leclerc, Dijon, FRANCE
| | - C Charon-Barra
- Department of Pathology, Centre Georges François Leclerc, Dijon, FRANCE
| | - S Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, FRANCE.,INSERM U866, University of Burgundy, Dijon, France
| | - F Arbez-Gindre
- Department of Pathology, University Hospital Jean Minjoz, Besançon, FRANCE
| | - A Bertaut
- Biostatistics Unit, Centre Georges François Leclerc, Dijon, FRANCE
| | - F Ghiringhelli
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, FRANCE.,INSERM U866, University of Burgundy, Dijon, France
| | - A Leroux
- Department of Pathology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy Cedex France
| | - D Peiffert
- Department of Radiation-Oncology, Institut de Cancérologie de Lorraine Vandoeuvre-les-Nancy CedexFrance
| | - C Borg
- Department of Medical Oncology, University Hospital Jean Minjoz, Besançon, FRANCE.,UMR1098 INSERM/Université de Franche Comté/Etablissement Français du Sang, Besançon, France
| | - J F Bosset
- Department of Radiation-Oncology, University Hospital Jean Minjoz, Besançon, FRANCE
| | - G Créhange
- Department of Radiation-Oncology, Centre Georges François Leclerc, Dijon, FRANCE.,Medical Imaging Group, Laboratory of Electronics, Computer Science and Imaging, (Le2I), University of Burgundy, Dijon, France
| |
Collapse
|
41
|
Pflumio C, Levitchi M, Faivre JC, Royer P, Peiffert D, Beckendorf V. Suivi après radiothérapie des cancers du sein localisés : évaluation des pratiques professionnelles. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.043] [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: 10/18/2022]
|
42
|
Créhange G, Bertaut A, Le Prisé É, Étienne P, Rio E, Pereira R, Noêl G, Bénézery K, Seitz J, Bonnetain F, Peiffert D. Essai de phase II randomisé de chimioradiothérapie exclusive avec ou sans escalade de dose chez des patients atteints de cancer de l’œsophage : concorde (Prodige 26). Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.07.006] [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: 10/18/2022]
|
43
|
Kim S, Francois E, Bidard FC, Samalin E, El Hajbi F, Baba-Hamed N, Dumont S, Pernot S, Peiffert D, Ghiringhelli F, Bouche O, Desrame J, Zoubir M, Parzy A, Smith D, de la Fouchardiere C, Buecher B, Vendrely V, Bonnetain F, Borg C. Docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy in the treatment of metastatic or unresectable locally recurrent anal squamous cell carcinoma: A phase II study of French interdisciplinary GERCOR and FFCD Groups (Epitopes-HPV02 study). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.062] [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: 11/14/2022] Open
|
44
|
Royer P, Salleron J, Vogin G, Taillandier L, Clément-Duchêne C, Klein O, Faivre JC, Peiffert D, Bernier V. [Hypofractionated stereotactic radiotherapy for brain metastasis: Benefit of additional whole brain radiotherapy?]. Cancer Radiother 2017; 21:731-740. [PMID: 28711413 DOI: 10.1016/j.canrad.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 02/01/2017] [Accepted: 02/28/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE To study overall survival, risk of neurological death, local recurrence and development of new brain metastasis in patients treated for brain oligometastases with hypofractionated stereotactic radiotherapy with CyberKnife®, according to the association or not with an additional whole brain irradiation. PATIENTS AND METHODS Institutional retrospective study of 102 patients treated for one to three brain metastasis: 76 with exclusive hypofractionated stereotactic radiotherapy and 26 with hypofractionated stereotactic radiotherapy and whole brain irradiation. Objectives were assessed and compared between these two groups according to the Kaplan-Meier method and Cox model. RESULTS Median follow-up was 18.8 months. There were no difference between exclusive hypofractionated stereotactic radiotherapy and hypofractionated stereotactic radiotherapy with whole brain irradiation for overall survival (respective median 21.5 and 20.1 months), risk of neurological death (respectively 9.2% and 15.4% at one year). At one year: the risk of cerebral progressive disease was greater in the group receiving exclusive hypofractionated stereotactic radiotherapy (respectively 43.4% vs. 26.2%, P=0.043), the risk of local recurrence was 25% versus 17.6% (P=0.28) and the development of new brain metastasis was 23.7% versus 11.5% (P=0.27). After salvage treatments, crude local control was similar in the two groups, respectively 78.6% and 73.5%. Whole brain irradiation has been avoided for 72.4% of patients in the group receving exclusive hypofractionated stereotactic radiotherapy. CONCLUSION Whole brain irradiation improves local control of brain metastatic disease in addition to hypofractionated stereotactic radiotherapy. Sparing whole brain irradiation for salvage treatments only does not affect overall survival or risk of neurological death in selected patients with favourable prognosis.
Collapse
Affiliation(s)
- P Royer
- Département universitaire de radiothérapie-curiethérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France.
| | - J Salleron
- Cellule datamanagement et biostatistiques, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - G Vogin
- Département universitaire de radiothérapie-curiethérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - L Taillandier
- Service de neurologie, université de Lorraine, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, CO 60034, 54035 Nancy, France
| | - C Clément-Duchêne
- Département universitaire d'oncologie médicale, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - O Klein
- Service de neurochirurgie pédiatrique, hôpital d'enfants, université de Lorraine, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - J-C Faivre
- Département universitaire de radiothérapie-curiethérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - D Peiffert
- Département universitaire de radiothérapie-curiethérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Bernier
- Département universitaire de radiothérapie-curiethérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| |
Collapse
|
45
|
Nesseler J, Peiffert D, Vogin G, Nickers P. Cancer, radiothérapie et système immunitaire. Cancer Radiother 2017; 21:307-315. [DOI: 10.1016/j.canrad.2017.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/05/2017] [Accepted: 02/17/2017] [Indexed: 12/20/2022]
|
46
|
Nesseler J, Peiffert D, Vogin G, Nickers P. Cancer, radiothérapie et système immunitaire. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.04.006] [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]
|
47
|
Nesseler J, Peiffert D, Vogin G, Nickers P. Cancer, radiothérapie et système immunitaire. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.04.005] [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]
|
48
|
Gamelon-Bénichou C, Oldrini S, Charra-Brunaud C, Vogin G, Salleron J, Peiffert D. [Comparison of survival and chronic gastrointestinal toxicities in patients with locally advanced cervical cancer, treated by conventional or intensity-modulated radiation technique]. Cancer Radiother 2017; 21:171-179. [PMID: 28457817 DOI: 10.1016/j.canrad.2016.11.007] [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: 09/20/2015] [Revised: 10/28/2016] [Accepted: 11/23/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate prospectively chronic gastrointestinal toxicity in patients with cervical cancer treated with conventional irradiation or with intensity-modulated irradiation (IMRT). PATIENTS AND METHODS Between June 2005 and September 2013, 109 patients underwent external radiotherapy followed by brachytherapy for cervical cancer at the "Institut de Cancérologie de Lorraine". Each patient receiving IMRT was paired with a patient receiving conventional radiotherapy on the following criteria: concomitant chemotherapy, additional nodal dose, treatment of para-aortic lymph node area, age. The toxicity collection was prospective using the RTOG scale. The main objective was to compare the incidence of gastrointestinal toxicity chronic between the two groups. In a second time, the influence of dosimetric parameters on chronic GI toxicity was investigated. Comparisons of acute toxicity, chronic genitourinary toxicities, overall survival, disease-free survival were secondary objectives. RESULTS Sixty-six patients were able to be matched. Overall survival at 36 months was 71% in the conventional radiotherapy group against 73% in the IMRT group (P=0.54). There was no significant difference between the two groups in terms of digestive chronic toxicity (P=0.17), nor in terms acute gastrointestinal toxicities (P=0.6445) and genitourinary (P=0.5724). IMRT spared significantly small bowel (P=0.0006) and rectum (P=0.0046) from 30Gy dose, and bladder from 45Gy (P<0.001). The incidence of genitourinary toxicity was significantly different between the two groups (P=0.03) in favor of conventional radiotherapy. CONCLUSION Our study does not seem to show significant difference in the occurrence of chronic gastrointestinal toxicities between the two groups. Clinical efficacy seems comparable. Larger studies with longer follow-up period should be conducted.
Collapse
Affiliation(s)
- C Gamelon-Bénichou
- Département universitaire de radiothérapie, institut de cancérologie de Lorraine-Alexis-Vautrin, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy cedex, France.
| | - S Oldrini
- Département universitaire de radiothérapie, institut de cancérologie de Lorraine-Alexis-Vautrin, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy cedex, France
| | - C Charra-Brunaud
- Département universitaire de radiothérapie, institut de cancérologie de Lorraine-Alexis-Vautrin, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy cedex, France
| | - G Vogin
- Département universitaire de radiothérapie, institut de cancérologie de Lorraine-Alexis-Vautrin, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy cedex, France
| | - J Salleron
- Cellule data biostatistique, institut de cancérologie de Lorraine-Alexis-Vautrin, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy cedex, France
| | - D Peiffert
- Département universitaire de radiothérapie, institut de cancérologie de Lorraine-Alexis-Vautrin, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy cedex, France
| |
Collapse
|
49
|
Huertas A, Oldrini S, Nesseler JP, Courrech F, Rétif P, Charra-Brunaud C, Peiffert D. FIGO stage IB1 cervical carcinoma: Place and principles of brachytherapy. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.01.007] [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: 11/26/2022]
|
50
|
Huertas A, Oldrini S, Nesseler JP, Courrech F, Rétif P, Charra-Brunaud C, Peiffert D. FIGO stage IB1 cervical carcinoma: Place and principles of brachytherapy. Cancer Radiother 2017; 21:155-163. [DOI: 10.1016/j.canrad.2016.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 09/21/2016] [Accepted: 09/21/2016] [Indexed: 02/06/2023]
|