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Quéro L, Fumagalli I, Benadon B, Mignot F, Guillerm S, Labidi M, Hennequin C. [Place of radiotherapy in the treatment of cutaneous carcinomas]. Cancer Radiother 2021; 25:593-597. [PMID: 34400089 DOI: 10.1016/j.canrad.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/03/2021] [Accepted: 07/25/2021] [Indexed: 11/24/2022]
Abstract
Basal cell carcinomas and cutaneous squamous cell carcinomas are among the most common cancerous tumors in the world. Their treatment is most often based on surgery. Adjuvant radiotherapy may be indicated in case of risk factors for recurrence or as an alternative to surgery if surgery is not feasible due to the patient's advanced age and/or co-morbidities or as an alternative to potentially mutilating surgery. Radiotherapy is also part of the therapeutic arsenal for rarer skin tumors such as Merkel cell carcinoma, cutaneous lymphomas, Kaposi's disease and cutaneous adnexal carcinomas.
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Affiliation(s)
- L Quéro
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France.
| | - I Fumagalli
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France
| | - B Benadon
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France
| | - F Mignot
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France
| | - S Guillerm
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France
| | - M Labidi
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France
| | - C Hennequin
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France
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Fabien M, Schernberg A, Gouy S, Maulard A, Alexandra L, Genestie C, Pierre A, Kissel M, Fumagalli I, Pautier P, Deutsch E, Haie-Meder C, Morice P, Chargari C. PD-0655: Comprehensive analysis of patient outcome after local relapse of locally advanced cervical cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00677-0] [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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3
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Bronsart E, Petit C, Gouy S, Bockel S, Espenel S, Kumar T, Fumagalli I, Maulard A, Ayachy RE, Genestie C, Leary A, Pautier P, Morice P, Haie-Meder C, Chargari C. Evaluation of adjuvant vaginal vault brachytherapy in early stage cervical cancer patients. Cancer Radiother 2020; 24:860-865. [PMID: 33129715 DOI: 10.1016/j.canrad.2020.10.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/12/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Adjuvant external beam radiotherapy (EBRT) was shown to decrease pelvic relapses in patients with an early stage cervical cancer and intermediate-risk histopathological prognostic factors, at the cost of increased bowel morbidity. We examined the feasibility and results of adjuvant brachytherapy alone as an alternative to EBRT in this situation. PATIENTS AND METHODS Medical records of consecutive patients receiving adjuvant brachytherapy between 1991 and 2018 for an early stage cervical cancer were examined. Patients were included if they presented a pT1a2N0 or pT1b1N0 disease following radical colpohysterectomy. Adjuvant vaginal wall brachytherapy (without EBRT) was indicated because of a tumor size≥2cm and/or presence of lymphovascular space invasion (LVSI). Patients received 60Gy to 5mm of the vaginal wall, through low-dose or pulse-dose rate technique. Patients' outcome was examined for disease control, toxicities and prognostic factors. RESULTS A total of 40 patients were included. Eight patients (20%) had LVSI, 26 patients (65%) had a tumor size≥2cm. With median follow-up time of 42.0 months, 90% of patients were in complete remission and four patients (10%) experienced tumor relapse, all in the peritoneal cavity, and associated with synchronous pelvic lymph node failure in 2/4 patients. No vaginal or isolated pelvic nodal failure was reported. At 5 year, overall survival was 83.6% (CI95%: 67.8-100%) and disease-free survival was 85.1% (CI95%: 72.6-99.9%). In univariate analysis, probability of relapse correlated with tumor size≥3cm (P=0.004). No acute or late toxicity grade more than 2 was reported. CONCLUSION Brachytherapy alone was a well-tolerated adjuvant treatment for selected patients with intermediate risk factors. The risk of relapse in patients with tumor size≥3cm was however high, suggesting that EBRT is more appropriate in this situation.
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Affiliation(s)
- E Bronsart
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - C Petit
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - S Gouy
- Department of Gynecologic Surgery, Gustave-Roussy, Villejuif, France
| | - S Bockel
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - S Espenel
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - T Kumar
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - I Fumagalli
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - A Maulard
- Department of Gynecologic Surgery, Gustave-Roussy, Villejuif, France
| | - R El Ayachy
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France
| | - C Genestie
- Department of Pathology, Gustave-Roussy, Villejuif, France
| | - A Leary
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - P Pautier
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - P Morice
- Department of Gynecologic Surgery, Gustave-Roussy, Villejuif, France
| | - C Haie-Meder
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France; GIE Charlebourg, groupe Amethyst, 65, avenue Foch, 92250 La-Garenne-Colombes, France
| | - C Chargari
- Department of Radiation Oncology, Gustave-Roussy, Paris-Saclay University, Villejuif, France; French Military Health Academy, Paris, France; Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France.
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4
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Espenel S, Kissel M, Garcia MA, Schernberg A, Gouy S, Bockel S, Limkin E, Fabiano E, Meillan N, Magné N, Leary A, Pautier P, Morice P, Fumagalli I, Haie-Meder C, Chargari C. Implementation of image-guided brachytherapy as part of non-surgical treatment in inoperable endometrial cancer patients. Gynecol Oncol 2020; 158:323-330. [PMID: 32475773 DOI: 10.1016/j.ygyno.2020.05.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/28/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study assessed outcomes of inoperable endometrial cancer (IEC) patients treated with definitive external beam radiation therapy (EBRT) followed by a 3D image-guided brachytherapy boost. METHODS All consecutive patients treated with EBRT followed by 3D image-guided brachytherapy for IEC were retrospectively included. EBRT delivered a dose of 45Gy. Then, patients had an uterovaginal brachytherapy guided by 3D imaging. Clinical target volume (CTVBT) included the whole uterus and the initial disease extent. Gross tumour volume (GTVres) included the residual disease at time of brachytherapy. RESULTS Twenty-seven patients were identified. Causes of inoperability were comorbidities (37%) or tumour loco regional extent (63%). Including EBRT and brachytherapy, the median D90 (minimal dose delivered to 90% of the volume) was 60.7 GyEQD2 (IQR = 56.4-64.2) for the CTVBT, and was 73.6 GyEQD2 (IQR = 64.1-83.7) for the GTVres. The median overall treatment time was 50 days (IQR = 46-54). The mean follow-up was 36.5 months (SD = 30.2). The cumulative incidence of local, pelvic and distant failures was 19% (n = 5), 7% (n = 2) and 26% (n = 7), respectively. Five-year overall survival was 63% (95% CI = 43-91). Late urinary and gastro intestinal toxicities ≥ grade 2 were reported in four (15%) and two patients (7%) respectively. No vaginal toxicity ≥ grade 2 was reported. CONCLUSIONS EBRT followed by intracavitary brachytherapy seems to be an effective option for IEC. The implementation of 3D concepts at time of brachytherapy may contribute to high local control probability and low toxicity profile. Large scale retrospective or prospective data are needed to confirm these early data.
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Affiliation(s)
- S Espenel
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - M Kissel
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - M A Garcia
- Department of Public Health, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint-Priest-en-Jarez, France
| | - A Schernberg
- Department of Radiation Oncology, Institut Curie, 26 Rue d'Ulm, 75005 Paris, France
| | - S Gouy
- Department of Surgery, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - S Bockel
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - E Limkin
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - E Fabiano
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - N Meillan
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - N Magné
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint-Priest-en-Jarez, France.
| | - A Leary
- Department of Medical Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - P Pautier
- Department of Medical Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - P Morice
- Department of Surgery, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France; Paris Saclay University, Kremlin Bicêtre, 63 Rue Gabriel Péri, 94270 Le Kremlin-Bicêtre, France.
| | - I Fumagalli
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - C Haie-Meder
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
| | - C Chargari
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800 Villejuif, France; Paris Saclay University, Kremlin Bicêtre, 63 Rue Gabriel Péri, 94270 Le Kremlin-Bicêtre, France; Institut de Recherche Biomédicale des Armées, D19, 91220 Brétigny sur Orge, France.
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5
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Mignot F, Gouy S, Schernberg A, Bockel S, Espenel S, Maulard A, Leary A, Genestie C, Annede P, Kissel M, Fumagalli I, Pautier P, Deutsch E, Haie-Meder C, Morice P, Chargari C. Comprehensive analysis of patient outcome after local recurrence of locally advanced cervical cancer treated with concomitant chemoradiation and image-guided adaptive brachytherapy. Gynecol Oncol 2020; 157:644-648. [PMID: 32173045 DOI: 10.1016/j.ygyno.2020.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/29/2019] [Accepted: 03/02/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Since dose escalation allowed by image-guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer (LACC), local relapses have become a rare event. Only scarce data are available on the outcome of patients experiencing a local relapse after IGABT. METHODS Between 2004 and 2016, all consecutive patients treated at Gustave Roussy Institute for LACC and receiving concomitant chemoradiation and IGABT were analysed. Clinical and treatment-related prognostic factors for survival after local relapse were searched, in order to potentially identify patients requiring salvage treatment. RESULTS Two hundred and fifty-nine patients were treated during this period. With a median follow-up of 4.1 years, 10.8% (n = 28) had a local relapse. Among these patients, 53.6% had synchronous lymph nodes or distant metastatic relapse and only 13 patients (5% of all patients) had isolated local relapse. After local relapse, median survival was 47 months and three patients were alive at last follow-up. Only three patients with local relapse could receive salvage surgery (10.7%). Metastases occurrence and pelvic wall involvement were the main contraindications (67.9%) for salvage surgery. Among the three patients treated with surgery, two are still alive at last follow-up without significant complication. Improved survival was observed among the two patients who could have surgery (p = .02). Local progression led to serious symptoms in 75% of patients. Only the time interval between brachytherapy and relapse (<1 year) was prognostic for 2-year overall survival (p = .005). CONCLUSION Salvage surgery is feasible in a very low number of highly selected patients with local relapse following IGABT. Local failure is a major cause of severe local symptoms, confirming that every effort should be done to achieve long-term local control through dose escalation.
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Affiliation(s)
- F Mignot
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France.
| | - S Gouy
- Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - A Schernberg
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - S Bockel
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - S Espenel
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - A Maulard
- Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - A Leary
- Department of Medical Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - C Genestie
- Department of Pathology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - P Annede
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - M Kissel
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - I Fumagalli
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - P Pautier
- Department of Medical Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - E Deutsch
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - C Haie-Meder
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - P Morice
- Department of Surgery, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - C Chargari
- Brachytherapy Unit, Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France; French Military Health Services Academy, Paris, France; Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France
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6
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Kumar T, Schernberg A, Busato F, Laurans M, Fumagalli I, Dumas I, Deutsch E, Haie-Meder C, Chargari C. Correlation between pelvic bone marrow radiation dose and acute hematological toxicity in cervical cancer patients treated with concurrent chemoradiation. Cancer Manag Res 2019; 11:6285-6297. [PMID: 31372035 PMCID: PMC6636180 DOI: 10.2147/cmar.s195989] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/25/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate the association between pelvic bone marrow (BM) dose volume parameters and probability of acute hematological toxicity (HT), a cohort of cervical cancer patients receiving definitive chemoradiation (CRT) was assessed. Materials and methods Medical records of patients treated by CRT (45 Gy in 25 fractions, without dose constraints applied to the BM) were reviewed. Baseline and weekly hematological parameters were collected. BM was retrospectively delineated and divided into sub-sites: iliac crests, lower pelvis, lumbosacral region. BM volumes (V) receiving 5, 10, 20, 30, 40 Gy (V5, V10, V20, V30, V40, respectively) and mean dose (Dm) were calculated. Logistic regression was used to analyze associations between HT and dose-volume histograms parameters. Results 114 patients were included. 75.4% were treated with 3D radiation therapy and 24.6% were receiving intensity modulated radiation therapy (IMRT). Neither age, chemotherapy regimen (cisplatin vs carboplatin), number of chemotherapy cycles, performance status, body mass index, or para-aortic irradiation were associated with HT. In univariate analysis, more frequent grade 3+ leukopenia was found in the IMRT group (odds ratio [OR]: 3.5; 95% CI, 1.4–9.1; p=0.007). In multivariate analysis, grade 4 HT was associated with lower pelvis V5>95% (OR 4.1; 95% CI, 1.6–14. p=0.02), lower pelvis V20>45% (OR 3.5; 95% CI, 1.1–13.4; p=0.05), total pelvic bone V20>65%, and iliac crests Dm >31 Gy (OR 4.5; 95% CI, 1.4–14.7; p=0.02). Conclusion The following dose constraints could be proposed to decrease acute HT risk: lower pelvis V5<95%, lower pelvis V20≤45%, total pelvic bone V20<65%, and iliac crests Dm <31 Gy.
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Affiliation(s)
- T Kumar
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France.,Radiotherapy Department, University Hospital of Grenoble, Grenoble, France
| | - A Schernberg
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - F Busato
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - M Laurans
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - I Fumagalli
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - I Dumas
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - E Deutsch
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - C Haie-Meder
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France
| | - C Chargari
- Brachytherapy Unit, Gustave Roussy, Cancer Campus, Villejuif, France.,Radiotherapy Department, Gustave Roussy, Villejuif, France.,Departement 'Effets Biologiques des Radiations', Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France.,French Military Health Academy, Ecole du Val-de-Grâce, Paris, France
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Kissel M, Chirat E, Annede P, Burtin P, Fumagalli I, Bronsart E, Mignot F, Schernberg A, Dumas I, Haie-Meder C, Chargari C. OC-0431 Esophageal brachytherapy: Institut Gustave Roussy’s experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30851-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Quéro L, Gilardin L, Fumagalli I, Martin V, Guillerm S, Bauduceau O, Kirova YM, Hennequin C, Brice P. Anti-PD-1 immunotherapy in combination with sequential involved-site radiotherapy in heavily pretreated refractory Hodgkin lymphoma. Cancer Radiother 2019; 23:132-137. [PMID: 30733172 DOI: 10.1016/j.canrad.2018.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/03/2018] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to assess efficacy and tolerance of anti-programmed death (PD)-1 immunotherapy in combination with sequential involved-site radiotherapy in heavily pretreated refractory Hodgkin lymphoma. In this case series, we reported the outcome of four heavily pretreated patients with refractory Hodgkin lymphoma treated by anti-PD-1 immunotherapy and involved site radiation therapy. After a median follow-up of 13-month, all patients were alive with complete metabolic response. After radiotherapy, all four patients experienced lung toxicity, which was resolved after antibiotherapy with or without corticosteroid treatment. Anti-PD-1 immunotherapy followed by involved-site radiotherapy is feasible and showed very encouraging results in heavily pretreated patients.
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Affiliation(s)
- L Quéro
- Radiation oncology department, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - L Gilardin
- Department of haemato-oncology, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - I Fumagalli
- Radiation oncology department, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - V Martin
- Radiation oncology department, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - S Guillerm
- Radiation oncology department, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - O Bauduceau
- Radiation oncology department, Hartmann Oncology Radiotherapy Group, 4, rue Kléber, CS 90004, 92309 Levallois-Perret cedex, France
| | - Y M Kirova
- Radiation oncology department, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - C Hennequin
- Radiation oncology department, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - P Brice
- Department of haemato-oncology, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Schernberg A, Bockel S, Fumagalli I, Annede P, Escande A, Mignot F, Kissel M, Morice P, Deutsch E, Haie-Meder C, Chargari C. Tumor Shrinkage during Chemoradiation in Locally Advanced Cervical Cancer Patients: Prognostic Significance, and Impact for Image-Guided Adaptive Brachytherapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.143] [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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10
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Bibault JE, Denis F, Roué A, Gibon D, Fumagalli I, Hennequin C, Barillot I, Quéro L, Paumier A, Mahé MA, Servagi Vernat S, Créhange G, Lapeyre M, Blanchard P, Pointreau Y, Lafond C, Huguet F, Mornex F, Latorzeff I, de Crevoisier R, Martin V, Kreps S, Durdux C, Antoni D, Noël G, Giraud P. [Siriade 2.0: An e-learning platform for radiation oncology contouring]. Cancer Radiother 2018; 22:773-777. [PMID: 30360973 DOI: 10.1016/j.canrad.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/23/2018] [Accepted: 02/08/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE In 2008, the French national society of radiation oncology (SFRO) and the association for radiation oncology continued education (AFCOR) created Siriade, an e-learning website dedicated to contouring. MATERIAL AND METHODS Between 2015 and 2017, this platform was updated using the latest digital online tools available. Two main sections were needed: a theoretical part and another section of online workshops. RESULTS Teaching courses are available as online commented videos, available on demand. The practical section of the website is an online contouring workshop that automatically generates a report quantifying the quality of the user's delineation compared with the experts'. CONCLUSION Siriade 2.0 is an innovating digital tool for radiation oncology initial and continuous education.
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Affiliation(s)
- J-E Bibault
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France
| | - F Denis
- Service de radiothérapie, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - A Roué
- Institut national des sciences et techniques nucléaires, centre CEA de Saclay, D36, 91191 Gif-sur-Yvette, France
| | - D Gibon
- Aquilab, parc Eurasanté, biocentre Fleming, 250, rue Salvador-Allende, 59120 Loos, France
| | - I Fumagalli
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - C Hennequin
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - I Barillot
- Service d'oncologie radiothérapie, centre universitaire de cancérologie Henry-S.-Kaplan, 2, boulevard Tonnellé, 37044 Tours, France; Université François-Rabelais, 2, boulevard Tonnellé, 37044 Tours, France
| | - L Quéro
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - A Paumier
- Service d'oncologie radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Professeur-Jacques-Monod, 44805 Saint-Herblain, France
| | - M-A Mahé
- Service d'oncologie radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Professeur-Jacques-Monod, 44805 Saint-Herblain, France
| | - S Servagi Vernat
- Service d'oncologie radiothérapie, institut Jean-Godinot, 1, rue Koenig, 51100 Reims, France
| | - G Créhange
- Service d'oncologie radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - M Lapeyre
- Service d'oncologie radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63011 Clermont-Ferrand, France
| | - P Blanchard
- Service d'oncologie radiothérapie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Y Pointreau
- Service de radiothérapie, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - C Lafond
- Service de radiothérapie, centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires de l'Est parisien, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, 4, rue de la Chine, 75020 Paris, France
| | - F Mornex
- Service d'oncologie radiothérapie, CHU Lyon Sud, 65, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - I Latorzeff
- Service d'oncologie radiothérapie, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
| | - R de Crevoisier
- Service d'oncologie radiothérapie, centre Eugène-Marquis, avenue de la Bataille-Flandre-Dunkerque, 35700 Rennes, France
| | - V Martin
- Service d'oncologie radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefau, 75010 Paris, France
| | - S Kreps
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France
| | - C Durdux
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Sorbonne Cité, 20, rue Leblanc, 75015 Paris, France.
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Fumagalli I, Haie-Méder C, Chargari C. 3D brachytherapy for cervical cancer: New optimization ways. Cancer Radiother 2018; 22:345-351. [DOI: 10.1016/j.canrad.2017.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 01/14/2023]
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Haie-Méder C, Maroun P, Fumagalli I, Lazarescu I, Dumas I, Martinetti F, Chargari C. Pourquoi la curiethérapie reste-t-elle indispensable en 2017 ? Cancer Radiother 2018; 22:307-311. [DOI: 10.1016/j.canrad.2017.11.009] [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: 11/13/2017] [Accepted: 11/15/2017] [Indexed: 10/16/2022]
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Viaroli P, Naldi M, Christian RR, Fumagalli I. The role of macroalgae and detritus in the nutrient cycles in a shallow-water dystrophic lagoon. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/03680770.1992.11900319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hennequin C, Fumagalli I, Martin V, Quero L. [Combination of radiotherapy and androgen deprivation therapy for localized prostate cancer]. Cancer Radiother 2017; 21:462-468. [PMID: 28870416 DOI: 10.1016/j.canrad.2017.07.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/02/2017] [Indexed: 10/18/2022]
Abstract
Combination of radiotherapy and androgen deprivation is now considered as the standard of care for patients with a localized prostate cancer but poor prognosis factors. Two groups of randomized trials have led to this recommendation: some have compared radiotherapy alone versus hormonal treatment and radiotherapy: these trials demonstrated, now with a long follow-up, an improvement in 10-year survival for the combined treatment. Three recent trials compared androgen deprivation alone or combined with radiotherapy; a benefit in survival was also demonstrated in favour of the combination. Some questions remained concerning the optimal duration of hormonal treatment, in view of its potential side effects. Patients in the intermediate prognostic groups could receive a short-term androgen deprivation, but those with a high Gleason score must be treated with a long-term hormonal treatment. Modalities of radiotherapy, regarding volumes and dose must also be précised in the next years.
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Affiliation(s)
- C Hennequin
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France.
| | - I Fumagalli
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France
| | - V Martin
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France
| | - L Quero
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France
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Guillerm S, Bourstyn E, Itti R, Fumagalli I, Martin V, Cahen-Doidy L, Quero L, Giacchetti S, Cuvier C, Espié M, Hennequin C. EP-1150: Preliminary results of Intra-Operative RadioTherapy in old women with good prognostic features. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31586-4] [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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Abstract
Extracranial stereotactic radiotherapy is booming. The development and spread of dedicated accelerators coupled with efficient methods of repositioning can now allow treatments of mobile lesions with moderate size, with high doses per fraction. Intuitively, except for the prostate, pelvic tumours, often requiring irradiation of regional lymph node drainage, lend little to this type of treatment. However, in some difficult circumstances, such as boost or re-radiation, stereotactic irradiation condition is promising and clinical experiences have already been reported.
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Affiliation(s)
- R Mazeron
- Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - I Fumagalli
- Département universitaire de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combenale, BP 307, 59020 Lille cedex, France
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Fumagalli I, Cordoba A, Belot-Cheval V, Kramar A, Lartigau E, Jumelle C, Nickers P. PO-1006: Is MRI brachytherapy mandatory when boosting small residual cervical tumors after high doses external beam therapy ? Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31124-5] [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: 10/23/2022]
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Fumagalli I, Faivre JC, Thureau S, Bibault JE, Diaz O, Leroy T, Pichon B, Riou O, Fournier C, Hannoun-Lévi JM, Peiffert D. État des lieux de la formation des internes français d’oncologie radiothérapie en curiethérapie. Cancer Radiother 2014; 18:28-34. [DOI: 10.1016/j.canrad.2013.07.150] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 07/19/2013] [Accepted: 07/24/2013] [Indexed: 12/01/2022]
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Thureau S, Challand T, Bibault JE, Biau J, Cervellera M, Diaz O, Faivre JC, Fumagalli I, Leroy T, Lescut N, Martin V, Pichon B, Riou O, Dubray B, Giraud P, Hennequin C. Delegation of medical tasks in French radiation oncology departments: Current situation and impact on residents’ training. Cancer Radiother 2013; 17:370-7. [DOI: 10.1016/j.canrad.2013.07.144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/15/2013] [Indexed: 11/15/2022]
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Bibault J, Lacornerie T, Dewas S, Fumagalli I, Jerraya H, Lartigau E, Mirabel X. Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: A Prognostic Factors Analysis. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.864] [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: 10/27/2022]
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Fumagalli I, Bibault J, Dewas S, Kramar A, Mirabel X, Prevost B, Lacornerie T, Jerraya H, Lartigau E. Robotic Stereotactic Body Radiation Therapy for Patients With Pulmonary and Hepatic Oligometastases. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2191] [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: 10/27/2022]
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Bibault J, Lacornerie T, Dewas S, Fumagalli I, Jerraya H, Lartigau É, Mirabel X. Radiothérapie stéréotaxique de carcinome hépatocellulaire : analyse multifactorielle des facteurs pronostiques. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.015] [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: 10/27/2022]
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Fumagalli I, Bibault J, Dewas S, Kramar A, Lacornerie T, Jarraya H, Prévost B, Mirabel X, Lartigau É. Oligométastases hépatiques et pulmonaires : radiothérapie stéréotaxique robotisée. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dewas S, Mirabel X, Kramar A, Jarraya H, Lacornerie T, Dewas-Vautravers C, Fumagalli I, Lartigau É. [Stereotactic body radiation therapy for liver primary and metastases: the Lille experience]. Cancer Radiother 2011; 16:58-69. [PMID: 22209710 DOI: 10.1016/j.canrad.2011.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 06/17/2011] [Accepted: 06/29/2011] [Indexed: 01/06/2023]
Abstract
PURPOSE The CyberKnife(®) system is a recent radiation therapy technique that allows treatment of liver lesions with real-time tracking. Because of its high precision, the dose administered to the tumor can be increased. We report Oscar-Lambret Cancer Centre experience in the treatment of primary and secondary liver lesions. PATIENTS AND METHODS It is a retrospective study analyzing all the patients who have been treated for their liver lesions since July 2007. A hundred and twenty patients have been treated: 42 for hepatocellular carcinoma, 72 for liver metastases and six for cholangiocarcinoma. Gold seeds need to be implanted before the treatment and are used as markers to follow the movement of the lesion due to respiration. On average, the treatment is administered in three to four sessions over 12 days. A total dose of 40 to 45 Gy at the 80% isodose is delivered. Local control and overall survival analysis with Log-rank is performed for each type of lesion. RESULTS Treatment tolerance is good. The most common toxicities are of digestive type, pain and asthenia. Six gastro-duodenal ulcers and two radiation-induced liver disease (RILD) were observed. At a median follow-up of 15 months, the local control rate is respectively of 80.4% and 72.5% at 1 and 2 years. Overall survival is 84.6 and 58.3% at 1 and 2 years. The local control is significantly better for the hepatocellular carcinoma and overall survival is significantly better for liver metastases (P<0.05). The local control rate and overall survival at 1 year for cholangiocarcinoma is 100%. CONCLUSION CyberKnife(®) is a promising technique, well tolerated, with tumoral local control rates comparable to other techniques. Its advantage is that it is very minimally invasive delivered as an outpatient procedure in a frail population of patient (disease, age).
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Affiliation(s)
- S Dewas
- Département universitaire de radiothérapie, CLCC Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France.
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Fumagalli I, Faivre JC, Bibault JE, Diaz O, Lévy A, Liem X, Riou O, Thureau S, Hannoun-Lévi JM, Peiffert D. Évaluation de la formation à la curiethérapie des jeunes oncologues radiothérapeutes français. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dewas S, Mirabel X, Kramar A, Jarraya H, Lacornerie T, Dewas-Vautravers C, Fumagalli I, Lartigau É. Radiothérapie stéréotaxique hépatique par CyberKnife® : résultats chez 120 patients. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.017] [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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Fumagalli I, Dewas S, Bibault J, Mirabel X, Kramar A, Jarraya H, Lacornerie T, Dewas-Vautravers C, Lartigau E. Stereotactic radiation therapy for liver metastases from colorectal cancer: Predictors for outcome. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14013] [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: 11/20/2022] Open
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Vanhuyse M, Penel N, Caty A, Fumagalli I, Alt M, Zini L, Adenis A. Brain metastasis in metastatic renal cell carcinoma: Predictive factors of occurrence and survival with or without antiangiogenic therapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
394 Background: We analyzed renal cell carcinoma (RCC) brain metastasis (BM) risk factors and compared BM occurrence in advanced RCC treated with or without antiangiogenic agents (AAA). Methods: Data from all consecutive metastatic RCC patients (pts) treated in the Northern France Cancer Center (Centre Oscar Lambret, Lille) between 1995 and 2008 were reviewed. Eligible pts had histologically confirmed advanced RCC without synchronous BM at the time of metastasis diagnosis. Bellini duct and neuroendocrine carcinoma and sarcoma were excluded. AAA were sorafenib, sunitinib, bevacizumab, temsirolimus, and everolimus. Characteristics of the two groups, treated with or without AAA, were compared with a Fisher exact test. Impact of AAA on overall survival (OS) and BM-free survival (BMFS) was explored by Kaplan-Meier method and adjusted to confounders parameters in a Cox model. Results: A total of 199 pts with advanced RCC were identified, 51 treated with AAA and 148 treated without AAA. The median follow-up duration was 40 months. BM occurred in 35 pts. As expected in this retrospective analysis, characteristics between AAA treated and non AAA treated groups were unbalanced for 11 parameters including age, Motzer prognostic factors, performance status and favoring better prognostic factors in the AAA treated group. The median overall survival was 24 months. Overall survival was higher in patients with AAA versus patients without AAA (31 versus 18 months, hazard ratio (HR) 0.67 [0.45–0.97], p=0.038). The AAA were not associated with better BMFS (HR=0.58 [0.26–1.30], p=0.187). The alkaline phosphatase was an independent prognostic factor for BM (p=0.05). In multivariate cox model, AAA treatment improved the OS (adjusted HR 0.60 [0.38–0.94] but not the BMFS (adjusted HR 0.53 [0.22–1.32]. Conclusions: In this retrospective single center study, elevated alkaline phosphatase is a predictive factor for brain metastasis in metastatic RCC. AAA significantly improved overall survival in advanced RCC without any significant impact on brain-metastasis-free survival. No significant financial relationships to disclose.
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Affiliation(s)
- M. Vanhuyse
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - N. Penel
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - A. Caty
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - I. Fumagalli
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - M. Alt
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - L. Zini
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - A. Adenis
- Centre Oscar Lambret, Lille, France; Centre Hospitalier Régional Universitaire de Lille, Lille, France
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Liem X, Blanchard P, Pointreau Y, Cadwallader JS, Lévy A, Fumagalli I, Dewas S, Cuenca X, Leysalle A. La recherche chez les internes français d’oncologie radiothérapie : état des lieux 2010. Cancer Radiother 2010. [DOI: 10.1016/j.canrad.2010.07.594] [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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Abstract
This is an outcomes pharmacodynamic study using Nonsteroidal antiinflammatory agents, particularly acetylsalicylic acid (ASA), have been shown useful in various cardiovascular disorders, but they can be a major cause of iatrogenic gastrointestinal injury. Newer NSAIDs such as indobufen, an inhibitor of platelet aggregation that acts by reversibly inhibiting the platelet cyclooxygenase enzyme, have proven to be as effective as the older NSAIDs and appear to have a better gastrointestinal tolerability profile. When the gastroduodenal tolerability of 10 days of oral treatment with indobufen or ASA was assessed in healthy adult volunteers using endoscopic evaluation and the modified score scale of Lanza, only 1 of 18 (6%) volunteers who received indobufen had an increased erosion score at the completion of therapy, compared with 6 of 18 volunteers who received ASA (33%). Overall, both drugs were well tolerated. These results suggest that indobufen has a lower incidence of gastrointestinal effects than other NSAIDs and should be useful in the management of patients with cardiovascular disease.
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Affiliation(s)
- A Marzo
- Institute for Pharmacokinetic and Analytical Studies, Ligornetto, Switzerland
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Graber R, Farine JC, Fumagalli I, Tatti V, Losa GA. Apoptosis and oxidative status in peripheral blood mononuclear cells of diabetic patients. Apoptosis 2004; 4:263-70. [PMID: 14692396 DOI: 10.1023/a:1026408409916] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We have compared the concentrations of intracellular glutathione (GSH), glutathione-dependent antioxidative enzymes, the cell death rate and immunophenotype profile of peripheral blood mononuclear cells (PBMC) from healthy donors and from patients with insulin-dependent type II (NIDDM) diabetes mellitus. The IDDM and NIDDM patients had above-normal absolute lymphocyte counts, whereas the percentages of CD3, CD4 adn CD8 T lymphocytes were significantly reduced. In contrast, the absolute number and percentage of B lymphocytes was higher in diabetic patients than in healthy donors. The low intracellular reduced glutathione(GSH) and the unbalanced profile of key enzymes involved in GSH metabolism, gamma-glutamyltransferase (gamma-GT) and glutathione-S-transferase (GST), account for the increased oxidative status of PBMC from diabetic patients. The plasma membranes of PBMC for diabetic patients were less permeable to propidium iodide than those of PBMC from healthy donors, indicating that the apoptotic cell death rate was lower in the cells from diabetic patients. These differences are potentially useful markers of pathogenic metabolic changes which occur during clinical diabetes and if they are confirmed could be use dot identify the onset of diabetes.
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Affiliation(s)
- R Graber
- Laboratorio di Patologia Cellulare, Istituto Cantonale di Patologia, Locarno, Switzerland
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Körner T, Schütze K, van Leendert RJM, Fumagalli I, Costa Neves B, Bohuschke M, Gatz G. Comparable efficacy of pantoprazole and omeprazole in patients with moderate to severe reflux esophagitis. Results of a multinational study. Digestion 2003; 67:6-13. [PMID: 12743434 DOI: 10.1159/000070201] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2002] [Accepted: 02/20/2003] [Indexed: 02/04/2023]
Abstract
AIM To compare the efficacy and tolerability of pantoprazole 40 mg and omeprazole MUPS 40 mg in patients with moderate to severe gastroesophageal reflux disease (GERD). METHODS In this randomized, double-blind, parallel-group, multicenter study conducted in Austria, Germany, Portugal, Switzerland and The Netherlands, patients with endoscopically confirmed moderate to severe GERD (Savary/Miller esophagitis grade II/III) were enrolled. They received a once-daily dose of either 40 mg pantoprazole or 40 mg omeprazole MUPS. Healing was determined by endoscopy after 4 weeks of treatment. If patients were not healed, treatment was extended for another 4 weeks. An additional endoscopy was performed in these cases after 8 weeks of treatment. Healing was determined by endoscopy after 4 and 8 weeks. In addition, treatment effect on symptoms was evaluated by the investigator using a questionnaire assessing heartburn, reflux regurgitation and pain on swallowing at each visit, as well as by a self-administered questionnaire comprising further 24 gastrointestinal symptoms. Analyses were performed for the intention-to-treat (ITT) and the per-protocol (PP) population. In addition, patients with high compliance (HC: 90% </=110%) were considered in a separate group. Adverse events and the influence of the Helicobacter pylori status were investigated. RESULTS A total of 669 outpatients were enrolled in the study, with 337 patients receiving pantoprazole and 332 omeprazole MUPS. The PP population consisted of 552 patients, 282 treated with pantoprazole and 270 with omeprazole MUPS. The healing rates in both treatment groups were shown to be equivalent and were higher in patients who adhered closely to the administration protocol (HC). According to ITT (ITT(HC)) analyses, healing rates were 65.3% (77.4%) in the pantoprazole and 66.3% (74.7%) in the omeprazole group after 4 weeks. Furthermore, patients infected with H. pylori had slightly but not significantly higher healing rates than those with a negative test result. The safety profile of both treatments was comparable. CONCLUSION Pantoprazole 40 mg and omeprazole MUPS 40 mg were equivalent with respect to healing after 4 and 8 weeks of treatment in patients with reflux esophagitis grade II/III. Overall, HC patients had higher healing rates than the regular compliant patients. Both drugs were well tolerated and safe.
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Affiliation(s)
- T Körner
- Zentralklinikum Suhl gGmbH, Suhl, Germany.
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Müller-Lissner SA, Fumagalli I, Bardhan KD, Pace F, Pecher E, Nault B, Rüegg P. Tegaserod, a 5-HT(4) receptor partial agonist, relieves symptoms in irritable bowel syndrome patients with abdominal pain, bloating and constipation. Aliment Pharmacol Ther 2001; 15:1655-66. [PMID: 11564007 DOI: 10.1046/j.1365-2036.2001.01094.x] [Citation(s) in RCA: 330] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM To investigate the efficacy and safety of tegaserod, a novel 5-HT(4) receptor partial agonist, in a randomized, double-blind, placebo-controlled, 12-week treatment, multicentre study. METHODS Eight hundred and eighty-one patients with irritable bowel syndrome, characterized by abdominal pain, bloating and constipation, received tegaserod, 2 mg b.d. or 6 mg b.d., or placebo for 12 weeks. RESULTS Tegaserod, 2 mg b.d. and 6 mg b.d., showed a statistically significant relief of overall irritable bowel syndrome symptoms, measured by a weekly, self-administered questionnaire. At end-point, treatment differences from placebo were 12.7% and 11.8% for 2 mg b.d. and 6 mg b.d., respectively. The effect of tegaserod was noted as early as week 1, and was sustained over the 12-week treatment period. Individual irritable bowel syndrome symptoms assessed daily also showed a statistically significant improvement of abdominal discomfort/pain, number of bowel movements and stool consistency, and a favourable trend for reducing days with significant bloating. Adverse events were similar in all groups, with transient diarrhoea being the only adverse event seen more frequently with tegaserod than placebo. CONCLUSIONS Based upon the results of this study, tegaserod offers rapid and sustained relief of the abdominal pain and constipation associated with irritable bowel syndrome. Tegaserod is also well tolerated.
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Talley NJ, Verlinden M, Snape W, Beker JA, Ducrotte P, Dettmer A, Brinkhoff H, Eaker E, Ohning G, Miner PB, Mathias JR, Fumagalli I, Staessen D, Mack RJ. Failure of a motilin receptor agonist (ABT-229) to relieve the symptoms of functional dyspepsia in patients with and without delayed gastric emptying: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther 2000; 14:1653-61. [PMID: 11121915 DOI: 10.1046/j.1365-2036.2000.00868.x] [Citation(s) in RCA: 168] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Motilin-receptor agonists are prokinetics; whether they relieve the symptoms of functional dyspepsia is unknown. We aimed to test the efficacy of the motilin agonist ABT-229 in functional dyspepsia patients with and without delayed gastric emptying. METHODS Patients were randomized with postprandial symptoms and documented functional dyspepsia by endoscopy (n=589 in intention-to-treat analysis). Patients were assigned to either the delayed or normal gastric emptying strata, based on a validated 13C octanoic acid breath test. Patients were then further randomized within each strata, to receive one of four doses of ABT-229 (1.25, 2. 5, 5 or 10 mg b.d. before breakfast and dinner) or placebo for 4 weeks, following a 2-week baseline. The primary outcome was the assessment of change in symptom severity over the 2 weeks from baseline to final visit, based on a self-report questionnaire measuring severity on visual analogue scales. RESULTS Baseline characteristics across the treatment arms were very similar. No significant differences in the upper abdominal discomfort severity score (maximum 800 mm) were observed for any active treatment arm vs. placebo (mean change from baseline -139, -141, -145, -160 and -134 mm for placebo, 1.25, 2.5, 5, and 10 mg, respectively, at 4 weeks by intention-to-treat). More patients on placebo reported a good or excellent global response than patients on 1.25 or 5 mg of active therapy (both P < 0.05). The results were very similar in those with and without delayed gastric emptying. Helicobacter pylori status did not predict response. Excluding patients with any baseline heartburn (total remaining n=240), ABT-229 10 mg was inferior to placebo in relief of upper abdominal discomfort. CONCLUSIONS ABT-229 was of no value for relief of symptoms in functional dyspepsia, compared with placebo.
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Affiliation(s)
- N J Talley
- Department of Medicine, University of Sydney, Nepean Hospital, Penrith NSW, Australia; Abbott Laboratories, Abbott Park Illinois, USA.
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Plein K, Hotz J, Wurzer H, Fumagalli I, Lühmann R, Schneider A. Pantoprazole 20 mg is an effective maintenance therapy for patients with gastro-oesophageal reflux disease. Eur J Gastroenterol Hepatol 2000; 12:425-32. [PMID: 10783996 DOI: 10.1097/00042737-200012040-00010] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES To compare the efficacy of 20 mg with 40 mg pantoprazole in maintaining symptomatic and endoscopic remission in patients with gastro-oesophageal reflux disease (GORD). STUDY DESIGN Patients (18-84 years old; n = 433) with healed GORD II or III were included in this prospective multi-centre, randomized, parallel, double-blind study. Pantoprazole was administered once daily for up to 1 year as either a 20 mg or 40 mg enteric-coated tablet to 221 and 212 patients, respectively. Symptoms of GORD were assessed every 3 months. Endoscopy was performed at entry, after 6 and 12 months, or when symptoms of GORD were perceived on at least three consecutive days. The primary efficacy parameter was the time until endoscopically proven relapse of GORD occurred (stage I or greater); the secondary parameters included tolerability, safety, and time until symptomatic relapse occurred. RESULTS In the 20 mg treatment group, 87% and 75% of patients were in endoscopic remission after 6 and 12 months, respectively; the corresponding rates in the 40 mg treatment group were 91% and 78%. In both treatment groups, GORD stage I accounted for about 50% of endoscopic relapses. The symptomatic remission rates in the 20 mg group were estimated as 85% and 77% after 6 and 12 months, respectively; the corresponding values in the 40 mg group were 87% and 76%. No correlation was seen either between the endoscopically proven relapse and perception of symptoms, or between the severity of the pre-treatment stage of GORD and the maintenance dose of pantoprazole. Both doses were well tolerated. CONCLUSIONS Both the 20 mg and 40 mg doses of pantoprazole are safe and effective in maintaining patients with healed reflux oesophagitis in remission. Moreover, for the majority of patients, the 20 mg dose provides adequate long-term therapeutic efficacy at a minimal drug exposure and lower costs.
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Affiliation(s)
- K Plein
- General Hospital, Celle, Germany
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37
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Fumagalli I, Mignanego L, Violini G. Effects of tropospheric ozone on white clover plants exposed in open-top chambers or protected by the antioxidant ethylene-diurea (EDU). ACTA ACUST UNITED AC 1997. [DOI: 10.1051/agro:19970502] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
The efficacy and tolerability of cisapride (5 mg three times daily) and metoclopramide (10 mg three times daily) were evaluated in a randomized double-blind trial in patients with functional dyspepsia. Sixty patients, equally distributed in the two groups, entered the trial. After 4 weeks of treatment there was a significant improvement of symptom severity versus base line (p < 0.001) in both groups. The percentage of responders (with no or only mild symptoms) was 87% in the cisapride group and 77% in the metoclopramide group (no statistically significant intergroup difference). At the follow-up visit 2 weeks after completion of the trial this response rate was significantly higher in the cisapride group (73%) than in the metoclopramide group (47%) (p < 0.05). Four of the patients receiving cisapride and 2 of the patients receiving metoclopramide reported adverse events. On assessment of extrapyrimidal symptoms, relevant clinical values were found in one patient receiving metoclopramide. Increased prolactin concentrations were observed in seven patients of the metoclopramide group versus only 1 of the cisapride group (p < 0.05). The present data indicate that during the 2 weeks after completion of treatment in patients with functional dyspepsia, cisapride may result in a better, more sustained overall response when compared with metoclopramide.
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Blum AL, Adami B, Bouzo MH, Brandstätter G, Fumagalli I, Galmiche JP, Hebbeln H, Hentschel E, Hüttemann W, SChütz E. Effect of cisapride on relapse of esophagitis. A multinational, placebo-controlled trial in patients healed with an antisecretory drug. The Italian Eurocis Trialists. Dig Dis Sci 1993; 38:551-60. [PMID: 8444088 DOI: 10.1007/bf01316514] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The effect of a prokinetic agent, cisapride, on the relapse of reflux esophagitis was investigated in a randomized, double-blind trial conducted in 443 patients whose esophagitis had previously been healed with an acid antisecretory drug. Patients received cisapride, 20 mg at night, cisapride 10 mg twice daily, or placebo for 12 months or until endoscopic relapse was confirmed endoscopically. In 88% of all patients (respectively 133, 132, and 124), endoscopic data were available at discontinuation of treatment. In comparison with placebo, the two cisapride regimens prolonged both the time to endoscopically confirmed relapse (Kaplan-Meier analysis; P = 0.001) and the time to symptomatic relapse (P = 0.012). The life-table endoscopic relapse rates at 12 months were 51% for placebo, 32% for cisapride 20 mg at night (P = 0.005), and 34% for cisapride 10 mg twice daily (P = 0.02). Patients with more severe esophagitis before healing relapsed more rapidly during maintenance therapy, regardless of the treatment regimen. Adverse events were infrequent in all three groups. These findings indicate that maintenance treatment with the prokinetic drug cisapride prevents the relapse of esophagitis after it has been healed by acid antisecretory therapy.
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Affiliation(s)
- A L Blum
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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40
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Wunderlich PF, Braun L, Fumagalli I, D'Apuzzo V, Heim F, Karly M, Lodi R, Politta G, Vonbank F, Zeltner L. Double-blind report on the efficacy of lactic acid-producing Enterococcus SF68 in the prevention of antibiotic-associated diarrhoea and in the treatment of acute diarrhoea. J Int Med Res 1989; 17:333-8. [PMID: 2676650 DOI: 10.1177/030006058901700405] [Citation(s) in RCA: 124] [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: 01/02/2023] Open
Abstract
A multicentre double-blind, placebo-controlled clinical trial, involving 123 patients at 10 centres, was carried out to assess the efficacy of a preparation of lactic acid-producing Enterococcus SF 68 in the prevention of antibiotic-associated diarrhoea and in the treatment of acute diarrhoea. In the prevention study, 45 patients being treated with antibiotics were given, concurrently, one capsule twice daily of either Enterococcus SF68 or placebo. Acute diarrhoea was present in 78 patients who were given the same treatment but three times daily. All treatments were continued for 7 days. Enterococcus SF 68 was shown to be effective in reducing the incidence of antibiotic-associated diarrhoea in comparison with placebo (8.7% compared with 27.2%, respectively). Patients with acute enteritis showed a significantly faster resolution of bowel abnormalities during treatment with Enterococcus SF68 compared with placebo.
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Affiliation(s)
- P F Wunderlich
- Department of Internal Medicine, District Hospital, Faido, Switzerland
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41
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Businger JA, Fumagalli I, Michel H, Delas N, Stocker H. Rioprostil, a new prostaglandin E1 analogue, in the once-daily treatment for the prevention of duodenal ulcer recurrence: a comparison with ranitidine. Scand J Gastroenterol Suppl 1989; 164:152-9; discussion 159-60. [PMID: 2510260 DOI: 10.3109/00365528909091205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The efficacy of Rioprostil (a new prostaglandin E1 analogue) is compared with that of ranitidine in the recurrence prevention of duodenal ulcer(s). Duration of treatment is 6 months. Ninety-seven patients received rioprostil, 600 micrograms once-daily orally, and 110 patients received ranitidine, 150 mg once-daily orally. On rioprostil, 14.9% of patients showed a relapse after 6 months compared to 10.1% on ranitidine. Diarrhoea occurred in 7 patients on rioprostil and 3 patients on ranitidine. Rioprostil given 600 micrograms daily in the evening is a highly effective treatment for the prevention of duodenal ulcer relapse, the efficacy not being significantly different from ranitidine 150 mg.
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Affiliation(s)
- J A Businger
- Cilag Ltd, Dept Clinical Research and Development, Schaffhausen, Switzerland
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Gonvers JJ, Aenishänslin W, Backwinkel K, Bretholz A, Egger G, Feyerabend H, Fumagalli I, Güller R, Hammer B, Mattle WP. Gastric ulcer: a double blind comparison of 800 mcg misoprostol versus 300 mg ranitidine. Hepatogastroenterology 1987; 34:233-5. [PMID: 3119449] [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: 01/04/2023]
Abstract
Seventy-nine patients with endoscopically confirmed gastric ulcers received either ranitidine (37 patients) or misoprostol (42 patients) in a randomized double-blind manner. Fifty-six percent of the patients treated with ranitidine, and 38% of those treated with misoprostol presented with endoscopically healed ulcers after four weeks of treatment. After eight weeks complete healing had occurred in 86% of the patients receiving ranitidine, and 74% of those on misoprostol. These differences were not statistically significant. In smokers, ranitidine was superior to misoprostol, leading to a higher healing rate at four weeks (73% versus 20%). Thus there was no evidence that in patients with gastric ulcer misoprostol overcomes the negative effect of cigarette smoking.
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Affiliation(s)
- J J Gonvers
- Division of Gastroenterology CHUV-PMU, University of Lausanne
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Bertschinger P, Lacher G, Aenishänslin W, Baerlocher C, Bernoulli R, Egger G, Eisner M, Fasel F, Fehr HR, Fumagalli I. Presenting characteristics of patients with duodenal ulcer and outcome of medical treatment in controlled clinical trials using cimetidine and diethylamine persilate to treat ulcer attack and diethylamine persilate and placebo to prevent relapses. Digestion 1987; 36:148-61. [PMID: 3297895 DOI: 10.1159/000199412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A double-blind controlled clinical trial on the medical treatment of the acute episode of duodenal ulcer and the prevention of symptomatic relapses was performed. A total of 164 patients with active duodenal ulcer were either treated with cimetidine 1 g/day (70 patients), diethylaminepersilate (DAP) 1.5 g/day (64 patients) or DAP 2.5 g/day (30 patients). DAP is an allegedly protective agent stimulating mucosal prostaglandin synthesis. Cumulative healing rates after 4 weeks in the 3 groups were 66, 28 and 28% and after 8 weeks 94, 70 and 63%, respectively. One hundred and five patients with healed duodenal ulcer received, in a second double-blind study, either DAP 0.5 g/day or placebo. Thus, ulcer healing was more rapid with cimetidine than with DAP. DAP did not prevent relapses. No presenting characteristic was associated with slow healing. Three presenting characteristics--smoking, teetotalling and bleeding episode in the past--were associated with early symptomatic relapse. The present study was compared with a previous study performed by the same group of investigators using a similar study protocol. In both trials, an early relapse was associated with smoking. No other presenting characteristic was identified which in both trials was associated with slow healing or early symptomatic relapse. Thus, smoking appears to be the only one of the commonly available presenting characteristics which allows a prediction of the course of duodenal ulcer disease.
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Koelz HR, Birchler R, Bretholz A, Bron B, Capitaine Y, Delmore G, Fehr HF, Fumagalli I, Gehrig J, Gonvers JJ. Healing and relapse of reflux esophagitis during treatment with ranitidine. Gastroenterology 1986; 91:1198-205. [PMID: 3530865 DOI: 10.1016/s0016-5085(86)80017-8] [Citation(s) in RCA: 149] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In 108 patients the healing and relapse of reflux esophagitis, defined endoscopically by the presence of epithelial defects (erosions and ulcerations) of the esophageal mucosa, were studied. In the first study, with open treatment of ranitidine, the healing rate after 6 wk was 50%. The most important factor that negatively influenced healing was the extent of esophageal erosions. Patients with isolated erosions had a 6-wk healing rate of 78%; the healing rate was 38% in patients with longitudinally confluent lesions and 23% in those with circumferential erosions of the distal esophagus. Smoking also had an unfavorable effect. Age, sex, duration of history, body weight, and alcohol consumption were not related to outcome. Symptoms improved during treatment with ranitidine, but the correlation between symptoms and endoscopic findings at 6 wk was weak. In the second study, relapse was investigated in 61 patients with healed esophagitis in a randomized, double-blind trial comparing placebo and ranitidine (150 mg at bedtime for 6 mo). In both groups, relapse occurred in more than one-third of the patients, with no significant difference between ranitidine and placebo treatment. Patients with worse daytime symptoms at the time of previous healing had a higher relapse rate. The initial severity of esophagitis and smoking did not influence recurrence. Thus, the initial endoscopic findings are of prognostic value in reflux esophagitis. Smoking retards healing. Low-dose maintenance treatment with ranitidine does not prevent relapse.
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Aenishänslin W, Bärlocher C, Bernoulli R, Egger G, Eisner M, Fumagalli I, Güller R, Leuthold E, Osterkorn K, Pelloni S. [Misoprostol and cimetidine in the treatment of duodenal ulcer. A multicenter Swiss double-blind study]. Schweiz Med Wochenschr 1985; 115:1225-31. [PMID: 3931216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The efficacy and tolerance of misoprostol a synthetic prostaglandin E1 analogue-and of cimetidine were evaluated in the treatment of duodenal ulcer following a double blind multicenter design. A group of Swiss gastroenterologists recruited 119 patients with endoscopically proven acute duodenal ulcer. They were enrolled and treated according to a uniform protocol either with misoprostol 4 X 50 micrograms daily, with misoprostol 4 X 200 micrograms daily or with cimetidine 4 X 300 mg daily. Patients who were healed after 4 or 8 weeks were followed during 6 months. Cumulative healing rates at 4 weeks in groups receiving misoprostol 200 micrograms, misoprostol 800 micrograms or cimetidine 1200 mg daily were 42%, 58% and 71% respectively. Patients treated with cimetidine showed a more rapid improvement of symptoms than patients treated with misoprostol. Symptomatic recurrences after ulcer healing occurred in almost 40% of the patients within 6 months, irrespective of the type of acute ulcer treatment. Risk factors for slowed healing and increased rate of recurrence were evaluated in the present study, and the results were compared with the results of two previous trials performed according to a similar protocol. Smoking appeared to slow healing and to favor relapses. Moderate consumption of alcohol appeared to decrease the relapse rate. In the present trial, ulcer size was associated with ulcer pain but not with ulcer healing.
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Arma S, Fleischer M, Fumagalli I. [Primary sclerosing cholangitis]. Helv Chir Acta 1974; 41:699-703. [PMID: 4448665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Deyhle P, Fumagalli I. [Per-anal and per-oral endoscopy of the jejunum and ileum]. Minerva Med 1974; 65:3930-3. [PMID: 4417415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Nüesch HJ, Hahnloser P, Fumagalli I, Jenny S, Deyhle P. [Endoscopic retrograde cholangiography: method of choice in the diagnosis of choledochal cysts (author's transl)]. Dtsch Med Wochenschr 1973; 98:2069-70. [PMID: 4758627 DOI: 10.1055/s-0028-1107193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Deyhle P, Fumagalli I, Nüesch HJ, Holdener F, Siegenthaler G. [Oral fibroscopic removal of stones from the common bile duct (author's transl)]. Dtsch Med Wochenschr 1973; 98:1891-2. [PMID: 4758615 DOI: 10.1055/s-0028-1107152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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50
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Jenny S, Deyhle P, Knoblauch M, Fumagalli I. [Clinical importance of duodenal bulb endoscopy]. Schweiz Med Wochenschr 1973; 103:729-31. [PMID: 4540838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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