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Billa O, Bonnetain F, Chamois J, Ligey A, Ganansia V, Renard S, Maillard S, Quivrin M, Vulquin N, Truntzer P, Noel G, Maingon P, Dabakuyo-Yonli TS. Predictive value of health-related quality of life on radiotherapy-related toxicities in patients with head and neck cancer. Support Care Cancer 2023; 31:268. [PMID: 37058164 DOI: 10.1007/s00520-023-07736-0] [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: 08/08/2022] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Little is known about whether baseline health-related quality of life (HRQoL) scores also could predict occurrence radiotherapy-related toxicities, which we aim to assess in this study. METHODS This study analyzed data from 200 patients enrolled in randomized study investigating the utility of HRQoL. HRQOL was assessed at baseline and during follow up using QLQ-C30 questionnaire and major toxicity was considered as adverse event ≥ 3 according to NCI-CTCAE classification. Cox regressions adjusting for clinical and sociodemographic data were used to assess prognostic significance of HRQOL scores. RESULTS In multivariable analyses adjusted on clinical and sociodemographic data, every 10-point improvement in physical (HR = 0.74), role (HR = 0.87) and social (HR = 0.88) functioning was associated with 24%, 13% and 12% lower hazard of occurrence of major toxicity respectively while every 10 point-increase in dyspnea (HR = and loss appetite was associated with 15% and 16% increased hazard of major toxicity. CONCLUSION Certain baseline HRQoL scores were found to be significantly associated with the occurrence of major toxicity.
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Affiliation(s)
- Oumar Billa
- Epidemiology and Quality of Life Unit, Georges-François Leclerc Cancer Centre-UNICANCER, 21000, Dijon, France.
- Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000, Dijon, France.
- Epidemiology and Quality of Life Unit, Lipids, Nutrition, Cancer Research Center, U1231 INSERM, Georges-François Leclerc Cancer Centre-UNICANCER, 1 rue Professeur Marion BP 77980, 21079, Dijon Cedex, France.
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, Inserm UMR 1098, University Hospital of Besancon, Besancon, France
| | - Jérôme Chamois
- Centre Hospitalier Saint Gregoire, 35760, Saint-Grégoire, France
| | - Angeline Ligey
- Centre Hospitalier Fleriat, 01012, Bourg-en-Bresse, France
| | | | - Sophie Renard
- Institut de Cancérologie de Lorraine, 54519, Vandœuvre-lès-Nancy, France
| | | | - Magali Quivrin
- Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France
| | - Noémie Vulquin
- Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France
| | - Pierre Truntzer
- Paul Strauss Cancer Centre-Unicancer, 67000, Strasbourg, France
| | - Georges Noel
- Paul Strauss Cancer Centre-Unicancer, 67000, Strasbourg, France
- Institut de Cancerologie Strasbourg Europe, ICANS.eu, 67000, Strasbourg, France
| | - Philippe Maingon
- Radiotherapy Department, Georges-François Leclerc Cancer Centre-UNICANCER, 1 Rue Professeur Marion, 21000, Dijon, France
- Radiotherapy Unit, Hôpital de la Pitié-Salpêtrière-APHP, 75013, Paris, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- Epidemiology and Quality of Life Unit, Georges-François Leclerc Cancer Centre-UNICANCER, 21000, Dijon, France
- Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000, Dijon, France
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Billa O, Bonnetain F, Chamois J, Ligey A, Ganansia V, Renard S, Quivrin M, Truntzer P, Vulquin N, Noel G, Maingon P, Dabakuyo-Yonli S. Predictive Value of Health-Related Quality of Life on Radiotherapy Related Toxicities in Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Herrscher H, Truntzer P, Sauer B, Robert C. Réponses anti-tumorales induites par une réaction immunitaire dirigée contre le virus SARS-CoV-2. Annales de Dermatologie et de Vénéréologie - FMC 2021. [PMCID: PMC8603754 DOI: 10.1016/j.fander.2021.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction L’immunothérapie fait partie des standards de traitement actuels du mélanome et des cancers bronchiques non à petites cellules. Les infections bactériennes et virales entraînent une réponse immunitaire anti-infectieuse qui peut également conduire à une réponse anti-tumorale. Nous présentons 2 cas de vraisemblable réponse tumorale médiée par une réaction immunitaire dirigée contre le SARS-CoV-2. Matériel et méthodes Nous avons précédemment publié le cas d’une patiente de 84 ans suivie pour un mélanome BRAF sauvage métastatique ganglionnaire et péritonéal. Un traitement par dabrafénib + tramétinib était administré de juillet à septembre 2020 et interrompu pour toxicité. Compte tenu de son mauvais état général, des soins palliatifs exclusifs étaient engagés. En décembre 2020, une métastase ganglionnaire cervicale était irradiée en RCMI (20 Gy en 5 × 4 Gy). En janvier 2021, la patiente était hospitalisée pour une pneumopathie à SARS-CoV-2. Le scanner révélait une régression spontanée de 20 à 25% de la taille de l’ensemble des lésions secondaires. Parallèlement, en janvier 2021, un homme de 61 ans était pris en charge pour une récidive pulmonaire d’un carcinome épidermoïde bronchique métastatique antérieurement traité par 6 cycles carboplatine–paclitaxel de novembre 2018 à avril 2019 puis par irradiation d’une première récidive pulmonaire d’avril à juin 2020. Une biopsie de la récidive était réalisée en mars 2021 qui confirmait la récidive d’un carcinome épidermoïde bronchique PD-L1 négatif. Entre février et mars 2021, le patient recevait 2 injections du vaccin ARN BNT162b2 contre le SARS-CoV-2. Le scanner d’avril 2021 révélait une diminution spontanée de la récidive pulmonaire avec une levée complète de l’atélectasie sous-jacente. Discussion Ces deux observations de réponse anti-tumorale spontanée après une réaction immunitaire dirigée contre le SARS-CoV-2 nous font émettre l’hypothèse d’une réaction immunitaire anti-tumorale croisée. L’infection par le SARS-CoV-2 entraîne une réaction immunitaire innée en stimulant le TLR et la sécrétion de cytokines pro-inflammatoires. Le vaccin ARN BNT162b2 provoque également une réaction immunitaire qui fait intervenir les lymphocytes T CD4+ et CD8+ à orientation Th1 qui sont impliqués dans la réponse immunitaire anti-tumorale. Nous pensons que la stimulation immunitaire initiée par le SARS-CoV-2 ou le vaccin dirigé contre le virus dans les 2 observations présentées a entraîné secondairement une réponse immunitaire anti-tumorale. Conclusion La réponse immunitaire anti-infectieuse induite par le SARS-CoV-2 et le vaccin ARN dirigé contre ce virus pourrait entraîner une réponse anti-tumorale croisée.
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Billa O, Bonnetain F, Chamois J, Ligey A, Ganansia V, Noel G, Renard S, Maillard S, Quivrin M, Vulquin N, Truntzer P, Dabakuyo-Yonli TS, Maingon P. Randomized Trial Assessing the Impact of Routine Assessment of Health-Related Quality of Life in Patients with Head and Neck Cancer. Cancers (Basel) 2021; 13:cancers13153826. [PMID: 34359726 PMCID: PMC8345055 DOI: 10.3390/cancers13153826] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary The purpose of this research was to investigate the impact of routine assessment of health-related quality of life (HRQoL) on quality of life and satisfaction with care in patients with head and neck cancer (HNC). A randomized controlled open-label clinical trial with 200 patients with HNC managed in four cancer centers in Eastern France was performed. In the intervention arm (regularly completed HRQoL questionnaires), HRQoL mean change was significantly improved at 2 years from baseline. Compared with the control arm, differences were not statistically significant, but minimal clinically important differences in favor of the intervention arm were found for HRQoL, satisfaction with waiting times, and satisfaction with accessibility. In patients with head and neck cancer undergoing treatments, routine assessment of HRQoL is a simple practice and may have HRQoL and satisfaction benefits. Abstract The impact of routine assessment of health-related quality of life (HRQoL) on satisfaction with care and the HRQoL of patients with head and neck cancer (HNC) treated with radiotherapy was assessed. Patients with HNC were randomly assigned to two arms, with stratification on sex, cancer localization, and stage of the disease. In the intervention arm, the patients completed the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires first before randomization, then before each medical appointment during radiotherapy (7 weeks), and then every 3 months until 1 year and at 2 years thereafter. In the control arm, the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires were completed before randomization and at 1 year and 2 years thereafter. The primary endpoint was mean change in HRQoL at score at 2 years from baseline assessed by EQ VAS from the EuroQol questionnaire. The secondary endpoint was mean change in satisfaction with care at 2 years from baseline assessed by QLQ-SAT32. Two hundred patients with head and neck cancers were involved in this study (mean age, 58.83 years (range, 36.56–87.89)), of whom 100 were assigned to the intervention arm and 100 to the control arm. Patients in the intervention arm were reported to have a statistically significant increase in EQ VAS at 2 years (p < 0.0001) and exceeded the minimal clinically important difference (mean change at 2 years from baseline = 10.46). In the two arms, mean differences between arms were not statistically significant, but minimal clinically important differences in favor of the intervention arm were found for EQ VAS (mean change difference (MD) = 5.84), satisfaction with care, in particular waiting times (MD = 10.85) and satisfaction with accessibility (MD = 6.52). Routine assessment of HRQoL improves HRQoL and satisfaction with care for patients with HNC treated with radiotherapy.
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Affiliation(s)
- Oumar Billa
- Georges-François Leclerc Cancer Centre-UNICANCER, Epidemiology and Quality of Life Unit, 21000 Dijon, France;
- Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000 Dijon, France
- National Quality of Life and Cancer Clinical Research Platform, 21000 Dijon, France
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, Inserm UMR 1098, University Hospital of Besancon, 25000 Besancon, France;
| | - Jérôme Chamois
- Georges-François Leclerc Cancer Centre-UNICANCER, Radiotherapy Department, 1 Rue Professeur Marion, 21000 Dijon, France; (J.C.); (M.Q.); (N.V.); (P.M.)
- Centre Hospitalier Saint Gregoire, 35760 Saint-Grégoire, France
| | - Angeline Ligey
- Centre Hospitalier Fleriat, 01012 Bourg-en-Bresse, France;
| | - Valérie Ganansia
- Paul Strauss Cancer Centre-Unicancer, 67000 Strasbourg, France; (V.G.); (G.N.); (P.T.)
| | - Georges Noel
- Paul Strauss Cancer Centre-Unicancer, 67000 Strasbourg, France; (V.G.); (G.N.); (P.T.)
| | - Sophie Renard
- Institut de cancérologie de Lorraine, 54519 Vandœuvre-lès-Nancy, France;
| | | | - Magali Quivrin
- Georges-François Leclerc Cancer Centre-UNICANCER, Radiotherapy Department, 1 Rue Professeur Marion, 21000 Dijon, France; (J.C.); (M.Q.); (N.V.); (P.M.)
| | - Noémie Vulquin
- Georges-François Leclerc Cancer Centre-UNICANCER, Radiotherapy Department, 1 Rue Professeur Marion, 21000 Dijon, France; (J.C.); (M.Q.); (N.V.); (P.M.)
| | - Pierre Truntzer
- Paul Strauss Cancer Centre-Unicancer, 67000 Strasbourg, France; (V.G.); (G.N.); (P.T.)
| | - Tienhan Sandrine Dabakuyo-Yonli
- Georges-François Leclerc Cancer Centre-UNICANCER, Epidemiology and Quality of Life Unit, 21000 Dijon, France;
- Lipids, Nutrition, Cancer Research Center, U1231 INSERM, 21000 Dijon, France
- National Quality of Life and Cancer Clinical Research Platform, 21000 Dijon, France
- Correspondence: ; Tel.: +33-345-348-067
| | - Philippe Maingon
- Georges-François Leclerc Cancer Centre-UNICANCER, Radiotherapy Department, 1 Rue Professeur Marion, 21000 Dijon, France; (J.C.); (M.Q.); (N.V.); (P.M.)
- Radiotherapy Unit, Hôpital de la Pitié-Salpêtrière-APHP, 75013 Paris, France
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Billa O, Bonnetain F, Quivrin M, Vulquin M, Truntzer P, Noel G, Maingon P, Dabakuyo S. Les patients atteints d’un cancer de la tête et du cou. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2021.04.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Herrscher H, Sauer B, Truntzer P, Robert C. Abscopal antitumor effect in a patient with melanoma and coronavirus disease 2019. Eur J Cancer 2021; 149:91-93. [PMID: 33839589 PMCID: PMC7955944 DOI: 10.1016/j.ejca.2021.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Affiliation(s)
- Hugo Herrscher
- Department of Medical Oncology, Strasbourg Oncologie Libérale, 184 route de la Wantzenau 67000 Strasbourg, France.
| | - Benoit Sauer
- Department of Radiology, Clinique Sainte-Anne, rue Philippe Thys 67000 Strasbourg, France
| | - Pierre Truntzer
- Department of Radiotherapy, Strasbourg Oncologie Libérale, 184 route de la Wantzenau 67000 Strasbourg, France
| | - Caroline Robert
- Medicine Department, Dermatology Service, Gustave Roussy Comprehensive Cancer Center, 114, rue Edouard Vaillant, F-94800 Villejuif, France
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Rouers M, Bornert F, Truntzer P, Dubourg S, Bourrier C, Antoni D, Noël G. Ability to Propose Optimal Prosthetic Rehabilitation can be Improved by Discussion between the Dentist and Radiation Oncologist Regarding Upstream Dosimetry. Eur J Dent 2019; 13:88-94. [PMID: 31170766 PMCID: PMC6635961 DOI: 10.1055/s-0039-1688523] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective
Improvement of dental rehabilitation for patients who have undergone radiation therapy requires knowledge of the dose in the maxillary and mandible bones.
Materials and Methods
Forty-three patients with head and neck cancers underwent evaluation for dental rehabilitation before radiation treatment dosimetry. The delivered dose to the maxilla and mandible was determined. From the dose data in the literature, three levels of risk of implant failure were defined. According to the delivered doses, the authors calculated the percentage of patients who could be fully rehabilitated with an implant, as proposed by the dentist before radiation planning.
Results
Before dosimetry calculation, all of the completely edentulous arches and 94 partially edentulous (PESs) sextants could be optimally rehabilitated. After dose calculation, among the 14 arches of 7 patients who were completely edentulous, according to the mean and maximal delivered doses, 11 arches (78.6%) and 7 arches (50%) could receive an optimal prosthesis, respectively. For the three patients, who were PESs but with one arch that was completely edentulous, according to the mean and maximal delivered doses, one arch for each dose condition could receive an optimal prosthesis. Among the 94 PESs sextants, according to the mean and maximal delivered doses, 41 (43.6%) and 24 (25.5%) sextants could receive an optimal prosthesis, respectively.
Conclusion
By determining the sites of implantation before dosimetry, the radiation oncologist could shield specified areas, potentially improving the possibilities for dental rehabilitation. The dialogue between the dentist and the radiation oncologist can improve the possibilities for implants and decrease the risk of unsafe implantation.
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Affiliation(s)
- Mélanie Rouers
- Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France
| | - Fabien Bornert
- Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France
| | - Pierre Truntzer
- University Radiation Department, Centre Paul Strauss, Strasbourg, France
| | - Sarah Dubourg
- Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France
| | - Cyrielle Bourrier
- University Radiation Department, Centre Paul Strauss, Strasbourg, France
| | - Delphine Antoni
- University Radiation Department, Centre Paul Strauss, Strasbourg, France.,Strasbourg University, Radiobiology Lab, Centre Paul Strauss, Strasbourg, France
| | - Georges Noël
- University Radiation Department, Centre Paul Strauss, Strasbourg, France.,Strasbourg University, Radiobiology Lab, Centre Paul Strauss, Strasbourg, France
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Pin Y, Antoni D, Keller A, Truntzer P, Clavier J, Schaeffer O, Schmitt M, Waissi W, Noël G. OC-0419 Evaluation of Metabrain: a semi-automated delineation tool for edema surrounding brain metastasis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30839-4] [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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Clavier J, Eugene R, Thariat J, Antoni D, Beneyton V, Claude L, Fontbonne J, Gaillot N, Ganansia V, Jamain C, Lepinoy A, Laude C, Mazzara C, Noblet C, Racadot S, Ruffier A, Servagi S, Truntzer P, Guihard S. EP-1662 Multicentric structured medical data production on an OIS for modeling of radiotherapy effects. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32082-1] [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]
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Menoux I, Antoni D, Truntzer P, Keller A, Massard G, Noël G. Stereotactic body radiation therapy for stage I non-small cell lung carcinomas: Moderate hypofractionation optimizes outcome. Lung Cancer 2018; 126:201-207. [PMID: 30527188 DOI: 10.1016/j.lungcan.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 10/05/2018] [Revised: 11/04/2018] [Accepted: 11/09/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In case of inoperability or refusal of surgery, stereotactic body radiation therapy (SBRT) is the most effective treatment for a stage I non-small cell lung carcinoma (NSCLC). The results obtained by this irradiation technique are considerably superior to those observed in the time of conventional 3D irradiation and its toxicities are much less important, which makes it possible in elderly patients, or those presenting cardio-pulmonary comorbidities and a poor perfomance status. MATERIALS AND METHODS This study is a retrospective analysis of 90 patients who underwent SBRT for a stage I NSCLC between 2010 and 2015. Its purpose is to describe its effectiveness in term of overall survival (OS), specific survival (SS), local control (LC), regional control (RC) and metastatic control (MC) as well as their prognostic factors, and its tolerance. RESULTS LC, RC, MC as well as OS and SS rate at 4 years were comparable to the main prospective studies, respectively 89%, 92%, 70%, 33% and 66%. No LC prognostic factor could be identified. Radiation pneumonitis was observed with a rate of 61.5%, of which 56% were asymptomatic, and 4% of the patients had a rib fracture. CONCLUSIONS SBRT is an efficient and well-tolerated treatment for stage I non-small cell lung carcinomas.
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Affiliation(s)
- I Menoux
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - D Antoni
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France; Laboratory of Radiobiology, EA 3430, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University, Strasbourg, France.
| | - P Truntzer
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - A Keller
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - G Massard
- Department of Thoracic surgery, Nouvel hôpital Civil, 1, place de l'hôpital, 67000, Strasbourg, France.
| | - G Noël
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France; Laboratory of Radiobiology, EA 3430, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University, Strasbourg, France.
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Guihard S, Eugène R, Thariat J, Beneyton V, Claude L, Fontbonne JM, Gaillot N, Ganansia V, Jamain C, Lepinoy A, Laude C, Mazzara C, Racadot S, Ruffier A, Servagi S, Truntzer P, Clavier J. Dossier structuré commun de radiothérapie basé sur Mosaiq®. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Menoux I, Antoni D, Santelmo N, Truntzer P, Schumacher C, Labani A, Noël G. Radiographic findings after stereotactic radiotherapy for lung carcinoma: retrospective analysis of 90 patients. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2811] [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: 11/05/2022]
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13
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Menoux I, Antoni D, Truntzer P, Keller A, Massard G, Noël G. Hypofractionated radiotherapy for stage I lung carcinomas: moderate hypofractionation optimizes outcome. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2212] [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: 11/05/2022]
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Ohnleiter T, Antoni D, Lefebvre F, Truntzer P, Schultz P, Burgy M, Borel C, Noël G. Factors improving the outcome of patients re-irradiated with intensity-modulated radiotherapy (IMRT) for relapse or new head and neck cancer developed in irradiated areas. Chin Clin Oncol 2018; 7:60. [PMID: 30180748 DOI: 10.21037/cco.2018.06.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 03/19/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with secondary/recurrent squamous cell head and neck cancer have poor prognoses. Re-irradiation is a treatment option. However, best technique to re-irradiate is not known. This study aims to evaluate the outcome of patients treated with curative-intent intensity-modulated radiotherapy (IMRT) re-irradiation (re-RT) for head and neck (H&N) cancers. METHODS Fifty patients with recurrent H&N cancers underwent fractionated IMRT re-RT. The median time between the two courses of radiotherapy was 22 months. The median dose of re-RT was 66 Gy. RESULTS The median follow-up of surviving patients was 13.6 months. The median overall survival (OS) was 15.7 months, and the 1- and 2-year OS rates were 62.4% and 33.9%, respectively. On multivariate analysis, performance status (PS) 0-1 (HR, 0.518; 95% CI: 0.292-0.917; P=0.024) and 3D-RT use during the first irradiation course technique (HR, 0.415; 95% CI: 0.183-0.938; P=0.035) were favorable, independent of significant prognostic factors of OS. The median loco-regional progression-free survival (LRPFS) was 8.3 months, and, the 1- and 2-year LRPFS rates were 46.6% and 35.9%, respectively. On multivariate analysis, a surgical resection before re-RT (HR, 0.107; 95% CI: 0.027-0.428; P=0.002), a higher age (HR, 0.894; 95% CI: 0.833-0.960; P=0.002), a PS 0-1 (HR, 0.316; 95% CI: 0.140-0.715; P=0.006), and a long re-RT interval (HR, 0.970; 95% CI: 0.945-0.996; P=0.024) were favorable independent significant prognostic factors of LRPFS. The median progression-free survival (PFS) was 7.0 months and, the 1- and 2-year PFS rates were 45.0% and 30.4%, respectively. On multivariate analysis, a surgical resection before re-RT (HR, 0.129; 95% CI: 0.036-0.466; P=0.002), a PS 0-1 (HR, 0.399; 95% CI: 0.208-0.764; P=0.006) and, a long re-RT interval (HR, 0.958; 95% CI: 0.927-0.989; P=0.009) were favorable, independent significant prognostic factors. The early and late toxicities rates were 28% and 34%, respectively. CONCLUSIONS Re-RT for H&N cancers can be curative, and the complications can be manageable but patients need to be strictly selected. Surgery before re-RT could improve the patient outcome. Dose and irradiation schedules should be prospectively evaluated.
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Affiliation(s)
- Thomas Ohnleiter
- Department of Radiotherapy, Emile Muller Hospital, Mulhouse, France
| | - Delphine Antoni
- Department of Radiotherapy, Centre de lutte contre le Cancer PaulStrauss, Strasbourg, France; Centre Paul Strauss, Unicancer, Université de Strasbourg, CNRS, IPHC UMR 7871, Strasbourg, France
| | - François Lefebvre
- Public Health Department, Strasbourg University Hospital, Strasbourg, France
| | - Pierre Truntzer
- Department of Radiotherapy, Emile Muller Hospital, Mulhouse, France
| | - Philippe Schultz
- Head and Neck Surgery Department, Hautepierre University Hospital, Strasbourg, France
| | - Mickael Burgy
- Department of Medical Oncology, Centre de lutte contre le Cancer Paul-Strauss, Strasbourg, France
| | - Christian Borel
- Department of Medical Oncology, Centre de lutte contre le Cancer Paul-Strauss, Strasbourg, France
| | - Georges Noël
- Department of Radiotherapy, Centre de lutte contre le Cancer PaulStrauss, Strasbourg, France; Centre Paul Strauss, Unicancer, Université de Strasbourg, CNRS, IPHC UMR 7871, Strasbourg, France.
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Le Fèvre C, Antoni D, Thiéry A, Keller A, Truntzer P, Vigneron C, Clavier JB, Guihard S, Pop M, Schumacher C, Salze P, Noël G. [Radiotherapy of bone metastases in France: A descriptive monocentric retrospective study]. Cancer Radiother 2018; 22:148-162. [PMID: 29602695 DOI: 10.1016/j.canrad.2017.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/03/2017] [Accepted: 09/08/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Bone metastases cause pain and affect patients' quality of life. Radiation therapy is one of the reference analgesic treatments. The objective of this study was to compare the current practices of a French radiotherapy department for the treatment of uncomplicated bone metastases with data from the literature in order to improve and optimize the management of patients. MATERIAL AND METHODS A retrospective monocentric study of patients who underwent palliative irradiation of uncomplicated bone metastases was performed. RESULTS Ninety-one patients had 116 treatments of uncomplicated bone metastases between January 2014 and December 2015, including 44 men (48%) and 47 women (52%) with an average age of 63years (25-88years). Primary tumours most commonly found were breast cancer (35%), lung cancer (16%) and prostate cancer (12%). The regimens used were in 29% of cases 30Gy in ten fractions (group 30Gy), in 21% of cases 20Gy in five fractions (group 20Gy), in 22% of cases 8Gy in one fraction (group 8Gy) and in 28% of cases 23.31Gy in three fractions of stereotactic body irradiation (stereotactic group). The general condition of the patient (P<0.001), pain score and analgesic (P<0.001), oligometastatic profile (P=0.003) and practitioner experience (P<0.001) were factors influencing the choice of the regimen irradiation. Age (P=0.46), sex (P=0.14), anticancer treatments (P=0.56), concomitant hospitalization (P=0.14) and the distance between the radiotherapy centre and home (P=0.87) did not influence the decision significantly. A total of three cases of spinal compression and one case of post-therapeutic fracture were observed, occurring between one and 128days and 577days after irradiation, respectively. Eight percent of all irradiated metastases were reirradiated with a delay ranging between 13 and 434days after the first irradiation. The re-irradiation rate was significantly higher after 8Gy (P=0.02). The rate of death was significantly lower in the stereotactic arm (P<0.001) and overall survival was significantly greater in the stereotactic arm (P<0.001). CONCLUSION This study showed that patients' analysed was comparable to the population of different studies. Predictive factors for the choice of the treatment regimen were identified. Non-fractionnated therapy was underutilised while stereotactic treatment was increasingly prescribed, showing an evolution in the management of patients.
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Affiliation(s)
- C Le Fèvre
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire EA 3430, Fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 67000 Strasbourg, France
| | - A Thiéry
- Département de santé publique, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - A Keller
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - P Truntzer
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - C Vigneron
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - J-B Clavier
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - S Guihard
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - M Pop
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - C Schumacher
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - P Salze
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Laboratoire EA 3430, Fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 67000 Strasbourg, France.
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Waissi W, Antoni D, Keller A, Truntzer P, Clavier J, Noël G. PO-0849: Lymph node stereotactic body radiotherapy for oligometastatic patients postpones systemic treatment. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Renaud S, Seitlinger J, Truntzer P, Noel G, Massard G. Comment on "Epidermal growth factor receptor mutation predicts favorable outcomes in non-small cell lung cancer patients with brain metastases treated with stereotactic radiosurgery", by Yang WC et al. Radiother Oncol 2017; 129:187. [PMID: 29254842 DOI: 10.1016/j.radonc.2017.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Stéphane Renaud
- Department of Thoracic Surgery, Nancy University Hospital, France.
| | - Joseph Seitlinger
- Department of Thoracic Surgery, Strasbourg University Hospital, France
| | - Pierre Truntzer
- Department of Radiation Therapy, Cancer Centre Paul Strauss, Strasbourg University Hospital, France
| | - Georges Noel
- Department of Radiation Therapy, Cancer Centre Paul Strauss, Strasbourg University Hospital, France
| | - Gilbert Massard
- Department of Thoracic Surgery, Strasbourg University Hospital, France
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Ohnleiter T, Truntzer P, Antoni D, Guihard S, Elgard AM, Noël G. Facteurs pronostiques de la ré-irradiation des cancers des voies aérodigestives supérieures : revue de la littérature. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.04.007] [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: 10/19/2022]
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Ohnleiter T, Truntzer P, Antoni D, Guihard S, Elgard AM, Noël G. Facteurs pronostiques de la ré-irradiation des cancers des voies aérodigestives supérieures : revue de la littérature. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.04.008] [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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Burgy M, Barthélémy P, Lefevre F, Dupret-Bories A, Truntzer P, Korenbaum C, Flesch H, Bronner G, Borel C. Cetuximab-Carboplatin-5-Fluorouracil Regimen in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous-Cell Carcinoma: A French Retrospective Survey. Oncology 2017; 93:11-17. [DOI: 10.1159/000454732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 11/24/2016] [Indexed: 11/19/2022]
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21
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Rouers M, Antoni D, Bornert F, Wong CL, Dubourg S, Truntzer P, Qiu H, Thompson A, Bourrier C, Meyer P, Guihard S, Noel G. Ability to Deliver Safe Dental Care and Optimal Prosthetic Rehabilitation Are Correlating With Irradiation Doses in Maxillary and Mandible. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Antoni D, Pop M, Truntzer P, Rieger E, Salze P, Clavier J, Guihard S, Bauer N, Vigneron C, Velten M, Noel G. Impact of a Specific One-on-One Announcement Procedure Provided by a Radiation Therapist Before Radiation Therapy: Results of a Prospective Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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23
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Truntzer P, Antoni D, Santelmo N, Schumacher C, Falcoz PE, Quoix E, Massard G, Noël G. Superior sulcus non-small cell lung carcinoma: A comparison of IMRT and 3D-RT dosimetry. Rep Pract Oncol Radiother 2016; 21:427-34. [PMID: 27489512 DOI: 10.1016/j.rpor.2016.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/24/2015] [Accepted: 03/22/2016] [Indexed: 12/25/2022] Open
Abstract
AIM A dosimetric study comparing intensity modulated radiotherapy (IMRT) by TomoTherapy to conformational 3D radiotherapy (3D-RT) in patients with superior sulcus non-small cell lung cancer (NSCLC). BACKGROUND IMRT became the main technique in modern radiotherapy. However it was not currently used for lung cancers. Because of the need to increase the dose to control lung cancers but because of the critical organs surrounding the tumors, the gains obtainable with IMRT is not still demonstrated. MATERIAL AND METHODS A dosimetric comparison of the planned target and organs at risk parameters between IMRT and 3D-RT in eight patients who received preoperative or curative intent irradiation. RESULTS In the patients who received at least 66 Gy, the mean V95% was significantly better with IMRT than 3D-RT (p = 0.043). IMRT delivered a lower D2% compared to 3D-RT (p = 0.043). The IH was significantly better with IMRT (p = 0.043). The lung V 5 Gy and V 13 Gy were significantly higher in IMRT than 3D-RT (p = 0.043), while the maximal dose (D max) to the spinal cord was significantly lower in IMRT (p = 0.043). The brachial plexus D max was significantly lower in IMRT than 3D-RT (p = 0.048). For patients treated with 46 Gy, no significant differences were found. CONCLUSION Our study showed that IMRT is relevant for SS-NSCLC. In patients treated with a curative dose, it led to a reduction of the exposure of critical organs, allowing a better dose distribution in the tumor. For the patients treated with a preoperative schedule, our results provide a basis for future controlled trials to improve the histological complete response by increasing the radiation dose.
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Affiliation(s)
- Pierre Truntzer
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065 Strasbourg Cedex, France
| | - Delphine Antoni
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065 Strasbourg Cedex, France; Radiobiology Laboratory EA 3430, Federation of Translational Medicine in Strasbourg (FMTS), Strasbourg University, Strasbourg, France
| | - Nicola Santelmo
- Thoracic Surgery Department, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France
| | - Catherine Schumacher
- Thoracic Surgery Department, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France
| | - Pierre-Emmanuel Falcoz
- Thoracic Surgery Department, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France
| | - Elisabeth Quoix
- Pneumology Department, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France
| | - Gilbert Massard
- Thoracic Surgery Department, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France
| | - Georges Noël
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065 Strasbourg Cedex, France; Radiobiology Laboratory EA 3430, Federation of Translational Medicine in Strasbourg (FMTS), Strasbourg University, Strasbourg, France
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Rouers M, Dubourg S, Bornert F, Truntzer P, Antoni D, Couchot J, Ganansia V, Bourrier C, Guihard S, Noël G. État buccodentaire des patients avant radiothérapie des voies aérodigestives supérieures : analyse prospective de 48 patients. Cancer Radiother 2016; 20:199-204. [PMID: 27131393 DOI: 10.1016/j.canrad.2015.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 12/12/2015] [Accepted: 12/16/2015] [Indexed: 12/21/2022]
Affiliation(s)
- M Rouers
- Faculté de chirurgie dentaire de Strasbourg, 8, rue Sainte-Élisabeth, 67000 Strasbourg, France
| | - S Dubourg
- Faculté de chirurgie dentaire de Strasbourg, 8, rue Sainte-Élisabeth, 67000 Strasbourg, France; Unité de pathologie-chirurgie buccale, pôle de médecine et de chirurgie buccodentaires, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - F Bornert
- Faculté de chirurgie dentaire de Strasbourg, 8, rue Sainte-Élisabeth, 67000 Strasbourg, France; Unité de pathologie-chirurgie buccale, pôle de médecine et de chirurgie buccodentaires, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - P Truntzer
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Fédération de médecine translationnelle de Strasbourg (FMTS), laboratoire EA 3430, université de Strasbourg, 67065 Strasbourg, France
| | - J Couchot
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - V Ganansia
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - C Bourrier
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - S Guihard
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France
| | - G Noël
- Département universitaire de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France; Fédération de médecine translationnelle de Strasbourg (FMTS), laboratoire EA 3430, université de Strasbourg, 67065 Strasbourg, France.
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Rouers M, Antoni D, Thompson A, Truntzer P, Haoming QC, Bourrier C, Meyer P, Dubourg S, Ganansia V, Guihard S, Bornert F, Noel G. Maxillary and mandible contouring in patients with a head and neck area irradiation. Pract Radiat Oncol 2016; 6:e61-e72. [DOI: 10.1016/j.prro.2015.10.003] [Citation(s) in RCA: 4] [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: 06/05/2015] [Revised: 09/01/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
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Rouers M, Truntzer P, Dubourg S, Guihard S, Antoni D, Noël G. État dentaire des patients atteints d’un cancer des voies aérodigestives supérieures. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.03.006] [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: 10/23/2022]
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Truntzer P, Antoni DN, Santelmo N, Schumacher C, Falcoz PE, Quoix E, Steib JP, Massard G, Noël G. Superior sulcus non small cell lung carcinoma: retrospective analysis of 42 patients. Radiat Oncol 2014; 9:259. [PMID: 25424982 PMCID: PMC4268789 DOI: 10.1186/s13014-014-0259-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 11/06/2014] [Indexed: 12/25/2022] Open
Abstract
Aims Retrospective, monocentric analysis of localized superior sulcus non-small cell cancer (SS-NSCLC), article management. Materials and methods Between 2000 and 2010, 42 patients have been treated for a SS-NSCLC. Median age was 54.7 years (34.5-86.8). Nineteen tumors (45.2%) were stage IIB, 18 were stage IIIA (42.9%) and 5 were stage IIIB (11.9%). Twenty-two patients were treated by pre-operative radiotherapy or chemoradiotherapy, 20 received exclusive radiotherapy or chemoradiotherapy. Preoperative and exclusive median radiotherapy doses were 46 Gy (40–47 Gy) and 51.8 Gy (40–70 Gy), respectively. All patients treated with chemotherapy received at least platinum. Mean follow up was 44.1 months (0–128 months). Results Local, loco-regional and metastatic relapses occurred in 11 (26.2%), 2 (4.8%) and 15 patients (35.7%), respectively. Most common metastatic site was cerebral (7 patients, 46.7%). Median disease-free survival (DFS) was 9.7 months (8.9-10.4). One-, 2- and 5- years DFS rates were 44%, 33% and 26.5%, respectively. No prognostic factor was identified. Median overall survival (OS) was 22.6 months (10.4-34.8). One-, 2- and 5- years OS rates were 61.9%, 44.9% and 30.1%, respectively. Univariate prognostic factors for OS were WHO (p = 0.027) and tumoral response (p = 0.05). In multivariate analysis, independent favorable prognostic factors were WHO 0–1 (p = 0.017; OR = 0.316 [CI95% 0.123-0.81) and complete response to treatment (p = 0.035; OR = 0.312 [IC95% 0.106-0.919]). Conclusion This study highlighted that a good performans status and complete response to treatment are independent factors of OS, whatever the delivered treatment. Brain was the most common metastatic relapse site.
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Affiliation(s)
- Pierre Truntzer
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - Delphine N Antoni
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065, Strasbourg cedex, France. .,Radiobiology Laboratory EA 3430, Federation of Translational Medicine in Strasbourg (FMTS), Strasbourg University, Strasbourg, France.
| | - Nicola Santelmo
- Thoracic surgery department, Nouvel Hôpital civil, 1, place de l'Hôpital, 67091, Strasbourg cedex, France.
| | - Catherine Schumacher
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - Pierre-Emmanuel Falcoz
- Thoracic surgery department, Nouvel Hôpital civil, 1, place de l'Hôpital, 67091, Strasbourg cedex, France.
| | - Elisabeth Quoix
- Pneumology department, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67091, Strasbourg cedex, France.
| | - Jean-Pierre Steib
- Orthopaedic Department, Hôpital Civil, 1, place de l'Hôpital, 67091, Strasbourg cedex, France.
| | - Gilbert Massard
- Thoracic surgery department, Nouvel Hôpital civil, 1, place de l'Hôpital, 67091, Strasbourg cedex, France.
| | - Georges Noël
- Radiotherapy Department, Centre Paul Strauss, 3, rue de la Porte de l'Hôpital, BP 42, 67065, Strasbourg cedex, France. .,Radiobiology Laboratory EA 3430, Federation of Translational Medicine in Strasbourg (FMTS), Strasbourg University, Strasbourg, France.
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Billaud G, Antoni D, Bauer N, Clavier J, Pop M, Truntzer P, Vigneron C, Schumacher C, Noël G, Salze P. Analyse des dossiers de radiothérapie en réunion, analyse d’un recueil prospectif des conformités aux protocoles d’un service de radiothérapie. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.063] [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]
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Burgy M, Barthélémy P, Dupret-Bories A, Truntzer P, Korenbaum C, Meyer N, Flesch H, Bronner G, Heitz D, Nehme H, Guihard S, Hemar P, Borel C. Cetuximab plus platinum-based chemotherapy in elderly patients with recurrent or metastatic head and neck squamous cell carcinoma: A French experience from a single institution. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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30
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Clavier J, Antoni D, Bauer N, Guillerme F, Truntzer P, Atlani D, Guihard S, Lahlou A, Pop M, Thiriat S, Vigneron C, Poulin N, Noël G. Delineation of Brain Metastases for Stereotactic Radiation Therapy: An Interobserver Contour Comparison. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1037] [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: 11/16/2022]
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31
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Truntzer P, Santelmo N, Antoni D, Schumacher C, Falcoz P, Quoix E, Massard G, Noel G. EP-1150 Superior sulcus non small cell lung carcinoma: Retrospective analysis of 42 patients. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31268-8] [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: 11/16/2022]
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Keller A, Clavier J, Waisse W, Vigneron C, Bauer N, Antoni D, Truntzer P, Guihard S, Schumacher C, Pop M, Salze P, Noël G. Peut-on se passer de l’imagerie multimodalités dans la délinéation du lit opératoire des métastases cérébrales ? Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.07.005] [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: 10/26/2022]
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Antoni D, Clavier JB, Truntzer P, Pop M, Schumacher C, Lefebvre F, Noël G. Facteurs pronostiques de prise en charge thérapeutique des métastases cérébrales : analyse rétrospective de 777 cas. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.06.012] [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]
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Truntzer P, Atlani D, Pop M, Clavier JB, Guihard S, Schumacher C, Noel G. Early evaluation predicts pain relief of irradiated bone metastases: a single-center prospective study. BMC Palliat Care 2013; 12:12. [PMID: 23496823 PMCID: PMC3600038 DOI: 10.1186/1472-684x-12-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Accepted: 02/14/2013] [Indexed: 11/10/2022] Open
Abstract
Background Radiation therapy is a well-recognized, effective modality used for palliative care. Most studies completed to date have endpoints of one month or greater after treatment completion. This study analyzed the response rates at different time points during the first month after treatment. Methods From May 2010 to November 2011, 61 patients treated for 74 metastases were included in the study. The end points were defined as the completion of treatment (CT) and d8, d15 and d30 after the completion of treatment. The response rate was measured by the worst pain in the last 24 hours and the administered opioid dose. Patient assessment was performed during consultations and phone appointments. Results The overall response rate significantly improved from the CT (38%) to d8 (53.8%), d15 (53.8%) and d30 (57.1%) (respectively p < 0.001; p < 0.001 and p = 0.001). The improvement peaked at d8. Patients responding to the treatment at d8 had a significative longer pain relapse free survival (PRFS) compared to patients not responding (3.38 weeks vs 0.3 weeks; p < 0.001). From the beginning of treatment to the CT and at d8 , d15 and d30, oral morphine equivalent dose (OMED) did not significantly differ. However, the pain decrease did not result in a performance status improvement, which declined over time (p < 0.001). Conclusion Radiation therapy is an efficient treatment method for providing pain relief. This relief peaked at d8 after treatment, and the response at d8 is predictive of the response at 4 weeks. Pain management alone is not enough to improve performance status; further studies are needed to evaluate a more global supportive care approach.
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Affiliation(s)
- Pierre Truntzer
- Radiation department, against cancer center Paul Strauss, 3, rue de la porte de l'hôpital BP42, Strasbourg cedex, 67065, France.
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Truntzer P, Monjour A, Gaultier C, Ahle G, Guillerme F, Boutenbat G, Stilhart B, Salze P, Atlani D. SMART Syndrome : à propos d’un cas d’une complication rare après radiothérapie cérébrale et revue de la littérature. Cancer Radiother 2012; 16:295-301. [DOI: 10.1016/j.canrad.2012.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 03/26/2012] [Accepted: 03/28/2012] [Indexed: 10/28/2022]
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Guillerme F, Truntzer P, Prim N, Chenard MP, Voirin J, Noël G. [Solitary fibrous tumors: Case report of a late relapse]. Cancer Radiother 2011; 15:330-3. [PMID: 21680220 DOI: 10.1016/j.canrad.2010.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 06/09/2010] [Accepted: 06/16/2010] [Indexed: 11/16/2022]
Abstract
Authors report a case of a woman with a metastasis of a solitary fibrous tumor, 14 years after the diagnosis of a hemangiopericytoma of the soft tissues. This case report allows discussing the pathological features, the therapeutical option and the outcome of these tumors.
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Affiliation(s)
- F Guillerme
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'hôpital, BP 42, 67065 Strasbourg cedex, France
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