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Huguet F, Riou O, Pasquier D, Modesto A, Quéro L, Michalet M, Bordron A, Schipman B, Orthuon A, Lisbona A, Vendrely V, Jaksic N. Radiation therapy of the primary tumour and/or metastases of digestive metastatic cancers. Cancer Radiother 2024; 28:66-74. [PMID: 37806823 DOI: 10.1016/j.canrad.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 10/10/2023]
Abstract
Metastatic gastrointestinal cancer is not an uncommon situation, especially for pancreatic, gastric, and colorectal cancers. In this setting, few data are available on the impact of the treatment of the primary tumour. Oligometastatic disease is associated with longer survival in comparison with more advanced disease. Metastasis-directed therapy, such as stereotactic body radiotherapy, seems related to better outcomes, but the level of evidence is low. In most tumour locations, prospective data are very scarce and inclusion in ongoing trials is strongly recommended.
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Affiliation(s)
- F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, AP-HP, DMU Orphé, Sorbonne université, Paris, France; Laboratory of Cancer Biology and Therapeutics, centre de recherche Saint-Antoine, U938, Inserm, Paris, France.
| | - O Riou
- Institut de recherche en cancérologie de Montpellier, U1194, Inserm, université de Montpellier, Montpellier, France; Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, ICM, institut régional du cancer de Montpellier, Montpellier, France
| | - D Pasquier
- Service d'oncologie radiothérapie, centre Oscar-Lambret, Lille, France; Université de Lille, CNRS, école centrale de Lille, UMR 9189 - CRIStAL, Lille, France
| | - A Modesto
- Département de radiothérapie, institut universitaire du cancer de Toulouse, Toulouse, France; Centre de recherche du cancer de Toulouse, UMR 1037, Inserm, université Toulouse-III Paul-Sabatier, Toulouse, France
| | - L Quéro
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, AP-HP Nord, DMU Icare, Paris, France; Université Paris Cité, U1160, Inserm, Paris, France
| | - M Michalet
- Institut de recherche en cancérologie de Montpellier, U1194, Inserm, université de Montpellier, Montpellier, France; Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, ICM, institut régional du cancer de Montpellier, Montpellier, France
| | - A Bordron
- Département de radiothérapie, centre hospitalier universitaire de Brest, Brest, France
| | - B Schipman
- Institut de cancérologie de Bourgogne, Dijon, France
| | - A Orthuon
- Institut de cancérologie de Bourgogne, Dijon, France
| | - A Lisbona
- Institut de cancérologie de l'Ouest, centre René-Gauducheau, Saint-Herblain, France
| | - V Vendrely
- Service d'oncologie radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - N Jaksic
- Institut de cancérologie et radiothérapie Brétillien, Saint-Malo, France
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2
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Boustani J, Huguet F, Vendrely V. Practice-changing clinical trials in radiation oncology for gastrointestinal malignancies in 2021-2023. Cancer Radiother 2023; 27:768-777. [PMID: 38415359 DOI: 10.1016/j.canrad.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/22/2023] [Indexed: 02/29/2024]
Abstract
Gastrointestinal cancers are one of the most frequent cancers and a leading cause of cancer deaths worldwide. We provide an overview of the most important practice-changing trials that were either published or presented at the international scientific meetings in 2021-2023. Highlights included reports on three phase III trials (CONCORDE/PRODIGE 26, ARTDECO, and a study by Xu et al.) that evaluated dose escalation in the definitive setting for locally advanced oesophageal cancers, as well as two phase III trials that evaluated the role of chemotherapy (neo-AEGIS) and targeted therapy (NRG/RTOG 1010) in the neoadjuvant setting for adenocarcinoma oesophageal cancers or gastroesophageal junction cancer. CheckMate 577 evaluated nivolumab in patients who had residual pathological disease after neoadjuvant chemoradiation followed by complete resection. The use of radiation therapy for borderline and locally advanced pancreatic cancer is also discussed (SMART and CONKO-007 trials). Stereotactic body radiation therapy followed by sorafenib was compared to sorafenib alone in patients with hepatocellular carcinoma in the NRG/RTOG 1112 study. New options in the management of rectal cancer are emerging such as total neoadjuvant treatment (PRODIGE 23, RAPIDO, PROSPECT), organ preservation (OPRA, OPERA), and the role of immunotherapy in patients with DNA mismatch-repair deficient/microsatellite instability. Finally, preliminary results of the ACT 4 trial that evaluated de-escalation in anal cancer are presented.
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Affiliation(s)
- J Boustani
- Department of Radiation Oncology, centre hospitalier universitaire de Besançon, Besançon, France; Inserm, EFS BFC, UMR 1098, RIGHT, Greffon-hôte-tumeur interactions/Ingénierie cellulaire et génique, université de Franche-Comté, Besançon, France.
| | - F Huguet
- Department of Radiation Oncology, hôpital Tenon, AP-HP, Sorbonne université, Paris, France
| | - V Vendrely
- Department of Radiation Oncology, centre hospitalier universitaire de Bordeaux, Bordeaux, France; BoRdeaux Institute of onCology (BRIC), UMR1312, Inserm, université de Bordeaux, 33000, Bordeaux, France
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3
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Vuong T, Garant A, Vendrely V, Martin AG, Devic S. Clinical applications of high dose rate endorectal brachytherapy for patients with rectal cancer. Cancer Radiother 2022; 26:879-883. [PMID: 36031497 DOI: 10.1016/j.canrad.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022]
Abstract
With the establishment of total mesorectal excision for the treatment of rectal cancer, local recurrence rates have significantly decreased. The addition of preoperative external beam irradiation further reduces this risk to less than 6%. As the local treatment becomes successful and more widely used, the associated treatment-related toxicity is becoming clinically important. If 4 to 6% of the patients are to benefit from neo-adjuvant therapy before total mesorectal excision, the acute and the long-term toxicity burden must be reasonable. With the introduction of better-quality imaging for tumour visualization and treatment planning, a new-targeted radiation treatment was introduced with high dose rate endorectal brachytherapy. The treatment concept was tested in phase I and II studies first in the preoperative setting, then as a boost after external beam radiation therapy as a dose escalation study to achieve higher tumour local control in a radical treatment setting with no surgery. High dose rate endorectal brachytherapy is safe and effective in achieving high tumour regression rate and was well tolerated. It is presently explored in a phase III dose escalation study in the non-operative management of patients with operable rectal cancer.
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Affiliation(s)
- T Vuong
- Radiation Oncology Department, Jewish General Hospital, McGill University, Montreal, Québec, Canada H3T 1E2.
| | - A Garant
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, USA
| | - V Vendrely
- Department of Radiation Oncology, CHU de Bordeaux, 33000 Bordeaux, France; BoRdeaux Institute of onCology (BRIC), UMR1312, Inserm, université de Bordeaux, 33000 Bordeaux, France
| | - A-G Martin
- Service de radio-oncologie, CHU de Québec, Université Laval, Québec, Canada
| | - S Devic
- Radiation Oncology Department, Jewish General Hospital, McGill University, Montreal, Québec, Canada H3T 1E2
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Mollier O, Dupin C, Marnat G, Benech J, Vendrely V, Giraud N, Trouette R, Barreau X, Huchet A. [Stereotactic radiotherapy of non-tumoral brain pathologies: Arteriovenous malformations and trigeminal neuralgias]. Cancer Radiother 2022; 26:779-783. [PMID: 36030190 DOI: 10.1016/j.canrad.2022.06.023] [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: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 10/15/2022]
Abstract
Stereotactic radiotherapy and radiosurgery allow delivery of high irradiation doses in a limited volume. These techniques are specially adapted to brain and nervous pathologies. Indication are not only cancers and tumors but also non tumor tissues such as arteriovenous malformations. In some case purpose of stereotactic radiotherapy is solely functional, for example for trigeminal neuralgia. We detail the questions that raise treatment of these non-tumor pathologies. These pathologies imply a multidisciplinary approach that associate radiation oncologists, neuro-radiologist and neurosurgeons.
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Affiliation(s)
- O Mollier
- Service de neurochirurgie A, hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - C Dupin
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France; U1312-BRIC, eq BioGO, Inserm, université de Bordeaux, 33000 Bordeaux, France
| | - G Marnat
- Service de radiologie et de neuro-imagerie diagnostique et thérapeutique, hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - J Benech
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - V Vendrely
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France; U1312-BRIC, eq BioGO, Inserm, université de Bordeaux, 33000 Bordeaux, France
| | - N Giraud
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - R Trouette
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - X Barreau
- Service de radiologie et de neuro-imagerie diagnostique et thérapeutique, hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - A Huchet
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France.
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5
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Delhiat AC, Combet-Curt V, Vendrely V. [Anal cancer: Focus on current treatment and future perspective]. Cancer Radiother 2022; 26:871-874. [PMID: 36008262 DOI: 10.1016/j.canrad.2022.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 10/15/2022]
Abstract
Anal cancer is considered a rare tumor, accounting for 6 % of digestive cancers and about 2000 new cases per year in France. It is mostly diagnosed at a localized stage. For many years, the standard of care for patients with localized disease is an association with radiotherapy and chemotherapy including Mitomycin C and 5-Fluorouracil. There weren't any major changes in the therapeutic management of these tumors despite several phase III studies. However, there is an improvement in patient prognostic. This can be explained by imaging progress, using magnetic resonance imaging and positron emission tomography-computed tomography, permitting better staging and evaluation of disease. Moreover, irradiation modalities changed because of the development of Intensity Modulated Radiotherapy. Actual research focuses on a more personalized strategy according to tumoral stages. Patients with early-stage tumors are potentially over-treated with a risk of chronic digestive toxicities. Several studies are interested in irradiation de-escalation for these patients. On the other hand, treatment results for patients with advanced tumoral stages are disappointing. It seems relevant to propose a therapeutic intensification for these patients, such as dose escalation, association with new therapies like immunotherapy or induction chemotherapy using taxans given promising results at the metastatic stage.
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Affiliation(s)
- A C Delhiat
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - V Combet-Curt
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - V Vendrely
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France; U1312-BRIC, eq BioGO, Inserm, université de Bordeaux, 33000 Bordeaux, France.
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6
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Larrouy A, Giraud N, Huguet F, Vendrely V. [Organ preservation for rectal cancer: What are the arguments in favor of radiotherapy?]. Cancer Radiother 2022; 26:766-770. [PMID: 35995720 DOI: 10.1016/j.canrad.2022.06.013] [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: 06/10/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
Standard care for rectal cancers relies on both tumor (location relative to the sphincter, T and N stage, sphincter involvement) and patients characteristics. Radical surgery (total mesorectal excision) following short-course radiotherapy (RT) or standard chemo-radiotherapy, associated with induction or consolidation chemotherapy (total neoadjuvant treatment), remains the cornerstone of locally advanced rectal cancer (T3cd, T4 and/or N+) treatment. Nevertheless, for early stages, this radical resection could be avoided in favor of conservative approaches combining RT (external, contact, brachytherapy) with or without chemotherapy (concurrent, induction or consolidative), or even be limited, for good responders, to a local excision with view of organ-preservation strategies. This conservative approach could also be offered selectively to patients with complete clinical response after the induction sequence, irrespective of initial tumor characteristics. The Watch and Wait strategy relies on clinical, endoscopic and radiological evaluations, as well as sustained surveillance. Ongoing studies aim to improve response rates, either with chemotherapy intensification, or RT boost dose escalation with brachytherapy or contact-therapy.
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Affiliation(s)
- A Larrouy
- Institut cancérologie Paris Nord, service d'oncologie radiothérapie, avenue Charles-Péguy, 95200 Sarcelles, France.
| | - N Giraud
- Service d'oncologie radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France
| | - F Huguet
- Assistance publique-Hôpitaux de Paris, service d'oncologie radiothérapie, hôpital Tenon, AP-HP, Sorbonne université, Paris, France
| | - V Vendrely
- Service d'oncologie radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, Bordeaux, France; U1312-BRIC, eq BioGO, Inserm, université de Bordeaux, 33000 Bordeaux, France
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Evin C, Quéro L, Le Malicot K, Blanchet-Deverly S, François E, Buchalet C, Lemanski C, Baba Hamed N, Rivin del Campo E, Bauwens L, Pommier P, Lièvre A, Tougeron D, Macé V, Sergent G, Diaz O, Zucman D, Mornex F, Locher C, De la Rochefordière A, Vendrely V, Huguet F. MO-0226 Clinical outcomes of HIV-positive patients with anal cancer in the ANABASE multicentric cohort. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02328-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Dupin C, Caspar V, Charleux T, Beddok A, Giraud N, Bernard B, Martin M, Trouette R, Thariat J, Huchet A, Vendrely V. OC-0926 Dose to the dorsal vagal complex is predictive of radiation induced nausea. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02706-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
We present the updated recommendations of the French society for radiation oncology on radiotherapy of oesophageal cancer. Oesophageal cancer still remains a malignant tumour with a poor prognosis. Surgery remains the standard treatment for localized cancers, regardless of histology. For locally advanced stages, surgery remains a standard for adenocarcinomas after neoadjuvant treatment with chemotherapy or chemoradiotherapy. However, it is a therapeutic option after initial chemoradiotherapy for stage III squamous cell carcinomas, given the increased morbidity and mortality with a multimodal treatment, which results in an equivalent overall survival with or without surgery. Preoperative or exclusive chemoradiotherapy should be delivered according to validated regimens with an effective total dose (50Gy), if surgery is not planned or if the tumour is deemed resectable before chemoradiotherapy. Intensity-modulated radiotherapy significantly reduces irradiation of the lungs and heart and may reduce the morbidity of this treatment, especially in combination with surgery. In case of exclusive chemoradiotherapy, dose escalation beyond 50Gy is not currently recommended. Some technical considerations still remain questionable, such as the place of prophylactic lymph node irradiation, adaptive radiotherapy, evaluation of response during and after chemoradiotherapy and the value of proton therapy.
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Affiliation(s)
- G Créhange
- Service d'oncologie radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
| | - A Modesto
- Service d'oncologie radiothérapie, institut Claudius-Regaud, université de Toulouse, 31000 Toulouse, France
| | - V Vendrely
- Service d'oncologie radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France
| | - L Quéro
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefeaux, 75010 Paris, France
| | - X Mirabel
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - P Rétif
- Département of physique médicale, CHRU de Metz, 1, allée du Château, 57085 Metz, France
| | - F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires Est Parisien, Sorbonne université, 75020 Paris, France
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Peiffert D, Huguet F, Vendrely V, Moureau-Zabotto L, Rivin Del Campo E, Créhange G, Dietmann AS, Moignier A. Radiotherapy of anal canal cancer. Cancer Radiother 2021; 26:279-285. [PMID: 34955416 DOI: 10.1016/j.canrad.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present the update of the recommendations of the French society for radiation oncology on external radiotherapy and brachytherapy of anal canal carcinoma. The following guidelines are presented: indications, treatment procedure, as well as dose and dose-constraints objectives, immediate postoperative management, post-treatment evaluation, and long-term follow-up.
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Affiliation(s)
- D Peiffert
- Département de radiothérapie, Institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
| | - F Huguet
- Service de radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - V Vendrely
- Service d'oncologie-radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France; Inserm U1035, université de Bordeaux, 33000 Bordeaux, France
| | - L Moureau-Zabotto
- Service de radiothérapie, institut Paoli-Calmettes, 13000 Marseille, France
| | - E Rivin Del Campo
- Service de radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - G Créhange
- Département d'oncologie radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - A-S Dietmann
- Département de radiothérapie, Institut de cancérologie de Lorraine Alexis-Vautrin, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - A Moignier
- Service de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, 44805 Saint-Herblain, France
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Vendrely V, Rivin Del Campo E, Modesto A, Jolnerowski M, Meillan N, Chiavassa S, Serre AA, Gérard JP, Créhanges G, Huguet F, Lemanski C, Peiffert D. Rectal cancer radiotherapy. Cancer Radiother 2021; 26:272-278. [PMID: 34953708 DOI: 10.1016/j.canrad.2021.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We present the updated recommendations of the French society of oncological radiotherapy for rectal cancer radiotherapy. The standard treatment for locally advanced rectal cancer consists in chemoradiotherapy followed by radical surgery with total mesorectal resection and adjuvant chemotherapy according to nodal status. Although this strategy efficiently reduced local recurrences rates below 5% in expert centres, functional sequelae could not be avoided resulting in 20 to 30% morbidity rates. The early introduction of neoadjuvant chemotherapy has proven beneficial in recent trials, in terms of recurrence free and metastasis free survivals. Complete pathological responses were obtained in 15% of tumours treated by chemoradiation, even reaching up to 30% of tumours when neoadjuvant chemotherapy is associated to chemoradiotherapy. These good results question the relevance of systematic radical surgery in good responders. Personalized therapeutic strategies are now possible by improved imaging modalities with circumferential margin assessed by magnetic resonance imaging, by intensity modulated radiotherapy and by refining surgical techniques, and contribute to morbidity reduction. Keeping the same objectives, ongoing trials are now evaluating therapeutic de-escalation strategies, in particular rectal preservation for good responders after neoadjuvant treatment, or radiotherapy omission in selected cases (Greccar 12, Opera, Norad).
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Affiliation(s)
- V Vendrely
- Service d'oncologie radiothérapie, Hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France; Inserm U1035, université de Bordeaux, 33000 Bordeaux, France.
| | - E Rivin Del Campo
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires Est Parisien, Sorbonne université, 75020 Paris, France
| | - A Modesto
- Service d'oncologie radiothérapie, institut Claudius-Regaud, université de Toulouse, 31000 Toulouse, France
| | - M Jolnerowski
- Service universitaire de radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 54000 Nancy, France
| | - N Meillan
- Service d'oncologie radiothérapie, hôpital Pitié Salpêtrière, APHP, Sorbonne université, 75013 Paris, France
| | - S Chiavassa
- Service de physique médicale, Institut de cancérologie de l'Ouest (ICO) centre René-Gauducheau, 44805 Saint-Herblain, France
| | - A-A Serre
- Service d'oncologie radiothérapie, centre Léon-Bérard, 69000 Lyon, France
| | - J-P Gérard
- Service d'oncologie radiothérapie, centre Antoine-Lacassagne, université Côte d'Azur, 06000 Nice, France
| | - G Créhanges
- Service d'oncologie radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, Hôpitaux universitaires Est Parisien, Sorbonne université, 75020 Paris, France
| | - C Lemanski
- Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, Institut du cancer de Montpellier, université de Montpellier, 34000 Montpellier, France
| | - D Peiffert
- Service universitaire de radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 54000 Nancy, France
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12
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Huguet F, Rivin Del Campo E, Orthuon A, Mornex F, Bessières I, Guimas V, Vendrely V. Radiation therapy of pancreatic cancers. Cancer Radiother 2021; 26:259-265. [PMID: 34953706 DOI: 10.1016/j.canrad.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We present the update of the recommendations of the French society of oncological radiotherapy on radiotherapy of pancreatic tumors. Currently, the use of radiation therapy for patients with pancreatic cancer is subject to discussion. In the adjuvant setting, the standard treatment is six months of chemotherapy with 5-fluorouracile, irinotecan and oxaliplatin. Chemoradiation may improve the survival of patients with incompletely resected tumours (R1). This remains to be confirmed by a prospective trial. Neoadjuvant chemoradiation is a promising treatment especially for patients with borderline resectable tumours. For patients with locally advanced tumours, there is no standard. An induction chemotherapy followed by chemoradiation for non progressive patients reduces the rate of local relapse. Whereas in the first trials of chemoradiation large fields were used, the treated volumes have been reduced to improve tolerance. Tumour movements induced by breathing should be taken in account. Intensity modulated radiation therapy allows a reduction of doses to the organs at risk. Whereas widely used, this technique has poor evidence-based recommendation. Stereotactic body radiation therapy is also being studied, as a neoadjuvant or exclusive treatment.
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Affiliation(s)
- F Huguet
- Service d'oncologie radiothérapie, hôpital Tenon, hôpitaux universitaires Est Parisien, Sorbonne Université, 4, rue de la Chine, 75020 Paris, France.
| | - E Rivin Del Campo
- Service d'oncologie radiothérapie, hôpital Tenon, hôpitaux universitaires Est Parisien, Sorbonne Université, 4, rue de la Chine, 75020 Paris, France
| | - A Orthuon
- Service d'oncologie radiothérapie, hôpital Tenon, hôpitaux universitaires Est Parisien, Sorbonne Université, 4, rue de la Chine, 75020 Paris, France
| | - F Mornex
- Service de radiothérapie, centre hospitalier Lyon-Sud, hospices civils, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - I Bessières
- Département de physique médicale, centre Georges-François-Leclerc, 1, rue Professeur-Marion, 21000 Dijon, France
| | - V Guimas
- Service d'oncologie radiothérapie, institut de cancérologie de l'Ouest centre René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - V Vendrely
- Service de radiothérapie, CHU de Bordeaux, 33604 Pessac cedex, France
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Caspar V, Charleux T, Beddok A, Giraud N, Bernard B, Martin M, Thariat J, Dupin C, Huchet A, Vendrely V. Impact dosimétrique de la dose au complexe vagal dorsal et survenue de nausées en cours de radiothérapie. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Evin C, Quéro L, Le Malicot K, Blanchet-Deverly S, François E, Buchalet C, Lemanski C, Baba Hamed N, Rivin Del Campo E, Bauwens L, Pommier P, Lièvre A, Tougeron D, Mace V, Sergent G, Diaz O, Zucman D, Mornex F, Locher C, de La Rochefordiere A, Vendrely V, Huguet F. Efficacité et toxicité de la (chimio)radiothérapie chez les patients séropositifs pour le VIH atteints d’un carcinome épidermoïde du canal anal, analyse en sous-groupe de la cohorte multicentrique Anabase. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Martin M, Giraud N, Capdepont M, Sarrade C, Viaouet A, Smith D, Terrebonne E, Frulio N, Rullier A, Denost Q, Rullier E, Vendrely V. Morbidité chirurgicale sévère après une chimioradiothérapie néoadjuvante en technique conformationnelle tridimensionnelle comparée à la modulation d’intensité pour l’adénocarcinome rectal localement évolué. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Pouypoudat C, Trouette R, Bernard B, Vendrely V. [Role of stereotactic radiotherapy in the treatment of oligometastatic colorectal cancer]. Cancer Radiother 2021; 25:523-525. [PMID: 34454836 DOI: 10.1016/j.canrad.2021.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Abstract
Stereotactic radiotherapy is used for patients with oligometastases from colorectal cancer. It results in good local tumour control, especially for hepatic and pulmonary metastases, subject to a sufficiently high biologically effective dose, and is well-tolerated. It can be associated with other local treatments such as surgery or radiofrequency as part of combined treatments, in order to increase patient survival.
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Affiliation(s)
- C Pouypoudat
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33, avenue Magellan, 33600 Pessac, France.
| | - R Trouette
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33, avenue Magellan, 33600 Pessac, France
| | - B Bernard
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33, avenue Magellan, 33600 Pessac, France
| | - V Vendrely
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33, avenue Magellan, 33600 Pessac, France
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Martin M, Giraud N, Capdepont M, Sarrade C, Viaouet A, Smith D, Terrebonne E, Frulio N, Rullier A, Denost Q, Rullier E, Vendrely V. PO-1244 Severe surgical morbidity after chemoradiotherapy conformational-3D versus IMRT for rectal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07695-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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De Baère T, Pracht M, Rolland Y, Durand-Labrunie J, Nguyen F, Bronowicki J, Vendrely V, Cunha AS, Croisé-Laurent V, Rio E, Le Sourd S, Said P, Gustin P, Perret C, Peiffert D, Deutsch E, Chajon E. PH-0159: NANORAY-103: Phase I/II trial of NBTXR3 activated by SBRT in patients with HCC and liver metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Denost Q, Moreau JB, Vendrely V, Celerier B, Rullier A, Assenat V, Rullier E. Intersphincteric resection for low rectal cancer: the risk is functional rather than oncological. A 25-year experience from Bordeaux. Colorectal Dis 2020; 22:1603-1613. [PMID: 32649005 DOI: 10.1111/codi.15258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 04/03/2020] [Indexed: 02/07/2023]
Abstract
AIM There are few data evaluating the long-term outcomes of intersphincteric resection (ISR), especially the impact of inclusion of more juxtapositioned and intra-anal tumours on oncological and functional outcomes. We compared the oncological and functional results of patients treated by total mesorectal excision and ISR for low rectal cancer over a 25-year period. METHOD This is a retrospective study from a single institution evaluating results of ISR over three periods: 1990-1998, 1999-2006 and 2007-2014. Patients treated by partial or total ISR, with or without neoadjuvant chemoradiotherapy, for low rectal cancer (≤ 6 cm from the anal verge) were included. We compared postoperative morbidity, quality of surgery and oncological and functional outcomes in the time periods studied. RESULTS Of 813 patients operated on for low rectal cancer, 303 had ISR. Tumour stage did not differ; however, the distance of the tumour from the anorectal junction decreased from 1 to 0 cm (P < 0.001) and the distal resection margin shortened from 25 to 10 mm (P < 0.001) from 1990 to 2014. The postoperative morbidity and quality of surgery did not change significantly over time. The 5-year local recurrence (4.3% vs 5.9% vs 3.5%; P = 0.741) and disease-free survival (72% vs 71% vs 75%; P = 0.918) did not differ between the three time periods. Functional results improved during the last period; however, overall 42% of patients experienced major bowel dysfunction. CONCLUSION Pushing the envelope of sphincter-saving resection in ultra-low rectal cancer reaching or invading the anal sphincter did not compromise oncological and functional outcomes. The main limitation of the ISR procedure appears to be functional rather than oncological, suggesting that bowel rehabilitation programmes should be developed.
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Affiliation(s)
- Q Denost
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - J-B Moreau
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - V Vendrely
- Department of Radiotherapy, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - B Celerier
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - A Rullier
- Department of Pathology, CHU Bordeaux, Pellegrin Hospital, University of Bordeaux, Bordeaux, France
| | - V Assenat
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
| | - E Rullier
- Department of Colorectal Surgery, CHU Bordeaux, Haut-Leveque Hospital, University of Bordeaux, Pessac, France
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François MO, Buscail E, Vendrely V, Célérier B, Assénat V, Moreau JB, Rullier E, Denost Q. Delayed coloanal anastomosis: an alternative option for restorative rectal cancer surgery after high-dose pelvic radiotherapy for prostate cancer. Colorectal Dis 2020; 22:1545-1552. [PMID: 32463973 DOI: 10.1111/codi.15144] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/27/2020] [Indexed: 02/08/2023]
Abstract
AIM Restorative total mesorectal excision (TME) for rectal cancer after high-dose pelvic radiotherapy for prostate cancer has been reported to provide an unacceptable rate of pelvic sepsis. In a previous publication we proposed that delayed coloanal anastomosis (DCAA) should be performed in this situation. The present study aimed to assess the feasibility and outcomes of this strategy. METHOD Between 2000 and 2018, 1094 men were operated on for rectal cancer in our institution. All men with T2/T3 mid and low rectal cancer with preoperative radiotherapy and restorative TME were considered for this study (n = 416). Patients with external-beam high-dose radiotherapy (EBHRT) for prostate cancer (70-78 Gy) were identified and compared with patients with conventional long-course chemoradiotherapy (CRT) followed by TME. We compared our already published historical cohort (2000-2012), including arm A (CRT + TME; n = 236) and arm B (EBHRT + TME; n = 12), with our early cohort (2013-2018), including arm C (CRT + TME; n = 158) and arm D (EBHRT + TME-DCAA; n = 10). The end-points were morbidity, pelvic sepsis, reoperation rate and quality of the specimen. RESULTS Overall morbidity was not significantly different between groups. Pelvic sepsis decreased from 50% (arm B) to 10% (arm D) with the use of DCAA (P = 0.074), and was similar between arms A, C and D. Quality of the specimen was not significantly different between the four groups. CONCLUSION Our results suggest that TME with DCAA in patients with previous EBHRT is feasible, with the same postoperative pelvic sepsis rate as conventional CRT.
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Affiliation(s)
- M-O François
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - E Buscail
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - V Vendrely
- Department of Radiotherapy, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - B Célérier
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - V Assénat
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - J-B Moreau
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - E Rullier
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
| | - Q Denost
- Department of Digestive Surgery, CHU de Bordeaux, Haut-Lévêque Hospital, Pessac, France
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21
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Giraud N, Aparicio T, Ronchin P, Bazire LA, Le Malicot K, Lemanski C, Mirabel X, Étienne PL, Lièvre A, Cacheux W, Darut-Jouve A, de la Fouchardière C, Breysacher G, Argo-Leignel D, Tessier A, Magné N, Ben Abdelghani M, Lepage C, Saut O, Vendrely V. Apport de la radiomique sur IRM pour prédire la réponse à 2 ans après chimioradiothérapie des cancers du canal anal localement évolués. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.009] [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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22
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Kim S, Meurisse A, Stouvenot M, Jary M, Hon TNT, Francois E, Buecher B, Andre T, Samalin E, Boulbair F, De Bari B, Almotlak H, Klajer E, Calcagno F, Chatillon E, Spehner L, Jacquin M, Vendrely V, Vernerey D, Borg C. Updated data of epitopes-HPV02 trial and external validation of efficacy of DCF in prospective epitopes-HPV01 study in advanced anal squamous cell carcinoma. Pooled analysis of 115 patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Guimbaud R, Quero L, Vendrely V, Tougeron D, Benerezy K, Samalin E, Aparicio T, Zitvogel L, Selves J, Otal P, Cohen-Jonathan Moyal E, Delord JP, Pezzella V, Filleron T, Modesto A. PRODIGE67_UCGI33 ARION: Association of radiochemotherapy and immunotherapy for the treatment of unresectable oesophageal cancer: A comparative randomized phase II trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Charleux T, Vendrely V, Trouette R, Huchet A, Tabarin A, Jecko V, Loiseau H, Dupin C. Évolution des adénomes hypophysaires non fonctionnels après chirurgie première : à propos de 256 patients. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.116] [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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25
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Giraud N, Herran C, Terlizzi M, Bacci M, Bringer S, Ortiz F, Vienne A, Trouette R, Buscail E, Pouypoudat C, Vendrely V. Tolérance de la chimioradiothérapie chez les patients âgés de plus de 70 ans pris en charge pour des cancers du pancréas. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.060] [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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26
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Martin M, Atallah V, Prey S, Gérard E, Amestoy F, Benziane N, Leduc N, Huchet A, Beylot-Barry M, Dupin C, Nora O, Dutriaux C, Trouette R, Dousset L, Vendrely V. Radiothérapie concomitante chez des patients pris en charge par immunothérapie pour mélanome avec mutation de B-RAF après thérapie ciblée : étude monocentrique comparative sur 114 patients. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.061] [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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27
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Bringer-Macquère S, Trouette R, Dupin C, Pouypoudat C, Adgie S, Bailly L, Benech J, Bernard B, Coulibaly S, Sarrade C, Proust F, Vendrely V. Radiothérapie stéréotaxique des oligométastases surrénaliennes : retour d’expérience du CHU de Bordeaux. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pracht M, Chajon E, Rolland Y, de Baere T, Nguyen F, Bronowicki JP, Vendrely V, Sa Cunha A, Baumann AS, Croisé-Laurent V, Rio E, Said P, Le Sourd S, Gustin P, Perret C, Peiffert D, Deutsch E. Phase I/II trial of NBTXR3 activated by SBRT in patients with hepatocellular carcinoma or liver metastasis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rodriguez EC, Pracht M, Rolland Y, De Baere T, Nguyen T, Bronowicki J, Vendrely V, Cunha AS, Baumann A, Croisé-Laurent V, Rio E, Le Sourd S, Gustin P, Perret C, Peiffert D, Deutsch E. Hafnium Oxide Nanoparticles Activated by SBRT for the Treatment of Hepatocellular Carcinoma and Liver Metastasis: A Phase I/II Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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De Baere T, Pracht M, Rolland Y, Nguyen F, Bronowicki J, Vendrely V, Cunha AS, Baumann A, Croisé-Laurent V, Rio E, Sourd SL, Gustin P, Perret C, Peiffert D, Deutsch E, Chajon E. Hafnium oxide nanoparticles activated by SBRT: a new interventional radiation therapy approach for the treatment of unresectable liver cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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31
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Benziane N, Atallah V, Amestoy F, Gerard E, Leduc N, Huchet A, Barry MB, Dupin C, Prey S, Dousset L, Ouabrache N, Martin M, Gillon P, Dutriaux C, Trouette R, Vendrely V. EP-1596 Radiotherapy and Ipilimumab as first-line immunotherapy: A comparative study on 63 patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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32
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Lambert S, Huchet A, Trouette R, Karahissarlian V, Pouypoudat C, Atallah V, Dutriaux C, Vendrely V. EP-1226 Survival in patients with melanoma brain metastases treated by stereotactic radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31646-9] [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: 10/26/2022]
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33
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Vendrely V, Amintas S, Noël C, Moranvillier I, Lamrissi I, Rousseau B, Coulibaly S, Bedel A, Moreau-Gaudry F, Buscail E, Chiche L, Belleannée G, Dupin C, Dabernat S. OC-0266 Pancreatic ductal adenocarcinoma sensitization to radiotherapy by bioactive food components. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30686-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Charleux T, Vendrely V, Huchet A, Trouette R, Tabarin A, Jecko V, Loiseau H, Dupin C. EP-1245 Evolution of non functioning pituitary adenoma after first surgery : long follow-up of 256 patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31665-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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35
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Dupin C, Poncin R, Daste A, Majoufre C, Castetbon V, De-Mones E, Trouette R, Vendrely V. EP-1162 Post-radiotherapy sarcopenia: a new prognostic factor in oropharyngeal cancers? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31582-8] [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: 11/28/2022]
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36
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Chajon E, Pracht M, De Baere T, N’Guyen F, Bronowicki J, Vendrely V, Baumann A, Croisé-Laurent V, Rio E, Rolland Y, Le Sourd S, Gustin P, Perret C, Mornex F, Peiffert D, Merle P, Deutsch E. OC-0281 Phase I/II trial of hafnium oxide nanoparticles activated by SBRT in the treatment of liver cancers. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30701-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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37
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Blais E, Vendrely V, Sargos P, Créhange G, Huguet F, Maingon P, Simon JM, Bourdais R, Ozsahin M, Bourhis J, Clément-Colmou K, Belghith B, Proudhom Briois MA, Gilliot O, Dujols JP, Peyras A, Dupin C, Riet FG, Canova CH, Huertas A, Troussier I. Chimioradiothérapie des cancers de l’œsophage : revue critique de la littérature. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2018.12.004] [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: 10/27/2022]
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Blais E, Vendrely V, Sargos P, Créhange G, Huguet F, Maingon P, Simon JM, Bourdais R, Ozsahin M, Bourhis J, Clément-Colmou K, Belghith B, Proudhom Briois MA, Gilliot O, Dujols JP, Peyras A, Dupin C, Riet FG, Canova CH, Huertas A, Troussier I. [Chemoradiation for oesophageal cancer: A critical review of the literature]. Cancer Radiother 2019; 23:62-72. [PMID: 30639379 DOI: 10.1016/j.canrad.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 10/27/2022]
Abstract
Locally advanced oesophageal cancer treatment requires a multidisciplinary approach with the combination of chemotherapy and radiotherapy for preoperative and definitive strategy. Preoperative chemoradiation improves the locoregional control and overall survival after surgery for locally advanced oesophageal cancer. Definitive chemoradiation can also be proposed for non-resectable tumours or medically inoperable patients. Besides, definitive chemoradiation is considered as an alternative option to surgery for locally advanced squamous cell carcinomas. Chemotherapy regimen associated to radiotherapy consists of a combination of platinum derived drugs (cisplatinum or oxaliplatin) and 5-fluorouracil or a weekly scheme combination of carboplatin and paclitaxel according to CROSS protocol in a neoadjuvant strategy. Radiation doses vary from 41.4Gy to 45Gy for a preoperative strategy or 50 to 50.4Gy for a definitive treatment. The high risk of lymphatic spread due to anatomical features could justify the use of an elective nodal irradiation when the estimated risk of microscopic involvement is higher than 15% to 20%. An appropriate delineation of the gross tumour volume requires an exhaustive and up-to-date evaluation of the disease. Intensity-modulated radiation therapy represents a promising approach to spare organs-at-risk. This critical review of the literature underlines the roles of radiotherapy for locally advanced oesophageal cancers and describes doses, volumes of treatment, technical aspects and dose constraints to organs-at-risk.
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Affiliation(s)
- E Blais
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - V Vendrely
- Service de radiothérapie, CHU de Bordeaux-Haut Lévêque, avenue du Haut-Lévêque, 33600 Pessac, France
| | - P Sargos
- Service de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - G Créhange
- Service de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - F Huguet
- Service de radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - P Maingon
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - J-M Simon
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - R Bourdais
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Ozsahin
- Service de radio-oncologie, CHUV, rue du Bugnon 46, 1011 Lausanne, Suisse
| | - J Bourhis
- Service de radio-oncologie, CHUV, rue du Bugnon 46, 1011 Lausanne, Suisse
| | - K Clément-Colmou
- Service de radiothérapie, institut de cancérologie de l'Ouest (ICO) centre René-Gauducheau, boulevard Professeur-Jacques-Monod, 44800 Saint-Herblain, France
| | - B Belghith
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M-A Proudhom Briois
- Service de radiothérapie, groupe de radiothérapie et d'oncologie des Pyrénées, 49, rue Aristide-Briand, 64000 Pau, France
| | - O Gilliot
- Service de radiothérapie, groupe de radiothérapie et d'oncologie des Pyrénées, 49, rue Aristide-Briand, 64000 Pau, France
| | - J-P Dujols
- Service de radiothérapie, groupe de radiothérapie et d'oncologie des Pyrénées, 49, rue Aristide-Briand, 64000 Pau, France
| | - A Peyras
- Service de radiothérapie, groupe de radiothérapie et d'oncologie des Pyrénées, 49, rue Aristide-Briand, 64000 Pau, France
| | - C Dupin
- Service de radiothérapie, CHU de Bordeaux-Haut Lévêque, avenue du Haut-Lévêque, 33600 Pessac, France
| | - F-G Riet
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - C-H Canova
- Service de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Huertas
- Service de radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - I Troussier
- Service de radio-oncologie, hôpitaux universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1205 Genève, Suisse
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Atallah V, Amestoy F, Gerard E, Leduc N, Huchet A, Beylot-Barry M, Dupin C, Prey S, Dousset L, Trouette R, Ouabrache N, Maillot O, Martin M, Gillon P, Dutriaux C, Vendrely V. Concurrent Radiation Therapy for Patients with Metastatic Melanoma and Receiving Anti-Programmed-Death 1 Therapy: A Retrospective Monocentric Study on 141 Patients. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.208] [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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40
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Miguet M, Adam JP, Blanc JF, Lapuyade B, Bernard P, Buscail E, Neau-Cransac M, Vendrely V, Laurent C, Chiche L. Multidisciplinary meetings specific to hepatocellular carcinoma: How to proceed? J Visc Surg 2018; 156:217-227. [PMID: 31203872 DOI: 10.1016/j.jviscsurg.2018.09.007] [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] [Indexed: 02/08/2023]
Abstract
The French "cancer plan" has created a framework for good practice in the course of care for cancer patients. Decisions must be made in a multidisciplinary team meeting (MDM) and an individualized care plan (ICP) is to be established for each patient. Hepatocellular carcinoma (HCC) is a common cancer with complex treatments that warrant a dedicated meeting. Cancer coordination centers (3C) ensure the organization and the functioning of MDMs. Multidisciplinary, standardized and systematic assessment of HCC patients allows for personalized management and orients them toward treatment that is either curative (transplantation, surgical resection, ablathermy) or palliative (chemoembolization, radiotherapy, systemic treatment, supportive care). MDMs bring together all the professionals treating the disease, and who are tasked with producing an enforceable document effective that justifies decisions and is often an essential step towardinclusion of patients in a clinical trial. It must be carried out according to a systematic schema in an approach applied from initial diagnosis to treatment outset and throughout the treatment. Numerous advances in HCC treatments have rendered their management complex, with the possibility of liver transplantation, twhose access is regulated by the Biomedicine Agency requiring the submission of MDM reports. MDMs must meet specific quality criteria to ensure effective management based on general guidelines and yet specifically tailored to each patient.
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Affiliation(s)
- M Miguet
- Chirurgie digestive, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - J P Adam
- Chirurgie digestive, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - J F Blanc
- Hépato gastro-entérologie, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - B Lapuyade
- Radiologie, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - P Bernard
- Hépato gastro-entérologie, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - E Buscail
- Chirurgie digestive, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - M Neau-Cransac
- Hépato gastro-entérologie, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - V Vendrely
- Radiologie, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - C Laurent
- Chirurgie digestive, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
| | - L Chiche
- Chirurgie digestive, hôpital Haut-Leveque, CHU de Bordeaux, 33600 Pessac, France.
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41
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Vendrely V, Lemanski C, Baba-Hamed N, Barbier E, Bénézery K, de La Rochefordière A, Guibert P, Bonichon-Lamichhane N, Pommier P, Créhange G, Colliaux J, Gnep K, Ronchin P, Saliou M, Diaz O, Lepage C, Quéro L. Traitement du cancer du canal anal : premiers résultats de la cohorte nationale Anabase. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.012] [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: 10/28/2022]
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42
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Amestoy F, Antoine M, Henriques B, Lipinski F, Genebes C, Blouet A, Celerier D, Regnault de la Mothe P, Debelleix C, Petit A, Laharie-Mineur H, Bonichon-Lamichhane N, Vendrely V. Sites de récidives du cancer du canal anal après chimioradiothérapie avec modulation d’intensité : analyse rétrospective multicentrique. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.068] [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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43
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Bernard-Tessier A, Jeannot E, Guenat D, Michel M, Proudhon C, Vincent-Salomon A, Bièche I, Pierga JY, Buecher B, Francois E, Kim S, André T, Jary M, Vendrely V, Samalin E, El Hajbi F, Baba-Hamed N, Meurisse A, Bidard FC, Borg C. HPV circulating tumor DNA as predictive biomarker of sustained response to chemotherapy in advanced anal carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Lafon M, Huchet A, Bronnimann C, Adgie S, Martin M, Trouette R, Jecko V, Wavasseur T, Dupin C, Vendrely V. Réirradiation des rechutes de gliomes de haut grade après un premier radiothérapie et témozolomide. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.041] [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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45
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Martin M, Bacci M, Coulibaly S, Dupin C, Heraudet L, Lafon M, Trouette R, Vendrely V. Efficacité et tolérance de la radiothérapie stéréotaxique des lésions primitives et secondaires hépatiques au CHU de Bordeaux. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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46
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Marref I, Reichling C, Vendrely V, Mouillot T. Prise en charge du cancer du canal anal en 2018. ONCOLOGIE 2018. [DOI: 10.3166/onco-2018-0015] [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]
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47
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Poncin R, Dupin C, Daste A, De Mones E, Castetbon V, Majoufre C, Trouette R, Vendrely V. Sarcopénie après la radiothérapie : un nouveau facteur pronostique pour les cancers de l’oropharynx ? Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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48
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Pracht M, Chajon E, de Baere T, Nguyen F, Bronowicki JP, Vendrely V, Baumann AS, Croisé-Laurent V, Rio E, Rolland Y, Le Sourd S, Gustin P, Perret C, Mornex F, Peiffert D, Merle P, Deutsch E. Hepatocellular carcinoma and liver metastasis treated by hafnium oxide nanoparticles activated by stereotactic body radiation therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Dupin C, Arsène-Henry A, Charleux T, Haaser T, Trouette R, Vendrely V. Prévalence et attentes de l’utilisation des « médecines alternatives et complémentaires » pendant la radiothérapie en 2016 : étude prospective. Cancer Radiother 2018; 22:682-687. [DOI: 10.1016/j.canrad.2018.06.016] [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] [Received: 06/14/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
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50
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Peiffert D, Baumann AS, Serre AA, Vendrely V, Rouard N, Faivre JC, Vogin G. [Anal canal cancer: In the era of intensity-modulated radiotherapy, outstanding issues]. Cancer Radiother 2018; 22:509-514. [PMID: 30181029 DOI: 10.1016/j.canrad.2018.07.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/15/2018] [Indexed: 02/07/2023]
Abstract
Intensity-modulated radiotherapy makes possible to optimize the irradiation and spare normal tissues. The toxicity remains important with concomitant chemotherapy often associated. The improvement of MRI and PET-CT define more precisely the target volumes, which need a higher dose, but necessitates to respect the rules of contouring. The treatment is uniform whatever the stage but should be individualized based on clinical stage and tumor response. New paradigms concern biology, staging, volumes and doses, fractionation and combined treatments.
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Affiliation(s)
- D Peiffert
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; EA 4360 Apemac, université de Lorraine, 9, avenue de la Forêt-de-Haye, 54500 Nancy, France.
| | - A S Baumann
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A A Serre
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Vendrely
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France
| | - N Rouard
- Hôpital Édouard-Hériot, 69000 Lyon, France
| | - J C Faivre
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - G Vogin
- Service de radiothérapie, institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
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