72 results on '"Maroie Barkati"'
Search Results
2. EPV113/#323 Prognostic factors and oncologic outcomes for patients treated with adjuvant chemotherapy and vaginal vault brachytherapy for stage I endometrial serous carcinomas
- Author
-
Maroie Barkati, V. Samouelian, V Dorion, Beatrice Cormier, M-C Beauchemin, and E Tremblay
- Subjects
medicine.medical_specialty ,Serous fluid ,business.industry ,Adjuvant chemotherapy ,medicine.medical_treatment ,Brachytherapy ,Medicine ,Vaginal vault ,Radiology ,business - Published
- 2021
- Full Text
- View/download PDF
3. Performance of an integrated multimodality image guidance and dose-planning system supporting tumor-targeted HDR brachytherapy for prostate cancer
- Author
-
Maroie Barkati, Samuel Kadoury, David Grajales, Jean-François Carrier, Dominic Béliveau-Nadeau, Mustafa-Karim Benhacene-Boudam, Gilion Hautvast, William Le, Jean DaSilva, Roozbeh Shams, Benedicte Nicolas, Guila Delouya, Cynthia Ménard, and Daniel Juneau
- Subjects
Male ,Computer science ,business.industry ,Phantoms, Imaging ,medicine.medical_treatment ,Distortion (optics) ,Brachytherapy ,Navigation system ,Initialization ,Image registration ,Prostatic Neoplasms ,Radiotherapy Dosage ,Hematology ,Catheter ,Workflow ,Oncology ,Calibration ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Nuclear medicine ,business - Abstract
BACKGROUND AND PURPOSE Advances in high-dose-rate brachytherapy to treat prostate cancer hinge on improved accuracy in navigation and targeting while optimizing a streamlined workflow. Multimodal image registration and electromagnetic (EM) tracking are two technologies integrated into a prototype system in the early phase of clinical evaluation. We aim to report on the system's accuracy and workflow performance in support of tumor-targeted procedures. MATERIALS AND METHODS In a prospective study, we evaluated the system in 43 consecutive procedures after clinical deployment. We measured workflow efficiency and EM catheter reconstruction accuracy. We also evaluated the system's MRI-TRUS registration accuracy with/without deformation, and with/without y-axis rotation for urethral alignment at initialization. RESULTS The cohort included 32 focal brachytherapy and 11 integrated boost whole-gland implants. Mean procedure time excluding dose delivery was 38 min (range: 21-83) for focal, and 56 min (range: 38-89) for whole-gland implants; stable over time. EM catheter reconstructions achieved a mean difference between computed and measured free-length of 0.8mm (SD 0.8, no corrections performed), and mean axial manual corrections 1.3mm (SD 0.7). EM also enabled the clinical use of a non or partially visible catheter in 21% of procedures. Registration accuracy improved with y-axis rotation for urethral alignment at initialization and with the elastic registration (mTRE 3.42mm, SD 1.49). CONCLUSION The system supported tumor-targeting and was implemented with no demonstrable learning curve. EM reconstruction errors were small, correctable, and improved with calibration and control of external distortion sources; increasing confidence in the use of partially visible catheters. Image registration errors remained despite rotational alignment and deformation, and should be carefully considered.
- Published
- 2021
4. A Phase 2 Randomized Pilot Study Comparing High-Dose-Rate Brachytherapy and Low-Dose-Rate Brachytherapy as Monotherapy in Localized Prostate Cancer
- Author
-
Omar Mahmoud, Philippe Després, Maroie Barkati, Yaqun Wang, Frédéric Lacroix, William Foster, Guila Delouya, Daniel Taussky, Lara Hathout, Irina Vergalasova, Gerard Morton, André-Guy Martin, and Eric Vigneault
- Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,lcsh:R895-920 ,medicine.medical_treatment ,Brachytherapy ,Urology ,Urinary incontinence ,lcsh:RC254-282 ,030218 nuclear medicine & medical imaging ,law.invention ,Genitourinary Cancer ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Radiology, Nuclear Medicine and imaging ,business.industry ,Repeated measures design ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,High-Dose Rate Brachytherapy ,Low-Dose Rate Brachytherapy ,Oncology ,030220 oncology & carcinogenesis ,International Prostate Symptom Score ,medicine.symptom ,business - Abstract
Purpose To compare health-related quality of life (HRQOL) of high-dose-rate brachytherapy (HDRB) versus low dose-rate brachytherapy (LDRB) for localized prostate cancer in a multi-institutional phase 2 randomized trial. Methods and Materials Men with favorable-risk prostate cancer were randomized between monotherapy brachytherapy with either Iodine-125 LDRB to 144 Gy or single-fraction Iridium-192 HDRB to 19 Gy. HRQOL and urinary toxicity were recorded at baseline and at 1, 3, 6, and 12 months using the Expanded Prostate Cancer Index Composite (EPIC)-26 scoring and the International Prostate Symptom Score (IPSS). Independent samples t test and mixed effects modeling were performed for continuous variables. Time to IPSS resolution, defined as return to its baseline score ±5 points, was calculated using Kaplan-Meier estimator curves with the log-rank test. A multiple-comparison adjusted P value of ≤.05 was considered significant. Results LDRB and HDRB were performed in 15 and 16 patients, respectively, for a total of 31 patients. At 3 months, patients treated with LDRB had a higher IPSS score (mean, 15.5 vs 6.0, respectively; P = .003) and lower EPIC urinary irritative score (mean, 69.2 vs 85.3, respectively; P = .037) compared with those who received HDRB. On repeated measures at 1, 3, 6, and 12 months, the IPSS (P = .003) and EPIC urinary irritative scores (P = .019) were significantly better in the HDR arm, translating into a lower urinary toxicity profile. There were no significant differences in the EPIC urinary incontinence, sexual, or bowel habit scores between the 2 groups at any measured time point. Time to IPSS resolution was significantly shorter in the HDRB group (mean, 2.0 months) compared with the LDRB group (mean, 6.0 months; P = .028). Conclusions HDRB monotherapy is a promising modality associated with a lower urinary toxicity profile and higher HRQOL in the first 12 months compared with LDRB.
- Published
- 2019
- Full Text
- View/download PDF
5. MRI-based interstitial brachytherapy for vaginal tumors: A multi-institutional study on practice patterns, contouring, and consensus definitions of target volumes
- Author
-
Eric Leung, David D'Souza, Nikhilesh Patil, Eric Vigneault, Maroie Barkati, Elizabeth Barnes, Francois Bachand, Israel Fortin, David Bowes, Robyn Banerjee, Vikram Velker, William Foster, Joanne Alfieri, Kathy Han, Ericka Wiebe, Lisa Barbera, Ananth Ravi, and Fleur Huang
- Subjects
Adult ,Male ,3d planning ,medicine.medical_specialty ,Consensus ,Vaginal Neoplasms ,medicine.medical_treatment ,Brachytherapy ,Planning target volume ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Cohen's kappa ,Surveys and Questionnaires ,Terminology as Topic ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Practice Patterns, Physicians' ,Aged ,Contouring ,Practice patterns ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Interstitial brachytherapy ,Radiotherapy Dosage ,Magnetic Resonance Imaging ,Tumor Burden ,Oncology ,030220 oncology & carcinogenesis ,Radiation Oncology ,Female ,Radiology ,business ,Kappa ,Radiotherapy, Image-Guided - Abstract
Purpose Interstitial brachytherapy (ISBT) can be effective for vaginal tumors due to its ability to deliver conformal treatment with 3D planning. As there is no consensus for 3D vaginal brachytherapy (BT) contouring, the goals of this study are to evaluate the variability in practices and contouring, and to develop consensus concepts on target definitions. Methods A survey/contouring study was conducted with 16 radiation oncologists from 10 Canadian academic centers. The study included three vaginal ISBT cases. Participants were provided staging, prebrachytherapy (pre-BT), and BT MRIs. Participants responded to a questionnaire and contoured on the provided images. Agreement between contours was analyzed. A meeting was held to develop consensus definitions of targets. Results Median ISBT experience was 3.5 years. All 16 participants regularly contour with MRI, whereas three also plan on MRI. For the three cases, there was variation into how CTV HR and CTV IR was defined. Kappa statistics showed higher agreement with bulky tumors (mean 0.59) as compared with small residual tumors (mean 0.29). For all cases, kappa was highest in pre-BT GTV res as compared with BT GTV res (mean 0.58, 0.46). Consensus concepts to define targets were developed. Conclusions Variations exist in how ISBT targets are defined for vaginal tumors. Highest contouring variability was seen with small residual at BT. Contouring is more consistent on pre-BT MRI as compared with BT MRI suggesting a needle distortion effect. Consensus CTV HR and CTV IR definitions have been developed and further work is warranted to establish international standards.
- Published
- 2019
- Full Text
- View/download PDF
6. DEVIL, VAAD and vLSC constitute a spectrum of HPV-independent, p53-independent intra-epithelial neoplasia of the vulva
- Author
-
Annick Pina, Cécile Le Page, Danh Tran-Thanh, Maroie Barkati, Kurosh Rahimi, Jahg Wong, Simon F. Roy, and Vincent Q. Trinh
- Subjects
Pathology ,medicine.medical_specialty ,Histology ,Stromal cell ,Vulvar Squamous Cell Carcinoma ,Acanthosis ,Pallor ,Pathology and Forensic Medicine ,Vulva ,Lesion ,Cohort Studies ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Vulvar Neoplasms ,Proportional hazards model ,business.industry ,General Medicine ,Middle Aged ,Vulvar intraepithelial neoplasia ,medicine.disease ,medicine.anatomical_structure ,Female ,medicine.symptom ,Tumor Suppressor Protein p53 ,business ,Precancerous Conditions ,Carcinoma in Situ - Abstract
Aims We aimed to characterise a large cohort of non-invasive, human papillomavirus (HPV) and p53-independent verruciform lesions, such as 'vulvar acanthosis with altered differentiation' (VAAD), 'differentiated exophytic vulvar intra-epithelial lesion' (DEVIL) and 'verruciform lichen simplex chronicus' (vLSC). Methods and results From January 2008 to December 2020 we retrospectively identified 36 eligible patients with verruciform non-invasive lesions (n = 36) and collected clinical, histological and follow-up parameters. Verruciform non-invasive lesions occurred at a median age of 71 years, with a median follow-up of 33.5 months. Clinically, pruritus was only reported in patients with VAAD (n = 3, 21%). Lesion colour was significantly different across categories (P = 0.028). Apart from the histopathological criteria already known to distinguish these entities (hypogranulosis, epithelial pallor and low-magnification architecture), no other significant criteria were discovered and significant overlap was observed, particularly between VAAD and DEVIL. Patients with vLSC trended towards longer survival without recurrence compared to VAAD and DEVIL (P = 0.082), but showed comparable invasion-free survival interval (P = 0.782). Squamous cell carcinomas (SCC) associated with either VAAD, DEVIL or vLSC displayed similar clinical, histopathological and biological parameters. In non-invasive precursor lesions, stromal oedema was associated with invasion (P = 0.015) and remained so upon Cox regression analysis (P = 0.009). Conclusion Our study of HPV and p53 independent non-invasive verruciform lesions of the vulva highlights significant clinical, histopathological and biological overlap between VAAD, DEVIL and vLSC, suggesting that these pre-invasive lesions should be viewed as a spectrum. We also show that stromal features such as oedema might play an import role in progression to invasion.
- Published
- 2021
7. Primary Endpoint Analysis of a Randomized Phase III Trial of Hypofractionated vs. Conventional Post-Prostatectomy Radiotherapy: NRG Oncology GU003
- Author
-
T M Schroeder, Louis Potters, Richard K. Valicenti, J. Kittel, Colleen A. Lawton, Mark K. Buyyounouski, Maroie Barkati, H.M. Sandler, M Mann, Stephanie L. Pugh, C E Duncan, J. Rodgers, D.C. Monitto, Rajat J. Kudchadker, J.M. Michalski, Ronald C. Chen, Eric Vigneault, Andre Konski, Omar Y. Mian, and Raquibul Hannan
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,Post prostatectomy radiotherapy ,Genitourinary system ,business.industry ,medicine.medical_treatment ,Urology ,Local failure ,EPIC ,Disease control ,Radiation therapy ,Oncology ,Toxicity ,medicine ,Clinical endpoint ,Radiology, Nuclear Medicine and imaging ,business - Abstract
Purpose/Objective(s) To determine if hypofractionated post-operative prostate bed radiotherapy (HYPORT) does not increase patient-reported genitourinary (GU) or gastrointestinal (GI) toxicity over conventionally fractionated post-operative radiotherapy (COPORT). Materials/Methods Eligibility criteria were: 1) an undetectable PSA ( Results Between July 2017 and July 2018, 298 patients were screened and 296 were randomized: 144 to HYPORT and 152 to COPORT. Compliance with the EPIC was 100% at baseline, 83% at the end of RT, 77% at 6 months, 78% at 12 months, and 73% at 24 months. At the end of RT, the HYPORT and COPORT mean GU change scores were neither clinically significant nor significantly different and remained so at 6 and 12 months. The mean GI change scores for HYPORT and COPORT were both clinically significant and significantly different at the end of RT (HYPORT mean GI = -15.0 vs COPORT mean GI = -6.8 P ≤ 0.01). However, both the HYPORT and COPORT mean GI change scores clinically and statistically significant differences were resolved at 6 and 12 months. The 24-month mean GU and GI change scores for HYPORT and COPORT remained neither clinically nor statistically significant (HYPORT mean GU = -5.2 vs COPORT mean GU = -3.0, P = 0.81; HYPORT mean GI = -2.2 vs COPORT mean GI = -1.5, P = 0.12). With a median follow-up for censored patients of 2.1 years, there was no difference between HYPORT versus COPORT for biochemical failure defined as a PSA ≥ 0.4 ng/mL followed by a value higher than the first by any amount (2-yr actuarial, 12% vs 8%, P = 0.29) or local failure (2-yr actuarial, 0.7% vs 0.8%, P = 0.35). Conclusion HYPORT is non-inferior to COPORT in terms of late patient-reported GU or GI toxicity. More follow-up is needed to appropriately assess disease control endpoints. In some clinic scenarios, HYPORT may be considered an acceptable practice standard.
- Published
- 2021
- Full Text
- View/download PDF
8. Oncologic outcomes in the era of modern radiation therapy using FIGO 2018 staging system for cervical cancer
- Author
-
Marie-Claude Beauchemin, Vanessa Samouëlian, Thomas Warkus, Maroie Barkati, Beatrice Cormier, Omar Moreira Bacha, Melica Nourmoussavi Brodeur, and Romain Dejean
- Subjects
0301 basic medicine ,Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Uterine Cervical Neoplasms ,Cervix Uteri ,Kaplan-Meier Estimate ,Disease-Free Survival ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Stage IIIC ,Stage (cooking) ,Survival analysis ,Aged ,Neoplasm Staging ,Retrospective Studies ,Cervical cancer ,Aged, 80 and over ,business.industry ,Obstetrics and Gynecology ,Chemoradiotherapy ,Middle Aged ,medicine.disease ,Prognosis ,Magnetic Resonance Imaging ,Cervical cancer staging ,Radiation therapy ,Survival Rate ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Cohort ,Female ,Radiology ,Neoplasm Recurrence, Local ,business ,Radiotherapy, Image-Guided - Abstract
Objectives: The first ASTRO guidelines on cervical cancer has recently been published recommending the use of modern radiation therapy. Furthermore, imaging has been incorporated in the new FIGO 2018 cervical cancer staging, which now re-categorizes nodal disease (IIIC). We sought to evaluate the outcomes and patterns of recurrence using FIGO 2018 staging in a cohort of patients treated in an era of high precision image-guided radiotherapy. Methods: A retrospective database review of 196 non-metastatic patients treated at a single institution from 2011 to 2018 was performed. All had pre-treatment MRI and PET scans and were treated with definitive concurrent chemoradiation using both intensity-modulated radiotherapy and 3D-image guided brachytherapy. Previously assigned 2009 FIGO staging and all imaging were reviewed for FIGO 2018 re-classification. Descriptive analyses and Kaplan-Meier survival curves were performed. Log-rank test was used to compare outcome between groups. Results: Five-year locoregional control rate, OS and DFS and were 82%, 79.6% and 70.1% respectively, with a median follow-up time of 51 months. Forty-eight patients experienced a recurrence, 80% of which included distant disease. In-field recurrence rate was 11.7%. Using the new FIGO staging, 48% of patients were upstaged to IIIC. Compared to FIGO 2009, OS and DFS were higher for all early 2018 FIGO stages, while stage III and IVA disease had poorer outcomes. Five-year OS was 91.6%, 72.8% and 61.7% for node-negative disease, IIIC1 and IIIC2 stages, respectively (p Conclusions: Integration of state-of-the-art imaging in cervical cancer staging as well as in radiotherapy and brachytherapy planning leads to excellent oncologic outcomes, however distant recurrence remains an important issue. FIGO 2018 staging better reflects patient prognosis, highlighting the need for new treatment strategies in stage IIIC cervical cancer.
- Published
- 2021
9. The Clinical Significance of Bone Mineral Density Changes Following Long-Term Androgen Deprivation Therapy in Localized Prostate Cancer Patients
- Author
-
Rachel Vaughan, Marjory Jolicoeur, Julia Khriguian, Mohiuddin, Tamim Niazi, André-Guy Martin, Hugo Villeneuve, Maroie Barkati, Robert Archambault, Michael Jonathan Kucharczyk, Redouane Bettahar, Abdenour Nabid, L.S. Vincent, Levon Igidbashian, Boris Bahoric, Michael A. Yassa, and James M. G. Tsui
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Time Factors ,Bone density ,Antineoplastic Agents, Hormonal ,Urology ,chemistry.chemical_element ,Calcium ,Androgen deprivation therapy ,Gonadotropin-Releasing Hormone ,Tosyl Compounds ,Prostate cancer ,Bone Density ,Internal medicine ,Nitriles ,medicine ,Vitamin D and neurology ,Humans ,Clinical significance ,Anilides ,Prospective Studies ,Aged ,Randomized Controlled Trials as Topic ,Bone mineral ,Aged, 80 and over ,business.industry ,Prostatic Neoplasms ,Androgen Antagonists ,Middle Aged ,medicine.disease ,chemistry ,Decreased bone mineral density ,Leuprolide ,business - Abstract
Long-term androgen deprivation therapy has been associated with decreased bone mineral density in men with prostate cancer. Some evidence suggests that there is no impact on fracture risk despite this bone mineral density loss. Our study aimed to quantify changes in bone mineral density in men with high risk prostate cancer on long-term androgen deprivation therapy and calcium and vitamin D supplementation.Bone mineral density analysis was conducted for localized high risk prostate cancer patients enrolled in the phase III randomized trial PCS-V (Prostate Cancer Study 5), comparing conventional and hypofractionated radiation therapy. Patients received 28 months of luteinizing hormone-releasing hormone agonist and calcium and vitamin D supplementation (500 mg calcium BID+400 IU vitamin D3 BID). The areal density and T-scores (spine, femoral neck and total femur) at baseline and 30 months of followup were extracted, and the absolute change was calculated. Clinical bone density status (normal, osteopenia, osteoporosis) was monitored.The lumbar spine, femoral neck and total femoral bone mineral density were measured for 226, 231, and 173 patients, respectively. The mean percent change in bone mineral density was -2.65%, -2.76% and -4.27% for these respective sites (p0.001 for all). The average decrease in bone mineral density across all sites was -3.2%, with no decline in bone mineral density category in most patients (83%). Eight patients (4%) became osteoporotic.Despite a mild decline in bone mineral density, the change in clinical bone mineral density category remained low with long-term androgen deprivation therapy. Consequently, calcium and vitamin D supplementation alone may suffice for most localized prostate cancer patients on long-term androgen deprivation therapy.
- Published
- 2021
10. Quality of Life: A Prospective Randomized Trial of Palliative Volumetric Arc Therapy Versus 3-Dimensional Conventional Radiation Therapy
- Author
-
Louise Lambert, Carole Lambert, Israel Fortin, Phengsavanh Thanomsack, Maroie Barkati, Julie Lafontaine, Philip Wong, Genevieve Coulombe, David Roberge, and Anne-Marie Charpentier
- Subjects
Diarrhea ,Male ,Organs at Risk ,Cancer Research ,medicine.medical_specialty ,Randomization ,medicine.medical_treatment ,Health Status ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Quality of life ,law ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Karnofsky Performance Status ,Aged ,Volumetric arc therapy ,Analysis of Variance ,Radiation ,business.industry ,Palliative Care ,Repeated measures design ,Cancer ,Nausea ,Radiotherapy Dosage ,Cancer Pain ,Middle Aged ,medicine.disease ,Health Surveys ,humanities ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,Dose Fractionation, Radiation ,Radiotherapy, Intensity-Modulated ,Radiotherapy, Conformal ,business - Abstract
Purpose Volumetric arc therapy (VMAT) is a radiation therapy (RT) technique that spares normal tissues from high and intermediate RT doses but increases the volume of tissues receiving low doses of RT compared with 3-dimensional conformal RT (3DCRT). We hypothesized that palliative VMAT would reduce the detriment to patient quality of life (QOL) compared with palliative 3DCRT. Methods and Materials This phase 2 trial randomized patients to palliative RT using VMAT or 3DCRT to 1 painful site of metastatic disease in the trunk. Treating physicians could choose 8 Gy in 1 fraction or 20 Gy in 5 fractions to stratify randomization. The primary endpoint was the change in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30) global health status QOL subscale at 1 week after RT. Repeated measures analysis of variance was used to assess the relationship of patient QOL over time with other factors. Results From July 2014 to November 2017, 37 patients who underwent 3DCRT and 32 patients who underwent VMAT were randomized into the study. Median overall survival was 9 months. Overall pain responses to RT were equivalent (P = .53) between the techniques. Patient compliance in returning QOL questionnaires was 94%, 81%, and 69% at baseline, 1 week after RT, and 1 month after RT, respectively. At 1 week after RT, change in global QOL was not significantly (P = .31) different between VMAT versus 3DCRT. At 4 weeks after RT, VMAT induced significantly (P = .049) less global QOL deterioration than 3DCRT did. Patients who underwent VMAT maintained better physical (P = .012), role (P = .041), and social (P = .025) functioning, but they reported more diarrhea symptoms (P = .017) than in the 3DCRT group. Conclusions Palliative VMAT and 3DCRT did not differ in their ability to control pain; however, palliative VMAT induced fewer QOL detriments than 3DCRT did at 4 weeks after RT.
- Published
- 2020
11. Neoadjuvant radiotherapy and brachytherapy in endometrial cancer with gross cervical involvement: a CHIRENDO research group study
- Author
-
Melica Nourmoussavi Brodeur, Vanessa Samouëlian, Yohann Dabi, Maroie Barkati, Marie-Claude Beauchemin, and Beatrice Cormier
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Cervix Uteri ,Kaplan-Meier Estimate ,Adenocarcinoma ,Hysterectomy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Stage (cooking) ,Radical Hysterectomy ,Aged ,Retrospective Studies ,Aged, 80 and over ,Group study ,business.industry ,Endometrial cancer ,Obstetrics and Gynecology ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Endometrial Neoplasms ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Median body ,Female ,Radiotherapy, Adjuvant ,Radiology ,business - Abstract
BackgroundHistorically, radical hysterectomy followed by adjuvant radiotherapy has been offered to patients with endometrial cancer who have gross cervical involvement; however, this approach is known to carry considerable morbidity. Neoadjuvant radiotherapy followed by extra-fascial hysterectomy has been proposed as an alternative treatment but has been poorly studied to date.ObjectiveTo evaluate the locoregional control rate associated with neoadjuvant radiotherapy followed by extra-fascial hysterectomy.MethodsA retrospective cohort study of 30 patients with endometrial cancer with gross cervical involvement treated between May 2006 and January 2016 was performed. Eligible patients were those aged >18 years with non-metastatic endometrial adenocarcinoma and gross cervical disease treated with curative intent at the Centre hospitalier de l’Université de Montréal. Treatment protocol consisted of pelvic neoadjuvant radiotherapy and high-dose rate brachytherapy followed by extra-fascial hysterectomy. Kaplan-Meier curves were used for survival analysis.ResultsThe median age was 60 (range 37–82) and median body mass index was 32 kg/m2 (range 16–55). Twenty-four (80%) patients were diagnosed with a positive cervical/endocervical biopsy. Clinical staging confirmed 36.7% (n=11) as stage II, 20% (n=6) stage IIIB, 30% (n=9) stage IIIC1, and 13.3% (n=4) stage IIIC2. Seventy-seven per cent (n=23) of patients had an endometrioid histology. Locally advanced disease was identified by imaging alone in six patients. Rates of parametrial, adnexal, vaginal, and nodal invasion were 10% (n=3), 6.7% (n=2), 13.3% (n=4), and 43.3% (n=13) at diagnosis, respectively. All patients completed pelvic radiotherapy (13.3% extended field) and 90% received brachytherapy. Twenty per cent (n=6) of surgeries were performed using minimal invasive technique. On surgical specimen, 63.3% (n=19) had complete cervical response, 90% (n=27) had negative margins, and 10% (n=3) had residual nodal involvement. Median follow-up time was 62 months (range 1–120). Six recurrences were identified; all except one involved distant failure, and two with locoregional failure. Five-year locoregional control rate, disease-free, overall, and disease-specific survival were 90.5%, 78.5%, 92.6%, and 96.2%, respectively. Two patients (6.7%) had grade 3+ acute radiation-related complications (all grade 3). Grade 3+ post-operative morbidity was noted in 2 (6.7%) patients.ConclusionsNeoadjuvant radiotherapy followed by extra-fascial hysterectomy offers good locoregional control with low treatment-related morbidity in patients with endometrial cancer with overt cervical involvement.
- Published
- 2020
12. A comparison of early prostate-specific antigen decline between prostate brachytherapy and different fractionation of external beam radiation—Impact on biochemical failure
- Author
-
Jean-Paul Bahary, Carole Lambert, Daniel Taussky, Maroie Barkati, Stéphane Bedwani, Marie-Claude Beauchemin, Nissan Meissner, Guila Delouya, and Cynthia Ménard
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Brachytherapy ,Urology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Risk Factors ,Interquartile range ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Aged ,Retrospective Studies ,business.industry ,Proportional hazards model ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Radiation therapy ,Prostate-specific antigen ,Oncology ,030220 oncology & carcinogenesis ,Radiation Dose Hypofractionation ,Neoplasm Recurrence, Local ,business ,Nadir (topography) ,Prostate brachytherapy ,Follow-Up Studies - Abstract
Purpose The aim of this study was to compare early prostate-specific antigen (PSA) decline patterns and PSA nadirs between low-dose-rate seed prostate brachytherapy (LDR-PB) and different fractionations of external beam radiotherapy (EBRT) and their predictive importance for biochemical failure (bF). Methods and Materials Patients with D'Amico low- or intermediate-risk prostate cancer who underwent a single-modality treatment without androgen deprivation were included in this study. Three different treatment groups were compared: (1) normofractionation EBRT up to 70.2–79.2 Gy/1.8–2.0 Gy, (2) LDR-PB, and (3) EBRT with hypofractionation 60 Gy/3 Gy daily or 5–7.25 Gy once a week over 9–5 weeks, to a total dose of 45–36.25 Gy, respectively. The log-rank test, Cox regression analysis, and nonparametric tests were used. Results We analyzed 892 patients: the median followup for patients without bF was 84 months (interquartile range 60–102 months), with 12% of patients experiencing bF. The PSA decline within the first 15 months was generally exponential. LDR-PB showed a faster early exponential decline compared with EBRT treatments, but whether decline was fast or slow had no influence on recurrence. The only factors that were positive predictive factors in univariate and multivariate analyses were the time to nadir >48 months (median), PSA nadir Conclusions Although there are significant differences in early exponential PSA decline between different treatments, only the PSA nadir and longer time to nadir were predictive factors for bF.
- Published
- 2018
- Full Text
- View/download PDF
13. PO-0192 Prototype testing the 3D-printed Montreal split-ring applicator (GYN) using biocompatible materials
- Author
-
B. Basaric, L. Morgan, Jean-François Carrier, Maroie Barkati, M. Roy, Stéphane Bedwani, Y Kamio, F. DeBlois, and Marie-Claude Beauchemin
- Subjects
Split ring ,3d printed ,Materials science ,Oncology ,business.industry ,Optoelectronics ,Radiology, Nuclear Medicine and imaging ,Hematology ,business ,Biocompatible material - Published
- 2021
- Full Text
- View/download PDF
14. OC-0038 Outcomes in focal vs. dose-painted salvage HDR brachytherapy for locally recurrent prostate cancer
- Author
-
Z. Liu, Marie-Claude Beauchemin, Cynthia Ménard, Tamim Niazi, Daniel Taussky, D. Béliveau-Nadeau, Maroie Barkati, Alexandra Rink, Guila Delouya, Lisa Joseph, Joelle Helou, Inmaculada Navarro, A. Berlin, Srinivas Raman, Peter Chung, and Samuel Kadoury
- Subjects
medicine.medical_specialty ,Oncology ,business.industry ,medicine.medical_treatment ,Brachytherapy ,medicine ,Radiology, Nuclear Medicine and imaging ,Recurrent prostate cancer ,Hematology ,Radiology ,business - Published
- 2021
- Full Text
- View/download PDF
15. PO-0177 A new software for designing patient-specific sleeves for the Montreal split-ring applicator
- Author
-
M. Crocker, Jean-François Carrier, Maroie Barkati, B. Basaric, Stéphane Bedwani, F. DeBlois, C. Engelberts, Y Kamio, L. Morgan, D. Orbovic, and Marie-Claude Beauchemin
- Subjects
Split ring ,Engineering drawing ,Software ,Oncology ,Computer science ,business.industry ,Radiology, Nuclear Medicine and imaging ,Hematology ,Patient specific ,business - Published
- 2021
- Full Text
- View/download PDF
16. In Vivo Confirmation of Prostate Tumor Burden During HDR Brachytherapy With a Combined Raman Spectroscopy and MRI Radiomics Approach
- Author
-
Maroie Barkati, Frederic Leblond, Fabien Picot, David Grajales, D. Béliveau-Nadeau, Roozbeh Shams, Samuel Kadoury, B. Nicolas, Guila Delouya, and Cynthia Ménard
- Subjects
Cancer Research ,Image fusion ,Radiation ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Brachytherapy ,medicine.disease ,Prostate cancer ,medicine.anatomical_structure ,Oncology ,Radiomics ,In vivo ,Prostate ,Feature (computer vision) ,Biopsy ,medicine ,Radiology, Nuclear Medicine and imaging ,business ,Nuclear medicine - Abstract
PURPOSE/OBJECTIVE(S) TRUS-guided biopsies still yield a notable rate of sampling error for prostate cancer (PCa) and do not allow in situ characterization. Raman spectroscopy (RS) is a minimally invasive optical imaging modality allowing to measure tissue properties within seconds. In this study, we present the first in man results from a navigated RS optical probe used to confirm sites of tumor burden during HDR brachytherapy. MATERIALS/METHODS The study included 8 prospectively recruited subjects with PCa prior to HDR brachytherapy. An electromagnetic (EM) guidance system was used to navigate in vivo RS acquisition using MRI-TRUS image fusion, and integrated within the HDR brachytherapy procedure workflow. The optical device includes a dual wavelength laser source (680 and 785 nm), a spectrometer, a custom design probe, and an acquisition/processing software. For each case, deformable registration of mpMRI (with prostate, urethra and GTV segmentations) to interventional 3D TRUS reconstructed images (with prostate and urethra segmentations), enabled visualization of GTV with the navigation system. The EM tracked RS probe was inserted through a co-axial needle. Once in place, high wavenumber (HW) and fingerprint (FP) spectra were measured, a biopsy was taken at the corresponding site, and the location was recorded; then, the HDR brachytherapy procedure resumed. Biopsy samples were evaluated histologically to confirm presence of cancer. For the radiomics analysis, 8 first order and 8 GLCM image features were calculated on the MRI (T2W and ADC), extracted from the corresponding optically scanned sites, using open-source software. RESULTS In total, 26 sites were inspected with the RS probe and biopsied (range 2-5 per case). The pathology results identified 14 samples as cancer (Gleason score ≥ 7) and 12 samples as benign. On average the optical measurements took 45 seconds per site (range 23-90) and added 20 minutes (range 15-24) to the intervention. The spectra were pre-processed and labeled according to the pathology results. Neighborhood component analysis was applied to select the features that optimize the prediction performance, extracting 15 features from FP, 1 from HW and 11 from MRI radiomics. Classification models using a support vector machine were trained with a leave one out scheme for evaluation, using different feature combinations. Table 1 presents the average results over all folds. CONCLUSION We presented an image-guided system allowing the first in situ characterization of prostate lesions with RS during brachytherapy, in a manner integrated with the procedural workflow. The acquired spectra from benign and malignant regions show promising preliminary data, demonstrating the potential of the technique for real-time PCa confirmation. Finally, the combination of optical and MRI features yields an improvement in classification accuracy.
- Published
- 2021
- Full Text
- View/download PDF
17. PO-1128: Oncologic outcomes of cervical cancer using FIGO 2018 staging in the era of modern radiation therapy
- Author
-
Marie-Claude Beauchemin, R. Dejean, H. Bahig, V. Samouelian, Beatrice Cormier, Melica Nourmoussavi, Maroie Barkati, and T. Warkus
- Subjects
Radiation therapy ,Cervical cancer ,medicine.medical_specialty ,Oncology ,business.industry ,medicine.medical_treatment ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,Radiology ,business ,medicine.disease - Published
- 2020
- Full Text
- View/download PDF
18. MRI/PET Directed and TRUS/EM Guided Prostate Tumor Targeted HDR Brachytherapy: Performance of a Prototype System
- Author
-
Cynthia Ménard, M.K. Benhacene-Boudam, Maroie Barkati, D. Lopera, Guila Delouya, D. Béliveau-Nadeau, Jean N. DaSilva, Jean-François Carrier, B. Nicolas, D. Juneau, Samuel Kadoury, and Roozbeh Shams
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,Brachytherapy ,Tumor targeted ,medicine.anatomical_structure ,Oncology ,Prostate ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2020
- Full Text
- View/download PDF
19. Analysis of PSA Kinetics and Late Treatment Related Toxicity in a Phase 2 Randomized Pilot Study Comparing High Dose Rate Brachytherapy and Low Dose Rate Brachytherapy as Monotherapy in Localized Prostate Cancer
- Author
-
Maroie Barkati, T. Reynaud, Frédéric Lacroix, Daniel Taussky, André-Guy Martin, Damien Carignan, Lara Hathout, Guila Delouya, Eric Vigneault, William Foster, and G. Morton
- Subjects
Cancer Research ,medicine.medical_specialty ,Psa kinetics ,Radiation ,business.industry ,Urology ,medicine.disease ,High-Dose Rate Brachytherapy ,Low-Dose Rate Brachytherapy ,Prostate cancer ,Oncology ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Treatment related toxicity - Published
- 2020
- Full Text
- View/download PDF
20. Clinical Applications of MRI in Radiotherapy Planning
- Author
-
Cynthia Ménard, Maroie Barkati, Eugene Koay, David C. Fuller, and Houda Bahig
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Planning target volume ,Magnetic resonance imaging ,medicine.disease ,Functional imaging ,Radiation therapy ,medicine.anatomical_structure ,Prostate ,medicine ,Radiology ,Multiple tumors ,Head and neck ,Lung cancer ,business - Abstract
MRI has been adopted as part of the standard planning workflow of multiple tumor sites in radiotherapy. While computed tomography remains the standard of care for dose calculation, the use of MRI in radiotherapy planning allows for higher-quality delineation of target volumes and organs at risk. Increased accuracy of delineation, combined with the possibilities of functional imaging, has the potential to improve therapeutic ratios and enhance individualized approaches in radiotherapy planning. In this chapter, we review the applications and evidence for the use of MRI in radiotherapy planning in head and neck, central nervous system, prostate, gynecological, gastrointestinal, breast, and lung cancer sites.
- Published
- 2019
- Full Text
- View/download PDF
21. PP-0156 HDR and LDR comparison as monotherapy in localized prostate cancer: PSA kinetic and late toxicity
- Author
-
William Foster, Daniel Taussky, Frédéric Lacroix, Lara Hathout, Maroie Barkati, Thomas Reynaud, Damien Carignan, André-Guy Martin, Eric Vigneault, and Guila Delouya
- Subjects
Oncology ,Late toxicity ,Prostate cancer ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,medicine.disease ,business - Published
- 2021
- Full Text
- View/download PDF
22. Randomized Controlled Trial of PSMA PET/CT Guided Intensification of Radiotherapy for Prostate Cancer: Detection Rates and Impact on Radiotherapeutic Management
- Author
-
Daniel Taussky, G. Mok, E. Vallee, David Roberge, D. Duplan, Jean N. DaSilva, Fred Saad, Levon Igidbashian, Jean-Paul Bahary, A.S. Gauthier-Pare, Marie-Claude Beauchemin, Guila Delouya, D. Juneau, Philip Wong, S. Clavel, Maroie Barkati, Cynthia Ménard, and K.V. Key
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,medicine.disease ,law.invention ,Radiation therapy ,Prostate cancer ,Oncology ,Randomized controlled trial ,law ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Detection rate ,business ,Psma pet ct - Published
- 2020
- Full Text
- View/download PDF
23. 15: Acura Analysis of PSA Kinetics and Late Treatment Related Toxicity in a Phase 2 Randomized Pilot Study Comparing High Dose Rate Brachytherapy and Low Dose Rate Brachytherapy as Monotherapy in Localized Prostate Cancer
- Author
-
Eric Vigneault, Lara Hathout, Daniel Taussky, André-Guy Martin, Gerard Morton, Damien Carignan, Thomas Reynaud, William Foster, Guila Delouya, Frédéric Lacroix, and Maroie Barkati
- Subjects
medicine.medical_specialty ,Psa kinetics ,business.industry ,Urology ,Hematology ,medicine.disease ,High-Dose Rate Brachytherapy ,Low-Dose Rate Brachytherapy ,Prostate cancer ,Oncology ,medicine ,Radiology, Nuclear Medicine and imaging ,business ,Treatment related toxicity - Published
- 2020
- Full Text
- View/download PDF
24. 199 The Clinical Significance of Bone Mineral Density Changes Following Long Term Androgen Deprivation Therapy in Prostate Cancer Patients Enrolled in the PCS V Trial
- Author
-
Boris Bahoric, Rachel Vaughan, Michael Jonathan Kucharczyk, André-Guy Martin, James M. G. Tsui, Michael A. Yassa, Maroie Barkati, Levon Igidbashian, Abdenour Nabid, Marjory Jolicoeur, Hugo Villeneuve, L.S. Vincent, Tamim Niazi, Robert Archambault, Redouane Bettahar, and Mohiuddin
- Subjects
Bone mineral ,Oncology ,medicine.medical_specialty ,business.industry ,Hematology ,medicine.disease ,Term (time) ,Androgen deprivation therapy ,Prostate cancer ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Clinical significance ,business - Published
- 2019
- Full Text
- View/download PDF
25. 41 Partnership Initiative for the Evaluation of Technical Innovation in Radiotherapy (PERA): Pilot Performance of a Novel Trial Methodology
- Author
-
Diane Trudel, Guila Delouya, Jean-Paul Bahary, David Roberge, Cynthia Ménard, Maroie Barkati, Tibor Schuster, Philip Wong, Marie-Claude Beauchemin, and Daniel Taussky
- Subjects
Engineering management ,Engineering ,Oncology ,biology ,business.industry ,General partnership ,Technical innovation ,Radiology, Nuclear Medicine and imaging ,Hematology ,biology.organism_classification ,business ,Pera ,Trial methodology - Published
- 2019
- Full Text
- View/download PDF
26. 115 Optimal Hypofractionated Rectal Dose-Volume Constraint from the Prostate Cancer Patients of the PCS V Trial
- Author
-
Julia Khriguian, Levon Igidbashian, Hugo Villeneuve, Boris Bahoric, Maroie Barkati, Tamim Niazi, Abdenour Nabid, Michael Jonathan Kucharczyk, Robert Archambault, Michael A. Yassa, L.S. Vincent, Marjory Jolicoeur, André-Guy Martin, James M. G. Tsui, Mohiuddin, and Redouane Bettahar
- Subjects
Constraint (information theory) ,Prostate cancer ,medicine.medical_specialty ,Oncology ,business.industry ,medicine ,Urology ,Radiology, Nuclear Medicine and imaging ,Hematology ,medicine.disease ,business ,Volume (compression) - Published
- 2019
- Full Text
- View/download PDF
27. 125 Rectal Wall Versus Whole Rectum Dose: Which Volume Better Predicts Gastrointestinal Toxicity from Prostate External Beam Radiotherapy?
- Author
-
Marjory Jolicoeur, Tamim Niazi, Abdenour Nabid, L.S. Vincent, Boris Bahoric, Michael Jonathan Kucharczyk, André-Guy Martin, Hugo Villeneuve, Robert Archambault, Julia Khriguian, Levon Igidbashian, Michael A. Yassa, Maroie Barkati, James M. G. Tsui, Mohiuddin, and Redouane Bettahar
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gastrointestinal toxicity ,Rectum ,Hematology ,medicine.anatomical_structure ,Oncology ,Rectal wall ,Volume (thermodynamics) ,Prostate ,medicine ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Radiology ,business - Published
- 2019
- Full Text
- View/download PDF
28. Prognostic Assessment of Interim FDG-PET in Esophageal Cancer Treated with Chemoradiation with or without Surgery
- Author
-
Sophie Lavertu, Jocelyne Martin, Marie-Pierre Campeau, I. Ben Aicha, Maroie Barkati, David Roberge, David Donath, and Sylvain Beaulieu
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,Oncology ,business.industry ,Interim ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Esophageal cancer ,business ,medicine.disease - Published
- 2019
- Full Text
- View/download PDF
29. Optimal Hypofractionated Rectal Dose-Volume Constraint From The Prostate Cancer Patients of The PCS V Trial
- Author
-
Maroie Barkati, Julia Khriguian, Redouane Bettahar, Michael A. Yassa, L.S. Vincent, Robert Archambault, Marjory Jolicoeur, André-Guy Martin, James M. G. Tsui, Abdenour Nabid, Tamim Niazi, M. Mohiuddin, Boris Bahoric, Michael Jonathan Kucharczyk, Levon Igidbashian, and Hugo Villeneuve
- Subjects
Constraint (information theory) ,Cancer Research ,medicine.medical_specialty ,Prostate cancer ,Radiation ,Oncology ,business.industry ,Urology ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,medicine.disease ,Volume (compression) - Published
- 2019
- Full Text
- View/download PDF
30. The Clinical Significance of Bone Mineral Density Changes Following Long Term Androgen Deprivation Therapy in Prostate Cancer Patients Enrolled in the PCS V Trial
- Author
-
Marjory Jolicoeur, Rachel Vaughan, Levon Igidbashian, Hugo Villeneuve, Tamim Niazi, Maroie Barkati, M. Mohiuddin, Boris Bahoric, Michael A. Yassa, André-Guy Martin, Redouane Bettahar, Abdenour Nabid, James M. G. Tsui, Michael Jonathan Kucharczyk, Robert Archambault, and L.S. Vincent
- Subjects
Oncology ,Bone mineral ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.disease ,Androgen deprivation therapy ,Prostate cancer ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,Clinical significance ,business - Published
- 2019
- Full Text
- View/download PDF
31. Magnetic resonance imaging for prostate bed radiotherapy planning: An inter- and intra-observer variability study
- Author
-
Dany Simard, Maroie Barkati, Daniel Taussky, and Guila Delouya
- Subjects
medicine.medical_specialty ,Contouring ,medicine.diagnostic_test ,business.industry ,Prostatectomy ,medicine.medical_treatment ,Magnetic resonance imaging ,030218 nuclear medicine & medical imaging ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Prostate Bed ,030220 oncology & carcinogenesis ,medicine ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Radiology ,business ,Radiation treatment planning ,Radiation oncologist - Abstract
Introduction We assessed the inter- and intra-observer variability in contouring the prostate bed for radiation therapy planning using MRI compared with computed tomography (CT). Methods We selected 15 patients with prior radical prostatectomy. All had CT and MRI simulation for planning purposes. Image fusions were done between CT and MRI. Three radiation oncologists with several years of experience in treating prostate cancer contoured the prostate bed first on CT and then on MRI. Before contouring, each radiation oncologist had to review the Radiation Therapy Oncology Group guidelines for postoperative external beam radiotherapy. The agreement between volumes was calculated using the Dice similarity coefficient (DSC). Analysis was done using the Matlab software. The DSC was compared using non-parametric statistical tests. Results Contouring on CT alone showed a statistically significant (P = 0.001) higher similarity between observers with a mean DSC of 0.76 (standard deviation ± 0.05) compared with contouring on MRI with a mean of 0.66 (standard deviation ± 0.05). Mean intra-observer variability between CT and MRI was 0.68, 0.75 and 0.78 for the three observers. The clinical target volume was 19–74% larger on CT than on MRI. The intra-observer difference in clinical target volume between CT and MRI was statistically significant in two observers and non-significant in the third one (P = 0.09). Conclusions We found less inter-observer variability when contouring on CT than on MRI. Radiation Therapy Oncology Group contouring guidelines are based on anatomical landmarks readily visible on CT. These landmarks are more inter-observer dependent on MRI. Therefore, present contouring guidelines might not be applicable to MRI planning.
- Published
- 2015
- Full Text
- View/download PDF
32. MP05-08 THE IMPACT OF BASELINE SERUM TESTOSTERONE ON THE RISK OF BIOCHEMICAL FAILURE AFTER DEFINITIVE RADIATION THERAPY FOR PROSTATE CANCER: MORE FAVOURABLE ONCOLOGICAL OUTCOMES IN HYPOGONADAL INVIDIDUALS
- Author
-
Carole Lambert, Sami-Ramzi Leyh-Bannurah, Markus Graefen, Emanuele Zaffuto, Jean-Paul Bahary, Alberto Briganti, Fred Saad, Maroie Barkati, M. Beauchemin, Daniel Taussky, Helen Davis Bondarenko, Cynthia Ménard, Pierre I. Karakiewicz, and Guila Delouya
- Subjects
Gynecology ,Oncology ,Serum testosterone ,medicine.medical_specialty ,Prostate cancer ,business.industry ,Urology ,Biochemical failure ,Internal medicine ,medicine ,business ,medicine.disease ,Definitive Radiation Therapy - Published
- 2017
- Full Text
- View/download PDF
33. External Beam Radiotherapy Affects Serum Testosterone in Patients With Localized Prostate Cancer
- Author
-
Emanuele Zaffuto, Daniel Taussky, Guila Delouya, Pierre I. Karakiewicz, Zhe Tian, Cynthia Ménard, Michele Marchioni, Jean-Paul Bahary, Derya Tilki, Carole Lambert, Raisa S. Pompe, Jonas Schiffmann, Sami-Ramzi Leyh-Bannurah, Ariane Smith, Markus Graefen, Marco Bandini, Maroie Barkati, Fred Saad, and M. Beauchemin
- Subjects
0301 basic medicine ,Biochemical recurrence ,Male ,medicine.medical_specialty ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Endocrinology ,medicine ,Humans ,In patient ,Testosterone ,External beam radiotherapy ,Aged ,Gynecology ,Serum testosterone ,Radiotherapy ,business.industry ,Proportional hazards model ,Hypogonadism ,Prostatic Neoplasms ,Testosterone (patch) ,Prostate-Specific Antigen ,medicine.disease ,Psychiatry and Mental health ,030104 developmental biology ,Treatment Outcome ,Reproductive Medicine ,030220 oncology & carcinogenesis ,business ,Adjuvant - Abstract
Background Previous studies have examined testosterone levels after external beam radiation (EBRT) monotherapy, but since 2002 only sparse contemporary data have been reported. Aim To examine testosterone kinetics in a large series of contemporary patients after EBRT. Methods The study was conducted in 425 patients who underwent definitive EBRT for localized prostate cancer from 2002 through 2014. Patients were enrolled in several phase II and III trials. Exclusion criteria were neoadjuvant or adjuvant androgen-deprivation therapy or missing data. Testosterone was recorded at baseline and then according to each study protocol (not mandatory in all protocols). Statistical analyses consisted of means and proportions, Kaplan-Meier plots, and logistic and Cox regression analyses. Outcomes Testosterone kinetics after EBRT monotherapy and their influence on biochemical recurrence. Results Median follow-up of 248 assessable patients was 72 months. One hundred eighty-six patients (75.0%) showed a decrease in testosterone. Median time to first decrease was 6.4 months. Median percentage of decrease to the nadir was 30% and 112 (45.2%) developed biochemical hypogonadism (serum testosterone < 8 nmol/L). Of all patients with testosterone decrease, 117 (62.9%) recovered to at least 90% of baseline levels. Advanced age, increased body mass index, higher baseline testosterone level, and lower nadir level were associated with a lower chance of testosterone recovery. Subgroup analyses of 166 patients treated with intensity-modulated radiotherapy confirmed the results recorded for the entire cohort. In survival analyses, neither testosterone decrease nor recovery was predictive for biochemical recurrence. Clinical Implications EBRT monotherapy influences testosterone kinetics, and although most patients will recover, approximately 45% will have biochemical hypogonadism. Strengths and Limitations We report on the largest contemporary series of patients treated with EBRT monotherapy in whom testosterone kinetics were ascertained. Limitations are that testosterone follow-up was not uniform and the study lacked information on health-related quality-of-life data. Conclusion Our findings indicate that up to 75% of patients will have a profound testosterone decrease, with up to a 40% increase in rates of biochemical hypogonadism, although the latter events will leave biochemical recurrence unaffected.
- Published
- 2017
34. Pre-radiotherapy PSA progression is a negative prognostic factor in prostate cancer patients using 5‑alpha-reductase inhibitors
- Author
-
Marie-Claude Beauchemin, Marc Zanaty, Jean-Paul Bahary, Vimal Krishnan, Kevin C. Zorn, Julie Piotte, Carole Lambert, Cynthia Ménard, Daniel Taussky, Guila Delouya, and Maroie Barkati
- Subjects
Oncology ,Biochemical recurrence ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Biopsy ,Brachytherapy ,030232 urology & nephrology ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,5-alpha Reductase Inhibitors ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Aged ,Neoplasm Staging ,Univariate analysis ,business.industry ,Hazard ratio ,Cancer ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Tumor Burden ,Radiation therapy ,Treatment Outcome ,030220 oncology & carcinogenesis ,Disease Progression ,Neoplasm Grading ,business ,Follow-Up Studies - Abstract
To investigate the impact of 5‑alpha-reductase inhibitor (5-ARI) use on radiotherapy outcomes for localized prostate cancer. We included 203 patients on a 5-ARI from our institutional database comprising over 2500 patients who had been treated with either external beam radiotherapy (EBRT) or brachytherapy for localized prostate cancer. Patients received a 5-ARI for urinary symptoms or active surveillance. Cancer progressions at the time of definitive treatment were analyzed according to the following criteria: (a) progression of Gleason score or increase in cancer volume on biopsy, (b) first biopsy positive for cancer after being treated for urinary symptoms with a 5-ARI, and (c) prostate-specific antigen (PSA) progression with or without a previous cancer diagnosis. Biochemical failure (BF) was defined by the Phoenix definition. Log-rank test was used for survival analysis. At a median follow-up of 38.2 months (standard deviation 22.2 months), 10 (4.9%) patients experienced BF. Concerning prostate cancer progression criteria, 52% of men demonstrated none, 37% showed only one criterion, and 11% showed two. Using univariate analysis, PSA progression (p = 0.004) and appearance of a positive biopsy (p < 0.001) were significant predictive factors for BF, while Gleason progression (p = 0.3) was not. In multivariate analysis adjusted for cancer aggressiveness, rising PSA (hazard ratio, HR, 5.7; 95% confidence interval, CI, 1.1–28.8; p = 0.04) and the number of cancer progression factors (HR 2.9, 95% CI 1.2–7.0, p = 0.02) remained adverse risk factors. PSA progression experienced during 5‑ARI treatment before radiotherapy is predictive of worse biochemical outcome. Such details should be considered when counseling men prior to radiation therapy.
- Published
- 2017
35. Vaginal Epithelioid Angiosarcoma
- Author
-
Maroie Barkati, Caroline Meunier, Suzanne Fortin, Diane Provencher, Kurosh Rahimi, and Maxime Richer
- Subjects
Adult ,Pathology ,medicine.medical_specialty ,Vaginal Neoplasms ,Hemangiosarcoma ,Vimentin ,macromolecular substances ,Keratin ,Humans ,Medicine ,chemistry.chemical_classification ,Microscopy ,integumentary system ,biology ,Histocytochemistry ,business.industry ,Keratin 20 ,Gynecologic pathology ,Obstetrics and Gynecology ,General Medicine ,Immunohistochemistry ,chemistry ,Keratin 7 ,Keratin 8 ,biology.protein ,Female ,Desmin ,business ,Epithelioid cell - Abstract
Objective Epithelioid angiosarcoma of the vagina is a rare variant that can easily be misdiagnosed considering the much higher frequency of epithelial neoplasms at that particular site. Material and methods We report the case of a 41-year-old gravida 2, para 1, aborta 1, with no prior history of irradiation, who consulted after the discovery of 3 lesions at the lower right portion of the vagina. Result The lesion consisted of epithelioid cells with high-grade nuclei and prominent nucleoli. These cells expressed CD31, CD34, factor VIII, Fli-1, vimentin, smooth muscle actin, and WT-1. Keratin 8/18 was focally positive. They were immunonegative for keratin AE1/AE3, keratin 34βE12, keratin 7, keratin 20, S100, HMB-45, myogenin, desmin, and human herpesvirus type 8. Polymerase chain reaction-based HPV viral search was also negative. Conclusions A broad immunohistochemical panel including antibodies against vascular differentiation markers as well as various cytokeratins allows proper diagnosis of this unusual and aggressive entity.
- Published
- 2014
- Full Text
- View/download PDF
36. A Phase II Randomized Pilot Study Comparing High-Dose Rate Brachytherapy and Low-Dose Rate Brachytherapy as Monotherapy in Localized Prostate Cancer
- Author
-
André-Guy Martin, Gerard Morton, Maroie Barkati, Daniel Taussky, Khaly Mbodji, Lara Hathout, O.M.E.E. Mahmoud, I. Vergalasova, Philippe Després, Frédéric Lacroix, Guila Delouya, Eric Vigneault, and William Foster
- Subjects
Cancer Research ,Radiation ,business.industry ,medicine.disease ,Low-Dose Rate Brachytherapy ,High-Dose Rate Brachytherapy ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Medicine ,Radiology, Nuclear Medicine and imaging ,Nuclear medicine ,business - Published
- 2018
- Full Text
- View/download PDF
37. Rectal Wall vs. Whole Rectum Dose: Which Volume Better Predicts Gastrointestinal Toxicity from Prostate External Beam Radiotherapy?
- Author
-
Julia Khriguian, Abdenour Nabid, Marjory Jolicoeur, Hugo Villeneuve, Michael A. Yassa, Michael Jonathan Kucharczyk, L.S. Vincent, Maroie Barkati, André-Guy Martin, Redouane Bettahar, James M. G. Tsui, M. Mohiuddin, Boris Bahoric, Tamim Niazi, Robert Archambault, and Levon Igidbashian
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,Gastrointestinal toxicity ,Rectum ,medicine.anatomical_structure ,Oncology ,Rectal wall ,Volume (thermodynamics) ,Prostate ,medicine ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Radiology ,business - Published
- 2019
- Full Text
- View/download PDF
38. Hemoglobin Level in Cervical Cancer
- Author
-
Maroie Barkati, Israel Fortin, Jean-François Carrier, Kailash Narayan, Linda Mileshkin, and David Bernshaw
- Subjects
Adult ,medicine.medical_specialty ,Anemia ,medicine.medical_treatment ,Uterine Cervical Neoplasms ,Cervix Uteri ,Gastroenterology ,Hemoglobins ,Internal medicine ,Biomarkers, Tumor ,Carcinoma ,medicine ,Humans ,Neoplasm Invasiveness ,Positron emission ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cervical cancer ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Magnetic resonance imaging ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Radiation therapy ,Phenotype ,Oncology ,Lymphatic Metastasis ,Regression Analysis ,Female ,Hemoglobin ,business - Abstract
Hemoglobin (Hb) is a prognostic factor in cervical cancer, but the underlying mechanisms remain unknown. In this study, we hypothesized that low Hb level, either before or during radiotherapy (RT), is a surrogate for a more infiltrative and therefore aggressive disease, with uterine corpus invasion and nodal metastases.Prospectively collected data of patients with locally advanced cervical cancer treated with curative intent using chemoradiation at a tertiary academic center was reviewed. All eligible patients had a positron emission tomographic scan and pelvic magnetic resonance imaging. Hemoglobin levels before RT and Hb nadir during RT were collected from the medical record.The median follow-up for 263 eligible patients was 38.7 months. Ninety-six patients (36.5%) had both uterine corpus invasion and positron emission tomography-positive nodal disease (C+N+). Patients with pretreatment Hb level of less than 120 g/L were more likely to have C+N+ disease (47%) compared with patients with a high pretreatment Hb level (32%; P = 0.034). The 3-year disease-free survival and overall survival (OS) were significantly lower in the C+N+ group compared with the remaining patients (40.1% vs 76.1%, P0.001, and 59.7% vs 83.1%, P0.001, respectively). Patients with low Hb nadir were more likely to have a C+N+ disease (P0.001), and low Hb nadir during RT was significantly an indicator of a higher recurrence rate (P = 0.002) and lower OS (P0.001). In multifactor analysis, statistically significant prognostic factors for OS included histology, high-echelon nodal involvement, tumor volume on magnetic resonance imaging, C+N+ status, and Hb nadir during treatment. Pretreatment Hb level was not an independent prognostic factor.The combination of corpus invasion and nodal metastases is associated with lower Hb level and inferior prognosis. Because C+N+ state is related to tumor growth from early invasion to the time of presentation, it is unlikely that the correction of Hb level during treatment will have a major impact on outcome.
- Published
- 2013
- Full Text
- View/download PDF
39. Prostate-specific antigen density is predictive of outcome in suboptimal prostate seed brachytherapy
- Author
-
Maroie Barkati, David Benzaquen, Cynthia Ménard, Guila Delouya, and Daniel Taussky
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Brachytherapy ,030232 urology & nephrology ,Urology ,Risk Assessment ,Disease-Free Survival ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Interquartile range ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Treatment Failure ,Aged ,Aged, 80 and over ,Univariate analysis ,business.industry ,Cancer ,Prostatic Neoplasms ,Radiotherapy Dosage ,Organ Size ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Prostate-specific antigen ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business ,Follow-Up Studies - Abstract
Purpose In prostate seed brachytherapy, a D90 of
- Published
- 2016
40. Changes in periprostatic adipose tissue induced by 5α-reductase inhibitors
- Author
-
Shanie Campeau, Khalid Zerouali, Daniel Taussky, Fred Saad, Maroie Barkati, Guila Delouya, and Amal Nadiri
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Urology ,Endocrinology, Diabetes and Metabolism ,Adipose tissue ,Fat pad ,Metastasis ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Endocrinology ,5-alpha Reductase Inhibitors ,Periprostatic ,Prostate ,Internal medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,business.industry ,Cancer ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Reproductive Medicine ,Adipose Tissue ,030220 oncology & carcinogenesis ,business ,Subcutaneous tissue - Abstract
Summary There is increasing interest in periprostatic fat and its influence on prostate cancer aggressiveness. In vitro data suggest that adipose stromal/stem cells (ASCs) can increase production of cytokines and growth factors resulting in invasive growth and metastasis in prostate cancer. The objective of the study was to determine the interaction between 5α-reductase inhibitors (5ARIs) and periprostatic adipose tissue (PPAT) and factors of prostate cancer aggressiveness. In this retrospective study, we identified 61 patients treated with 5ARIs for a period of ≥12 months before undergoing radiation therapy (brachytherapy or external beam radiotherapy). The control group consisted of 117 patients without any exposure to 5ARIs. Prior to being treated, all patients underwent abdominal computed tomography (CT). To measure PPAT, we defined the fat pad anteriorly to the prostate, as well as the intra-abdominal visceral adipose tissue (VAT) and subcutaneous tissue (SAT) at the level of L4/L5. All contours were performed manually. These adipose tissue measurements were correlated with the Cancer of the Prostate Risk Assessment (CAPRA) score using Pearson correlation coefficient. Differences in fat contents were evaluated using Student's t-test. Median time on 5ARIs for the 61 patients was 12 months (range 12–96). Patient on 5ARIs had a significantly (p
- Published
- 2016
41. EP-2013: Single fraction HDR BT boost using ultrasound plng for prostate cancer: dosimetrics and toxicity
- Author
-
Maroie Barkati, Guila Delouya, Cynthia Ménard, O. Lauche, and Daniel Taussky
- Subjects
medicine.medical_specialty ,business.industry ,Ultrasound ,Urology ,Hematology ,medicine.disease ,Single fraction ,Prostate cancer ,Oncology ,Radiology Nuclear Medicine and imaging ,Toxicity ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2016
- Full Text
- View/download PDF
42. Adjuvant Chemotherapy and Vaginal Vault Brachytherapy With or Without Pelvic Radiotherapy for Stage 1 Papillary Serous or Clear Cell Endometrial Cancer
- Author
-
Marie-Claude Beauchemin, Jean-François Carrier, Thu Van Nguyen-Huynh, Maroie Barkati, Audrey Tétreault-Laflamme, Philippe Sauthier, and Vanessa Samouëlian
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Urology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Medicine ,Humans ,External beam radiotherapy ,Stage (cooking) ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,030219 obstetrics & reproductive medicine ,business.industry ,Endometrial cancer ,Carcinoma ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Carboplatin ,Surgery ,Endometrial Neoplasms ,Serous fluid ,Oncology ,chemistry ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Vaginal vault ,Female ,business - Abstract
Objective The aim of this study was to assess and compare adjuvant chemotherapy followed by either high–dose-rate vaginal vault brachytherapy (VBT) alone or combined with pelvic external beam radiotherapy (EBRT) for International Federation of Gynaecology and Obstetrics stage 1 serous or clear cell (CC) endometrial cancer. Methods Between 2006 and 2012, 84 women with stage 1 serous or CC endometrial cancer were evaluated postoperatively for adjuvant treatment at our hospital. More than 80% of patients had pelvic lymphadenectomy. Patients declining or not completing adjuvant treatments were excluded. Twenty-five women received 4 to 6 cycles of carboplatin/paclitaxel followed by EBRT and VBT. Thirty-two women received 6 cycles of carboplatin/paclitaxel followed by VBT. Locoregional control and toxicities were assessed during follow-up. Results The 3-year disease-free survival and overall survival rates for the VBT group compared with the EBRT + VBT group were 88% versus 84%, P = 0.6, and 100% versus 94%, P = 0.6, respectively. Only 1 patient in the EBRT + VBT group developed a distant recurrence. One patient had grade 3 toxicity (chronic gastrointestinal [GI] toxicity) in the EBRT + VBT group. Acute grade 1-to-2 GI and grade 1 genitourinary (GU) toxicities were less frequent in the VBT group compared with the EBRT + VBT group (P = 0.008 and P = 0.019, respectively). Late GI and GU toxicities were comparable. Grade 1 vaginal toxicity was similar in both groups. No acute or late grade 2 GU or vaginal toxicities were reported. Conclusions According to this study, VBT alone seems to be as effective as EBRT and VBT for stage 1 serous and CC endometrial cancer treated with surgery and adjuvant chemotherapy. Furthermore, less acute GI and GU toxicities were seen in the VBT group.
- Published
- 2016
43. High-Dose-Rate Brachytherapy as a Monotherapy for Favorable-Risk Prostate Cancer: A Phase II Trial
- Author
-
Gillian M. Duchesne, Keen Hun Tai, Maroie Barkati, Scott Williams, Sarat Chander, Andrew See, Sylvia van Dyk, and Farshad Foroudi
- Subjects
Male ,Risk ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Urology ,Urinary incontinence ,Adenocarcinoma ,Prostate cancer ,Erectile Dysfunction ,medicine ,Humans ,Dysuria ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Radiation Injuries ,Aged ,Neoplasm Staging ,Radiation ,business.industry ,Urinary retention ,Rectum ,Prostatic Neoplasms ,Cancer ,Radiotherapy Dosage ,Common Terminology Criteria for Adverse Events ,Middle Aged ,Prostate-Specific Antigen ,Urination Disorders ,medicine.disease ,Surgery ,Prostate-specific antigen ,Oncology ,Quality of Life ,Feasibility Studies ,Neoplasm Grading ,Neoplasm Recurrence, Local ,medicine.symptom ,business - Abstract
Purpose There are multiple treatment options for favorable-risk prostate cancer. High-dose-rate (HDR) brachytherapy as a monotherapy is appealing, but its use is still investigational. A Phase II trial was undertaken to explore the value of such treatment in low-to-intermediate risk prostate cancer. Methods and Materials This was a single-institution, prospective study. Eligible patients had low-risk prostate cancer features but also Gleason scores of 7 (51% of patients) and stage T2b to T2c cancer. Treatment with HDR brachytherapy with a single implant was administered over 2 days. One of four fractionation schedules was used in a dose escalation study design: 3 fractions of 10, 10.5, 11, or 11.5 Gy. Patients were assessed with the Common Terminology Criteria for Adverse Events version 2.0 for urinary toxicity, the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scoring schema for rectal toxicity, and the Expanded Prostate Cancer Index Composite (EPIC) questionnaire to measure patient-reported health-related quality of life. Biochemical failure was defined as a prostate-specific antigen (PSA) nadir plus 2 ng/ml. Results Between 2003 and 2008, 79 patients were enrolled. With a median follow-up of 39.5 months, biochemical relapse occurred in 7 patients. Three- and 5-year actuarial biochemical control rates were 88.4% (95% confidence interval [CI], 78.0-96.2%) and 85.1% (95% CI, 72.5-94.5%), respectively. Acute grade 3 urinary toxicity was seen in only 1 patient. There was no instance of acute grade 3 rectal toxicity. Rates of late grade 3 rectal toxicity, dysuria, hematuria, urinary retention, and urinary incontinence were 0%, 10.3%, 1.3%, 9.0%, and 0%, respectively. No grade 4 or greater toxicity was recorded. Among the four (urinary, bowel, sexual, and hormonal) domains assessed with the EPIC questionnaire, only the sexual domain did not recover with time. Conclusions HDR brachytherapy as a monotherapy for favorable-risk prostate cancer, administered using a single implant over 2 days, is feasible and has acceptable acute and late toxicities. Further follow-up is still required to better evaluate the efficacy of such treatment.
- Published
- 2012
- Full Text
- View/download PDF
44. Phase 3 Study of Hypofractionated, Dose Escalation Radiation Therapy for High-Risk Adenocarcinoma of the Prostate
- Author
-
Michael A. Yassa, Maroie Barkati, Redouane Bettahar, Marjory Jolicoeur, L. Azoulay, M. Mohiuddin, Boris Bahoric, André-Guy Martin, Abdenour Nabid, Hugo Villeneuve, Levon Igidbashian, Robert Archambault, Tamim Niazi, and L.S. Vincent
- Subjects
0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,Phases of clinical research ,medicine.disease ,Hypofractionated Dose ,Radiation therapy ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Prostate ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Adenocarcinoma ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2017
- Full Text
- View/download PDF
45. Prognostic Factors in Radium-223 Treatment—An Early Canadian Single-Center Experience
- Author
-
Maroie Barkati, Fred Saad, Guila Delouya, Daniel Taussky, S. Traboulsi, and Jean-Paul Bahary
- Subjects
Radium-223 ,Cancer Research ,medicine.medical_specialty ,Radiation ,Oncology ,business.industry ,General surgery ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Single Center ,medicine.drug - Published
- 2017
- Full Text
- View/download PDF
46. EP-1774: Randomized phase II trial of IGRT with or without HDR boost in intermediate-risk prostate cancer
- Author
-
Tamim Niazi, A. Kamran, G. Springer, Peter Chung, Eric Vigneault, Maroie Barkati, M. Montreal, Andrew Loblaw, K. Ding, W. Perulekar, G. Morton, and W. Koll
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Phase (waves) ,Hematology ,medicine.disease ,Prostate cancer ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Intermediate risk ,business ,Image-guided radiation therapy - Published
- 2017
- Full Text
- View/download PDF
47. Patterns of Failure and Treatment-Related Toxicity in Advanced Cervical Cancer Patients Treated Using Extended Field Radiotherapy With Curative Intent
- Author
-
Sylvia van Dyk, Maroie Barkati, Srinivas Kondalsamy-Chennakesavan, David Bernshaw, Christhanthi Rajasooriyar, and Kailash Narayan
- Subjects
Adult ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Uterine Cervical Neoplasms ,Adenocarcinoma ,Disease-Free Survival ,Bone Marrow ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiation Injuries ,Aged ,Retrospective Studies ,Salvage Therapy ,Cervical cancer ,Chemotherapy ,Radiation ,business.industry ,Cancer ,Radiotherapy Dosage ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Primary tumor ,Surgery ,Gastrointestinal Tract ,Radiation therapy ,Oncology ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Female ,Neoplasm Recurrence, Local ,business ,Chemoradiotherapy - Abstract
Purpose: The purpose of this study was to evaluate the patterns of failure and overall survival (OS) and diseasefree survival (DFS) rates in cervical cancer patients who had metastatic disease in common iliac or para-aortic lymph nodes and were treated with curative intent, using extended field radiotherapy (EFRT). Methods and Materials: This was a retrospective study involving 39 patients treated from January 1996 to June 2007, using EFRT with concurrent chemotherapy and intracavitary brachytherapy. EFRT consisted of 45 Gy in 1.8-Gy fractions. Radiation to involved nodes was boosted to a total dose of 50.4 to 54 Gy. Primary tumor radiation was boosted to a dose of 80 Gy using brachytherapy. Results: Overall, 30 patients (77%) have relapsed. The 5-year OS rate was 26% (95% confidence interval [CI], 11‐44). The 5-year DFS rate was 19.4% (95% CI, 8‐35). Only 3 patients (7.5%) experienced treatment failure exclusively within the treatment field, and 2 patients underwent salvage treatment. Grade 3 to 4 acute bone marrow and gastrointestinal toxicities were observed in 10 (26%) and 7 (18%) patients, respectively. Conclusions: Concurrent chemotherapy and EFRT treatment was well tolerated. Most patients showed failure at multiple sites and outside the treatment field. Only 3/39 patients had failures exclusively within the treatment field, and 2 underwent salvage treatment. 2011 Elsevier Inc. Uterine cervical cancer, Extended field radiotherapy, Chemoradiation, Treatment outcome, Toxicity.
- Published
- 2011
- Full Text
- View/download PDF
48. Hypofractionated, dose escalation radiotherapy for high-risk prostate cancer: The primary endpoint of a group led phase III trial. (PCS5)
- Author
-
Robert Archambault, L.S. Vincent, André-Guy Martin, Hugo Villeneuve, Levon Igidbashian, Maroie Barkati, Marjory Jolicoeur, Mohiuddin, Tamim Niazi, Michael A. Yassa, Redouane Bettahar, Abdenour Nabid, Boris Bahoric, and James M. G. Tsui
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Androgen suppression ,medicine.disease ,030218 nuclear medicine & medical imaging ,Hypofractionated Dose ,law.invention ,Radiation therapy ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine.anatomical_structure ,Randomized controlled trial ,law ,Prostate ,030220 oncology & carcinogenesis ,Internal medicine ,Clinical endpoint ,medicine ,business ,Adjuvant - Abstract
123 Background: The low α\β ratio of prostate cancer (PCa), 1.5-2, suggests high radiation-fraction sensitivity and predicts a therapeutic advantage of hypofractionated radiation treatment (HFRT). Most available data of moderate HFRT have focused on low, intermediate and/or mixed risk groups. We therefore conducted the first randomized trial of moderately HFRT in high-risk PCa patients and present the primary safety analysis of side effects at 2 years. Methods: We conducted a Canadian multi-centric phase III trial of conventional fractionated radiation therapy (CFRT) vs. intensity-modulated HFRT in men with high-risk PCa as per NCCN definition. From February 2012 to March 2015, 329 patients were randomized in a 1:1 ratio to receive either CFRT or HFRT. All patients received neo-adjuvant, concurrent and adjuvant androgen suppression, with a median duration of 24 months. CFRT consisted of 76 Gy in 2 Gy per fraction to the prostate where 46 Gy was delivered to the pelvic lymph nodes. HFRT consisted of concomitant dose escalation of 68 Gy in 2.72 Gy per fraction to the prostate and 45 Gy, in 1.8Gy per fraction to the pelvic lymph nodes. The primary endpoint was to compare the toxicities at 6 months and at 24 months using the CTCAE v.4. Results: Of the329 patients, 164 were randomized to HFRT and 165 to CFRT. The minimum, median and maximum follow-up were 24, 40 and 60 months respectively. At 24 months, 12 patients in the CFRT arm and 15 patients in the HFRT arm had grade 2 or worse gastrointestinal (GI)-related adverse events (HR:1.32 [0.62.2.83] 95% CI; P=NS). Similarly, 11 patients in the CFRT arm and 3 patients in HFRT arm had grade 2 or higher genitourinary (GU) toxicities (HR:0.26 [0.07-0.94] 95% CI; P=0.037). In the HFRT arm, there were 3 grade 3 GI and one grade 3 GU related toxicities. In the CFRT arm there were 3 grade 3 GU and no grade 3 GI related toxicities. There were no grade 4 toxicities in either arm. Conclusions: This is the first hypofractionated dose escalated radiotherapy study in high-risk PCa patients treated with contemporary radiation and androgen suppression. Our results indicate that moderate HFRT to high risk PCa patients is equally well tolerated as CFRT at 2 years. Clinical trial information: NCT01444820.
- Published
- 2018
- Full Text
- View/download PDF
49. Single-fraction high-dose-rate brachytherapy using real-time transrectal ultrasound based planning in combination with external beam radiotherapy for prostate cancer: dosimetrics and early clinical results
- Author
-
Yannick Hervieux, Daniel Taussky, Maroie Barkati, O. Lauche, Dominic Béliveau-Nadeau, Cynthia Ménard, Guila Delouya, and Renée Larouche
- Subjects
0106 biological sciences ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,brachytherapy ,Urology ,lcsh:Medicine ,HDR ,01 natural sciences ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Dosimetry ,Medicine ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,TRUS ,single fraction ,Original Paper ,business.industry ,lcsh:R ,Common Terminology Criteria for Adverse Events ,medicine.disease ,prostate cancer ,High-Dose Rate Brachytherapy ,Urethra ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,International Prostate Symptom Score ,Radiology ,Nuclear medicine ,business ,010606 plant biology & botany - Abstract
Purpose : To validate the feasibility of a single-fraction high-dose-rate brachytherapy (HDRBT) boost for prostate cancer using real-time transrectal ultrasound (TRUS) based planning. Material and methods : From August 2012 to September 2015, 126 patients underwent a single-fraction HDRBT boost of 15 Gy using real-time TRUS based planning. External beam radiation therapy (EBRT) (37.5 Gy/15 fractions, 44 Gy/22 fractions, or 45 Gy/25 fractions) was performed before (31%) or after (69%) HDRBT boost. Genito-urinary (GU) and gastro-intestinal (GI) toxicity were assessed 4 and 12 months after the end of combined treatment using the international prostate symptom score scale (IPSS) and the common terminology criteria for adverse events (CTCAE) v3.0. Results : All dose-planning objectives were achieved in 90% of patients. Prostate D 90 ≥ 105% and ≤ 115% was achieved in 99% of patients, prostate V 150 ≤ 40% in 99%, prostate V 200 < 11% in 96%, urethra D 10 < 120% for 99%, urethra V 125 = 0% in 100%, and rectal V 75 < 1 cc in 93% of patients. Median IPSS score was 4 at baseline and did not change at 4 and 12 months after combined treatment. No patients developed ≥ grade 2 GI toxicity. With a median follow-up of 10 months, only two patients experienced biochemical failure. Among patients who didn’t receive ADT, cumulative percentage of patients with PSA ≤ 1 ng/ml at 4 and 18 months was respectively 23% and 66%. Conclusions : Single-fraction HDRBT boost of 15 Gy using real-time TRUS based planning achieves consistently high dosimetry quality. In combination with EBRT, toxicity outcomes appear promising. A longer follow-up is needed to assess long-term outcome and toxicities.
- Published
- 2015
50. Impact of visceral fat volume and fat density on biochemical outcome after radical prostatectomy and postoperative radiotherapy
- Author
-
Denis Rompotinos, Maroie Barkati, Daniel Taussky, Shanie Campeau, Michel Zimmermann, and Guila Delouya
- Subjects
0301 basic medicine ,Biochemical recurrence ,Male ,medicine.medical_specialty ,Intra-Abdominal Fat ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Urology ,Adipose tissue ,Body Mass Index ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Humans ,External beam radiotherapy ,Molecular Biology ,Aged ,Prostatectomy ,Univariate analysis ,Radiotherapy ,business.industry ,Prostatic Neoplasms ,Seminal Vesicles ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,business ,Body mass index - Abstract
Background: To assess the predictive value of visceral adipose tissue (VAT) and adipose tissue density after both radical prostatectomy (RP) and adjuvant or salvage external beam radiotherapy (EBRT). Materials and methods: We randomly selected 201 patients treated with RP and EBRT between 2005 and 2015. Visceral adipose tissue and subcutaneous adipose tissue volumes were manually contoured and corresponding tissue densities in Hounsfield units (HU) calculated. Time to biochemical recurrence (BCR) was calculated using the Kaplan-Meier method and comparisons were made using the log-rank test. Cox regression analysis was done for multivariate analysis. Results: Median time to BCR or last follow-up was 32 months. In univariate analysis for BCR, VAT volume and fat density were both associated with a better outcome (p=0.025 and p=0.024, respectively) as well as seminal vesicle involvement (p=0.024). Body mass index (BMI) was not predictive of BCR (p=0.32). In a multivariate model including seminal vesicle involvement, both a VAT volume above the median (HR2.5, 95%CI 1.1–5.7, p=0.03) and a VAT density (HR 2.4, 95%CI 1.1–5.1, p=0.028) above the median remained predictive for a better biochemical outcome. Adjusting for BMI did not significantly change the model. Conclusions: In both univariate and multivariate analysis, patients with both a larger VAT volume and density had a better biochemical outcome. The interaction between prostate cancer aggressiveness and visceral fat volume and density needs to be further evaluated to provide a better understanding of this disease.
- Published
- 2015
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.