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1. Impact of dosimetric parameters on local control for patients treated with three-dimensional pulsed dose-rate brachytherapy for cervical cancer

Author

Claude Krzisch, Didier Peiffert, Sabrina Boyrie, Valentin Harter, Martine Delannes, Xavier Montbarbon, Claire Charra-Brunaud, Isabelle Barillot, Anne Ducassou, Philippe Lang, Marie-Hélène Baron, Youlia M. Kirova, Institut Claudius Regaud, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Département de radiothérapie oncologique [Paris], Institut Curie [Paris], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), CHU Amiens-Picardie, Service d'Oncologie Radiothérapie [CHU Pitié Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Léon Bérard [Lyon], Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), CRLCC Institut Claudius Regaud, Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), Institut Curie, Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Hôpital Universitaire d'Amiens, Service de Radiothérapie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de radiothérapie (CHRU Besançon), and Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)

Subjects
medicine.medical_treatment, Brachytherapy, Planning target volume, Uterine Cervical Neoplasms, MESH: Magnetic Resonance Imaging, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, Prospective Studies, Prospective cohort study, MESH: Radiotherapy Dosage, MESH: Treatment Outcome, Cervical cancer, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, medicine.diagnostic_test, Radiotherapy Dosage, MESH: Carcinoma, Squamous Cell, MESH: Follow-Up Studies, Middle Aged, Magnetic Resonance Imaging, 3. Good health, MESH: Uterine Cervical Neoplasms, Treatment Outcome, Oncology, MESH: Survival Analysis, Carcinoma, Squamous Cell, Female, MESH: Tomography, X-Ray Computed, MESH: Brachytherapy, MESH: Neoplasm Recurrence, Local, Adult, MESH: Imaging, Three-Dimensional, Adenocarcinoma, Kerma, Imaging, Three-Dimensional, MESH: Dose-Response Relationship, Radiation, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pulsed-Dose Rate Brachytherapy, External beam radiotherapy, Aged, Pulsed dose-rate brachytherapy, MESH: Humans, business.industry, MESH: Adenocarcinoma, Magnetic resonance imaging, Dose-Response Relationship, Radiation, MESH: Adult, medicine.disease, Survival Analysis, MESH: Prospective Studies, Three-dimensional brachytherapy, Local control, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neoplasm Recurrence, Local, business, Nuclear medicine, Tomography, X-Ray Computed, MESH: Female, Follow-Up Studies
Abstract

International audience; To investigate the impact of dose-volume histograms parameters on local control of three-dimensional (3D) image-based pulsed dose-rate brachytherapy (BT).METHODS AND MATERIALS:Within a French multicentric prospective study, the data of the 110 patients treated for cervical cancer with external beam radiotherapy followed by 3D image-based and optimized pulsed dose-rate BT were analyzed. Delineation procedures were performed on magnetic resonance imaging in a minority of cases and on CT for the majority of cases, adapted from the Gynaecological Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology recommendations. Optimization procedure was left to the discretion of the treating center.RESULTS:At 2 years, local control rate reached 78%. Dose to Point A, total reference air kerma, and intermediate-risk clinical target volume (IR-CTV) V60 were predictive factors for local control (p = 0.001, p = 0.001, and p = 0.013, respectively). Patients with IR-CTV V60

Published
2014
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2. Impact of dynamic IMRT and tomotherapy in pelvic cancers: A prospective dosimetric study with 51 patients

Author

Servagi-Vernat, S., Giraud, P., Fenoglietto, P., Azria, D., Lisbona, A., de La Rochefordière, A., Zefkili, S., Fau, P., Resbeut, M., Huger, S., Peiffert, D., Meyer, P., Noël, G., Mazurier, J., Latorzeff, I., Biston, M.-C., Pommier, P., Ledu, D., Garcia, R., Chauvet, B., Dudouet, P., Belhomme, S., Kantor, G., Mahé, M.-A., Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Service d’oncologie-radiothérapie [HEGP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), CRLCC Val d'Aurelle - Paul Lamarque, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Curie [Paris], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), CRLCC Paul Strauss, Clinique Pasteur [Toulouse], Centre Léon Bérard [Lyon], Institut Sainte Catherine [Avignon], Clinique Pont-de-Chaume, Institut Bergonié [Bordeaux], CRLCC René Gauducheau, Service de radiothérapie (CHRU Besançon), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes, Institut Curie, Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), and Institut Bergonié - CRLCC Bordeaux

Subjects
Male, Organs at Risk, Tomothérapie hélicoïdale, Pelvic radiotherapy, Models, Statistical, Radiothérapie pelvienne, Prostatic Neoplasms, Radiotherapy Dosage, Dynamic IMRT, Comparaison dosimétrique, RCMI rotationnelle, Anus Neoplasms, Tomotherapy, Rapid’Arc®, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Lymph Nodes, Prospective Studies, Radiotherapy, Intensity-Modulated, Dosimetric comparison, Organ Sparing Treatments
Abstract

International audience; PurposeTo compare the dosimetric results of different techniques of dynamic intensity modulated radiation therapy (IMRT) in patients treated for a pelvic cancer with nodal irradiation.Patients and methodsData of 51 patients included prospectively in the Artpelvis study were analyzed. Thirty-six patients were treated for a high-risk prostate cancer (13 with helical tomotherapy, and 23 with Rapid’Arc®) and 15 patients were treated for a localized anal cancer (nine with helical tomotherapy and six with Rapid’Arc®). Plan quality was assessed according to several different dosimetric indexes of coverage of planning target volume and sparing of organs at risk.ResultsAlthough some dosimetric differences were statistically significant, helical tomotherapy and Rapid’Arc provided very similar and highly conformal plans. Regarding organs at risk, Rapid’Arc® provided better pelvic bone sparing with a lower non-tumoral integral dose.ConclusionIn pelvis cancer with nodal irradiation, Rapid’Arc and helical tomotherapy provided very similar plans. The clinical evaluation of Artpelvis study will verify this equivalence hypothesis.; ObjectifComparaison dosimétrique entre différentes techniques de radiothérapie conformationnelle avec modulation d’intensité (RCMI) rotationnelles chez des patients traités pour un cancer pelvien avec irradiation ganglionnaire.Patients et méthodesLes données dosimétriques de 51 patients inclus prospectivement dans le protocole Artpelvis ont été analysées. Trente-six patients atteints d’un cancer de prostate à haut risque ont été traités, dont 13 par un appareil de tomothérapie hélicoïdale et 23 par RapidArc®. Quinze patients atteints un cancer du canal anal localement évolué ont été traités, dont neuf par un appareil de tomothérapie hélicoïdale et six par RapidArc®. L’analyse a porté sur la comparaison de différents indices de qualité dosimétriques pour les volumes cibles prévisionnels et sur les doses reçues aux organes à risque.RésultatsMalgré de légères différences, l’analyse des paramètres dosimétriques a montré que les deux techniques généraient une bonne et semblable couverture des volumes cibles prévisionnels, conforme à la prescription et aux contraintes prédéfinies. En ce qui concerne les organes à risque, les doses délivrées au bassin et la dose intégrale étaient légèrement plus élevées avec la tomothérapie hélicoïdale.ConclusionPour des cancers pelviens traités avec irradiation une ganglionnaire, le RapidArc®et la tomothérapie hélicoïdale permettent d’obtenir des résultats dosimétriques équivalents. L’évaluation du suivi clinique de l’étude Artpelvis permettra de vérifier cette hypothèse d’équivalence.

Published
2014
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3. Unilateral or bilateral irradiation in cervical lymph node metastases of unknown primary? A retrospective cohort study

Author

J. Khalifa, C. Pflumio, Shakeel Sumodhee, Matthieu Caubet, Ludivine Catteau, Xu Shan Sun, Amel Rehailia-Blanchard, A. Beddok, Vincent Roth, I. Troussier, Joël Castelli, Marco Krengli, Charles Dupin, Nicolas Blanchard, Valentin Calugaru, Jean-Christophe Faivre, Yoann Pointreau, Juliette Thariat, Julia Salleron, Jessica Miroir, Mélanie Doré, Edouard Romano, Paul Giraud, Samir H. Patel, S. Servagi-Vernat, Alexandre Coutte, René-Jean Bensadoun, Claire Petit, Lionnel Geoffrois, Yungan Tao, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Hôpital Nord Franche-Comté [Hôpital de Trévenans] (HNFC), Institut Gustave Roussy (IGR), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut Jean Godinot [Reims], CRLCC Eugène Marquis (CRLCC), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), CHU Amiens-Picardie, Service d'Oncologie radiothérapie [Clinique Victor Hugo], Clinique Victor Hugo [Le Mans], Mayo Clinic, CHU Saint-Etienne, Centre hospitalier universitaire de Poitiers (CHU Poitiers), EASY CRF : la recherche clinique en ligne, and ARCHADE (Advanced Resource Centre for HADrontherapy in Europe)

Subjects
Male, 0301 basic medicine, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Neck dissection, Head and neck neoplasms, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Cervical lymphadenopathy, Neoplasms, Chemotherapy, Radiotherapy, Unknown primary, Carcinoma, Humans, Medicine, Cumulative incidence, Lymph node, Aged, Retrospective Studies, Squamous Cell Carcinoma of Head and Neck, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, Surgery, Radiation therapy, 030104 developmental biology, medicine.anatomical_structure, Oncology, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Concomitant, Neoplasms, Unknown Primary, Female, Lymph Nodes, medicine.symptom, business
Abstract

Patients with cervical lymphadenopathy of unknown primary carcinoma (CUP) usually undergo neck dissection and irradiation. There is an ongoing controversy regarding the extent of nodal and mucosal volumes to be irradiated. We assessed outcomes after bilateral or unilateral nodal irradiation.This retrospective multicentre study included patients with CUP and squamous cellular carcinoma who underwent radiotherapy (RT) between 2000 and 2015.Of 350 patients, 74.5% had unilateral disease and 25.5% had bilateral disease. Of 297 patients with available data on disease and irradiation sides, 61 (20.5%) patients had unilateral disease and unilateral irradiation, 155 (52.2%), unilateral disease and bilateral irradiation and 81 (27.3%), bilateral disease and bilateral irradiation. Thirty-four (9.7%) and 217 (62.0%) patients received neoadjuvant and/or concomitant chemotherapy, respectively. Median follow-up was 37 months. Three-year local, regional, locoregional failure rates and CUP-specific survival were 5.6%, 11.7%, 15.0% and 84.7%, respectively. In patients with unilateral disease, the 3-year cumulative incidence of regional/local relapse was 7.7%/4.3% after bilateral irradiation versus 16.9%/11.1% after unilateral irradiation (hazard ratio = 0.56/0.61, p = 0.17/0.32). The cumulative incidence of CUP-specific deaths was 9.2% after bilateral irradiation and 15.5% after unilateral irradiation (p = 0.92). In multivariate analysis, mucosal irradiation was associated with better local control, whereas no neck dissection, ≥N2b and interruption of RT for more than 4 days were associated with poorer regional control. Toxicity was higher after bilateral irradiation (p 0.05). No positron-emission tomography-computed tomography, largest node diameter, ≥N2b, neoadjuvant chemotherapy and interruption of RT were associated with poorer cause-specific survival.Bilateral nodal irradiation yielded non-significant better nodal and mucosal control rates but was associated with higher rates of severe toxicity.

Published
2019
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4. Miniaturized fiber dosimeter of medical ionizing radiations on a narrow optical fiber

Author

Louise Robillot, Miguel Angel Suarez, Valentin Maillot, Patrick Bontemps, Lionel Pazart, Thomas Lihoreau, Tony Lim, Thierry Grosjean, Femto-st, Optique, Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université de Franche-Comté (UFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])

Subjects
Single mode fibers, [PHYS.PHYS.PHYS-OPTICS] Physics [physics]/Physics [physics]/Optics [physics.optics], Photon, Optical fiber, Materials science, Physics::Instrumentation and Detectors, Physics::Medical Physics, Silica fibers, Physics::Optics, 02 engineering and technology, Radiation, Scintillator, Total internal reflection, 01 natural sciences, law.invention, 010309 optics, Plastic optical fibers, law, 0103 physical sciences, Miniaturization, [PHYS.PHYS.PHYS-INS-DET]Physics [physics]/Physics [physics]/Instrumentation and Detectors [physics.ins-det], Fiber, Irradiation, [PHYS]Physics [physics], [PHYS.PHYS.PHYS-OPTICS]Physics [physics]/Physics [physics]/Optics [physics.optics], Dosimeter, business.industry, Multimode fibers, 021001 nanoscience & nanotechnology, Atomic and Molecular Physics, and Optics, Effective refractive index, Optoelectronics, 0210 nano-technology, business
Abstract

International audience; Fiber dosimeters have recently drawn much interest for measuring in vivo and in real time the dose of medical radiations. This paper presents the first miniaturized fiber dosimeter integrated at the end of a narrow 125 μm outer diameter optical fiber. Miniaturization is rendered possible by exploiting the concept of a leaky wave optical antenna for interfacing the scintillators and the fiber and by taking advantage of the low propagation loss of narrow silica fibers and high detection yield of single-pixel photon counters. Upon irradiation at 6 MV in air, our fiber probe leads to a linear detection response with a signal-to-noise ratio as high as 195. Although implemented with inorganic scintillators and fiber, our miniaturized fiber probe induces minimum screening effects on ionizing radiations over a negligible area (0.153 mm2). Our nano-optically driven approach may thus result in ultra-compact fiber dosimeters of negligible footprint in the radiotherapeutic processes, even with non-water equivalent fibers and scintillators. This opens new opportunities for a large panel of therapies relying on ionizing radiations (photons or charged particles).

Published
2019
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5. Radical cystectomy or bladder preservation with radiochemotherapy in elderly patients with muscle-invasive bladder cancer: Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators

Author

Matthew I. Milowsky, Federica Recine, Sumanta K. Pal, Matthew D. Galsky, Thomas Powles, Simon Chowdhury, Joaquim Bellmunt, Jihane Boustani, Matthieu Caubet, Aurélie Bertaut, Sylvain Ladoire, Gilles Créhange, Guenter Niegisch, Lauren C. Harshman, Ugo De Giorgi, Simon J. Crabb, Loïc Balssa, Jonathan E. Rosenberg, Evan Y. Yu, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Unité de biostatistiques [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Memorial Sloane Kettering Cancer Center [New York], Dana-Farber Cancer Institute [Boston], Barts Cancer Institute, Queen Mary University of London (QMUL), Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Guy's and St Thomas' Hospital [London], Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], University of Washington [Seattle], City of Hope Comprehensive Cancer Center [Duarte], University of Southampton, University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Lineberger Comprehensive Cancer Center (UNC Lineberger), University of North Carolina System (UNC)-University of North Carolina System (UNC), Département d'oncologie médicale [Centre Georges-François Leclerc], and Service de radiothérapie [Centre Georges-François Leclerc]

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Kaplan-Meier Estimate, Cystectomy, Bladder preservation, Disease-Free Survival, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Carcinoma, medicine, Humans, Radiology, Nuclear Medicine and imaging, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, Carcinoma, Transitional Cell, Bladder cancer, business.industry, Proportional hazards model, Muscle invasive, Retrospective cohort study, Hematology, General Medicine, Chemoradiotherapy, medicine.disease, 3. Good health, Surgery, Treatment Outcome, Oncology, Urinary Bladder Neoplasms, 030220 oncology & carcinogenesis, Female, business
Abstract

IF 3.156; International audience; Background: Radical cystectomy (RC) and radiochemotherapy (RCT) are curative options for muscle-invasive bladder cancer (MIBC). Optimal treatment strategy remains unclear in elderly patients.Material and methods: Patients aged 80 years old and above with T2-T4aN0-2M0-Mx MIBC were identified in the Retrospective International Study of Cancers of the Urothelial Tract (RISC) database. Patients treated with RC were compared with those treated with RCT. The impact of surgery on overall survival (OS) was assessed using a Cox proportional hazard model. Progression included locoregional and metastatic relapse and was considered a time-dependent variable.Results: Between 1988 and 2015, 92 patients underwent RC and 72 patients had RCT. Median age was 82.5 years (range 80–100) and median follow-up was 2.90 years (range 0.04–11.10). Median OS was 1.99 years (95%CI 1.17–2.76) after RC and 1.97 years (95%CI 1.35–2.64) after RCT (p = .73). Median progression-free survival (PFS) after RC and RCT were 1.25 years (95%CI 0.80–1.75) and 1.52 years (95%CI 1.01–2.04), respectively (p = .54). In multivariate analyses, only disease progression was significantly associated with worse OS (HR = 10.27 (95%CI 6.63–15.91), p

Published
2017
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6. EP-1502: Is it possible to optimize the prescription of PET/CT and MRI in anal cancer patients follow-up?

Author

D. Aloi, Gilles Créhange, J.F. Bosset, C. Reichling, Zaher Lakkis, Stefano Kim, B. De Bari, Alexis Lepinoy, C. Teyssier, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Département de Radiations Oncologie, Centre Paul Strauss, Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC), Service de Chirurgie Digestive [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'Oncologie Médicale [CHRU Besançon], Département de Radiation oncologie, CGFL, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Laboratoire d'Electronique, d'Informatique et d'Image [EA 7508] (Le2i), Université de Technologie de Belfort-Montbeliard (UTBM)-Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), and European Society of Radiotherapy & Oncology

Subjects
PET-CT, medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, business.industry, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Hematology, medicine.disease, 030218 nuclear medicine & medical imaging, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, medicine, Anal cancer, Radiology, Nuclear Medicine and imaging, Radiology, Medical prescription, business, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2018
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7. A cost-analysis of image-guided radiation therapy (IGRT) in prostate cancer: results from a phase III clinical trial

Author

Perrier, Lionel, Morelle, Magali, Pommier, Pascal, Lagrange, Jean-Léon, Laplanche, Agnès, Dudouet, Philippe, Mahé, Marc, Chauvet, Bruno, Nguyen, Tan Dat, Créhange, Gilles, Duparc, Angélique, Zawadi, Ayman, Chapet, Olivier, Latorzeff, Igor, Bossi, Alberto, Beckendorf, Véronique, Pene, Françoise, Muracciole, Xavier, Bachaud, Jean-Marc, De Crevoisier, Renaud, Groupe d'analyse et de théorie économique (GATE Lyon Saint-Étienne), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Centre Léon Bérard [Lyon], Service de chirurgie plastique et reconstructive [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Laboratoire de mathématiques de Brest (LM), Université de Brest (UBO)-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon), Groupe d'Analyse et de Théorie Economique Lyon - Saint-Etienne (GATE Lyon Saint-Étienne), École normale supérieure de Lyon (ENS de Lyon)-Université Lumière - Lyon 2 (UL2)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Dao, Taï, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de radiothérapie, and Hôpital Jean Minjoz-CHU Besan

Subjects
image-guided radiation therapy (IGRT), [SHS.ECO] Humanities and Social Sciences/Economics and Finance, prostate cancer, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, ComputingMilieux_MISCELLANEOUS, cost-analysis
Abstract

International audience

Published
2012

8. Classification of prostate magnetic resonance spectra using Support Vector Machine

Author

Gilles Créhange, Paul Walker, Sébastien Parfait, Xavier Tizon, Johel Miteran, Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Oncodesign [Dijon], Financements région Bourgogne, FSE, Oncodesign, Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Oncodesign Inc., and Oncodesign Biotechnology®

Subjects
Clustering high-dimensional data, [ INFO.INFO-TS ] Computer Science [cs]/Signal and Image Processing, Computer science, SVM, Health Informatics, [ SPI.SIGNAL ] Engineering Sciences [physics]/Signal and Image processing, Spectral line, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Nuclear magnetic resonance, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, Prostate, [ INFO.INFO-BI ] Computer Science [cs]/Bioinformatics [q-bio.QM], Magnetic resonance spectroscopy, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Preprocessor, [ SDV.BIBS ] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], medicine.diagnostic_test, [ INFO.INFO-IM ] Computer Science [cs]/Medical Imaging, business.industry, Magnetic resonance imaging, Pattern recognition, medicine.disease, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], 3. Good health, Support vector machine, medicine.anatomical_structure, Multilayer perceptron, Signal Processing, Artificial intelligence, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, 030217 neurology & neurosurgery
Abstract

International audience; Prostate cancer is the most common cancer in men over 50 years of age and it has been shown that nuclear magnetic resonance spectra are sensitive enough to distinguish normal and cancer tissues. In this paper, we propose a classification technique of spectra from magnetic resonance spectroscopy. We studied automatic classification with and without quantification of metabolite signals. The dataset is composed of 22 patient datasets with a biopsy-proven cancer, from which we extracted 2464 spectra from the whole prostate and of which 1062 were localised in the peripheral zone. The spectra were manually classed into 3 different categories by a spectroscopist with 4 years experience in clinical spectroscopy of prostate cancer: undetermined, healthy and pathologic. We used different preprocessing methods (module, phase correction only, phase correction and baseline correction) as input for Support Vector Machine and for Multilayer Perceptron, and we compared the results with those from the expert. If we class only healthy and pathologic spectra we reach a total error rate of 4.51%. However, if we class all spectra (undetermined, healthy and pathologic) the total error rate rises to 11.49%. We have shown in this paper that the best results are obtained using the pre-processed spectra without quantification as input for the classifiers and we confirm that Support Vector Machine are more efficient than Multilayer Perceptron in processing high dimensional data.

Published
2011
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9. Feasibility of chemoradiotherapy for oesophageal cancer in elderly patients aged >or=75 years: a prospective, single-arm phase II study

Author

Marc Puyraveau, Philippe Maingon, Gilles Créhange, Joëlle Buffet-Miny, Stéphanie Servagi-Vernat, Mariette Mercier, Jean François Bosset, Mathieu Bosset, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), and Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL )

Subjects
Male, MESH: Combined Modality Therapy, Esophageal Neoplasms, MESH : Aged, MESH : Prospective Studies, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH : Adenocarcinoma, MESH: Aged, 80 and over, Pharmacology (medical), MESH : Neoplasm Staging, MESH : Female, Prospective Studies, MESH : Carcinoma, Squamous Cell, Prospective cohort study, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, education.field_of_study, Standard treatment, MESH: Carcinoma, Squamous Cell, MESH: Follow-Up Studies, MESH: Neoplasm Staging, MESH : Survival Rate, Combined Modality Therapy, Survival Rate, MESH : Antineoplastic Agents, Treatment Outcome, MESH: Esophageal Neoplasms, Carcinoma, Squamous Cell, MESH : Disease-Free Survival, Female, medicine.medical_specialty, MESH: Survival Rate, MESH : Male, Population, Antineoplastic Agents, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Adenocarcinoma, Disease-Free Survival, MESH : Cisplatin, medicine, Humans, education, MESH : Aged, 80 and over, Survival rate, Aged, Neoplasm Staging, MESH: Humans, Performance status, business.industry, MESH : Humans, MESH: Adenocarcinoma, MESH: Quality of Life, MESH : Follow-Up Studies, MESH : Quality of Life, MESH: Male, MESH: Prospective Studies, Surgery, Regimen, MESH: Cisplatin, Localized disease, MESH: Disease-Free Survival, Quality of Life, MESH: Antineoplastic Agents, MESH : Esophageal Neoplasms, Geriatrics and Gerontology, Cisplatin, business, MESH : Combined Modality Therapy, MESH: Female, Chemoradiotherapy, Follow-Up Studies
Abstract

Background: The number of elderly patients with oesophageal cancer is expected to increase with the aging of the population and the rapidly increasing incidence of adenocarcinoma. Surgical resection is standard treatment for patients with localized disease considered fit for operation. However, elderly patients with oesophageal cancer are rarely referred for surgery. Objective: The aim of this prospective, single-arm, phase II study was to evaluate the feasibility and efficacy (tumour response) of chemoradiotherapy in the treatment of elderly patients with localized oesophageal cancer. Secondary endpoints were progression-free survival (PFS) and quality of life (QOL). Methods: The main study inclusion criteria were: patients aged ≥75 years; oesophageal cancer disease stage II–III; Charlson co-morbidity index score ≤4; Eastern Cooperative Oncology Group (ECOG) performance status 0–2; and weight loss

Published
2009

10. Role of STAT3 in CD4+CD25+FOXP3+ regulatory lymphocyte generation: implications in graft-versus-host disease and antitumor immunity

Author

Xavier Pivot, Xiang Ling, Pierre Tiberghien, Emilie Brillard, Philippe Saas, Gilles Crehange, Jean-René Pallandre, Christophe Borg, Pierre-Simon Rohrlich, Amandine Radlovic, Jean-Paul Remy-Martin, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Section of Molecular Hematology and Therapy, The University of Texas Health Science Center at Houston (UTHealth)-The University of Texas M.D. Anderson Cancer Center [Houston], Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), and Saas, Philippe

Subjects
MESH: Signal Transduction, CD4-Positive T-Lymphocytes, Male, Adoptive cell transfer, MESH: Antigens, CD28, CD3 Complex, MESH: Antigens, CD3, medicine.medical_treatment, Lymphocyte, Graft vs Host Disease, Immunotherapy, Adoptive, T-Lymphocytes, Regulatory, Mice, MESH: Reverse Transcriptase Polymerase Chain Reaction, Neoplasms, MESH: RNA, Small Interfering, Immunology and Allergy, MESH: Animals, MESH: Neoplasms, IL-2 receptor, Phosphorylation, RNA, Small Interfering, Mice, Inbred BALB C, Reverse Transcriptase Polymerase Chain Reaction, FOXP3, CD28, MESH: STAT3 Transcription Factor, MESH: CD4-Positive T-Lymphocytes, hemic and immune systems, Forkhead Transcription Factors, MESH: Gene Expression Regulation, Neoplastic, Gene Expression Regulation, Neoplastic, medicine.anatomical_structure, Phenotype, MESH: Immunotherapy, Adoptive, [SDV.IMM]Life Sciences [q-bio]/Immunology, Signal Transduction, STAT3 Transcription Factor, MESH: Cell Line, Tumor, [SDV.IMM] Life Sciences [q-bio]/Immunology, T cell, Immunology, MESH: Mice, Inbred BALB C, MESH: Graft vs Host Disease, chemical and pharmacologic phenomena, Biology, MESH: Phenotype, MESH: Gene Expression Profiling, CD28 Antigens, MESH: Mice, Inbred C57BL, MESH: Forkhead Transcription Factors, Cell Line, Tumor, medicine, Animals, RNA, Messenger, MESH: Mice, MESH: RNA, Messenger, MESH: Phosphorylation, MESH: T-Lymphocytes, Regulatory, Gene Expression Profiling, T-cell receptor, Immunotherapy, MESH: Male, Mice, Inbred C57BL, Disease Models, Animal, Cancer research, MESH: Disease Models, Animal, MESH: Neoplasm Transplantation, Neoplasm Transplantation
Abstract

Immunological tolerance is maintained by specialized subsets of T cells including CD4+CD25+FOXP3+ regulatory cells (Treg). Previous studies established that Treg thymic differentiation or peripheral conversion depend on CD28 and Lck signaling. Moreover, foxp3 gene transfer in murine CD4+CD25− T lymphocytes results in the acquisition of suppressive functions. However, molecular pathways leading to FOXP3 expression remain to be described. In this study, we investigated the molecular events driving FOXP3 expression. We demonstrated that CD28 activation in CD4+CD25− T lymphocytes leads to STAT3 Tyr705 phosphorylation in an Lck-dependent manner. STAT3 neutralization during naive peripheral CD4+CD25− T cell conversion into Treg through costimulation with TCR/CD28 and TGF-β1, decreased FOXP3 expression, prevented the acquisition of suppressive functions and restored the ability of the converted lymphocytes to produce IL-2 and IFN-γ. Furthermore, we observed that STAT3 ablation using small interfering RNA strategies inhibited FOXP3 expression and suppressive functions among naturally differentiated CD4+CD25+ T lymphocytes, suggesting a direct role of STAT3 in Treg phenotype and function maintenance. CD4+CD25+ T lymphocytes transduced with specific STAT3 small interfering RNA were devoid of suppressive functions and failed to control the occurrence of acute graft-vs-host disease. Finally, STAT3 inhibition in CD4+ lymphocytes enhanced the anti-tumor immunity conferred by a lymphocyte adoptive transfer. In summary, our findings determine that STAT3 is critical in the molecular pathway required for FOXP3 expression. STAT3 modulation should be taken into account when assessing how regulatory T cells contribute to inflammatory diseases and tumor immunosurveillance.

Published
2007

11. Preoperative radiotherapy in elderly patients with rectal cancer

Author

Mathieu Bosset, Fabrice Lorchel, Jean-François Bosset, Mariette Mercier, Marc Puyraveau, Philippe Maingon, K. Peignaux, Gilles Créhange, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Pierre Süe (LPS), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Interactions et dynamique des environnements de surface (IDES), Université Paris-Sud - Paris 11 (UP11)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Pierre Süe ( LPS ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Centre National de la Recherche Scientifique ( CNRS ), Interactions et dynamique des environnements de surface ( IDES ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut national des sciences de l'Univers ( INSU - CNRS ) -Centre National de la Recherche Scientifique ( CNRS ), and Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO)

Subjects
Male, MESH: Radiotherapy, MESH: Chi-Square Distribution, MESH : Retrospective Studies, Colorectal cancer, medicine.medical_treatment, MESH : Aged, MESH : Leucovorin, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, MESH: Rectum, Medicine, MESH : Neoplasm Staging, MESH: APACHE, MESH : Rectal Neoplasms, APACHE, Aged, 80 and over, MESH : Antimetabolites, Antineoplastic, Gastroenterology, General Medicine, MESH: Follow-Up Studies, Prognosis, 3. Good health, 030220 oncology & carcinogenesis, MESH: Karnofsky Performance Status, MESH : Vitamin B Complex, MESH : APACHE, MESH: Preoperative Care, Antimetabolites, Antineoplastic, medicine.medical_specialty, MESH: Radiotherapy, Adjuvant, World Health Organization, MESH : Radiotherapy, Adjuvant, MESH: Prognosis, MESH : Karnofsky Performance Status, 03 medical and health sciences, Humans, Karnofsky Performance Status, MESH : Aged, 80 and over, Aged, Retrospective Studies, MESH: Age Factors, Chi-Square Distribution, MESH: Humans, MESH : Chi-Square Distribution, Rectal Neoplasms, MESH : Radiotherapy, MESH : Humans, Rectum, MESH: Rectal Neoplasms, MESH : Follow-Up Studies, MESH: Retrospective Studies, medicine.disease, Survival Analysis, Radiation therapy, MESH : Preoperative Care, Concomitant, MESH: Data Interpretation, Statistical, MESH: Female, MESH: Fluorouracil, MESH: Combined Modality Therapy, Time Factors, Leucovorin, MESH: World Health Organization, Postoperative Complications, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, MESH: Postoperative Complications, MESH : Female, 030212 general & internal medicine, MESH: Radiotherapy Dosage, MESH: Aged, Univariate analysis, MESH: Antimetabolites, Antineoplastic, MESH : Prognosis, MESH : Radiotherapy Dosage, Age Factors, Radiotherapy Dosage, MESH: Neoplasm Staging, Combined Modality Therapy, MESH : Risk Factors, medicine.anatomical_structure, Data Interpretation, Statistical, MESH: Survival Analysis, Vitamin B Complex, MESH : Rectum, MESH : Fluorouracil, Female, Fluorouracil, MESH : Time Factors, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, Preoperative care, Preoperative Care, MESH : Data Interpretation, Statistical, Neoplasm Staging, Radiotherapy, Performance status, MESH: Vitamin B Complex, business.industry, MESH: Time Factors, Retrospective cohort study, MESH: Male, Surgery, Radiotherapy, Adjuvant, MESH : Age Factors, MESH : Postoperative Complications, MESH : World Health Organization, MESH : Survival Analysis, MESH : Combined Modality Therapy, business, MESH: Leucovorin, Follow-Up Studies
Abstract

Summary Purpose We performed a retrospective analysis in order to eva-luate the compliance with preoperative radiotherapy in patients aged ≥70 with locally advanced resectable rectal cancer, and to evaluate the influence of comorbidities on treatment tolerance and oncological results. Methods From March 1984 to December 2000, 95 patients with T3-T4 N0 M0 rectal cancer received a preoperative radiotherapy in 2 radiotherapy departments. Nineteen patients received concomitant chemotherapy. Results All patients completed the radiation schedule. Six patients suffered grade 3 acute WHO toxicity. Surgical resection was performed in 87 patients. There were 3 post-operative deaths. Analysis of peri-operative complications showed thromboembolism (4.9%), ileus (9.8%) and diarrhoea (6.1%). After a median follow-up of 29 months, the 3- and 5-year overall survival rates were 65% and 49% respectively. In univariate analysis, a tumour located in the mid part of the rectum, a radiation dose less than 40 Gy, the absence of chemotherapy were significantly associated with a poor prognosis. There was a trend to a better survival for patients with a Charlson score of 0 (P=0.0584). In multivariate analysis, only initial WHO performance status was significant. Conclusions Compliance with preoperative radiotherapy is good in elderly patients. Toxicity rates are similar to those described in randomised trials in which only younger patients were included. Initial WHO performance status ≤1 is significantly associated with better survival.

Published
2007

12. Combining cisplatin and mitomycin with radiotherapy in anal carcinoma

Author

Mathieu Bosset, Gilles Créhange, Jean François Bosset, Marc Puyraveau, Jean Luc Dumas, Joëlle Buffet-Miny, Fabrice Lorchel, Mariette Mercier, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon )

Subjects
Male, MESH : Mitomycin, MESH: Carcinoma, MESH: Combined Modality Therapy, Anal Carcinoma, MESH : Antineoplastic Combined Chemotherapy Protocols, medicine.medical_treatment, MESH : Aged, Phases of clinical research, 030218 nuclear medicine & medical imaging, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Anus Neoplasms, 0302 clinical medicine, MESH: Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Medicine, MESH : Female, MESH: Radiotherapy Dosage, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, MESH : Neoplasm Recurrence, Local, MESH : Radiotherapy Dosage, MESH : Carcinoma, MESH: Mitomycin, Gastroenterology, Radiotherapy Dosage, General Medicine, Middle Aged, MESH : Adult, Anus Neoplasms, Combined Modality Therapy, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, Treatment Outcome, Fluorouracil, 030220 oncology & carcinogenesis, Female, MESH: Neoplasm Recurrence, Local, medicine.drug, Adult, medicine.medical_specialty, MESH : Feasibility Studies, Mitomycin, MESH : Male, MESH : Drug Administration Schedule, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, MESH: Drug Administration Schedule, Drug Administration Schedule, MESH : Cisplatin, 03 medical and health sciences, Carcinoma, Humans, Anal cancer, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : Anus Neoplasms, Aged, MESH: Humans, business.industry, Mitomycin C, MESH : Humans, MESH: Adult, medicine.disease, MESH: Male, Surgery, Radiation therapy, MESH: Cisplatin, Feasibility Studies, Cisplatin, Neoplasm Recurrence, Local, business, MESH : Combined Modality Therapy, MESH: Feasibility Studies, MESH: Female, Chemoradiotherapy
Abstract

International audience; PURPOSE: The European Organization for Research and Treatment of Cancer (EORTC) phase II study No. 22953 demonstrated the feasibility of reducing the overall treatment time of chemoradiation, delivering mitomycin C twice rather than once and fluorouracil during the whole treatment. We tested the feasibility of chemoradiation in anal carcinoma with mitomycin and cisplatin in a phase II study. METHODS: Twenty-one patients with locally advanced anal carcinoma (15 women, 6 men) were treated. The first sequence of radiotherapy consisted of 36 Gy over four weeks. After a gap interval of 16 days, a second sequence of radiotherapy was given, delivering 23.4 Gy over 2.5 weeks. Mitomycin C was delivered at 10 mg/m(2) day 1 of each sequence and cisplatin was delivered at 25 mg/m(2)/week of each sequence. RESULTS: The compliance rates for the first sequence with radiation, mitomycinm, and cispaltin (dose and timing) were 100 percent. The median duration gap was 16 days (14-30 days). The compliance rates for the second sequence with radiation, mitomycin, and cisplatin (dose and timing) were 100, 76.2, and 85.7 percent, respectively. Grade > or = 2 acute toxicities of 62, 29, 25, and 5 percent were observed for skin, diarrhea, hematologic, and renal toxicities, respectively. Nineteen patients were in complete response (90.5 percent). CONCLUSIONS: Combining radiation with mitomycin and cisplatin in patients with locally advanced anal cancer is feasible. The results are promising. The EORTC is currently comparing this combination with mitomycin and 5-fluorouracil in a large phase II-III trial.

Published
2007
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13. Tumor volume as outcome determinant in patients treated with chemoradiation for locally advanced esophageal cancer

Author

Gilles, Créhange, Mathieu, Bosset, Fabrice, Lorchel, Lorchel, Fabrice, Joëlle, Buffet-Miny, Jean Luc, Dumas, Mariette, Mercier, Marc, Puyraveau, Philippe, Maingon, Jean François, Bosset, Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)

Subjects
Oncology, Male, Cancer Research, MESH: Combined Modality Therapy, MESH : Retrospective Studies, Esophageal Neoplasms, MESH : Aged, 030218 nuclear medicine & medical imaging, Metastasis, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, MESH: Aged, 80 and over, MESH : Tomography, X-Ray Computed, MESH : Neoplasm Staging, MESH : Female, MESH: Treatment Outcome, MESH: Aged, Aged, 80 and over, Univariate analysis, MESH: Middle Aged, MESH : Prognosis, MESH: Neoplasm Staging, Esophageal cancer, MESH : Adult, Middle Aged, Prognosis, Dysphagia, Combined Modality Therapy, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, MESH: Survival Analysis, MESH: Esophageal Neoplasms, Female, Radiology, medicine.symptom, MESH: Tomography, X-Ray Computed, Adult, medicine.medical_specialty, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, TNM staging system, MESH: Prognosis, MESH: Multivariate Analysis, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, Survival analysis, Aged, Neoplasm Staging, Retrospective Studies, MESH: Humans, business.industry, MESH : Humans, MESH : Multivariate Analysis, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Survival Analysis, MESH: Male, Clinical trial, Multivariate Analysis, MESH : Esophageal Neoplasms, MESH : Survival Analysis, business, MESH : Combined Modality Therapy, Tomography, X-Ray Computed, MESH: Female
Abstract

International audience; OBJECTIVE: The currently used tumor-node metastasis (TNM) staging method is generally not applicable to patients with unresectable esophageal carcinomas. There is a need for both an efficient, easy-to-perform clinical classification and for identification of pretherapeutic prognostic factors that would be useful for oncologists, one of which is tumor volume. METHODS: Records of 148 patients, admitted to hospital during the period January 1993 to December 2001, were evaluated retrospectively. Median age was 65.7 years (range, 35.5-85.5 years). Most patients had SCC (84.5%). Using the computed tomography (CT) scan classification, tumors were recorded as follows: 1 T1, 42 T2, 93 T3, 6 T4, 2 Nx, 72 N0, 74 N1. Tumor volume from the CT scans was determined as the sum of 2 opposed truncated cones. Median tumor volume was 57.5 cm3 (range, 0.6-288 cm3). RESULTS: Median follow-up was 15.1 month (range, 0.3-82.8 months). Survival rates at 1, 2, and 3 years were 42.5%, 21.6%, and 8%, respectively. Prognostic factors identified by univariate analysis were: dysphagia grade > or =2, other histology than squamous cell, tumor location below the carina, age or =100 cm3. Prognostic factors identified with multivariate analysis were: dysphagia grade > or =2 (P = 0.013), weight loss > or =10% (P = 0.047), tumor location below the carina (P = 0.002), and tumor volume > or =100 cm3 (P = 0.041). CONCLUSIONS: For patients that the TNM staging system is not applicable, tumor volume is a new powerful determinant of survival. Further clinical trials need to be carried out to validate this prospectively.

Published
2006
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14. [Place of neoadjuvant treatments in oesophageal cancers care]

Author

Créhange , Gilles, Lorchel , Fabrice, Bosset , Jean-François, Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC )

Subjects
MESH: Humans, MESH: Radiotherapy, Esophageal Neoplasms, Radiotherapy, MESH : Antineoplastic Combined Chemotherapy Protocols, MESH : Radiotherapy, MESH : Humans, MESH: Neoadjuvant Therapy, MESH: Carcinoma, Squamous Cell, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Randomized Controlled Trials as Topic, Neoadjuvant Therapy, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Antineoplastic Combined Chemotherapy Protocols, MESH: Randomized Controlled Trials as Topic, Antineoplastic Combined Chemotherapy Protocols, MESH: Esophageal Neoplasms, Carcinoma, Squamous Cell, Humans, MESH : Esophageal Neoplasms, MESH : Carcinoma, Squamous Cell, MESH : Neoadjuvant Therapy, Randomized Controlled Trials as Topic
Abstract

International audience; Esophageal cancer has a poor prognosis. Recent epidemiological data has shown a modification of histologic types, as adenocarcinoma represents more than 50% of all patients newly diagnosed. Despite progress of surgery, overall survival at 5 years is still about 20% for resectable tumors, supporting the need for additional therapies. Objectives for neoadjuvant treatments are to increase the rate of resectability R0, to decrease the rate of local failure, to treat precociously the micrometastatic disease especially since adjuvant therapies were inefficient or inapplicable. This work is a review of main data from the literature about preoperative treatments : radiotherapy, chemotherapy and chemoradiotherapy for both adenocarcinoma and squamous cell cancers. New therapeutic strategies are arising in order to optimize these results including new drugs as irinotecan, taxans and targeted therapies. Moreover it is necessary to question the place of surgery in locally advanced but resectable tumors.

Published
2006

15. Tumor volume as outcome determinant in patients with locally advanced esophage cancer treated with chemoradiation

Author

Créhange, Gilles, Bosset, M., Lorchel, F., Miny-Buffet, J., Dumas, Jl., Chaigneau, Loïc, Mercier, Mariette, Puyraveau, M., Maingon, Philippe, Bosset, Jf., Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Pierre Süe (LPS), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Interactions et dynamique des environnements de surface (IDES), Université Paris-Sud - Paris 11 (UP11)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Service de Radiothérapie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Service d'Oncologie Médicale [CHRU Besançon], Service de radiothérapie, CHU Besan-Hôpita Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Service d'oncologie Médicale, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Laboratoire Pierre Süe ( LPS ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Centre National de la Recherche Scientifique ( CNRS ), Interactions et dynamique des environnements de surface ( IDES ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut national des sciences de l'Univers ( INSU - CNRS ) -Centre National de la Recherche Scientifique ( CNRS ), and Viala, Pascale

Subjects
[SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.CAN]Life Sciences [q-bio]/Cancer, ComputingMilieux_MISCELLANEOUS, [ SDV.CAN ] Life Sciences [q-bio]/Cancer
Abstract

Objective: The currently used tumor-node metastasis (TNM) staging method is generally not applicable to patients with unresectable esophageal carcinomas. There is a need for both an efficient, easy-to-perform clinical classification and for identification of pretherapeutic prognostic factors that would be useful for oncologists, one of which is tumor volume. Methods: Records of 148 patients, admitted to hospital during the period January 1993 to December 2001, were evaluated retrospectively. Median age was 65.7 years (range, 35.5-85.5 years). Most patients had SCC (84.5%). Using the computed tomography (CT) scan classification, tumors were recorded as follows: 1 T1, 42 T2, 93 T3, 6 T4, 2 Nx, 72 N0, 74 N1. Tumor volume from the CT scans was determined as the sum of 2 opposed truncated cones. Median tumor volume was 57.5 cm3 (range, 0.6-288 cm3). Results: Median follow-up was 15.1 month (range, 0.3-82.8 months). Survival rates at 1, 2, and 3 years were 42.5%, 21.6%, and 8%, respectively. Prognostic factors identified by univariate analysis were: dysphagia grade ≥2, other histology than squamous cell, tumor location below the carina, age

Published
2006

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