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Background: Breast cancer is the most diagnosed women’s cancer with a high survival rate nowadays. Because cancer is a systemic disease characterized by variable course, heterogeneity and unequal environmental inputs, disparities in the persons’ future are the norm. Despite enormous progress in early accurate detection and treatment’s effectiveness/precision, life reconstruction is well beyond the current care path. It requires comprehensive cross-sectoral approaches between different knowledge areas and deeper consideration of the challenges the patients have to deal with. The psychological and social sciences must be integrated to the physiological sciences to build a robust patient-centered healthcare practice. Methods: We conducted a randomized open, prospective, two-arms controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy), according to strict inclusion and exclusion criteria. The 6-months program included, in the treated group, an initial 1-week daily hippotherapy session followed by three short 2-days sessions with an interval of 2 months between each where the patients received conventional supportive care. On the other hand, the control group received a 6-month conventional supportive care. The primary end point was quality of life, whereas cognitive performances, fatigue, anxiety and depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. Results: We observed statistical differences for each measurement test and items between the treated and control group. Indeed, the treated group showed a significant and continuous improvement of quality of life, cognitive performance, fatigue, anxiety and depression, and body image as early as the first week after hippotherapy treatment compared to the conventional supportive care group. Conclusions: We demonstrate through this clinical trial, the therapeutic relevance of hippotherapy, an one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on treatments’ efficiency and reconstruction of the individuals’ shattered life and their ecosystem. This work reveals a layer of complexity that needs to be broadly considered. Trial registration: ClincalTrials.gov NCT04350398. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.

PurposeThe objective of this study was to build and validate a radiomic signature to predict early a poor outcome using baseline and 2-month evaluation CT and to compare it to the RECIST1·1 and morphological criteria defined by changes in homogeneity and borders.MethodsThis study is an ancillary study from the PRODIGE-9 multicentre prospective study for which 491 patients with metastatic colorectal cancer (mCRC) treated by 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) and bevacizumab had been analysed. In 230 patients, computed texture analysis was performed on the dominant liver lesion (DLL) at baseline and 2 months after chemotherapy. RECIST1·1 evaluation was performed at 6 months. A radiomic signature (Survival PrEdiction in patients treated by FOLFIRI and bevacizumab for mCRC using contrast-enhanced CT TextuRe Analysis (SPECTRA) Score) combining the significant predictive features was built using multivariable Cox analysis in 120 patients, then locked, and validated in 110 patients. Overall survival (OS) was estimated with the Kaplan-Meier method and compared between groups with the logrank test. An external validation was performed in another cohort of 40 patients from the PRODIGE 20 Trial.ResultsIn the training cohort, the significant predictive features for OS were: decrease in sum of the target liver lesions (STL), (adjusted hasard-ratio(aHR)=13·7, p=1·93×10–7), decrease in kurtosis (ssf=4) (aHR=1·08, p=0·001) and high baseline density of DLL, (aHR=0·98, p0·02 had a lower OS in the training cohort (pConclusionA radiomic signature (combining decrease in STL, density and computed texture analysis of the DLL) at baseline and 2-month CT was able to predict OS, and identify good responders better than RECIST1.1 criteria in patients with mCRC treated by FOLFIRI and bevacizumab as a first-line treatment. This tool should now be validated by further prospective studies.Trial registrationClinicaltrial.gov identifier of the PRODIGE 9 study: NCT00952029.Clinicaltrial.gov identifier of the PRODIGE 20 study: NCT01900717.