51
|
Biau J, Miroir J, Millardet C, Saroul N, Pham-Dang N, Racadot S, Huguet F, Kwiatkowski F, Pereira B, Bourhis J, Lapeyre M. [Description of the GORTEC 2017-03 study: Postoperative stereotactic radiotherapy for early stage oropharyngeal and oral cavity cancer with high risk margin (PHRC-K-16-164)]. Cancer Radiother 2017; 21:527-532. [PMID: 28865970 DOI: 10.1016/j.canrad.2017.07.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/16/2017] [Accepted: 07/19/2017] [Indexed: 12/20/2022]
Abstract
The GORTEC 2017-03-Stereo-postop study is a phase 2, multicentric, nationwide study, funded by the hospital clinical research program (PHRC). The sponsor is Centre Jean-Perrin in Clermont-Ferrand, in partnership with the GORTEC. The principal investigators are Dr J Biau and Dr M Lapeyre. The main objective is to study severe late toxicity of postoperative stereotactic radiotherapy (6×6Gy) for early stage oropharyngeal and oral cavity cancer with high risk margins. The secondary objectives include acute toxicity, efficacy, nutritional impact and quality of life. The population is adult patients, with pT1 or pT2 squamous cell carcinoma of the oropharynx or oral cavity (except lips), without indication of neck irradiation or concomitant chemotherapy, with at risk margin (R1, less than 5mm or uncertain). Ninety patients will be included over a 2-year period; this was calculated to limit the rate of 2-year severe toxicity at 5 to 15%, with a 2-year local control of at least 80 to 90%. If this study is considered as positive, stereotactic radiotherapy (6×6Gy) could become the third therapeutic option, with brachytherapy and normofractionated intensity-modulated radiotherapy (IMRT), for postoperative irradiation of oropharyngeal and oral cavity cancer with high risk margins.
Collapse
|
52
|
Pointreau Y, Lizée T, Bensadoun RJ, Boisselier P, Racadot S, Thariat J, Graff P. Radiothérapie conformationnelle avec modulation d’intensité des cancers des voies aérodigestives supérieures. Dose de tolérance des tissus sains : glandes salivaires et mandibule. Cancer Radiother 2016; 20:445-51. [DOI: 10.1016/j.canrad.2016.07.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/08/2016] [Indexed: 11/29/2022]
|
53
|
Kotzki L, Bournaud C, Vardanian C, Carrie C, Racadot S. Irradiation orbitaire dans l’exophtalmie de Basedow sévère : une technique peu utilisée. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
54
|
Thariat J, Racadot S, Pointreau Y, Boisselier P, Grange JD, Graff P, Weber D. Radiothérapie conformationnelle avec modulation d’intensité des cancers des voies aérodigestives supérieures : dose de tolérance de l’œil et des voies optiques. Cancer Radiother 2016; 20:467-74. [DOI: 10.1016/j.canrad.2016.07.079] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 11/26/2022]
|
55
|
Boisselier P, Racadot S, Thariat J, Graff P, Pointreau Y. Radiothérapie conformationnelle avec modulation d’intensité des cancers des voies aérodigestives supérieures. Dose de tolérance des tissus sains : moelle épinière et plexus brachial. Cancer Radiother 2016; 20:459-66. [DOI: 10.1016/j.canrad.2016.08.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/03/2016] [Indexed: 12/25/2022]
|
56
|
Guimas V, Thariat J, Graff-Cailleau P, Boisselier P, Pointreau Y, Pommier P, Montbarbon X, Laude C, Racadot S. Radiothérapie conformationnelle avec modulation d’intensité des cancers des voies aérodigestives supérieures, dose de tolérance des tissus sains : appareil cochléovestibulaire et tronc cérébral. Cancer Radiother 2016; 20:475-83. [DOI: 10.1016/j.canrad.2016.07.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 07/09/2016] [Accepted: 07/11/2016] [Indexed: 12/25/2022]
|
57
|
Lapeyre M, Biau J, Racadot S, Moreira J, Berger L, Peiffert D. Radiothérapie des cancers de la cavité buccale. Cancer Radiother 2016; 20 Suppl:S116-25. [DOI: 10.1016/j.canrad.2016.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
58
|
Granzotto A, Benadjaoud MA, Vogin G, Devic C, Ferlazzo ML, Bodgi L, Pereira S, Sonzogni L, Forcheron F, Viau M, Etaix A, Malek K, Mengue-Bindjeme L, Escoffier C, Rouvet I, Zabot MT, Joubert A, Vincent A, Venezia ND, Bourguignon M, Canat EP, d'Hombres A, Thébaud E, Orbach D, Stoppa-Lyonnet D, Radji A, Doré E, Pointreau Y, Bourgier C, Leblond P, Defachelles AS, Lervat C, Guey S, Feuvret L, Gilsoul F, Berger C, Moncharmont C, de Laroche G, Moreau-Claeys MV, Chavaudra N, Combemale P, Biston MC, Malet C, Martel-Lafay I, Laude C, Hau-Desbat NH, Ziouéche A, Tanguy R, Sunyach MP, Racadot S, Pommier P, Claude L, Baleydier F, Fleury B, de Crevoisier R, Simon JM, Verrelle P, Peiffert D, Belkacemi Y, Bourhis J, Lartigau E, Carrie C, De Vathaire F, Eschwege F, Puisieux A, Lagrange JL, Balosso J, Foray N. Influence of Nucleoshuttling of the ATM Protein in the Healthy Tissues Response to Radiation Therapy: Toward a Molecular Classification of Human Radiosensitivity. Int J Radiat Oncol Biol Phys 2016; 94:450-60. [DOI: 10.1016/j.ijrobp.2015.11.013] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/24/2015] [Accepted: 11/05/2015] [Indexed: 01/20/2023]
|
59
|
Fayette J, Molin Y, Lavergne E, Montbarbon X, Racadot S, Poupart M, Ramade A, Zrounba P, Ceruse P, Pommier P. Radiotherapy potentiation with weekly cisplatin compared to standard every 3 weeks cisplatin chemotherapy for locoregionally advanced head and neck squamous cell carcinoma. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:6203-10. [PMID: 26648696 PMCID: PMC4664534 DOI: 10.2147/dddt.s81488] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Despite its toxicity, cisplatin every 3 weeks (q3w) is the standard potentiation of chemo-radiotherapy for head and neck squamous cell carcinoma. This study aimed to determine whether weekly cisplatin (q1w) could be a safe and effective alternative. Patients and methods Two hundred and sixty-two patients with head and neck squamous cell carcinoma, irradiated in our institution with cisplatin (q1w or q3w) between January 2004 and December 2008, were retrospectively included. Overall survival (OS) and progression-free survival (PFS) were evaluated. Survival distributions were estimated by Kaplan–Meier method and compared using the log-rank test. Prognostic effect of chemo-radiotherapy was explored using Cox model. Results A total of 165 and 97 patients received q1w and q3w cisplatin, respectively. Median age, stage at diagnosis, alcohol consumption, intensity-modulated radiation therapy use, median weight, and renal failure before radiotherapy were significantly different, showing lower risk in the q3w group. Q3w cisplatin was found to be more toxic in terms of weight loss, renal failure, worse chemotherapy plan completion, and grade 3/4 mucositis and dermatitis, with more patients requiring analgesics, secondary hospitalization, and radiotherapy interruption (≥3 days), and patients affected by long-term toxicities. With a median follow-up of 73 months (95% confidence interval [CI] [68.9–76.2]), OS was found to be significantly better with q3w (5 years OS: 62.3%; 95% CI [51.6–71.3]) than with q1w cisplatin (5 years OS: 52.6%; 95% CI [44.5–60.0]) (log-rank P=0.0146). More number of patients treated according to the q1w schedule experienced a recurrence: 47.3% vs 30.9% (P=0.009). Thus, the PFS for q3w schedule was found to be globally better (5 years PFS: 55.8%; 95% CI [45.0–65.3]) than for q1w schedule (5 years PFS: 43.6%; 95% CI [35.9–51.0]) (log-rank P=0.0161). However, both multivariate analyses, OS and PFS, produce no significant hazard ratio for chemo-radiotherapy modality once adjusted on unbalanced covariates according to the descriptive analysis. Conclusion Though q1w seemed to be safer than q3w according to the descriptive analysis, multivariate analyses failed to conclude about its efficiency. Therefore, we conclude that the q3w schedule should remain the standard and prospective comparisons are needed.
Collapse
|
60
|
Tanguy R, Malet C, Pommier P, Carrie C, Claude L, Racadot S, Isabelle M, Sunyach M. Evolution of Small Cerebral Metastases Treated With Either Hypofractionated Stereotactic Radiation Therapy (hfSRT) or Radiosurgery (RS). Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
61
|
Daoud J, Aupérin A, Tao Y, Lang P, Sun X, Racadot S, Thariat J, Alfonsi M, Tuchais C, Moussai A, Cornely A, Bourhis J. OC-004: A randomized trial of concomitant cisplatin-RT +/- induction TPF in locally advanced nasopharyngeal carcinomas. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34764-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
62
|
Huguet F, Hammel P, Goldstein D, Spry N, Van Laethem JL, Van Houtte P, Glimelius B, Gubanski M, Bonnetain F, Racadot S. Étude de la relation entre le score d’assurance qualité de la radiothérapie, la toxicité et la survie dans l’essai de phase III LAP07 dans le cancer du pancréas localement évolué. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
63
|
Thariat J, Bensadoun RJ, Etienne-Grimaldi MC, Grall D, Penault-Llorca F, Dassonville O, Giraud P, Racadot S, Van Obberghen-Schilling E, Milano G. Dissociation entre rôle pronostique et prédictif du récepteur de l’epidermal growth factor1 dans la réponse au géfitinib combiné à une radiochimiothérapie postopératoire ORL (essai CARISSA du Gortec 2004-02). Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
64
|
Thariat J, Bensadoun RJ, Etienne-Grimaldi MC, Grall D, Penault-Llorca F, Dassonville O, Bertucci F, Cayre A, De Raucourt D, Geoffrois L, Finetti P, Giraud P, Racadot S, Morinière S, Sudaka A, Van Obberghen-Schilling E, Milano G. Contrasted Outcomes to Gefitinib on Tumoral IGF1R Expression in Head and Neck Cancer Patients Receiving Postoperative Chemoradiation (GORTEC Trial 2004-02). Clin Cancer Res 2012; 18:5123-33. [DOI: 10.1158/1078-0432.ccr-12-1518] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
65
|
Toledano I, Graff P, Serre A, Boisselier P, Bensadoun RJ, Ortholan C, Pommier P, Racadot S, Calais G, Alfonsi M, Favrel V, Giraud P, Lapeyre M. Intensity-modulated radiotherapy in head and neck cancer: results of the prospective study GORTEC 2004-03. Radiother Oncol 2012; 103:57-62. [PMID: 22296746 DOI: 10.1016/j.radonc.2011.12.010] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 12/12/2011] [Accepted: 12/28/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE In 2003, the French Authority for Health (HAS) recommended the use of intensity modulated radiotherapy (IMRT) in prospective trial before its routine use. The Oncology and Radiotherapy Group for Head and Neck Cancer (GORTEC) proposed to evaluate prospectively acute and late toxicities, locoregional control and overall survival for patients treated for head and neck cancer (HNC) with IMRT and bilateral neck irradiation. MATERIALS AND METHODS Between 2002 and 2008, 208 patients with HNC were treated with IMRT in 8 centres. There were 38 nasopharynx, 117 oropharynx, 25 pharyngo-larynx, 24 oral cavity and 4 unknown primary (28.5% stage I-II and 71% Stage III-IV). Ninety-three patients (46%) had postoperative IMRT and 78 patients (37.5%) received concurrent chemotherapy. The doses were 70 Gy to the gross tumour, 66 Gy to the high-risk postoperative sites and 50 Gy to the subclinical disease. Toxicities were graded according to the RTOG-EORTC scales. RESULTS The median follow-up was 25.3 months (range: 0.4-72 months). There were 29 local-regional failures: 24 were in-field, three were marginal and one was out-field. The two-year loco-regional control and overall survival were 86% and 86.7%, respectively. At 18 months, grade ≥ 2 xerostomia was 16.1%. A mean dose to the spared parotid below 28 Gy led to significantly less grade ≥ 2 xerostomia (8.5% vs 24%) with a relative risk of 1.2 [95% CI: 1.02-1.41, p = 0.03]. Grade ≥ 2 xerostomia increased by approximately 3% per Gy of mean parotid dose up to 28, Gy then 7% per Gy above 33 Gy. CONCLUSIONS IMRT for HN cancer seems to reduce late toxicities without jeopardising local control and overall survival.
Collapse
|
66
|
Thariat J, Etienne-Grimaldi MC, Grall D, Bensadoun RJ, Cayre A, Penault-Llorca F, Veracini L, Francoual M, Formento JL, Dassonville O, De Raucourt D, Geoffrois L, Giraud P, Racadot S, Morinière S, Milano G, Van Obberghen-Schilling E. Epidermal growth factor receptor protein detection in head and neck cancer patients: a many-faceted picture. Clin Cancer Res 2012; 18:1313-22. [PMID: 22228639 DOI: 10.1158/1078-0432.ccr-11-2339] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Epidermal growth factor receptor (EGFR) overexpression is associated with poor prognosis in head and neck squamous cell carcinoma (HNSCC). Despite intensive biomarker studies, a consensual method for assessing EGFR protein expression is still lacking. Here we set out to compare three EGFR detection methods in tumor specimens from HNSCC patients. EXPERIMENTAL DESIGN Tumors were prospectively excised from a series of 79 high-risk HNSCC patients enrolled in a GORTEC-sponsored clinical trial. EGFR expression was determined using a ligand-binding assay on membranes, Western blotting (WB) on membranes and total homogenates, and immunohistochemistry (IHC) on tissue microarrays. In addition, phosphorylated EGFR (pEGFR) was measured by WB on membranes. RESULTS Distributions and ranges of tumor EGFR expression were method dependent. Moderate positive correlations (Spearman coefficient r ≈ 0.50) were observed between EGFR expression measured by the binding assay and WB or IHC. pEGFR levels positively and significantly correlated with total EGFR expression measured by WB or ligand binding, but not by IHC. The highest correlation (r = 0.85) was observed between EGFR and pEGFR levels, both measured by WB on membranes. Interestingly, the fraction of phosphorylated receptor (pEGFR/EGFR both measured by WB on membranes) significantly declined with increasing tumor EGFR expression, by all assessment methods used. CONCLUSION This study shows significant correlations between EGFR detection methods. The observed relationships between EGFR and pEGFR indicate that high-throughput pEGFR/EGFR analyses merit further investigations and consideration for routine use in patient samples.
Collapse
|
67
|
Tredan O, Ray-Coquard I, Arnaud A, Racadot S, Guastalla JP. [Cervix cancer and corpus cancer of the uterus]. LA REVUE DU PRATICIEN 2011; 61:1435-1442. [PMID: 22288360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
68
|
Bouteloup C, Talvas J, Dillies A, Bachmann P, Achim AC, Pezet D, Pommier P, Racadot S, Ramdani M, Vasson MP. P160 Limiter les complications de la radiochimiothérapie des cancers de la tête et du cou : effet d’une immunonutrition. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70227-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
69
|
Azria D, Cowen D, Bourgier C, de la Lande B, Gourgou-Bourgade S, Douadi Gaci Z, Leblanc-Onfroy M, Latorzeff I, Pradier O, Maingon P, Lecouillard I, Bontemps P, Ellis S, Levy C, Benyoucef A, Racadot S, Laharie-Mineur H, Lagarde P, Marchal C, Lemanski C. Phase III randomized French multicentric study to evaluate the impact of a localized 16-Gy boost after conservative surgery and a 50-Gy whole-breast irradiation in breast ductal carcinoma in situ (the BONBIS trial). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
70
|
Bodard AG, Racadot S, Salino S, Pommier P, Zrounba P, Montbarbon X. A new, simple maxillary-sparing tongue depressor for external mandibular radiotherapy: a case report. Head Neck 2010; 31:1528-30. [PMID: 19283842 DOI: 10.1002/hed.21047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In external radiotherapy, the use of leaded intraoral devices to shield adjacent tissues is well described, but stabilization of the mandible is often realized with standard bite blocks, which do not allow a good stabilization of the mandible. METHODS AND RESULTS A 40-year-old patient presenting with a local recurrence of a tumor of the floor of the mouth underwent external radiotherapy. To shield the maxilla during mandibular irradiation and to ensure mandible and tongue immobility during external radiotherapy, a custom-made device was realized. The apparatus consists of a polymethylmethacrylate resin plate and 2 wedges. Only 2 steps are needed. CONCLUSION The realization is simple and cheap, the apparatus is comfortable, and modifications are easy. It can be used in all patients, except in patients with totally mandibular edentulous with severe bone resorption.
Collapse
|
71
|
Laude C, Montella A, Montbarbon X, Mathevet P, Malet C, Racadot S, Buenerd A, Pommier P. Chimioradiothérapie, curiethérapie et chirurgie des cancers du col utérin localement évolués : facteurs pronostiques de contrôle local et de survie globale. Cancer Radiother 2009. [DOI: 10.1016/j.canrad.2009.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
72
|
Toledano I, Graff P, Serre A, Bensadoun RJ, Ortholan C, Racadot S, Calais G, Alfonsi M, Giraud P. Radiothérapie conformationnelle avec modulation d’intensité et boost intégré des cancers de la tête et du cou : expérience de l’institut Curie. Cancer Radiother 2009. [DOI: 10.1016/j.canrad.2009.08.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
73
|
Laude C, Montella A, Montbarbon X, Mathevet P, Racadot S, Malet C, Buenerd A, Pommier P. EFFECT OF PATHOLOGICAL RESPONSE AFTER MULTIMODAL THERAPY IN LOCALLY ADVANCED CERVIX CARCINOMA ON LOCAL CONTROL AND SURVIVAL. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
74
|
Fayette J, Montella A, Bachelot T, Pommier P, Girodet D, Racadot S, Montbarbon X, Favier B, Zrounba P. Paclitaxel in relapsed squamous cell carcinoma of head and neck (SSCHN): Retrospective study of a single institution. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e17047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17047 Background: For relapse or metastatic SCCHN the standard treatment is the combination of cisplatin and 5FU that showed higher response rate than methotrexate but similar overall survival. Cetuximab demonstrated in a phase III (N Engl J Med. 2008;359:1116) its efficacy and paclitaxel showed efficacy in a phase II study (Cancer. 1998;82:2270). The objective of this study was to evaluate paclitaxel (P) in our institution in various situations. Methods: We retrospectively reviewed 56 pts with relapse or metastatic SSCHN treated with P in a single institution in Lyon (France) between June 2002 and February 2008. P was administered in first line for locally advanced disease, in first line for relapsed or metastatic disease, or in second or more line. P was administered q1w or q3w, alone or in combination with carboplatin or cetuximab. Results: Median age was 59 years (36–84) at the beginning of paclitaxel. Localizations of primitive tumor: oral cavity (14%), oropharynx (30%), hypopharynx (39%) larynx (7%), rhinopharynx (4%), or other (6%). All patients received adequate initial treatment with surgery and/or radiotherapy, 47% had have neoadjuvant chemotherapy (71% with cddp-5fu, but 5 pts received P). Five patients received P as neoadjuvant treatment. Among 52 evaluable patients, 33 received P in first line of treatment after relapse, 12 in second line. Monotherapy was administered to 20 patients and 22 received P combined with carboplatin, and 1 with cetuximab. For all patients, objective response rate (OR) was 30.8% (95% CI 18.7–45.1%). In first line of relapse, OR was 39.4% (95% CI 22.9–57.9%) and 16.7% (95% CI 2.1–18.4%) in second line. In monotherapy OR was 30.0% (95% CI 11.9–54.3%) and 36.4% (95% CI 17.2–59.3%) in combination with carboplatin. The overall survival (OS) of all patients was 6.3 months (95% CI 3.9–7.9 m), and 7.7 m (95% CI 3.9–11 m) and 5.2 m (95% CI 2.8–7.9 m) in first and second line, respectively. There is no difference in OS between monotherapy and combination: 6.1 m (95% CI 3.9–7.9 m) and 5.3 m (95% CI 3.9–7.9 m), respectively. Conclusions: P did not improve overall survival but showed interesting response rate in relapsed patients who are often symptomatic. Recent studies suggest high potentialities in combination with EGFR inhibitors. No significant financial relationships to disclose.
Collapse
|
75
|
Racadot S, Mercier M, Dussart S, Dessard-Diana B, Bensadoun RJ, Martin M, Malaurie E, Favrel V, Housset M, Durdux C, Journel C, Calais G, Huet J, Pillet G, Hennequin C, Haddad E, Diana C, Blaska-Jaulerry B, Henry-Amar M, Géhanno P, Baillet F, Mazeron JJ. Randomized clinical trial of post-operative radiotherapy versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement. Radiother Oncol 2008; 87:164-72. [PMID: 18222010 DOI: 10.1016/j.radonc.2007.12.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Revised: 12/30/2007] [Accepted: 12/30/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE Post-operative radiotherapy is indicated for the treatment of head and neck cancers. In vitro, chemotherapy potentiates the cytotoxic effects of radiation. We report the results of a randomized trial testing post-operative radiotherapy alone versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement. MATERIALS AND METHODS The study involved patients undergoing curative-intent surgery for head and neck cancers with histological evidence of lymph node involvement. Patients were randomly assigned to receive radiotherapy alone (54-72Gy, 30-40 fractions, 6-8 weeks) or identical treatment plus concomitant Carboplatin (50mg/m(2) administered by IV infusion twice weekly). RESULTS Between February 1994 and June 2002, 144 patients were included. With a median follow-up of 106 months (95% confidence interval (CI) [92-119]), the 2-year rate of loco-regional control was 73% (95% CI: 0.61-0.84) in the combined treatment group and 68% (95% CI: 0.57-0.80) in the radiotherapy group (p=0.26). Overall survival did not differ significantly between groups (hazard ratio for death, 1.05; 95% CI: 0.69-1.60; p=0.81). CONCLUSIONS Twice-weekly administration of carboplatin concomitant to post-operative radiotherapy did not improve local control or overall survival rates in this population of patients with node-positive head and neck cancers.
Collapse
|
76
|
Mazeron JJ, Noel G, Feuvret L, Calugaru V, Racadot S. Clinical complementarities between proton and carbon therapies. Radiother Oncol 2005; 73 Suppl 2:S50-2. [PMID: 15971309 DOI: 10.1016/s0167-8140(04)80013-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Protons are characterised by low LET, but compared with photons and electrons have an improved physical depth dose distribution. Some indications for protons, i.e., ocular melanoma, chordoma and chondrosarcoma of the base of skull or cervical spine, are now accepted by the radiation oncology community as the treatment of choice. Others are still under evaluation, e.g. meningioma, locally advanced nasopharynx tumours, paediatric tumours. Neutrons have the biological advantage of a high LET, but their distribution of dose is in most cases suboptimal. Despite this, there are radiobiological arguments leading to expect that neutrons might be of some benefit in patients with tumours that are resistant to photons, slowly growing or containing a high proportion of hypoxic cells. There is some clinical evidence or rationale for a potential high LET advantage for locally extensive (I think that the current (jargon) word is extended in English..) salivary gland tumours, locally extensive(extended) prostate carcinoma, slowly growing inoperable soft tissue sarcoma, adenocarcinoma, adenoid cystic carcinoma of the paranasal sinuses, melanoma and rectal carcinoma. Light ions combine the high LET advantage of neutrons and the improved physical depth dose distribution of protons. The opportunity offered by an optimised distribution of dose should open a new era for high-LET particles, especially in deeply situated x-ray resistant tumours, where the use of neutron beams was restricted by the low quality of their depth-dose profiles. Preliminary results are encouraging.
Collapse
|
77
|
Simon JM, Noel G, Hoang-Xuan K, Carpentier AF, Mokhtari K, Racadot S, Baillet F, Mazeron JJ. Radiotherapy and concomitant weekly carboplatin and daily etoposide for patients with inoperable biopsy proven glioblastoma multiforme. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
78
|
|
79
|
Lapeyre M, Marchesi V, Mege A, Aletti P, Graff P, Racadot S, Noel A, Marchal C. Radiothérapie conformationnelle avec modulation d'intensité des cancers des voies aérodigestives supérieures avec irradiation bilatérale du cou : résultats préliminaires. Cancer Radiother 2004; 8:134-47. [PMID: 15217581 DOI: 10.1016/j.canrad.2004.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2004] [Revised: 03/05/2004] [Accepted: 03/11/2004] [Indexed: 11/26/2022]
Abstract
PURPOSE To report preliminary results of a prospective study of intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinoma (HNC) with bilateral irradiation of the neck. PATIENTS AND METHODS At the Alexis Vautrin Cancer Center, 23 patients have been treated with IMRT for HNC since January 2002-August 2003. The first 10 patients with a minimum follow-up of 3 months were analyzed. All tumors were oropharyngeal. There were four females and six males, with a mean age of 50 years (range 39-66). Stages were I-II in eight and III-IV in two. CTV1 was microscopic disease and N0 neck (prescribed dose : 50 Gy) and CTV2 was macroscopic disease and the volume at risk (prescribed dose: 66-70 Gy). PTV were CTV + 5 mm. Patient's immobilization consisted of a five-point head neck shoulder thermoplastic mask. Set-up verifications were done by semi-automatically matching portal images and digitized reconstructed radiographs. IMRT used dynamic multileaf collimation. Five patients (group A) received 50 Gy IMRT (two post-operative and three with a brachytherapy boost with a mean dose: 27.5 Gy), and five patients (group B) received 66-70 Gy IMRT (four post-operative). Acute and late normal tissue effects were graded according to the RTOG-EORTC radiation morbidity scoring criteria. RESULTS With a median follow-up of 7.4 months (range 3-18.5), no patient died or had loco-regional relapse. The displacements were <4 mm in 98% cases. CTV1 and 2 received 95% of the prescribed dose in 100% of the volume. On average the mean dose to the contralateral parotid was 25.5 Gy for group A vs. 31 Gy for group B (P = 0.09). Mean doses <26 Gy were obtained in three of five patients in group A vs. zero of five patients in group B (P = 0.04). Acute skin toxicities were grade 1 in five patients, grade 2 in four and grade 3 in one. Acute mucositis cases were grade 1 in three patients, grade 2 in five and localized grade 3 in two. At 3 months, 50% of the patients had a grade 0-1 late xerostomia. CONCLUSION The 26 Gy dose limit constraint to the contralateral parotid was easier to satisfy when IMRT was prescribed at a maximum dose of 50 Gy. Acute toxicity is low. The displacements in the mask indicate that it is possible to define the PTV as CTV + 4 mm. This reduction should decrease the mean dose to the parotids. At 3 months, a 50% rate of grade 0-1 late xerostomia encourages the hope of a very low rate at 2 years.
Collapse
|
80
|
Racadot S, Mazeron JJ. [In patients with cancer of the larynx, chemoradiotherapy with cisplatin is superior to neoadjuvant chemotherapy followed by radiotherapy and to exclusive radiotherapy]. Bull Cancer 2004; 91:211-2. [PMID: 15171045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
|
81
|
Mazeron JJ, Racadot S. [45th meeting of the American Society of Therapeutic Radiology and Oncology Astro, Salt Lake City, 19-23 October 2003]. Bull Cancer 2004; 91:105-15. [PMID: 14983882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
|
82
|
Racadot S, Marchal C, Charra-Brunaud C, Verhaeghe JL, Peiffert D, Bey P. Ré-irradiation pariétale après mastectomie de rattrapage pour récidive d’un cancer du sein après traitement conservateur : étude rétrospective sur 20 patientes (Nancy : 1988–2001). Cancer Radiother 2003; 7:369-79. [PMID: 14725910 DOI: 10.1016/j.canrad.2003.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. PATIENTS AND METHODS Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). RESULTS Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). CONCLUSION Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain.
Collapse
MESH Headings
- Adult
- Aged
- Brachytherapy
- Breast/pathology
- Breast Neoplasms/drug therapy
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/surgery
- Chemotherapy, Adjuvant
- Chi-Square Distribution
- Combined Modality Therapy
- Data Interpretation, Statistical
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Mastectomy
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Neoplasm Recurrence, Local/surgery
- Radiotherapy/adverse effects
- Radiotherapy Dosage
- Retrospective Studies
- Salvage Therapy
- Time Factors
Collapse
|
83
|
Racadot S, Mazeron JJ. Compte rendu de la quarante-quatrième réunion de l’American Society of Therapeutic Radiology and Oncology (ASTRO). La Nouvelle Orléans, 6–10 octobre 2002. Cancer Radiother 2002. [DOI: 10.1016/s1278-3218(02)00254-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
84
|
Mazeron JJ, Racadot S. [44th meeting of the American Society of Therapeutic Radiology and Oncology (Astro): New Orleans, 6-10 October 2002]. Bull Cancer 2002; 89:985-90. [PMID: 12495887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
|