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Fizazi K, Laplanche A, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Laguerre B, Davin JL, Martin AL, Habibian M, Faivre L, Culine S. Docetaxel-estramustine in localized high-risk prostate cancer: Results of the French Genitourinary Tumor Group GETUG 12 phase III trial. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gravis G, Marino P, Joly F, Oudard S, Priou F, Esterni B, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Habibian M, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Labourey JL, Machiels JP, El Kouri C, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Soulie M, Fizazi K. Patients' self-assessment versus investigators' evaluation in a phase III trial in non-castrate metastatic prostate cancer (GETUG-AFU 15). Eur J Cancer 2014; 50:953-62. [PMID: 24424105 DOI: 10.1016/j.ejca.2013.11.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Toxicity, which is a key parameter in the evaluation of cancer treatments, can be underestimated by clinicians. We investigated differences between patients and physicians in reporting adverse events of androgen deprivation therapy (ADT) with or without docetaxel in a multicentre phase III trial in non-castrate metastatic prostate cancer. METHODS The 385 patients included were invited to complete a 26-symptom questionnaire 3 and 6 months after the start of treatment, among which eighteen symptoms were also assessed by physicians, reported in medical records and graded using the Common Toxicity Criteria of the National Cancer Institute. Positive and negative agreements as well as Kappa concordance coefficients were computed. FINDINGS Data were available for 220 and 165 patients at 3 and 6 months respectively. Physicians systematically under-reported patients' symptoms. Positive agreement rates (at respectively 3 and 6 months) for the five most commonly reported symptoms were: 61.0% and 64.3% hot flushes, 50.0% and 43.6% fatigue, 29.4% and 31.1% sexual dysfunction, 24.4% and 14.4% weigh gain/loss, 16.7% and 19.3% for joint/muscle pain. For symptoms most frequently reported as disturbing or very disturbing by patients, the clinicians' failure to report them ranged from 50.8% (hot flushes) to 89.5% (joint/muscle pain) at 3 months, and from 48.2% (hot flushes) to 88.4% (joint/muscle pain) at 6 months. INTERPRETATION Physicians often failed to report treatment-related symptoms, even the most common and disturbing ones. Patients' self-evaluation of toxicity should be used in clinical trials to improve the process of drug assessment in oncology. FUNDING French Health Ministry and Institut National du Cancer (PHRC), Sanofi-Aventis, Astra-Zeneca, and Amgen.
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Niemier JY, Perret-Guillaume C, Rousselot H, Krakowski I, Benetos A. Oncogeriatric activity in Lorraine, France: Oganization of a regional oncogeriatric coordination unit. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.182] [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]
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Boissier R, Descotes JL, Oudard S, Cormier L, Krakowski I, Houédé N, Albigès L. Erratum à « Cancer de prostate et optimisation de la prise en charge multidisciplinaire : le point sur le RCP, et la prise en charge du cancer de prostate résistant à la castration » [Prog. Urol. 23 (HS4) (2013) 7–12]. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Niemier JY, Perret-Guillame C, Rousselot H, Krakowski I, Benetos A. Oncogeriatric activity in Lorraine, France: Organization of a regional oncogeriatric coordination unit. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Farsi F, Klein I, Jovenin N, Labrosse H, Brunet M, Block V, Krakowski I. P312 A French Project Of Interregional And Shared Guidelines In Supportive Care. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Scotté F, Hervé C, Oudard S, Bugat M, Bugat R, Farsi F, Namer M, Tourani J, Tournigand C, Yazbek G, Richard S, Krakowski I. Supportive care organisation in France: An in depth study by the French speaking association for supportive care in cancer (AFSOS). Eur J Cancer 2013; 49:1090-6. [DOI: 10.1016/j.ejca.2012.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 11/04/2012] [Indexed: 11/25/2022]
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Gravis G, Fizazi K, Joly F, Oudard S, Priou F, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Theodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Esterni B, Habibian M, Soulie M. Identification of prognostic groups in patients with hormone-sensitive metastatic prostate cancer at the present time: An analysis of the GETUG 15 phase III trial. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.6_suppl.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
26 Background: Patients with upfront metastases at the time of prostate cancer (PC) diagnosis are less frequent than in the past in Western countries, but still represent 5-10% of all patients and almost one half of PC patients will eventually die of the disease. Prognostic factors (lymph node metastases/appendicular vs axial bone disease, performance status > 1, Gleason score > 8 and PSA > 65 ng/ml) have been proposed (Glass et al., 2003), leading to the definition of three subgroups with good, intermediate and poor prognosis. However, the current natural history of metastatic prostate cancer has not been well described. Methods: Patients with hormone sensitive metastatic PC were randomized to receive continuous androgen deprivation therapy (ADT) plus docetaxel (75 mg/m²/21d up to 9 cycles) and prednisone or ADT alone. Glass risk groups were used as stratification factors. Results: From October 2004 to December 2008, 385 pts were included. They were distributed into good (50%), intermediate (29%), and poor (21%) prognosis groups. The median follow up was 50 months [95% CI: 49 - 54]. The primary endpoint analysis showed no difference in overall survival (OS) (HR: 1.01 [95%CI: 0.75-1.36]) between the 2 arms but a significant PFS improvement was observed in the docetaxel group (HR: 0.75 [0.59-0.94] p=0.0147) (Gravis, ESMO 2012). The median OS in the ADT alone arm was 54 months [42-NR]. It was 69 [95% CI: 60.9-NR], 47 [95% CI: 37.7-NR, HR = 1.6] and 37 [95% CI: 28.5-58.9, HR = 2.12] months respectively in the good, intermediate, and poor prognosis groups (p=0.001) in the whole cohort. No interaction between prognosis groups and treatment was found. A detailed analysis using the Cox model will be presented. Conclusions: At the present time, median life expectancy of patients with metastatic PC seems to exceed 4 years. Subgroups with favorable or unfavorable outcome can be identified. Clinical trial information: NCT00055731.
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Gravis G, Fizazi K, Joly F, Oudard S, Priou F, Esterni B, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Habibian M, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Labourey JL, Machiels JP, El Kouri C, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Soulie M. Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol 2013; 14:149-58. [PMID: 23306100 DOI: 10.1016/s1470-2045(12)70560-0] [Citation(s) in RCA: 483] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Early chemotherapy might improve the overall outcomes of patients with metastatic non-castrate (ie, hormone-sensitive) prostate cancer. We investigated the effects of the addition of docetaxel to androgen-deprivation therapy (ADT) for patients with metastatic non-castrate prostate cancer. METHODS In this randomised, open-label, phase 3 study, we enrolled patients in 29 centres in France and one in Belgium. Eligible patients were older than 18 years and had histologically confirmed adenocarcinoma of the prostate and radiologically proven metastatic disease; a Karnofsky score of at least 70%; a life expectancy of at least 3 months; and adequate hepatic, haematological, and renal function. They were randomly assigned to receive to ADT (orchiectomy or luteinising hormone-releasing hormone agonists, alone or combined with non-steroidal antiandrogens) alone or in combination with docetaxel (75 mg/m(2) intravenously on the first day of each 21-day cycle; up to nine cycles). Patients were randomised in a 1:1 ratio, with dynamic minimisation to minimise imbalances in previous systemic treatment with ADT, chemotherapy for local disease or isolated rising concentration of serum prostate-specific antigen, and Glass risk groups. Patients, physicians, and data analysts were not masked to treatment allocation. The primary endpoint was overall survival. Efficacy analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00104715. FINDINGS Between Oct 18, 2004, and Dec 31, 2008, 192 patients were randomly allocated to receive ADT plus docetaxel and 193 to receive ADT alone. Median follow-up was 50 months (IQR 39-63). Median overall survival was 58·9 months (95% CI 50·8-69·1) in the group given ADT plus docetaxel and 54·2 months (42·2-not reached) in that given ADT alone (hazard ratio 1·01, 95% CI 0·75-1·36). 72 serious adverse events were reported in the group given ADT plus docetaxel, of which the most frequent were neutropenia (40 [21%]), febrile neutropenia (six [3%]), abnormal liver function tests (three [2%]), and neutropenia with infection (two [1%]). Four treatment-related deaths occurred in the ADT plus docetaxel group (two of which were neutropenia-related), after which the data monitoring committee recommended treatment with granulocyte colony-stimulating factor. After this recommendation, no further treatment-related deaths occurred. No serious adverse events were reported in the ADT alone group. INTERPRETATION Docetaxel should not be used as part of first-line treatment for patients with non-castrate metastatic prostate cancer. FUNDING French Health Ministry and Institut National du Cancer (PHRC), Sanofi-Aventis, AstraZeneca, and Amgen.
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Falandry C, Krakowski I, Curé H, Carola E, Soubeyran P, Guérin O, Freyer G. Place of geriatric assessment in treatment decision in gynecologic oncology: A 2011 survey from the AFSOS (French Association for Supportive Care in Oncology) and the SOFOG (French OncoGeriatric Society) on 928 patients. J Geriatr Oncol 2012. [DOI: 10.1016/j.jgo.2012.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gravis G, Fizazi K, Joly Lobbedez F, Oudard S, Priou F, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero J, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Esterni B, Habibian M, Soulie M. Survival Analysis of a Randomized Phase III Trial Comparing Androgen Deprivation Therapy (ADT) Plus Docetaxel Versus ADT Alone in Hormone-Sensitive Metastatic Prostate Cancer (GETUG-AFU 15/0403). Ann Oncol 2012. [DOI: 10.1093/annonc/mds400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Poulain P, Michenot N, Ammar D, Delorme C, Delorme T, Diquet B, Filbet M, Hubault P, Jovenin N, Krakowski I, Morere JF, Rostaing S, Serrie A. Mise au point sur l’utilisation du fentanyl transmuqueux chez le patient présentant des douleurs d’origine cancéreuse (version longue). ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s11724-012-0287-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Scotte F, Herve C, Bugat R, Farsi F, Namer M, Tourani JM, Tournigand C, Yazbek G, Richard S, Oudard S, Krakowski I. Supportive care in cancer organization in France: State of the art. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e19640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19640 Background: Second Cancer Act was defined in France in December 2009 including enhancement of supportive care in Cancer (SCC). How are supportive care organized in France? Are patients informed about supportive treatment side effects? Methods: The AFSOS (French Speaking Association for Supportive Care in Cancer) conducted this observational study to evaluate practices, organizations and informations given to patients (pts) about SCC. Among 1621 french medical doctors (MD) caring cancer pts who were sent an adhoc questionnaire, 20% (330 MD including 44% medical oncologists) answered. Results: Three different organizations were described: Single MD, transversal team and specific structure specialized in global care (specifically developed in comprehensive cancer centers-CCC). Psycho-oncology, palliative care, nutrition and pain care were the four main items considered as supportive care. During their disease, 68% of pts are receiving SCC, presented by their MD (88%) or nurse devoted to announcement of disease and SCC information (57%). Supportive care is more dispensed during palliative period (90%) than at diagnosis (44%). Patients information is rather supplied during palliative care (85%) than at diagnosis (52%) using a specific questionnaire for outpatient (20%) or specific supportive care session (17%). 71% of cancer department have a cross team to provide supportive care, with specific SCC team particularly in CCC (62%; p=0.01)). 37% have inpatient specific units. Only 40% have a specific organization in home care connection, more in CCC than in public or private centers (respectively 69%, 45%, 20%; p=0.01). 73% use specific financial valorization of CSC activity. Adverse events information is dispensed to 54% of the pts for erythropoiesis stimulating agents (ASE), 74% for biphosphonates and 94% for opioids treatments, rather by medical oncologist than other specialists (p=0.01). Conclusions: Specific organization developed especially in comprehensive cancer centers seems to facilitate SCC organization and information to pts. In the mean time, recommendations include this information, involvement in supportive care team and methods have to be enhanced. Further results compared with patient point of views are expected.
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Fizazi K, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houedé N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Laguerre B, Fléchon A, Ravaud A, Cojean-Zelek I, Oudard S, Labourey JL, Lagrange JL, Chinet-Charrot P, Linassier C, Deplanque G, Beuzeboc P, Geneve J, Davin JL, Tournay E, Culine S. A phase III trial of docetaxel–estramustine in high-risk localised prostate cancer: A planned analysis of response, toxicity and quality of life in the GETUG 12 trial. Eur J Cancer 2012; 48:209-17. [DOI: 10.1016/j.ejca.2011.10.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 10/12/2011] [Accepted: 10/13/2011] [Indexed: 10/15/2022]
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Poulain P, Delorme C, Filbet M, Ammar D, Krakowski I, Scotté F, Serrie A, Meunier JP, Grangé V, Morere JF. Caractéristiques des accès douloureux paroxystiques en 2010 : résultats de l’enquête prospective ADEPI. Rev Epidemiol Sante Publique 2011. [DOI: 10.1016/j.respe.2011.08.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Hennequin C, Calais G, Antoun S, Durand JP, Krakowski I, Senesse P, Hébuterne X. Calories : une étude nationale observationnelle sur les pratiques nutritionnelles en oncologie en France. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Durand J, Antoun S, Calais G, Hennequin C, Krakowski I, Senesse P, Hébuterne X. 3046 POSTER Results of a Nationwide Observational Study on Nutritional Practices Amongst French Cancer Physicians. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Brantus JF, Roemer-Becuwe C, Cony-Makhoul P, Salino S, Fontana A, Debourdeau P, Thomas T, Guastalla JP, Ghesquieres H, Sebban C, Pavic M, Collet P, Larbre JP, Martinon S, Brocard F, Bodard AG, Blanc G, Balestrière V, Favier B, Farsi F, Krakowski I, Biron P. Guide de recommandations d’utilisation des bisphosphonates dans les lésions osseuses malignes des tumeurs solides et du myélome multiple. Rev Med Interne 2011; 32:494-505. [DOI: 10.1016/j.revmed.2010.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 08/31/2010] [Accepted: 11/27/2010] [Indexed: 01/06/2023]
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Morere JF, Poulain P, Filbet M, Krakowski I, Serrie A, Delorme C, Ammar D, Scotte F, Grange V. A national prospective survey of breakthrough cancer pain characteristics and treatments in France 10 years after the preliminary study (ASCO 2000). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19661] [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
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Scotte F, Herve C, Bugat R, Farsi F, Lucas B, Namer M, Tourani J, Tournigand C, Yazbek G, Oudard S, Tahiri K, Krakowski I. Supportive care organization in France: State of the art. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e16575] [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
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Fizazi K, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero J, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Kerbrat P, Davin J, Berille J, Habibian M, Ichante J, Laplanche A, Culine S. Docetaxel-estramustine in high-risk localized prostate cancer: First results of the French Genitourinary Tumor Group phase III trial (GETUG 12). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4513] [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
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Faivre JC, Mecellem H, Albertini L, Belle A, Henry A, Rousselot H, Cretineau N, Montaut T, Chone L, Cabessut S, Bevilacqua S, Henneton C, Scotté F, Launay-Vacher V, Chenot ÉD, Desandes E, Toussaint S, Peiffert D, Krakowski I. MéMoPratic’ VDHA: guide de prescription pour les voies digestives hautes altérées. ONCOLOGIE 2011. [DOI: 10.1007/s10269-011-1994-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sanou R, Bazin C, Krakowski I, Boccaccini H, Mathias J, Beot S, Marchal F, Regent D. [Radiofrequency ablation for palliation of soft tissue tumor pain]. ACTA ACUST UNITED AC 2010; 91:281-6. [PMID: 20508558 DOI: 10.1016/s0221-0363(10)70039-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the efficacy of radiofrequency (RF) ablation for palliation of soft tissue tumor pain. MATERIALS AND METHODS Retrospective study of 12 patients receiving palliative treatment for soft tissue tumors (5 primary tumors including 4 sarcomas and 1 PEComa and 7 metastatic tumors) with pain refractory to standard management. RF ablation was performed under CT or ultrasound guidance. RESULTS The efficacy was determined by using pain scores and treatment regimen modifications after RF ablation. Response was graded as absent, partial or complete. Short term symptomatic relief was observed in 100% of cases, with complete response in 43% of cases ; Mid term and long term symptomatic relief was observed in 70% and 83% of cases respectively. We also observed dosage reduction for narcotics with corresponding reduction in related side-effects and functional improvement in some patients. A single case of complication with serosanguinous collection within a region of necrosis was observed. CONCLUSION Radiofrequency ablation for palliation of soft tissue tumor pain may be a useful complement to standard management. It results in symptomatic improvement with few complications.
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Latorzeff I, Esterni B, Habibian M, Delplanque G, Theodore C, Baciuchka M, Dauba J, Laguerre B, Krakowski I, Gravis G. Safety results of a phase III trial evaluating ADT+ docetaxel versus ADT alone in hormone-naïve metastatic prostate cancer patients (GETUG-AFU 15/0403). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Eymard JC, Oudard S, Gravis G, Ferrero JM, Theodore C, Joly F, Priou F, Krakowski I, Zannetti A, Thill L, Beuzeboc P. Docetaxel reintroduction in patients with metastatic castration-resistant docetaxel-sensitive prostate cancer: a retrospective multicentre study. BJU Int 2010; 106:974-8. [PMID: 20230389 DOI: 10.1111/j.1464-410x.2010.09296.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate the potential benefit of reintroducing docetaxel chemotherapy in patients with progressive metastatic castration-resistant prostate cancer (mCRPC) who had initially responded to first-line docetaxel-based regimen. PATIENTS AND METHODS Records were evaluated retrospectively from French patients with mCRPC who had been included in seven controlled clinical studies of docetaxel as first-line treatment. We identified patients who were confirmed as responders to first-line treatment, discontinued for reasons other than disease progression or unacceptable toxicity, and who received further docetaxel chemotherapy for disease progression. The primary objective was to assess efficacy in terms of the prostate-specific antigen (PSA) response after resuming a docetaxel-based chemotherapy. Secondary objectives were overall survival and tolerance. RESULTS Of the 148 patients who responded to first-line docetaxel, 50 received further therapy with docetaxel and were analysed. The median (range) response duration to first-line docetaxel was 10.3 (4.6-45.7) months and the median docetaxel-free interval was 18.4 (5.0-46.7) months. Docetaxel was reintroduced as second-line therapy in 52% of patients and as further lines in 48%. After docetaxel reintroduction, 24 patients (48%) had a 50% decrease in PSA level (95% confidence interval, CI, 34.1-61.8%). The median (95% CI) overall survival from docetaxel reintroduction was 16 (13-20) months. Re-treatment was well tolerated (6% of grade 3-4 haemotoxicity). CONCLUSION Docetaxel reintroduction appears to be effective, with favourable tolerance profiles, in patients with mCRPC having responded to first-line docetaxel, and should be prospectively assessed in clinical trials against alternative therapies or investigational agents given alone or in combination, to define further management.
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