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Thomas-Joulié A, Tran S, El Houari L, Seyve A, Bielle F, Birzu C, Lozano-Sanchez F, Mokhtari K, Giry M, Marie Y, Laigle-Donadey F, Dehais C, Houillier C, Psimaras D, Alentorn A, Laurenge A, Touat M, Sanson M, Hoang-Xuan K, Kas A, Rozenblum L, Habert MO, Nichelli L, Leclercq D, Galanaud D, Jacob J, Karachi C, Capelle L, Carpentier A, Mathon B, Belin L, Idbaih A. Prognosis of glioblastoma patients improves significantly over time interrogating historical controls. Eur J Cancer 2024; 202:114004. [PMID: 38493668 DOI: 10.1016/j.ejca.2024.114004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Glioblastoma (GBM) is the most common devastating primary brain cancer in adults. In our clinical practice, median overall survival (mOS) of GBM patients seems increasing over time. METHODS To address this observation, we have retrospectively analyzed the prognosis of 722 newly diagnosed GBM patients, aged below 70, in good clinical conditions (i.e. Karnofsky Performance Status -KPS- above 70%) and treated in our department according to the standard of care (SOC) between 2005 and 2018. Patients were divided into two groups according to the year of diagnosis (group 1: from 2005 to 2012; group 2: from 2013 to 2018). RESULTS Characteristics of patients and tumors of both groups were very similar regarding confounding factors (age, KPS, MGMT promoter methylation status and treatments). Follow-up time was fixed at 24 months to ensure comparable survival times between both groups. Group 1 patients had a mOS of 19 months ([17.3-21.3]) while mOS of group 2 patients was not reached. The recent period of diagnosis was significantly associated with a longer mOS in univariate analysis (HR=0.64, 95% CI [0.51 - 0.81]), p < 0.001). Multivariate Cox analysis showed that the period of diagnosis remained significantly prognostic after adjustment on confounding factors (adjusted Hazard Ratio (aHR) 0.49, 95% CI [0.36-0.67], p < 0.001). CONCLUSION This increase of mOS over time in newly diagnosed GBM patients could be explained by better management of potentially associated non-neurological diseases, optimization of validated SOC, better management of treatments side effects, supportive care and participation in clinical trials.
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Affiliation(s)
- A Thomas-Joulié
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France; AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service d'Oncologie-Radiothérapie, F-75013 Paris, France
| | - S Tran
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - L El Houari
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Unité de Recherche Clinique, F-75013 Paris, France
| | - A Seyve
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - F Bielle
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - C Birzu
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - F Lozano-Sanchez
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - K Mokhtari
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - M Giry
- Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, F-75013 Paris, France
| | - Y Marie
- Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, F-75013 Paris, France
| | - F Laigle-Donadey
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - C Dehais
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - C Houillier
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - D Psimaras
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Alentorn
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Laurenge
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - M Touat
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - M Sanson
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - K Hoang-Xuan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Kas
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - L Rozenblum
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - M-O Habert
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - L Nichelli
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - D Leclercq
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - D Galanaud
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - J Jacob
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service d'Oncologie-Radiothérapie, F-75013 Paris, France
| | - C Karachi
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - L Capelle
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - A Carpentier
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - B Mathon
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - L Belin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Unité de Recherche Clinique Pitié-Salpêtrière-Charles Foix, Paris, France
| | - A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Unité de Recherche Clinique Pitié-Salpêtrière-Charles Foix, Paris, France.
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Dequirez PL, Pues M, Queval L, Vercleyen S, Carpentier A, Lebuffe G, Seguy D, Blanchard A, Vermersch P, Biardeau X. Standardized one-day evaluation before urinary reconstructive surgery for neurogenic lower urinary tract dysfunction: Feasibility and impact on surgical strategy and care pathway. Prog Urol 2023; 33:1014-1025. [PMID: 37858377 DOI: 10.1016/j.purol.2023.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES To describe a concept of standardized preoperative one-day evaluation before urinary reconstructive or diversion surgery for the treatment of neurogenic lower urinary tract (LUT) dysfunction, and to evaluate its feasibility and its impact on the care pathway. MATERIALS AND METHODS All patients who underwent a one-day standardized evaluation before a urinary reconstructive or derivation surgery for the treatment of neurogenic LUT dysfunction between January 2017 and December 2021 in our institution were included. Data were collected retrospectively from standardized reports. The main outcome was the rate of completion of the tests and consultations planned during this evaluation. Secondary outcomes included the findings from the one-day evaluation and changes in the urological surgical strategy at different time points within one year. RESULTS One hundred and thirty-one patients benefited from this one-day standardized evaluation. The overall completeness rate of the data collected was 77.5%, increasing from 62.3% in 2017 to 89.3% in 2021. The urological surgical plan was modified for 19.1% of patients following this preoperative evaluation. The indication was then confirmed for 114 patients (87.0%) by the multidisciplinary meeting and was carried out unchanged during the following year for 89 patients (67.9%). An associated colostomy procedure was proposed for 18.3% of patients and was finally performed in 11.5%. CONCLUSION A standardized multidisciplinary preoperative one-day evaluation before performing reconstructive or diversion surgery for the treatment of neurogenic LUT dysfunction seems feasible and makes it possible to optimize the surgical plan and adapt the course of care. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- P-L Dequirez
- Department of Urology, CHU de Lille, université de Lille, 59000 Lille, France.
| | - M Pues
- Department of Urology, CHU de Lille, université de Lille, 59000 Lille, France
| | - L Queval
- Department of Urology, CHU de Lille, université de Lille, 59000 Lille, France
| | - S Vercleyen
- Department of Urology, CHU de Lille, université de Lille, 59000 Lille, France
| | - A Carpentier
- Department of Urology, CHU de Lille, université de Lille, 59000 Lille, France
| | - G Lebuffe
- Department of Anesthesiology and Critical Care Anesthesiology, CHU de Lille, université de Lille, 59000 Lille, France
| | - D Seguy
- Department of Nutrition, CHU de Lille, université de Lille, 59000 Lille, France
| | - A Blanchard
- Department of Physical and Rehabilitation Medicine, CHU de Lille, université de Lille, 59000 Lille, France
| | - P Vermersch
- UMR-S1172 LilNCog, Lille Neuroscience and Cognition, CHU de Lille, Inserm, université de Lille, 59000 Lille, France
| | - X Biardeau
- Department of Urology, CHU de Lille, université de Lille, 59000 Lille, France; UMR-S1172 LilNCog, Lille Neuroscience and Cognition, CHU de Lille, Inserm, université de Lille, 59000 Lille, France
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3
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Dimancea A, Mattioni S, Nouet A, Drir M, Santin A, Marrot B, Shotar E, Corcy C, Bottin L, Sourour NA, Premat K, Alamowitch S, Carpentier A, Degos V, Clarençon F, Lionnet F, Lenck S. Preventive treatment of unruptured intracranial aneurysms in adult patients with sickle cell anemia: A cohort study. J Neuroradiol 2023; 50:511-517. [PMID: 36781119 DOI: 10.1016/j.neurad.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND PURPOSE Intracranial aneurysms are frequent in patients with sickle cell anemia, while subarachnoid hemorrhage is a major cause of death and disability in young adult patients. Several characteristics, such as younger age and smaller size at rupture, may incline therapeutic decision towards exclusion treatments. Clinical guidelines on treatment of unruptured intracranial aneurysms in this population are still missing. We aimed to assess the safety and efficacy of the treatment of unruptured intracranial aneurysm in patients with sickle cell anemia, using an adapted hematological preparation regimen. PATIENTS AND METHODS Adult patients with sickle cell anemia and treated unruptured aneurysms by endovascular therapy or neurosurgery were included in this retrospective cohort study. Treatment decision was reached after multi-disciplinary assessment. A pre-operative blood transfusion protocol was undertaken targeting a HbS below 30%. Demographic data, hematological preparation parameters and clinical and radiological outcomes were documented. RESULTS AND CONCLUSIONS Twenty-five procedures were performed in 18 patients encompassing 19 aneurysms treated by embolization and 6 by surgery. Median age at treatment was 34 years-old and median aneurysm dome size was 4.4 mm. Immediate aneurysm exclusion rate was 85.7% after endovascular therapy and 100% after neurosurgery. Median follow-up was 6 months, with all patients being asymptomatic at last follow-up. Two transitory ischemic neurological deficits, as well as four cases of iodine-induced encephalopathy were identified after embolization. No complication occurred after surgery. Endovascular therapy by coiling and neurosurgical treatment of unruptured intracranial aneurysms appears to be safe in patients with sickle cell anemia and should be considered given the specific hemorrhagic risk observed in this population. A rigorous hematological preparation, associated with a dedicated peri‑operative protocol and an adequate therapeutic strategy are essential prerequisites.
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Affiliation(s)
- A Dimancea
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - S Mattioni
- Reference Center for Sickle Cell Disease, Department of Internal Medicine, Tenon University Hospital, Paris, France
| | - A Nouet
- Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France
| | - M Drir
- Department of Neuro-anesthesia and Critical Care, Pitié-Salpêtrière University Hospital, Paris, France
| | - A Santin
- Reference Center for Sickle Cell Disease, Department of Internal Medicine, Tenon University Hospital, Paris, France
| | - B Marrot
- Department of Radiology, Tenon University Hospital, Paris, France
| | - E Shotar
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - C Corcy
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - L Bottin
- Department of Neurology, Pitié-Salpêtrière University Hospital, Paris, France
| | - N A Sourour
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - K Premat
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France
| | - S Alamowitch
- Department of Neurology, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France
| | - A Carpentier
- Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France
| | - V Degos
- Department of Neuro-anesthesia and Critical Care, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France
| | - F Clarençon
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France; GRC BioFast. Paris VI University. Paris. France
| | - F Lionnet
- Reference Center for Sickle Cell Disease, Department of Internal Medicine, Tenon University Hospital, Paris, France
| | - S Lenck
- Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Paris, France; Paris Sorbonne University, Paris, France; Inserm UMR 1127, Paris Brain Institute, Paris, France.
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4
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Ahmed MH, Canney M, Carpentier A, Idbaih A. Overcoming the blood brain barrier in glioblastoma: Status and future perspective. Rev Neurol (Paris) 2023; 179:430-436. [PMID: 37062676 DOI: 10.1016/j.neurol.2023.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/19/2023] [Indexed: 04/18/2023]
Abstract
Glioblastoma is the most common primary brain malignancy in adults. Treatment of glioblastoma patients is based on neurosurgery, radiation therapy and chemotherapy. Despite this multimodal therapeutic regimen, the prognosis of glioblastoma patients is poor. Indeed, glioblastoma is very resistant to treatments due to multiple molecular and cellular mechanisms including the existence of the blood-brain barrier (BBB). The BBB consists of multiple layers surrounding brain vessels and limits drug penetration within the brain. Therefore, overcoming the BBB is a strategy to increase bioavailability and efficacy of therapeutic agents against glioblastoma cells. The development of two approaches is ongoing: i) enhancing the delivery of drugs to the brain and ii) improving the penetration of drugs into the brain. One way to enhance drug delivery to the brain is through high-dose intravenous chemotherapy, with or without bone marrow transplantation, or via intra-arterial chemotherapy, with or without disrupting the BBB through osmotic means. Conversely, improving drug penetration within the brain can be achieved through modifying either the drug itself or the BBB. Promising results in terms of safety and signals of efficacy were obtained with these approaches in early phase clinical trials. More advanced comparative clinical trials are needed to investigate the clinical benefit for glioblastoma patients.
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Affiliation(s)
- M H Ahmed
- School of Cancer & Pharmaceutical Sciences, King's College London, London SE1 9NH, United Kingdom
| | | | - A Carpentier
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, 75013, Paris, France
| | - A Idbaih
- Service de Neurologie 2-Mazarin, Charles Foix, DMU Neurosciences, Sorbonne Université, AP-HP, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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Bex A, Bex V, Carpentier A, Mathon B. Therapeutic ultrasound: The future of epilepsy surgery? Rev Neurol (Paris) 2022; 178:1055-1065. [PMID: 35853776 DOI: 10.1016/j.neurol.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 02/08/2023]
Abstract
Epilepsy is one of the leading neurological diseases in both adults and children and in spite of advancement in medical treatment, 20 to 30% of patients remain refractory to current medical treatment. Medically intractable epilepsy has a real impact on a patient's quality of life, neurologic morbidity and even mortality. Actual therapy options are an increase in drug dosage, radiosurgery, resective surgery and non-resective neuromodulatory treatments (deep brain stimulation, vagus nerve stimulation). Resective, thermoablative or neuromodulatory surgery in the treatment of epilepsy are invasive procedures, sometimes requiring long stay-in for the patients, risks of permanent neurological deficit, general anesthesia and other potential surgery-related complications such as a hemorrhage or an infection. Radiosurgical approaches can trigger radiation necrosis, brain oedema and transient worsening of epilepsy. With technology-driven developments and pursuit of minimally invasive neurosurgery, transcranial MR-guided focused ultrasound has become a valuable treatment for neurological diseases. In this critical review, we aim to give the reader a better understanding of current advancement for ultrasound in the treatment of epilepsy. By outlining the current understanding gained from both preclinical and clinical studies, this article explores the different mechanisms and potential applications (thermoablation, blood brain barrier disruption for drug delivery, neuromodulation and cortical stimulation) of high and low intensity ultrasound and compares the various possibilities available to patients with intractable epilepsy. Technical limitations of therapeutic ultrasound for epilepsy surgery are also detailed and discussed.
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Affiliation(s)
- A Bex
- Department of Neurosurgery, CHR Citadelle, Liege, Belgium; Department of Neurosurgery, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, 75013, Paris, France
| | - V Bex
- Department of Neurosurgery, CHR Citadelle, Liege, Belgium
| | - A Carpentier
- Department of Neurosurgery, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, 75013, Paris, France; Sorbonne University, GRC 23, Brain Machine Interface, AP-HP, La Pitié-Salpêtrière Hospital, 75013 Paris, France; Sorbonne University, Advanced Surgical Research Technology Lab, Paris, France
| | - B Mathon
- Department of Neurosurgery, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, 75013, Paris, France; Sorbonne University, GRC 23, Brain Machine Interface, AP-HP, La Pitié-Salpêtrière Hospital, 75013 Paris, France; Sorbonne University, Advanced Surgical Research Technology Lab, Paris, France; Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne University, UMRS, 1127 Paris, France.
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Sturbois A, Cozic A, Schaal G, Desroy N, Riera P, Le Pape O, Le Mao P, Ponsero A, Carpentier A. Stomach content and stable isotope analyses provide complementary insights into the trophic ecology of coastal temperate bentho-demersal assemblages under environmental and anthropogenic pressures. Mar Environ Res 2022; 182:105770. [PMID: 36265253 DOI: 10.1016/j.marenvres.2022.105770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/14/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Assessing organic matter fluxes and species interactions in food webs is of main interest to understand the ecological functioning in bays and estuaries characterised by a wide diversity of primary producers and consumers. Demersal fish and cephalopod assemblages were studied across a network of 24 shallow subtidal stations in the bay of Saint-Brieuc for their diversity, stable isotope compositions and stomach contents. The community was composed of 21 taxa, eight species accounting for 94.4% of the total abundance. Three different assemblages were identified along bathymetric gradient and spatial patterns in fish dredging. Marine POM and SOM were the most likely bases of food webs regarding δ13C range displayed by fish and cephalopod without differences among assemblages. Amphipoda was the main prey item in stomachs leading to significant diet overlaps among fish species, with some variations in additional items. Sepia officinalis was characterised by a singular diet and very low dietary overlap with other species. Contrasted stable isotope values and niche overlaps among species were evidenced in the δ13C/δ15N space. Callionymus lyra and Buglossidium luteum, characterised by the widest isotopic niches, encompassed those of other species, except the singular 13C-depleted Spondyliosoma cantharus. Coupling taxonomic assemblages, stomach contents and stable isotope analyses help disentangling the resources uses and evidencing trophic pathways. Contrasts in fish and cephalopod demersal assemblages occurring at different depths not necessarily imply differences in the trophic resources uses in such complex shallow coastal ecosystems under anthropogenic influences.
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Affiliation(s)
- A Sturbois
- Vivarmor Nature, 18 C rue du Sabot, 22440, Ploufragan, France; Réserve naturelle nationale de la Baie de Saint-Brieuc, site de l'étoile, 22120, Hillion, France; Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER, BP 70, 29280 Plouzané, France.
| | - A Cozic
- Vivarmor Nature, 18 C rue du Sabot, 22440, Ploufragan, France; Réserve naturelle nationale de la Baie de Saint-Brieuc, site de l'étoile, 22120, Hillion, France
| | - G Schaal
- Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER, BP 70, 29280 Plouzané, France
| | - N Desroy
- Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc, 35800, Dinard, France
| | - P Riera
- Sorbonne Université, CNRS, Station Biologique de Roscoff, UMR7144, Place Georges Teissier, CS90074, 29688, Roscoff Cedex, France
| | - O Le Pape
- DECOD (Ecosystem Dynamics and Sustainability), Institut Agro, INRAe, Ifremer Rennes, France
| | - P Le Mao
- Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc, 35800, Dinard, France
| | - A Ponsero
- Réserve naturelle nationale de la Baie de Saint-Brieuc, site de l'étoile, 22120, Hillion, France; Saint-Brieuc Agglomération Baie d'Armor, 5 rue du 71ème RI, 22000, Saint-Brieuc, France
| | - A Carpentier
- Université de Rennes 1, BOREA, Muséum National d'Histoire Naturelle, Sorbonne Université, Université de Caen Normandie, Université des Antilles, Campus de Beaulieu, 35000, Rennes, France
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Idbaih A, Sonabend A, Stupp R, Chinot O, Dufour H, Ducray F, Menei P, de Groot J, Desseaux C, Carpentier A. OS07.3.A Phase 1/2 clinical trial of blood-brain barrier opening with the SonoCloud-9 implantable ultrasound device in recurrent glioblastoma patients receiving IV carboplatin. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Low intensity pulsed ultrasound (LIPU) in combination with microbubbles is a promising approach for brain drug delivery. A phase 1/2 clinical study (NCT03744026) was initiated to demonstrate the safety and efficacy of blood-brain barrier (BBB) disruption over a large volume using an implantable ultrasound system (SonoCloud-9) in patients with recurrent glioblastoma receiving carboplatin chemotherapy.
Material and Methods
The SonoCloud-9 device (Carthera, Paris, France) was placed at the end of tumor resection and replaced the bone flap. The device was activated 9-14 days after surgery for a duration of 270 seconds every 4 weeks until progression or treatment completion, concomitantly with IV DEFINITY microbubbles (10 μl/kg, Lantheus, Billerica, US). The Phase 1 cohort consisted of an escalation of BBB disruption volume by activation of 3 (n=3), 6 (n=3), then 9 (n=3) emitters of the device. Dose limiting toxicity (DLT) was assessed during the first 2 weeks after the 1st sonication. A subsequent expansion cohort consisted of patients treated with 9 emitters in which the primary endpoint was assessment of BBB opening on MRI using gadolinium (<1 hr after sonication). All patients received carboplatin either after (n=21) or before (n=12) device activation to disrupt the BBB. In addition, a sub-study was performed to investigate carboplatin concentration enhancement in the peritumoral region with sonication at time of device implantation.
Results
Study accrual is complete with 38 patients enrolled and 33 patients having been implanted and received at least one sonication+carboplatin. A total of 101 sonications were performed (range=1-10 sonication sessions/patient). No DLTs were observed. A total of 14 SAEs were observed including five events considered as possibly treatment related. BBB disruption was confirmed by gadolinium enhancement after sonication. In an analysis of 60 treatments in 27 patients that had all nine emitters active, 90% of activated emitters led to BBB opening in gray and/or white matter with good repeatability of BBB opening. In 3 patients who underwent intraoperative sonication and carboplatin administration, a 7.58-fold increase in brain/plasma drug levels was demonstrated. Updated and mature outcome results will be presented.
Conclusion
These results confirm the safety and feasibility of repeated BBB disruption using an implantable ultrasound system. LIPU substantially increases drug levels in the peritumoral brain.
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Affiliation(s)
- A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin , Paris , France
| | - A Sonabend
- Malnati Brain Tumor Institute, Lurie Comprehensive Cancer Center, Departments of Neurological Surgery and Neurology, Northwestern Memorial Hospital, Northwestern University , Chicago, IL , United States
| | - R Stupp
- Malnati Brain Tumor Institute, Lurie Comprehensive Cancer Center, Departments of Neurological Surgery and Neurology, Northwestern Memorial Hospital, Northwestern University , Paris , France
| | - O Chinot
- Hôpital de la Timone , Marseille , France
| | - H Dufour
- Hôpital de la Timone , Marseille , France
| | - F Ducray
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1 , Lyon , France
| | - P Menei
- CHU Angers , Angers , France
| | - J de Groot
- MD Anderson Cancer Center , Houston, TX , United States
| | | | - A Carpentier
- Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie , Paris , France
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Tran S, Thomas A, Touat M, Karachi C, Lozano F, Mokhtari K, Dehais C, Feuvret L, Carpentier C, Giry M, Doukani H, Lerond J, Marie Y, Sanson M, Idbaih A, Carpentier A, Hoang-Xuan K, Capelle L, Bielle F. OS07.1.A A threshold of mitotic activity and post-surgery residual volume are independant prognostic factors in astrocytoma IDH-mutant. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The distinction between grade 2 and 3 is instrumental to choose between observational follow-up and adjuvant treatment in resected astrocytoma IDH-mutant. However, criteria of grade 2 versus 3 have not been updated since the WHO 2007 classification. There is no consensus on the method of evaluation of the mitotic activity or a cut-off of mitoses separating grade 2 and grade 3 tumors. The objectives were to evaluate the maximal mitotic activity on a series of resected astrocytoma IDH-mutant and assess its prognostic impact on survival.
Material and Methods
Maximal mitotic activity on consecutive high power fields corresponding to 3 mm2 was examined in 118 lower-grade astrocytoma IDH-mutant. The prognostic value for time-to-treatment (TTT) and overall survival (OS) of mitotic activity and other putative prognostic factors (including age, performance status, pre-surgical tumor volume, plurilobar involvement, post-surgical residual tumor volume, midline involvement) was assessed in tumors with (i) ATRX loss, and (ii) without CDKN2A homozygous deletion, lesional enhancement, histological necrosis nor microvascular proliferation.
Results
Among the 75 (64%) of tumors which had gone through observational follow-up after resection, the maximal mitotic activity, the post-surgical residual volume and the plurilobar involvement were independent prognostic factors of TTT (p < 0.0001). A threshold of mitotic activity for grade 2 was fitted on TTT and OS prognosis. Using this threshold, patients with “grade 2 tumors” had a median TTT of 55 months versus 19 months for “grade 3” (p = 0.0057) and a median OS of 102 months versus 73 months respectively (p = 0.001). Residual volume < 1 cm3 was associated with longer OS (113 months versus 88 months, p = 0.0021).
Conclusion
Mitotic activity and post-surgical residual volume can be combined to evaluate prognosis in resected astrocytoma IDH-mutant and could select the best candidates for observational follow-up.
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Affiliation(s)
- S Tran
- Pitie-Salpetriere Hospital, Department of Neuropathology , Paris , France
| | - A Thomas
- Institut de Cancérologie Strasbourg Europe, Department of Radiation Oncology , Strasbourg , France
| | - M Touat
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - C Karachi
- Pitie-Salpetriere Hospital, Department of Neurosurgery , Paris , France
| | - F Lozano
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - K Mokhtari
- Pitie-Salpetriere Hospital, Department of Neuropathology , Paris , France
| | - C Dehais
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - L Feuvret
- Pitie-Salpetriere Hospital, Department of Radiotherapy , Paris , France
| | - C Carpentier
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - M Giry
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - H Doukani
- Sorbonne Universite INSERM, Plateforme post-genomique de la Pitie-Salpetriere , Paris , France
| | - J Lerond
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - Y Marie
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - M Sanson
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - A Idbaih
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - A Carpentier
- Pitie-Salpetriere Hospital, Department of Neurosurgery , Paris , France
| | - K Hoang-Xuan
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - L Capelle
- Pitie-Salpetriere Hospital, Department of Neurosurgery , Paris , France
| | - F Bielle
- Pitie-Salpetriere Hospital, Department of Neuropathology , Paris , France
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Holub K, Froelich S, Guichard J, Passeri T, Polivka M, Carpentier A, Adle-Biassette H, Feuvret L, Lot G, Bolle S, Beddok A, El Ayachy R, Goudji F, Pasquie I, Calugaru V, Dendale R, Mammar H. PO-1129 Post-operative Proton Beam Therapy in cervical chordoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03093-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Apra C, Serra M, Robert H, Carpentier A. Early rehabilitation using gait exoskeletons is possible in the neurosurgical setting, even in patients with cognitive impairment. Neurochirurgie 2022; 68:458-460. [DOI: 10.1016/j.neuchi.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 10/18/2022]
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11
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Sturbois A, Riera P, Desroy N, Brébant T, Carpentier A, Ponsero A, Schaal G. Spatio-temporal patterns in stable isotope composition of a benthic intertidal food web reveal limited influence from salt marsh vegetation and green tide. Mar Environ Res 2022; 175:105572. [PMID: 35134641 DOI: 10.1016/j.marenvres.2022.105572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
Assessing fluxes of matter and energy in food webs within and across benthic habitats is important to understand the ecological functioning in bays and estuaries, where the productivity is favoured by a wide diversity of primary producers. The temporal variability (March vs September 2019) in the carbon and nitrogen stable isotope composition of primary food sources and benthic invertebrates consumers was investigated in a large intertidal area (Western English-Channel, France). The study area is influenced by megatidal conditions and characterised by salt marshes in the sheltered part, and seasonal Ulva spp. blooms. The spatio-temporal variability in the structure of the benthic food web was analysed at the scales of both the whole bay and the different assemblages, which constitute the mosaic of habitats. Inferences on potential sources fuelling the food web were supported by spatio-temporal patterns based on covariations and stable isotope trajectory analysis. Results highlighted that phytoplankton, microphytobenthos and SOM were, most likely, the main food sources. The trophic connectivity between salt marsh and benthic habitats within the bay was limited to some macrofauna species inhabiting muddy creeks within the salt marsh. Unexpectedly, the influence of Ulva spp. blooms appeared also limited. Spatial patterns illustrates the constancy of the spatial variability in the benthic pelagic coupling, with a higher influence of microphytobenthos in the upper shore compared to low shore assemblages. This first attempt to characterize intertidal benthic food web constitutes a relevant baseline for the conservation of the bay of Saint-Brieuc where a national Nature Reserve has been created in 1998 for the conservation of overwintering birds. The spatial and temporal patterns of the benthic food web observed in this study (1) confirm the importance to consider food web variability at spatial and temporal scales from sampling designs to data analysis, and (2) demonstrate the ability of the stable isotope trajectory analysis framework to highlight food web dynamics.
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Affiliation(s)
- A Sturbois
- Vivarmor Nature, 18 C rue du Sabot, 22440, Ploufragan, France; Réserve naturelle nationale de la Baie de Saint-Brieuc, site de l'étoile, 22120, Hillion, France; Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc, 35800, Dinard, France; Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER, BP 70, 29280, Plouzané, France.
| | - P Riera
- Sorbonne Université, CNRS, Station Biologique de Roscoff, UMR7144, Place Georges Teissier, CS90074, 29688, Roscoff Cedex, France
| | - N Desroy
- Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc, 35800, Dinard, France
| | - T Brébant
- Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc, 35800, Dinard, France
| | - A Carpentier
- Université de Rennes 1, BOREA, Muséum National d'Histoire Naturelle, Sorbonne Université, Université de Caen Normandie, Université des Antilles), Campus de Beaulieu, 35000, Rennes, France
| | - A Ponsero
- Réserve naturelle nationale de la Baie de Saint-Brieuc, site de l'étoile, 22120, Hillion, France; Saint-Brieuc Agglomération Baie d'Armor, 5 rue du 71ème RI, 22000, Saint-Brieuc, France
| | - G Schaal
- Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER, BP 70, 29280, Plouzané, France
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Sturbois A, Cucherousset J, De Cáceres M, Desroy N, Riera P, Carpentier A, Quillien N, Grall J, Espinasse B, Cherel Y, Schaal G. Stable Isotope Trajectory Analysis (
SITA
): A new approach to quantify and visualize dynamics in stable isotope studies. ECOL MONOGR 2021. [DOI: 10.1002/ecm.1501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Sturbois
- Vivarmor Nature, 18 C rue du Sabot Ploufragan France
- Réserve naturelle nationale de la Baie de Saint‐Brieuc, site de l'étoile, 22120 Hillion France
- Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc Dinard France
- Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER BP 70, 29280 Plouzané France
| | - J. Cucherousset
- UMR 5174 EDB (Laboratoire Évolution & Diversité Biologique), CNRS, Université Paul Sabatier, IRD, 118 route de Narbonne Toulouse France
| | | | - N. Desroy
- Ifremer, Laboratoire Environnement et Ressources Bretagne nord, 38 rue du Port Blanc Dinard France
| | - P. Riera
- Sorbonne Université, CNRS, Station Biologique de Roscoff, UMR7144, Place Georges Teissier CS90074, 29688, Roscoff Cedex France
| | - A. Carpentier
- Université de Rennes 1, BOREA, Muséum National d'Histoire Naturelle, Sorbonne Université, Université de Caen Normandie, Université des Antilles, Campus de Beaulieu Rennes France
| | - N. Quillien
- France Energies Marines, 525 Avenue Alexis de Rochon Plouzané France
| | - J. Grall
- Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER BP 70, 29280 Plouzané France
| | - B. Espinasse
- Department of Arctic and Marine Biology UiT The Arctic University of Norway Tromsø Norway
| | - Y. Cherel
- Centre d'Etudes Biologiques de Chizé, UMR 7372 du CNRS‐La Rochelle Université Villiers‐en‐Bois France
| | - G. Schaal
- Laboratoire des Sciences de l'Environnement Marin (LEMAR), UMR 6539 CNRS/UBO/IRD/IFREMER BP 70, 29280 Plouzané France
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Laigle-Donadey F, Metellus P, Guyotat J, Menei P, Proust F, Dufour H, Chinot O, Honnorat J, Faillot T, Paquis P, Peruzzi P, Emery E, Guillamo JS, Carpentier A, Wager M, Lebbah S, Hajage D, Delattre JY, Cornu P. PL03.1.A Surgery for glioblastomas in the elderly: an ANOCEF trial (CSA). Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
The role of surgery for the treatment of malignant gliomas in patients 70 years of age or older is unsettled. We conducted a randomized trial that compared surgical resection of the tumor and biopsy only, both followed by standard therapy, in such patients.
MATERIAL AND METHODS
Patients aged 70 years and older, with a KPS of at least 50, presenting with a radiological suspicion of an operable glioblastoma (GBM) were randomly assigned between tumor resection and biopsy. Subsequently, they underwent standard radiotherapy during the first years of the trial (2008–2017), with the adjunction of concomitant and adjuvant temozolomide when this regimen became standard (2017–2019). The primary end point was survival; secondary endpoints were progression free survival (PFS), cognitive status (MMS), autonomy (KPS), quality of life (EORTC QLQ C30 and BN20), and perioperative morbidity/ mortality.
RESULTS
From 2008 to 2019, 107 patients from 9 centers were enrolled in the study, of whom 101 were evaluable for analysis because the diagnosis of GBM was histologically confirmed (50 patients in the “surgery” arm and 51 patients in the “biopsy” arm). There was no statistically significant difference of median survival between the “surgery” arm (9.37 mo) and the “biopsy” arms (8.96 mo, p=0.36). However, the surgery group had increased PFS (5.06 mo vs 4.02 mo; p=0.034; p=0.002 on multivariate analysis) and better QOL (e.g. physical and cognitive functioning, motor dysfunction, fatigue) and KPS score evolution as compared to the “biopsy” group. Surgery was not associated with increased mortality or morbidity.
CONCLUSION
This study suggests that optimal debulking surgery does not provide a significant survival benefit in elderly patients suffering from newly diagnosed malignant glioma, but resection improves QOL and autonomy with a significant though modest improvement of PFS.
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Affiliation(s)
| | - P Metellus
- Hôpital Privé Clairval, Marseille, France
| | | | - P Menei
- CHU d’Angers, Angers, France
| | - F Proust
- Hôpital Charles Nicolle, Rouen, France
| | - H Dufour
- Hôpital de la Timone, Marseille, France
| | - O Chinot
- Hôpital de la Timone, Marseille, France
| | | | | | | | | | | | | | | | - M Wager
- CHU de Poitiers, Poitiers, France
| | - S Lebbah
- Hôpital Pitié-Salpêtrière, Paris, France
| | - D Hajage
- Hôpital Pitié-Salpêtrière, Paris, France
| | | | - P Cornu
- Hôpital Pitié-Salpêtrière, Paris, France
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14
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Dequirez P, Queval L, Vercleyen S, Carpentier A, Seguy D, Lebuffe G, Blanchard A, Biardeau X. Hôpital de jour pour évaluation préopératoire standardisée avant chirurgie lourde en neuro-urologie : concept, faisabilité et résultats. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jacob J, Ribeiro M, Benadjaoud M, Jenny C, Feuvret L, Simon J, Bernier M, Antoni D, Hoang-Xuan K, Psimaras D, Carpentier A, Ricard D, Maingon P. OC-0696: Development of dose constraints to the brain areas implied in cognition: a prospective study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Vieillevoye S, Poortmans J, Carpentier A. Effects of essential amino acids supplementation on muscle damage following a heavy-load eccentric training session. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Tremblay S, Girard R, Noll C, Carpentier A, Boudreau F. A267 ROLE OF INTESTINAL EPITHELIAL NUCLEAR RECEPTOR HNF4A DURING METABOLIC DISORDERS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
HNF4α belongs to the hormone nuclear receptor family and is expressed in liver, intestinal epithelium and pancreas where it regulates genes involved in the control of metabolism. Inactivating mutations in the HNF4A gene cause several forms of maturity-onset diabetes of the young (MODY). However, the specific deletion of Hnf4a in mouse pancreatic beta cells does not lead to diabetes, suggesting the contribution of other tissues, such as the intestine, are necessary for the progression of the disease.
Aims
Our main hypothesis was that intestinal epithelial HNF4α regulates gene products that act through a paracrine mode of communication in the context of glucose metabolism. The aims of this study were to investigate the impact of deleting Hnf4a in the mouse intestinal epithelium during glucose homeostasis and to identify molecular mechanisms involved during glucose-induced obesity resistance.
Methods
The Villin-Cre recombinase transgenic mouse model was used to conditionally delete Hnf4a in the intestinal epithelium (Hnf4adeltaIEC). Hnf4adeltaIEC mice were put on a high sugar diet for 8 to 12 weeks, using a 30% sucrose supplemented ab lithium water. Blood glucose values in controls and mutants were measured from whole venous blood from fasted mice or during glucose and insulin tolerance tests. Mouse serum hormone levels (Ghrelin, Fibroblast-growth factor-15 (Fgf15), Insulin, Cholecystokinin (CCK), etc.) were measured using mouse ELISA kits. The Promethion High-Definition Room Calorimetry System was used for indirect calorimetry and metabolic studies.
Results
Both male and female Hnf4adeltaIEC mice displayed a metabolic resistance to develop obesity under sucrose supplementation when compared to control mice. While male mutant mice showed a resistance to obesity after only 2 weeks of treatment, female mutant mice took at least 6 weeks to display some resistance. The gut hormones ghrelin and Fgf15 were also found modified in fasted mutant mice. Female mutant mice presented a significant increase of 1.8 fold in circulating Fgf15 and an increase of 1.4 fold in circulating ghrelin. Similar changes were observed in male mutant mice. However, only male mutant mice presented an insulin resistance and an oral glucose tolerance after between 6 and 8 weeks. Brown adipose tissue (BAT) whitening was observed after 8 weeks of sucrose treatment in control obese animals, a condition that was prevented in Hnf4adeltaIEC mice.
Conclusions
The identification of paracrine intestinal targets for HNF4α in association with glucose metabolism will provide a better understanding of the molecular nature of tissues crosstalk in energy balance and in metabolism disorders including diabetes and obesity.
Funding Agencies
CIHR
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Affiliation(s)
- S Tremblay
- Université of Sherbrooke, Sherbrooke, QC, Canada
| | - R Girard
- Université of Sherbrooke, Sherbrooke, QC, Canada
| | - C Noll
- Université of Sherbrooke, Sherbrooke, QC, Canada
| | - A Carpentier
- Université of Sherbrooke, Sherbrooke, QC, Canada
| | - F Boudreau
- Université of Sherbrooke, Sherbrooke, QC, Canada
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Rafii H, Frère C, Benzidia I, Crichi B, Andre T, Assenat E, Bournet B, Carpentier A, Connault J, Doucet L, Durant C, Emmerich J, Gris JC, Hij A, Le Hello C, Madelaine I, Messas E, Ndour A, Villiers S, Marjanovic Z, Ait Abdallah N, Yannoutsos A, Farge D. Management of cancer-related thrombosis in the era of direct oral anticoagulants: A comprehensive review of the 2019 ITAC-CME clinical practice guidelines. On behalf of the Groupe Francophone Thrombose et Cancer (GFTC). J Med Vasc 2020; 45:28-40. [PMID: 32057323 DOI: 10.1016/j.jdmv.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Venous thromboembolism (VTE) is a common disease complication in cancer patients and the second cause of death after cancer progression. VTE management and prophylaxis are critical in cancer patients, but effective therapy can be challenging because these patients are at higher risk of VTE recurrence and bleeding under anticoagulant treatment. Numerous published studies report inconsistent implementation of existing evidence-based clinical practice guidelines (CPG), including underutilization of thromboprophylaxis, and wide variability in clinical practice patterns across different countries and various practitioners. This review aims to summarize the 2019 ITAC-CME evidence-based CPGs for treatment and prophylaxis of cancer-related VTE, which include recommendations on the use of direct oral anticoagulants specifically in cancer patients. The guidelines underscore the gravity of developing VTE in cancer and recommend the best approaches for treating and preventing cancer-associated VTE, while minimizing unnecessary or over-treatment. Greater adherence to the 2019 ITAC guidelines could substantially decrease the burden of VTE and improve survival of cancer patients.
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Affiliation(s)
- H Rafii
- Eurocord, Équipe 3 EA3518, hôpital Saint-Louis, Université de Paris, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Frère
- Inserm UMRS_1166, Department of Haematology, hôpital Pitié-Salpêtrière, Université de Paris, Sorbonne Paris-Cité, AP-HP, Paris, France
| | - I Benzidia
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - B Crichi
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - T Andre
- Hôpital Saint-Antoine, AP-HP, Paris, France
| | - E Assenat
- Montpellier school of Medicine, Saint-Eloi University Hospital, Montpellier, France
| | - B Bournet
- Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | | | | | - L Doucet
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - A Hij
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - C Le Hello
- CHU Saint-Étienne, Saint-Étienne, France
| | | | - E Messas
- Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - A Ndour
- Hôpital Saint-Louis, AP-HP, Paris, France
| | - S Villiers
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | - N Ait Abdallah
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | | | - D Farge
- Internal Medicine (UF04), Équipe 3 EA 3518, Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, AP-HP, Sorbonne Paris-Cité, Paris, France; Department of Medicine, McGill University, Montreal, QC, Canada
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Jacob J, Clausse E, Benadjaoud M, Jenny C, Ribeiro M, Feuvret L, Mazeron JJ, Antoni D, Bernier MO, Hoang-Xuan K, Psimaras D, Carpentier A, Ricard D, Maingon P. Dose distribution of the brain tissue associated with cognitive functions in high-grade glioma patients. Cancer Radiother 2020; 24:1-10. [DOI: 10.1016/j.canrad.2019.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/22/2022]
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Riche M, Mathon B, Mokhtari K, Carpentier A, Amelot A. Cylindroma spine metastasis: Long-term follow-up is required. Neurochirurgie 2019; 66:45-49. [PMID: 31634508 DOI: 10.1016/j.neuchi.2019.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/21/2019] [Accepted: 09/21/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC), or cylindroma, is a rare malignancy believed to arise from epithelial cells of salivary glands. It is a slow-growing but aggressive tumor with a propensity for perineural invasion. Metastases are common to the lung, but rare to the spine. The natural history of ACC spine metastases is unknown and progression is unpredictable. METHODS (1) A case report was described for a patient diagnosed with spine ACC metastasis of the T6/T7 vertebrae. (2) A literature search was conducted on Medline via PubMed and the Cochrane databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify articles from 1973 to March 2019 using following keywords: adenoid cystic carcinoma, cylindroma, metastasis, salivary glands. RESULTS/CASE REPORT We report an unusual case of spine ACC metastasis of the T6/T7 vertebrae in a patient suffering from progressive radiculopathy and thoracic pain. Based on these findings, the patient underwent T6/T7 laminectomy. The diagnosis was confirmed by the pathology results. The primary parotid tumor had been resected 35 years before spine metastasis. A review of literature encompassing 40 years identified 16 patients treated for ACC spine metastases. Mean time to spine metastases was 4.1 years after primary treatment of ACC. Spine metastases were isolated, without local recurrence at the neck. CONCLUSION This case highlights the critical importance of long follow up of ACC patients, due to late spine metastases. Diagnosis spinal metastasis of salivary carcinoma should be considered, to guide management, especially in clinical follow-up.
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Affiliation(s)
- M Riche
- Department of Neurosurgery, groupe hospitalier universitaire de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - B Mathon
- Department of Neurosurgery, groupe hospitalier universitaire de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne-University, UPMC, University Paris 06, 75013 Paris, France
| | - K Mokhtari
- Department of Neuro-pathology, La Pitié-Salpétrière Hospital, 75013 Paris, France; Sorbonne-University, UPMC, University Paris 06, 75013 Paris, France
| | - A Carpentier
- Department of Neurosurgery, groupe hospitalier universitaire de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne-University, UPMC, University Paris 06, 75013 Paris, France
| | - A Amelot
- Department of Neurosurgery, groupe hospitalier universitaire de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne-University, UPMC, University Paris 06, 75013 Paris, France.
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Lahmi L, Idbaih A, Rivin Del Campo E, Hoang-Xuan K, Mokhtari K, Sanson M, Canova CH, Carpentier A, Jacob J, Maingon P, Feuvret L. Whole brain radiotherapy with concurrent temozolomide in multifocal and/or multicentric newly diagnosed glioblastoma. J Clin Neurosci 2019; 68:39-44. [DOI: 10.1016/j.jocn.2019.07.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/12/2019] [Accepted: 07/17/2019] [Indexed: 11/15/2022]
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Idbaih A, Canney M, Bouchoux G, Desseaux C, Vignot A, Lafon C, Chapelon J, Delattre J, Belin L, Carpentier A. P05.05 Safety and feasibility of temporary blood-brain barrier disruption with the SonoCloud-1/3 implantable ultrasound device in recurrent glioblastoma. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
The blood-brain barrier (BBB) limits penetration of drug therapies to the brain and may account for the limited effectiveness of chemotherapies in patients with primary brain cancer. An implantable ultrasound (US) device, SonoCloud, was developed to temporarily disrupt the BBB in patients with recurrent glioblastoma (rGBM) prior to carboplatin chemotherapy administration to enhance brain drug concentrations. BBB disruption was investigated with a single emitter device, SonoCloud-1 (SC1) and a three-emitter device, SonoCloud-3 (SC3) in a safety and feasibility study in rGBM patients at the Hôpitaux Universitaires La Pitié Salpêtrière in Paris, France (NCT02253212).
MATERIAL AND METHODS
The SC1 implant consisted of a 1 MHz, 10-mm diameter ultrasound transducer encapsulated in a biocompatible housing while the SC3 consisted of (3) separate SC1 emitters implanted in a triangular pattern to disrupt the BBB over a 3x larger volume. Patients were implanted with the SonoCloud device during tumor debulking or in a dedicated surgical procedure. The devices were activated monthly by connecting the device to an external generator via a transdermal needle. Intravenous injection of SonoVue® microbubbles was performed with device activation to temporarily disrupt the BBB. Magnetic resonance imaging (MRI) was performed after sonications with gadolinium contrast to verify BBB disruption followed by carboplatin infusion at AUC4-6. Patients received treatments until disease progression.
RESULTS
Between 2014 and 2016, 21 patients were registered for the study and implanted with the SC1; 19 patients received at least one sonication. Six additional patients were implanted and received sonications with the SC3. A total of 89 US sessions were performed to disrupt the BBB - 65 with the SC1 and 24 with the SC3. Treatment-related adverse events observed were transient and manageable. No carboplatin-related neurotoxicity was observed. SC1 patients with no or poor BBB disruption (n=8) visible on MRI had a median progression-free survival (PFS) of 2.73 months, and a median overall survival (OS) of 8.64 months. SC1 patients with clear BBB disruption (n=11) had a median PFS of 4.11 months, and a median OS of 12.94 months. The SC3 device was as well-tolerated as the SC1 device, with SC3 patients receiving between 1–12 monthly sonications.
CONCLUSION
These results provide the first safety data on the effects of disrupting the BBB in rGBM patients prior to carboplatin chemotherapy using an implantable low intensity pulsed ultrasound device on enlarged areas of brain. This study has now been completed. A new safety study with a larger device, SonoCloud-9, that covers the tumor and surrounding infiltrative regions, has started in France in early 2019 (NCT03744026). Work supported by CarThera and APHP.
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Affiliation(s)
- A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - M Canney
- CarThera, Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - G Bouchoux
- CarThera, Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - C Desseaux
- CarThera, Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - A Vignot
- CarThera, Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - C Lafon
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France
| | - J Chapelon
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France
| | - J Delattre
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - L Belin
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, Département Biostatistique Santé Publique et Information Médicale, INSERM, CIC-1421, Paris, France
| | - A Carpentier
- Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires La Pitié-Salpêtrière, Service de Neurochirurgie and Sorbonne Université, UPMC Univ Paris 06, Paris, France
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URSU R, Doridam J, Chaugne E, Zannou H, Belin C, Cuzzubbo S, Sirven-Villaros L, Brichler S, Levy-Piedbois C, Carpentier A. P14.31 CMV reactivation in a cohort of newly-diagnosed glioblastoma patients treated with temozolomide chemoradiotherapy. A single center analysis. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
The Cytomegalovirus (CMV) is a ubiquitous herpes virus which infects 60–80 % of the population in Europe. Although the CMV usually remains latent, reactivation can occur in the context of an immunodepression, such as low CD4-lymphocyte levels in HIV patients. Glioblastoma (GBM) patients frequently show lymphopenia, which is related to both the immunosuppressive nature of the tumor and to the treatment with concomitant temozolomide (TMZ) and radiotherapy (RT). Surprisingly, the incidence of CMV reactivation in GBM patients has not been clearly studied so far. We report here our experience on CMV reactivation in a cohort of newly-diagnosed GBM patients, treated with RT and TMZ. We assessed the incidence of CMV reactivation in these patients and tried to identify risk factors for such reactivation.
MATERIAL AND METHODS
All consecutive patients with histologically confirmed malignant GBM recommended for temozolomide chemoradiotherapy in our institution from October 2013 to December 2015 were reviewed. In all patients, sex, age, Karnofsky performance status (KPS), lymphocyte level, serological CMV status and steroid dosages were recorded at the onset, and one month after completion of the concomitant radio-chemotherapy regimen. A CMV reactivation was defined by a detection of CMV DNA > 1000 copies/ml in the patient’s serum.
RESULTS
103 patients meeting the analysis criteria were reviewed. Within these 103 patients, 34 patients (33%) had initial negative serology for CMV, and none of them developed a seroconversion after treatment with concomitant RT + TMZ. Among patients with positive IgG (n=69), 16 patients (23%) developed a positive viremia at one point during treatment with concomitant RT + TMZ. Age (>60 years), lymphocyte count before RT (<1500/mm3) and use of steroids were correlated with CMV reactivation (p<0.05 in univariate analysis). A positive CMV viremia during RT+TMZ did not impact the progression free survival (PFS) but was associated with a shorter overall survival (OS) when compared to the others patients (median: 12 months vs 15 months; p=0.04). No clinical symptoms suggestive of CMV infection were reported.
CONCLUSION
In this single center series, we showed that CMV reactivation occurs in 23% of the GBM patients having a positive serology for CMV. Reactivation was more frequent in older patients, with low lymphocyte counts and treated with steroids. A positive viremia was not associated with poor PFS, a fact that does not support a promoting role of CMV in glioma oncogenesis, which has been sometimes suggested. Yet, the group of patients with CMV reactivation showed a shorter OS, which might be related to an older age and /or poorer clinical conditions in this group.
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Affiliation(s)
- R URSU
- Department of Neurology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - J Doridam
- Department of Neurology, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
- Université Paris 13, UFR de Santé, Médecine et Biologie Humaine, Bobigny, France
| | - E Chaugne
- Department of Neurology, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - H Zannou
- Department of Neurology, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - C Belin
- Department of Neurology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - S Cuzzubbo
- Department of Neurology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - L Sirven-Villaros
- Department of Neurology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - S Brichler
- Department of Microbiologie Clinique, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
- Université Paris 13, UFR de Santé, Médecine et Biologie Humaine, Bobigny, France
| | - C Levy-Piedbois
- Institut de Radiothérapie des Hautes Energies, Bobigny, France
| | - A Carpentier
- Department of Neurology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, Paris, France
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Maillet D, Narme P, Menard V, Larrieu M, Sahel K, Belin C, Carpentier A. P14.20 Anxiety level in a prospective cohort of newly diagnosed glioblastoma patients: preliminary results from the IMAGE study. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Quality of life (QoL) is an important area of clinical neuro-oncology, especially in glioblastoma patients. Although previous studies showed an association between QoL and anxiety, few studies have focused on the anxiety level throughout the disease progression (Bunevicius et al., 2017; Kilbride et al., 2007). Underestimating anxiety may have several consequences: a low treatment compliance, exacerbation of somatic symptoms or side effects of treatment, difficulties with understanding medical information and lower cooperation with the medical staff (Spencer, 2010). In the present study, we aimed assessing the current state of anxiety in a prospective cohort of patients treated for glioblastoma. We also investigated potential correlations with other clinical and psychological variables to better understand determinants of anxiety in this population.
MATERIAL AND METHODS
At the beginning of their cycle of temozolomide cure and after radio-chemotherapy, 30 patients with glioblastoma were included. Inclusion criteria were: Karnofsky index (IK) ≥ 70% and absence of cognitive disorder that could interfere with the completion of questionnaires. The characteristics of patients were as follows: mean age of 56.6 years ± 12.5 (70% were more than 50 years old); 20% were women; 50% had a university degree and IK of 87% ± 5. Anxiety level was assessed using the State-Trait Anxiety Inventory. This scale consists of 40 items on a self-report basis measuring how patients feel right now (“state”) and how they generally feel (“trait”). We also assessed (i) QoL using the Cancer Quality of Life Questionnaire 30 and the Brain Cancer Module-20; (ii) the presence of depressive symptoms using the Hospital Anxiety and Depression Scale; (iii) the self-esteem using the Rosenberg self-esteem scale and (iv) memory complains using the Prospective and Retrospective Memory Questionnaire.
RESULTS
The preliminary results showed that - at baseline - 21% of our sample reported high levels of anxiety. Correlation analyses showed that state anxiety was correlated with trait anxiety (rho=0.799, p< .001), QoL (rho=0.678, p< .001), level of self-esteem (rho=-0.514, p=0.004) and memory complains (rho=0.618, p< .001). Any correlation was found with age, education level, lesional lateralization or depressive symptoms. Women had higher state anxiety scores than men (t(27)=-2.4, p=0.02).
CONCLUSION
These preliminary results suggest that higher current state of anxiety is associated with lower QoL and lower self-esteem, regardless the presence of depressive symptoms, age, education level or lesional lateralization. Anxiety level at the follow-up (4 and 6 months after the baseline) and determinants of its progression will also be presented and might help health professionals to understand patients’ experience and better meet their needs.
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Affiliation(s)
- D Maillet
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
- Laboratoire PSITEC, EA 4072, UFR de Psychologie, Université de Lille, Villeneuve d’Ascq, France
| | - P Narme
- Laboratoire Mémoire Cerveau et Cognition (EA7536), Institut de Psychologie, Université de Paris, Boulogne-Billancourt, France
| | - V Menard
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
| | - M Larrieu
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
| | - K Sahel
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
| | - C Belin
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
| | - A Carpentier
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
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Mathon B, Clémenceau S, Carpentier A. Guidage élastographique dynamique peropératoire en chirurgie de l’épilepsie. Neurochirurgie 2019. [DOI: 10.1016/j.neuchi.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Richez U, Latremouille C, Netuka I, Roussel J, Saubamea B, Rossi E, Kindo M, Pya Y, Capel A, Jansen P, Carpentier A, Smadja D. Hemocompatibility of Bioprosthetic valve in bovine pericardium is based on fibrin formation and its endothelization. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schussler O, Lila N, Perneger T, Mootoosamy P, Grau J, Francois A, Smadja DM, Lecarpentier Y, Ruel M, Carpentier A. Recipients with blood group A associated with longer survival rates in cardiac valvular bioprostheses. EBioMedicine 2019; 42:54-63. [PMID: 30878598 PMCID: PMC6491382 DOI: 10.1016/j.ebiom.2019.02.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/12/2019] [Accepted: 02/20/2019] [Indexed: 01/02/2023] Open
Abstract
Background Pigs/bovines share with humans some of the antigens present on cardiac valves. Two such antigens are: the major xenogenic Ag, “Gal” present in all pig/bovine very close to human B-antigen of ABO-blood-group system; the minor Ag, pig histo-blood-group AH-antigen identical to human AH-antigen and present by some animals. We hypothesize that these antigens may modify the immunogenicity of the bioprosthesis and also its longevity. ABO distribution may vary between patients with low (<6 years) and high (≥15 years) bioprostheses longevity. Methods Single-centre registry study (Paris, France) including all degenerative porcine bioprostheses (mostly Carpentier-Edwards 2nd/3rd generation heart valves) explanted between 1985 and 1998 and some bovine bioprostheses. For period 1998–2014, all porcine bioprostheses with longevity ≥13 years (follow-up ≥29 years). Important predictive factors for bioprosthesis longevity: number, site of implantation, age were collected. Blood group and other variables were entered into an ordinal logistic regression analysis model predicting valve longevity, categorized as low (<6 years), medium (6–14.9 years), and high (≥15 years). Findings Longevity and ABO-blood group were obtained for 483 explanted porcine bioprostheses. Mean longevity was 10.2 ± 3.9 years [0–28] and significantly higher for A-patients than others (P = 0.009). Using multivariate analysis, group A was a strong predictive factor of longevity (OR 2.09; P < 0.001). For the 64 explanted bovine bioprosthesis with low/medium longevity, the association, with A-group was even more significant. Interpretation Patients of A-group but not B have a higher longevity of their bioprostheses. Future graft-host phenotyping and matching may give rise to a new generation of long-lasting bioprosthesis for implantation in humans, especially for the younger population. Fund None.
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Affiliation(s)
- O Schussler
- Division of Cardiovascular Surgery and Cardiovascular Research Laboratory, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - N Lila
- Laboratory of Biosurgical Research (Alain Carpentier Foundation), University Paris Descartes, Sorbonne Paris Cité, Paris F-75475, France
| | - T Perneger
- Department of Clinical Epidemiology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - P Mootoosamy
- Division of Cardiovascular Surgery and Cardiovascular Research Laboratory, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - J Grau
- Division of Cardiac Surgery and Research Laboratory, Department of Epidemiology, Ottawa Heart Institute, University of Ottawa Heart, Ottawa, Ontario, Canada
| | - A Francois
- Etablissement Français du Sang (EFS), Ile de France, Immuno-hematology Laboratory, Georges Pompidou Hospital, Paris, France
| | - D M Smadja
- Division of Cardiovascular Surgery and Cardiovascular Research Laboratory, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; AP-HP, Hôpital Européen Georges Pompidou, Hematology Department, Paris Descartes University, Sorbonne Paris Cite, Inserm UMR-S1140, Paris, France
| | - Y Lecarpentier
- Centre de Recherche Clinique, Grand Hôpital de l'Est Francilien (GHEF), Meaux, France
| | - M Ruel
- Division of Cardiac Surgery and Research Laboratory, Department of Epidemiology, Ottawa Heart Institute, University of Ottawa Heart, Ottawa, Ontario, Canada
| | - A Carpentier
- Laboratory of Biosurgical Research (Alain Carpentier Foundation), University Paris Descartes, Sorbonne Paris Cité, Paris F-75475, France; AP-HP, Hôpital Européen Georges Pompidou, Department of Cardiovascular Surgery, Paris, France
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Lemasson J, Baroudjian B, Doucet L, Vitaux H, Herms F, Carpentier A, Lebbé C, Gounant V, Hautefort C, Delyon J. Toxicité audiovestibulaire des immunothérapies : première série de 4 cas. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cuzzubbo S, Ursu R, Mazoyer J, Belin C, Baroudjian B, Lebbe C, Carpentier A. P05.76 Resuming treatment with immune checkpoint inhibitors in cancer patients who developed immune-related meningitis. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Cuzzubbo
- Service de Neurologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - R Ursu
- Service de Neurologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - J Mazoyer
- Service de Neurologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - C Belin
- Service de Neurologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - B Baroudjian
- APHP Dermatology and CIC Departments, INSERM U976, Université Paris Diderot, Sorbonne Paris Cité, Hôpital Saint Louis, Paris, France
| | - C Lebbe
- APHP Dermatology and CIC Departments, INSERM U976, Université Paris Diderot, Sorbonne Paris Cité, Hôpital Saint Louis, Paris, France
| | - A Carpentier
- Service de Neurologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
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URSU R, Thomas L, Psimaras D, Chinot O, Le Rhun E, Ricard D, Charissoux M, Cuzzubbo S, Sejalon F, Quillien V, Hoang-Xuan K, Ducray F, Portal J, Levy-Piedbois C, Vicaut E, Carpentier A. OS2.4 Angiotensin II Receptor Blockers, steroids and radiotherapy in glioblastoma - A randomized multicenter trial (ASTER Trial). An ANOCEF Study. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R URSU
- Hopital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - L Thomas
- Hospices Civils de Lyon, Groupe Hospitalier Est, Lyon, Lyon, France
| | - D Psimaras
- Hopital Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - O Chinot
- Department of Neuro-Oncology, CHU Timone, Marseille, France
| | - E Le Rhun
- Oscar Lambret Center, Neurology, Medical Oncology Department, Lille, France
| | - D Ricard
- Department of Neurology, Hôpital d’Instruction des Armées Percy, Service de Santé des Armées, Paris, France
| | - M Charissoux
- Department of Radiation Oncology, Institut du Cancer de Montpellier, Montpellier, France
| | - S Cuzzubbo
- Hopital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - F Sejalon
- Hopital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - V Quillien
- Centre de lutte contre le cancer Eugène Marquis, Rennes, France
| | - K Hoang-Xuan
- Hopital Pitié - Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - F Ducray
- Department of Neuro-Oncology, Hospices Civils de Lyon, Groupe Hospitalier Est, Lyon, France
| | - J Portal
- AP-HP, Unité de Recherche Clinique, Hôpital Fernand Widal, Paris, France
| | - C Levy-Piedbois
- Ramsey Générale de Santé, Institut de Radiothérapie des Hauts-Energies, Bobigny, France
| | - E Vicaut
- AP-HP, Unité de Recherche Clinique, Hôpital Fernand Widal, Paris, France
| | - A Carpentier
- Hopital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
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Vincent F, Rauch A, Loobuyck V, Nix C, Vincentelli A, Leprince P, Smadja D, Jansen P, Debry N, Moussa M, Carpentier A, Spillemaeker H, Lenting P, Susen S, Van Belle E. P2659Modulation of the acquired VWF defect by arterial pulsatility in continuous-flow mechanical circulatory devices. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Vincent
- Lille University Hospital, Interventional cardiology, Lille, France
| | - A Rauch
- Lille University Hospital, Hematology and transfusion, Lille, France
| | - V Loobuyck
- Lille University Hospital, Department of cardiac surgery, Lille, France
| | - C Nix
- Abiomed Gmbh, Aachen, Germany
| | - A Vincentelli
- Lille University Hospital, Department of cardiac surgery, Lille, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Department of cardiac surgery, Paris, France
| | - D Smadja
- Hospital Pitie-Salpetriere, Department of hematology, Paris, France
| | - P Jansen
- CARMATSAS, Velizy Villacoublay, France
| | - N Debry
- Lille University Hospital, Interventional cardiology, Lille, France
| | - M Moussa
- Lille University Hospital, Intensive care unit and anesthesia, Lille, France
| | | | - H Spillemaeker
- Lille University Hospital, Interventional cardiology, Lille, France
| | - P Lenting
- Inserm U1176, Le Kremlin Bicètre, France
| | - S Susen
- Lille University Hospital, Hematology and transfusion, Lille, France
| | - E Van Belle
- Lille University Hospital, Interventional cardiology, Lille, France
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Montero AS, Bielle F, Goldwirth L, Lalot A, Beccaria K, Pradat PF, Salachas F, Carpentier A. Ouverture transitoire de la barrière hémato-médullaire de lapin par ultrasons pulsés de faible intensité. Neurochirurgie 2018. [DOI: 10.1016/j.neuchi.2018.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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33
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Jouffroy R, Saade A, Ellouze S, Carpentier A, Michaloux M, Carli P, Vivien B. Prehospital triage of septic patients at the SAMU regulation: Comparison of qSOFA, MRST, MEWS and PRESEP scores. Am J Emerg Med 2018; 36:820-824. [DOI: 10.1016/j.ajem.2017.10.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 01/04/2023] Open
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34
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Fischer EC, Chachques J, Garcia A, Pichel R, Morales M, Carpentier A. Temporary Mechanical Circulatory Support for Severe Cardiac Failure: Experimental Study. Int J Artif Organs 2018. [DOI: 10.1177/039139889101400804] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - J.C. Chachques
- Department of Cardiovascular Surgery, Broussais Hospital, Paris - France
| | - A. Garcia
- Department of Cardiac Research, Favaloro Foundation, Buenos Aires - Argentina
| | - R.H. Pichel
- Department of Cardiac Research, Favaloro Foundation, Buenos Aires - Argentina
| | - M.C. Morales
- Department of Cardiac Research, Favaloro Foundation, Buenos Aires - Argentina
| | - A. Carpentier
- Department of Cardiovascular Surgery, Broussais Hospital, Paris - France
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Jouffroy R, Saade A, Carpentier A, Ellouze S, Philippe P, Idialisoa R, Carli P, Vivien B. Triage of Septic Patients Using qSOFA Criteria at the SAMU Regulation: A Retrospective Analysis. PREHOSP EMERG CARE 2017; 22:84-90. [DOI: 10.1080/10903127.2017.1347733] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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36
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Latrémouille C, Roussel J, Kindo M, Leprince P, Duveau D, Tchakgarian B, Perlès J, Jansen P, Carpentier A. Evaluation of a Virtual Implant Technique to Optimise Implantation of a Bioprosthetic Total Artificial Heart. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mesti T, Bouchemal N, Banissi C, Triba M, Marbeuf-Gueye C, Le Moyec L, Ocvirk J, Savarin P, Carpentier A. P08.41 The metabolic effect of bevacizumab in mutant IDH1 glioma cells assessed by NMR spectroscopy. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Mathon B, Navarro V, Carpentier A, Bielle F, Cornu P, Clemenceau S. Résultats et facteurs pronostiques de la chirurgie de l’épilepsie mésiotemporale associée à une sclérose hippocampique. Neurochirurgie 2017. [DOI: 10.1016/j.neuchi.2016.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Quillien V, Carpentier A, Gey A, Avril T, Tartour E, Sejalon F, Campillo-Gimenez B, Vauleon E. P06.13 A low baseline blood neutrophil count and a high percentage of Treg among leucocytes are associated with an increased overall survival of recurrent high-grade glioma patients treated with Bevacizumab. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Laurent C, Penzer F, Letroye B, Carpentier A, Baudry S, Duchateau J. Effect of a strength training method characterized by an incremental number of repetitions across sets and a very short rest interval. Sci Sports 2016. [DOI: 10.1016/j.scispo.2016.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Mammar H, Polivka M, Belkacemi Y, Lot G, Froelich S, Carpentier A, Clemenceau S, Gaillard S, Paquis P, Birtwisle-Peyrottes I, Burel-Vandenbos F, Mokhtari K, Kerrou K, Talbot J, Dendale R, Bondiau P, Pouyssegur J, Mazure N. Hypoxia and Metabolism Regulation in Chordomas: Correlation Between Biology and Clinical Features for Potential Targeted Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Poortmans J, Jeannaud F, Baudry S, Carpentier A. Changes in Kidney Functions during Middle-distance Triathlon in Male Athletes. Int J Sports Med 2015; 36:979-83. [DOI: 10.1055/s-0034-1398681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- J. Poortmans
- Faculty of Motor Sciences, Université libre de Bruxelles
| | - F. Jeannaud
- Faculty of Motor Sciences, Université libre de Bruxelles
| | - S. Baudry
- Faculty of Motor Sciences, Université libre de Bruxelles
| | - A. Carpentier
- Faculty of Motor Sciences, Université libre de Bruxelles
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Stragier S, Baudry S, Poortmans JR, Duchateau J, Carpentier A. Contribution of muscle hypertrophy to strength gain after training in elderly adults. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:2062-3. [DOI: 10.1080/10255842.2015.1070593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- S. Stragier
- Laboratory for Biometry and Exercise Nutrition, Université libre de Bruxelles, Bruxelles
- Laboratory of Applied Biology, Université libre de Bruxelles, Bruxelles, Belgium
| | - S. Baudry
- Laboratory of Applied Biology, Université libre de Bruxelles, Bruxelles, Belgium
| | - J. R. Poortmans
- Laboratory for Biometry and Exercise Nutrition, Université libre de Bruxelles, Bruxelles
| | - J. Duchateau
- Laboratory of Applied Biology, Université libre de Bruxelles, Bruxelles, Belgium
| | - A. Carpentier
- Laboratory for Biometry and Exercise Nutrition, Université libre de Bruxelles, Bruxelles
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Abstract
At the present time, glutaraldehyde-preserved porcine valves appear to be a reasonable alternative in valvular replacement. The expected durability limit of 8-15 years with the models currently commercially available is counterbalanced by a lower risk of acute complications; particularly thromboembolism. This allows the patient to be free from drugs and related problems. Our opinion is that the patient should take part in choosing between a bioprosthesis and a mechanical prosthesis. This critical choice will depend upon the relative importance for each individual of an improved quality of life with a bioprosthesis versus a lower risk of reoperation with a mechanical valve.
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Le Rhun É, Dhermain F, Noël G, Reyns N, Carpentier A, Mandonnet E, Taillibert S, Metellus P. [ANOCEF guidelines for the management of brain metastases]. Cancer Radiother 2015; 19:66-71. [PMID: 25666314 DOI: 10.1016/j.canrad.2014.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 11/26/2014] [Indexed: 12/30/2022]
Abstract
The incidence of brain metastases is increasing because of the use of new therapeutic agents, which allow an improvement of overall survival, but with only a poor penetration into the central nervous system brain barriers. The management of brain metastases has changed due to a better knowledge of immunohistochemical data and molecular biological data, the development of new surgical, radiotherapeutic approaches and improvement of systemic treatments. Most of the time, the prognosis is still limited to several months, nevertheless, prolonged survival may be now observed in some sub-groups of patients. The main prognostic factors include the type and subtype of the primitive, age, general status of the patient, number and location of brain metastases, extracerebral disease. The multidisciplinary discussion should take into account all of these parameters. We should notice also that treatments including surgery or radiotherapy may be proposed in a symptomatic goal in advanced phases of the disease underlying the multidisciplinary approach until late in the evolution of the disease. This article reports on the ANOCEF (French neuro-oncology association) guidelines. The management of brain metastases of breast cancers and lung cancers are discussed in the same chapter, while the management of melanoma brain metastases is reported in a separate chapter due to different responses to the brain radiotherapy.
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Affiliation(s)
- É Le Rhun
- Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Laboratoire Prism, université Lille 1, Inserm U1192, bâtiment SN3 1(er) étage, 59655 Villeneuve d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC) , 13273 Marseille cedex 09, France.
| | - F Dhermain
- Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC) , 13273 Marseille cedex 09, France; Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; Réunion de concertation pluridisciplinaire de neuro-oncologie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - G Noël
- Département universitaire de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France
| | - N Reyns
- Département de neurochirurgie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France
| | - A Carpentier
- Service de neurologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93009 Bobigny cedex, France
| | - E Mandonnet
- Département de neurochirurgie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France
| | - S Taillibert
- Département de neurologie 2, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Département de radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Université Pierre-et-Marie-Curie Paris VI, 4, place Jussieu, 75005 Paris, France
| | - P Metellus
- Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC) , 13273 Marseille cedex 09, France; Département de neurochirurgie, centre hospitalo-universitaire La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Centre de recherche en oncologie et oncopharmacologie (CRO2), faculté de médecine Timone, université Aix-Marseille, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France; Inserm U911, faculté de médecine Timone, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France
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Mathon B, Bédos-Ulvin L, Baulac M, Dupont S, Navarro V, Carpentier A, Cornu P, Clemenceau S. Évolution des idées et des techniques, et perspectives d’avenir en chirurgie de l’épilepsie. Rev Neurol (Paris) 2015; 171:141-56. [DOI: 10.1016/j.neurol.2014.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/10/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
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47
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Métellus P, Tallet A, Dhermain F, Reyns N, Carpentier A, Spano JP, Azria D, Noël G, Barlési F, Taillibert S, Le Rhun É. Stratégie globale de prise en charge des métastases cérébrales : une approche multidisciplinaire. Cancer Radiother 2015; 19:61-5. [DOI: 10.1016/j.canrad.2014.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 11/26/2014] [Indexed: 11/30/2022]
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48
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Zanello M, Peyre M, Mokhtari K, Boch A, Capelle L, Carpentier A, Clemenceau S, Karachi C, Navarro S, Nouet A, Reina V, Sanson M, Cornu P, Kalamarides M. Méningiomes multi-récidivants : établissement de critères de réponse thérapeutiques après analyse des cinétiques de croissance et des types de récidive. Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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49
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Latremouille C, Duveau D, Cholley B, Zilberstein L, Bruneval P, Perles J, Jansen P, Carpentier A. 131 * CHRONIC ANIMAL EXPERIENCE WITH THE CARMAT BIOPROSTHETIC ARTIFICIAL HEART. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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50
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Chauvet D, Carpentier A, Cornu P, Hans S. Transoral Robot-Assisted Approach of the Sella: Preliminary Feasibility on Cadavers. J Neurol Surg B Skull Base 2014. [DOI: 10.1055/s-0034-1383951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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