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François E, Magné N, Boulahssass R, Ronchin P, Huguenet V, De Lavigerie B, Nouhaud E, Cattenoz C, Martel-Lafay I, Terret C, Artru P, Clavere P, Tchalla A, Vendrely V, Duc S, Boige V, De Sousa Carvalho N, Gal J, De Bari B. Short course radiotherapy versus radiochemotherapy for locally advanced rectal cancers in the elderly (UNICANCER PRODIGE 42/GERICO 12 study): Quality of life and comprehensive geriatric assessment. Radiother Oncol 2024; 193:110144. [PMID: 38341097 DOI: 10.1016/j.radonc.2024.110144] [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: 12/04/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND The results of the PRODIGE 42/GERICO 12 study showed that short course radiotherapy had a better tolerance profile than radiochemotherapy, with comparable oncological results. We have included Quality of Life analyses and oncogeriatric evaluations in this study. PATIENTS AND METHODS In all, 101 patients ≥75 years of age with resectable T3-T4 rectal adenocarcinoma less than 12 cm from the anal margin received short course radiotherapy (5X5 Gy in one week) or radiochemotherapy (50 Gy, 2 y/f and capecitabine 800 mg/m2, 5 days/week) with delayed surgery (7 weeks ± 1) in both groups. The Quality of Life analyses (EORTC QLQ C-30 et ELD14) were conducted upon inclusion, pre-operatively, at 3, 6 and 12 months post-op, together with the oncogeriatric evaluations, including an evaluation of the IADL and ADL scores, walking speed, GDS15, MMSE, MNA. RESULTS We did not highlight any statistical difference for the global EORTC QLQ-C30 score; several factors are statistically in favor of the short course radiotherapy group at 3 months post-op (cognitive functions, fatigue, appetite). In the case of the ELD14 score, the disease burden is perceived as more negative at 3, 6 and 12 months postop in the radiochemotherapy group. The IADL score deteriorated in 44.8 % of the radiochemotherapy group and 14.8 % of the radiotherapy group (p = 0.032); similarly, the GDS15 depression score was better preserved in the short course radiotherapy group (p = 0.05). An analysis of the other scores: ADL, walking speed, MNA, MMSE did not highlight any statistical difference. CONCLUSION Short course radiotherapy achieves better results in terms of Quality of Life and preservation of autonomy in patients aged ≥75 treated for locally advanced rectal cancer.
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Affiliation(s)
| | - Nicolas Magné
- Institut de Cancérologie Lucien-Neuwrith, Saint-Priest-en-Jarez, France
| | - Rabia Boulahssass
- Centre Antoine-Lacassagne, Nice, France; Centre Azuréen de Cancérologie, Mougins, France
| | | | - Virginie Huguenet
- Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France
| | | | | | | | | | | | | | - Pierre Clavere
- Centre Hospitalier Régional Universitaire Dupuytren 1, Limoges, France
| | - Achille Tchalla
- Centre Hospitalier Régional Universitaire Dupuytren 1, Limoges, France
| | | | - Sophie Duc
- Centre Hospitalier Régional Universitaire Bordeaux, Bordeaux, France
| | | | | | | | - Berardino De Bari
- Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France
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Pascual TNB, Paez D, Iagaru A, Gnanasegaran G, Lee ST, Sathekge M, Buatti JM, Giammarile F, Al-Ibraheem A, Pardo MA, Baum RP, De Bari B, Ben-Haim S, Blay JY, Brink A, Estrada-Lobato E, Fanti S, Golubic AT, Hatazawa J, Israel O, Kiess A, Knoll P, Louw L, Mariani G, Mirzaei S, Orellana P, Prior JO, Urbain JL, Vichare S, Vinjamuri S, Virgolini I, Scott AM. Guiding principles on the education and practice of theranostics. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06657-2. [PMID: 38453729 DOI: 10.1007/s00259-024-06657-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The recent development and approval of new diagnostic imaging and therapy approaches in the field of theranostics have revolutionised nuclear medicine practice. To ensure the provision of these new imaging and therapy approaches in a safe and high-quality manner, training of nuclear medicine physicians and qualified specialists is paramount. This is required for trainees who are learning theranostics practice, and for ensuring minimum standards for knowledge and competency in existing practising specialists. METHODS To address the need for a training curriculum in theranostics that would be utilised at a global level, a Consultancy Meeting was held at the IAEA in May 2023, with participation by experts in radiopharmaceutical therapy and theranostics including representatives of major international organisations relevant to theranostics practice. RESULTS Through extensive discussions and review of existing curriculum and guidelines, a harmonised training program for theranostics was developed, which aims to ensure safe and high quality theranostics practice in all countries. CONCLUSION The guiding principles for theranostics training outlined in this paper have immediate relevance for the safe and effective practice of theranostics.
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Affiliation(s)
| | - Diana Paez
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Andrei Iagaru
- Division of Nuclear Medicine and Molecular Imaging, Stanford University Medical Center, Stanford, CA, USA
| | - Gopi Gnanasegaran
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Sze Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
- School of Health and Biomedicine, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Mike Sathekge
- Steve Biko Academic Hospital, Pretoria, South Africa
- University of Pretoria, Pretoria, South Africa
| | - John M Buatti
- Department of Radiation Oncology, Holden Comprehensive Cancer Center, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Francesco Giammarile
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- School of Medicine, University of Jordan, Amman, Jordan
| | - Manuela Arevalo Pardo
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Richard P Baum
- Center for Advanced Radiomolecular Precision Oncology, Curanosticum Wiesbaden, FrankfurtWiesbaden, Germany
| | - Berardino De Bari
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland
| | - Simona Ben-Haim
- Department of Biophysics and Nuclear Medicine, Hadassah University Hospital, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- University College London, London, UK
| | - Jean-Yves Blay
- Department of Medicine, Centre Leon Berard, Lyon, France
- University Claude Bernard Lyon, Lyon, France
| | - Anita Brink
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Enrique Estrada-Lobato
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Stefano Fanti
- Nuclear Medicine Division, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Policlinico S.Orsola, Bologna, Italy
| | - Anja Tea Golubic
- Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ora Israel
- B. Rappaport School of Medicine, Israel Institute of Technology-Technion, Haifa, Israel
| | - Ana Kiess
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Knoll
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Lizette Louw
- Center of Molecular Imaging and Theranostics, Johannesburg, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | - Giuliano Mariani
- Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Siroos Mirzaei
- Department of Nuclear Medicine With PET-Centre, Clinic Ottakring, Vienna, Austria
| | | | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Shrikant Vichare
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Sobhan Vinjamuri
- Nuclear Medicine Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Irene Virgolini
- Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.
- School of Cancer Medicine, La Trobe University, Melbourne, Australia.
- Faculty of Medicine, University of Melbourne, Melbourne, Australia.
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De Bari B, Guibert G, Slimani S, Bashar Y, Risse T, Guisolan N, Trouillot J, Abel J, Weber P. Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion. Curr Oncol 2024; 31:962-974. [PMID: 38392066 PMCID: PMC10887766 DOI: 10.3390/curroncol31020072] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Stereotactic Body Radiotherapy (SBRT) is as a standard treatment for prostate cancer (PCa). Tight margins and high dose gradients are needed, and the precise localization of the target is mandatory. Our retrospective study reports our experience regarding the evaluation of intrafraction prostate motion during LINAC-based SBRT evaluated with a novel electromagnetic (EM) tracking device. This device consists of an integrated Foley catheter with a transmitter connected to a receiver placed on the treatment table. METHODS We analyzed 31 patients who received LINAC-based SBRT using flattening filter-free (FFF) volumetric modulated arc therapy (VMAT). The patients were scheduled to be treated for primary (n = 27) or an intraprostatic recurrent PCa (n = 4). A simulation CT scan was conducted while the patients had a filled bladder (100-150 cc) and an empty rectum, and an EM tracking device was used. The same rectal and bladder conditions were employed during the treatment. The patients received 36.25 Gy delivered over five consecutive fractions on the whole prostate and 40 Gy on the nodule(s) visible via MRI, both delivered with a Simultaneous Integrated Boost approach. The CTV-to-PTV margin was 2 mm for both the identified treatment volumes. Patient positioning was verified with XVI ConeBeam-CT (CBCT) matching before each fraction. When the signals exceeded a 2 mm threshold in any of the three spatial directions, the treatment was manually interrupted. A new XVI CBCT was performed if this offset lasted >20 s. RESULTS We analyzed data about 155 fractions. The median and mean treatment times, calculated per fraction, were 10 m31 s and 12 m44 s (range: 6 m36 s-65 m28 s), and 95% of the fractions were delivered with a maximum time of 27 m48 s. During treatment delivery, the mean and median number of XVI CBCT operations realized during the treatment were 2 and 1 (range: 0-11). During the treatment, the prostate was outside the CTV-to-PTV margin (2 mm), thus necessitating the stoppage of the delivery +/- a reacquisition of the XVI CBCT for 11.2%, 8.9%, and 3.9% of the delivery time in the vertical, longitudinal, and lateral direction, respectively. CONCLUSIONS We easily integrated an EM-transmitter-based gating for prostate LINAC-based SBRT into our normal daily workflow. Using this system, a 2 mm CTV-to-PTV margin could be safely applied. A small number of fractions showed a motion exceeding the predefined 2 mm threshold, which would have otherwise gone undetected without intrafraction motion management.
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Affiliation(s)
- Berardino De Bari
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland (N.G.)
| | - Geoffroy Guibert
- Medical Physics Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland
| | - Sabrine Slimani
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland (N.G.)
| | - Yanes Bashar
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland (N.G.)
| | - Terence Risse
- Medical Physics Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland
| | - Nicole Guisolan
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland (N.G.)
| | - Juliane Trouillot
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland (N.G.)
| | - Jonathan Abel
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland (N.G.)
| | - Patrick Weber
- Medical Physics Department, Réseau Hospitalier Neuchâtelois, CH-2300 La Chaux-de-Fond, Switzerland
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Mathier E, Althaus A, Zwahlen D, Lustenberger J, Zamboglou C, De Bari B, Aebersold DM, Guckenberger M, Zilli T, Shelan M. HypoFocal SRT Trial: Ultra-hypofractionated focal salvage radiotherapy for isolated prostate bed recurrence after radical prostatectomy; single-arm phase II study; clinical trial protocol. BMJ Open 2024; 14:e075846. [PMID: 38296279 PMCID: PMC10828884 DOI: 10.1136/bmjopen-2023-075846] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Despite radical prostatectomy (RP) and radiotherapy (RT) being established treatments for localised prostate cancer, a significant number of patients experience recurrent disease. While conventionally fractionated RT is still being used as a standard treatment in the postoperative setting, ultra-hypofractionated RT has emerged as a viable option with encouraging results in patients with localised disease in the primary setting. In addition, recent technological advancements in RT delivery and precise definition of isolated macroscopic recurrence within the prostate bed using prostate-specific membrane antigen-positron emission tomography (PSMA-PET) and multiparametric MRI (mpMRI) allow the exploration of ultra-hypofractionated schedules in the salvage setting using five fractions. METHODS AND ANALYSIS In this single-arm prospective phase II multicentre trial, 36 patients with node-negative prostate adenocarcinoma treated with RP at least 6 months before trial registration, tumour stage pT2a-3b, R0-1, pN0 or cN0 according to the UICC TNM 2009 and evidence of measurable local recurrence within the prostate bed detected by PSMA PET/CT and mpMRI within the last 3 months, will be included. The patients will undergo focal ultra-hypofractionated salvage RT with 34 Gy in five fractions every other day to the site of local recurrence in combination with 6 months of androgen deprivation therapy. The primary outcome of this study is biochemical relapse-free survival at 2 years. Secondary outcomes include acute side effects (until 90 days after the end of RT) of grade 3 or higher based on Common Terminology Criteria for Adverse Events V.5, progression-free survival, metastasis-free survival, late side effects and the quality of life (based on European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, QLQ-PR25). ETHICS AND DISSEMINATION The study has received ethical approval from the Ethics Commission of the Canton of Bern (KEK-BE 2022-01026). Academic dissemination will occur through publications and conference presentations. TRIAL REGISTRATION NUMBER NCT05746806.
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Affiliation(s)
- Etienne Mathier
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Althaus
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Jens Lustenberger
- Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Berardino De Bari
- Department of Radiation Oncology, Réseau hospitalier neuchâtelois, Neuchatel, Switzerland
| | - Daniel M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Thomas Zilli
- Department of Radiation Oncology, Oncological Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
- Università della Svizzera italiana, Lugano, Switzerland
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Deantonio L, De Bari B, Franco P. Editorial: Ano-rectal and gastro-esophageal cancer: diving into diagnostic and therapeutic imaging modalities for radiotherapy. Front Oncol 2023; 13:1276334. [PMID: 37719016 PMCID: PMC10501854 DOI: 10.3389/fonc.2023.1276334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 09/19/2023] Open
Affiliation(s)
- Letizia Deantonio
- Radiotherapy Clinic, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland
| | - Berardino De Bari
- Department of Radiation Oncology, Réseal Hospitalier Neuchâtelois, La-Chaux-de Fonds, Switzerland
| | - Pierfrancesco Franco
- Radiation Oncology Department, Azienda Ospedaliera Universitaria (AOU)‘Maggiore della Carità’, Novara, Italy
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
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Nicosia L, Franceschini D, Perrone-Congedi F, Molinari A, Gerardi MA, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo RM, Bruni A, Cappelli A, D'Angelo E, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti FM, Lunardi G, Valdagni R, Fazio I, Scarzello G, Vavassori V, Maranzano E, Maria Magrini S, Arcangeli S, Gambacorta MA, Valentini V, Paiar F, Ramella S, Di Muzio NG, Loi M, Jereczek-Fossa BA, Casamassima F, Osti MF, Scorsetti M, Alongi F. A predictive model of polymetastatic disease from a multicenter large retrospectIve database on colorectal lung metastases treated with stereotactic ablative radiotherapy: The RED LaIT-SABR study. Clin Transl Radiat Oncol 2023; 39:100568. [PMID: 36935855 PMCID: PMC10014322 DOI: 10.1016/j.ctro.2022.100568] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/02/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Aim Stereotactic ablative radiotherapy (SABR) showed increasing survival in oligometastatic patients. Few studies actually depicted oligometastatic disease (OMD) evolution and which patient will remain disease-free and which will rapidly develop a polymetastatic disease (PMD) after SABR. Therefore, apart from the number of active metastases, there are no clues on which proven factor should be considered for prescribing local treatment in OMD. The study aims to identify predictive factors of polymetastatic evolution in lung oligometastatic colorectal cancer patients. Methods This international Ethical Committee approved trial (Prot. Negrar 2019-ZT) involved 23 Centers and 450 lung oligometastatic patients. Primary end-point was time to the polymetastatic conversion (tPMC). Additionally, oligometastases number and cumulative gross tumor volume (cumGTV) were used as combined predictive factors of tPMC. Oligometastases number was stratified as 1, 2-3, and 4-5; cumGTV was dichotomized to the value of 10 cc. Results The median tPMC in the overall population was 26 months. Population was classified in the following tPMC risk classes: low-risk (1-3 oligometastases and cumGTV ≤ 10 cc) with median tPMC of 35.1 months; intermediate-risk (1-3 oligometastases and cumGTV > 10 cc), with median tPMC of 13.9 months, and high-risk (4-5 oligometastases, any cumGTV) with median tPMC of 9.4 months (p = 0.000). Conclusion The present study identified predictive factors of polymetastatic evolution after SABR in lung oligometastatic colorectal cancer. The results demonstrated that the sole metastases number is not sufficient to define the OMD since patients defined oligometastatic from a numerical point of view might rapidly progress to PMD when the cumulative tumor volume is high. A tailored approach in SABR prescription should be pursued considering the expected disease evolution after SABR, with the aim to avoid unnecessary treatment and toxicity in those at high risk of polymetastatic spread, and maximize local treatment in those with a favorable disease evolution.
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Affiliation(s)
- Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
- Corresponding author at: Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034 Verona, Negrar, Italy.
| | - Davide Franceschini
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Francesca Perrone-Congedi
- Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | | | | | - Michele Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
| | - Rosario Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
| | - Marco Perna
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Vieri Scotti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Andrei Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Aurelia Iurato
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128 Rome, Italy
| | - Francesco Pasqualetti
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
- Department of Oncology, University of Oxford, Oxford, UK
| | - Giovanni Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Alessio Bruni
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Anna Cappelli
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Elisa D'Angelo
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia – Brescia University, Brescia, Italy
| | | | | | - Berardino De Bari
- Radiation Oncology Department, Neuchâtel Hospital Network, la Chaux-de-Fonds, Switzerland
| | - Matteo Sepulcri
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Dario Aiello
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | | | - Claudia Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marzia Franceschini
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Gianluigi Lunardi
- Clinical Analysis Laboratory and Transfusional Medicine, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Riccardo Valdagni
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| | - Ivan Fazio
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | - Giovanni Scarzello
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | | | - Stefano Maria Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia – Brescia University, Brescia, Italy
| | - Stefano Arcangeli
- Department of Radiation Oncology, University of Milan Bicocca, Italy
| | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabiola Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
| | - Sara Ramella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128 Rome, Italy
| | - Nadia Gisella Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Mauro Loi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| | | | - Mattia Falchetto Osti
- Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Marta Scorsetti
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele – Milan, Italy
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
- University of Brescia, Brescia, Italy
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François E, De Bari B, Ronchin P, Nouhaud E, Martel-Lafay I, Artru P, Clavere P, Vendrely V, Boige V, Gargot D, Lemanski C, De Sousa Carvalho N, Gal J, Pernot M, Magné N. Comparison of short course radiotherapy with chemoradiotherapy for locally advanced rectal cancers in the elderly: A multicentre, randomised, non-blinded, phase 3 trial. Eur J Cancer 2023; 180:62-70. [PMID: 36535196 DOI: 10.1016/j.ejca.2022.11.020] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/08/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is no specific guideline for the treatment of locally advanced rectal cancers in the elderly. Here we compared R0 resection rate and degradation of autonomy based on the instrumental activities of daily living score between neoadjuvant, short course radiotherapy and chemoradiotherapy in this specific population. PATIENTS AND METHODS Patients ≥75 years with resectable T3-T4 rectal adenocarcinoma within 12 cm of the anal verge or T2 of the very low rectum were randomised between short course radiotherapy (5 × 5 Gy in one week) and chemoradiotherapy (50 Gy, 2 Gy/f, 5 weeks with capecitabine: 800 mg/m2 twice daily, 5 days per week), with delayed surgery 7 ± 1 weeks for the two arms. RESULTS One hundred and three eligible patients were enrolled between January 2016 and December 2019 when the trial was closed due to poor accrual. The R0 resection rate (first co-primary objective) was 84.3%; confidence interval 95% [73.26-94.18] in the short course group and 88%; confidence interval 95% [77.77-96.60] in the chemoradiotherapy group (non-inferiority p = 0.28). The deterioration of the instrumental activities of daily living score was not different during the pre-operative phase, it was significantly more deteriorated in the chemoradiotherapy group at 3 months post-operative (44.8% versus 14.8%; p = 0.032) but was not different at 12 months post-operative (second co-primary objective). During pre-operative phase, 9.8% of patients in short course group and 22% of patients in chemoradiotherapy group presented a serious adverse event, but we observed no difference during the post-operative phase between the two groups. CONCLUSION Although the main objectives of the study were not achieved, the short course radiotherapy followed by delayed surgery could represent a preferred treatment option in patients ≥75 years with locally advanced rectal cancer; a new study must be performed to confirm the improvement in overall and specific survival results.
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Affiliation(s)
| | - Berardino De Bari
- Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France
| | | | | | | | | | - Pierre Clavere
- Centre Hospitalier Régional Universitaire Dupuytren 1, Limoges, France
| | | | | | | | - Claire Lemanski
- Institut de Cancérologie de Montpellier, Montpellier, France
| | | | | | - Mandy Pernot
- Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France
| | - Nicolas Magné
- Institut de Cancérologie Lucien-Neuwrith, Saint-Priest-en-Jarez, France
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8
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Kim S, De Bari B, Spehner L. Editorial: New understandings and research in anal squamous cell carcinoma. Front Oncol 2023; 12:1131678. [PMID: 36727066 PMCID: PMC9886058 DOI: 10.3389/fonc.2022.1131678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- Stefano Kim
- Clinical Investigational Center, INSERM CIC-1431, Centre Hospitalier Universitaire de Besançon, Besancon, France,Department of Oncology, Sanatorio Allende, Cordoba, Argentina,*Correspondence: Stefano Kim,
| | - Berardino De Bari
- Service de radio-oncologie, Réseau Hospitalier Neuchâtelois (RHNE), La Chaux-de-Fonds, Switzerland
| | - Laurie Spehner
- INSERM U1098 Interactions Hôte-Greffon-Tumeur & Ingénierie Cellulaire et Génique, Besançon, France
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9
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De Bari B, Lefevre L, Henriques J, Gatta R, Falcoz A, Mathieu P, Borg C, Dinapoli N, Boulahdour H, Boldrini L, Valentini V, Vernerey D. Could 18-FDG PET-CT Radiomic Features Predict the Locoregional Progression-Free Survival in Inoperable or Unresectable Oesophageal Cancer? Cancers (Basel) 2022; 14:cancers14164043. [PMID: 36011035 PMCID: PMC9406583 DOI: 10.3390/cancers14164043] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background: We evaluated the value of pre-treatment positron-emission tomography−computed tomography (PET-CT)-based radiomic features in predicting the locoregional progression-free survival (LR-PFS) of patients with inoperable or unresectable oesophageal cancer. Material and Methods: Forty-six patients were included and 230 radiomic parameters were extracted. After a principal component analysis (PCA), we identified the more robust radiomic parameters, and we used them to develop a heatmap. Finally, we correlated these radiomic features with LR-PFS. Results: The median follow-up time was 17 months. The two-year LR-PFS and PFS rates were 35.9% (95% CI: 18.9−53.3) and 21.6% (95%CI: 10.0−36.2), respectively. After the correlation analysis, we identified 55 radiomic parameters that were included in the heatmap. According to the results of the hierarchical clustering, we identified two groups of patients presenting statistically different median LR-PFSs (22.8 months vs. 9.9 months; HR = 2.64; 95% CI 0.97−7.15; p = 0.0573). We also identified two radiomic features (“F_rlm_rl_entr_per” and “F_rlm_2_5D_rl_entr”) significantly associated with LR-PFS. Patients expressing a “F_rlm_2_5D_rl_entr” of <3.3 had a better median LR- PFS (29.4 months vs. 8.2 months; p = 0.0343). Patients presenting a “F_rlm_rl_entr_per” of <4.7 had a better median LR-PFS (50.4 months vs. 9.9 months; p = 0.0132). Conclusion: We identified two radiomic signatures associated with a lower risk of locoregional relapse after CRT.
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Affiliation(s)
- Berardino De Bari
- Radiation Oncology Department, Neuchâtel Hospital Network, CH-2300 La Chaux-de-Fonds, Switzerland
- Radiation Oncology Department, University Hospital of Besançon, F-25000 Besancon, France
- Correspondence: ; Tel.: +41-32-967-21-46
| | - Loriane Lefevre
- Radiation Oncology Department, University Hospital of Besançon, F-25000 Besancon, France
- Radiation Oncology Department, Centre Eugène Marquis, F-35042 Rennes, France
| | - Julie Henriques
- INSERM, Établissement Français du Sang Bourgogne Franche-Comté, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Bourgogne Franche-Comté University, F-25000 Besancon, France
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000 Besancon, France
| | - Roberto Gatta
- Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, I-25123 Brescia, Italy
| | - Antoine Falcoz
- INSERM, Établissement Français du Sang Bourgogne Franche-Comté, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Bourgogne Franche-Comté University, F-25000 Besancon, France
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000 Besancon, France
| | - Pierre Mathieu
- Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, F-25000 Besancon, France
| | - Christophe Borg
- INSERM, Établissement Français du Sang Bourgogne Franche-Comté, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Bourgogne Franche-Comté University, F-25000 Besancon, France
- Department of Medical Oncology, University Hospital of Besançon, F-25000 Besancon, France
| | - Nicola Dinapoli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, I-00100 Rome, Italy
| | - Hatem Boulahdour
- EA 4662-“Nanomedicine Lab, Imagery and Therapeutics”, Nuclear Medicine Department, University Hospital of Besançon, F-25000 Besancon, France
| | - Luca Boldrini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, I-00100 Rome, Italy
| | - Vincenzo Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, I-00100 Rome, Italy
| | - Dewi Vernerey
- INSERM, Établissement Français du Sang Bourgogne Franche-Comté, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Bourgogne Franche-Comté University, F-25000 Besancon, France
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000 Besancon, France
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10
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Grave A, Blanc J, De Bari B, Pernot M, Boulbair F, Noirclerc M, Vienot A, Kim S, Borg C, Boustani J. Long-Term Disease Control After locoregional Pelvic Chemoradiation in Patients with Advanced Anal Squamous Cell Carcinoma. Front Oncol 2022; 12:918271. [PMID: 35936677 PMCID: PMC9354951 DOI: 10.3389/fonc.2022.918271] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The incidence of metastatic squamous cell carcinoma of the anus (SCCA) is increasing. Even if systemic docetaxel, cisplatin, and 5-Fluorouracil (DCF) provide a high rate of long-term remission, the role of pelvic chemoradiation (CRT) is unknown in this setting. We reported the safety and efficacy of local CRT in patients with synchronous metastatic SCCA who achieved objective response after upfront DCF. Methods Patients included in Epitopes HPV01 or Epitopes HPV02 or SCARCE trials and treated with DCF followed by pelvic CRT were included. Concurrent chemotherapy was based on mitomycin (MMC) (10 mg/m² for two cycles) and fluoropyrimidine (capecitabine 825 mg/m² twice a day at each RT treatment day or two cycles of intra-venous 5FU 1000 mg/m² from day 1 to day 4). Primary endpoints were safety, local complete response rate, and local progression-free survival (PFS). Secondary endpoints were PFS, overall survival (OS), and metastasis-free survival (MFS). Results From 2013 to 2018, 16 patients received DCF followed by a complementary pelvic CRT for advanced SCCA. Median follow-up was 42 months [range, 11-71]. All patients received the complete radiation dose. Compliance to concurrent CT was poor. Overall, 13/15 of the patients (87%) had at least one grade 1-2 acute toxicity and 11/15 of the patients (73%) had at least one grade 3-4 toxicity. There was no treatment-related death. The most frequent grade 3-4 adverse effects were neutropenia (36%), dermatitis (40%), and anitis (47%). Eleven patients (73%) had at least one chronic grade 1 or 2 toxicity. One patient had a grade 4 chronic rectitis (7%). Complete local response rate was 81% at first evaluation and 62.5% at the end of the follow-up. Median local PFS was not reached and the 3-year local PFS was 77% (95%CI 76.8-77). Conclusions In patients with metastatic SCCA who had a significant objective response after upfront DCF, local CRT was feasible with high complete local response rate. The good local control rate, despite interruptions due to toxicities and low CT compliance, underline the role of pelvic RT. The high rate of toxicity prompts the need to adapt CRT regimen in the metastatic setting.
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Affiliation(s)
- Athénaïs Grave
- Department of Radiation Oncology, University Hospital of Besançon, Besançon, France
| | - Julie Blanc
- Department of Statistics, Centre Georges François Leclerc, Dijon, France
| | - Berardino De Bari
- Department of Radiation Oncology, Réseau hospitalier neuchâtelois, La Chaux-de-Fonds, Switzerland
| | - Mandy Pernot
- Department of Radiation Oncology, University Hospital of Besançon, Besançon, France
| | - Fatiha Boulbair
- Department of Radiation Oncology, Nord Franche-Comté Hospital, Montbéliard, France
| | - Monique Noirclerc
- Department of Radiation Oncology, Hasenrain Hospital, Mulhouse, France
| | - Angélique Vienot
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Stefano Kim
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Christophe Borg
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Jihane Boustani
- Department of Radiation Oncology, University Hospital of Besançon, Besançon, France
- *Correspondence: Jihane Boustani,
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11
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Mauri D, Kamposioras K, Tsali L, Dambrosio M, De Bari B, Hindi N, Salembier C, Nixon J, Dimitrios T, Alongi F, Hameed H, Valachis A, Papadimitriou K, Corradini S, Popovic L, Kopecky J, Rodriguez A, Antunac K, Yi J, Lovey J, Strojan P, Saraireh H, Røtterud R, Chojnacka M, Olalla SC, Chilingirova N, De Mello RA, Araujo Amaral G, Arbabi F, Vidra R, Rapushi E, Takeuchi D, Christopoulos C, Ivanova I, Djan I, Petricevic B, Cellini F, Mihaylova I, Dedic Plavetic N, Grašič Kuhar C, Takeuchi E, Kountourakis P, Ntellas P, Gazouli I, Gkoura S, Yuce S, ER Ö, Yasmina C, Kumaran G, Spahiu O, Yusuf A, Gono P, Apostolidis K, Tolia M. COVID-19 Vaccinations: Summary Guidance for Cancer Patients in 28 Languages: Breaking Barriers to Cancer Patient Information. Rev Recent Clin Trials 2022; 17:11-14. [PMID: 34967300 PMCID: PMC9241076 DOI: 10.2174/1574887116666211028145848] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/16/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Covid-19 vaccination has started in the majority of the countries at the global level. Cancer patients are at high risk for infection, serious illness, and death from COVID-19 and need vaccination guidance and support. Guidance availability in the English language only is a major limit for recommendations' delivery and their application in the world's population and generates information inequalities across the different populations. METHODS Most of the available COVID-19 vaccination guidance for cancer patients was screened and scrutinized by the European Cancer Patients Coalition (ECPC) and an international oncology panel of 52 physicians from 33 countries. RESULTS A summary guidance was developed and provided in 28 languages in order to reach more than 70 percent of the global population. CONCLUSION Language barrier and e-guidance availability in the native language are the most important barriers when communicating with patients. E-guidance availability in various native languages should be considered a major priority by international medical and health organizations that are communicating with patients at the global level.
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Affiliation(s)
- Davide Mauri
- Address correspondence to this author at the Department Medical Oncology, EMEKEN, University Hospital of Ioannina, Ioannina, Greece; Tel: +302651099394; E-mail:
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12
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Valentini V, Cellini F, Riddell A, Brunner TB, Roeder F, Giuliante F, Alfieri S, Manfredi R, Ardito F, Fiorillo C, Porziella V, Morganti AG, Haustermans K, Margaritora S, De Bari B, Matzinger O, Gkika E, Belka C, Allum W, Verheij M. ESTRO ACROP guidelines for the delineation of lymph nodal areas in upper gastrointestinal malignancies. Radiother Oncol 2021; 164:92-97. [PMID: 34547352 DOI: 10.1016/j.radonc.2021.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/21/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
The European SocieTy for Radiation and Oncology -Advisory Committee on Radiation Oncology Practice (ESTRO-ACROP) endorsed a project to provide guidelines (GL) for the identification and delineation of clinically negative lymph-nodal stations (LNs) involved in upper gastrointestinal clinical scenarios. The presented GL is focused on preoperative (or definitive) setting. The project aim is to improve the consistency of clinical target volume (CTV) delineation by providing: a description of the anatomical boundaries of the LNs; a radiological computed tomography-based atlas depicting the LNs areas; a free, web-based, interactive example case for independent training of radiation oncologists on LNs delineation according to the presented GL, by both qualitative and quantitative analysis (through the FALCON EduCase platform). This project was carried out with the intention to facilitate and improve uniformity of future upper gastrointestinal guidelines on nodal CTV delineation. We report methodology and results from the collaboration of a working group panel selected by the ESTRO-ACROP.
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Affiliation(s)
- Vincenzo Valentini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini,. Radioterapia Oncologica ed Ematologia, Rome, Italy.
| | - Francesco Cellini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini,. Radioterapia Oncologica ed Ematologia, Rome, Italy.
| | - Angela Riddell
- Department of Diagnostic Radiology, The Royal Marsden, London, United Kingdom.
| | - Thomas B Brunner
- Department of Radiation Oncology, University Hospital Magdeburg, Germany.
| | - Falk Roeder
- Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University Salzburg, Landeskrankenhaus, Salzburg, Austria.
| | - Felice Giuliante
- Hepatobiliary Surgery Unit, Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome, Italy.
| | - Sergio Alfieri
- Divisione di Chirurgia Digestiva, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS; Largo Agostino Gemelli, 8, 00168, Rome (Italy); CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome (Italy); Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome (Italy).
| | - Riccardo Manfredi
- Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini,. Radioterapia Oncologica ed Ematologia, Rome, Italy.
| | - Francesco Ardito
- Hepatobiliary Surgery Unit, Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome, Italy.
| | - Claudio Fiorillo
- Divisione di Chirurgia Digestiva, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS; Largo Agostino Gemelli, 8, 00168, Rome (Italy); CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome (Italy); Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome (Italy).
| | - Venanzio Porziella
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Alessio G Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna; Bologna, Italy; DIMES, Alma Mater Studiorum - Bologna University; Bologna, Italy.
| | | | - Stefano Margaritora
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy.
| | - Berardino De Bari
- Radiation Oncology Department, Réseau hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland.
| | - Oscar Matzinger
- Department of Radiation Oncology, Genolier Clinic, Genolier, Switzerland.
| | - Eleni Gkika
- Department of Radiation Oncology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
| | - Claus Belka
- Department of Radiation Oncology, University of Munich (LMU), Munich, Germany.
| | - William Allum
- Dept of Academic Surgery Royal Marsden NHS Foundation Trust, London, United Kingdom.
| | - Marcel Verheij
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
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13
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Jereczek-Fossa BA, Marvaso G, Zaffaroni M, Gugliandolo SG, Zerini D, Corso F, Gandini S, Alongi F, Bossi A, Cornford P, De Bari B, Fonteyne V, Hoskin P, Pieters BR, Tree AC, Arcangeli S, Fuller DB, Franzese C, Hannoun-Levi JM, Janoray G, Kerkmeijer L, Kwok Y, Livi L, Loi M, Miralbell R, Pasquier D, Pinkawa M, Scher N, Scorsetti M, Shelan M, Toledano A, van As N, Vavassori A, Zilli T, Pepa M, Ost P. Salvage stereotactic body radiotherapy (SBRT) for intraprostatic relapse after prostate cancer radiotherapy: An ESTRO ACROP Delphi consensus. Cancer Treat Rev 2021; 98:102206. [PMID: 33965893 DOI: 10.1016/j.ctrv.2021.102206] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Between 30% and 47% of patients treated with definitive radiotherapy (RT) for prostate cancer are at risk of intraprostatic recurrence during follow-up. Re-irradiation with stereotactic body RT (SBRT) is emerging as a feasible and safe therapeutic option. However, no consensus or guidelines exist on this topic. The purpose of this ESTRO ACROP project is to investigate expert opinion on salvage SBRT for intraprostatic relapse after RT. MATERIALS AND METHODS A 40-item questionnaire on salvage SBRT was prepared by an internal committee and reviewed by a panel of leading radiation oncologists plus a urologist expert in prostate cancer. Following the procedure of a Delphi consensus, 3 rounds of questionnaires were sent to selected experts on prostate re-irradiation. RESULTS Among the 33 contacted experts, 18 (54.5%) agreed to participate. At the end of the final round, participants were able to find consensus on 14 out of 40 questions (35% overall) and major agreement on 13 questions (32.5% overall). Specifically, the consensus was reached regarding some selection criteria (no age limit, ECOG 0-1, satisfactory urinary flow), diagnostic procedures (exclusion of metastatic disease, SBRT target defined on the MRI) and therapeutic approach (no need for concomitant ADT, consideration of the first RT dose, validity of Phoenix criteria for salvage SBRT failure). CONCLUSION While awaiting the results of ongoing studies, our ESTRO ACROP Delphi consensus may serve as a practical guidance for salvage SBRT. Future research should address the existing disagreements on this promising approach.
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Affiliation(s)
- Barbara A Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Simone Giovanni Gugliandolo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy; Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Dario Zerini
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Corso
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Centre for Analysis Decisions and Society (CADS), Human Technopole, Department of Mathematics (DMAT) - MOX Laboratory, Politecnico di Milano, Milan, Italy
| | - Sara Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Filippo Alongi
- Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy; University of Brescia, Brescia, Italy
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | - Philip Cornford
- Liverpool University Hospitals Foundation NHS Trust, Liverpool, UK
| | - Berardino De Bari
- Radiation Oncology, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland; University of Lausanne (UniL), Lausanne, Switzerland
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Bradley R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Alison C Tree
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - Stefano Arcangeli
- Department of Radiation Oncology, S. Gerardo Hospital, University of Milan Bicocca, Milan, Italy
| | - Donald B Fuller
- Department of Radiation Oncology, Genesis Health Care Partners, Inc, San Diego, CA, USA
| | - Ciro Franzese
- Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milan, Italy
| | - Jean-Michel Hannoun-Levi
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice, France
| | - Guillaume Janoray
- Department of Radiation-Oncology, Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; University François-Rabelais, Tours, France
| | | | - Young Kwok
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lorenzo Livi
- Radiotherapy Department, University of Florence, Florence, Italy
| | - Mauro Loi
- Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | | | - David Pasquier
- Academic Department of Radiation Oncology, Centre O. Lambret, Lille, France; CRIStAL UMR 9189, Lille University, Lille, France
| | - Michael Pinkawa
- Department of Radiation Oncology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Nathaliel Scher
- Hartmann Radiotherapy Institute, Hartmann Oncology Radiotherapy Group, Levallois-Perret, France; Rafael Institute Center for Predictive Medicine, Levallois-Perret, France
| | - Marta Scorsetti
- Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milan, Italy
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alain Toledano
- Hartmann Radiotherapy Institute, Hartmann Oncology Radiotherapy Group, Levallois-Perret, France; Rafael Institute Center for Predictive Medicine, Levallois-Perret, France
| | - Nicholas van As
- Department of Clinical Oncology, St Thomas' Hospital, London, UK
| | - Andrea Vavassori
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Thomas Zilli
- Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland; Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Matteo Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Piet Ost
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
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14
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De Bari B. Cautious SBRT. Int J Radiat Oncol Biol Phys 2021; 109:315. [PMID: 33422273 DOI: 10.1016/j.ijrobp.2019.07.018] [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] [Received: 05/27/2019] [Revised: 05/27/2019] [Accepted: 07/04/2019] [Indexed: 10/22/2022]
Affiliation(s)
- Berardino De Bari
- Radiation Oncology Department, University Hospital of Besançon, F-25000 Besançon cedex, France
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15
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Rimini M, Franco P, De Bari B, Zampino MG, Vagge S, Frassinetti GL, Arcadipane F, Bacigalupo A, Valgiusti M, Aloi D, Gervaso L, Corvò R, Bartolini G, Gerardi MA, Cascinu S, Casadei-Gardini A. The Prognostic Value of the New Combined Hemo-Eosinophil Inflammation Index (HEI Index): A Multicenter Analysis of Anal Cancer Patients Treated with Concurrent Chemo-Radiation. Cancers (Basel) 2021; 13:cancers13040671. [PMID: 33562397 PMCID: PMC7914854 DOI: 10.3390/cancers13040671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/27/2022] Open
Abstract
Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox's proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low- and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04-5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.
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Affiliation(s)
- Margherita Rimini
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, 41000 Modena, Italy;
| | - Pierfrancesco Franco
- Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy;
- Correspondence: ; Tel.: +39-011-670-53-52
| | - Berardino De Bari
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France; (B.D.B.); (D.A.)
- Department of Radiation Oncology, Réseau Hospitalier Neuchâtelois, 2300 La Chaux-de-Fonds, Switzerland
| | - Maria Giulia Zampino
- Division of Gastrointestinal Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, 20019 Milan, Italy; (M.G.Z.); (L.G.)
| | - Stefano Vagge
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, 16121 Genova, Italy; (S.V.); (A.B.)
| | - Giovanni Luca Frassinetti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’–IRST, 47014 Meldola, Italy; (G.L.F.); (M.V.); (G.B.)
| | - Francesca Arcadipane
- Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy;
| | - Almalina Bacigalupo
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, 16121 Genova, Italy; (S.V.); (A.B.)
| | - Martina Valgiusti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’–IRST, 47014 Meldola, Italy; (G.L.F.); (M.V.); (G.B.)
| | - Deborah Aloi
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France; (B.D.B.); (D.A.)
| | - Lorenzo Gervaso
- Division of Gastrointestinal Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, 20019 Milan, Italy; (M.G.Z.); (L.G.)
| | - Renzo Corvò
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino and Health Science Department (DISSAL), University of Genova, 16121 Genova, Italy;
| | - Giulia Bartolini
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’–IRST, 47014 Meldola, Italy; (G.L.F.); (M.V.); (G.B.)
| | | | - Stefano Cascinu
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, 20019 Milan, Italy; (S.C.); (A.C.-G.)
| | - Andrea Casadei-Gardini
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, 20019 Milan, Italy; (S.C.); (A.C.-G.)
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16
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Roland A, Drouet C, Boulahdour H, Cochet A, De Bari B. Unusual uptakes on 18F-fluorocholine positron emission tomography/computed tomography (PET/CT): a retrospective study of 368 prostate cancer patients referred for a biochemical recurrence or an initial staging. Quant Imaging Med Surg 2021; 11:172-182. [PMID: 33392020 DOI: 10.21037/qims-19-981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background 18F-fluorocholine positron emission tomography/computed tomography (F-choline PET/CT) is considered a cornerstone in the staging and restaging of patients with prostate cancer (PCa). The aim of this study was to retrospectively assess unusual uptakes in patients who underwent a F-choline PET/CT for the initial staging or for the restaging of a relapsing PCa. Methods Three hundred and sixty-eight PCa patients were staged or restaged using F-choline PET/CT. Unusual uptakes were defined as uptakes occurring outside the usual paths of diffusion of PCa or as uptake in bone with a clear morphological evidence of nonmetastatic lesion. Results We found unusual uptakes in 47/368 patients (12.8%). Among them, 41/47 presented with benign F-choline uptake, usually within lymph nodes, due to inflammatory processes (22/47). Other benign processes were found in: thyroid (3/47), adrenal gland (3/47), brain (2/47), liver (1/47), bowel (3/47), frontal sinus (1/47), lungs (4/47), parotid gland (1/47) and bone (1/47). The six remaining patients presented with a second cancer, including lymphoma (1/47), non-small cell lung cancer (4/47) and neuroendocrine tumor (1/47). Conclusions unusual uptakes on F-choline PET/CT are quite frequent and should be explored since they may correspond to non-PCa.
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Affiliation(s)
- Antoine Roland
- Nuclear Medicine Department, University Hospital of Besançon, Besançon, France
| | - Clément Drouet
- Department of Nuclear Medicine, Georges-François Leclerc Cancer Center, Dijon, France
| | - Hatem Boulahdour
- Nuclear Medicine Department, University Hospital of Besançon, Besançon, France
| | - Alexandre Cochet
- Department of Nuclear Medicine, Georges-François Leclerc Cancer Center, Dijon, France.,ImViA EA 7535, University of Burgundy, Dijon, France
| | - Berardino De Bari
- Radiation Oncology Department, University Hospital of Besançon, Besançon, France
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17
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Doussot A, Vernerey D, Rullier E, Lefevre JH, Meillat H, Cotte E, Piessen G, Tuech JJ, Panis Y, Mege D, Meurisse A, De Bari B, Heyd B, Lakkis Z. Surgical Management and Outcomes of Rectal Cancer with Synchronous Prostate Cancer: A Multicenter Experience from the GRECCAR Group. Ann Surg Oncol 2020; 27:4286-4293. [PMID: 32500342 DOI: 10.1245/s10434-020-08683-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Synchronous prostate cancer (PC) and rectal cancer (RC) is a rare clinical situation. While combining curative-intent management for both cancers can be challenging, available data for guiding the multidisciplinary strategy are lacking. METHODS Consecutive patients undergoing rectal resection for a mid-low RC with synchronous PC treated at 9 tertiary-care centers between 2008 and 2018 were included. Management strategy and data on postoperative and long-term outcomes were retrospectively analyzed. RESULTS Overall, 25 patients underwent curative-intent RC resection combined with PC management. Nine (36%), 10 (40%) and 6 (24%) patients had low-, intermediate-, and high-risk PC, respectively. Management mostly consisted of chemoradiotherapy combined in 18 patients (72%) with either TME in 12 patients or pelvic exenteration for resection of both cancers in 6 patients. Most patients underwent RC resection using a laparoscopic approach (n = 16, 64%). Anastomosis was performed in 18 patients (72%) of whom 13 received diverting ileostomy. The complete R0 resection rate was 96% (n = 24). The overall morbidity rate was 64% (n = 16) and 5 patients (20%) experienced severe surgical morbidity of which two died within 90 days of surgery after pelvic exenteration. Among patients with anastomosis, 2 patients (11%) experienced anastomotic leak requiring surgical management. After a median follow-up of 31.2 months, 3-year OS and RFS were 80.2% (CI 95% 58.8-92.2) and 68.6% (CI 95% 42.3-84.8), respectively. CONCLUSIONS This series is the largest to report that simultaneous curative-intent management of synchronous PC and RC is feasible and safe. Pelvic exenteration might be a better option when RC complete resection seems not achievable through TME.
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Affiliation(s)
- Alexandre Doussot
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon Cedex, France
| | - Dewi Vernerey
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France
| | - Eric Rullier
- Department of Colorectal Surgery, Haut-Lévèque Hospital, Pessac, France
| | - Jérémie H Lefevre
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Sorbonne Université, Paris, France
| | - Hélène Meillat
- Department of Digestive Surgical Oncology, Department of Mini Invasive Interventions (DIMI), Paoli Calmettes Institute, Marseille, France
| | - Eddy Cotte
- Department of Digestive and Oncological Surgery, Lyon Sud University Hospital, Pierre Bénite, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | - Jean-Jacques Tuech
- Department of Digestive Surgery, Rouen University Hospital, Rouen, France
| | - Yves Panis
- Department of Colorectal Surgery, Beaujon Hospital, Clichy, France
| | - Diane Mege
- Department of Digestive and General Surgery, Timone Hospital, Marseille, France
| | - Aurélia Meurisse
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France
| | - Berardino De Bari
- Department of Radiotherapy, University Hospital of Besançon, Besançon, France.,Department of Radiotherapy, University Hospital of Lausanne, Lausanne, Switzerland
| | - Bruno Heyd
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon Cedex, France
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon Cedex, France.
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18
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Franco P, Kochbati L, Siano M, De Bari B. Suggestions for Radiation Oncologists during the COVID-19 Pandemic. Biomed Res Int 2020; 2020:4892382. [PMID: 32509860 PMCID: PMC7254074 DOI: 10.1155/2020/4892382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/19/2020] [Indexed: 01/25/2023]
Abstract
SARS-CoV-2 pandemic and COVID-19 diffusion have recently become an international public health emergency. Cancer patients, as a frail population, are particularly exposed to the risk related to infections. The clinical decision-making process and the organizational workflow of radiotherapy department should be revised in the light of the critical situation. We herein provide practical suggestions derived from the available literature and discussed during an online session held within the e-learning educational program of the European School of Oncology on March 31st 2020.
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Affiliation(s)
| | - Lofti Kochbati
- Department of Radiation Oncology, Ariana, Tunis El Manar University, Tunisia
| | - Marco Siano
- Interdisciplinary Cancer Service-SIC, Riviera-Chablais Hospital, Rennaz, Switzerland
| | - Berardino De Bari
- Department of Radiation Oncology, Réseal Hospitalier Neuchâtelois, La-Chaux-de Fonds, Switzerland
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19
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Witjes JA, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Gillessen S, James N, Maclennan S, Palou J, Powles T, Ribal MJ, Shariat SF, Van Der Kwast T, Xylinas E, Agarwal N, Arends T, Bamias A, Birtle A, Black PC, Bochner BH, Bolla M, Boormans JL, Bossi A, Briganti A, Brummelhuis I, Burger M, Castellano D, Cathomas R, Chiti A, Choudhury A, Compérat E, Crabb S, Culine S, De Bari B, De Blok W, De Visschere PJL, Decaestecker K, Dimitropoulos K, Dominguez-Escrig JL, Fanti S, Fonteyne V, Frydenberg M, Futterer JJ, Gakis G, Geavlete B, Gontero P, Grubmüller B, Hafeez S, Hansel DE, Hartmann A, Hayne D, Henry AM, Hernandez V, Herr H, Herrmann K, Hoskin P, Huguet J, Jereczek-Fossa BA, Jones R, Kamat AM, Khoo V, Kiltie AE, Krege S, Ladoire S, Lara PC, Leliveld A, Linares-Espinós E, Løgager V, Lorch A, Loriot Y, Meijer R, Mir MC, Moschini M, Mostafid H, Müller AC, Müller CR, N'Dow J, Necchi A, Neuzillet Y, Oddens JR, Oldenburg J, Osanto S, Oyen WJG, Pacheco-Figueiredo L, Pappot H, Patel MI, Pieters BR, Plass K, Remzi M, Retz M, Richenberg J, Rink M, Roghmann F, Rosenberg JE, Rouprêt M, Rouvière O, Salembier C, Salminen A, Sargos P, Sengupta S, Sherif A, Smeenk RJ, Smits A, Stenzl A, Thalmann GN, Tombal B, Turkbey B, Lauridsen SV, Valdagni R, Van Der Heijden AG, Van Poppel H, Vartolomei MD, Veskimäe E, Vilaseca A, Rivera FAV, Wiegel T, Wiklund P, Willemse PPM, Williams A, Zigeuner R, Horwich A. Corrigendum to 'EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort Under the Auspices of the EAU-ESMO Guidelines Committees' [European Urology 77 (2020) 223-250]. Eur Urol 2020; 78:e48-e50. [PMID: 32446863 DOI: 10.1016/j.eururo.2020.03.017] [Citation(s) in RCA: 4] [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: 10/24/2022]
Affiliation(s)
- J Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Marek Babjuk
- Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Joaquim Bellmunt
- IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Harvard Medical School, Boston, Massachusetts, USA
| | - H Maxim Bruins
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo M De Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - Maria De Santis
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Charité University Hospital, Berlin, Germany
| | - Silke Gillessen
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK; Division of Oncology and Haematology, Kantonsspital St Gallen, St Gallen, Switzerland; University of Bern, Bern, Switzerland
| | - Nicholas James
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Juan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tom Powles
- The Royal Free NHS Trust, London, UK; Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
| | - Shahrokh F Shariat
- Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, New York, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Theo Van Der Kwast
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Evanguelos Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France
| | - Neeraj Agarwal
- Huntsman Cancer Institute, University of Utah (NCI-CCC), Salt Lake City, Utah, USA
| | - Tom Arends
- Urology Department, Canisius-Wilhelmina Ziekenhuis Nijmegen, The Netherlands
| | - Aristotle Bamias
- 2nd Propaedeutic Dept of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Alison Birtle
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK
| | - Peter C Black
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Colombia, Canada
| | - Bernard H Bochner
- Department of Urology, Weill Cornell Medical College, New York, New York, USA; Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Michel Bolla
- Emeritus Professor of Radiation Oncology, Grenoble-Alpes University, Grenoble, France
| | - Joost L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | - Alberto Briganti
- Department of Urology, Urological Research Institute, Milan, Italy; Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Iris Brummelhuis
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Max Burger
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Daniel Castellano
- Medical Oncology Department, 12 de Octubre University Hospital (CIBERONC), Madrid, Spain
| | - Richard Cathomas
- Departement Innere Medizin, Abteilung Onkologie und Hämatologie, Kantonsspital Graubünden, Chur, Switzerland
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Research Hospital, Milan, Italy
| | - Ananya Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - Eva Compérat
- Department of Pathology, Tenon Hospital, HUEP, Paris, France; Sorbonne University, Paris, France
| | - Simon Crabb
- Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - Stephane Culine
- Department of Cancer Medicine, Hôpital Saint Louis, Paris, France
| | - Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz" of Besançon, INSERM UMR 1098, Besançon, France; Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
| | - Willem De Blok
- Department of Oncological Urology, University Medical Center, Utrecht Cancer Center, Utrecht, The Netherlands
| | - Pieter J L De Visschere
- Department of Radiology and Nuclear Medicine, Division of Genitourinary Radiology and Mammography, Ghent University Hospital, Ghent, Belgium
| | | | | | | | - Stefano Fanti
- Department of Nuclear Medicine, Policlinico S Orsola, University of Bologna, Italy
| | - Valerie Fonteyne
- Department of Radiotherapy Oncology, Ghent University Hospital, Ghent, Belgium
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Jurgen J Futterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Georgios Gakis
- Department of Urology and Paediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Würzburg, Germany
| | - Bogdan Geavlete
- Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania
| | - Paolo Gontero
- Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy
| | | | - Shaista Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Donna E Hansel
- Department of Urology, University of California, San Diego Pathology, La Jolla, California, USA
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Dickon Hayne
- Department of Urology, UWA Medical School, University of Western Australia, Perth, Australia
| | - Ann M Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Virginia Hernandez
- Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | - Harry Herr
- Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ken Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - Peter Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK; Mount Vernon Centre for Cancer Treatment, London, UK
| | - Jorge Huguet
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Barbara A Jereczek-Fossa
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy; Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Rob Jones
- Institute of Cancer Sciences, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ashish M Kamat
- Department of Urology - Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Vincent Khoo
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK; Department of Medicine, University of Melbourne, Australia; Monash University, Melbourne, Australia
| | - Anne E Kiltie
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - Susanne Krege
- Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Pedro C Lara
- Department of Oncology, Hospital Universitario San Roque, Spain; Universidad Fernando Pessoa, Canarias, Spain
| | - Annemarie Leliveld
- Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Vibeke Løgager
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - Anja Lorch
- Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - Yohann Loriot
- Département de Médecine Oncologique, Gustave Roussy, INSERM U981, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Richard Meijer
- UMC Utrecht Cancer Center, MS Oncologic Urology, Utrecht, The Netherlands
| | - M Carmen Mir
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Marco Moschini
- Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Hugh Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
| | | | | | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Andrea Necchi
- Department of Medical Oncology, Istituto Nazionale Tumori of Milan, Milan, Italy
| | - Yann Neuzillet
- Department of Urology, Hospital Foch, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France
| | - Jorg R Oddens
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - Jan Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Susanne Osanto
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wim J G Oyen
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Research Hospital, Milan, Italy; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - Luís Pacheco-Figueiredo
- Department of Urology, Centro Hospitalar São João, Porto, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Manish I Patel
- Department of Urology, Westmead Hospital, University of Sydney, Sydney, Australia
| | - Bradley R Pieters
- Department Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Karin Plass
- EAU Guidelines Office, Arnhem, The Netherlands
| | - Mesut Remzi
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Margitta Retz
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Jonathan Richenberg
- Department of Imaging and Nuclear Medicine, Royal Sussex County Hospital, Brighton, UK; Brighton and Sussex Medical School, Brighton, UK
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Roghmann
- Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany
| | - Jonathan E Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA
| | - Morgan Rouprêt
- Department of Urology, Sorbonne Université, GRC n_5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Rouvière
- Hospices Civils de Lyon, Service d'Imagerie Urinaire et Vasculaire, Hôpital Edouard Herriot, Lyon, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon, France
| | - Carl Salembier
- Department of Radiation Oncology, Europe Hospitals Brussels, Belgium
| | - Antti Salminen
- Department of Urology, University Hospital of Turku, Finland
| | - Paul Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
| | - Shomik Sengupta
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Amir Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå university, Umeå, Sweden
| | - Robert J Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anita Smits
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arnulf Stenzl
- Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - George N Thalmann
- Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Bertrand Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium
| | - Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, Bethesda, Maryland, USA
| | - Susanne Vahr Lauridsen
- Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Riccardo Valdagni
- Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Mihai D Vartolomei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
| | - Erik Veskimäe
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Antoni Vilaseca
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
| | - Franklin A Vives Rivera
- Clinica HematoOncologica Bonadona Prevenir, Universidad Metropolitana, Clinica Club de Leones, Barranquilla, Colombia
| | - Thomas Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - Peter Wiklund
- Icahn School of Medicine, Mount Sinai Health System New York City, New York, USA; Department of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Peter-Paul M Willemse
- Department of Oncological Urology, University Medical Center, Utrecht Cancer Center, Utrecht, The Netherlands
| | - Andrew Williams
- Department of Urology, Auckland City Hospital, Auckland, New Zealand
| | - Richard Zigeuner
- Department of Urology, Medizinische Universität Graz, Graz, Austria
| | - Alan Horwich
- Emeritus Professor, The Institute of Cancer Research, London, UK
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Terlizzi M, Le Pechoux C, Salas S, Rapeaud E, Lerouge D, Sunyach MP, Vogin G, Sole CV, Zilli T, Lutsyk M, Mampuya A, Calvo FA, Attal J, Karahissarlian V, De Bari B, Ozsahin M, Baumard F, Krengli M, Gomez-Brouchet A, Sargos P, Rochcongar G, Bazille C, Roth V, Salleron J, Thariat J. Postoperative Radiation Therapy in Patients with Extracranial Chondrosarcoma: A Joint Study of the French Sarcoma Group and Rare Cancer Network. Int J Radiat Oncol Biol Phys 2020; 107:726-735. [PMID: 32289473 DOI: 10.1016/j.ijrobp.2020.03.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Postoperative radiation therapy (poRT) of intracranial/skull base chondrosarcomas (CHSs) is standard treatment. However, consensus is lacking for poRT in extracranial CHS (eCHS) owing to their easier resectability and intrinsic radioresistance. We assessed the practice and efficacy of poRT in eCHS. METHODS AND MATERIALS This multicentric retrospective study of the French Sarcoma Group/Rare Cancer Network included patients with eCHS who were operated on between 1985 and 2015. Inverse propensity score weighting (IPTW) was used to minimize poRT allocation biases. RESULTS Of 182 patients, 60.4% had bone and 39.6% had soft-tissue eCHS. eCHS were of conventional (31.9%), myxoid (28.6%; 41 extraskeletal, 11 skeletal), mesenchymal (9.9%), or other subtypes. En-bloc surgery with complete resection was performed in 52.6% and poRT in 36.8% of patients (median dose, 54 Gy). Irradiated patients had unfavorable initial characteristics, with higher grade and incomplete resection. Median follow-up time was 61 months. Five-year incidence of local relapse was 10% with poRT versus 21.6% without (P = .050). Using the IPTW method, poRT reduced the local relapse risk (hazard ratio, 0.27; 95% confidence interval, 0.14-0.52; P < .001). Five-year disease-free survival (DFS) was 71.8% with poRT and 64.2% without (P = .680). Using the IPTW method, poRT improved DFS (hazard ratio, 0.51; 95% confidence interval, 0.30-0.85; P = .010). The benefit of poRT on local relapse and DFS was confirmed after exclusion of the extraskeletal subtype. There was no difference in overall survival. Prognostic factors of poorer DFS in multivariate analysis were deeper location, higher grade, incomplete resection, and no poRT. CONCLUSIONS poRT should be offered in patients with eCHS and high-grade or incomplete resection, regardless of the histologic subtype.
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Affiliation(s)
- Mario Terlizzi
- Department of Radiation Oncology, Institut Bergonie, Bordeaux, France
| | | | - Sébastien Salas
- Assistance Publique Hôpitaux de Marseille, Timone Hospital, Marseille, France
| | - Etienne Rapeaud
- Department of Radiation Oncology, Centre Baclesse/ARCHADE-Normandie Université, Caen, France
| | - Delphine Lerouge
- Department of Radiation Oncology, Centre Baclesse/ARCHADE-Normandie Université, Caen, France
| | | | - Guillaume Vogin
- Institut de Cancérologie de Lorraine, Vandoeuvre Les Nancy, France
| | - Claudio V Sole
- Clinica Instituto de Radiomedicina (IRAM) and Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Thomas Zilli
- Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | | | - Ange Mampuya
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Felipe A Calvo
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Berardino De Bari
- Centre Hospitalier Régional Universitaire "Jean Minjoz," Université de Bourgogne-Franche Comté, Besançon, France
| | - Mahmut Ozsahin
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Florian Baumard
- Department of Biostatistics, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Marco Krengli
- Department of Radiation Oncology, University Hospital, Novara, Italy
| | | | - Paul Sargos
- Department of Radiation Oncology, Institut Bergonie, Bordeaux, France
| | | | - Céline Bazille
- Department of Pathology, University Hospital of Caen, Caen, France
| | | | - Julia Salleron
- Department of Biostatistics, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre Baclesse/ARCHADE-Normandie Université, Caen, France; Laboratoire de Physique Corpusculaire, Caen, France; Unicaen-Normandie Université, Caen, France.
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21
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Krengli M, Cena T, Zilli T, Jereczek-Fossa BA, De Bari B, Villa Freixa S, Kaanders JH, Torrente S, Pasquier D, Sole CV, Lutsyk M, Dincbas FO, Habboush Y, Fariselli L, Dragan T, Baumert BG, Khanfir K, Ugurluer G, Thariat J. Radiotherapy in the treatment of extracranial hemangiopericytoma/solitary fibrous tumor: Study from the Rare Cancer Network. Radiother Oncol 2020; 144:114-120. [DOI: 10.1016/j.radonc.2019.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 01/06/2023]
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22
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Witjes JA, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Gillessen S, James N, Maclennan S, Palou J, Powles T, Ribal MJ, Shariat SF, Der Kwast TV, Xylinas E, Agarwal N, Arends T, Bamias A, Birtle A, Black PC, Bochner BH, Bolla M, Boormans JL, Bossi A, Briganti A, Brummelhuis I, Burger M, Castellano D, Cathomas R, Chiti A, Choudhury A, Compérat E, Crabb S, Culine S, De Bari B, De Blok W, J L De Visschere P, Decaestecker K, Dimitropoulos K, Dominguez-Escrig JL, Fanti S, Fonteyne V, Frydenberg M, Futterer JJ, Gakis G, Geavlete B, Gontero P, Grubmüller B, Hafeez S, Hansel DE, Hartmann A, Hayne D, Henry AM, Hernandez V, Herr H, Herrmann K, Hoskin P, Huguet J, Jereczek-Fossa BA, Jones R, Kamat AM, Khoo V, Kiltie AE, Krege S, Ladoire S, Lara PC, Leliveld A, Linares-Espinós E, Løgager V, Lorch A, Loriot Y, Meijer R, Mir MC, Moschini M, Mostafid H, Müller AC, Müller CR, N'Dow J, Necchi A, Neuzillet Y, Oddens JR, Oldenburg J, Osanto S, J G Oyen W, Pacheco-Figueiredo L, Pappot H, Patel MI, Pieters BR, Plass K, Remzi M, Retz M, Richenberg J, Rink M, Roghmann F, Rosenberg JE, Rouprêt M, Rouvière O, Salembier C, Salminen A, Sargos P, Sengupta S, Sherif A, Smeenk RJ, Smits A, Stenzl A, Thalmann GN, Tombal B, Turkbey B, Lauridsen SV, Valdagni R, Van Der Heijden AG, Van Poppel H, Vartolomei MD, Veskimäe E, Vilaseca A, Rivera FAV, Wiegel T, Wiklund P, Williams A, Zigeuner R, Horwich A. EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort †: Under the Auspices of the EAU-ESMO Guidelines Committees. Eur Urol 2020; 77:223-250. [PMID: 31753752 DOI: 10.1016/j.eururo.2019.09.035] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/26/2019] [Indexed: 12/09/2022]
Abstract
BACKGROUND Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference. SETTING Online Delphi survey and consensus conference. PARTICIPANTS The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), and 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time when further evidence is available to guide our approach. PATIENT SUMMARY This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available.
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Affiliation(s)
- J Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Marek Babjuk
- Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Joaquim Bellmunt
- IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Harvard Medical School, Boston, Massachusetts, USA
| | - H Maxim Bruins
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo M De Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - Maria De Santis
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Charité University Hospital, Berlin, Germany
| | - Silke Gillessen
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK; Division of Oncology and Haematology, Kantonsspital St Gallen, St Gallen, Switzerland; University of Bern, Bern, Switzerland
| | - Nicholas James
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Juan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tom Powles
- The Royal Free NHS Trust, London, UK; Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
| | - Shahrokh F Shariat
- Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, New York, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Theo Van Der Kwast
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Evanguelos Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France
| | - Neeraj Agarwal
- Huntsman Cancer Institute, University of Utah (NCI-CCC), Salt Lake City, Utah, USA
| | - Tom Arends
- Urology Department, Canisius-Wilhelmina Ziekenhuis Nijmegen, The Netherlands
| | - Aristotle Bamias
- 2nd Propaedeutic Dept of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Alison Birtle
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK
| | - Peter C Black
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Colombia, Canada
| | - Bernard H Bochner
- Department of Urology, Weill Cornell Medical College, New York, New York, USA; Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Michel Bolla
- Emeritus Professor of Radiation Oncology, Grenoble - Alpes University, Grenoble, France
| | - Joost L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | - Alberto Briganti
- Department of Urology, Urological Research Institute, Milan; Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Iris Brummelhuis
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Max Burger
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Daniel Castellano
- Medical Oncology Department, 12 de Octubre University Hospital (CIBERONC), Madrid, Spain
| | - Richard Cathomas
- Departement Innere Medizin, Abteilung Onkologie und Hämatologie, Kantonsspital Graubünden, Chur, Switzerland
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Research Hospital, Milan, Italy
| | - Ananya Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - Eva Compérat
- Department of Pathology, Tenon hospital, HUEP, Paris, France; Sorbonne University, Paris, France
| | - Simon Crabb
- Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - Stephane Culine
- Department of Cancer Medicine, Hôpital Saint Louis, Paris, France
| | - Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz" of Besançon, INSERM UMR 1098, Besançon, France; Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
| | - Willem De Blok
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pieter J L De Visschere
- Department of Radiology and Nuclear Medicine, Division of Genitourinary Radiology and Mammography, Ghent University Hospital, Ghent, Belgium
| | | | | | | | - Stefano Fanti
- Department of Nuclear Medicine, Policlinico S Orsola, University of Bologna, Italy
| | - Valerie Fonteyne
- Department of Radiotherapy Oncology, Ghent University Hospital, Ghent, Belgium
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Jurgen J Futterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Georgios Gakis
- Department of Urology and Paediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Würzburg, Germany
| | - Bogdan Geavlete
- Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania
| | - Paolo Gontero
- Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy
| | | | - Shaista Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Donna E Hansel
- Department of Urology, University of California, San Diego Pathology, La Jolla, California, USA
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Dickon Hayne
- Department of Urology, UWA Medical School, University of Western Australia, Perth, Australia
| | - Ann M Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Virginia Hernandez
- Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | - Harry Herr
- Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ken Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - Peter Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK; Mount Vernon Centre for Cancer Treatment, London, UK
| | - Jorge Huguet
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Barbara A Jereczek-Fossa
- Department of Oncology and Hemato-oncology, University of Milan, Milan; Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Rob Jones
- Institute of Cancer Sciences, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ashish M Kamat
- Department of Urology - Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Vincent Khoo
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK; Department of Medicine, University of Melbourne; Monash University, Melbourne, Australia
| | - Anne E Kiltie
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - Susanne Krege
- Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Pedro C Lara
- Department of Oncology, Hospital Universitario San Roque; Universidad Fernando Pessoa, Canarias, Spain
| | - Annemarie Leliveld
- Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Vibeke Løgager
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - Anja Lorch
- Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - Yohann Loriot
- Département de Médecine Oncologique, Gustave Roussy, INSERM U981, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Richard Meijer
- UMC Utrecht Cancer Center, MS Oncologic Urology, Utrecht, The Netherlands
| | - M Carmen Mir
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Marco Moschini
- Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Hugh Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
| | | | | | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Andrea Necchi
- Department of Medical Oncology, Istituto Nazionale Tumori of Milan, Milan, Italy
| | - Yann Neuzillet
- Department of Urology, Hospital Foch, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France
| | - Jorg R Oddens
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - Jan Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Susanne Osanto
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wim J G Oyen
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Research Hospital, Milan, Italy; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - Luís Pacheco-Figueiredo
- Department of Urology, Centro Hospitalar São João, Porto, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Manish I Patel
- Department of Urology, Westmead Hospital, University of Sydney, Sydney, Australia
| | - Bradley R Pieters
- Department Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Karin Plass
- EAU Guidelines Office, Arnhem, The Netherlands
| | - Mesut Remzi
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Margitta Retz
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Jonathan Richenberg
- Department of Imaging and Nuclear Medicine, Royal Sussex County Hospital, Brighton, UK; Brighton and Sussex Medical School, Brighton, UK
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Roghmann
- Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany
| | - Jonathan E Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA
| | - Morgan Rouprêt
- Department of Urology, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Rouvière
- Hospices Civils de Lyon, Service d'Imagerie Urinaire et Vasculaire, Hôpital Edouard Herriot, Lyon, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon, France
| | - Carl Salembier
- Department of Radiation Oncology, Europe Hospitals Brussels, Belgium
| | - Antti Salminen
- Department of Urology, University Hospital of Turku, Finland
| | - Paul Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
| | - Shomik Sengupta
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Amir Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå university, Umeå, Sweden
| | - Robert J Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anita Smits
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arnulf Stenzl
- Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - George N Thalmann
- Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Bertrand Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium
| | - Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, Bethesda, Maryland, USA
| | - Susanne Vahr Lauridsen
- Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Riccardo Valdagni
- Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Mihai D Vartolomei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
| | - Erik Veskimäe
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Antoni Vilaseca
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
| | - Franklin A Vives Rivera
- Clinica HematoOncologica Bonadona Prevenir, Universidad Metropolitana, Clinica Club de Leones, Barranquilla, Colombia
| | - Thomas Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - Peter Wiklund
- Icahn School of Medicine, Mount Sinai Health System New York City, New York, USA; Department of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Andrew Williams
- Department of Urology, Auckland City Hospital, Auckland, New Zealand
| | - Richard Zigeuner
- Department of Urology, Medizinische Universität Graz, Graz, Austria
| | - Alan Horwich
- Emeritus Professor, The Institute of Cancer Research, London, UK
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Cacicedo J, Navarro-Martin A, Gonzalez-Larragan S, De Bari B, Salem A, Dahele M. Systematic review of educational interventions to improve contouring in radiotherapy. Radiother Oncol 2019; 144:86-92. [PMID: 31786422 DOI: 10.1016/j.radonc.2019.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/18/2019] [Revised: 10/31/2019] [Accepted: 11/04/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND PURPOSE Contouring is a critical step in the radiotherapy process, but there is limited research on how to teach it and no consensus about the best method. We summarize the current evidence regarding improvement of contouring skills. METHODS AND MATERIALS Comprehensive literature search of the Pubmed-MEDLINE database, EMBASE database and Cochrane Library to identify relevant studies (independently examined by two investigators) that included baseline contouring followed by a re-contouring assessment after an educational intervention. RESULTS 598 papers were identified. 16 studies met the inclusion criteria representing 370 participants (average number of participants per study of 23; range (4-141). Regarding the teaching methodology, 5/16 used onsite courses, 8/16 online courses, and 2/16 used blended learning. Study quality was heterogenous. There were only 3 randomized studies and only 3 analyzed the dosimetric impact of improving contouring homogeneity. Dice similarity coefficient was the most common evaluation metric (7/16), and in all these studies at least some contours improved significantly post-intervention. The time frame for evaluating the learning effect of the teaching intervention was almost exclusively short-time, with only one study evaluating the long-term utility of the educational program beyond 6 months. CONCLUSION The literature on educational interventions designed to improve contouring performance is limited and heterogenous. Onsite, online and blended learning courses have all been shown to be helpful, however, sample sizes are small and impact assessment is almost exclusively short-term and typically does not take into account the effect on treatment planning. The most effective teaching methodology/format is unknown and impact on daily clinical practice is uncertain.
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Affiliation(s)
- Jon Cacicedo
- Radiation Oncology Department, Cruces University Hospital, Osakidetza/Biocruces Health Research Institute/Department of Surgery, Radiology and Physical Medicine of the University of the Basque Country (UPV/EHU), Barakaldo, Spain.
| | - Arturo Navarro-Martin
- Radiation Oncology Department, Hospital Duran i Reynals (ICO) Avda, Gran VIa de ĹHospitalet, Barcelona, Spain.
| | | | - Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire Jean Minjoz, INSERM U1098 EFS/BFC, Besançon, France.
| | - Ahmed Salem
- Division of Cancer Sciences, University of Manchester, United Kingdom; Department of Clinical Oncology, The Christie Hospital NHS Trust, Manchester, United Kingdom.
| | - Max Dahele
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC (VUmc location), the Netherlands.
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Valentini V, Marijnen C, Beets G, Bujko K, De Bari B, Cervantes A, Chiloiro G, Coco C, Gambacorta MA, Glynne-Jones R, Haustermans K, Meldolesi E, Peters F, Rödel C, Rutten H, van de Velde C, Aristei C. The 2017 Assisi Think Tank Meeting on rectal cancer: A positioning paper. Radiother Oncol 2019; 142:6-16. [PMID: 31431374 DOI: 10.1016/j.radonc.2019.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 06/06/2019] [Accepted: 07/01/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSES To describe current practice in the management of rectal cancer, to identify uncertainties that usually arise in the multidisciplinary team (MDT)'s discussions ('grey zones') and propose next generation studies which may provide answers to them. MATERIALS AND METHODS A questionnaire on the areas of controversy in managing T2, T3 and T4 rectal cancer was drawn up and distributed to the Rectal-Assisi Think Tank Meeting (ATTM) Expert European Board. Less than 70% agreement on a treatment option was indicated as uncertainty and selected as a 'grey zone'. Topics with large disagreement were selected by the task force group for discussion at the Rectal-ATTM. RESULTS The controversial clinical issues that had been identified within cT2-cT3-cT4 needed further investigation. The discussions focused on the role of (1) neoadjuvant therapy and organ preservation on cT2-3a low-middle rectal cancer; (2) neoadjuvant therapy in cT3 low rectal cancer without high risk features; (3) total neoadjuvant therapy, radiotherapy boost and the best chemo-radiotherapy schedule in T4 tumors. A description of each area of investigation and trial proposals are reported. CONCLUSION The meeting successfully identified 'grey zones' and, in the light of new evidence, proposed clinical trials for treatment of early, intermediate and advanced stage rectal cancer.
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Affiliation(s)
- Vincenzo Valentini
- Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Corrie Marijnen
- Department of Radiotherapy, Leiden University Medical Centre, the Netherlands
| | - Geerard Beets
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands; GROW School of Oncology and Developmental Biology, University of Maastricht, the Netherlands
| | - Krzysztof Bujko
- Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland
| | - Berardino De Bari
- Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Andres Cervantes
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Spain
| | - Giuditta Chiloiro
- Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudio Coco
- Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Italy
| | | | | | - Karin Haustermans
- Department of Radiation Oncology, University Hospitals, Leuven, Belgium
| | - Elisa Meldolesi
- Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Femke Peters
- Department of Radiotherapy, Leiden University Medical Centre, the Netherlands
| | - Claus Rödel
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe University, Germany
| | - Harm Rutten
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; GROW School of Oncology and Developmental Biology, University of Maastricht, the Netherlands
| | | | - Cynthia Aristei
- Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia and Perugia General Hospital, Italy
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De Bari B, Franzetti-Pellanda A, Saidi A, Biggiogero M, Hahnloser D, Montemurro M, Bourhis J, Zeverino M, Ozsahin M. Correction to: Neoadjuvant chemoradiotherapy delivered with helical tomotherapy under daily image guidance for rectal cancer patients: efficacy and safety in a large, multi-institutional series. J Cancer Res Clin Oncol 2019; 145:2167. [PMID: 31201485 DOI: 10.1007/s00432-019-02939-7] [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: 10/26/2022]
Abstract
The article "Neoadjuvant chemoradiotherapy delivered with helical tomotherapy under daily image guidance for rectal cancer patients: efficacy and safety in a large, multi-institutional series".
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Affiliation(s)
- Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, CHUV, 46 rue du Bugnon, 1011, Lausanne, Switzerland.
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire Jean Minjoz, INSERM U1098 EFS/BFC, Besançon, France.
| | | | - Asma Saidi
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, CHUV, 46 rue du Bugnon, 1011, Lausanne, Switzerland
| | - Maira Biggiogero
- Radiation Oncology Department, Clinica Luganese, 6900, Lugano, Switzerland
| | - Dieter Hahnloser
- Surgery Department, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
| | - Michael Montemurro
- Medical Oncology Department, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
| | - Jean Bourhis
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, CHUV, 46 rue du Bugnon, 1011, Lausanne, Switzerland
| | - Michele Zeverino
- Medical Physics Department, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
| | - Mahmut Ozsahin
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, CHUV, 46 rue du Bugnon, 1011, Lausanne, Switzerland
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Casadei-Gardini A, Montagnani F, Casadei C, Arcadipane F, Andrikou K, Aloi D, Prete AA, Zampino MG, Argentiero A, Pugliese G, Martini S, Iorio GC, Scartozzi M, Mistrangelo M, Fornaro L, Cassoni P, Marisi G, Dell'Acqua V, Ravenda PS, Lonardi S, Silvestris N, De Bari B, Ricardi U, Cascinu S, Franco P. Immune inflammation indicators in anal cancer patients treated with concurrent chemoradiation: training and validation cohort with online calculator (ARC: Anal Cancer Response Classifier). Cancer Manag Res 2019; 11:3631-3642. [PMID: 31118786 PMCID: PMC6506779 DOI: 10.2147/cmar.s197349] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/19/2019] [Indexed: 12/13/2022] Open
Abstract
Background: In anal cancer, there are no markers nor other laboratory indexes that can predict prognosis and guide clinical practice for patients treated with concurrent chemoradiation. In this study, we retrospectively investigated the influence of immune inflammation indicators on treatment outcome of anal cancer patients undergoing concurrent chemoradiotherapy. Methods: All patients had a histologically proven diagnosis of squamous cell carcinoma of the anal canal/margin treated with chemoradiotherapy according to the Nigro’s regimen. Impact on prognosis of pre-treatment systemic index of inflammation (SII) (platelet x neutrophil/lymphocyte), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were analyzed. Results: A total of 161 consecutive patients were available for the analysis. Response to treatment was the single most important factor for progression-free survival (PFS) and overall survival (OS). At univariate analysis, higher SII level was significantly correlated to lower PFS (p<0.01) and OS (p=0.046). NLR level was significantly correlated to PFS (p=0.05), but not to OS (p=0.06). PLR level significantly affected both PFS (p<0.01) and OS (p=0.02). On multivariate analysis pre-treatment, SII level was significantly correlated to PFS (p=0.0079), but not to OS (p=0.15). We developed and externally validated on a cohort of 147 patients a logistic nomogram using SII, nodal status and pre-treatment Hb levels. Results showed a good predictive ability with C-index of 0.74. An online available calculator has also been developed. Conclusion: The low cost and easy profile in terms of determination and reproducibility make SII a promising tool for prognostic assessment in this oncological setting.
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Affiliation(s)
- Andrea Casadei-Gardini
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Chiara Casadei
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Francesca Arcadipane
- Department of Oncology, Radiation Oncology, AOU Città della Salute e della Scienza, Turin, Italy
| | - Kalliopi Andrikou
- Department of Hematology and Oncology, University of Modena and Reggio Emilia, Modena, Italy
| | - Deborah Aloi
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz", Besançon Cedex, France
| | - Alessandra Anna Prete
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy.,Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I University Hospital, Rome, Italy
| | - Maria Giulia Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Giuseppe Pugliese
- Department of Hematology and Oncology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Martini
- Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy
| | | | - Mario Scartozzi
- Department of Medical Oncology, University of Cagliari, Cagliari, Italy
| | | | - Lorenzo Fornaro
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana University, Pisa, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Giorgia Marisi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per Lo Studio e La Cura Dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Veronica Dell'Acqua
- Department of Radiotherapy, IRCCS, European Institute of Oncology, Milan, Italy
| | - Paola Simona Ravenda
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Sara Lonardi
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy
| | - Nicola Silvestris
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I University Hospital, Rome, Italy
| | - Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz", Besançon Cedex, France
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, AOU Città della Salute e della Scienza, Turin, Italy
| | - Stefano Cascinu
- Department of Hematology and Oncology, University of Modena and Reggio Emilia, Modena, Italy
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Salembier C, Villeirs G, De Bari B, Hoskin P, Pieters BR, Van Vulpen M, Khoo V, Henry A, Bossi A, De Meerleer G, Fonteyne V. ESTRO ACROP consensus guideline on CT- and MRI-based target volume delineation for primary radiation therapy of localized prostate cancer. Radiother Oncol 2018; 127:49-61. [PMID: 29496279 DOI: 10.1016/j.radonc.2018.01.014] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [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: 01/17/2018] [Revised: 01/22/2018] [Accepted: 01/22/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Delineation of clinical target volumes (CTVs) remains a weak link in radiation therapy (RT), and large inter-observer variation is seen. Guidelines for target and organs at risk delineation for prostate cancer in the primary setting are scarce. The aim was to develop a delineation guideline obtained by consensus between a broad European group of radiation oncologists. MATERIAL AND METHODS An ESTRO contouring consensus panel consisting of leading radiation oncologists and one radiologist with known subspecialty expertise in prostate cancer was asked to delineate the prostate, seminal vesicles and rectum on co-registered CT and MRI scans. After evaluation of the different contours, literature review and multiple informal discussions by electronic mail a CTV definition was defined and a guide for contouring the CTV of the prostate and the rectum was developed. RESULTS The panel achieved consensus CTV contouring definitions to be used as guideline for primary RT of localized prostate cancer. CONCLUSION The ESTRO consensus on CT/MRI based CTV delineation for primary RT of localized prostate cancer, endorsed by a broad base of the radiation oncology community, is presented to improve consistency and reliability.
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Affiliation(s)
- Carl Salembier
- Department of Radiation Oncology, Europe Hospitals Brussels, Belgium
| | - Geert Villeirs
- Department of Radiology, Ghent University Hospital, Belgium
| | | | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Bradley R Pieters
- Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands
| | - Marco Van Vulpen
- Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands
| | - Vincent Khoo
- Department of Clinical Oncology, Royal Marsden Hospital, London, United Kingdom
| | - Ann Henry
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, United Kingdom
| | - Alberto Bossi
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Gert De Meerleer
- Department of Radiation Oncology, University Hospital Leuven, Belgium
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Belgium.
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De Bari B, Breuneval T, Zeverino M, Godin S, Deantonio L, Geldhof C, Bourhis J, Schaefer N, Moeckli R, Prior J, Ozsahin M. Hepatobiliary scintigraphy allows the evaluation of short-term functional toxicity of liver stereotactic body radiotherapy: Results of a pilot study. PLoS One 2018; 13:e0204013. [PMID: 30304045 PMCID: PMC6179216 DOI: 10.1371/journal.pone.0204013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/14/2018] [Accepted: 08/31/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To study the potential of (99m)Tc-Mebrofenin hepatobiliary scintigraphy (HBS) in identifying the short-term variations of liver function after stereotactic body radiotherapy (SBRT) for liver cancers. MATERIAL AND METHODS We treated with SBRT 3 patients (pts) affected by a cholangiocarcinoma and 3 patient presenting liver metastases (3x15 Gy, 4 pts; 5x8 Gy, 1 pt; 6x5 Gy, 1 pt). All patients received HBS before and 3 months after SBRT, which were co-registered with the simulation CT-scan. Structures corresponding to isodoses from 10-90 Gy were created, with intervals of 10 Gy. Finally, the variations of the mean activity (MBq) in each isodose structure have been calculated. Then, a linear regression analysis was performed. RESULTS We showed a linear reduction of the activity, significantly related to the delivered dose (p<0.01), and a reduction of the perfusion of 0.78% for each delivered Gy. The linear equation has predictive value of the loss of the function of 96% (R2 = 0.9605). CONCLUSIONS HBS could improve treatment plans for liver SBRT, by allowing the identification of the liver function variations after SBRT and, potentially, the prediction of remnant liver function after SBRT. These preliminary results should be confirmed on long-term prospective data and larger population.
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Affiliation(s)
- Berardino De Bari
- Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- Service de Radio-oncologie, Centre Hospitalier Régional Universitaire « Jean Minjoz », INSERM U1098 EFS/BFC, Besançon cedex, France
| | - Thomas Breuneval
- Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Michele Zeverino
- Institut de Radiophysique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Sarah Godin
- Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Letizia Deantonio
- University Hospital Maggiore della Carità, Dept. of Radiation Oncology, Novara, Italy
| | - Christine Geldhof
- Service de Médecine Nucléaire, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Jean Bourhis
- Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Nicklaus Schaefer
- Service de Médecine Nucléaire, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Raphaël Moeckli
- Institut de Radiophysique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - John Prior
- Service de Médecine Nucléaire, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Mahmut Ozsahin
- Service de Radio-oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Herrera FG, Valerio M, Berthold D, Tawadros T, Meuwly JY, Vallet V, Baumgartner P, Thierry AC, De Bari B, Jichlinski P, Kandalaft L, Coukos G, Harari A, Bourhis J. 50-Gy Stereotactic Body Radiation Therapy to the Dominant Intraprostatic Nodule: Results From a Phase 1a/b Trial. Int J Radiat Oncol Biol Phys 2018; 103:320-334. [PMID: 30267761 DOI: 10.1016/j.ijrobp.2018.09.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/03/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Although localized prostate cancer (PCa) is multifocal, the dominant intraprostatic nodule (DIN) is responsible for disease progression after radiation therapy. PCa expresses antigens that could be recognized by the immune system. We therefore hypothesized that stereotactic dose escalation to the DIN is safe, may increase local control, and may initiate tumor-specific immune responses. PATIENTS AND METHODS Patients with localized PCa were treated with stereotactic extreme hypofractionated doses of 36.25 Gy in 5 fractions to the whole prostate while simultaneously escalating doses to the magnetic resonance image-visible DIN (45 Gy, 47.5 Gy, and 50 Gy in 5 fractions). The phase 1a part was designed to determine the recommended phase 1b dose in a "3 + 3" cohort-based, dose-escalation design. The primary endpoint was dose-limiting toxicities defined as ≥grade 3 gastrointestinal (GI) or genitourinary (GU) toxicity (or both) by National Cancer Institute Common Terminology Criteria for Adverse Events (version 4) up to 90 days after the first radiation fraction. The secondary endpoints were prostate-specific antigen kinetics, quality of life (QoL), and blood immunologic responses. RESULTS Nine patients were treated in phase 1a. No dose-limiting toxicities were observed at either level, and therefore the maximum tolerated dose was not reached. Further characterization of tolerability, efficacy, and immunologic outcomes was conducted in the subsequent 11 patients irradiated at the highest dose level (50 Gy) in the phase 1b expansion cohort. Toxicity was 45% and 25% for grades 1 and 2 GU, and 20% and 5% for grades 1 and 2 GI, respectively. No grade 3 or worse toxicity was reported. The average (±standard error of the mean) of the QoL assessments at baseline and at 3-month posttreatment were 0.8 (±0.8) and 3.5 (±1.5) for the bowel (mean difference, 2.7; 95% confidence interval, 0.1-5), and 6.4 (±0.8) and 7.27 (±0.9) for the International Prostate Symptom Score (mean difference, 0.87; 95% confidence interval, 0.3-1.9), respectively. A subset of patients developed antigen-specific immune responses against prostate-specific membrane antigen (n = 2), prostatic acid phosphatase (n = 1), prostate stem cell antigen (n = 4), and prostate-specific antigen (n = 2). CONCLUSIONS Irradiation of the whole prostate with 36.25 Gy in 5 fractions and dose escalation to 50 Gy to the DIN was tolerable and determined as the recommended phase 1b dose. This treatment has promising antitumor activity, which will be confirmed by the ongoing phase 2 part. Preliminary QoL analysis showed minimal impact in GU, GI, and sexual domains. Stereotactic irradiation induced antigen-specific immune responses in a subset of patients.
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Affiliation(s)
- Fernanda G Herrera
- Department of Oncology, Radiation Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Oncology, Immune Monitoring Core Facility, Center of Experimental Therapeutics, Ludwig Cancer Research Center, Lausanne, Switzerland.
| | - Massimo Valerio
- Department of Oncology, Department of Surgery, Urology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Dominik Berthold
- Department of Oncology, Medical Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Thomas Tawadros
- Department of Oncology, Department of Surgery, Urology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-Yves Meuwly
- Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Veronique Vallet
- Department of Oncology, Radiation Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Petra Baumgartner
- Department of Oncology, Immune Monitoring Core Facility, Center of Experimental Therapeutics, Ludwig Cancer Research Center, Lausanne, Switzerland
| | - Anne-Christine Thierry
- Department of Oncology, Immune Monitoring Core Facility, Center of Experimental Therapeutics, Ludwig Cancer Research Center, Lausanne, Switzerland
| | - Berardino De Bari
- Department of Oncology, Radiation Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Patrice Jichlinski
- Department of Oncology, Department of Surgery, Urology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Lana Kandalaft
- Department of Oncology, Immune Monitoring Core Facility, Center of Experimental Therapeutics, Ludwig Cancer Research Center, Lausanne, Switzerland
| | - George Coukos
- Department of Oncology, Medical Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Oncology, Immune Monitoring Core Facility, Center of Experimental Therapeutics, Ludwig Cancer Research Center, Lausanne, Switzerland
| | - Alexandre Harari
- Department of Oncology, Immune Monitoring Core Facility, Center of Experimental Therapeutics, Ludwig Cancer Research Center, Lausanne, Switzerland
| | - Jean Bourhis
- Department of Oncology, Radiation Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Franco P, De Bari B, Arcadipane F, Lepinoy A, Ceccarelli M, Furfaro G, Mistrangelo M, Cassoni P, Valgiusti M, Passardi A, Casadei Gardini A, Trino E, Martini S, Iorio GC, Evangelista A, Ricardi U, Créhange G. Comparing simultaneous integrated boost vs sequential boost in anal cancer patients: results of a retrospective observational study. Radiat Oncol 2018; 13:172. [PMID: 30201015 PMCID: PMC6131808 DOI: 10.1186/s13014-018-1124-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 08/31/2018] [Indexed: 02/12/2023] Open
Abstract
Background To evaluate clinical outcomes of simultaneous integrated boost (SIB) - intensity modulated radiotherapy (RT) in patients with non metastatic anal cancer compared to those of a set of patients treated with 3-dimensional conformal RT and sequential boost (SeqB). Methods A retrospective cohort of 190 anal cancer patients treated at 3 academic centers with concurrent chemo-RT employing either SIB or SeqB was analysed. The SIB-group consisted of 87 patients, treated with 2 cycles of Mitomycin (MMC) and 5-Fluorouracil (5FU) using SIB-IMRT delivering 42-45Gy/28–30 fractions to the elective pelvic lymph nodes and 50.4-54Gy/28-30fractions to the primary tumor and involved nodes, based on pre-treatment staging. The SeqB group comprised 103 patients, treated with MMC associated to either 5FU or Capecitabine concurrent to RT with 36 Gy/20 fractions to a single volume including gross tumor, clinical nodes and elective nodal volumes and a SeqB to primary tumor and involved nodes of 23.4 Gy/13 fractions. We compared colostomy-free survival (CFS), overall survival (OS) and the cumulative incidence of colostomy for each radiation modality. Cox proportional-hazards model addressed factors influencing OS and CFS. Results Median follow up was 34 (range 9–102) and 31 months (range 2–101) in the SIB and SeqB groups. The 1- and 2-year cumulative incidences of colostomy were 8.2% (95%CI:3.6–15.2) and 15.0% (95%CI:8.1–23.9) in the SIB group and 13.9% (95%CI: 7.8–21.8) and 18.1% (95%CI:10.8–27.0) in the SeqB group. Two-year CFS and OS were 78.1% (95%CI:67.0–85.8) and 87.5% (95%CI:77.3–93.3) in the SIB group and 73.5% (95%CI:62.6–81.7) and 85.4% (95%CI:75.5–91.6) in the SeqB, respectively. A Cox proportional hazards regression model highlighted an adjusted hazard ratio (AdjHR) of 1.18 (95%CI: 0.67–2.09;p = 0.560), although AdjHR for the first 24 months was 0.95 (95%CI: 0.49–1.84;p = 0.877) for the SIB approach. Conclusions SIB-based RT provides similar clinical outcomes compared to SeqB-based in the treatment of patients affected with non metastatic anal cancer.
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Affiliation(s)
- Pierfrancesco Franco
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy.
| | - Berardino De Bari
- Department of Radiation Oncology, Centre Hospitalier Régional Universitaire 'Jean Minjoz', Besançon, France
| | - Francesca Arcadipane
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Alexis Lepinoy
- Department of Radiation Oncology, Centre 'Paul Strauss', Strasbourg, France
| | - Manuela Ceccarelli
- Unit of Cancer Epidemiology and CPO Piedmont, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Gabriella Furfaro
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | | | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Martina Valgiusti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessandro Passardi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Andrea Casadei Gardini
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elisabetta Trino
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Stefania Martini
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Giuseppe Carlo Iorio
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Andrea Evangelista
- Unit of Cancer Epidemiology and CPO Piedmont, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Gilles Créhange
- Department of Radiation Oncology, Centre 'Georges-François-Leclerc', Dijon, France
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Alongi F, de Crevoisier R, Corradini S, Créhange G, De Bari B. Daily IGRT for prostate cancer: Can we stop the train? Radiother Oncol 2018; 128:389-390. [PMID: 29807835 DOI: 10.1016/j.radonc.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/07/2018] [Accepted: 05/07/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Filippo Alongi
- Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy; Radiation Oncology Department, University of Brescia, Brescia, Italy
| | - Renaud de Crevoisier
- Radiation Oncology Department, centre régional de lutte contre le cancer Eugène-Marquis, Rennes, France
| | | | - Gilles Créhange
- Radiation Oncology Department, centre Georges-François Leclerc, Dijon, France
| | - Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM U1098 EFS/BFC, Besançon Cedex, France.
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De Bari B, Mazzola R, Aiello D, Fersino S, Gregucci F, Alongi P, Nicodemo M, Cavalleri S, Salgarello M, Alongi F. Could 68-Ga PSMA PET/CT become a new tool in the decision-making strategy of prostate cancer patients with biochemical recurrence of PSA after radical prostatectomy? A preliminary, monocentric series. Radiol Med 2018; 123:719-725. [DOI: 10.1007/s11547-018-0890-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 04/09/2018] [Indexed: 12/17/2022]
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Pegurri L, Buglione M, Girelli G, Guarnieri A, Meattini I, Ricardi U, Mangoni M, Gabriele P, Bellavita R, Krengli M, Bonetta A, Cagna E, Bunkheila F, Borghesi S, Signor M, Di Marco A, Bertoni F, Stefanacci M, Gatta R, De Bari B, Magrini SM. Changes in Patterns of Practice for Prostate Cancer Radiotherapy in Italy 1995–2003. A Survey of the Prostate Cancer Study Group of the Italian Radiation Oncology Society. Tumori Journal 2018. [DOI: 10.1177/1430.15812] [Citation(s) in RCA: 6] [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: 11/16/2022]
Affiliation(s)
| | | | | | | | - Icro Meattini
- Radiation Oncology Dept, Florence University, Florence
| | | | | | - Pietro Gabriele
- Radiation Oncology Dept, Fondazione Piemontese per la Ricerca sul Cancro, Candiolo
| | | | - Marco Krengli
- Radiation Oncology Dept, Piemonte Orientale University, Novara
| | | | | | | | | | | | | | | | | | - Roberto Gatta
- Istituto del Radio “O Alberti”, Brescia University, Brescia
| | - Berardino De Bari
- Istituto del Radio “O Alberti”, Brescia University, Brescia
- Radiation Oncology Dept, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Alongi F, De Bari B, Scorsetti M. Could Single-high-dose Radiotherapy be Considered the New Frontier of Stereotactic Ablative Radiation Therapy? Tumori Journal 2018. [DOI: 10.1177/1578.17244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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)
- Filippo Alongi
- Radiation Oncology Department, Sacro Cuore Hospital, Negrar-Verona, Italy
| | - Berardino De Bari
- Service de Radio-Oncologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Marta Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Rozzano, Milan, Italy
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Caubet M, Pasquier D, Bertaut A, Grobois S, De Bari B, Kleinclauss F, Thiery Vuillemin A, Martin E, Quivrin M, Cormier L, Crehange G. The role of whole pelvic nodal radiotherapy compared with prostate bed only radiotherapy after radical prostatectomy for prostate cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.93] [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: 11/20/2022] Open
Abstract
93 Background: In international guidelines, target volumes for postoperative radiotherapy (PORT) after radical prostatectomy concern the bed of the prostate and seminal vesicles. The benefit of whole pelvic nodal radiotherapy (WPRT) in the case of PORT remains uncertain. Methods: We reviewed the charts of all patients diagnosed with high-risk prostate cancer after radical prostatectomy who were selected for PORT and treated with adjuvant radiotherapy (n = 242, 43.1%) or early salvage RT (n = 320, 56.9%) between 2002 and 2011. 111 patients (19.8%) who underwent WPRT were compared with 441 patients (80.2%) who had prostate bed radiotherapy only (PBRT). We examined associations between patient, tumor, and treatment characteristics and biochemical progression-free survival (bPFS), disease-free survival (DFS) and overall survival (OS) with uni- and multivariate analyses using Cox models. Acute and late toxicities were also compared between the two groups. Results: We found a significantly lower rate of acute G2+ gastrointestinal (GI) toxicity with PBRT than with WPRT with neither difference in acute G3+ nor on late GI toxicity. Regarding genitoruinary (GU) toxicity, we found no difference in acute G2+ or G3+ toxicity but rates of late G3+ GU toxicity were significantly lower in PBRT (1.55%) than in WPRT patients (p = 0.035). With a median follow-up of 65.2 months [95% CI: 62.8 - 67.9], a deleterious effect of WPRT was observed on OS (HR = 3.27 [95% CI: 1.44 - 7.45], p = 0.009). We found no impact of WPRT on bPFS (HR = 0.79 [95% CI: 0.49 - 1.25], p = 0.31) or DFS (HR = 0.97 [95% CI: 0.63 - 1.49], p = 0.88). Only a positive surgical margin was an independent prognostic factor for better bPFS. Age≥63 years and WPRT (HR = 2.86 [95% CI: 1.20-6.80], p = 0.018) were independent prognostic factors for worse OS. Conclusions: After radical prostatectomy, we found no difference on bPFS or DFS but lower rates of OS with WPRT compared to PBRT. PBRT must remain the standard of care. The results of RTOG NRG Oncology 0534 should shed light on this unresolved issue.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Luc Cormier
- Centre Hospitalier Universitaire de Dijon, Dijon, France
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De Bari B, Lestrade L, Franzetti-Pellanda A, Jumeau R, Biggiogero M, Kountouri M, Matzinger O, Miralbell R, Bourhis J, Ozsahin M, Zilli T. Modern intensity-modulated radiotherapy with image guidance allows low toxicity rates and good local control in chemoradiotherapy for anal cancer patients. J Cancer Res Clin Oncol 2018; 144:781-789. [PMID: 29441419 DOI: 10.1007/s00432-018-2608-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 12/28/2017] [Accepted: 02/07/2018] [Indexed: 01/28/2023]
Abstract
PURPOSE To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques. METHODS We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/- chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II-IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81). All patients received 36 Gy (1.8 Gy/fraction) on the pelvic and inguinal nodes, on the rectum, on the mesorectum and on the anal canal, and a sequential boost up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal canal and on the nodal gross tumor volumes. RESULTS Median follow-up was 38 months (interquartile range 12-51). Toxicity data were available for 143 patients: 22% of them presented a G3+ acute toxicity, mainly as moist desquamation (n = 25 patients) or diarrhea (n = 10). Three patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Patients treated with fixed-gantry IMRT delivered with a sliding window technique presented a significantly higher risk of acute grade 3 (or more) toxicity compared to those treated with VMAT or helical tomotherapy (38.5 vs 15.3%, p = 0.049). Actuarial 4-year local control rate was 82% (95% CI 76-91%). CONCLUSIONS Modern intensity-modulated radiotherapy with daily image-guided radiotherapy is effective and safe in treating anal cancer patients and should be considered the standard of care in this clinical setting.
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Affiliation(s)
- Berardino De Bari
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. .,Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM U1098 EFS/BFC, 3, Boulevard Fleming, 25000, Besançon Cedex, France.
| | - Laëtitia Lestrade
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM U1098 EFS/BFC, 3, Boulevard Fleming, 25000, Besançon Cedex, France.,Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland
| | | | - Raphael Jumeau
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland
| | - Maira Biggiogero
- Radiation Oncology Department, Clinica Luganese, Lugano, Switzerland
| | - Melpomeni Kountouri
- Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland
| | - Oscar Matzinger
- Radiation Oncology Department, Riviera-Chablais Hospital, Vevey, Switzerland
| | - Raymond Miralbell
- Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland
| | - Jean Bourhis
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland
| | - Mahmut Ozsahin
- Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland
| | - Thomas Zilli
- Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland
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Conrad M, Bolard G, Nowak M, De Bari B, Jeanneret-Sozzi W, Bourhis J, Germond JF, Bochud F, Moeckli R. Determination of the effective dose delivered by image guided radiotherapy in head & neck and breast treatments. Z Med Phys 2018; 28:276-285. [PMID: 29426589 DOI: 10.1016/j.zemedi.2018.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 07/12/2017] [Revised: 11/23/2017] [Accepted: 01/03/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Image guided radiotherapy (IGRT) improves patient positioning for treatment delivery at the cost of an additional dose. This work aimed to calculate the effective dose (as an indicator of dose) for head & neck (H&N) and breast IGRT treatments by implementing dose calculation models to determine the dose distributions. METHODS The kV dose-models were created for the IGRT systems of Elekta Synergy (XVI) and Varian Clinac (OBI) linear accelerators within Philips Pinnacle TPS. Profiles and depth dose curves were measured in water. The models were validated in a CIRS thorax phantom. The IGRT dose distributions for five H&N and five breast patients were calculated. The effective dose was determined from the dose distributions following ICRP 103 recommendations. Moreover, time-saving approximations were studied in order to propose an alternative way of segmenting the tissues for a clinical implementation of the method. RESULTS AND CONCLUSION The effective dose specifically associated with IGRT varied from 1 to 10mSv depending on the protocol. The kV dose-model allowed us to calculate the dose distributions from IGRT for different configurations and patients, and to determine effective dose for IGRT protocols. The clinical implementation of the method was found to reduce time and to introduce a small enough increase of uncertainty in the results to be clinically usable.
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Affiliation(s)
- Mireille Conrad
- Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland; University of Geneva, Geneva, Switzerland
| | | | - Marie Nowak
- Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
| | - Berardino De Bari
- Department of Radio-Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Jean Bourhis
- Department of Radio-Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - François Bochud
- Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
| | - Raphaël Moeckli
- Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland.
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Laffay L, Depaepe L, D'hombres A, Balme B, Thomas L, De Bari B. Histological Features and Treatment Approach of Trichoblastic Carcinomas: From a Case Report to a Review of the Literature. Tumori 2018. [DOI: 10.1177/030089161209800222] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Trichoblastic carcinoma (or malignant trichoblastoma) is a rare malignant cancer of adnexal structures with morphological features that in some cases are reminiscent of a trichoblastoma. Trichoblastic carcinoma is underdiagnosed as it is a rather recent entity which is still not recognized as such by all pathologists. The differential diagnosis with basal cell carcinoma is often difficult to make and the optimal treatment has not yet been established. Case report We report the case of a 43-year-old patient who underwent surgical excision and adjuvant radiotherapy for a growing mass of 40 × 48 mm located in the lumbar right paraspinal skin. The pathological findings demonstrated a trichoblastic carcinoma. The clinicopathological profile, the histogenesis, and the difficulties related to the histopathological diagnosis and treatment of this rare entity are discussed in this article. Conclusion Although the published reports on this disease are few, surgery should be considered the standard therapeutic approach for trichoblastic carcinomas. Selected cases presenting clinical features of local aggressiveness can safely be treated with adjuvant irradiation to improve local control. However, acute and particularly late toxicities need to be taken into account in the decision.
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Affiliation(s)
- Lisa Laffay
- Department of Radiotherapy-Oncology, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex
| | - Lauriane Depaepe
- Department of Pathology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex, France
| | - Anne D'hombres
- Department of Radiotherapy-Oncology, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex
| | - Brigitte Balme
- Department of Pathology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex, France
| | - Luc Thomas
- Department of Dermatology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex, France
| | - Berardino De Bari
- Department of Radiotherapy-Oncology, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex
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De Bari B, Fiorentino A, Greto D, Ciammella P, Arcangeli S, Avuzzi B, D'Angelillo RM, Desideri I, Kirienko M, Marchiori D, Massari F, Fundoni C, Franco P, Filippi AR, Alongi F. Prostate cancer as a paradigm of multidisciplinary approach? Highlights from the Italian young radiation oncologist meeting. Tumori 2018; 99:637-49. [DOI: 10.1177/030089161309900601] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Aims and background The diagnostic and therapeutic approach to prostate cancer has evolved rapidly in last decades. Young professionals need an update about these recent developments in order to improve the care of patients treated in their daily clinical practice. Methods On May 18, 2013, AIRO Giovani (the young section of the Italian Association of Radiation Oncology) organized a multidisciplinary meeting involving, as speakers, several young physicians from many parts of Italy actively involved in the diagnostic and therapeutic approach to prostate cancer. The meeting was specifically addressed to young physicians (radio-oncologists, urologists, medical oncologists) and presented the state-of-the-art of the diagnostic/therapeutic approach based on the latest evidence on the issue. Highlights of the congress are summarized and presented in this report. Results The large participation in the meeting (more than 120 participants were present) confirmed the interest of young radiation oncologists in improving their skills in prostate cancer management. The contributions of the speakers confirmed the need for regular updates, considering the promising results of recently published studies and the many new ongoing trials, on the diagnostic and therapeutic approaches to prostate cancer. Conclusions Multidisciplinary meetings are helpful to improve the skills of young professionals.
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Affiliation(s)
- Berardino De Bari
- Radiation Oncology Department, AO Spedali Civili and University of Brescia, Brescia
| | - Alba Fiorentino
- Radiation Oncology Department, IRCCS/CROB, Rionero in Vulture (PZ)
- Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | | | - Patrizia Ciammella
- Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia
| | | | - Barbara Avuzzi
- Radiation Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | | | | | | | - Francesco Massari
- Medical Oncology, ‘GB Rossi’ Academic Hospital, University of Verona, Verona
| | | | - Pierfrancesco Franco
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale U Parini, AUSL Valle d'Aosta, Aosta
| | - Andrea R Filippi
- Department of Oncology, Radiation Oncology, University of Torino, Turin
| | - Filippo Alongi
- Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
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Balducci M, Di Rito A, Mantini G, Manfrida S, Chiesa S, Frascino V, D'Agostino GR, Valentini V, De Bari B. Role of Radiotherapy in the Treatment of Fibrosarcoma of the Spermatic Cord: A Case Report and Review of the Literature. Tumori 2018; 97:36e-8e. [DOI: 10.1177/030089161109700624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Spermatic cord sarcomas are rare. The therapeutic approach is based only on case reports and small series. The standard treatment is radical orchiectomy with wide local resection, while the role of adjuvant therapies is not clear. We present a case of fibrosarcoma of the spermatic cord treated with surgery and adjuvant radiotherapy. A review of the literature about the role of adjuvant treatments is also discussed. Case Report A 59-year-old man presented a right testicular mass of about 4 × 3 cm in size. Biopsy showed a high-grade polymorphous sarcoma, consistent with a diagnosis of poorly differentiated fibromyosarcoma. He underwent a right radical inguinal orchiectomy and adjuvant radiotherapy (total dose: 5940 cGy). During treatment the patient developed a G3 skin toxicity (RTOG score) in the inguinal fold. After a follow-up of 57 months, he is alive and without evidence of local or distant recurrence. No late toxicity was noted. Conclusion The optimal adjuvant management of spermatic cord sarcoma is still uncertain. Looking at the literature, it seems that adjuvant radiotherapy can improve locoregional control and disease-free survival without additional late toxicity.
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Affiliation(s)
- Mario Balducci
- Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy
| | - Alessia Di Rito
- Service de Radiothérapie, Centre Medical de Forcilles, Ferolles-Attilly, France
| | - Giovanna Mantini
- Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy
| | - Stefania Manfrida
- Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy
| | - Silvia Chiesa
- Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy
| | - Vincenzo Frascino
- Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy
| | | | - Vincenzo Valentini
- Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy
| | - Berardino De Bari
- Service de Radiothérapie-Oncologie, Centre Hospitalier Lyon-Sud, Pierre Benite, France
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De Bari B, Chiesa S, Filippi AR, Gambacorta MA, D'Emilio V, Murino P, Livi L. The INTER-ROMA Project - a Survey among Italian Radiation Oncologists on Their Approach to the Treatment of Bone Metastases. Tumori 2018; 97:177-84. [DOI: 10.1177/030089161109700208] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Radiotherapy has an established palliative role for bone metastases but despite the large number of patients treated there is still controversy surrounding the optimal radiotherapy schedule to prescribe. The aim of this survey was to determine the decision patterns of Italian radiation oncologists in four different clinical cases of patients with bone metastases. Methods and study design During the latest national meeting of the Italian Association of Radiation Oncology (AIRO), four clinical cases were presented to attending radiation oncologists. The cases were different with respect to the histology of the primary tumor, performance status, pain before and after analgesics, tumor site, and radiological characteristics of the metastatic lesions. For each clinical case the respondents were asked to give an indication for treatment; prescribe doses, volumes and treatment field arrangements; decide whether to prescribe prophylactic supportive therapy or not; and provide information about factors that particularly influenced prescription. Finally, a descriptive statistical analysis was performed. Results Three hundred questionnaires were distributed to radiation oncologists attending the congress. One hundred twenty-five questionnaires were returned but only 122 (40.6%) were adequately completed and considered for the analysis. Considerable differences were observed among radiation oncologists in prescribing and delivering radiotherapy for bone metastases. There was also a notable divergence from international guidelines, which will be discussed in this report. Conclusions Despite the results of clinical trials, Italian radiation oncologists differ considerably in their decisions on treatment doses and volumes. National guidelines are needed in order that patients can be treated uniformly and better data will become available for evidence-based palliative radiotherapy.
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Affiliation(s)
| | - Berardino De Bari
- Service de Radiothérapie Oncologie, Centre Hospitalier Lyon-Sud, Université Claude Bernard, Pierre Benite cedex, France, and EA 3738
| | - Silvia Chiesa
- Bio-Images and Radiological Sciences Department, Radiotherapy Institute, Catholic University, Rome
| | - Andrea Riccardo Filippi
- Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Turin, Ospedale S. Giovanni Battista, Turin
| | | | - Valentina D'Emilio
- Radiation Oncology Department, Azienda Ospedaliera “Civile-MP Arezzo”, Ragusa
| | - Paola Murino
- Radiation Oncology Department, Ospedale Cardinale Ascalesi, Naples
| | - Lorenzo Livi
- Radiotherapy Unit, University of Florence, Florence, Italy
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Balducci M, De Bari B, Manfrida S, D'Agostino GR, Valentini V. Treatment of Merkel Cell Carcinoma with Radiotherapy and Imiquimod (Aldara): A Case Report. Tumori 2018; 96:508-11. [DOI: 10.1177/030089161009600324] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background Merkel cell carcinoma (MCC) is a rare skin tumor occurring mostly in older people. Postoperative radiotherapy is strongly recommended to improve local control. A case of a MCC treated by radiotherapy associated with imiquimod (Aldara) is presented. A possible physiopathological rationale for this concomitant treatment is also given. Materials and methods We treated a diabetic 82-year-old man presenting with a MCC of the right zygomatic area. Despite surgery, postoperative ultrasonography showed a firm, painless residual mass of about 11 × 10 cm, fixed to the deep tissues. Parotid and zygomatic areas were treated along with the ipsilateral laterocervical lymph nodes. The total dose to the planning target volume was 50.4 Gy (1.8 Gy/day). Imiquimod was applied once a day to the zygomatic area with macroscopic infiltration and to the surrounding erythema. Results During the combination treatment, the patient showed acute G3 skin toxicity (RTOG) and a scab that resolved after a 3-week interruption of the radiotherapy and imiquimod treatment. When the scab was removed, the underlying skin appeared completely re-epithelialized. Imiquimod was suspended and treatment was continued only with irradiation. During this second phase of the treatment, the patient developed G2 dermatitis and G2 stomatitis. Clinical and instrumental re-evaluation showed a complete response 7 months after the end of radiotherapy, with very good local tropism. Conclusion This case report suggests the possible effective use of immunomodulators, in this case imiquimod, combined with radiation therapy for cutaneous malignancies such as MCC. Skin tolerance should be an important issue to consider.
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Affiliation(s)
- Mario Balducci
- Radiotherapy Department, Catholic University of Rome, Rome, Italy
| | - Berardino De Bari
- Département de Radiothérapie-Oncologie, Centre Hospitalier Lyon Sud, Pierre Benite, France and EA3738
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De Bari B, Stish B, Ball MW, Habboush Y, Sargos P, Krengli M, Bossi A, Stabile A, Sole Pesutic C, Lestrade L, Smeenk RJ, Jereczek-Fossa BA, Zilli T, Créhange G, Alongi F, Zaorsky N, Ozsahin M. Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study. Prostate 2017; 77:1160-1166. [PMID: 28594087 DOI: 10.1002/pros.23375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/03/2017] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Adult prostatic sarcoma (PS) is a rare disease. While surgery is considered the standard approach, the role of other therapies is not completely established. We report results of the largest multicentric contemporary cohort of PS patients. MATERIALS AND METHODS This study included 61 adult PS patients treated in 16 American and European Institutions. Median age was 64.4 years (range: 22-87). Curative surgery was delivered in 48 patients (prostatectomy = 26, cystoprostatectomy = 22), usually with lymphadenectomy (n = 40). Curative radiotherapy (RT) was delivered in 32 patients, as radical (n = 5), neoadjuvant (n = 10), or postoperative treatment (n = 17). Eighteen patients received chemotherapy. None of the patients received hormonal therapy. RESULTS Median follow-up was 72 months (95%CI: 55-not reached). Five-year local control (LC), overall survival (OS), cancer-specific survival, disease-free survival, and metastases-free rates were 47%, 53%, 56%, 35%, and 35%, respectively. Notably, curative RT (neoadjuvant, adjuvant, or definitive) was associated with improved 5-year LC (55% vs. 31%, P = 0.02) and OS (59% vs. 46%, P = 0.1). Surgically treated patients presenting with a cT3-4 tumor (n = 31), who received RT (n = 24), had a significantly improved 5-year LC (68% vs, 33%, P = 0.004) and OS (65% vs. 21%, P < 0.001) rates compared to patients not receiving RT. cT4 patients demonstrated a significantly lower 5-year OS (43% vs. 61%, P = 0.006) and LC (29% vs. 69%, P < 0.001) rates. Histologic subtype was not associated with LC and OS, but patients with prostatic stromal sarcoma, rhabdomyosarcoma, or sarcomatoid carcinoma had worse 5-year LC compared to other types (47% vs. 55%) and OS (49% vs. 58%). CONCLUSION Adult PS has a poor prognosis. Locally advanced tumors have poor LC and OS rates. Curative RT should be considered part of the multidisciplinary approach to PS.
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Affiliation(s)
- Berardino De Bari
- Department of Radiation Oncology, Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM, UMR1098, Besançon, France
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Bradley Stish
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Mark Wayne Ball
- Department of Urology, Johns Hopkins University School of Medicine, Bethesda, Maryland
| | - Yacob Habboush
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida
| | - Paul Sargos
- Department of Radiation Oncology, Institut Bergonie, Bordeaux, France
| | - Marco Krengli
- Department of Radiation Oncology, University Hospital Maggiore della Carità, Novara, Italy
| | - Alberto Bossi
- Department of Radiation Oncology, Institut Gustave Roussy, Paris, France
| | | | - Claudio Sole Pesutic
- Facultad de Medicina, Department of Radiation Oncology, Clínica IRAM, Universitad "Diego Portales", Santiago, Chile
| | - Laëtitia Lestrade
- Department of Radiation Oncology, Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM, UMR1098, Besançon, France
- Department of Radiation Oncology, Hôpitaux Universitaires De Genève, Geneva, Switzerland
| | - Robert Jan Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Alicja Jereczek-Fossa
- Department of Radiation Oncology, European Institute of Oncology, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Thomas Zilli
- Department of Radiation Oncology, Hôpitaux Universitaires De Genève, Geneva, Switzerland
| | - Gilles Créhange
- Department of Radiation Oncology, Centre Georges-François-Leclerc, CNRS, UMR6306 Le2i, Dijon, France
| | - Filippo Alongi
- Department of Radiation Oncology, Ospedale Sacro Cuore-Don Calabria, Cancer Care Center, Negrar, Italy
| | - Nicholas Zaorsky
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Mahmut Ozsahin
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Herrmann E, Mertineit N, De Bari B, Hoeng L, Caparotti F, Leiser D, Jumeau R, Cihoric N, Jensen AD, Aebersold DM, Ozsahin M. Outcome of proximal esophageal cancer after definitive combined chemo-radiation: a Swiss multicenter retrospective study. Radiat Oncol 2017; 12:97. [PMID: 28615060 PMCID: PMC5470205 DOI: 10.1186/s13014-017-0834-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/02/2017] [Indexed: 02/08/2023] Open
Abstract
Objective To report oncological outcomes and toxicity rates, of definitive platin-based chemoradiadiationtherapy (CRT) in the management of proximal esophageal cancer. Methods We retrospectively reviewed the medical records of patients with cT1-4 cN0-3 cM0 cervical esophageal cancer (CEC) (defined as tumors located below the inferior border of the cricoid cartilage, down to 22 cm from the incisors) treated between 2004 and 2013 with platin–based definitive CRT in four Swiss institutions. Acute and chronic toxicities were retrospectively scored using the National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 4.0 (CTCAE-NCI v.4.0). Primary endpoint was loco-regional control (LRC). We also evaluated overall survival (OS) and disease-free survival (DFS) rates. The influence of patient- and treatment related features have been calculated using the Log-rank test and multivariate Cox proportional hazards model. Results We enrolled a total of 55 patients. Median time interval from diagnosis to CRT was 78 days (6–178 days). Median radiation dose was 56Gy (28–72Gy). Induction chemotherapy (ICHT) was delivered in 58% of patients. With a median follow up of 34 months (6–110months), actuarial 3-year LRC, DFS and OS were 52% (95% CI: 37–67%), 35% (95% CI: 22–50%) and 52% (95% CI: 37–67%), respectively. Acute toxicities (dysphagia, pain, skin-toxicity) ranged from grade 0 – 4 without significant dose-dependent differences. On univariable analyses, the only significant prognostic factor for LRC was the time interval > 78 days from diagnosis to CRT. On multivariable analysis, total radiation dose >56Gy (p <0.006) and ICHT (p < 0.004) were statistically significant positive predictive factors influencing DFS and OS. Conclusion Definitive CRT is a reliable therapeutic option for proximal esophageal cancer, with acceptable treatment related toxicities. Higher doses and ICHT may improve OS and DFS and. These findings need to be confirmed in further prospective studies.
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Affiliation(s)
- Evelyn Herrmann
- Department of Radiation Oncology, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland.
| | - Nando Mertineit
- Department of Radiation Oncology, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland.,Department of Diagnostic, Interventional and Pediatric Radiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Berardino De Bari
- Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland.,Radiation Oncology Department, Besançon University Hospital, Besançon, France
| | - Laura Hoeng
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Francesca Caparotti
- Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Dominic Leiser
- Department of Radiation Oncology, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Raphael Jumeau
- Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Nikola Cihoric
- Department of Radiation Oncology, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Alexandra D Jensen
- Department of Radiation Oncology, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Daniel M Aebersold
- Department of Radiation Oncology, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Mahmut Ozsahin
- Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland
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Affiliation(s)
- Berardino De Bari
- Berardino De Bari, André Durham, Jean Bourhis, and Mahmut Ozsahin, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - André Durham
- Berardino De Bari, André Durham, Jean Bourhis, and Mahmut Ozsahin, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean Bourhis
- Berardino De Bari, André Durham, Jean Bourhis, and Mahmut Ozsahin, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mahmut Ozsahin
- Berardino De Bari, André Durham, Jean Bourhis, and Mahmut Ozsahin, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Miny J, Bertaut A, Bosset JF, Boustani J, Rouffiac M, Ghiringhelli F, Borg C, De Bari B, Crehange G. Exclusive chemoradiation with carboplatin-paclitaxel versus FOLFOX-4 in locally advanced esophageal cancer: A matched-pair analysis. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.145] [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: 11/20/2022] Open
Abstract
145 Background: The PRODIGE 5 trial has demonstrated the safety and the efficacy of FOLFOX-4 combined with exclusive 50Gy external RT while the CROSS trial showed an improvement in overall survival with Carboplatin-Taxol (C-TAX) when combined with 41.4Gy before surgery. We sought to determine the feasibility and efficacy of exclusive RT with C-TAX compared to FOLFOX-4 regimen. Methods: 46 patients with locally advanced esophageal cancer who were treated with exclusive chemoradiation were matched 1:1 : 23 patients were treated with FOLFOX-4 regimen (group A) and 23 patients with C-TAX (group B). Comparison between the 2 groups was performed using Mac Nemar test for paired data. All tests were two sided and Pvalues were considered significant when less than 0.05. Results: The mean age in group A was 69.4 years (12.5) and 72.4 years (12.6) in group B (p = ns). In each group, 11 patients had a stage III disease at diagnosis (47.8%) with only 2 stage IV in group A (8.7%) vs none in group B. The median delivered RT doses were 50Gy [14-60] in group A while it was 50Gy [20-70] in group B. 6 courses of chemotherapy were delivered in 12 patients in group A (52.2%) and 14 patients in group B (60.9%) (p = 0.51). After chemoradiation, G1 or higher esophagitis was observed in 5 patients (26.3%) in group A and 3 patients (13.0%) in group B of whom 0 vs 2 G3 were observed in group A and B, respectively. Four patients (21.1%) had a pulmonary infection in group A and 3 in group B (13.0%). Two patients (8.7%) vs 4 patients (17.4%) had G3 neutropenia, with only 0 and 2 neutropenic fever in group A and B, respectively. Neither G3 anemia, nor G3 thrombopenia occured. After a median follow-up of 17.7 months [0.0-46.9], 25 patients had died, 14 in group A (60.9%) and 11 in group B (47.8%). The median PFS rates were 14.0 months in group A [7.7-NR] vs 12.1 months [4.4-NR] in group B (p = 0.32). The median OS rates were 20.3 months in group A [6.2-39.3] vs 17.0 months [4.8-NR] in group B (p = 0.82). Conclusions: Exclusive chemoradiation with C-TAX seems feasible with similar toxicity and survival outcomes than FOLFOX-4. The safety and efficacy of the CROSS regimen needs to be tested prospectively with RT doses > 41.4Gy in a phase II or III trial.
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Affiliation(s)
- Joelle Miny
- Besancon University Hospital, Besancon, France
| | | | | | | | | | | | - Christophe Borg
- Department of Medical Oncology, Besancon University Hospital, Besancon, France
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Gatta R, Lenkowicz J, Vallati M, Rojas E, Damiani A, Sacchi L, De Bari B, Dagliati A, Fernandez-Llatas C, Montesi M, Marchetti A, Castellano M, Valentini V. pMineR: An Innovative R Library for Performing Process Mining in Medicine. Artif Intell Med 2017. [DOI: 10.1007/978-3-319-59758-4_42] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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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48
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Pellanda AF, De Bari B, Deniaud-Alexandre E, Krengli M, Van Houtte P, Richetti A, Villà S, Goldberg H, Szutowicz-Zielińska E, Bolla M, Rutten H, Van Eijkeren M, Poortmans P, Henke G, Anacak Y, Chan S, Landmann C, Kirkove C, Scandolaro L, Bernier J, Mirimanoff RO, Ozsahin M. Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study. Chin J Cancer Res 2017; 29:521-532. [PMID: 29353974 DOI: 10.21147/j.issn.1000-9604.2017.06.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS. Methods We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model. Results All patients underwent surgery. Seventy-five patients (68%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16%). Seventeen patients (15%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity. Conclusions In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.
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Affiliation(s)
- Alessandra Franzetti Pellanda
- Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland.,Clinica Luganese Moncucco, 6903 Lugano, Switzerland
| | - Berardino De Bari
- Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland.,Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM, UMR1098, 25030 Besançon, France
| | | | - Marco Krengli
- Università degli Studi del Piemonte Orientale e Ospedale Maggiore della Carità, 28100 Novara, Italy
| | | | - Antonella Richetti
- Ospedale di Circolo, 21100 Varese, Italy.,Istituto Oncologico della Svizzera Italiana, EOC, 6500 Bellinzona, Switzerland
| | - Salvador Villà
- Catalan Institute of Oncology, Universitat Autònoma de Barcelona, 08916 Barcelona 08916, Spain
| | | | | | - Michel Bolla
- Hôpital Michallon, BP217, 38043, Grenoble cedex 09, France
| | - Heidi Rutten
- Radboud University Medical Center, 6525 Nijmegen, The Netherlands
| | | | - Philip Poortmans
- Radboud University Medical Center, 6525 Nijmegen, The Netherlands.,Institute Verbeeten, 90120 Tilburg, The Netherlands
| | - Guido Henke
- Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland
| | - Yavuz Anacak
- Karadeniz Technical University, 61080 Trabzon, Turkey
| | - Steve Chan
- Nottingham University Hospital, NHS trust, NG5 1PB Nottingham, United Kingdom
| | | | | | | | - Jacques Bernier
- Ospedale San Giovanni, 6500 Bellinzona, Switzerland.,Clinique de Genolier, Genolier, 1272 Switzerland
| | | | - Mahmut Ozsahin
- Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland
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De Bari B, Arcangeli S, Ciardo D, Mazzola R, Alongi F, Russi EG, Santoni R, Magrini SM, Jereczek-Fossa BA. Extreme hypofractionation for early prostate cancer: Biology meets technology. Cancer Treat Rev 2016; 50:48-60. [PMID: 27631875 DOI: 10.1016/j.ctrv.2016.08.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 05/19/2016] [Revised: 08/11/2016] [Accepted: 08/16/2016] [Indexed: 02/07/2023]
Abstract
The aim of this review is to present the available radiobiological, technical and clinical data about extreme hypofractionation in primary prostate cancer radiotherapy. The interest in this technique is based on the favourable radiobiological characteristics of prostate cancer and supported by advantageous logistic aspects deriving from short overall treatment time. The clinical validity of short-term treatment schedule is proven by a body of non-randomised studies, using both isocentric (LINAC-based) or non-isocentric (CyberKnife®-based) stereotactic body irradiation techniques. Twenty clinical studies, each enrolling more than 40 patients for a total of 1874 treated patients, were revised in terms of technological setting, toxicity, outcome and quality of life assessment. The implemented strategies for the tracking of the prostate and the sparing of the rectal wall have been investigated with particular attention. The urinary toxicity after prostate stereotactic body irradiation seems slightly more pronounced as compared to rectal adverse events, and this is more evident for late occurring events, but no worse as respect to conventional fractionation schemes. As far as the rate of severe acute toxicity is concerned, in all the available studies the treatment was globally well tolerated. While awaiting long-term data on efficacy and toxicity, the analysed studies suggest that the outcome profile of this approach, alongside the patient convenience and reduced costs, is promising. Forty-eight ongoing clinical trials are also presented as a preview of the expectation from the near future.
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Affiliation(s)
- Berardino De Bari
- Division of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Stefano Arcangeli
- Division of Radiation Oncology, San Camillo-Forlanini Hospitals, Rome, Italy
| | - Delia Ciardo
- Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.
| | - Rosario Mazzola
- Division of Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Filippo Alongi
- Division of Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Elvio G Russi
- S.C. di Radioterapia Oncologica, Azienda ospedaliera S. Croce e Carle, Cuneo, Italy
| | - Riccardo Santoni
- Università di Roma, Tor Vergata, U.O.C. di Radioterapia, Policlinico Tor Vergata, Roma, Italy
| | - Stefano M Magrini
- Istituto del Radio "O. Alberti", Spedali Civili, Università di Brescia, Brescia, Italy
| | - Barbara A Jereczek-Fossa
- Division of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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50
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De Bari B, Ozsahin M, Bize P, Boussaha T, Deplanque G, Wagner D, Bourhis J, Denys A. Can Stereotactic Body Radiotherapy Really Be Considered the Preferred Treatment in Large Hepatocellular Carcinoma? J Clin Oncol 2016; 34:2798-9. [PMID: 27325861 DOI: 10.1200/jco.2016.66.7196] [Citation(s) in RCA: 2] [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: 12/31/2022] Open
Affiliation(s)
| | - Mahmut Ozsahin
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pierre Bize
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Tarek Boussaha
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Gaël Deplanque
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Dorothea Wagner
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alban Denys
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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