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Demoor-Goldschmidt C, Veillon P, Esvan M, Leonard M, Chauvet S, Bertrand A, Carausu L, Delehaye F, Lejeune J, Rouger J, Schneider P, Thomas C, Millot F, Claude L, Leseur J, Missohou F, Supiot S, Bihannic N, Debroise I, Jeanneaud C, Lebreton E, Roumy M, Aguerris L, Chrétien JM, Gandemer V, Pellier I. A software tool to support follow-up care in a French childhood cancer cohort: construction and feasibility. BMC Cancer 2024; 24:130. [PMID: 38267891 PMCID: PMC10809785 DOI: 10.1186/s12885-024-11857-y] [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: 06/10/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Treatment summaries and a personalized survivorship care plans based on internationally approved, organ-specific follow-up care recommendations are essential in preserving the health and quality of life for cancer survivors. Cohorts made up of survivors of childhood cancer have made significant contributions to the understanding of early mortality, somatic late complications, and psychosocial outcomes among former patients. New treatment protocols are needed to enhance survival and reduce the potential risk and severity of late effects, and working with treatment databases is crucial in doing so. CONSTRUCTION AND CONTENT In the GOCE (Grand Ouest Cancer de l'Enfant [Western Region Childhood Cancer]) network, in a participative approach, we developed the LOG-after medical tool, on which health data are registered and can be extracted for analysis. Its name emphasizes the tool's goal, referring to 'logiciel' (the French word for software) that focuses on the period "after" the acute phase. This tool is hosted on a certified health data server. Several interfaces have been developed that can be used depending on the user's profile. Here we present this innovative co-constructed tool that takes national aspects into account, including the results of the feasibility/satisfaction study and its perspective. UTILITY AND DISCUSSION The database contains data relating to 2558 patients, with samples from 1702 of these (66.54%) being held in a tumor bank. The average year in which treatment started was 2015 (ranging from December 1967 to November 2022: 118 patients were treated before 2012 and registered retrospectively when seen in long-term follow-up consultations or for another cancer since November 2021). A short questionnaire was distributed to healthcare professionals using the tool (physicians and research associates or technicians, n = 14), of whom 11 answered and were all satisfied. Access to the patient interface is currently open to 124 former patients. This was initially offered to 30 former patients who were over 15 years old, affected by the disease within the last 5 years, and had agreed to test it. Their opinions were collected by their doctor by e-mail, telephone, or during a consultation in an open-ended question and a non-directive interview. All patients were satisfied with the tool, with interest in testing it in the long term. Some former patients found that the tool provided them with some ease of mind; one, for instance, commented: "I feel lighter. I allow myself to forget. I know I will get a notification when the time comes." CONCLUSIONS Freely available to all users, LOG-after: (1) provides help with determining personalized survivorship care plans for follow-up; (2) builds links with general practitioners; (3) empowers the patient; and (4) enables health data to be exported for analysis. Database URL for presentation: https://youtu.be/2Ga64iausJE.
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Affiliation(s)
- Charlotte Demoor-Goldschmidt
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France.
- Department of Radiotherapy, Centre François Baclesse, University of Caen, Caen, France.
- Department of Supportive Care, Centre François Baclesse, University of Caen, Caen, France.
- Inserm U 1018, Epidemiology of Radiation, Gustave Roussy, Villejuif, France.
| | - Pascal Veillon
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France
| | - Maxime Esvan
- Department of Biostatitics, University Hospital of Rennes, Rennes, France
| | - Mathilde Leonard
- Department of Biostatitics, University Hospital of Rennes, Rennes, France
| | - Sophie Chauvet
- Department of Oncohematopediatrics, University Hospital of Nantes, Nantes, France
| | | | - Liana Carausu
- Department of Oncohematopediatrics, University Hospital of Brest, Brest, France
| | - Fanny Delehaye
- Department of Oncohematopediatrics, University Hospital of Caen, Caen, France
| | - Julien Lejeune
- Department of Oncohematopediatrics, University Hospital of Tours, Tours, France
| | - Jérémie Rouger
- Department of Oncohematopediatrics, University Hospital of Caen, Caen, France
| | - Pascale Schneider
- Department of Oncohematopediatrics, University Hospital of Rouen, Rouen, France
| | - Caroline Thomas
- Department of Oncohematopediatrics, University Hospital of Nantes, Nantes, France
| | - Frédéric Millot
- Department of Oncohematopediatrics, University Hospital of Poitiers, Poitiers, France
| | - Line Claude
- Department of Radiotherapy, Centre Leon Berard, Lyon, France
| | - Julie Leseur
- Department of Radiotherapy, Centre Eugène Marquis, Rennes, France
| | - Fernand Missohou
- Department of Radiotherapy, Centre François Baclesse, University of Caen, Caen, France
| | - Stéphane Supiot
- Department of Radiotherapy, Institut de Cancérologie de L'Ouest, Nantes, France
| | - Nathalie Bihannic
- Department of Oncohematopediatrics, University Hospital of Brest, Brest, France
| | | | - Carole Jeanneaud
- Department of Oncohematopediatrics, University Hospital of Tours, Tours, France
| | - Esther Lebreton
- Department of Oncohematopediatrics, University Hospital of Caen, Caen, France
| | - Marianne Roumy
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France
| | | | - Jean-Marie Chrétien
- Data Science Department, Clinical and Innovation Direction, CHU Angers, Angers, France
| | - Virginie Gandemer
- Department of Oncohematopediatrics, University Hospital of Rennes, Rennes, France
| | - Isabelle Pellier
- Department of Oncohematopediatrics, University Hospital of Angers, University of Angers, Angers, France
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van Ewijk R, Chatziantoniou C, Adams M, Bertolini P, Bisogno G, Bouhamama A, Caro-Dominguez P, Charon V, Coma A, Dandis R, Devalck C, De Donno G, Ferrari A, Fiocco M, Gallego S, Giraudo C, Glosli H, Ter Horst SAJ, Jenney M, Klein WM, Leemans A, Leseur J, Mandeville HC, McHugh K, Merks JHM, Minard-Colin V, Moalla S, Morosi C, Orbach D, Ording Muller LS, Pace E, Di Paolo PL, Perruccio K, Quaglietta L, Renard M, van Rijn RR, Ruggiero A, Sirvent SI, De Luca A, Schoot RA. Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma: an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee. Pediatr Radiol 2023; 53:2539-2551. [PMID: 37682330 PMCID: PMC10635937 DOI: 10.1007/s00247-023-05745-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma. MATERIAL AND METHODS We performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols. We performed two-dimensional single-slice tumor delineation. Areas of necrosis or hemorrhage were delineated to be excluded in the primary analysis. Mean, median and 5th and 95th apparent diffusion coefficient (ADC) were extracted. RESULTS Of 134 included patients, 82 had measurable tumor at diagnosis and response and DW-MRI scans of adequate quality and were included in the analysis. Technical heterogeneity in scan acquisition protocols and scanners was observed. Mean ADC at diagnosis was 1.1 (95% confidence interval [CI]: 1.1-1.2) (all ADC expressed in * 10-3 mm2/s), versus 1.6 (1.5-1.6) at response assessment. The 5th percentile ADC was 0.8 (0.7-0.9) at diagnosis and 1.1 (1.0-1.2) at response. Absolute change in mean ADC after neoadjuvant chemotherapy was 0.4 (0.3-0.5). Exploratory analyses for association between ADC and clinical parameters showed a significant difference in mean ADC at diagnosis for alveolar versus embryonal histology. Landmark analysis at nine weeks after the date of diagnosis showed no significant association (hazard ratio 1.3 [0.6-3.2]) between the mean ADC change and event-free survival. CONCLUSION A significant change in the 5th percentile and the mean ADC after chemotherapy was observed. Strong heterogeneity was identified in DW-MRI acquisition protocols between centers and in individual patients.
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Affiliation(s)
- Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - Cyrano Chatziantoniou
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Madeleine Adams
- Department of Paediatric Oncology, Children's Hospital for Wales, University Hospital, Cardiff, UK
| | - Patrizia Bertolini
- Pediatric Hematology-Oncology Unit University-Hospital of Parma, Parma, Italy
| | - Gianni Bisogno
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy
| | - Amine Bouhamama
- Service de Radiologie Interventionnelle Oncologique, Centre Léon Bérard, Lyon, France
| | - Pablo Caro-Dominguez
- Pediatric Radiology Unit, Department of Radiology, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot S/N, Seville, Spain
| | | | - Ana Coma
- Paediatric Radiology Unit, Vall d´Hebron Hospital Campus, Barcelona, Spain
| | - Rana Dandis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | | | - Giulia De Donno
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Mathematical Institute, Leiden University, Leiden, The Netherlands
| | - Soledad Gallego
- Pediatric Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Chiara Giraudo
- Unit of Advanced Clinical and Translational Imaging, Department of Medicine-DIMED, University of Padova, 35122, Padua, Italy
| | - Heidi Glosli
- Department of Paediatric Research, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Simone A J Ter Horst
- Department of Radiology and Nuclear Medicine, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands
| | - Meriel Jenney
- Paediatric Oncology, Cardiff and Vale UHB, Cardiff, UK
| | - Willemijn M Klein
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Julie Leseur
- Service de Radiothérapie, Centre Eugène Marquis, Rennes, France
| | - Henry C Mandeville
- Department of Radiotherapy, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, UK
| | - Kieran McHugh
- Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Salma Moalla
- Department of Imaging, Institut Gustave Roussy, Villejuif, France
| | - Carlo Morosi
- Diagnostic and Interventional Radiology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA With Cancer), Institut Curie, PSL Research University, Paris, France
| | - Lil-Sofie Ording Muller
- Department of Radiology and Intervention Unit for Paediatric Radiology, Oslo University Hospital, Ullevål, Norway
| | - Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Pier Luigi Di Paolo
- Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Katia Perruccio
- Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria, Ospedale Santa Maria Della Misericordia, Perugia, Italy
| | - Lucia Quaglietta
- Neuro-Oncology Unit, Department of Paediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Marleen Renard
- Department of Paediatric Hemato-Oncology, University Hospital Leuven, Louvain, Belgium
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara I Sirvent
- Pediatric Radiology Department, Hospital Niño Jesús, Madrid, Spain
| | - Alberto De Luca
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
- Department of Neurology, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, The Netherlands
| | - Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
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Le Quellenec G, Bernier-Chastagner V, Sellami N, Helfre S, Satragno C, Leseur J, Escande A, Jolnerovski M, Noel G, Missohou F, Claude L, Cantaloube M, Laprie A, Huchet A, Scouarnec C, Guimard G, Muracciole X, Paul J, Supiot S, Jouglar E. Post-operative flank irradiation using conformal versus highly conformal radiotherapy techniques for paediatric renal tumours: Results from the French registry PediaRT. Pediatr Blood Cancer 2023; 70:e30627. [PMID: 37580901 DOI: 10.1002/pbc.30627] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/11/2023] [Accepted: 08/05/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE Three-dimensional conformal RT (3D-RT) techniques are gold standard for post-operative flank radiotherapy (RT) in paediatric renal tumours. Recently, highly conformal RT (HC-RT) techniques have been implemented without comparative clinical data. The main objective of this multicentre study was to compare locoregional control (LRC) in children treated either with HC-RT or 3D-RT techniques. METHODS Patients treated with post-operative flank RT for renal tumour registered in the national cohort PediaRT between March 2013 and September 2019 were included. Treatment and follow-up data, including toxicities and outcomes, were retrieved from the database. LRC was calculated, and dose reconstruction was performed in case of an event. RESULTS Seventy-nine patients were included. Forty patients were treated with HC-RT and 39 with 3D-RT. Median follow-up was 4.5 years. Three patients had locoregional failure (LRF; 4%). HC-RT was not associated with a higher risk of LRF. Three-year LRC were 97.4% and 94.7% in the HC-RT and 3D-RT groups, respectively. The proportion of planning target volumes receiving 95% or more of the prescribed dose did not significantly differ between both groups (HC-RT 88%; 3D-RT 69%; p = .05). HC-RT was better achieving dose constraints, and a significant mean dose reduction was observed in the peritoneal cavity and pancreas associated with lower incidence of acute gastrointestinal toxicity. CONCLUSION LRF after post-operative flank RT for renal tumours was rare and did not increase using HC-RT versus 3D-RT techniques. Dose to the pancreas and the peritoneal cavity, as well as acute toxicity, were reduced with HC-RT compared to 3D-RT.
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Affiliation(s)
- Gaelle Le Quellenec
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | | | - Noura Sellami
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Sylvie Helfre
- Department of Radiation Oncology, Institut Curie, PSL Research University, Paris, France
| | - Camilla Satragno
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
- Dipartimento di Medicina Sperimentale (DIMES), Università degli studi di Genova, Genoa, Italy
| | - Julie Leseur
- Department of Radiation Oncology, Centre Eugène Marquis, Rennes, France
| | - Alexandre Escande
- Department of Radiation Oncology, Centre Oscar Lambret, Lille, France
| | - Maria Jolnerovski
- Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Georges Noel
- Department of Radiation Oncology, Centre Paul Strauss, Strasbourg, France
| | - Fernand Missohou
- Department of Radiation Oncology, Centre François Baclesse, Caen, France
| | - Line Claude
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Marie Cantaloube
- Department of Radiation Oncology, Institut du cancer de Montpellier, Montpellier, France
| | - Anne Laprie
- Department of Radiation Oncology, Institut Claudius Regaud, IUCT-Oncopôle, Toulouse, France
| | - Aymeri Huchet
- Department of Radiation Oncology, Centre Hospitalier Universitaire, Bordeaux, France
| | - Cyrielle Scouarnec
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France
| | - Gregory Guimard
- Department of Paediatric Oncology, Centre Hospitalier Universitaire, Reims, France
| | - Xavier Muracciole
- Department of Radiation Oncology, La Timone Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Julie Paul
- Department of Biostatistics, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Emmanuel Jouglar
- Department of Radiation Oncology, Institut Curie, PSL Research University, Paris, France
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Tourniaire N, Leseur J, Roy A, de la Motte Rouge A, Pougheon Bertrand D. How to integrate a patient partner into a care team? Sante Publique 2023; 35:285-295. [PMID: 37848375 DOI: 10.3917/spub.233.0285] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Introduction It is not rare anymore to find patients with knowledge and experience of a care pathway integrating a team of health professionals in order to improve the quality and relevance of their peers’ care pathways. Purpose of research The aim of this article is to propose practical methodological answers and structuring questions to institutions and any health actor interested in integrating a Patient Partner (PP) into a team of health professionals. Results The results of an action-research (AR) carried out within a Cancer Treatment Centre (CTC) provide both a methodological framework and answers to the questions raised by this experimentation: How did the team and the PP organize themselves to implement the mission of peer support? What evaluations of the project should be put in place? How does everyone find their place in the project? And finally, what are the operational procedures, limits, and levers for integrating the PP into the team? Conclusions In the discussion section, we propose a model of experimentation based on AR, highlighting the main drivers and the interventions that feed them. Finally, we share a series of structuring questions arising from the co-construction work carried out by the people involved, which allowed us to build our action plan for the integration of a PP in the care team at the Rennes CTC, and which seems to us sufficiently generalizable to be tested and used by other teams and in other contexts.
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Affiliation(s)
- Nolwenn Tourniaire
- CAPPS Bretagne – Rennes – France
- Chaire de recherches sur l’Engagement des patients – Université Sorbonne Paris Nord – Bobigny – France
| | - Julie Leseur
- Département des radiations – Centre Eugène-Marquis – Rennes – France
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Desrousseaux J, Claude L, Chaltiel L, Tensaouti F, Padovani L, Bolle S, Escande A, Alapetite C, Supiot S, Bernier-Chastagner V, Huchet A, Leseur J, Truc G, Leblond P, Bertozzi AI, Ducassou A, Laprie A. Respective Roles of Surgery, Chemotherapy, and Radiation Therapy for Recurrent Pediatric and Adolescent Ependymoma: A National Multicentric Study. Int J Radiat Oncol Biol Phys 2023; 117:404-415. [PMID: 37437811 DOI: 10.1016/j.ijrobp.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 03/02/2023] [Accepted: 04/11/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE Half of the children and adolescents treated for intracranial ependymoma experience recurrences that are not managed in a standardized manner. This study aimed to retrospectively evaluate recurrence treatments. METHODS AND MATERIALS We assessed overall survival (OS) and progression-free survival (PFS) after a first relapse in a population of patients from the Pediatric Ependymoma Photons Protons and Imaging study (PEPPI study) who were treated with surgery and radiation therapy in French Society of Childhood Cancer reference centers between 2000 and 2013. Data were analyzed using the Cox model as well as a landmark analysis at 4 months that accounted for the guarantee-time bias. RESULTS The median follow-up of the whole population of 202 patients was 105.1 months, with a 10-year OS of 68.2% and PFS of 45.5%. Among the 100 relapse cases, 68.0% were local relapses, 20.0% were metastatic, and 12.0% were combined (local and metastatic). Relapses were treated by surgery (n = 79) and/or reirradiation (n = 52) and/or chemotherapy (n = 22). The median follow-up after relapse was 77.8 months. The OS and PFS at 5 years were 43.1% and 16.2%, respectively. After surgery or radiation therapy of the first relapse, OS and PFS were more favorable, whereas treatments that included chemotherapy with or without focal treatment were associated with worse OS and PFS. In the multivariate analysis, stereotactic hypofractionated reirradiation after surgery was associated with a significantly better outcome (OS, P = .030; PFS, P = .008) and chemotherapy with a worse outcome (OS, P = .028; PFS, P = .033). CONCLUSIONS This analysis of relapse treatments within the PEPPI study determined that irrespective of whether the relapse was localized or metastatic, treatments that included surgery and/or reirradiation had better outcomes.
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Affiliation(s)
- Jacques Desrousseaux
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.
| | - Line Claude
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Leonor Chaltiel
- Statistics Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Fatima Tensaouti
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France
| | - Laetitia Padovani
- Department of Radiation Oncology, Centre Hospitalier Universitaire La Timone, Marseille, France
| | - Stephanie Bolle
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - Alexandre Escande
- Department of Radiation Oncology, Centre Oscar Lambret, Lille, France
| | - Claire Alapetite
- Department of Radiation Oncology, Institut Curie, Paris, France; Department of Radiation Oncology, Centre de Protonthérapie, Orsay, France
| | - Stéphane Supiot
- Department of Radiation Oncology, Centre René Gauducheau, Nantes, France
| | | | - Aymeri Huchet
- Department of Radiation Oncology, Centre Hospitalier et Universitaire, Bordeaux, France
| | - Julie Leseur
- Department of Radiation Oncology, Centre Eugène Marquis, Rennes, France
| | - Gilles Truc
- Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Pierre Leblond
- Department of Pediatric Onco-Hematology, IHOP, Lyon, France
| | - Anne-Isabelle Bertozzi
- Department of Pediatric Onco-Hematology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Anne Ducassou
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Anne Laprie
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France; Toulouse NeuroImaging Center, ToNIC, Université de Toulouse, Inserm, UPS, Toulouse, France.
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de Crevoisier R, Leseur J, Bouvet C, Huguet F, Lagrange JL, Haaser T, Pasquier D, Créhange G, Supiot S, Pommier P, Roy A, Berna A, Blanchard P, Marcucci L. Compréhension/acceptation de la radiothérapie : un dilemme éthique résolu par une éthique de la considération et de la sollicitude. Cancer Radiother 2023; 27:115-125. [PMID: 37011968 DOI: 10.1016/j.canrad.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 03/02/2023]
Abstract
PURPOSE Ethical questions are poorly investigated specifically in radiation oncology. The objective of the study was to identify and understand the main ethical issue in radiation oncology. MATERIALS AND METHODS A quantitative analysis was based on the answers to a questionnaire of 200 professionals from 22 radiation oncology departments. The questionnaire mainly aimed to characterize the main ethical issue. A monocentric qualitative analysis was based on semi-structured interviews focused on the main identified ethical issue, carried out with eight technologists, and 20 patients undergoing radiotherapy. RESULTS The main ethical issue was the understanding and/or acceptance of the treatment by the patients (71 %), which frequently arises (more than once a month) (52 %), and corresponds to an ethical tension between the principles of respect for autonomy and beneficence (the good as viewed by the patient) as defined by Beauchamp and Childress. The technologists, wish the patient to be fully involved in his treatment, with the even possibility of refusing it. However, excluding paternalism and autonomic relentlessness, the technologists have the feeling of acting for the good of the patients by treating them with radiation, even if the patients are not always aware of it, because they are within a situation of vulnerability. If the hierarchy of principles is a compromise alternative, this problem is finally well resolved by the effective implementation of an ethic of consideration and solicitude, restoring the patient capabilities, i.e. the maximum development of his potentialities in his situation of vulnerability. Beyond the legal dimension, patient information is crucial and must consider the specific temporality of the patient. CONCLUSION The main ethical issue in radiation oncology is the understanding and/or acceptance of the treatment involving the development of an ethic of consideration and solicitude.
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Zhang C, Lafond C, Barateau A, Leseur J, Rigaud B, Chan Sock Line DB, Yang G, Shu H, Dillenseger JL, de Crevoisier R, Simon A. Automatic segmentation for plan-of-the-day selection in CBCT-guided adaptive radiation therapy of cervical cancer. Phys Med Biol 2022; 67. [PMID: 36541494 DOI: 10.1088/1361-6560/aca5e5] [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: 01/31/2022] [Accepted: 11/24/2022] [Indexed: 11/25/2022]
Abstract
Objective.Plan-of-the-day (PoD) adaptive radiation therapy (ART) is based on a library of treatment plans, among which, at each treatment fraction, the PoD is selected using daily images. However, this strategy is limited by PoD selection uncertainties. This work aimed to propose and evaluate a workflow to automatically and quantitatively identify the PoD for cervix cancer ART based on daily CBCT images.Approach.The quantification was based on the segmentation of the main structures of interest in the CBCT images (clinical target volume [CTV], rectum, bladder, and bowel bag) using a deep learning model. Then, the PoD was selected from the treatment plan library according to the geometrical coverage of the CTV. For the evaluation, the resulting PoD was compared to the one obtained considering reference CBCT delineations.Main results.In experiments on a database of 23 patients with 272 CBCT images, the proposed method obtained an agreement between the reference PoD and the automatically identified PoD for 91.5% of treatment fractions (99.6% when considering a 5% margin on CTV coverage).Significance.The proposed automatic workflow automatically selected PoD for ART using deep-learning methods. The results showed the ability of the proposed process to identify the optimal PoD in a treatment plan library.
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Affiliation(s)
- Chen Zhang
- Laboratory of Image Science and Technology, School of Computer Science and Engineering, Southeast University, Nanjing, People's Republic of China.,Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, F-35000 Rennes, France.,Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, People's Republic of China
| | - Caroline Lafond
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, F-35000 Rennes, France
| | - Anaïs Barateau
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, F-35000 Rennes, France
| | - Julie Leseur
- Radiotherapy Department, CLCC Eugène Marquis, F-35000 Rennes, France
| | - Bastien Rigaud
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, F-35000 Rennes, France
| | | | - Guanyu Yang
- Laboratory of Image Science and Technology, School of Computer Science and Engineering, Southeast University, Nanjing, People's Republic of China.,Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, People's Republic of China.,Centre de Recherche en Information Biomédical Sino-français (CRIBs), France
| | - Huazhong Shu
- Laboratory of Image Science and Technology, School of Computer Science and Engineering, Southeast University, Nanjing, People's Republic of China.,Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, People's Republic of China.,Centre de Recherche en Information Biomédical Sino-français (CRIBs), France
| | - Jean-Louis Dillenseger
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, F-35000 Rennes, France.,Centre de Recherche en Information Biomédical Sino-français (CRIBs), France
| | | | - Antoine Simon
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, F-35000 Rennes, France.,Centre de Recherche en Information Biomédical Sino-français (CRIBs), France
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Claude L, Bolle S, Morelle M, Huchet A, Vigneron C, Escande A, Chapet S, Leseur J, Bernier V, Carrie C, Barry A, Vizoso S, Blanc E, Laprie A, Supiot S. Hypofractionated stereotactic body radiation therapy (SBRT) in pediatric patients: results of a national prospective multicenter study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Leseur J, Créhange G, Pasquier D, Supiot S, Pommier P, Latorzeff I, Blanchard P, Mahé M, Sargos P, Colliaux J, Huguet F, Haaser T, Clavère P, Peiffert D, Lartigau É, Giraud P, Noël G, Simon JM, Hasbini A, Chauveinc L, Hennequin C, Lagrange J, de Crevoisier R. Évaluation du questionnement éthique en radiothérapie. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Di Perri D, Jouglar E, Blanc E, Ducassou A, Huchet A, Vigneron C, Escande A, Chapet S, Leseur J, Bernier V, Carrie C, Martin V, Claude L. Hypofractionated stereotactic body radiation therapy (SBRT) in pediatric patients: preliminary toxicity results of a national prospective multicenter study. Br J Radiol 2021; 94:20210176. [PMID: 34233469 DOI: 10.1259/bjr.20210176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES While hypofractionated stereotactic body radiotherapy (SBRT) has been largely adopted in the adult setting, its use remains limited in pediatric patients. This is due, among other factors, to fear of potential toxicities of hypofractionated regimens at a young age. In this context, we report the preliminary acute (<3 months from SBRT) and middle-term (3-24 months) toxicity results of a national prospective study investigating SBRT in pediatric patients. METHODS Between 2013 and 2019, 61 patients were included. The first 40 patients (median age: 12 y, range: 3-20) who completed a 2-year-follow-up were included in the present analysis. SBRT was used for treating lung, brain or (para)spinal lesions, either as first irradiation (35%) or in the reirradiation setting (65%). RESULTS Acute and middle-term grade ≥2 toxicities occurred in 12.5 and 7.5% of the patients, respectively. No grade ≥4 toxicities occurred. Almost all toxicities occurred in the reirradiation setting. CONCLUSION SBRT showed a favorable safety profile in young patients treated for lung, brain, and (para)spinal lesions. ADVANCES IN KNOWLEDGE SBRT appeared to be safe in pediatric patients treated for multiple oncology indications. These results support further evaluation of SBRT, which may have a role to play in this patient population in the future.
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Affiliation(s)
- Dario Di Perri
- Department of radiation oncology, Centre Léon Bérard, Lyon, France
| | - Emmanuel Jouglar
- Department of radiation oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Ellen Blanc
- Department of clinical research and innovation, Centre Léon Bérard, Lyon, France
| | - Anne Ducassou
- Department of radiation oncology, Institut Claudius Regaud, IUCT-Oncopôle, Toulouse, France
| | - Aymeri Huchet
- Department of radiation oncology, Centre Hospitalier Universitaire, Bordeaux, France
| | - Céline Vigneron
- Department of radiation oncology, Centre Paul Strauss, Strasbourg, France
| | - Alexandre Escande
- Department of radiation oncology, Centre Oscar Lambret, Lille, France
| | - Sophie Chapet
- Department of radiation oncology, Centre Hospitalier Universitaire, Tours, France
| | - Julie Leseur
- Department of radiation oncology, Centre Eugène Marquis, Rennes, France
| | - Valérie Bernier
- Department of radiation oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Christian Carrie
- Department of radiation oncology, Centre Léon Bérard, Lyon, France
| | - Valentine Martin
- Department of radiation oncology, Institut Gustave Roussy, Villejuif, France
| | - Line Claude
- Department of radiation oncology, Centre Léon Bérard, Lyon, France
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Machavoine R, Helfre S, Bernier V, Bolle S, Leseur J, Corradini N, Rome A, Defachelles AS, Deneuve S, Bernard S, Fayoux P, Nicollas R, Mondain M, Luscan R, Denoyelle F, Simon F, Kadlub N, Kolb F, Honart JF, Orbach D, Minard-Colin V, Moya-Plana A, Couloigner V. Locoregional Control and Survival in Children, Adolescents, and Young Adults With Localized Head and Neck Alveolar Rhabdomyosarcoma-The French Experience. Front Pediatr 2021; 9:783754. [PMID: 35186818 PMCID: PMC8855824 DOI: 10.3389/fped.2021.783754] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The head and neck (HN) are the most frequent sites of pediatric rhabdomyosarcoma (RMS). Alveolar RMS (ARMS) represents ~20% of all RMS cases and frequently spread to lymph nodes (LNs). The aim was to report locoregional control, event-free survival (EFS), and overall survival (OS), according to clinical and pathological features, LN staging, and treatment modalities. METHODS The study included all patients prospectively enrolled in EpSSG RMS 2005 study under 21 years of age with localized HN ARMS and diagnosed between 2005 and 2016 in France. Medical data including imaging, surgical report, and radiation therapy planes were analyzed. RESULTS Forty-eight patients (median age 6 years; range 4 months-21 years), corresponding to 30 parameningeal and 18 non-parameningeal ARMS, were included. There were 33 boys (69%). Tumor locations included the following: orbit (n = 7) among which four cases had bone erosion, paranasal sinuses and nasal cavity (n = 16), deep facial spaces (n = 10), nasolabial fold (n = 8), and other non-parameningeal HN sites (n = 7). A fusion transcript of PAX3-FOXO1 or PAX7-FOXO1 was expressed in 33 of the 45 cases (73%) with molecular analysis. At diagnosis, 10 patients had primary resection of the primary tumor (PRPT) (none with microscopic complete resection) and 9 had LN staging. After induction chemotherapy, 26 patients (54%) had secondary resection of the primary tumor (SRPT) and 13 patients (27%) had cervical LN dissection. A total of 43 patients (90%) were treated with radiation therapy.With a median follow-up of 7 years (range 2-13 years), 5-year OS and EFS were 78% (95% CI, 63-88%) and 66% (95% CI, 51-78%), respectively. We observed 16 events (10 deaths): 4 local, 4 regional, 1 local and regional, and 7 metastatic. In univariate analysis, OS was only superior for patients under 10 years of age (p = 0.002), while FOXO1-negative ARMS, SRPT for parameningeal ARMS, and LN surgery were associated with significantly better EFS. CONCLUSION Our study confirms a better outcome for fusion-negative ARMS and ARMS in children under 10 years. Moreover, LN surgery and SRPT of parameningeal tumor may improve EFS of ARMS. Larger studies are needed to confirm our findings.
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Affiliation(s)
- Roxane Machavoine
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Sylvie Helfre
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Valérie Bernier
- Département Universitaire de Radiothérapie-Curiethérapie, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Julie Leseur
- Service de Radiothérapie, Centre Eugène Marquis, Rennes, France
| | - Nadège Corradini
- Service d'Oncologie Pédiatrique, Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Angélique Rome
- Pediatric Oncology Department, Hôpitaux Universitaires de Marseille Timone, AP-HM, Marseille, France
| | | | - Sophie Deneuve
- Service d'Oto-Rhino-Laryngologie, Centre Léon Bérard, Lyon, France
| | - Sophie Bernard
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Robert Debré, APHP, Paris, France
| | - Pierre Fayoux
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Jeanne de Flandre, CHRU Lille, Lille, France
| | - Richard Nicollas
- Department of Pediatric Oto-Rhino-Laryngology, Hôpitaux Universitaires de Marseille Timone, AP-HM, Marseille, France
| | - Michel Mondain
- Service d'Oto-Rhino-Laryngologie, CHU Montpellier, Montpellier, France
| | - Romain Luscan
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Françoise Denoyelle
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - François Simon
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Natacha Kadlub
- Department of Pediatric Maxillo-Facial and Plastic Surgery, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Fréderic Kolb
- Plastic Surgery Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jean-François Honart
- Plastic Surgery Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Véronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Oto-Rhino-Laryngology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Vincent Couloigner
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
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Carrie C, Kieffer V, Figarella-Branger D, Masliah-Planchon J, Bolle S, Bernier V, Laprie A, Supiot S, Leseur J, Habrand JL, Alapetite C, Kerr C, Dufour C, Claude L, Chapet S, Huchet A, Bondiau PY, Escande A, Truc G, Nguyen TD, Pasteuris C, Vigneron C, Muracciole X, Bourdeaut F, Appay R, Dubray B, Colin C, Ferlay C, Dussart S, Chabaud S, Padovani L. Exclusive Hyperfractionated Radiation Therapy and Reduced Boost Volume for Standard-Risk Medulloblastoma: Pooled Analysis of the 2 French Multicentric Studies MSFOP98 and MSFOP 2007 and Correlation With Molecular Subgroups. Int J Radiat Oncol Biol Phys 2020; 108:1204-1217. [PMID: 32768563 DOI: 10.1016/j.ijrobp.2020.07.2324] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/03/2020] [Accepted: 07/29/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE Medulloblastoma has recently been characterized as a heterogeneous disease with 4 distinct molecular subgroups: wingless (WNT), sonic hedgehog (SHH), group 3, and group 4, with a new definition of risk stratification. We report progression-free survival, overall survival, and long-term cognitive effects in children with standard-risk medulloblastoma exclusively treated with hyperfractionated radiation therapy (HFRT), reduced boost volume, and online quality control, and we explore the prognostic value of biological characteristics in this chemotherapy-naïve population. METHODS AND MATERIALS Patients with standard-risk medulloblastoma were enrolled in 2 successive prospective multicentric studies, MSFOP 98 and MSFOP 2007, and received exclusive HFRT (36 Gy, 1 Gy/fraction twice daily) to the craniospinal axis followed by a boost at 68 Gy restricted to the tumor bed (1.5 cm margin), with online quality assurance before treatment. Patients with MYC or MYCN amplification were not excluded at the time of the study. We report progression-free survival and overall survival in the global population, and according to molecular subgroups as per World Health Organization 2016 molecular classification, and we present cognitive evaluations based on the Wechsler scale. RESULTS Data from 114 patients included in the MSFOP 98 trial from December 1998 to October 2001 (n = 48) and in the MSFOP 2007 from October 2008 to July 2013 (n = 66) were analyzed. With a median follow-up of 16.2 (range, 6.4-19.6) years for the MSFOP 98 cohort and 6.5 (1.6-9.6) years for the MSFOP 2007 cohort, 5-year overall survival and progression-free survival in the global population were 84% (74%-89%) and 74% (65%-81%), respectively. Molecular classification was determined for 91 patients (WNT [n = 19], SHH [n = 12], and non-WNT/non-SHH [n = 60]-including group 3 [n = 9], group 4 [n = 29], and not specified [n = 22]). Our results showed more favorable outcome for the WNT-activated subgroup and a worse prognosis for SHH-activated patients. Three patients had isolated extra-central nervous system relapse. The slope of neurocognitive decline in the global population was shallower than that observed in patients with a normofractionated regimen combined with chemotherapy. CONCLUSIONS HFRT led to a 5-year survival rate similar to other treatments combined with chemotherapy, with a reduced treatment duration of only 6 weeks. We confirm the MSFOP 98 results and the prognostic value of molecular status in patients with medulloblastoma, even in the absence of chemotherapy. Intelligence quotient was more preserved in children with medulloblastoma who received exclusive HFRT and reduced local boost, and intelligence quotient decline was delayed compared with patients receiving standard regimen. HFRT may be appropriate for patients who do not consent to or are not eligible for prospective clinical trials; for patients from developing countries for whom aplasia or ileus may be difficult to manage in a context of high cost/effectiveness constraints; and for whom shortened duration of RT may be easier to implement.
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Affiliation(s)
- Christian Carrie
- Department of Radiotherapy, Leon Berard Cancer Center, and University of Lyon, CNRS UMR 5220, INSERM U1044, INSA, Lyon, France.
| | - Virginie Kieffer
- Neuropsychologue CSI (Saint-Maurice hospital)/Gustave Roussy, Département de cancérologie de l'enfant et de l'adolescent, Gustave Roussy, Villejuif, France
| | - Dominique Figarella-Branger
- Aix Marseille Univ, CNRS, INP, Institute of Neurophysiopathology, Marseille, France; Department of AnatomoPathology and Neuropathology, AP-HM, University Hospital Center la Timone, Marseille, France
| | | | - Stéphanie Bolle
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Valérie Bernier
- Department of Radiotherapy, Alexis Vautrin Cancer Center, Vandoeuvre-les-Nancy, France
| | - Anne Laprie
- Department of Radiotherapy, University Institute of Cancer Toulouse-Oncopôle, France
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest (ICO), Nantes-Saint-Herblain, France
| | - Julie Leseur
- Department of Radiotherapy, Centre Eugène Marquis, Rennes, France
| | - Jean-Louis Habrand
- Department of Radiotherapy, François Baclesse Cancer Center, Caen, France
| | | | - Christine Kerr
- Department of Radiotherapy, Institut regional du Cancer, Val d'Aurelle, Montpellier, France
| | | | - Line Claude
- Department of Radiotherapy, Leon Berard Cancer Center, and University of Lyon, CNRS UMR 5220, INSERM U1044, INSA, Lyon, France
| | - Sophie Chapet
- Department of Radiotherapy, University Hospital Center of Tours, Tours, France
| | - Aymeri Huchet
- Department of Radiotherapy, University Hospital Center of Bordeaux, Bordeaux, France
| | | | | | - Gilles Truc
- Department of Radiotherapy, Georges-François Leclerc Cancer Center, Dijon, France
| | - Tan Dat Nguyen
- Department of Radiotherapy, Jean Godinot Institute, Reims, France
| | - Caroline Pasteuris
- Department of Radiotherapy, University Hospital Center of Grenoble, Grenoble, France
| | - Céline Vigneron
- Department of Radiotherapy, Centre Paul Strauss, Strasbourg, France
| | | | - Franck Bourdeaut
- SIREDO Pediatric Cancer Center, Institut Curie, Paris-Sciences-Lettres, Paris, France
| | - Romain Appay
- Aix Marseille Univ, CNRS, INP, Institute of Neurophysiopathology, Marseille, France; Department of AnatomoPathology and Neuropathology, AP-HM, University Hospital Center la Timone, Marseille, France
| | - Bernard Dubray
- Department of Radiotherapy, Henri Becquerel Cancer Center, Rouen, France
| | - Carole Colin
- Aix Marseille Univ, CNRS, INP, Institute of Neurophysiopathology, Marseille, France; Department of AnatomoPathology and Neuropathology, AP-HM, University Hospital Center la Timone, Marseille, France
| | - Céline Ferlay
- Department of Clinical Research and Innovation, Leon Berard Cancer center, Lyon, France
| | - Sophie Dussart
- Department of Clinical Research and Innovation, Leon Berard Cancer center, Lyon, France
| | - Sylvie Chabaud
- Department of Clinical Research and Innovation, Leon Berard Cancer center, Lyon, France
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Tahri S, Barateau A, Gobeli M, Leseur J, Williaume D, Crevoisier R, Hervé C, Trifard E, Lafond C, Perichon N. 39 Evaluation and comparison of CT-CBCT deformable image registration quality of two software for cervical cancer treatment. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Carrie C, Kieffer V, Figarella-Branger D, Masliah-Planchon J, Bolle S, Leseur J, Supiot S, Laprie A, Bernier V, Dufour C, Huchet A, Coche-Dequeant B, Truc G, Vigneron C, Alapetite C, Habrand J, Dubray B, Colin C, Ferlay C, Padovani L. Medulloblastoma Molecular Subgroup and Hyperfractionated Radiation Therapy Alone for Standard Risk Medulloblastoma : Results of the Pool Data of MSFOP 1998 and 2007 Studies. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Tensaouti F, Ducassou A, Chaltiel L, Bolle S, Habrand JL, Alapetite C, Coche-Dequeant B, Bernier V, Claude L, Carrie C, Padovani L, Muracciole X, Supiot S, Huchet A, Leseur J, Kerr C, Hangard G, Lisbona A, Goudjil F, Ferrand R, Laprie A. Feasibility of Dose Escalation in Patients With Intracranial Pediatric Ependymoma. Front Oncol 2019; 9:531. [PMID: 31293971 PMCID: PMC6598548 DOI: 10.3389/fonc.2019.00531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/22/2018] [Accepted: 05/31/2019] [Indexed: 12/25/2022] Open
Abstract
Background and purpose: Pediatric ependymoma carries a dismal prognosis, mainly owing to local relapse within RT fields. The current prospective European approach is to increase the radiation dose with a sequential hypofractionated stereotactic boost. In this study, we assessed the possibility of using a simultaneous integrated boost (SIB), comparing VMAT vs. IMPT dose delivery. Material and methods: The cohort included 101 patients. The dose to planning target volume (PTV59.4) was 59.4/1.8 Gy, and the dose to SIB volume (PTV67.6) was 67.6/2.05 Gy. Gross tumor volume (GTV) was defined as the tumor bed plus residual tumor, clinical target volume (CTV59.4) was GTV + 5 mm, and PTV59.4 was CTV59.4 + 3 mm. PTV67.6 was GTV+ 3 mm. After treatment plan optimization, quality indices and doses to target volume and organs at risk (OARs) were extracted and compared with the standard radiation doses that were actually delivered (median = 59.4 Gy [50.4 59.4]). Results: In most cases, the proton treatment resulted in higher quality indices (p < 0.001). Compared with the doses that were initially delivered, mean, and maximum doses to some OARs were no higher with SIB VMAT, and significantly lower with protons (p < 0.001). In the case of posterior fossa tumor, there was a lower dose to the brainstem with protons, in terms of V59 Gy, mean, and near-maximum (D2%) doses. Conclusion: Dose escalation with intensity-modulated proton or photon SIB is feasible in some patients. This approach could be considered for children with unresectable residue or post-operative FLAIR abnormalities, particularly if they have supratentorial tumors. It should not be considered for infratentorial tumors encasing the brainstem or extending to the medulla.
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Affiliation(s)
- Fatima Tensaouti
- ToNIC, Toulouse NeuroImaging Center, Universite de Toulouse, Inserm, Toulouse, France
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du, Cancer de Toulouse-Oncopole, Toulouse, France
- *Correspondence: Fatima Tensaouti ;
| | - Anne Ducassou
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du, Cancer de Toulouse-Oncopole, Toulouse, France
| | - Léonor Chaltiel
- Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Stéphanie Bolle
- Department of Radiotherapy Oncology, Institut Gustave Roussy, Villejuif, France
| | - Jean Louis Habrand
- Department of Radiation Oncology, Centre Francois Baclesse, Caen, France
| | | | | | - Valérie Bernier
- Department of Radiation Oncology, Centre Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | - Line Claude
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Christian Carrie
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | | | | | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancerologie de l'Ouest, Nantes, France
| | - Aymeri Huchet
- Department of Radiation Oncology, Centre Hospitalier et Universitaire, Bordeaux, France
| | - Julie Leseur
- Department of Radiation Oncology, Centre Eugéne Marquis, Rennes, France
| | - Christine Kerr
- Department of Radiation Oncology, Institut Regional du Cancer Montpellier, Val d'Aurelle, Montpellier, France
| | - Grégorie Hangard
- Department of Engineering and Medical Physics, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Albert Lisbona
- Department of Radiation Oncology, Institut de Cancerologie de l'Ouest, Nantes, France
| | - Farid Goudjil
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Régis Ferrand
- Department of Engineering and Medical Physics, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Anne Laprie
- ToNIC, Toulouse NeuroImaging Center, Universite de Toulouse, Inserm, Toulouse, France
- Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du, Cancer de Toulouse-Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
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Barateau A, Trifard E, Perichon N, Hervé C, Williaume D, Leseur J, Simon A, De Crevoisier R, Lafond C. EP-2003 Evaluation of three methods to calculate the dose on CBCT in case of IMRT for cervical cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Rigaud B, Simon A, Gobeli M, Leseur J, Duverge L, Williaume D, Castelli J, Lafond C, Acosta O, Haigron P, De Crevoisier R. Statistical Shape Model to Generate a Planning Library for Cervical Adaptive Radiotherapy. IEEE Trans Med Imaging 2019; 38:406-416. [PMID: 30130179 DOI: 10.1109/tmi.2018.2865547] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
External beam radiotherapy is extensively used to treat cervical carcinomas. A single planning CT scan enables the calculation of the dose distribution. The treatment is delivered over five weeks. Large per-treatment anatomical variations may hamper the dose delivery, with the potential of an organ-at-risk (OAR) overdose and a tumor underdose. To anticipate these deformations, a recent approach proposed three planning CTs with variable bladder volumes, which had the limitation of not covering all per-treatment anatomical variations. An original patient-specific population-based library has been proposed. It consisted of generating two representative anatomies, in addition to the standard planning CT anatomy. First, the cervix and bladder meshes of a population of 20 patients (314 images) were registered to an anatomical template, using a deformable mesh registration. An iterative point-matching algorithm was developed based on local shape context (histogram of polar or cylindrical coordinates and geodesic distance to the base) and on a topology constraint filter. Second, a standard principal component analysis (PCA) model of the cervix and bladder was generated to extract the dominant deformation modes. Finally, specific deformations were obtained using posterior PCA models, with a constraint representing the top of the uterus deformation. For a new patient, the cervix-uterus and bladder were registered to the template, and the patient's modeled planning library was built according to the model deformations. This method was applied following a leave-one-patient-out cross-validation. The performances of the modeled library were compared to those of the three-CT-based library, showing an improvement in both target coverage and OAR sparing.
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Tensaouti F, Ducassou A, Bolle S, Habrand J, Alapetite C, Coche-Dequeant B, Bernier V, Claude L, Carrie C, Padovani L, Muracciole X, Supiot S, Huchet A, Leseur J, Kerr C, Hangard G, Lisbona A, Goudjil F, Ferrand R, Laprie A. 19 Is dose escalation in intracranial pediatric ependymoma feasible with advanced radiation techniques? Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ducassou A, Padovani L, Chaltiel L, Bolle S, Habrand JL, Claude L, Carrie C, Muracciole X, Coche-Dequeant B, Alapetite C, Supiot S, Demoor-Goldschmidt C, Bernier-Chastagner V, Huchet A, Leseur J, Le Prise E, Kerr C, Truc G, Nguyen TD, Bertozzi AI, Frappaz D, Boetto S, Sevely A, Tensaouti F, Laprie A. Pediatric Localized Intracranial Ependymomas: A Multicenter Analysis of the Société Française de lutte contre les Cancers de l'Enfant (SFCE) from 2000 to 2013. Int J Radiat Oncol Biol Phys 2018; 102:166-173. [DOI: 10.1016/j.ijrobp.2018.05.036] [Citation(s) in RCA: 14] [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: 05/11/2018] [Accepted: 05/15/2018] [Indexed: 10/16/2022]
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Gobeli M, Rigaud B, Charra-Brunaud C, Renard S, De Rauglaudre G, Beneyton V, Racadot S, Peignaux K, Leseur J, Williaume D, Rannou N, Simon A, Lafond C, Jaksic N, Gnep K, Herve C, Riet F, Pougnet I, De Crevoisier R. PO-1078: CBCT guided adaptive radiotherapy for cervix cancer: Uncertainty of the choice of the plan of the day. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31388-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rigaud B, Simon A, Gobeli M, Lafond C, Leseur J, Barateau A, Jaksic N, Castelli J, Williaume D, Haigron P, De Crevoisier R. CBCT-guided evolutive library for cervical adaptive IMRT. Med Phys 2018; 45:1379-1390. [DOI: 10.1002/mp.12818] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/29/2017] [Accepted: 02/02/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Bastien Rigaud
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- INSERM; U1099, Campus de Beaulieu Rennes F-35042 France
| | - Antoine Simon
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- INSERM; U1099, Campus de Beaulieu Rennes F-35042 France
| | - Maxime Gobeli
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
| | - Caroline Lafond
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
| | - Julie Leseur
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
| | - Anais Barateau
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- INSERM; U1099, Campus de Beaulieu Rennes F-35042 France
| | - Nicolas Jaksic
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
| | - Joël Castelli
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- INSERM; U1099, Campus de Beaulieu Rennes F-35042 France
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
| | - Danièle Williaume
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
| | - Pascal Haigron
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- INSERM; U1099, Campus de Beaulieu Rennes F-35042 France
| | - Renaud De Crevoisier
- LTSI; Université de Rennes 1; Campus de Beaulieu Rennes F-35042 France
- INSERM; U1099, Campus de Beaulieu Rennes F-35042 France
- Radiotherapy Department; Centre Eugene Marquis; Rennes F-35000 France
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Padovani L, Chapon F, André N, Boucekine M, Geoffray A, Bourdeau F, Masliah-Planchon J, Claude L, Huchet A, Laprie A, Supiot S, Coche-Dequéant B, Kerr C, Alapetite C, Leseur J, Nguyen T, Chapet S, Bernier V, Bondiau PY, Noel G, Habrand JL, Bolle S, Doz F, Dufour C, Muracciole X, Carrie C. Hippocampal Sparing During Craniospinal Irradiation: What Did We Learn About the Incidence of Perihippocampus Metastases? Int J Radiat Oncol Biol Phys 2018; 100:980-986. [DOI: 10.1016/j.ijrobp.2017.12.265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/08/2017] [Accepted: 12/11/2017] [Indexed: 02/03/2023]
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Roman-Jimenez G, Acosta O, Leseur J, Devillers A, Der Sarkissian H, Guzman L, Grossiord E, Ospina JD, De Crevoisier R. Random forests to predict tumor recurrence following cervical cancer therapy using pre- and per-treatment 18F-FDG PET parameters. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:2444-2447. [PMID: 28324966 DOI: 10.1109/embc.2016.7591224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The ability to predict tumor recurrence after chemoradiotherapy of locally advanced cervical cancer is a crucial clinical issue to intensify the treatment of the most high-risk patients. The objective of this study was to investigate tumor metabolism characteristics extracted from pre- and per-treatment 18F-FDG PET images to predict 3-year overall recurrence (OR). A total of 53 locally advanced cervical cancer patients underwent pre- and per-treatment 18F-FDG PET (respectively PET1 and PET2). Tumor metabolism was characterized through several delineations using different thresholds, based on a percentage of the maximum uptake, and applied by region-growing. The SUV distribution in PET1 and PET2 within each segmented region was characterized through 7 intensity and histogram-based parameters, 9 shape descriptors and 16 textural features for a total of 1026 parameters. Predictive capability of the extracted parameters was assessed using the area under the receiver operating curve (AUC) associated to univariate logistic regression models and random forest (RF) classifier. In univariate analyses, 36 parameters were highly significant predictors of 3-year OR (p<;0.01), AUC ranging from 0.72 to 0.83. With RF, the Out-of-Bag (OOB) error rate using the totality of the extracted parameters was 26.42% (AUC=0.72). By recursively eliminating the less important variables, OOB error rate of the RF classifier using the nine most important parameters was 13.21% (AUC=0.90). Results suggest that both pre- and per-treatment 18F-FDG PET exams provide meaningful information to predict the tumor recurrence. RF classifier is able to handle a very large number of extracted features and allows the combination of the most prognostic parameters to improve the prediction.
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Demoor-Goldschmidt C, Drui D, Doutriaux I, Michel G, Auquier P, Dumas A, Berger C, Bernier V, Bohrer S, Bondiau PY, Filhon B, Fresneau B, Freycon C, Stefan D, Helfre S, Jackson A, Kerr C, Laprie A, Leseur J, Mahé MA, Oudot C, Pluchard C, Proust S, Sudour-Bonnange H, Vigneron C, Lassau N, Schlumberger M, Conter CF, de Vathaire F. A French national breast and thyroid cancer screening programme for survivors of childhood, adolescent and young adult (CAYA) cancers - DeNaCaPST programme. BMC Cancer 2017; 17:326. [PMID: 28499444 PMCID: PMC5427546 DOI: 10.1186/s12885-017-3318-1] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 05/03/2017] [Indexed: 02/04/2023] Open
Abstract
Background Survival of childhood, adolescent and young adult (CAYA) cancers has increased with progress in the management of the treatments and has reached more than 80% at 5 years. Nevertheless, these survivors are at great risk of second cancers and non-malignant co-morbidities in later life. DeNaCaPST is a non-interventional study whose aim is to organize a national screening for thyroid cancer and breast cancer in survivors of CAYA cancers. It will study the compliance with international recommendations, with the aim, regarding a breast screening programme, of offering for every woman living in France, at equal risk, an equal screening. Method DeNaCaPST trial is coordinated by the INSERM 1018 unit in cooperation with the LEA (French Childhood Cancer Survivor Study for Leukaemia) study’s coordinators, the long term follow up committee and the paediatric radiation committee of the SFCE (French Society of Childhood Cancers). A total of 35 centres spread across metropolitan France and la Reunion will participate. FCCSS (French Childhood Cancer Survivor Study), LEA and central registry will be interrogated to identify eligible patients. To participate, centers agreed to perform a complete “long-term follow-up consultations” according to good clinical practice and the guidelines of the SFCE (French Society of Children Cancers). Discussion As survival has greatly improved in childhood cancers, detection of therapy-related malignancies has become a priority even if new radiation techniques will lead to better protection for organs at risk. International guidelines have been put in place because of the evidence for increased lifetime risk of breast and thyroid cancer. DeNaCaPST is based on these international recommendations but it is important to recognize that they are based on expert consensus opinion and are supported by neither nonrandomized observational studies nor prospective randomized trials in this specific population. Over-diagnosis is a phenomenon inherent in any screening program and therefore such programs must be evaluated. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3318-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charlotte Demoor-Goldschmidt
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.
| | - Delphine Drui
- Department of endocrinology, CHU de Nantes, 44000, Nantes, France
| | - Isabelle Doutriaux
- Department of radiology, Institut de Cancérologie de l'Ouest - René Gauducheau, 44800, Saint Herblain, France
| | - Gérard Michel
- Service d'hématologie et oncologie pédiatrique, Hôpital d'enfants La Timone, Marseille, France.,Unité de recherche EA 3279, Université Aix-Marseille, Marseille, France
| | - Pascal Auquier
- Unité de recherche EA 3279, Université Aix-Marseille, Marseille, France.,Service de santé publique, assistance publique - hôpitaux de Marseille et université Aix-Marseille, Marseille, France
| | - Agnès Dumas
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 94805, Villejuif, France
| | - Claire Berger
- Claire Berger, hemato-oncology pediatric department, chu nord st Etienne, cedex, 42055, St Etienne, France
| | - Valérie Bernier
- Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Sandrine Bohrer
- Oncology and Hematology Unit, CHU de Saint Denis de La Réunion, Saint Denis, France
| | | | - Bruno Filhon
- Department of Pediatric Hematology and Oncology, Rouen University Hospital, Rouen, France
| | - Brice Fresneau
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Pediatric oncology department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Claire Freycon
- Service d'hématologie et d'oncologie pédiatrique du CHU de Grenoble, Grenoble, France
| | - Dinu Stefan
- Department of Radiation Oncology, Centre François Baclesse, Caen, France
| | - Sylvie Helfre
- Department of Radiation Oncology, institut Curie, Paris, France
| | - Angela Jackson
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France
| | - Christine Kerr
- Department of Radiation Oncology, institut du cancer de Montpellier, Montpellier, France
| | - Anne Laprie
- Department of Radiation Oncology, IUCT Oncopole, Toulouse, France
| | - Julie Leseur
- Department of Radiation Oncology, centre Eugène-Marquis, Rennes, France
| | | | - Caroline Oudot
- Pediatric Oncology Department, Hôpital de la Mère et de l'Enfant, 87042, Limoges, France
| | - Claire Pluchard
- Pediatric Oncology Department, chu Reims, hôpital américain, Reims, France
| | | | | | - Céline Vigneron
- Department of Radiation Oncology, Centre de lutte contre le Cancer Paul Strauss, Strasbourg, France
| | - Nathalie Lassau
- Imaging Department, Gustave Roussy Cancer Campus Grand Paris, IR4M UMR8081, Université Paris Sud, Villejuif, France
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Université Paris Saclay, 94805, Villejuif, France
| | | | - Florent de Vathaire
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 94805, Villejuif, France
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Prioul H, Simon P, Hulot C, Bouvet C, Le-Prisé É, Leseur J. Consultation d’accompagnement spécifique en radiothérapie pédiatrique : expérience du Centre Eugène-Marquis. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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26
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Leseur J, Roman-Jimenez G, Devillers A, Ospina-Arango JD, Williaume D, Castelli J, Terve P, Lavoue V, Garin E, Lejeune F, Acosta O, De Crevoisier R. Pre- and per-treatment 18F-FDG PET/CT parameters to predict recurrence and survival in cervical cancer. Radiother Oncol 2016; 120:512-518. [DOI: 10.1016/j.radonc.2016.08.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/03/2016] [Accepted: 08/03/2016] [Indexed: 11/29/2022]
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Demoor-Goldschmidt C, Claude L, Carrie C, Bolle S, Helfre S, Alapetite C, Jouin A, Padovani L, Ducassou A, Vigneron C, Le Prisé É, Huchet A, Stefan D, Kerr C, Nguyen TD, Truc G, Chapet S, Bondiau PY, Coche B, Muracciole X, Laprie A, Noël G, Leseur J, Habrand JL, Potet H, Ruffier A, Supiot S, Mahé MA, Bernier V. [French organization of paediatric radiation treatment: Results of a survey conducted by the radiotherapy Committee of the French Society of Paediatric Cancers (SFCE)]. Cancer Radiother 2016; 20:395-9. [PMID: 27421622 DOI: 10.1016/j.canrad.2016.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 02/19/2016] [Revised: 04/22/2016] [Accepted: 05/06/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Radiotherapy is a rare indication in paediatric oncology, with 800 to 900 children in treatment per year in France. Child cancers represent approximately 1% of cancers in France and half occur before the age of 5 years. Paediatric radiation requires appropriate tools, local, time and specific training. In France, in 2015, 18 centres are accredited by the French National Cancer Institute (INCa) for this activity. MATERIAL AND METHODS Survey conducted in February 2015 on the care of children (0 to 18 years) in radiotherapy departments in France. The survey was sent to the radiation oncologists involved in the 18 centres. The questions concerned the qualitative and quantitative aspect, medical and organizational aspects, and the involvement of assistant practitioners in the management of this activity. RESULTS Seventeen centres responded. In 2014, 889 children under 18 were treated in radiotherapy departments. These departments are working together with one to four paediatric oncology departments. Regarding access to general anaesthesia: three centres perform one to seven treatment(s) under anaesthesia per year, three centres eight to ten treatments under anaesthesia per year, three centres ten to 24 treatments under anaesthesia per year and nine centres out of 17 use hypnosis techniques. In terms of human resources, in 2015, 29 radiation therapists have a paediatric radiotherapy activity. Involvement of assistant practitioners is growing and specific training are desired. Regarding treatment preparation and delivery, 13 centres have specific paediatric contentions, 14 of 16 centres employ radiation intensity modulated if dosimetry is more satisfying with 11 regularly to the craniospinal irradiation. Radiotherapy on moving areas with respiratory gating or hypofractionation is under developed. CONCLUSION Paediatric radiation therapy is a specific activity requiring a dedicated management, both in human, organizational, medical and scientific aspects.
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Affiliation(s)
- C Demoor-Goldschmidt
- Radiothérapie, institut de cancérologie de l'Ouest-Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France; Inserm U1018, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - L Claude
- Radiothérapie, centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - C Carrie
- Radiothérapie, centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - S Bolle
- Radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - S Helfre
- Radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - C Alapetite
- Radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - A Jouin
- Radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - L Padovani
- Radiothérapie, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - A Ducassou
- Radiothérapie, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
| | - C Vigneron
- Radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000 Strasbourg, France
| | - É Le Prisé
- Radiothérapie, centre Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - A Huchet
- Radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France
| | - D Stefan
- Radiothérapie, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - C Kerr
- Radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France
| | - T-D Nguyen
- Radiothérapie, institut Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France
| | - G Truc
- Radiothérapie, institut Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - S Chapet
- Radiothérapie, Corad, hôpital Bretonneau, CHRU de Tours, 2 boulevard Tonnellé, 37000 Tours, France
| | - P-Y Bondiau
- Radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06100 Nice, France
| | - B Coche
- Radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - X Muracciole
- Radiothérapie, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - A Laprie
- Radiothérapie, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
| | - G Noël
- Radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000 Strasbourg, France
| | - J Leseur
- Radiothérapie, centre Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - J-L Habrand
- Radiothérapie, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - H Potet
- Radiothérapie, institut Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France
| | - A Ruffier
- Radiothérapie, Corad, hôpital Bretonneau, CHRU de Tours, 2 boulevard Tonnellé, 37000 Tours, France
| | - S Supiot
- Radiothérapie, institut de cancérologie de l'Ouest-Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - M-A Mahé
- Radiothérapie, institut de cancérologie de l'Ouest-Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - V Bernier
- Radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000 Strasbourg, France
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Padovani L, Chapon F, Geoffray A, Claude L, Huchet A, Laprie A, Dequeant BC, Kerr C, Alapetite C, Leseur J, Chapet S, Bernier V, Bondiau PY, Noel G, Andre N, Doz F, Carrie C, Dufour C, Muracciole X. MB-47RISK OF HIPPOCAMPAL REGION METASTASIS IN HIGH RISK MEDULLOBLASTOMA: SUFFICIENT RATIONAL FOR HIPPOCAMPAL SPARING DURING CRANIOSPINAL IRRADIATION? Neuro Oncol 2016. [DOI: 10.1093/neuonc/now076.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Roman-Jimenez G, Acosta O, Leseur J, Devillers A, Le Gouestre J, Ospina JD, Simon A, Terve P, De Crevoisier R. Weighted quantification of ¹⁸F-FDG tumor metabolism activity using fuzzy-thresholding to predict post-treatment tumor recurrence. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:2239-42. [PMID: 26736737 DOI: 10.1109/embc.2015.7318837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cervical cancer is one of the most common cancer to affect women worldwide. Despite the efficiency of radiotherapy treatment, some patients present post-treatment tumor recurrence which increases the risk of death. Early outcome prediction could help oncologists to adapt the treatment. Several studies suggest that quantification of tumor activity using (18)FFDG PET imaging could be used to predict post-treatment tumor recurrence. In this paper we study the predictive value of weighted quantification of tumor metabolism extracted by fuzzy-thresholding for tumor recurrence of locally advanced cervical cancer. Fifty-three patients with locally advanced cervical cancer treated by chemo-radiotherapy were considered in our study. For each patient, a coregistered (18)F-FDG PET/CT scan was acquired before the treatment and was segmented using different hard and fuzzy segmentations methods. The tumor activity was extracted through the total lesion glycolysis and through a weighted analog of the total lesion glycolysis using the probability maps provided by the fuzzy segmentations. Outcomes prediction was performed using the area under the receiver operating characteristic curve (AUC) and the Harrell's C-index. Results suggest that weighted quantification of tumor activity seems to be strongly informative and could be used to predict post-treatment tumor recurrence in cervical cancer.
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Gobeli M, Simon A, Gétain M, Dardelet E, Lafond C, Williaume D, Lahlou E, De Crevoisier R, Leseur J. Dosimetric Benefit of Adaptive Radiation Therapy With Reduced Planning Target Volume Margins in Cervix Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gobeli M, Simon A, Getain M, Leseur J, Lahlou E, Lafond C, Dardelet E, Williaume D, Rigaud B, de Crevoisier R. Bénéfice de la radiothérapie adaptative par bibliothèque de plans de traitement pour les cancers du col utérin ? Cancer Radiother 2015; 19:471-8. [DOI: 10.1016/j.canrad.2015.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 06/09/2015] [Accepted: 06/12/2015] [Indexed: 11/16/2022]
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Bernier V, Desandes E, Carrie C, Leseur J. Étude Avarthec : complications vasculaires de l’irradiation crânienne pour tumeur cérébrale durant l’enfance et l’adolescence. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Roman Jimenez G, Leseur J, Devillers A, Ospina J, Acosta O, Terve P, Gobeli M, Lavoué V, Williaume D, De Crevoisier R. PD-0356: 18F-FDG PET parameters during radio-chemotherapy to predict tumor recurrence in cervical cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Roman-Jimenez G, Ospina JD, Leseur J, Devillers A, Castelli J, Simon A, Terve P, Acosta O, de Crevoisier R. Investigating the contribution of pre- and per-treatment 18F-FDG PET-CT segmentation methodologies for post-treatment tumor recurrence prediction in cervical cancer. Ing Rech Biomed 2013. [DOI: 10.1016/j.irbm.2013.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ducassou A, Gambart M, Munzer C, Carrie C, Claude L, Habrand J, Bolle S, Bernier V, Helfre S, Leseur J, Padovani L, Huchet A, Bergeron C, Valteau-Couanet D, Schleiermacher G, Coze C, Defachelles A, Plouvier E, Plantaz D, Perel Y, Devalck C, Laprie A. Survie et toxicité tardive après radiothérapie pour un neuroblastome localisé. Dix ans d’expérience de la Société française de lutte contre les cancers de l’enfant (SFCE). Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Leseur J, Devillers A, Louvel G, Williaume D, Lévêque J, Bouriel C, Garin É, de Crevoisier R. Intérêt de la TEP et de l’IRM en cours de chimioradiothérapie pour prédire la récidive dans les cancers du col de l’utérus localement évolués. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Louvel G, Simon A, Chajon E, Cazoulat G, Lafond C, Henry O, Haigron P, Bensadoun R, Leseur J, de Crevoisier R. Radiothérapie adaptative en ORL pour diminuer la xérostomie. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Benchalal M, Cazoulat G, Bellec J, Leseur J, Chajon E, Haigron P, Léna H, de Crevoisier R, Simon A. Planification selon la position moyenne du cycle respiratoire : modèle de planification optimale pour une distribution de dose dans les tumeurs pulmonaires. Cancer Radiother 2012; 16:91-9. [DOI: 10.1016/j.canrad.2011.07.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 07/17/2011] [Accepted: 07/26/2011] [Indexed: 10/14/2022]
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Leseur J, Devillers A, Williaume D, Le Prisé E, Fougerou C, Bouriel C, Levêque J, Monpetit E, Blanchot J, de Crevoisier R, Garin E. [((18)F)-fluorodeoxyglucose PET/CT in cervix cancer: lymph node assessment and prognostic/predictive value of primary tumour analysis]. Cancer Radiother 2011; 15:699-708. [PMID: 22104953 DOI: 10.1016/j.canrad.2011.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 04/15/2011] [Accepted: 05/22/2011] [Indexed: 12/30/2022]
Abstract
PURPOSE In cervix carcinoma: (a) to evaluate the ability of ((18)F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the lymph node detection; (b) to investigate the prognostic and predictive value of the primary cervical PET parameters. PATIENTS AND METHODS Ninety patients treated for cervix carcinoma and evaluated initially by MRI and FGD PET were included. The performances of FDG-PET for lymph node detection (relatively to the lymph node dissection) have been described (sensitivity, specificity, positive predictive value and negative predictive value). PET tumour parameters analyzed were: maximum standard uptake value (SUVmax), the volume and the maximum diameter. The prognostic and predictive values of these parameters were investigated. The tumour response was evaluated on surgical specimens. RESULTS PET detected the cervical tumour with a sensitivity of 97% (mean values: SUVmax=15.8, volume=27 mm(3), maximum diameter=47). For the detection of the lymph nodes, the values of sensibility, specificity, positive predictive value and negative predictive value were: 86, 56, 69 and 78% in the pelvic, and 90, 67, 50 and 95% for the para-aortic area, respectively. The SUVmax was correlated with histologic response (P=0.04). The frequency of partial histological response was significantly higher for tumour SUVmax>10.9 (P=0.017). The maximum PET diameter and pathologic response had an impact on disease-free survival and overall survival in multivariate analysis (P<0.05). CONCLUSION PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors.
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Affiliation(s)
- J Leseur
- Département des Radiations, Centre Eugène-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France.
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Leseur J, Louvel G, Devillers A, Olivier P, Gillet N, Rodrigues C, Williaume D, Arango JO, Garin E, De Crevoisier R. 2000 ORAL Prognostic Value of Metabolic Response Assessed by 18F-FDG PET During Radiotherapy for Cervix and Head and Neck Carcinoma. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70958-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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de Crevoisier R, Chira C, Lafond C, Crouzet L, Simon A, Louvel G, Leseur J, Manens J, Le Prisé E. Benefit of IMRT in High Dose Prostate Cancer Radiotherapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leseur J, Bernier V, Habrand J, Laprie A, Mahe M, Supiot S, Truc G, Le Prisé E, Claude L, Carrie C. Intensity-modulated radiation therapy for pediatric head and neck rhabdomyosarcoma: French preliminary results. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Padovani L, Leseur J, André N, Figarella-Branger D, Lena G, Frappaz D, Gentet J, Carrie C, Cowen D, Muracciole X. Pediatric Medulloblastoma: Educational Long-term Outcome and Clinical Factors. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Leseur J, Carrie C, Le Prisé E, Bernier V, Beneyton V, Mahé M, Supiot S. Radiothérapie conformationnelle par modulation d’intensité des tumeurs pédiatriques. Cancer Radiother 2009; 13:536-42. [DOI: 10.1016/j.canrad.2009.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 06/23/2009] [Accepted: 07/06/2009] [Indexed: 01/16/2023]
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