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Bourbonne V, Lévy A, Khalifa J, Antoni D, Blais E, Darréon J, Le Péchoux C, Lerouge D, Giraud P, Marguerit A, Pourel N, Riet FG, Thureau S. Radiotherapy in the management of lung oligometastases. Cancer Radiother 2024; 28:36-48. [PMID: 38228422 DOI: 10.1016/j.canrad.2023.06.030] [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: 02/26/2023] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 01/18/2024]
Abstract
In recent years, the development of both medical imaging and new systemic agents (targeted therapy and immunotherapy) have revolutionized the field of oncology, leading to a new entity: oligometastatic disease. Adding local treatment of oligometastases to systemic treatment could lead to prolonged survival with no significant impact on quality of life. Given the high prevalence of lung oligometastases and the new systemic agents coming with increased pulmonary toxicity, this article provides a comprehensive review of the current state-of-art for radiotherapy of lung oligometastases. After reviewing pretreatment workup, the authors define several radiotherapy regimen based on the localization and size of the oligometastases. A comment on the synergistic combination of medical treatment and radiotherapy is also made, projecting on future steps in this specific clinical setting.
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Affiliation(s)
- V Bourbonne
- Radiation Oncology Department, CHU de Brest, Brest, France; LaTim, Inserm, UMR 1101, université de Bretagne occidentale, Brest, France
| | - A Lévy
- Department of Radiation Oncology, Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - J Khalifa
- Department of Radiation Oncology, institut Claudius-Regaud, institut universitaire du cancer Toulouse-Oncopôle, Toulouse, France
| | - D Antoni
- Department of Radiation Oncology, Institut de cancérologie Strasbourg Europe, Strasbourg, France
| | - E Blais
- Department of Radiation Oncology, polyclinique Marzet, Pau, France
| | - J Darréon
- Department of Radiation Oncology, institut Paoli-Calmettes, Marseille, France
| | - C Le Péchoux
- Department of Radiation Oncology, Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - D Lerouge
- Department of Radiation Oncology, centre François-Baclesse, Caen, France
| | - P Giraud
- Department of Radiation Oncology, hôpital européen Georges-Pompidou, Paris, France; Université Paris Cité, Paris, France
| | - A Marguerit
- Department of Radiation Oncology, Institut de cancérologie de Montpellier, Montpellier, France
| | - N Pourel
- Department of Radiation Oncology, institut Sainte-Catherine, Avignon, France
| | - F-G Riet
- Department of Radiation Oncology, centre hospitalier privé Saint-Grégoire, 35760 Saint-Grégoire, France
| | - S Thureau
- Radiotherapy Department, centre Henri-Becquerel, Rouen, France; QuantIF-Litis EA4108, université de Rouen, Rouen, France.
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2
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Khalifa J, Lévy A, Sauvage LM, Thureau S, Darréon J, Le Péchoux C, Lerouge D, Pourel N, Antoni D, Blais E, Martin É, Marguerit A, Giraud P, Riet FG. Radiotherapy in the management of synchronous metastatic lung cancer. Cancer Radiother 2024; 28:22-35. [PMID: 37574329 DOI: 10.1016/j.canrad.2023.03.002] [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: 01/05/2023] [Accepted: 03/02/2023] [Indexed: 08/15/2023]
Abstract
Metastatic lung cancer classically portends a poor prognosis. The management of metastatic lung cancer has dramatically changed with the emergence of immune checkpoint inhibitors, targeted therapy and due to a better understanding of the oligometastatic process. In metastatic lung cancers, radiation therapy which was only used with palliative intent for decades, represents today a promising way to treat primary and oligometastatic sites with a curative intent. Herein we present through a literature review the role of radiotherapy in the management of synchronous metastatic lung cancers.
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Affiliation(s)
- J Khalifa
- Department of Radiation Oncology, institut Claudius-Regaud/IUCT-Oncopole, Toulouse, France; U1037, Inserm, CRCT, Toulouse, France.
| | - A Lévy
- Department of Radiation Oncology, International Center for Thoracic Cancers (CICT), Gustave-Roussy, 94805 Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; Université Paris-Saclay, Molecular Radiotherapy and Therapeutic Innovation lab, Inserm U1030, 94805 Villejuif, France
| | - L-M Sauvage
- Department of Radiation Oncology, institut Curie, Paris, France
| | - S Thureau
- Department of Radiation Oncology, centre Henri-Becquerel, Rouen, France; QuantIf-Litis EA4108, université de Rouen, Rouen, France
| | - J Darréon
- Department of Radiation Oncology, institut Paoli-Calmettes, Marseille, France
| | - C Le Péchoux
- Department of Radiation Oncology, International Center for Thoracic Cancers (CICT), Gustave-Roussy, 94805 Villejuif, France
| | - D Lerouge
- Department of Radiation Oncology, centre François-Baclesse, Caen, France
| | - N Pourel
- Department of Radiation Oncology, institut Sainte-Catherine, Avignon, France
| | - D Antoni
- Department of Radiation Oncology, institut de cancérologie Strasbourg Europe, Strasbourg, France
| | - E Blais
- Department of Radiation Oncology, polyclinique Marzet, Pau, France
| | - É Martin
- Department of Radiation Oncology, centre Georges-François-Leclerc, Dijon, France
| | - A Marguerit
- Department of Radiation Oncology, institut de cancérologie de Montpellier, Montpellier, France
| | - P Giraud
- Department of Radiation Oncology, hôpital européen Georges-Pompidou, Paris, France; Université Paris Cité, Paris, France
| | - F-G Riet
- Department of Radiation Oncology, centre hospitalier privé Saint-Grégoire, Saint-Grégoire, France
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Giraud P, Fleury B, Le Prince C, Falk AT, Rousse C, Hance H, Santini JJ, Bicheron D, Palisson J, Hannoun-Lévi JM, Tack K, Marchesi V, Azria D. [Interprofessional recommendations on behalf of Société française de radiothérapie oncologique for the prevention, protection and management of cyberattacks in radiation oncology]. Cancer Radiother 2023; 27:683-688. [PMID: 37839920 DOI: 10.1016/j.canrad.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
Cybersecurity is currently a major issue. Large hospitals are no longer the only main targets of attacks, but all healthcare organizations and establishments, without distinction of size or activities. The information system is defined as all the resources needed to collect images, store and process them with general distribution of multiple information within an organization. Systems are therefore crucial for the functioning of a medical department. Radiation oncology is one of the specialties most dependent on digital resources, for imaging, data transfer, dosimetry, treatment and so on.. Radiation oncology departments are therefore a prime target for ransomware attacks, which have increased significantly in recent years. Cybersecurity can be likened to a viral or bacterial attack. It is based on the two usual pillars of antimicrobial protection : hygiene and prophylaxis. In this article, we will detail by analogy the three classic levels of prevention of a bacillary attack: "primary prevention", which acts upstream of the infection; "secondary prevention", which acts at an early stage of its evolution; and "tertiary prevention", which acts on complications and risks of recurrence. This article is the result of an interprofessional group on behalf of SFRO, the French society of radiation oncology, with the aim of helping all teams to implement safety adapted to the specificities of a radiation oncology department in France.
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Affiliation(s)
- P Giraud
- Université de Paris Cité, Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France.
| | - B Fleury
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - C Le Prince
- Service de physique médicale, Centre de la Baie, 1, avenue du Quesnoy, 50307 Avranches cedex, France
| | - A T Falk
- Centre azuréen de cancérologie, 1, place Dr-Jean-Luc-Broquerie, 06250 Mougins, France
| | - C Rousse
- Autorité de sûreté nucléaire, 15, rue Louis-Lejeune, CS 70013, 92541 Montrouge cedex, France
| | - H Hance
- Service qualité, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - J-J Santini
- Institut régional du cancer de Montpellier ICM, parc Euromédecine, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - D Bicheron
- Centre azuréen de cancérologie, 1, place Dr-Jean-Luc-Broquerie, 06250 Mougins, France
| | - J Palisson
- Service de physique médicale, Centre de la Baie, 1, avenue du Quesnoy, 50307 Avranches cedex, France
| | - J-M Hannoun-Lévi
- Centre Antoine-Lacassagne, université Côte d'Azur, 33, avenue de Valombrose, 06189 Nice, France
| | - K Tack
- Autorité de sûreté nucléaire, 15, rue Louis-Lejeune, CS 70013, 92541 Montrouge cedex, France
| | - V Marchesi
- Service de physique médicale, Institut de cancérologie de Lorraine, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; Société française de physique médicale, centre Antoine-Béclère, 47, rue de la Colonie, 75013, Paris, France
| | - D Azria
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Institut régional du cancer de Montpellier ICM, parc Euromédecine, 208, avenue des Apothicaires, 34090 Montpellier, France; Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, université de Montpellier, Inserm, U1194 IRCM, 34000 Montpellier, France
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4
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Laccourreye O, Gervais C, Garcia D, Amiri G, Mirghani H, Giraud P. Harmful impact of treatment refusal in T3-4M0 endolaryngeal squamous cell carcinoma candidates for total laryngectomy: A STROBE analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:221-225. [PMID: 37321906 DOI: 10.1016/j.anorl.2023.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Indexed: 06/17/2023]
Abstract
PURPOSE To evaluate the consequences of treatment refusal in total laryngectomy (TL) candidates with T3-4M0 endolaryngeal squamous cell carcinoma (SCC). MATERIALS AND METHODS A retrospective observational study was conducted in an inception cohort of 576 isolated T3-4M0 endolaryngeal SCC candidates for TL consecutively managed between 1970 and 2019 in a French university teaching hospital. The main endpoint was survival time and cause of death in 2 groups. Group A, 4.5% of the cohort, consisted of 26 patients who declined any laryngeal treatment. Group B consisted of 550 patients who accepted TL. Accessory endpoints were causes of TL refusal and associated variables. The STROBE guideline was applied. The significance threshold was set at P<0.005. RESULTS One-and 3-year actuarial survival estimates increased significantly (P<0.0001) from 39% and 15% in group A, to 83% and 63% in group B, respectively. In group A, 92% of causes of death implicated index SCC progression, whereas in group B intercurrent disease, metachronous second primary, locoregional and/or metastatic SCC progression and postoperative complications accounted for 37%, 31%, 29%, and 2%, respectively. The actuarial survival estimates within group A increased significantly (P=0.0003) from 0% at 1-year in patients managed with isolated supportive care to 56% in patients managed with chemotherapy (reaching 0% at 5years). Reasons for TL refusal were fear of surgery, refusal of tracheostoma, loss of physiologic phonation, and certain comorbidities. Age and chronologic period correlated significantly with TL refusal. Median age decreased (P<0.001) from 69years in group A to 58 years in group B. Percentage TL refusal increased (P<0.0001) from 2% to 11% before and after start 1990, respectively. CONCLUSION The current study determined loss of survival with refusal of any laryngeal treatment including TL, noted benefit of chemotherapy associated to supportive care, and discussed the possible contribution of immunotherapy.
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Affiliation(s)
- O Laccourreye
- Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - C Gervais
- Service d'Oncologie Médicale, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - D Garcia
- Hôpital Français, SO1 Pho Phuong Mai, Dong Da District, Hanoi, Viet Nam
| | - G Amiri
- Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - H Mirghani
- Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Service de Radiothérapie-Oncologie, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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5
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Guihard S, Piot M, Issoufaly I, Giraud P, Bruand M, Faivre JC, Eugène R, Liem X, Pasquier D, Lamrani-Ghaouti A, Ghannam Y, Ruffier A, Guilbert P, Larnaudie A, Thariat J, Rivera S, Clavier JB. [Real world data in radiotherapy: A data farming project by Unitrad]. Cancer Radiother 2023; 27:455-459. [PMID: 37517975 DOI: 10.1016/j.canrad.2023.06.016] [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: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 08/01/2023]
Abstract
The aim of the data farming project by the Unitrad group is to produce and use large quantities of structured real-life data throughout radiotherapy treatment. Starting in 2016, target real world data were selected at expert consensus conferences and regularly updated, then captured in MOSAIQ© as the patient was treated. For each partner institution, the data was then stored in a relational database, then extracted and used by researchers to create real world knowledge. This production was carried out in a multicentre, coordinated fashion. When necessary, the raw data was shared according to the research projects, in compliance with regulations. Feedack was provided at each stage, enabling the system to evolve flexibly and rapidly, using the "agile" method. This work, which is constantly evolving, has led to the creation of health data warehouses focused on data of interest in radiotherapy, and the publication of numerous academic studies. It forms part of the wider context of the exploitation of real-life data in cancerology. Unitrad data farming is a collaborative project for creating knowledge from real-life radiotherapy data, based on an active network of clinicians and researchers.
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Affiliation(s)
- S Guihard
- Radiothérapie, institut de cancérologie de Strasbourg (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France.
| | - M Piot
- Laboratoire List3N, école doctorale SPI de l'université de technologie de Troyes, 12, rue Marie-Curie, 10300 Troyes, France
| | - I Issoufaly
- Radiothérapie, Gustave-Roussy, Villejuif, France
| | - P Giraud
- Inserm, UMR 1138, équipe« Science de l'information au service de la médecine », 15, rue de l'École-de-Médecine, 75006 Paris, France; Radiothérapie, hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - M Bruand
- Radiothérapie, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - J-C Faivre
- Radiothérapie, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - R Eugène
- Oncology Informatics Consultant, Elekta SAS, Boulogne-Billancourt, France
| | - X Liem
- Radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - D Pasquier
- Radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | | | - Y Ghannam
- Radiothérapie, Gustave-Roussy, Villejuif, France
| | - A Ruffier
- Radiothérapie, institut interrégional de cancérologie, centre Jean-Bernard, clinique Victor-Hugo, Le Mans, France
| | - P Guilbert
- Radiothérapie, institut Godinot, 1, rue du Général-Koenig, 51100 Reims, France
| | - A Larnaudie
- Radiothérapie, centre François-Baclesse, 14000 Caen, France
| | - J Thariat
- Radiothérapie, centre François-Baclesse, 14000 Caen, France
| | - S Rivera
- Radiothérapie, Gustave-Roussy, Villejuif, France
| | - J-B Clavier
- Radiothérapie, institut de cancérologie de Strasbourg (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France
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Laccourreye O, Chambrin G, Garcia D, Troux C, Mirghani H, Giraud P. Successful 10-year outcomes after supracricoid partial laryngectomy for selected glottic squamous cell carcinoma classified as T3N0M0: A STROBE analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:165-170. [PMID: 36609114 DOI: 10.1016/j.anorl.2022.12.006] [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] [Indexed: 01/06/2023]
Abstract
PURPOSE To evaluate long-term oncological outcome for patients with selected glottic squamous cell carcinoma (SCC) classified as T3N0M0 treated by supracricoid partial laryngectomy (SCPL). MATERIALS AND METHODS Analysis of an inception cohort of 46 patients with isolated untreated SCC classified as T3N0M0 and minimum 10-year follow-up, consecutively treated by SCPL between 1982 and 2012 in a French university teaching hospital. The main endpoint was 5- and 10-year actuarial survival and local control estimates. Accessory endpoints comprised cause of death, screening for variables decreasing survival and increasing risk of local recurrence, oncologic consequences of local recurrence, and laryngeal preservation rate. RESULTS Five- and 10-year actuarial survival was 78.1%, and 53.3%, respectively. The main causes of death were intercurrent disease and metachronous second primary, each in 33.3% of cases. Postoperative mortality (aspiration pneumonia) was 2.1%. There were no significant correlations between survival and any study variables. Five- and 10-year local control was 90.5%. Overall local recurrence varied significantly (P=0.003), from 2.3% with negative margins (R0) to 100% with positive margins (R1) and/or dysplasia. Local recurrence was associated with a significantly (P<0.005) increased risk of nodal failure and distant metastasis, and reduced survival. Overall laryngeal preservation was 89.1%. CONCLUSION The present results suggest that SCPL should continue to be taught and that this type of partial laryngeal surgery should be included in the various organ-sparing strategies considered in advanced laryngeal cancer.
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Affiliation(s)
- O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale HEGP, université Paris Cité, AP-HP, 20-40 rue Leblanc, 75015 Paris, France.
| | - G Chambrin
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale HEGP, université Paris Cité, AP-HP, 20-40 rue Leblanc, 75015 Paris, France
| | - D Garcia
- Hôpital Français, SO1 Pho Phuong Mai, Dong Da District, Hanoi, Vietnam
| | - C Troux
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale HEGP, université Paris Cité, AP-HP, 20-40 rue Leblanc, 75015 Paris, France
| | - H Mirghani
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale HEGP, université Paris Cité, AP-HP, 20-40 rue Leblanc, 75015 Paris, France
| | - P Giraud
- Service d'oncologie-radiothérapie, université Paris Cité, HEGP, AP-HP, 20-40 rue Leblanc, 75015 Paris, France
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7
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Larnaudie A, Giraud P, Naessens C, Stefan D, Clavère P, Balosso J. Radiotherapy of skin adnexal carcinoma. Cancer Radiother 2023:S1278-3218(23)00062-8. [PMID: 37080860 DOI: 10.1016/j.canrad.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 04/22/2023]
Abstract
Skin adnexal carcinomas are rare skin cancer, developing from pilosebaceous, eccrine and apocrine unit. Treatment of localised tumours usually includes surgery and radiotherapy. Indications and modalities of radiotherapy depend on the pathological subtype with a lack of consensus for some histologies. This review summarises the place of radiotherapy in terms of indication, dose and fractionation, volumes to irradiate and discuss ongoing studies.
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Affiliation(s)
- A Larnaudie
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France; Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France.
| | - P Giraud
- Radiation Oncology, Pitié Salpêtrière, Charles-Foix University Hospital, 47-83, boulevard de l'hôpital, 75013 Paris, France; Médecine Sorbonne universités, 91-105, boulevard de l'hôpital, 75013 Paris, France
| | - C Naessens
- Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - D Stefan
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - P Clavère
- Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - J Balosso
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
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8
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Laccourreye O, Mirghani H, Guiquerro S, Quer M, Giraud P. Perception of survival/laryngeal preservation trade-off in advanced T-stage laryngeal cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:77-80. [PMID: 36642664 DOI: 10.1016/j.anorl.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate the perception of the survival/laryngeal preservation trade-off in advanced T-stage laryngeal cancer. MATERIAL AND METHODS The Cochrane, PubMed, Embase, and Science Direct databases were searched using the keywords "cancer, neoplasms, trade-off. One hundred and eighty four articles were found; 176 of these, without data in the Abstract documenting the survival/laryngeal preservation trade-off for advanced T-stage laryngeal cancer, were excluded. Eight articles, totaling 1,052 interviewees, were read to document modalities of evaluation, trade-off thresholds, and variables influencing the perception of trade-off. RESULTS Evaluation of trade-off was based on responses in group discussions, interviews and questionnaires and on patient file analysis. One study reported that 28.2% of respondents could not make a decision between options, and in 4 studies 22% to 80% of respondents would not consider jeopardizing survival. A mean 2-3 year gain (range, 6 months to 5 years) in survival was required before preferring total laryngectomy to chemoradiotherapy. The percentage loss of disease-free survival tolerated by respondents who would consider a trade-off to preserve the larynx ranged from 5% to 100%, for a median 30%. Variables influencing trade-off comprised respondent status (patient/healthcare provider/healthy subject) and characteristics (job, having children) and treatment data (amount and modalities of information delivered, survival estimates after radiation therapy, health status after treatment). A time for reflection after diagnosis and good quality information were important for respondents. CONCLUSION Several consequences emerge from these data. The first is to consider induction chemotherapy, to give the patient time to make an informed choice. The second is to not to give up teaching total laryngectomy The third is to determine whether the team's own results match the information delivered to patients.
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Affiliation(s)
- O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Paris Cité, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - H Mirghani
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Paris Cité, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - S Guiquerro
- Université Paris Cité, bibliothèque universitaire médicale Necker, 156, rue Vaugirard, 75730 Paris Cedex 15, France
| | - M Quer
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Autonome de Barcelone, Hospital de la Santa Creu i Sant Pau, 90, rue Mas Casanovas, 08041 Barcelona, Spain
| | - P Giraud
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Paris Cité, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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9
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Legouté F, Lesueur P, El Kabbaj O, Ghannam Y, Michalet M, Monpetit E, Azria D, Giraud P, Calais G, Pointreau Y, Ollivier L. [French careers in oncology radiotherapy: Crossing views]. Cancer Radiother 2023; 27:75-79. [PMID: 36008260 DOI: 10.1016/j.canrad.2022.07.016] [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: 05/07/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 02/06/2023]
Abstract
The French Society of Young Radiation Oncologists (SFjRO), the National Union of Radiation Oncologists (SNRO) and the French Society of Oncological Radiotherapy (SFRO) aim to reconcile career opportunities and demographic needs in oncology. In 2021, 932 radiation oncologists (RO) are in regular activity in France, this represents an increase of more than 20% in ten years. Physician distribution is changing in public hospitals, cancer centers and private clinics. Currently one third of ROs works in each sector. In addition, fifteen percent of ROs have a mixed activity. In 2021, 180 young RO (trainees and residents) were questioned by SFjRO board about their training, internship, coaching and career guidance. An interactive communication was organized during the 32nd SFRO Meeting in 2021. It was an opportunity to bring the results of this study. More than 70% RO interviewed answered to the survey, for 55% among them, career choice was difficult. In order to help young ROs in their professional approach, three RO made an oral presentation during this session, about radiotherapy in public hospitals, private centers or with a mixed practice. The aim of this article is to summarize the highlights of the last SFjRO/SFRO session: expectations of young RO, career prospects and trends.
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Affiliation(s)
- F Legouté
- Service de radiothérapie, centre hospitalier départemental Vendée, boulevard Stéphane-Moreau, 85000 La Roche-sur-Yon, France.
| | - P Lesueur
- Département de radiothérapie, centre François-Baclesse, Caen, France; Département de radiothérapie, centre Guillaume-le-Conquérant, Le-Havre, France
| | - O El Kabbaj
- Centre Saint-Yves-radiothérapie, 11, rue du Docteur-Audic, 56000 Vannes, France
| | - Y Ghannam
- Société française des jeunes radiothérapeutes oncologues (SFjRO), centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Département de radiothérapie, Institut de cancérologie de l'ouest, 15, rue André-Boquel, 49100 Angers, France
| | - M Michalet
- Société française des jeunes radiothérapeutes oncologues (SFjRO), centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Service d'oncologie radiothérapie, Institut du cancer de Montpellier, Montpellier, France
| | - E Monpetit
- Centre Saint-Yves-radiothérapie, 11, rue du Docteur-Audic, 56000 Vannes, France; Syndicat national des radiothérapeutes oncologues (SNRO), centre Saint-Yves radiothérapie, 11, rue du Docteur-Audic, 56000 Vannes, France
| | - D Azria
- Service d'oncologie radiothérapie, Institut du cancer de Montpellier, Montpellier, France; Société française de radiothérapie oncologique (SFRO), centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
| | - P Giraud
- Société française de radiothérapie oncologique (SFRO), centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - G Calais
- Service de radiothérapie, centre régional universitaire de cancérologie Henry-S.-Kaplan, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - Y Pointreau
- Service de radiothérapie, centre régional universitaire de cancérologie Henry-S.-Kaplan, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Centre Jean-Bernard, clinique Victor-Hugo, (Institut interrégional de cancérologie), 9, rue Beauverger, 72000 Le Mans, France
| | - L Ollivier
- Société française des jeunes radiothérapeutes oncologues (SFjRO), centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Département de radiothérapie, Institut de cancérologie de l'ouest, boulevard Professeur-Jacques-Monod, 44800 Saint-Herblain, France
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Trédaniel J, Barlési F, Le Péchoux C, Lerouge D, Pichon É, Le Moulec S, Moreau L, Friard S, Westeel V, Petit L, Carré O, Guichard F, Raffy O, Villa J, Prévost A, Langlais A, Morin F, Wislez M, Giraud P, Zalcman G, Mornex F. Final results of the IFCT-0803 study, a phase II study of cetuximab, pemetrexed, cisplatin, and concurrent radiotherapy in patients with locally advanced, unresectable, stage III, non-squamous, non-small-cell lung cancer. Cancer Radiother 2022; 26:670-677. [PMID: 35260342 DOI: 10.1016/j.canrad.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/24/2021] [Accepted: 12/12/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Roughly 20% of patients with non-small-cell lung cancer exhibit locally advanced, unresectable, stage III disease. Concurrent platinum-based chemoradiotherapy is the backbone treatment, which is followed by maintenance immunotherapy, yet with poor long-term prognosis. This phase II trial (IFCT-0803) sought to evaluate whether adding cetuximab to cisplatin and pemetrexed chemoradiotherapy would improve its efficacy in these patients. MATERIALS AND METHODS Eligible patients received weekly cetuximab (loading dose 400mg/m2 day 1; subsequent weekly 250mg/m2 doses until two weeks postradiotherapy). Chemotherapy comprised cisplatin (75mg/m2) and pemetrexed (500mg/m2), both delivered on day 1 of a 21-day cycle of maximally four. Irradiation with maximally 66Gy started on day 22. Disease control rate at week 16 was the primary endpoint. RESULTS One hundred and six patients were included (99 eligible patients). Compliance exceeded 95% for day 1 of chemotherapy cycles 1 to 4, with 76% patients receiving the 12 planned cetuximab doses. Maximal grade 3 toxicity occurred in 63% patients, and maximal grade 4 in 9.6%. The primary endpoint involving the first 95 eligible patients comprised two (2.1%) complete responses, 57 (60.0%) partial responses, and 27 (28.4%) stable diseases. This 90.5% disease control rate (95% confidence interval [95% CI]: 84.6%-96.4%) was achieved at week 16. After median 63.0-month follow-up, one-year and two-year survival rates were 75.8% and 59.5%. Median overall survival was 35.8months (95% CI: 23.5-NR), and median progression-free survival 14.4months (95% CI: 11.2-18.8), with one-year and two-year progression-free survival rates of 57.6% and 34.3%. CONCLUSION These survival rates compare favourably with published data, thus justifying further development of cetuximab-based induction chemoradiotherapy.
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Affiliation(s)
- J Trédaniel
- Department of pneumology, hôpital Saint-Joseph, 75014 Paris, France.
| | - F Barlési
- Multidisciplinary oncology and therapeutic innovations department, centre hospitalier universitaire de Marseille, 13000 Marseille, France
| | - C Le Péchoux
- Department of radiation oncology, Gustave-Roussy, 94805 Villejuif, France
| | - D Lerouge
- Department of radiation oncology, centre François-Baclesse, 14000 Caen, France
| | - É Pichon
- Department of pneumology, centre hospitalier universitaire de Tours, 37000 Tours, France
| | - S Le Moulec
- Department of pneumology, institut Bergonié, 33000 Bordeaux, France
| | - L Moreau
- Department of pneumology, hôpital Louis-Pasteur, 68024 Colmar, France
| | - S Friard
- Department of pneumology, hôpital Foch, 92150 Suresnes, France
| | - V Westeel
- Department of pneumology, centre hospitalier universitaire de Besançon, 25000 Besançon, France
| | - L Petit
- Department of pneumology, centre hospitalier Alpes Léman, 74130 Contamine-sur-Arve, France
| | - O Carré
- Department of pneumology, clinique de l'Europe, 80090 Amiens, France
| | - F Guichard
- Department of oncology, polyclinique, 33000 Bordeaux, France
| | - O Raffy
- Department of pneumology, hôpital de Chartres, 28000 Chartres, France
| | - J Villa
- Department of pneumology, centre hospitalier universitaire de Grenoble, 38000 Grenoble, France
| | - A Prévost
- Department of pneumology, centre de lutte contre le cancer Jean-Godinot, 51100 Reims, France
| | - A Langlais
- Intergroupe francophone de cancérologie thoracique, 75000 Paris, France
| | - F Morin
- Intergroupe francophone de cancérologie thoracique, 75000 Paris, France
| | - M Wislez
- Department of pneumology, hôpital Cochin, 75014 Paris, France
| | - P Giraud
- Department of radiation Oncology, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - G Zalcman
- Department of pneumology, centre hospitalier universitaire de Caen, 14000 Caen, France
| | - F Mornex
- Department of radiation oncology, centre hospitalier universitaire de Lyon, 69000 Lyon, France
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Escande A, Frey P, Lacornerie T, Mervoyer E, Chargari C, Laurans M, Mornex F, Marijon É, Giraud P. Radiotherapy for patient with cardiac implantable electronic device, consensus from French radiation oncology society. Cancer Radiother 2021; 26:404-410. [PMID: 34969621 DOI: 10.1016/j.canrad.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Radiotherapy in patients with cardiac implantable electronic device such as pacemakers or defibrillators, is a clinical situation that is becoming increasingly common. There is a risk of interaction between the magnetic field induced by accelerators and the cardiac implantable electronic device, but also a risk of device dysfunction due to direct and/or indirect irradiation if the cardiac implantable electronic device is in the field of treatment. The risk can be dose-dependent, but it is most often independent of the total dose and occurs randomly in case of neutron production (stochastic effect). The presence of this type of device is therefore described as a contraindication for radiotherapy by the French national agency for the safety of medicines and health products (Agence nationale de sécurité du médicament et des produits de santé, ANSM). Nevertheless, since radiotherapy is often possible, it is advisable to respect the recommendations of good practice, in particular the eligibility criteria, the monitoring modalities before, during and after irradiation according to the type of treatment, the dose and the characteristics of the cardiac implantable electronic device. It is sometimes necessary to discuss repositioning the device and/or modifying the treatment plan to minimize the risk of cardiac implantable electronic device dysfunction. We present the update of the recommendations of the French society of oncological radiotherapy on in patients with cardiac implantable electronic device.
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Affiliation(s)
- A Escande
- Département universitaire de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France; Faculté de médecine Henri-Warembourg, université de Lille, 59000 Lille, France; UMR 9189, Centre de recherche en informatique, signal et automatique de Lille (Cristal), 59655 Villeneuve d'Ascq, France.
| | - P Frey
- Département de cardiologie, centre hospitalier Annecy Genevois, 74370 Épagny-Metz-Tessy, France
| | - T Lacornerie
- Département de physique médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - E Mervoyer
- Département de cardiologie, Institut de cancérologie de l'Ouest, 44800 Saint-Herblain, France
| | - C Chargari
- Unité de curiethérapie, département de radiothérapie, Gustave-Roussy, 94805 Villejuif, France
| | - M Laurans
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - F Mornex
- Département de radiothérapie, centre hospitalier Lyon Sud, 69310 Pierre-Bénite, France
| | - É Marijon
- Département de cardiologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Université de Paris, 20, rue Leblanc, 75015 Paris, France
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Abstract
We present an update of the French society of oncological radiotherapy recommendation regarding indication, doses, and technique of radiotherapy for intrathoracic metastases. The recommendations for delineation of the target volumes and critical organs are detailed.
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Affiliation(s)
- A Lévy
- Département d'oncologie radiothérapie, Gustave-Roussy, 94805 Villejuif, France; Université Paris-Saclay, Inserm U1030, radiothérapie moléculaire, 94805, Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France.
| | - J Darréon
- Département d'oncologie radiothérapie, institut Paoli-Calmettes, 13000 Marseille, France; CRCM Inserm U1068, 13000 Marseille, France
| | - F Mornex
- Département d'oncologie radiothérapie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; EMR 3738, université Claude-Bernard Lyon1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 12, rue de l'École-de-Médecine, 75006 Paris, France
| | - S Thureau
- Département de d'oncologie radiothérapie, centre Henri-Becquerel, 1, rue d'Amiens, 76000 Rouen, France; QuantIf Litis EA4108, université de Rouen, 76000 Rouen, France
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13
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Hennequin C, Azria D, Blanchard P, Créhange G, Deutsch É, Lisbona A, Moyal É, Pasquier D, Roca L, Supiot S, Giraud P. Specificities of clinical research in radiotherapy. Cancer Radiother 2021; 26:104-107. [PMID: 34953712 DOI: 10.1016/j.canrad.2021.11.011] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this review is to present the specificities of clinical research in radiation oncology. Objectives are similar to all research in oncology: to improve the efficacy and to decrease toxic effects. Phase III trials remain the main methodology to demonstrate an improvement in efficiency, but phase I-II and registers are also important tools to validate an improvement in the therapeutic index with new technologies. In this article we discuss the special features of end-points, selection of population, and design for radiation oncology clinical trials. Quality control of delivered treatments is an important component of these protocols. Financial issues are also discussed, in the particular context of France.
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Affiliation(s)
- C Hennequin
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, université de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - D Azria
- IRCM Inserm U1194, Fédération universitaire d'oncologie radiothérapie Montpellier-Nîmes (Forom), Institut du cancer de Montpellier (ICM), université de Montpellier, 34000 Montpellier, France
| | - P Blanchard
- Institut Gustave-Roussy, 94800 Villejuif, France
| | - G Créhange
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - É Deutsch
- Institut Gustave-Roussy, 94800 Villejuif, France
| | - A Lisbona
- Institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - É Moyal
- Inserm UMR1037, CRCT, Institut universitaire du cancer, Oncopôle, 31000 Toulouse, France
| | - D Pasquier
- Cristal UMR 9189, département universitaire de radiothérapie, centre Oscar-Lambret, Lille, université de Lille, 59000 Lille, France
| | - L Roca
- Institut du cancer Montpellier (ICM), 34000 Montpellier, France
| | - S Supiot
- Institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, université de Paris, 20, rue Leblanc, 75015 Paris, France
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14
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Abstract
Herein are presented the recommendations from the Société française de radiothérapie oncologique regarding indications and modalities of lung cancer radiotherapy. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Affiliation(s)
- J Khalifa
- Département de radiothérapie, Institut universitaire du cancer de Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - D Lerouge
- Département de radiothérapie, centre François-Baclesse, 3, avenue du General-Harris, 14076 Caen, France
| | - C Le Péchoux
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - N Pourel
- Département de radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, CS80005, 84918 Avignon cedex 9, France
| | - J Darréon
- Service de physique médicale, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - F Mornex
- Service de radiothérapie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
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Abstract
We present the update of the recommendations of the French society of oncological radiotherapy on radiotherapy of laryngeal cancers. Intensity modulated radiotherapy is the standard of care radiotherapy for the management of laryngeal cancers. Early stage T1 or T2 tumours can be treated either by radiotherapy or conservative surgery. For tumours requiring total laryngectomy (T2 or T3), an organ preservation strategy by either induction chemotherapy followed by radiotherapy or chemoradiotherapy with cisplatin is recommended. For T4 tumours, a total laryngectomy followed by radiotherapy is recommended when feasible. Dose regimens for definitive and postoperative radiotherapy are detailed in this article, as well as the selection and delineation of tumour and lymph node target volumes.
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Affiliation(s)
- J Biau
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France.
| | - Y Pointreau
- Centre Jean-Bernard, clinique Victor-Hugo, (Institut interrégional de cancérologie), 9, rue Beauverger, 72000 Le Mans, France; Service de radiothérapie, centre régional universitaire de cancérologie Henry-S.-Kaplan, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - P Blanchard
- Département de radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - C Khampan
- Département de physique médicale, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, 84918 Avignon cedex 9, France
| | - P Giraud
- Service d'oncologie radiothérapie. université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - M Lapeyre
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - P Maingon
- Service de radiothérapie, APHP, Sorbonne Université, groupe hospitalier La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
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Chargari C, Giraud P, Lacornerie T, Cosset JM. Prevention of radiation-induced cancers. Cancer Radiother 2021; 26:92-95. [PMID: 34953687 DOI: 10.1016/j.canrad.2021.09.005] [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] [Indexed: 11/20/2022]
Abstract
The issue of radiation-induced cancers must be taken into consideration during therapeutic irradiations. Risk factors for radiation-induced cancer include: the age of the patients, the volumes irradiated, the presence of risk cofactors and the exposure of critical organs. Those should be part of the therapeutic decision, in terms of indication, as well as choice of the radiotherapy technique (including repositioning systems). We present the update of the recommendations of the French society for radiation oncology on the modalities for preventing radiation-induced cancers.
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Affiliation(s)
- C Chargari
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
| | - P Giraud
- Département d'oncologie radiothérapie, hôpital européen Georges-Pompidou, université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - T Lacornerie
- Service de physique médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - J-M Cosset
- Centre de radiothérapie Charlebourg/La Défense, groupe Amethyst, 65, avenue Foch, 92250 La Garenne-Colombes, France
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17
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Giraud P, Chargari C, Maingon P, Hannoun-Lévi JM, Azria D, Monpetit É, Mahé MA, Barillot I, Lisbona A, Mazeron JJ. Guidelines for external radiotherapy and brachytherapy procedures: 3rd edition. Cancer Radiother 2021; 26:2-6. [PMID: 34953691 DOI: 10.1016/j.canrad.2021.08.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of the first two editions of the guidelines for external radiotherapy procedures, published in 2007 and 2016 respectively, was to issue recommendations aimed at optimising, harmonising and standardising practices. The purpose of this third edition, which includes brachytherapy, is identical while also taking into account recent technological improvements (intensity modulation radiation therapy, stereotactic radiotherapy, and three-dimension brachytherapy) along with findings from literature. Part one describes the daily use of general principles (quality, security, image-guided radiation therapy); part two describes each treatment step for the main types of cancer.
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Affiliation(s)
- P Giraud
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Université de Paris, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| | - C Chargari
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Radiation oncology department, Gustave-Roussy Cancer Campus, Villejuif, France
| | - P Maingon
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Radiotherapy department, Sorbonne université, groupe hospitalier La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 75013 Paris, France
| | - J-M Hannoun-Lévi
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Radiotherapy department, centre Alexandre-Lacassagne, 06000 Nice, France
| | - D Azria
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, ICM, institut régional du cancer Montpellier, université de Montpellier, 34000 Montpellier, France
| | - É Monpetit
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Centre d'oncologie Saint-Yves, Vannes, France
| | - M-A Mahé
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Université de Caen Normandie, centre François-Baclesse, 14000 Caen, France
| | - I Barillot
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Hôpital Bretonneau, CHU de Tours, 37000 Tours, France
| | - A Lisbona
- Société française de physique médicale, Paris, France; Institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - J-J Mazeron
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France; Radiotherapy department, Sorbonne université, groupe hospitalier La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 75013 Paris, France
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Grégoire V, Boisbouvier S, Giraud P, Maingon P, Pointreau Y, Vieillevigne L. Management and work-up procedures of patients with head and neck malignancies treated by radiation. Cancer Radiother 2021; 26:147-155. [PMID: 34953696 DOI: 10.1016/j.canrad.2021.10.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Radiotherapy alone or in association with systemic treatment plays a major role in the treatment of head and neck tumours, either as a primary treatment or as a postoperative modality. The management of these tumours is multidisciplinary, requiring particular care at every treatment step. We present the update of the recommendations of the French Society of Radiation Oncology on the radiotherapy of head and neck tumours from the imaging work-up needed for optimal selection of treatment volume, to optimization of the dose distribution and delivery.
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Affiliation(s)
- V Grégoire
- Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon, France.
| | - S Boisbouvier
- Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - P Maingon
- Département de radiothérapie, Sorbonne Université, groupe hospitalier La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 75013 Paris, France
| | - Y Pointreau
- Institut interrégional de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - L Vieillevigne
- Unité de physique médicale, institut Claudius-Regaud, Institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
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19
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Barillot I, Monpetit É, Giraud P. Radiation therapy: Regulatory framework and constraints. Cancer Radiother 2021; 26:7-13. [PMID: 34953694 DOI: 10.1016/j.canrad.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this article is to describe the regulatory framework of the radiotherapy practice in France.
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Affiliation(s)
- I Barillot
- Hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
| | - É Monpetit
- Centre d'oncologie Saint-Yves, 11, rue du docteur Joseph-Audic, 56001 Vannes, France
| | - P Giraud
- Université de Paris, service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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20
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Nguyen M, Giraud P, Noël G. Suivi des patients concernés par des événements significatifs de radioprotection classés aux niveaux 2 et 2+ de l’échelle ASN-SFRO. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.014] [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: 10/20/2022]
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21
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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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22
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Klausner G, Troussier I, Fabiano E, Kreps S, Laccourreye O, Giraud P. 881P Impact of neck dissection in N2-3 oropharyngeal squamous-cell carcinomas treated with definitive chemo-radiotherapy: An observational real-life study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1291] [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: 10/20/2022] Open
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23
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Alati A, Fabiano E, Bibault J, Giraud P, Mejean A, Kreps S, Housset M, Durdux C. 702P Bladder preservation in elderly with muscle-invasive bladder cancer (MIBC): An observational study with concurrent chemotherapy and twice daily hypofractionated radiation therapy (HFTD) schedule. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.098] [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: 10/20/2022] Open
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24
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Maingon P, Marchesi V, Azria D, Balosso J, Deutsch E, Cohen Jonathan-Moyal E, Giraud P, Bayart E. RadioTransNet: Preclinical research network coordinated at the SFRO and SFPM. Cancer Radiother 2021; 26:108-115. [PMID: 34862132 DOI: 10.1016/j.canrad.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The RadioTransNet programme launched under the auspices of French societies for radiation oncology (SFRO) and medical physics (SFPM) was approved by the French national cancer institute (INCa) in December 2018 and is dedicated to proposing a relevant national and transversal structure for preclinical research including translational research in radiation oncology with well-defined priority areas of research. Its activities, coordinated by a scientific committee that includes radiation oncologists, medical physicists, academic biologists, are structured around several main areas, i.e.: target volume definition, interaction of radiation with normal tissues, combined treatments and modern dose calculation approaches. Four work packages have been created in these areas and are associated with other objectives pertaining to fundamental radiobiology, early implementation of new drugs in a preclinical setting, contribution of imaging in this task, research in medical physics including transversal components such as medical oncology, radiology, nuclear medicine and also cost/efficiency evaluation. All these tasks will be included in a national network that uses the complementary expertise provided by partners involved in the scheme. Calls for proposals will be selected by the scientific council to be submitted to INCa and the various academic associations to obtain funding for the human and technical resources required to conduct under optimal conditions projects in preclinical and translational research in radiation-oncology.
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Affiliation(s)
- P Maingon
- Service d'oncologie radiothérapie, groupe hospitalier La Pitié Salpêtrière, APHP, Sorbonne Université, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - V Marchesi
- Unité de radiophysique médicale, Institut de cancérologie de Lorraine, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy, France
| | - D Azria
- Fédération universitaire d'oncologie radiothérapie Montpellier-Nîmes (Forom), Institut du cancer Montpellier (ICM), IRCM Inserm U1194, université de Montpellier, 34000 Montpellier, France
| | - J Balosso
- Département d'oncologie radiothérapie, centre François-Baclesse, 3, rue du General-Harris, 14000 Caen, France
| | - E Deutsch
- Université Paris-Saclay, Inserm1030 radiothérapie moléculaire, département de radiothérapie Gustave-Roussy, 94805 Villejuif, France
| | - E Cohen Jonathan-Moyal
- Institut universitaire du cancer, Oncopôle, Inserm UMR1037, CRCT, 31000 Toulouse, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - E Bayart
- RadioTransNet, SFRO, 47, rue de la Colonie, 75013 Paris cedex, France; Laboratoire d'optique appliquée, ENSTA-ParisTech, École polytechnique, CNRS-UMR7639, Institut polytechnique de Paris, 828, boulevard des Maréchaux, 91762 Palaiseau cedex, France
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25
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Demarquay G, Moisset X, Lantéri-Minet M, de Gaalon S, Donnet A, Giraud P, Guégan-Massardier E, Lucas C, Mawet J, Roos C, Valade D, Ducros A. Revised guidelines of the French Headache Society for the diagnosis and management of migraine in adults. Part 1: Diagnosis and assessment. Rev Neurol (Paris) 2021; 177:725-733. [PMID: 34340812 DOI: 10.1016/j.neurol.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/15/2022]
Abstract
The French Headache Society proposes updated French guidelines for the management of migraine. The first part of these recommendations is focused on the diagnosis and assessment of migraine. First, migraine needs to be precisely diagnosed according to the currently validated criteria of the International Classification of Headache Disorders, 3d version (ICHD-3). Migraine-related disability has to be assessed and we suggest to use the 6 questions of the headache impact test (HIT-6). Then, it is important to check for risk factors and comorbidities increasing the risk to develop chronic migraine, especially frequency of headaches, acute medication overuse and presence of depression. We suggest to use a migraine calendar and the Hospital Anxiety and Depression scale (HAD). It is also necessary to evaluate the efficacy and tolerability of current migraine treatments and we suggest to systematically use the self-administered Migraine Treatment Optimization Questionnaire (M-TOQ) for acute migraine treatment. Finally, a treatment strategy and a follow-up plan have to be proposed. Guidelines for pharmacological and non-pharmacological treatments are presented in the second and third part of the recommendations.
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Affiliation(s)
- G Demarquay
- Neurological hospital, Lyon, Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France.
| | - X Moisset
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - M Lantéri-Minet
- Pain Department and FHU InovPain, CHU Nice - Côte Azur Université, Nice, France
| | - S de Gaalon
- Department of Neurology, Laënnec Hospital, CHU de Nantes, Nantes, France
| | - A Donnet
- Centre d'évaluation et de traitement de la douleur, FHU INOVPAIN, hôpital de La Timone, Marseille, France
| | - P Giraud
- Department of Neurology, Annecy Genevois Hospital, Annecy, France
| | | | - C Lucas
- Centre d'Evaluation et de Traitement de la Douleur, Service de Neurochirurgie, Hôpital Salengro, CHU de Lille, Lille, France
| | - J Mawet
- Emergency Headache Center (Centre d'Urgences Céphalées), Department of Neurology, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - C Roos
- Emergency Headache Center (Centre d'Urgences Céphalées), Department of Neurology, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - D Valade
- Department of Neurosurgery, Pitié-Sapêtrière Hospital, Paris, France
| | - A Ducros
- Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, University of Montpellier, 34000 Montpellier, France
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26
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Demarquay G, Mawet J, Guégan-Massardier E, de Gaalon S, Donnet A, Giraud P, Lantéri-Minet M, Lucas C, Moisset X, Roos C, Valade D, Ducros A. Revised guidelines of the French headache society for the diagnosis and management of migraine in adults. Part 3: Non-pharmacological treatment. Rev Neurol (Paris) 2021; 177:753-759. [PMID: 34340809 DOI: 10.1016/j.neurol.2021.07.009] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 01/16/2023]
Abstract
The French Headache Society proposes updated French guidelines for the management of migraine. This article presents the third part of the guidelines, which is focused on the non-pharmacological treatment of migraine, including physical exercise, dietary supplements and plants, diets, neuromodulation therapies, acupuncture, behavioral interventions and mindfulness therapy, patent foramen ovale closure and surgical nerve decompression.
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Affiliation(s)
- G Demarquay
- Inserm U1028, CNRS UMR5292, Neuroscience Research Center (CRNL), Neurological hospital, Lyon, France.
| | - J Mawet
- Department of Neurology, Emergency Headache Center (Centre d'urgences céphalées), Lariboisière Hospital, AP-HP, Paris, France
| | | | - S de Gaalon
- Department of Neurology, Laënnec Hospital, CHU de Nantes, Nantes, France
| | - A Donnet
- FHU INOVPAIN, centre d'évaluation et de traitement de la douleur, hôpital de La Timone, Marseille, France
| | - P Giraud
- Department of Neurology, Annecy-Genevois Hospital, Annecy, France
| | - M Lantéri-Minet
- Pain Department and FHU InovPain, CHU de Nice, Côte Azur Université, Nice, France
| | - C Lucas
- Service de neurochirurgie, centre d'évaluation et de traitement de la douleur, CHRU de Lille, hôpital Salengro, Lille, France
| | - X Moisset
- Inserm, Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Roos
- Department of Neurology, Emergency Headache Center (Centre d'urgences céphalées), Lariboisière Hospital, AP-HP, Paris, France
| | - D Valade
- Department of Neurosurgery, Hopital Pitié-Sapêtrière, Paris, France
| | - A Ducros
- Department of Neurology, Gui-de-Chauliac Hospital, CHU de Montpellier, University of Montpellier, 34000 Montpellier, France
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27
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Ducros A, de Gaalon S, Roos C, Donnet A, Giraud P, Guégan-Massardier E, Lantéri-Minet M, Lucas C, Mawet J, Moisset X, Valade D, Demarquay G. Revised guidelines of the French headache society for the diagnosis and management of migraine in adults. Part 2: Pharmacological treatment. Rev Neurol (Paris) 2021; 177:734-752. [PMID: 34340810 DOI: 10.1016/j.neurol.2021.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022]
Abstract
The French Headache Society proposes updated French guidelines for the management of migraine. This article presents the second part of the guidelines, which is focused on the pharmacological treatment of migraine, including both the acute treatment of attacks and the prophylaxis of episodic migraine as well as chronic migraine with and without medication overuse. The specific situations that can be encountered in women with migraine are also discussed, including pregnancy, menstrual migraine, contraception and hormonal replacement therapy.
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Affiliation(s)
- A Ducros
- Department of neurology, Gui-de-Chauliac hospital, CHU Montpellier, university of Montpellier, 34000 Montpellier, France
| | - S de Gaalon
- Department of neurology, Laënnec hospital, CHU de Nantes, Nantes, France
| | - C Roos
- Emergency headache center (centre d'urgences céphalées), department of neurology, Lariboisière hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - A Donnet
- Centre d'évaluation et de traitement de la douleur, FHU INOVPAIN, hôpital de La Timone, Marseille, France
| | - P Giraud
- Department of neurology, Annecy Genevois hospital, Annecy, France
| | | | - M Lantéri-Minet
- Pain department, FHU InovPain, CHU Nice Côte Azur université, Nice, France
| | - C Lucas
- Centre d'évaluation et de traitement de la douleur, service de neurochirurgie, hôpital Salengro, CHRU de Lille, Lille, France
| | - J Mawet
- Emergency headache center (centre d'urgences céphalées), department of neurology, Lariboisière hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - X Moisset
- Neuro-Dol, université Clermont Auvergne, CHU de Clermont-Ferrand, INSERM, Clermont-Ferrand, France
| | - D Valade
- Department of neurosurgery, hôpital Pitié-Sapêtrière, Paris, France
| | - G Demarquay
- Neurological hospital, Lyon, neuroscience research center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France.
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28
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Moisset X, Giraud P, Dallel R. Migraine in multiple sclerosis and other chronic inflammatory diseases. Rev Neurol (Paris) 2021; 177:816-820. [PMID: 34325914 DOI: 10.1016/j.neurol.2021.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/09/2021] [Indexed: 02/07/2023]
Abstract
Migraine is a very prevalent disease worldwide and is a major cause of disability. As known for a long time, migraine is associated with neurogenic inflammation. Epidemiological studies have shown that migraine is comorbid with several chronic inflammatory diseases, including multiple sclerosis (MS), chronic inflammatory rheumatic diseases (CIRDs) and inflammatory bowel diseases (IBDs). This brief narrative review highlights some recent data supporting a link between migraine and these three chronic inflammatory diseases. Studies found that migraine prevalence is approximately two-fold higher in these diseases compared to the general population. The causal link between migraine and these chronic inflammatory diseases has not been identified yet. Here, we suggest that systemic mediators (such as cytokines) and gut microbiome make migraine worse or add significant risks. Systemic inflammation biomarkers and gut microbiome modification are certainly avenues worth exploring.
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Affiliation(s)
- X Moisset
- Inserm, Neuro-Dol, Université Clermont-Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - P Giraud
- Annecy-Genevois Hospital, 74370 Annecy, France
| | - R Dallel
- Inserm, Neuro-Dol, Université Clermont-Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
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29
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Giraud P, Blais E, Jouinot A, Wasserman J, Ménégaux F, Leenhardt L, Maingon P, Simon JM. [Efficacy and tolerance of salvage curative radiotherapy for patients with cervical relapse of differentiated thyroid carcinoma]. Cancer Radiother 2021; 26:458-466. [PMID: 34253422 DOI: 10.1016/j.canrad.2021.06.013] [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: 04/30/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Radiation therapy is often the last resource treatment for cervical relapse in iodine refractory differentiated thyroid cancer. We present locoregional control data in patients with cervical relapse treated with curative intent radiation therapy with or without concomitant carboplatin. MATERIAL AND METHODS This monocentric retrospective study gathered data on patients with differentiated thyroid carcinoma - vesicular or papillary - in relapse after thyroidectomy who received a curative intent cervical radiation therapy. Locoregional progression free survival (LRPFS), progression free survival (PFS), overall survival (OS) were gathered as well as acute and chronic adverse events assessed with the CTCAE v4. RESULTS Thirty-nine patients were consecutively included between 2005 and 2019. The median follow-up was 36.6months. Fifteen patients (38%) had a locoregional relapse, locoregional control at 2years was 66.7%. The median LRPFS was 48months [32.9-not reached] and the median overall survival 49months [38.8-not reached]. In multivariate analysis, initial incomplete resection was associated with poorer OS (HR: 24.39 [3.57-166.78], P=0.00113) and LRPFS (HR: 33.91 [4.46-257.61], P=0.00066), extra nodal spread was associated with poorer LRPFS (HR: 13.45 [1.81-99,76], P=0.011). ECOG performance status was associated with OS (HR: 5.11 [1.57-16.66], P=0.00688). Carboplatin association with radiation therapy was not associated with improved survivals (OS: P=0.34, LRPFS: P=0.84). The rate of acute grade 3 toxicities was 14%. CONCLUSION Salvage cervical radiation therapy was associated with a locoregional control of 66.7% at 2years with a reasonable toxicity rate. Carboplatin association with radiation therapy did not improve locoregional control nor overall survival in comparison with radiotherapy alone.
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Affiliation(s)
- P Giraud
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - E Blais
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - A Jouinot
- Université de Paris, institut Cochin, Inserm, CNRS, 22, rue Méchain, 75014 Paris, France
| | - J Wasserman
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie médicale, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - F Ménégaux
- Service de chirurgie générale, viscérale et endocrinienne, Sorbonne université, GRC n(o) 16 tumeurs thyroïdiennes, hôpital de la Pitié, AP-HP, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - L Leenhardt
- Unité thyroïde tumeurs endocrines, Sorbonne université, GRC n(o) 16 tumeurs thyroïdiennes, AP-HP, hôpital de la Pitié-Salpêtrière, 75013 Paris, France
| | - P Maingon
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - J-M Simon
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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30
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Klausner G, Troussier I, Kreps S, Fabiano E, Laccourreye O, Giraud P. [Impact of neck dissection in N2-3 oropharyngeal squamous cell carcinomas treated with definitive chemoradiotherapy: An observational real-life study]. Cancer Radiother 2021; 25:771-778. [PMID: 34175226 DOI: 10.1016/j.canrad.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/07/2021] [Accepted: 05/25/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE The purpose of this study was to assess the efficacy in terms of neck failure of an initial neck dissection before definitive chemoradiotherapy in N2-3 oropharyngeal squamous cell carcinomas, as well as the dosimetric impact and the acute and delayed morbidity of this approach. MATERIALS AND METHODS All patients consecutively treated between 2009 and 2018 with definitive chemoradiotherapy using intensity-modulated conformal radiotherapy (IMRT) for a histologically proven N2-3 oropharyngeal squamous cell carcinomas were retrospectively included. The therapeutic approach consisted of induction chemotherapy, followed by cisplatine-based chemoradiotherapy preceded or not by neck dissection. Neck dissection was discussed on a case-by-case basis in a dedicated multidisciplinary tumour board for patients with a dissociated response to induction chemotherapy, defined as a better response on the primary than on the node. Chemoradiotherapy without neck dissection was systematically performed in case of a major lymph node response to induction chemotherapy (decrease in size of 90% or more). Intensity-modulated radiotherapy using a simultaneous-integrated boost delivered 70Gy in 35 fractions on macroscopic tumour volumes, 63Gy on intermediate-risk levels or extra-nodal extension and 54Gy on prophylactic lymph node areas. RESULTS Two groups were constituted: 47 patients without an initial neck dissection (62.7%), and 28 patients with a neck dissection prior to definitive chemoradiotherapy (37.3%). Initial patient characteristics were not statistically different between the two groups. The median follow-up was 60.1months (range: 3.2-119months). Incidence of neck failure was higher in patients without neck dissection (P=0.015). The neck failure rate at 5years was 19.8% (95% confidence interval: 7.4-30.6%; P=0.015) without neck dissection versus 0% following neck dissection. All lymph node failures occurred in the planned target volume at 70Gy. Upfront neck dissection suggested a decrease in the mean dose received by the homolateral parotid gland (P=0.01), mandible (P=0.02), and thyroid gland (P=0.02). Acute toxicity of chemoradiotherapy after neck dissection suggested a reduction in grade≥3 adverse events (P=0.04), early discontinuation of concomitant chemotherapy (P=0.009) and feeding tube-dependence (P=0.008) in univariate analysis. During follow-up, there was no difference between the two groups in terms of xerostomia, dysgeusia, dysphagia or gastrostomy dependence in univariate analysis. CONCLUSION Neck dissection prior to definitive chemoradiotherapy in N2-3 oropharyngeal squamous cell carcinoma was associated with high neck control without additional mid and long-term morbidity.
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Affiliation(s)
- G Klausner
- Université Pierre-et-Marie-Curie, Paris Sorbonne université, 91-105, boulevard de l'Hôpital, 75013 Paris, France
| | - I Troussier
- Oncologie-radiothérapie, centre de haute énergie, 06000 Nice, France; Département de radio-oncologie, hôpitaux universitaires de Genève, 1205 Genève, Suisse
| | - S Kreps
- Service d'oncologie-radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - E Fabiano
- Service d'oncologie-radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - O Laccourreye
- Service d'ORL et de chirurgie cervicofaciale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 75015 Paris, France
| | - P Giraud
- Service d'oncologie-radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 75015 Paris, France.
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31
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Leleu T, Bastit V, Doré M, Kammerer E, Florescu C, Alfonsi M, Troussier I, Bensadoun RJ, Biau J, Blais E, Coutte A, Deberne M, Wiazzane N, Dupin C, Faivre JC, Giraud P, Graff P, Guihard S, Huguet F, Janoray G, Liem X, Pointreau Y, Racadot S, Schick U, Servagi-Vernat S, Sun XS, Thureau S, Villa J, Vulquin N, Wong S, Patron V, Thariat J. Histosurgical mapping of endoscopic endonasal surgery of sinonasal tumours to improve radiotherapy guidance. Cancer Radiother 2021; 26:440-444. [PMID: 34175228 DOI: 10.1016/j.canrad.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/21/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Endoscopic endonasal surgery (EES) is becoming a standard for most malignant sinonasal tumours. Margin analysis after piecemeal resection is complex and optimally relies on accurate histosurgical mapping. Postoperative radiotherapy may be adapted based on margin assessment mapping to reduce the dose to some sinonasal subvolumes. We assessed the use of histosurgical mapping by radiation oncologists (RO). MATERIAL AND METHODS A French practice survey was performed across 29 ENT expert RO (2 did not answer) regarding integration of information on EES, as well as quality of operative and pathology reportsto refine radiotherapy planning after EES. This was assessed through an electronic questionnaire. RESULTS EES was ubiquitously performed in France. Operative and pathology reports yielded accurate description of EES samples according to 66.7% of interviewed RO. Accuracy of margin assessment was however insufficient according to more than 40.0% of RO. Additional margins/biopsies of the operative bed were available in 55.2% (16/29) of the centres. In the absence of additional margins, quality of resection after EES was considered as microscopically incomplete in 48.3% or dubious in 48.3% of RO. As performed, histosurgical mapping allowed radiotherapy dose and volumes adaptation according to 26.3% of RO only. CONCLUSIONS Standardized histosurgical mapping with margin and additional margin analysis could be more systematic. Advantages of accurate EES reporting could be dose painting radiotherapy to further decrease morbidity in sinonasal tumours.
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Affiliation(s)
- T Leleu
- Department of radiation oncology, centre François-Baclesse, Caen, France
| | - V Bastit
- Department of surgery, centre François-Baclesse, Caen, France
| | | | - E Kammerer
- Department of radiation oncology, centre François-Baclesse, Caen, France
| | - C Florescu
- Department of radiation oncology, centre François-Baclesse, Caen, France
| | | | | | | | - J Biau
- CJP, Clermont-Ferrand, France
| | - E Blais
- AP-HP, Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - X S Sun
- CHU, Besançon Montbéliard, France
| | | | | | | | | | - V Patron
- Department of ENT surgery, CHU Caen, Caen, France
| | - J Thariat
- Department of radiation oncology, centre François-Baclesse, Caen, France; Unicaen, Normandie Université, Caen, France; GORTEC, France.
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Kantor G, Schlienger M, Eschwège F, Giraud P. [.]. Cancer Radiother 2021; 25:S1278-3218(21)00075-5. [PMID: 33994310 PMCID: PMC8117009 DOI: 10.1016/j.canrad.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- G Kantor
- Institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France; Université de Bordeaux, 33000 Bordeaux, France.
| | - M Schlienger
- Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - F Eschwège
- Centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
| | - P Giraud
- Hôpital européen Georges-Pompidou, 20-40, rue Leblanc, 75015 Paris, France
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Bourbonne V, Michalet M, Lopez H, Pradier O, Spano JP, Giraud P. Guide du Docteur Junior en oncologie-radiothérapie. Cancer Radiother 2021; 25:296-299. [DOI: 10.1016/j.canrad.2020.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 11/25/2022]
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Lerouge D, Latorzeff I, Mirabel X, Dohan A, Mordant P, Barry De Longchamps N, Giraud P. [Erratum to "Stereotaxic radiotherapy of primary extracranial tumors" [Cancer Radiother. 24 (2020) DOI:10.1016/j.canrad.2020.06.020]]. Cancer Radiother 2020; 24:898. [PMID: 33004297 DOI: 10.1016/j.canrad.2020.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- D Lerouge
- Service d'oncologie radiothérapie, université de Paris, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - I Latorzeff
- Département de radiothérapie, centre François-Baclesse, avenue du Général-Harris, 14076 Caen, France
| | - X Mirabel
- Département de radiothérapie-oncologie, clinique Pasteur, bâtiment Atrium, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
| | - A Dohan
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - P Mordant
- Unité de radiologie abdominopelvienne et interventionnelle, service de radiologie A, université de Paris, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - N Barry De Longchamps
- Unité Inserm U1152, service de chirurgie vasculaire, thoracique, et de transplantation pulmonaire, université de Paris, hôpital Bichat, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | - P Giraud
- Équipe 4, Inserm U1151, service d'urologie, Institut Necker-Enfants-malades, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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Giraud P, Lerouge D, Latorzeff I, Mirabel X, Dohan A, Mordant P, Barry de Longchamps N. [Stereotaxic radiotherapy of primary extracranial tumors]. Cancer Radiother 2020; 24:513-522. [PMID: 32830055 DOI: 10.1016/j.canrad.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022]
Abstract
Stereotactic radiotherapy is a fundamental change from the conventional fractionated radiotherapy and represents a new therapeutic indication. Stereotactic radiotherapy is now a standard of care for inoperable patients or patients who refuse surgery. The results are encouraging with local control and survival rates very high in selected populations. The rate of late toxicity remains acceptable. Good tolerability makes it appropriate even for elderly and frail patients. In these fragile patients or in certain specific clinical situations, different surgical, radiotherapy or interventional radiology attitudes can be discussed on a case-by-case basis. These situations are considered in this article for the pulmonary, hepatic and prostatic localizations.
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Affiliation(s)
- P Giraud
- Service d'oncologie radiothérapie, université de Paris, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
| | - D Lerouge
- Département de radiothérapie, centre François-Baclesse, avenue du Général-Harris, 14076 Caen, France
| | - I Latorzeff
- Département de radiothérapie-oncologie, bâtiment Atrium, clinique Pasteur, 1, rue de la Petite-Vitesse, 31300 Toulouse, France
| | - X Mirabel
- Département de radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - A Dohan
- Service de radiologie A, université de Paris, unité de radiologie abdominopelvienne et interventionnelle, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - P Mordant
- Service de chirurgie vasculaire, thoracique, et de transplantation pulmonaire, hôpital Bichat, Assistance publique-Hôpitaux de Paris, unité Inserm U1152, université de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | - N Barry de Longchamps
- Service d'urologie, Inserm U1151 - équipe 4/Institut Necker Enfants Malades, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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Bibault JE, Denis F, Guihard S, Clavier JB, Durdux C, Giraud P, Kreps S, Maaradji S, Dautruche A, Fabiano E, Feutren T, Thariat J. [New concepts of medical consultation in oncology]. Cancer Radiother 2020; 24:751-754. [PMID: 32753236 PMCID: PMC7395590 DOI: 10.1016/j.canrad.2020.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 12/27/2022]
Abstract
New concepts of medical consultations are currently disrupting the practice of medicine. The use of standardized questionnaires, or patient-reported outcome (PRO and ePRO) has already significantly changed the relationship between the physician and the patient. Telemedicine, or even automatic conversational agents, such as chatbots, are also providing more convenient access to care and medical information for many patients. These tools have a major impact in oncology, precisely because of the rising chronicity of the diseases the radiation oncologists treat. In this article, we provide a detailed analysis of these new concepts.
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Affiliation(s)
- J-E Bibault
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Inserm, UMR 1138, équipe « science de l'information au service de la médecine », 15, rue de l'École-de-Médecine, 75006 Paris, France.
| | - F Denis
- Institut inter-régional de cancérologie Jean-Bernard, 9, rue Beauverger, 72100 Le Mans, France
| | - S Guihard
- Département de radiothérapie, institut de cancérologie Strasbourg-Europe, 17, rue Albert-Calmette, 67200 Strasbourg, France; Inserm, UMR 1113, équipe « Réponse au stress et thérapies innovantes », 3, avenue Molière, 67200 Strasbourg, France
| | - J-B Clavier
- Institut inter-régional de cancérologie Jean-Bernard, 9, rue Beauverger, 72100 Le Mans, France
| | - C Durdux
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - S Kreps
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - S Maaradji
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - A Dautruche
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - E Fabiano
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - T Feutren
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
| | - J Thariat
- Département de radiothérapie, centre François-Baclesse, 3, avenue General-Harris, 14000 Caen, France; Association advance resource centre for hadrontherapy in Europe (Archade), 3, avenue General-Harris, 14000 Caen, France; Laboratoire de physique corpusculaire, Institut national de physique nucléaire et de physique des particules (IN2P3), 6, boulevard Maréchal-Juin, 14000 Caen, France; École nationale supérieure d'ingénieurs de Caen (Ensicaen), 6, boulevard Maréchal-Juin, 14000 Caen, France; UMR6534, Unicaen, Normandie université, 3, avenue General-Harris, 14000 Caen, France
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Fournier L, Véra P, Giraud P. Avancées de l’imagerie anatomique et fonctionnelle au service de la radiothérapie. Cancer Radiother 2020; 24:357. [DOI: 10.1016/j.canrad.2020.06.001] [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: 11/28/2022]
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Boulle G, Velut Y, Mansuet-Lupo A, Gibault L, Blons H, Fournel L, Boni A, Cremer I, Wislez M, Duchatelle V, Trédaniel J, Hammond SA, Herbst R, Alifano M, Giraud P, Damotte D. Chemoradiotherapy efficacy is predicted by intra-tumour CD8+/FoxP3+ double positive T cell density in locally advanced N2 non-small-cell lung carcinoma. Eur J Cancer 2020; 135:221-229. [PMID: 32610210 DOI: 10.1016/j.ejca.2020.04.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Radiotherapy is a standard of care for locally advanced stage III N2 non-small-cell lung carcinoma (NSCLC) combined with surgery/chemotherapy. Radiotherapy is hypothesised to induce tumour immunogenic cell death, to release neoantigen resulting in intra-tumoural immune infiltration and abscopal effect. Conversely, it has not been demonstrated if immune cells are necessary to drive radiotherapy efficacy and predict patient's survival. PATIENTS AND METHODS We retrospectively analysed tumour samples and clinical data from 113 patients, 89 resected (PORT) and 24 non-resected (DRC) N2-NSCLC treated with chemotherapy and radiotherapy (same radiotherapy department from 2002 to 2015). The immune environment was characterised with in situ multiplex staining (CD8, FoxP3, PD-L1 and cytokeratin) and correlated with clinical data and survival. RESULTS High density of CD8+ T cells was associated with OS (p = 0.04, HR = 1.93 [0.99-3.78]) and DFS (p = 0.003, HR = 2.42 [1.31-4.47]) in the PORT. High density of CD8+/FoxP3+ double positive cells was associated with OS (p = 0.01, HR = 1.97 [1.11-3.48]) in the whole population, with OS (p = 0.05, HR = 1.92 [0.98-3.74]) and PFS (p = 0.03, HR = 1.83 [1.03-3.23]) in the PORT without reaching significance for the DRC. Intermediate PD-L1 expression in tumour cells (TPS = 1-49%) was associated with a higher survival in the PORT. CONCLUSIONS Intra-tumoural CD8+ T cell and particularly CD8+/FoxP3+ double positive T cell densities predict survival in stage III N2-NSCLC suggesting the need for a pre-existing intra-tumour immunity to mediate the action of radiotherapy. Density of CD8+/FoxP3+ cells was the best predictor of patient's survival in multivariate analysis and could represent a biomarker of radiotherapy efficacy.
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Affiliation(s)
- G Boulle
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - Y Velut
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - A Mansuet-Lupo
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France; Department of Pathology, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Paris, France
| | - L Gibault
- Department of Pathology, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - H Blons
- University Paris Descartes, Paris, France; INSERM UMRS 1147, Paris, France; Department of Biochemistry, APHP, Hôpital Européen Georges Pompidou, Paris, France
| | - L Fournel
- University Paris Descartes, Paris, France; Department of Thoracic Surgery, APHP, Hôpital Cochin, Paris, France; INSERM U1124, Paris, France
| | - A Boni
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - I Cremer
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France
| | - M Wislez
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; Department of Respiratory Medicine, APHP, Hôpital Cochin, Paris, France
| | - V Duchatelle
- Department of Pathology, St Joseph Hospital, Paris, France
| | - J Trédaniel
- University Paris Descartes, Paris, France; INSERM U1124, Paris, France; Department of Oncology, St Joseph Hospital, Paris, France
| | - S A Hammond
- Research and Early Discovery, Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - R Herbst
- Research and Early Discovery, Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - M Alifano
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France; Department of Thoracic Surgery, APHP, Hôpital Cochin, Paris, France
| | - P Giraud
- University Paris Descartes, Paris, France; APHP, Hôpital Européen Georges Pompidou, Department of Radiotherapy, Paris, France
| | - D Damotte
- Institut National de La Santé et de La Recherche Médicale (INSERM), UMRS 1138, Cordeliers Research Center, Team Cancer, inflammation and complement, Paris, France; University Paris Descartes, Paris, France; University Pierre et Marie Curie-Paris, Paris, France; Department of Pathology, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Paris, France.
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Chassagnon G, Martini K, Giraud P, Revel MP. Radiological assessment after stereotactic body radiation of lung tumours. Cancer Radiother 2020; 24:379-387. [PMID: 32534799 DOI: 10.1016/j.canrad.2020.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 12/17/2022]
Abstract
The increasing use of stereotactic body radiation therapy for lung tumours comes along with new post-therapeutic imaging findings that should be known by physicians involved in patient follow-up. Radiation-induced lung injury is much more frequent than after conventional radiation therapy, it can also be delayed and has a different radiological presentation. Radiation-induced lung injury after stereotactic body radiation therapy involves the lung parenchyma surrounding the target tumour and appears as a dynamic process continuing for years after completion of the treatment. Thus, the radiological pattern and the severity of radiation-induced lung injury are prone to changes during follow-up, which can make it difficult to differentiate from local recurrence. Contrary to radiation-induced lung injury, local recurrence after stereotactic body radiation therapy is rare. Other complications mainly depend on tumour location and include airway complications, rib fractures and organizing pneumonia. The aim of this article is to provide a wide overview of radiological changes occurring after SBRT for lung tumours. Awareness of changes following stereotactic body radiation therapy should help avoiding unnecessary interventions for pseudo tumoral presentations.
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Affiliation(s)
- G Chassagnon
- Service de radiologie, hôpital Cochin, AP-HP, centre université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université de Paris, 12, rue de l'École-de-Médecine, 75006 Paris, France.
| | - K Martini
- Service de radiologie, hôpital Cochin, AP-HP, centre université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - P Giraud
- Université de Paris, 12, rue de l'École-de-Médecine, 75006 Paris, France; Service de radiologie, hôpital européen Georges-Pompidou, AP-HP, centre université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - M-P Revel
- Service de radiologie, hôpital Cochin, AP-HP, centre université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université de Paris, 12, rue de l'École-de-Médecine, 75006 Paris, France
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Ladjal H, Giroux M, Beuve M, Giraud P, Shariat B. Patient-specific physiological model of the respiratory system based on inverse finite element analysis: a comparative study. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1713473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H. Ladjal
- LIRIS CNRS UMR 5205, Université de Lyon, Université Lyon 1, France
- IPNL CNRS UMR 5822, Université de Lyon, Université Lyon 1, France
| | - M. Giroux
- LIRIS CNRS UMR 5205, Université de Lyon, Université Lyon 1, France
| | - M. Beuve
- IPNL CNRS UMR 5822, Université de Lyon, Université Lyon 1, France
| | - P. Giraud
- Service d'Oncologie Radiothérapie, Hôpital Européen Georges Pompidou, France
| | - B. Shariat
- LIRIS CNRS UMR 5205, Université de Lyon, Université Lyon 1, France
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Azria D, Hennequin C, Giraud P. [Practical update of total dose compensation in case of temporary interruption of external radiotherapy in the COVID-19 pandemic context]. Cancer Radiother 2020; 24:182-187. [PMID: 32307313 PMCID: PMC7146696 DOI: 10.1016/j.canrad.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/25/2022]
Abstract
L’étalement est un facteur important de récidive locale et indirectement d’évolution à distance, notamment, en cas de durée de traitement allongée. La pandémie actuelle a un impact sur les patients en cours de radiothérapie qui doivent interrompre leur traitement de manière parfois prolongée du fait de la nécessité de soins respiratoires induits par le COVID-19. Les modèles utilisés de compensation de la dose totale en cas d’interruption prolongée de la radiothérapie sont connus, mais il nous a semblé important de synthétiser afin que chaque oncologue radiothérapeute puisse proposer un traitement le plus optimal possible tant en termes de risque de récidive locale que de protection des tissus sains. L’objectif de ce type de recommandation est d’homogénéiser les pratiques de l’ensemble de la discipline.
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Affiliation(s)
- D Azria
- IRCM, Institut de recherche en cancérologie de Montpellier (U1194), 208, avenue des Apothicaires, 34298 Montpellier cedex 5, France; Inserm, U1194, 208, avenue des Apothicaires, 34298 Montpellier cedex 5, France; Université de Montpellier, centre de recherche U1194, 208, avenue des Apothicaires, 34298 Montpellier cedex 05, France; Fédération universitaire d'oncologie radiothérapie, ICM, institut régional du cancer de Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France.
| | - C Hennequin
- Service de cancérologie-radiothérapie, AP-HP, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France
| | - P Giraud
- Service d'oncologie radiothérapie, AP-HP, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 20, rue Leblanc, 75015 Paris, France
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Bibault JE, Xing L, Giraud P, El Ayachy R, Giraud N, Decazes P, Burgun A, Giraud P. Radiomics: A primer for the radiation oncologist. Cancer Radiother 2020; 24:403-410. [PMID: 32265157 DOI: 10.1016/j.canrad.2020.01.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Radiomics are a set of methods used to leverage medical imaging and extract quantitative features that can characterize a patient's phenotype. All modalities can be used with several different software packages. Specific informatics methods can then be used to create meaningful predictive models. In this review, we will explain the major steps of a radiomics analysis pipeline and then present the studies published in the context of radiation therapy. METHODS A literature review was performed on Medline using the search engine PubMed. The search strategy included the search terms "radiotherapy", "radiation oncology" and "radiomics". The search was conducted in July 2019 and reference lists of selected articles were hand searched for relevance to this review. RESULTS A typical radiomics workflow always includes five steps: imaging and segmenting, data curation and preparation, feature extraction, exploration and selection and finally modeling. In radiation oncology, radiomics studies have been published to explore different clinical outcome in lung (n=5), head and neck (n=5), esophageal (n=3), rectal (n=3), pancreatic (n=2) cancer and brain metastases (n=2). The quality of these retrospective studies is heterogeneous and their results have not been translated to the clinic. CONCLUSION Radiomics has a great potential to predict clinical outcome and better personalize treatment. But the field is still young and constantly evolving. Improvement in bias reduction techniques and multicenter studies will hopefully allow more robust and generalizable models.
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Affiliation(s)
- J-E Bibault
- Radiation Oncology Department, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Inserm, UMR 1138, Team 22: Information Sciences to support Personalized Medicine, 15, rue de l'École-de-Médecine, 75006 Paris, France.
| | - L Xing
- Laboratory of Artificial Intelligence in Medicine and Biomedical Physics, Stanford University School of Medicine, 875 Blake Wilbur Drive, 94305-5847 Stanford, CA, USA
| | - P Giraud
- Inserm, UMR 1138, Team 22: Information Sciences to support Personalized Medicine, 15, rue de l'École-de-Médecine, 75006 Paris, France
| | - R El Ayachy
- Inserm, UMR 1138, Team 22: Information Sciences to support Personalized Medicine, 15, rue de l'École-de-Médecine, 75006 Paris, France
| | - N Giraud
- Radiation Oncology Department, CHU de Bordeaux, hôpital Haut-Lévêque, avenue Magellan, 33600 Pessac, France
| | - P Decazes
- Nuclear Medicine Department, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; Quantif, EA 4108, université de Rouen, avenue de l'Université, 76801 Saint-Étienne-du-Rouvray, France
| | - A Burgun
- Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Inserm, UMR 1138, Team 22: Information Sciences to support Personalized Medicine, 15, rue de l'École-de-Médecine, 75006 Paris, France; Biomedical Informatics and Public Health Department, hôpital européen Georges-Pompidou, Assistance publique-hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Radiation Oncology Department, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
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Giraud P, Monpetit E, Lisbona A, Chargari C, Marchesi V, Dieudonné A. [Covid-19 epidemic: guidelines issued by the French society of oncology radiotherapy (SFRO) for oncology radiotherapy professionals]. Cancer Radiother 2020; 24:87. [PMID: 32299663 PMCID: PMC7271288 DOI: 10.1016/j.canrad.2020.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- P Giraud
- Président de la SFRO, Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| | - E Monpetit
- Président du SNRO, Centre Saint-Yves-radiothérapie, 11, rue du Docteur-Audic, 56000 Vannes, France
| | - A Lisbona
- Service de physique médicale, Institut de cancérologie de l'Ouest, 44805 Saint-Herblain, France
| | - C Chargari
- Département de radiothérapie, Gustave-Roussy Cancer Campus, Villejuif, 94800, France
| | - V Marchesi
- Institut de cancérologie de Lorraine -centre Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A Dieudonné
- Président de la SFPM, service de médecine nucléaire, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France
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- Centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
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- Syndicat national des radiothérapeutes oncologues, 168A, rue de Grenelle, 75007 Paris, France
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- Centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
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Levy A, Doyen J, Botticella A, Bourdais R, Achkar S, Giraud P, Du C, Naltet C, Lavaud P, Besse B, Pradère P, Mercier O, Caramella C, Planchard D, Deutsch E, Le Péchoux C. [Role of immunotherapy in locally advanced non-small cell lung cancer]. Cancer Radiother 2020; 24:67-72. [PMID: 32037126 DOI: 10.1016/j.canrad.2019.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 01/26/2023]
Abstract
Concomitant radiochemotherapy has been the standard of care for unresectable stage III non-small cell lung cancer (NSCLC), irrespective of histological sub-type or molecular characteristics. Currently, only 15-30 % of patients are alive five years after radiochemotherapy, and this figure remains largely unchanged despite multiple phase III randomised trials. In recent years, immune-checkpoint blockades with anti-PD-(L)1 have revolutionised the care of metastatic NSCLC, becoming the standard front- and second-line strategy. Several preclinical studies reported an increased tumour antigen release, improved antigen presentation, and T-cell infiltration in irradiated tumours. Immunotherapy has therefore recently been evaluated for patients with locally advanced stage III NSCLC. Following the PACIFIC trial, the anti-PD-L1 durvalumab antibody has emerged as a new standard consolidative treatment for patients with unresectable stage III NSCLC whose disease has not progressed following concomitant platinum-based chemoradiotherapy. Immunoradiotherapy therefore appears to be a promising association in patients with localised NSCLC. Many trials are currently evaluating the value of concomitant immunotherapy and chemoradiotherapy and/or consolidative chemotherapy with immunotherapy in patients with locally advanced unresectable NSCLC.
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Affiliation(s)
- A Levy
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France; Université Paris Sud, université Paris-Saclay, 94270, Le Kremlin-Bicêtre, France.
| | - J Doyen
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189, Nice cedex 2, France; Université Côte d'Azur, fédération Claude-Lalanne, Nice cedex 2, France
| | - A Botticella
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - R Bourdais
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - S Achkar
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - P Giraud
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - C Du
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - C Naltet
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France
| | - P Lavaud
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France
| | - B Besse
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France; Université Paris Sud, université Paris-Saclay, 94270, Le Kremlin-Bicêtre, France
| | - P Pradère
- Département de chirurgie vasculaire et thoracique, hôpital Marie-Lannelongue, université Paris-Saclay, Le Plessis Robinson, France
| | - O Mercier
- Département de chirurgie vasculaire et thoracique, hôpital Marie-Lannelongue, université Paris-Saclay, Le Plessis Robinson, France
| | - C Caramella
- Département d'imagerie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - D Planchard
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France
| | - E Deutsch
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France; Université Paris Sud, université Paris-Saclay, 94270, Le Kremlin-Bicêtre, France
| | - C Le Péchoux
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
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Giraud P, Tournat H, Kreps S, Bibault JE, Dautruche A, Fabiano E, Feutren T, Durdux C. Radiothérapie des oligométastases : principaux essais en cours et à venir en France. Cancer Radiother 2019; 23:496-499. [DOI: 10.1016/j.canrad.2019.07.124] [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] [Received: 06/01/2019] [Revised: 06/30/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
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Giraud P, Kreps S, Tournat H, Bibault JE, Fabiano E, Feutren T, Dautruche A, Durdux C. [Stereotactic pulmonary radiotherapy: Which machine?]. Cancer Radiother 2019; 23:658-661. [PMID: 31471252 DOI: 10.1016/j.canrad.2019.07.126] [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: 06/10/2019] [Accepted: 07/03/2019] [Indexed: 11/29/2022]
Abstract
Stereotactic radiotherapy represents a fundamental change in the practice of radiotherapy of lung cancers. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Stereotactic radiotherapy can be realized either by a dedicated accelerator (CyberKnife®) or by a conventional accelerator associated with specific systems. The two modalities deliver a very precise irradiation whose very good results published to date are similar. Some technical characteristics specific to each type of linear accelerator could guide the choice according to the target volume treated.
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Affiliation(s)
- P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France.
| | - S Kreps
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - H Tournat
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - J-E Bibault
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - E Fabiano
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - T Feutren
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - A Dautruche
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - C Durdux
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France
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Clément-Zhao A, Luu M, Bibault JE, Daveau C, Kreps S, Jaulmes H, Dessard-Diana B, Housset M, Giraud P, Durdux C. Effective delivery of palliative radiotherapy: A prospective study. Cancer Radiother 2019; 23:365-369. [PMID: 31300329 DOI: 10.1016/j.canrad.2018.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/14/2018] [Accepted: 09/27/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE The main goal of palliative radiotherapy is to reduce patient's discomfort. But sometimes patients do not receive any benefits from this treatment because of rapid worsening of their general condition. This prospective monocentric study assessed the effective delivery of palliative radiotherapy. MATERIALS AND METHODS From 1st December 2015 to 29th February 2016, all consecutive patients receiving palliative radiotherapy in our hospital were included. The primary endpoint was the effective delivery of palliative radiotherapy according to the initial prescription (total dose, overall treatment time and fractionation). The secondary endpoints were the number of treatment breaks, the clinical benefit, the number of deaths and the delays for admission in the palliative care unit. RESULTS Fifty-nine patients were included and 64 treatments were analysed. The treatment sites were: bone (70.3%) and brain (21.9%). The treatment goals were: pain control only (43.8%), decompression only (21.9%), pain control and decompression (32.8%), haemostatic aim (1.6%). Palliative treatment was achieved in 57 cases (89%). Temporary interruption of the radiotherapy treatment was necessary in six cases (9.4%; three for medical reason, three for logistic reason). The main reason of permanent interruption was worsening of performance status (seven cases). Palliation of symptoms (complete or partial responses) was obtained in 44 cases (68.8%). Seven patients (11.9%) died during the month after the end of the treatment. No delay or cancellation for admission in the palliative care unit were observed. CONCLUSION Palliative radiotherapy was completed as originally planned in 51 cases (79.9%) with a clinical benefit for 44 cases (68.8%). Radiation therapy must not be neglected as a palliative treatment at the end-of-life.
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Affiliation(s)
- A Clément-Zhao
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Department of radiotherapy, institut Curie, 35 rue Dailly, 92210 Saint-Cloud, France.
| | - M Luu
- Mobile palliative care unit, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - J-E Bibault
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - C Daveau
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - S Kreps
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - H Jaulmes
- Mobile palliative care unit, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - B Dessard-Diana
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - M Housset
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - C Durdux
- Department of radiotherapy, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Abbassi LM, Laurans M, Gasnier A, Smulevici A, Tournat H, Bibault JE, Huertas A, Jouglar E, Suissa A, Kreps S, Giraud P, Durdux C. [Stereotactic body radiotherapy: Prospective study to evaluate asthenia and quality of life]. Cancer Radiother 2019; 23:316-321. [PMID: 31153770 DOI: 10.1016/j.canrad.2019.02.003] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate prospectively asthenia and the quality of life in patients treated by stereotactic body irradiation and to determine their predictive factors. METHODS AND MATERIALS Quality of life was assessed by the EORTC QLQ-C30 and asthenia was evaluated with the Brief Fatigue Inventory (BFI), on the first day (T1), last day (T2) and 1-3 weeks after the end of treatment (T3). RESULTS Sixty-three patients were treated with stereotactic body irradiation from February 2017 to May 2017 and 41 were included in the analysis (22 patients excluded for lack of understanding, organization, psychologic disorders or refusal). The mean number of fractions was 5 (±2). The compliance to quality of life assessment was 98%, 95% was 81% at T1, T2 and T3, respectively. An increase of asthenia and a worsened quality of life were found in 12 (29%) and 14 (34%) patients between T1 and T2. Univariate analysis demonstrated a correlation between asthenia and quality of life were correlated with performans status (P=0.03 and 0.05 respectively), hemoglobin level (p=0.01 and 0.004), albumin level (P=0.01 and 0.06), distance between home and radiotherapy department (P=0.05 and 0.02). Multivariate analysis demonstrated a correlation between female gender (P=0.012), albumin level (P<0.001), distance over 25km (P<0.001) with asthenia, and albumin level (P=0.003), hemoglobin level (P=0.004) and previous chemotherapy (P=0.003) with quality of life. No influence of stereotactic body ratiotherapy parameters was seen. CONCLUSION Despite hypofractionation, stereotactic body radiotherapy induced asthenia and deterioration of quality of life.
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Affiliation(s)
- L M Abbassi
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| | - M Laurans
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - A Gasnier
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - A Smulevici
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - H Tournat
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - J-E Bibault
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - A Huertas
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - E Jouglar
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - A Suissa
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - S Kreps
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - C Durdux
- Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Cloitre A, Duval X, Tubiana S, Giraud P, Veyrac G, Nosbaum A, Gouraud A, Mahé J, Lesclous P. Antibiotic prophylaxis for the prevention of infective endocarditis for dental procedures is not associated with fatal adverse drug reactions in France. Med Oral Patol Oral Cir Bucal 2019; 24:e296-e304. [PMID: 31011140 PMCID: PMC6530950 DOI: 10.4317/medoral.22818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/15/2018] [Accepted: 02/15/2019] [Indexed: 12/17/2022] Open
Abstract
Background One of the major reasons to stop antibiotic prophylaxis (AP) to prevent infective endocarditis (IE) in the United Kingdom but not in the rest of the world was that it would result in more deaths from fatal adverse drug reactions (ADRs) than the number of IE deaths. The main aim of this study was to quantify and describe the ADRs with amoxicillin or clindamycin for IE AP. The second aim was to infer a crude incidence of anaphylaxis associated with amoxicillin for IE AP. Material and Methods The Medical Dictionary for Regulatory Activities (MedDRA) was used to group ADRs for IE AP using the broad Standardized MedDRA Queries “Anaphylactic reaction, Amoxicillin, Clindamycin, Clostridium Difficile infection” to the French Pharmacovigilance Database System. From this first-line collection, we selected all cases occurring for IE AP and ultimately, the cases for IE AP for a dental procedure. Then, each case was analyzed. Results Of 11639 first-line recorded ADRs, 100 were for IE AP but no fatal anaphylaxis to amoxicillin or clindamycin and no C. difficile infection associated with clindamycin were identified. Only 17 cases of anaphylaxis to amoxicillin related to dental procedures were highlighted. The estimation of the crude incidence rate of anaphylaxis associated with amoxicillin for IE AP for invasive dental procedure was 1/57 000 (95% CI 0.2-0.6). Conclusions Fatal or severe ADRs with amoxicillin or clindamycin is not a rational argument to stop IE AP before invasive dental procedures. Key words:Infective endocarditis, antibiotic prophylaxis, anaphylaxis, adverse drug reaction, amoxicillin, clindamycin, pharmacovigilance.
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Affiliation(s)
- A Cloitre
- Faculty of Dentistry, 1 place Alexis Ricordeau, 44042 Nantes, France,
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Ta M, Schernberg A, Giraud P, Monnier L, Darai E, Bendifallah S, Schlienger M, Touboul E, Challand T, Huguet F, Rivin Del Campo E. EP-1492 Comparison of 3DCRT and IMRT in endometrial cancer: efficacy, safety, and prognostic analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31912-7] [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: 10/26/2022]
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