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Demogeot N, Salleron J, Beckendorf V, Peiffert D, Levitchi M, Charra-Brunaud C, Renard S. Impact of external beam pelvic radiotherapy of endometrial carcinoma: A focus on chronic digestive toxicity. Cancer Radiother 2022; 26:570-576. [PMID: 35172947 DOI: 10.1016/j.canrad.2021.10.012] [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: 04/14/2021] [Revised: 08/27/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The standard treatment for endometrial cancer is surgery, although depending on the risk factors, adjuvant radiation therapy may also be given. It is proposed for high-risk carcinomas for which an improvement in progression-free survival though not overall survival has been shown. However, despite the development of radiotherapy treatments with intensity modulation and image guidance, adjuvant radiation therapy remains toxic to the digestive system. We aimed to investigate the incidence of digestive toxicity and the presence of any predictive factors. MATERIALS AND METHODS Data were retrospectively collected from patients treated with adjuvant radiotherapy for endometrial carcinoma at the Institut de cancérologie de Lorraine and centre hospitalier Émile-Durkheim between January 2010 and October 2016 and analyzed to identify factors associated with chronic digestive toxicity. RESULTS One hundred and thirty-nine patients received a total dose of 50Gy fractionated into 25 sessions, five per week for five weeks. The median follow-up after irradiation completion was 38 months. The incidence of gastrointestinal and rectal toxicity in all patients treated with pelvic irradiation for endometrial carcinoma was 11.1% (95% confidence interval [95%CI]: 5.4-19%) for grade 3-4 and 25.6% (95%CI: 17.0-34.9%) for grade 2-4. No factor was found to be significantly predictive of chronic digestive toxicity. At five years, the overall survival was 74.3%, (95%CI: 65.3-81.4%), progression-free survival was 69.6% (95%CI: 60.1-77.3%) and incidence of pelvic recurrence was 7.9% (95%CI: 3.8-13.9%). CONCLUSION Our results confirmed that pelvic radiotherapy can induce a relatively high rate of digestive toxicity but failed to identify relevant factors able to predict it.
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Affiliation(s)
- N Demogeot
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France.
| | - J Salleron
- Département de biostatistiques, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| | - D Peiffert
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| | - M Levitchi
- Département de radiothérapie, centre Henri-Becquerel, 76000 Rouen, France
| | - C Charra-Brunaud
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
| | - S Renard
- Département de radiothérapie, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30 519, 54511 Vandœuvre-lès-Nancy, France
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Py JF, Salleron J, Courrech F, Beckendorf V, Croisé-Laurent V, Peiffert D, Vogin G, Dietmann AS. Long-term outcome of Stereotactic Body Radiation Therapy for patient with unresectable liver metastases from colorectal cancer. Cancer Radiother 2021; 25:350-357. [PMID: 33618909 DOI: 10.1016/j.canrad.2021.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate clinical outcome and predicting factors of local failures in patients with colorectal cancer treated for unresectable liver metastases with stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS We restrospectively reviewed the medical records of 67 patients treated with the Cyberknife SBRT system for 99 hepatic metastases between January 2007 and December 2015 in our center. In total, 37.5 to 54.0Gy in 3 to 5 fractions were prescribed to the 80% isodose line. Local control (LC), intrahepatic progression incidence, Progression-Free Survival (PFS), Overall Survival (OS) and toxicity were evaluated. RESULTS The median follow-up was 47 months (IQR, 28-59 months). The median OS was 53 months, the 2-year OS and PFS rates were 81.4% and 54.0%. The 1- and 2-year LC rates were 86.6% and 72.4%. In the multivariate analysis, the degree of differentiation was the only prognostic factor for LC (HR 0.31, 95% CI, 0.10-0.98, P=0.046). Margin expansion>5mm was not associated with a better LC (HR 0.72, 95% CI, 0.38-1.37, P=0.317). Performans Status≥2 (HR 3.27, 95% CI, 1.07-9.98, P=0.038), chemotherapy for metastases before SBRT (HR 0.36, 95% CI, 0.18-0.75, P=0.006) and regional lymph node at diagnosis (HR 2.19, 95% CI, 1.09-4.43, P=0.029) were independent prognostic factors for OS. We report 2 cases of grade≥3 toxicity (3.0%) - one grade 3 acute nausea and one grade 3 late gastric ulcer. CONCLUSION Stereotactic body radiation therapy is an effective and well-tolerated treatment that allow high LC for liver metastases from colorectal cancer during the first two years. A prescription dose of 45Gy in 3 fractions to the 80% isodose line with a risk adapted schedule to respect Organ At Risk constraints allows a low rate of toxicity.
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Affiliation(s)
- J F Py
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France.
| | - J Salleron
- Département de biostatistique et data management, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - F Courrech
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - V Beckendorf
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - V Croisé-Laurent
- Département de radiologie, CHU de Nancy, Vandœuvre-les-Nancy, France
| | - D Peiffert
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - G Vogin
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
| | - A S Dietmann
- Département de radiothérapie, institut de cancérologie de Lorraine, 54000 Nancy, France
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Zhu J, Simon A, Ospina J, Bossi A, Chira C, Gnep K, Beckendorf V, De Crevoisier R. EP-2005: NTCP model to predict late urinary toxicity after prostate cancer radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32314-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Crevoisier R, Bayar M, Pommier P, Muracciole X, Pene F, Dudouet P, Latorzeff I, Beckendorf V, Bachaud J, Supiot S, Chauvet B, Laplanche A, Bossi A, Nguyen T, Crehange G, Lagrange J. OC-0538: Daily versus weekly prostate cancer image-guided radiotherapy: A Phase 3 randomized trial. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30848-x] [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: 12/01/2022]
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Carette H, Faivre JC, Salleron J, Baumann AS, Uwer L, Clément-Duchêne C, Vignaud JM, Petit I, Siat J, Tiotiu A, Beckendorf V. [Prophylactic radiotherapy in a single fraction of 10Gy at intervention pleural site in patient with malignant pleural mesothelioma: A retrospective monocentric cohort study]. Cancer Radiother 2017; 21:774-783. [PMID: 29132802 DOI: 10.1016/j.canrad.2017.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/31/2017] [Revised: 05/20/2017] [Accepted: 06/09/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Prophylactic radiotherapy to prevent procedure-tracts metastases from malignant pleural mesothelioma remains controversial and clinical practice varies. The purpose was to assess the efficacy of local radiotherapy in a single fraction of 10Gy in preventing malignant seeding at intervention pleural site in patients with malignant pleural mesothelioma. MATERIAL AND METHODS This is a retrospective cohort study, including patients with histological confirmed malignant pleural mesothelioma treated by prophylactic irradiation to prevent interventional site metastases with a unique fraction of 10Gy with 6 to 18MeV, from January 1990 to December 2013 in the institut de cancérologie de Lorraine (Nancy, France). RESULTS Ninety-one patients were treated by irradiation in intervention site, involving 120 intervention pleural sites, 91 thoracoscopies, 17 thoracotomies with chest drain and 12 CT or ultrasound guided needle biopsies. The median follow-up was 7 months (interquartile between 3 and 15 months). The overall survival was 43.5% at 12 months. The local progression free survival was 43.7% at 12 month. The incidence of local recurrence was 8% at 12 months. The median interval from radiotherapy to local recurrence was 4 months (2; 32). No grade II or higher toxicity was observed. CONCLUSION Irradiation of pleural intervention sites with a single fraction of 10Gy is effective, well tolerated, simple, fast and cost effective.
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Affiliation(s)
- H Carette
- Département de pneumologie, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - J-C Faivre
- Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne CS 30519, 54519 Vandœuvre-lès-Nancy, France.
| | - J Salleron
- Département de biostatistiques, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne CS 30519, 54519 Vandœuvre-lès-Nancy, France
| | - A-S Baumann
- Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne CS 30519, 54519 Vandœuvre-lès-Nancy, France
| | - L Uwer
- Département d'oncologie médicale, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne CS 30519, 54519 Vandœuvre-lès-Nancy, France
| | - C Clément-Duchêne
- Département d'oncologie médicale, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne CS 30519, 54519 Vandœuvre-lès-Nancy, France
| | - J-M Vignaud
- Laboratoire d'anatomie et cytologie pathologiques, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - I Petit
- Département de radiologie, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - J Siat
- Département de chirurgie thoracique, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - A Tiotiu
- Département de pneumologie, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne CS 30519, 54519 Vandœuvre-lès-Nancy, France
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Pflumio C, Levitchi M, Faivre JC, Royer P, Peiffert D, Beckendorf V. Suivi après radiothérapie des cancers du sein localisés : évaluation des pratiques professionnelles. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Carette H, Faivre JC, Salleron J, Baumann AS, Uwer L, Clément-Duchêne C, Vignaud JM, Petit I, Siat J, Tiotiu A, Beckendorf V. Irradiation préventive en une séance de 10 Gy des sites d’intervention pleurale des patients atteints de mésothéliome pleural malin : une étude de cohorte rétrospective monocentrique. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.037] [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: 10/18/2022]
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Thureau S, Chaumet-Riffaud P, Modzelwski R, Hapdey S, Mahé M, Boisselier P, Beckendorf V, Salem N, Lerouge D, Dubray B, Vera P. Étude de phase II sur l’efficacité et la tolérance d’une augmentation de dose de radiothérapie des lésions hypoxiques définies par TEP-scanographie au fluoromisonidazole chez les patients suivis par un cancer bronchique non à petites cellules. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.115] [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: 10/21/2022]
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Jolnerosvki M, Salleron J, Beckendorf V, Peiffert D, Baumann A, Bernier-Chastagner V, Marchesi V, Huger S, Vogin G. EP-1367: IMRT from 70 Gy to 80 Gy in prostate cancer: clinical and dosimetric predictors of late toxicity. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32617-2] [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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Lam Cham Kee D, Hai Xing D, Beckendorf V, Salleron J, Peiffert D. Ré-irradiation stéréotaxique pulmonaire par CyberKnife®. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.034] [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: 11/29/2022]
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Py JF, Faivre J, Rossanaly-Vasram R, Perrin E, Peiffert D, Beckendorf V. Suivi après radiothérapie des cancers localisés de la prostate : évaluation des pratiques professionnelles à Épinal. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pommier P, Chabaud S, Lagrange J, Richaud P, Le Prisé É, Wagner JP, Hay M, Beckendorf V, Suchaud JP, Carrie C. Rôle de l’irradiation pelvienne pour les adénocarcinomes prostatiques localisés : résultats définitifs de l’essai du Gétug 01. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.014] [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: 11/28/2022]
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Thariat J, Clément-Colmou K, Vogin G, Beckendorf V, Ducassou A, Ali AM, Salas S, Saada E, Thyss A, Lapeyre M, Isambert N. [Radiation therapy of cardiac sarcomas]. Cancer Radiother 2014; 18:125-31. [PMID: 24637021 DOI: 10.1016/j.canrad.2014.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/23/2013] [Accepted: 02/05/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Primary cardiac sarcomas represent less than 10 yearly cases in France. Their median survival is approximately 18 months. The treatment consists of surgery when possible. The role of chemotherapy and radiation therapy is controversial, especially with respect to limiting cardiac radiation dose that is theoretically incompatible with the requirement of a tumoricidal dose for sarcoma. A recent series of 124 cases of the French Sarcoma Group suggested a benefit of radiation therapy on progression-free survival. PATIENTS AND METHODS The dosimetric data of 12 patients were analyzed. RESULTS There was variety in radiotherapy modalities and definition of target volumes, doses and techniques are evolving more conformal plans. Irradiation appeared feasible with conventional fractionation with respect to toxicities (although probably underestimated due to short follow-up and dismal prognosis) and previously demonstrated benefit of radiotherapy for primitive cardiac sarcomas. CONCLUSION A scheme of 45Gy in 1.8Gy per fraction to a preoperative volume with an additional dose of 14Gy in 7 fractions on areas at risk or residual disease and margins 1cm, may be proposed based on the preliminary data of this study. Intensity modulated radiotherapy with daily cone-beam CT-scanner should be evaluated.
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Affiliation(s)
- J Thariat
- Département d'oncologie-radiothérapie, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France; Université Nice Sophia-Antipolis, 06200 Nice, France.
| | - K Clément-Colmou
- Oncologie-radiothérapie, centre René-Gauducheau, institut de cancérologie de l'Ouest, 44805 Saint-Herblain, France
| | - G Vogin
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A Ducassou
- Oncologie-radiothérapie, centre Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31300 Toulouse, France
| | - A M Ali
- Clinical oncology, Sohag University, Sohag, Égypte
| | - S Salas
- Oncologie médicale, CHU la Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - E Saada
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - A Thyss
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - M Lapeyre
- Oncologie-radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - N Isambert
- Oncologie médicale, centre Georges-Francois-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
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Mathieu R, Ospina Arango J, Beckendorf V, Delobel J, Messai T, Bossi A, Le Prise E, Guerif S, Simon J, Dubray B, Zhu J, Lagrange J, Pommier P, Gnep K, Acosta O, De Crevoisier R. Outils de prédiction de la toxicité urinaire tardive après radiothérapie prostatique. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.233] [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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Gnep K, Delobel JB, Mathieu R, Beckendorf V, Le Prisé E, Chiran C, Guérif S, Ospina Arango JD, de Crevoisier R. Impact clinique de la RCMI et de la radiothérapie guidée par l’image prostatique. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.06.008] [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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Régnier É, Nguyen T, Beckendorf V, Lagrange JL. Marges en radiothérapie du cancer de la vessie. Cancer Radiother 2013; 17:470-6. [DOI: 10.1016/j.canrad.2013.06.024] [Citation(s) in RCA: 2] [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: 05/25/2013] [Revised: 06/14/2013] [Accepted: 06/21/2013] [Indexed: 10/26/2022]
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Ospina J, Zhu J, Le Prisé E, Bossi A, Haigron P, Gnep K, Beckendorf V, Acosta O, Simon A, de Crevoisier R. Random Forest are Strong Competitors of Published NTCP Models for Rectal and Bladder Toxicity Prediction. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tanguy R, Taste H, Beckendorf V, Peiffert D. Radiothérapie stéréotaxique des tumeurs bronchiques localisées : expérience du centre Alexis-Vautrin. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.129] [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: 11/27/2022]
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Pommier P, Morelle M, Perrier L, de Crevoisier R, Laplanche A, Dudouet P, Mahé MA, Chauvet B, Nguyen TD, Créhange G, Zawadi A, Chapet O, Latorzeff I, Bossi A, Beckendorf V, Touboul E, Muracciole X, Bachaud JM, Supiot S, Lagrange JL. Évaluation économique prospective de la radiothérapie guidée par l’image des cancers de la prostate dans le cadre du programme national de soutien aux thérapeutiques innovantes et coûteuses. Cancer Radiother 2012; 16:444-51. [DOI: 10.1016/j.canrad.2012.07.178] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022]
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Giraud P, Djadi-Prat J, Morvan E, Morelle M, Remmonay R, Pourel N, Durdux C, Carrie C, Mornex F, Le Péchoux C, Bachaud JM, Boisselier P, Beckendorf V, Dendale R, Daveau C, Garcia R. Intérêts dosimétriques et cliniques de la radiothérapie asservie à la respiration des cancers du poumon et du sein : résultats du Stic 2003. Cancer Radiother 2012; 16:272-81. [DOI: 10.1016/j.canrad.2012.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 03/07/2012] [Accepted: 03/12/2012] [Indexed: 12/25/2022]
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Fuks D, Verhaeghe JL, Marchal F, Guillemin F, Beckendorf V, Peiffert D, Leroux A, Rios M, Troufléau P, Marchal C. [Surgery and postoperative radiation therapy in primary retroperitoneal sarcomas: experience of the cancer centre Alexis-Vautrin]. Cancer Radiother 2012; 16:194-200. [PMID: 22387193 DOI: 10.1016/j.canrad.2011.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 11/16/2011] [Accepted: 11/25/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE Surgical resection remains the standard treatment for patients with resectable retroperitoneal sarcomas. The aim of this study was to retrospectively analyse the outcomes of patients with primary retroperitoneal sarcoma. PATIENTS AND METHODS We analysed data of 50 patients with primary retroperitoneal sarcoma who underwent curative-intent resection from 1975 to 2008. External beam radiotherapy and chemotherapy were delivered postoperatively. Demographics, surgical, pathological variables and chemo/radiation therapy were analysed as prognosis factors. RESULTS There were 22 males and 28 females (mean age 54 ± 13 years). Surgery required visceral resections in 30 patients. There were 16 leiomyosarcomas, 25 liposarcomas and eight other sub-types. Twenty-one patients had clear surgical margins. Twenty-eight patients received postoperative external beam radiotherapy (median 45 Gy) and 15 received chemotherapy. At the end of the follow-up (median 55 months), local recurrence occurred in 39% (n=14) among R0/R1 resection group (n=36). Postoperative external beam radiotherapy tends to increase the time of local recurrence from surgery (27 vs. 13 months, P=0.05). The overall survival rates were 81%, 55% and 46% at 1, 3 and 5 years, respectively. Although R0 resection (P=0.01), well tumour differentiation (P=0.004) and postoperative external beam radiotherapy (P=0.02) significantly influenced overall survival in univariate analysis, only R0 resection was an independent prognostic factor in a multivariate analysis. CONCLUSION We confirm the pre-eminence of radical surgery with negative margins as major prognostic factor and the benefit of postoperative radiotherapy.
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Affiliation(s)
- D Fuks
- Département de radiothérapie, centre Alexis-Vautrin, Vandœuvre-lès-Nancy, France
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Bouzid D, Huger S, Beckendorf V, Serre AA, Marchesi V, Noël A. Validation d’un algorithme de recalage élastique nommé « Superbaloo dense ». Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.141] [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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Gnep K, Zhu J, Chira C, Messai T, Bossi A, Beckendorf V, Le Prisé E, Simon A, Ospina Arango JD, de Crevoisier R. Identification et comparaison de modèles prédictifs de toxicité rectale et vésicale en cas d’irradiation prostatique. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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24
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Baumann A, Taste-George H, Marchesi V, Buccheit I, Beckendorf V, Peiffert D. Cas rapporté d’une toxicité de grade 3 après traitement d’une métastase hépatique par CyberKnife®. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.217] [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: 11/25/2022]
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25
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Serre AA, Marchesi V, Beckendorf V, Noël A, Peiffert D. Comparaison des différentes stratégies d’utilisation de l’imagerie embarquée (haute énergie [MV], basse énergie [kV], tomographie conique) en radiothérapie. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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26
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Zhu J, Simon A, Ospina J, Le Prisé E, Bossi A, Chira C, Gnep K, Beckendorf V, Polet V, De Crevoisier R. 7007 POSTER DISCUSSION Predictive Models of Bladder Toxicity in Prostate Cancer Radiotherapy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71958-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Dubray BM, Beckendorf V, Guerif S, Le Prise E, Reynaud-Bougnoux A, Hannoun Levi JM, Nguyen TD, Hennequin C, Cretin J, Fayolle-Campana M, Lagrange J, Bachaud J, Azria D, Grangirard A, Pommier P, Simon J, Harter V, Habibian M. Does short-term androgen depletion add to high-dose radiotherapy (80 Gy) in localized intermediate-risk prostate cancer? Intermediary analysis of GETUG 14 randomized trial (EU-20503/NCT00104741). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4521] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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28
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Renard-Oldrini S, Marchal C, Verhaeghe JL, El Hajj L, Beckendorf V, Tournier-Rangeard L, Peiffert D. Devenir de trois cas de sarcomes de la région sus claviculaire après radiothérapie mammaire. Cancer Radiother 2010. [DOI: 10.1016/j.canrad.2010.07.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Doyen J, Beckendorf V, Benezery K, Thariat J, Angellier G, Poudenx M, Venissac N, Bondiau P. Facteurs prédictifs pour la réponse des tumeurs pulmonaires traitées par radiothérapie stéréotaxique robotisée. Cancer Radiother 2010. [DOI: 10.1016/j.canrad.2010.07.566] [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: 10/19/2022]
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30
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Schipman B, Marchesi V, Beckendorf V, Desandes E, Bosset M, Peiffert D, Bosset JF. Cancers bronchiques non à petites cellules de stade I : radiothérapie tridimensionnelle et radiothérapie en conditions stéréotaxiques. Cancer Radiother 2010. [DOI: 10.1016/j.canrad.2010.07.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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31
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Aigle D, Sobczyk C, Androni ML, Peiffert D, Beckendorf V, Marchesi V, Buchheit I, Noel A. Management de la qualité et de la sécurité en radiothérapie « Quel rôle pour les qualiticiens ? » : exemple au centre Alexis-Vautrin. Cancer Radiother 2009; 13:455-7. [DOI: 10.1016/j.canrad.2009.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 06/30/2009] [Accepted: 07/01/2009] [Indexed: 11/26/2022]
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32
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Bondiau PY, Beckendorf V, Li G, Castelli J, Thariat J, Benezeri K, Mammar H, Angellier G, Poudenx M. Évaluation de l’apport du Cyberknife® chez le patient âgé. Cancer Radiother 2009. [DOI: 10.1016/j.canrad.2009.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Taste H, Peiffert D, Beckendorf V, Marchesi V, Noël A. Radiothérapie stéréotaxique par Cyberknife® des tumeurs digestives sous diaphragmatiques. Cancer Radiother 2009. [DOI: 10.1016/j.canrad.2009.08.054] [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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34
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Taste H, Fuks D, Peiffert D, Beckendorf V, Marchesi V, Noël A. Radiothérapie stéréotaxique par Cyberknife® dans les tumeurs hépatiques primitives et secondaires. Cancer Radiother 2008. [DOI: 10.1016/j.canrad.2008.08.103] [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: 10/21/2022]
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35
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Beckendorf V, Guerif S, Le Prise E, Cosset J, Bougnoux A, Chauvet B, Salem N, Romestaing P, Luporsi E, Bey P. 70 Gy versus (vs) 80 Gy Dose Escalation Getug 06 French Trial for Localized Prostate Cancer: Mature Results. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.986] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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36
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Marchesi V, Graff P, Noel A, Beckendorf V, Peiffert D. Optimisation et évaluation de la dose fœtale pendant une radiothérapie de la parotide droite. Cancer Radiother 2008; 12:380-4. [DOI: 10.1016/j.canrad.2008.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Revised: 03/14/2008] [Accepted: 03/27/2008] [Indexed: 11/16/2022]
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37
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Bondiau PY, Bénézery K, Beckendorf V, Peiffert D, Gérard JP, Mirabel X, Noël A, Marchesi V, Lacornerie T, Dubus F, Sarrazin T, Herault J, Marcié S, Angellier G, Lartigau E. [CyberKnife robotic stereotactic radiotherapy: technical aspects and medical indications]. Cancer Radiother 2008; 11:338-44. [PMID: 18029216 DOI: 10.1016/j.canrad.2007.09.146] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In 2006, 3 sites have been selected by the Institut national of cancer (Lille, Nancy et Nice) to evaluate a radiotherapy robot, the CyberKnife. This machine, able to track mobile tumours in real time, gives new possibilities in the field of extra cranial stereotactic radiotherapy. Functionalities and medico economical issues of the machine will be evaluated during 2 years on the 3 sites.
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Affiliation(s)
- P-Y Bondiau
- Département de Radiothérapie, Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189, Nice Cedex 02, France.
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38
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Peiffert D, Beckendorf V, Marchesi V, Noel A, Noel G, Maingon P, Bosset JF, Unterreiner M. Expérience préliminaire deradiothérapie enconditions stéréoxaques extracrânienne parCyberknife® aucentre Alexis-Vautrin. Cancer Radiother 2007. [DOI: 10.1016/j.canrad.2007.09.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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39
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Beckendorf V, Guerif S, Le Prise E, Cossett J, Le Floch O, Chauvet B, Salem N, Chapet O, Bourdin S, Bey P. Late Toxicity in the GETUG 06 Randomized Trial Comparing 70 Gy and 80 Gy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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40
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Beckendorf V, Guérif S, LePrisé E, Cosset J, Le Floch O, Chauvet B, Salem N, Chapet O, Luporsi E, Bey P. 4020 POSTER Toxicity and quality of life in the GETUG 06 randomized trial comparing 70 Gy and 80 Gy for localized prostate cancer. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71088-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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41
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Pommier P, Perol D, Lagrange J, Richaud P, Brune D, Le Prise E, Azria D, Beckendorf V, Martin E, Chabaud S, Carrie C. Does Pelvis and Prostate Radiation Therapy Compared to Prostate Radiation Therapy Alone Improve Survival in Patients with Non Metastatic Prostate Carcinoma? Preliminary Results of the Prospective Randomized GETUG 01 Trial. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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42
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Marchal C, Lapeyre M, Beckendorf V, Aletti P, Haslé E, Dubois JB, Maingon P, Bensadoun RJ, Le Prise E, Lartigau E, Carrie C, Dubray B, Marchesi V, Ailleres N, Naudy S, Marcie S, Manens JP, Mazurier J, Ginestet C, Chauvin F, Pommier P, Gerard JP, Carrere MO. [Preliminary results of the assessment of intensity modulated radiotherapy (IMRT) for prostatic and head and neck tumors (STIC 2001)]. Cancer Radiother 2004; 8 Suppl 1:S121-7. [PMID: 15679257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION Between May 2002 and May 2004, eight French comprehensive cancer centres did a prospective nonrandomized study including 200 patients, 100 with cancer of the prostate and 100 with head and neck cancers. Half of each patient group was treated by IMRT and the others by RTC 3D. This clinical study was associated with an economic study and a physics study. We report here the first results. PATIENTS AND METHODS For the clinical study, the analysis of the data of the first 88 patients irradiated for a prostatic cancer shows that 39 received RTC and 49 IMRT with a mean dose of 78 Gy at the ICRU point at 2 Gy per fraction. For H&N tumours, the preliminary analysis was done on the 87 first patients with a mean follow-up of 11.5 months (2 to 25 months) and a median of 8.4 months for the IMRT groups and 13.2 months for the RTC group. The economic study was done on the first 157 patients included during the first 18 months: 71 treated by RTC (35 for H&N and 36 for prostate) and 86 treated by IMRT (38 for H&N and 48 for prostate). The assessment of the direct costs was realized by a micro-costing technique. The physical study compared dose distributions for both techniques and has created quality control recommendations. RESULTS Clinical studies of the acute reactions do not show any difference between groups, but we want to point out the short follow-up and the relatively high dose delivered to cancers of the prostate. The physics study demonstrates that IMRT is technically feasible in good clinical conditions with high quality assurance, a good reproducibility and precision. Dosimetric data show that IMRT could certainly spare organs at risk more than RTC for H&N tumours. The direct costs of "routine" treatments for H&N tumours were 4922 euros for IMRT versus 1899 euros for RTC and for the prostatic cancers 4911 euros for IMRT versus 2357 for RTC.
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Affiliation(s)
- C Marchal
- Département de radiothŕapie, centre Alexis-Vautrin, 54511 Vandoeuvre-lès-Nancy, France.
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43
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Duval Y, Scheid P, Spaeth D, Desandes E, Grosdidier G, Siat J, Billon Y, Lamaze R, Beckendorf V. 174 Tolérance et risque de pneumopathie radique (PR) liée à la radio-chimiothérapie concomitante (RCT) par cisplatine-etoposide pour le cancer bronchique à petites cellules (CBPC) et non petites cellules (CBNPC). Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71800-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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44
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Beckendorf V, Guerif S, Le Prise E, Bey P, Cosset J, Le Floch O, Chauvet B, Salem N, Chapet O, Bourdin S, Bachaud J, Maingon P. The French 70 Gy versus 80 Gy dose escalation trial for localized prostate cancer: feasibility and toxicity. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)00924-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Chauvet B, Lagrange J, Geoffrois L, Beckendorf V, Ferrero J, Joly F, Allouache N, Bachaud J, Chevreau C, Mollevi C, Kramar A. Quality-of-life (QOL) assessment after concurrent chemoradiation for invasive bladder cancer. Preliminary results of a French multicenter prospective study. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)00965-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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46
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Beckendorf V, Bachaud JM, Bey P, Bourdin S, Carrie C, Chapet O, Cowen D, Guérif S, Hay HM, Lagrange JL, Maingon P, Le Prisé E, Pommier P, Simon JM. [Target-volume and critical-organ delineation for conformal radiotherapy of prostate cancer: experience of French dose-escalation trials]. Cancer Radiother 2002; 6 Suppl 1:78s-92s. [PMID: 12587386 DOI: 10.1016/s1278-3218(02)00217-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The delineation of target volume and organs at risk depends on the organs definition, and on the modalities for the CT-scan acquisition. Inter-observer variability in the delineation may be large, especially when patient's anatomy is unusual. During the two french multicentric studies of conformal radiotherapy for localized prostate cancer, it was made an effort to harmonize the delineation of the target volumes and organs at risk. Two cases were proposed for delineation during two workshops. In the first case, the mean prostate volume was 46.5 mL (extreme: 31.7-61.3), the mean prostate and seminal vesicles volume was 74.7 mL (extreme: 59.6-80.3), the rectal and bladder walls varied respectively in proportion from 1 to 1.45 and from 1 to 1.16; in the second case, the mean prostate volume was 53.1 mL (extreme: 40.8-73.1), the volume of prostate plus seminal vesicles was 65.1 mL (extreme: 53.2-89), the rectal wall varied proportionally from 1 to 1, 24 and the vesical wall varied from 1 to 1.67. For participating centers to the french studies of dose escalation, a quality control of contours was performed to decrease the inter-observer variability. The ways to reduce the discrepancies of volumes delineation, between different observers, are discussed. A better quality of the CT images, use of urethral opacification, and consensual definition of clinical target volumes and organs at risk may contribute to that improvement.
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Affiliation(s)
- V Beckendorf
- Radiothérapie, centre Alexis-Vautrin, 54511 Vandoeuvre-lès-Nancy, France.
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47
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Abstract
External radiotherapy is one of the modalities used to cure localized prostate carcinoma. Most of localized prostate carcinomas, specially those of the intermediate prognostic group, may benefit from escalated dose above 70 Gy at least as regard biochemical and clinical relapse free survival. 3D-CRT allows a reduction of the dose received by organs at risk and an increase of prostate dose over 70 Gy. It is on the way to become a standard. Intensity modulated radiation therapy increases dose homogeneity and reduces rectal dose. These methods necessitate rigorous procedures in reproducibility, delineation of volumes, dosimetry, daily treatment. They need also technological and human means. It is clear that localized prostate cancer is a good example for evaluation of these new radiotherapy modalities.
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Affiliation(s)
- P Bey
- Département de radiothérapie, centre Alexis-Vautrin, avenue de Bourgogne, 54511 Vandoeuvre-Les-Nancy, France.
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48
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Bey P, Beckendorf V, Carrie C, Aletti P, Ginestet C, Madelis G, Pommier P, Cowen D, Gonzague-Casabianca L, Simonian-Sauve M. Definitive results of a phase II escalating dose multicentric study in prostate adenocarcinoma from 66 Gy up to 80 Gy. Int J Radiat Oncol Biol Phys 2001. [DOI: 10.1016/s0360-3016(01)02349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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49
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Abstract
Radiation therapy of prostate carcinoma with a curative intent implies to treat the whole prostate at high dose (at least 66 Gy). According to clinical stage, PSA level, Gleason's score, the clinical target volume may include seminal vesicles and less often pelvic lymph nodes. Microscopic extracapsular extension is found in 15 to 60% of T1-T2 operated on, specially in apex tumors. On contrary, cancers developing from the transitional zone may stay limited to the prostate even with a big volume and with a high PSA level. Zonal anatomy of the prostate identifies internal prostate, including the transitional zone (5% of the prostate in young people). External prostate includes central and peripheral zones. The inferior limit of the prostate is not lower than the inferior border of the pubic symphysis. Clinical and radiological examination: ultrasonography, nuclear magnetic resonance (NMR), CT-scan identify prognostic factors as tumor volume, capsule effraction, seminal vesicles invasion and lymph node extension. The identification of the clinical target volume is now done mainly by CT-Scan which identifies prostate and seminal vesicles. NMR could be helpful to identify more precisely prostate apex. The definition of margins around the clinical target volume has to take in account daily reproducibility and organ motion and of course the maximum tolerable dose for organs at risk.
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Affiliation(s)
- P Bey
- Centre Alexis-Vautrin, centre régional de lutte contre le cancer, avenue de Bourgogne, Brabois, 54511 Vandaeuvre-lès-Nancy, France
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50
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Lagrange JL, Ramaioli A, Theodore CH, Terrier-Lacombe MJ, Beckendorf V, Biron P, Chevreau CH, Chinet-Charrot P, Dumont J, Delobel-Deroide A, D'Anjou J, Chassagne C, Parache RM, Karsenty JM, Mercier J, Droz JP. Non-Hodgkin's lymphoma of the testis: a retrospective study of 84 patients treated in the French anticancer centres. Ann Oncol 2001; 12:1313-9. [PMID: 11697846 DOI: 10.1023/a:1012224123385] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primary non-Hodgkin's lymphoma of the testicle is rare. We analysed cases treated in French anticancer centres from 1969 to 1995. All cases were reviewed and classified according to the R.E.A.L. Classification. Eighty-four cases were included in this study. The median age was 67 years (17-85). Disease was classified as stages I in 42 cases, stages II in 19 and stages III-IV in 23. Diffuse large B-cell lymphoma was diagnosed in 75% of cases. Treatment included orchidectomy and radiotherapy and/or chemotherapy. A complete response was obtained in 72.6% of the patient population and in 100%, 68% and 33% of stage I, II and III-IV disease respectively. Recurrence occurred in 32 cases and the most frequent site was the central nervous system: six of these patients presented stage I disease. Median overall survival was 32 months for the entire population, 52 months for stage I, 32 months for stage II, and 12 months for stage III-IV cases (P < 0.0001). Among patients presenting stage I disease, no difference was found between those treated with combined surgery and chemotherapy or surgery followed or not followed by radiotherapy. This study confirms that non-Hodgkin's lymphoma of the testicle carries a poor prognosis. Systemic adjuvant chemotherapy should be discussed because of the high recurrence rate. Inclusion of these cases in large co-operative prospective studies is recommended.
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Affiliation(s)
- J L Lagrange
- Radiation Therapy Group of the Federation of Cancer Centers, Paris, France
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