Stéphane SUPIOT
Professeur - Praticien Hospitalier Université
| Équipe : |
Thèmes de recherche
Radiobiologie des cancers de prostate
Publications
2 publications
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4 publications
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2020
Goineau, Aurore; Campion, Loïc; Commer, Jean-Marie; Vié, Brigitte; Ghesquière, Agnès; Béra, Guillaume; Jaffres, Didier; Magné, Nicolas; Artignan, Xavier; Chamois, Jérôme; Bergerot, Philippe; Créhange, Gilles; Deniaud-Alexandre, Elisabeth; Buthaud, Xavier; Belkacémi, Yazid; Doré, Mélanie; Decker, Laure De; Supiot, Stéphane
Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older? Article de journal
Dans: Cancers, vol. 12, no. 3, 2020, ISSN: 2072-6694.
@article{cancers12030635,
title = {Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?},
author = {Aurore Goineau and Loïc Campion and Jean-Marie Commer and Brigitte Vié and Agnès Ghesquière and Guillaume Béra and Didier Jaffres and Nicolas Magné and Xavier Artignan and Jérôme Chamois and Philippe Bergerot and Gilles Créhange and Elisabeth Deniaud-Alexandre and Xavier Buthaud and Yazid Belkacémi and Mélanie Doré and Laure De Decker and Stéphane Supiot},
url = {https://www.mdpi.com/2072-6694/12/3/635},
doi = {10.3390/cancers12030635},
issn = {2072-6694},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Cancers},
volume = {12},
number = {3},
abstract = {Curative radiotherapy for prostate cancer is common in the elderly. However, concerns about potential toxicity have inhibited access to radiotherapy for this population, for whom preserving quality of life (QoL) is crucial. The primary endpoint was to identify predictors of impaired QoL in men aged 75 years or older treated with curative intent radiotherapy with or without androgen deprivation therapy (ADT) for localized prostate cancer. We prospectively performed comprehensive geriatric assessment (CGA) and administered QoL questionnaires to 208 elderly (>75 years) patients prior to, plus two and six months after, radiotherapy (NCT 02876237). The median age of the patients was 77 years (range 75-89). At the start of the study, comorbidities were highlighted in 65% of patients: 23% were depressed, 23% had cognitive impairment, and 16% had reduced independence. At six months, 9% of patients had a consistently decreased QoL (>20 points), and a further 16% had a more moderate reduction (10 to 20 points) in QoL. None of the parameters studied (tumor characteristic, treatment, or oncogeriatric parameters) were predictive of a reduced QoL following radiotherapy. Though co-existing geriatric impairment was common, QoL was maintained for 75% of patients six months after radiotherapy. CGA was poorly predictive of tolerance of prostatic radiotherapy. Geriatric assessments dedicated to quality of life following radiotherapy need to be developed.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Curative radiotherapy for prostate cancer is common in the elderly. However, concerns about potential toxicity have inhibited access to radiotherapy for this population, for whom preserving quality of life (QoL) is crucial. The primary endpoint was to identify predictors of impaired QoL in men aged 75 years or older treated with curative intent radiotherapy with or without androgen deprivation therapy (ADT) for localized prostate cancer. We prospectively performed comprehensive geriatric assessment (CGA) and administered QoL questionnaires to 208 elderly (>75 years) patients prior to, plus two and six months after, radiotherapy (NCT 02876237). The median age of the patients was 77 years (range 75–89). At the start of the study, comorbidities were highlighted in 65% of patients: 23% were depressed, 23% had cognitive impairment, and 16% had reduced independence. At six months, 9% of patients had a consistently decreased QoL (>20 points), and a further 16% had a more moderate reduction (10 to 20 points) in QoL. None of the parameters studied (tumor characteristic, treatment, or oncogeriatric parameters) were predictive of a reduced QoL following radiotherapy. Though co-existing geriatric impairment was common, QoL was maintained for 75% of patients six months after radiotherapy. CGA was poorly predictive of tolerance of prostatic radiotherapy. Geriatric assessments dedicated to quality of life following radiotherapy need to be developed.
Michaud, Anne-Victoire; Samain, Benoit; Ferrer, Ludovic; Fleury, Vincent; Dore, Melanie; Colombie, Mathilde; Dupuy, Claire; Rio, Emmanuel; Guimas, Valentine; Rousseau, Thierry; Thiec, Maelle Le; Delpon, Gregory; Rousseau, Caroline; Supiot, Stéphane
Haute Couture or Ready-To-Wear? Tailored Pelvic Radiotherapy for Prostate Cancer Based on Individualized Sentinel Lymph Node Detection Article de journal
Dans: Cancers, vol. 12, no. 4, 2020, ISSN: 2072-6694.
@article{cancers12040944,
title = {Haute Couture or Ready-To-Wear? Tailored Pelvic Radiotherapy for Prostate Cancer Based on Individualized Sentinel Lymph Node Detection},
author = {Anne-Victoire Michaud and Benoit Samain and Ludovic Ferrer and Vincent Fleury and Melanie Dore and Mathilde Colombie and Claire Dupuy and Emmanuel Rio and Valentine Guimas and Thierry Rousseau and Maelle Le Thiec and Gregory Delpon and Caroline Rousseau and Stéphane Supiot},
url = {https://www.mdpi.com/2072-6694/12/4/944},
doi = {10.3390/cancers12040944},
issn = {2072-6694},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Cancers},
volume = {12},
number = {4},
abstract = {Prostate cancer (PCa) pelvic radiotherapy fields are defined by guidelines that do not consider individual variations in lymphatic drainage. We examined the feasibility of personalized sentinel lymph node (SLN)-based pelvic irradiation in PCa. Among a SLN study of 202 patients, we retrospectively selected 57 patients with a high risk of lymph node involvement. Each single SLN clinical target volume (CTV) was individually segmented and pelvic CTVs were contoured according to Radiation Therapy Oncology Group (RTOG) guidelines. We simulated a radiotherapy plan delivering 46 Gy and calculated the dose received by each SLN. Among a total of 332 abdominal SLNs, 305 pelvic SLNs (beyond the aortic bifurcation) were contoured (mean 5.4/patient). Based on standard guidelines, CTV missed 67 SLNs (22%), mostly at the common iliac level (40 SLNs). The mean distance between iliac vessels and the SLN was 11mm, and despite a 15mm margin around the iliac vessels, 9% of SLNs were not encompassed by the CTV. Moreover, 42 SLNs (63%) did not receive 95% of the prescribed dose. Despite a consensus on contouring guidelines, a significant proportion of SLNs were not included in the pelvic CTV and did not receive the prescribed dose. A tailored approach based on individual SLN detection would avoid underdosing pelvic lymph nodes that potentially contain tumor cells.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Prostate cancer (PCa) pelvic radiotherapy fields are defined by guidelines that do not consider individual variations in lymphatic drainage. We examined the feasibility of personalized sentinel lymph node (SLN)-based pelvic irradiation in PCa. Among a SLN study of 202 patients, we retrospectively selected 57 patients with a high risk of lymph node involvement. Each single SLN clinical target volume (CTV) was individually segmented and pelvic CTVs were contoured according to Radiation Therapy Oncology Group (RTOG) guidelines. We simulated a radiotherapy plan delivering 46 Gy and calculated the dose received by each SLN. Among a total of 332 abdominal SLNs, 305 pelvic SLNs (beyond the aortic bifurcation) were contoured (mean 5.4/patient). Based on standard guidelines, CTV missed 67 SLNs (22%), mostly at the common iliac level (40 SLNs). The mean distance between iliac vessels and the SLN was 11mm, and despite a 15mm margin around the iliac vessels, 9% of SLNs were not encompassed by the CTV. Moreover, 42 SLNs (63%) did not receive 95% of the prescribed dose. Despite a consensus on contouring guidelines, a significant proportion of SLNs were not included in the pelvic CTV and did not receive the prescribed dose. A tailored approach based on individual SLN detection would avoid underdosing pelvic lymph nodes that potentially contain tumor cells.
Mylona, Eugenia; Cicchetti, Alessandro; Rancati, Tiziana; Palorini, Federica; Fiorino, Claudio; Supiot, Stéphane; Magne, Nicolas; Crehange, Gilles; Valdagni, Riccardo; Acosta, Oscar; Crevoisier, Renaud
Local dose analysis to predict acute and late urinary toxicities after prostate cancer radiotherapy: Assessment of cohort and method effects Article de journal
Dans: Radiotherapy and Oncology, vol. 147, p. 40-49, 2020, ISSN: 0167-8140.
@article{MYLONA202040,
title = {Local dose analysis to predict acute and late urinary toxicities after prostate cancer radiotherapy: Assessment of cohort and method effects},
author = {Eugenia Mylona and Alessandro Cicchetti and Tiziana Rancati and Federica Palorini and Claudio Fiorino and Stéphane Supiot and Nicolas Magne and Gilles Crehange and Riccardo Valdagni and Oscar Acosta and Renaud Crevoisier},
url = {https://www.sciencedirect.com/science/article/pii/S0167814020301134},
doi = {https://doi.org/10.1016/j.radonc.2020.02.028},
issn = {0167-8140},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Radiotherapy and Oncology},
volume = {147},
pages = {40-49},
abstract = {Purpose
To perform bladder dose-surface map (DSM) analysis for (1) identifying symptom-related sub-surfaces (Ssurf) and evaluating their prediction capability of urinary toxicity, (2) comparing DSM with dose-volume map (DVM) (method effect), and (3) assessing the reproducibility of DSM (cohort effect).
Methods and materials
Urinary toxicities were prospectively analyzed for 254 prostate cancer patients treated with IMRT/IGRT at 78/80 Gy. DSMs were generated by unfolding bladder surfaces in a 2D plane. Pixel-by-pixel analysis was performed to identify symptom-related Ssurf. Likewise, voxel-by-voxel DVM analysis was performed to identify sub-volumes (Svol). The prediction capability of Ssurf and Svol DVHs was assessed by logistic/Cox regression using the area under the ROC curve (AUC). The Ssurf localization and prediction capability were compared to (1) the Svol obtained by DVM analysis in the same cohort and (2) the Ssurf obtained from other DSM studies.
Results Three Ssurf were identified in the bladder: posterior for acute retention (AUC = 0.64), posterior–superior for late retention (AUC = 0.68), and inferior–anterior–lateral for late dysuria (AUC = 0.73). Five Svol were identified: one in the urethra for acute incontinence and four in the posterior bladder part for acute and late retention, late dysuria, and hematuria. The overlap between Ssurf and Svol was moderate for acute retention, good for late retention, and bad for late dysuria, and AUCs ranged from 0.62 to 0.81. The prediction capabilities of Ssurf and Svol models were not significantly different. Among five symptoms comparable between cohorts, common Ssurf was found only for late dysuria, with a good spatial agreement.
Conclusion
Spatial agreement between methods is relatively good although DVM identified more sub-regions. Reproducibility of identified Ssurf between cohorts is low.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Purpose
To perform bladder dose-surface map (DSM) analysis for (1) identifying symptom-related sub-surfaces (Ssurf) and evaluating their prediction capability of urinary toxicity, (2) comparing DSM with dose-volume map (DVM) (method effect), and (3) assessing the reproducibility of DSM (cohort effect).
Methods and materials
Urinary toxicities were prospectively analyzed for 254 prostate cancer patients treated with IMRT/IGRT at 78/80 Gy. DSMs were generated by unfolding bladder surfaces in a 2D plane. Pixel-by-pixel analysis was performed to identify symptom-related Ssurf. Likewise, voxel-by-voxel DVM analysis was performed to identify sub-volumes (Svol). The prediction capability of Ssurf and Svol DVHs was assessed by logistic/Cox regression using the area under the ROC curve (AUC). The Ssurf localization and prediction capability were compared to (1) the Svol obtained by DVM analysis in the same cohort and (2) the Ssurf obtained from other DSM studies.
Results Three Ssurf were identified in the bladder: posterior for acute retention (AUC = 0.64), posterior–superior for late retention (AUC = 0.68), and inferior–anterior–lateral for late dysuria (AUC = 0.73). Five Svol were identified: one in the urethra for acute incontinence and four in the posterior bladder part for acute and late retention, late dysuria, and hematuria. The overlap between Ssurf and Svol was moderate for acute retention, good for late retention, and bad for late dysuria, and AUCs ranged from 0.62 to 0.81. The prediction capabilities of Ssurf and Svol models were not significantly different. Among five symptoms comparable between cohorts, common Ssurf was found only for late dysuria, with a good spatial agreement.
Conclusion
Spatial agreement between methods is relatively good although DVM identified more sub-regions. Reproducibility of identified Ssurf between cohorts is low.
To perform bladder dose-surface map (DSM) analysis for (1) identifying symptom-related sub-surfaces (Ssurf) and evaluating their prediction capability of urinary toxicity, (2) comparing DSM with dose-volume map (DVM) (method effect), and (3) assessing the reproducibility of DSM (cohort effect).
Methods and materials
Urinary toxicities were prospectively analyzed for 254 prostate cancer patients treated with IMRT/IGRT at 78/80 Gy. DSMs were generated by unfolding bladder surfaces in a 2D plane. Pixel-by-pixel analysis was performed to identify symptom-related Ssurf. Likewise, voxel-by-voxel DVM analysis was performed to identify sub-volumes (Svol). The prediction capability of Ssurf and Svol DVHs was assessed by logistic/Cox regression using the area under the ROC curve (AUC). The Ssurf localization and prediction capability were compared to (1) the Svol obtained by DVM analysis in the same cohort and (2) the Ssurf obtained from other DSM studies.
Results Three Ssurf were identified in the bladder: posterior for acute retention (AUC = 0.64), posterior–superior for late retention (AUC = 0.68), and inferior–anterior–lateral for late dysuria (AUC = 0.73). Five Svol were identified: one in the urethra for acute incontinence and four in the posterior bladder part for acute and late retention, late dysuria, and hematuria. The overlap between Ssurf and Svol was moderate for acute retention, good for late retention, and bad for late dysuria, and AUCs ranged from 0.62 to 0.81. The prediction capabilities of Ssurf and Svol models were not significantly different. Among five symptoms comparable between cohorts, common Ssurf was found only for late dysuria, with a good spatial agreement.
Conclusion
Spatial agreement between methods is relatively good although DVM identified more sub-regions. Reproducibility of identified Ssurf between cohorts is low.
Loubersac, Thomas; Guimas, Valentine; Rio, Emmanuel; Libois, Vincent; Rigaud, Jérome; Supiot, Stéphane
Prise en charge des rechutes oligométastatiques des cancers de prostate : actualités et perspectives Article de journal
Dans: Bulletin du Cancer, vol. 107, no. 5, Supplement, p. S35-S40, 2020, ISSN: 0007-4551, (Questions d’actualités en Onco-Urologie).
@article{LOUBERSAC2020S35,
title = {Prise en charge des rechutes oligométastatiques des cancers de prostate : actualités et perspectives},
author = {Thomas Loubersac and Valentine Guimas and Emmanuel Rio and Vincent Libois and Jérome Rigaud and Stéphane Supiot},
url = {https://www.sciencedirect.com/science/article/pii/S0007455120302769},
doi = {https://doi.org/10.1016/S0007-4551(20)30276-9},
issn = {0007-4551},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Bulletin du Cancer},
volume = {107},
number = {5, Supplement},
pages = {S35-S40},
abstract = {Résumé
Le cancer de la prostate oligométastatique est une notion récente et polymorphe. Son émergence est concomitante du développement d’examens d’imagerie de plus en plus sensibles, notamment les tomographies par émission de positions (TEP) à la fluorocholine (18FCH) et au 68gallium-prostate-specific membrane antigen (Ga-PSMA). Chez des patients hormono-naïfs présentant un cancer de la prostate oligorécurrent (généralement moins de cinq métastases avec site primitif contrôlé), plusieurs études rétrospectives ont montré un bénéfice du traitement local des métastases soit par radiothérapie stéréotaxique, soit par curage ganglionnaire de rattrapage, au prix d’une faible toxicité. Des études de phase 2 randomisées ont montré que la radiothérapie stéréotaxique des méta stases permet de retarder l’introduction d’une hormonothérapie et d’améliorer la survie sans récidive biochimique, voire la survie globale. À la suite de ces résultats, les recommandations de l’european association of urology et de l’American Society for Radiation Oncology recommandent à présent le traitement direct de métastases par rapport à la surveillance. Nettement moins de données sont disponibles chez les patients en oligoprogression, définis comme des patients non ou peu symptomatiques porteurs d’un cancer de la prostate métastatique résistant à la castration présentant une augmentation de quelques métastases ganglionnaires ou osseuses. De nombreux essais en France et à l’international sont en cours pour confirmer la place du traitement direct des métastases.
Summary
Oligometastatic prostate cancer (PCa) is an intense area of research thanks to the development of novel PET tracers such as 18F-choline or 68Ga-PSMA. Several retrospective studies in patients with hormone-sensitive oligorecurrent PCa (usually up to 5 metastases with a controlled primary tumor) showed PSA response and a low toxicity profile of metastasis-directed therapies (MDT) such as Stereotactic Body Radiation Therapy (SBRT) or salvage lymph node dissection. More recently, randomized phase 2 studies showed that SBRT can delay the introduction of androgen deprivation, decrease biochemical relapses and increase overall survival. Regarding oligoprogressive metastatic castration-resistant PCa, limited data is however available. Based on these studies the European Association of Urology and the American Society of Radiotherapy EAU now recommend using MDT instead of observation. Several studies are undergoing in France and worldwide in order to confirm the exact role of MDT.},
note = {Questions d’actualités en Onco-Urologie},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Résumé
Le cancer de la prostate oligométastatique est une notion récente et polymorphe. Son émergence est concomitante du développement d’examens d’imagerie de plus en plus sensibles, notamment les tomographies par émission de positions (TEP) à la fluorocholine (18FCH) et au 68gallium-prostate-specific membrane antigen (Ga-PSMA). Chez des patients hormono-naïfs présentant un cancer de la prostate oligorécurrent (généralement moins de cinq métastases avec site primitif contrôlé), plusieurs études rétrospectives ont montré un bénéfice du traitement local des métastases soit par radiothérapie stéréotaxique, soit par curage ganglionnaire de rattrapage, au prix d’une faible toxicité. Des études de phase 2 randomisées ont montré que la radiothérapie stéréotaxique des méta stases permet de retarder l’introduction d’une hormonothérapie et d’améliorer la survie sans récidive biochimique, voire la survie globale. À la suite de ces résultats, les recommandations de l’european association of urology et de l’American Society for Radiation Oncology recommandent à présent le traitement direct de métastases par rapport à la surveillance. Nettement moins de données sont disponibles chez les patients en oligoprogression, définis comme des patients non ou peu symptomatiques porteurs d’un cancer de la prostate métastatique résistant à la castration présentant une augmentation de quelques métastases ganglionnaires ou osseuses. De nombreux essais en France et à l’international sont en cours pour confirmer la place du traitement direct des métastases.
Summary
Oligometastatic prostate cancer (PCa) is an intense area of research thanks to the development of novel PET tracers such as 18F-choline or 68Ga-PSMA. Several retrospective studies in patients with hormone-sensitive oligorecurrent PCa (usually up to 5 metastases with a controlled primary tumor) showed PSA response and a low toxicity profile of metastasis-directed therapies (MDT) such as Stereotactic Body Radiation Therapy (SBRT) or salvage lymph node dissection. More recently, randomized phase 2 studies showed that SBRT can delay the introduction of androgen deprivation, decrease biochemical relapses and increase overall survival. Regarding oligoprogressive metastatic castration-resistant PCa, limited data is however available. Based on these studies the European Association of Urology and the American Society of Radiotherapy EAU now recommend using MDT instead of observation. Several studies are undergoing in France and worldwide in order to confirm the exact role of MDT.
Le cancer de la prostate oligométastatique est une notion récente et polymorphe. Son émergence est concomitante du développement d’examens d’imagerie de plus en plus sensibles, notamment les tomographies par émission de positions (TEP) à la fluorocholine (18FCH) et au 68gallium-prostate-specific membrane antigen (Ga-PSMA). Chez des patients hormono-naïfs présentant un cancer de la prostate oligorécurrent (généralement moins de cinq métastases avec site primitif contrôlé), plusieurs études rétrospectives ont montré un bénéfice du traitement local des métastases soit par radiothérapie stéréotaxique, soit par curage ganglionnaire de rattrapage, au prix d’une faible toxicité. Des études de phase 2 randomisées ont montré que la radiothérapie stéréotaxique des méta stases permet de retarder l’introduction d’une hormonothérapie et d’améliorer la survie sans récidive biochimique, voire la survie globale. À la suite de ces résultats, les recommandations de l’european association of urology et de l’American Society for Radiation Oncology recommandent à présent le traitement direct de métastases par rapport à la surveillance. Nettement moins de données sont disponibles chez les patients en oligoprogression, définis comme des patients non ou peu symptomatiques porteurs d’un cancer de la prostate métastatique résistant à la castration présentant une augmentation de quelques métastases ganglionnaires ou osseuses. De nombreux essais en France et à l’international sont en cours pour confirmer la place du traitement direct des métastases.
Summary
Oligometastatic prostate cancer (PCa) is an intense area of research thanks to the development of novel PET tracers such as 18F-choline or 68Ga-PSMA. Several retrospective studies in patients with hormone-sensitive oligorecurrent PCa (usually up to 5 metastases with a controlled primary tumor) showed PSA response and a low toxicity profile of metastasis-directed therapies (MDT) such as Stereotactic Body Radiation Therapy (SBRT) or salvage lymph node dissection. More recently, randomized phase 2 studies showed that SBRT can delay the introduction of androgen deprivation, decrease biochemical relapses and increase overall survival. Regarding oligoprogressive metastatic castration-resistant PCa, limited data is however available. Based on these studies the European Association of Urology and the American Society of Radiotherapy EAU now recommend using MDT instead of observation. Several studies are undergoing in France and worldwide in order to confirm the exact role of MDT.
Latorzeff, I; Sargos, P; Créhange, G; Belkacémi, Y; Azria, D; Hasbini, A; Dubergé, T; Toledano, A; Graff-Cailleaud, P; Chapet, O; Hennequin, C; Crevoisier, R; Supiot, S; Pasquier, D
Indications et perspectives de l’hormonoradiothérapie des cancers de prostate à haut risque Article de journal
Dans: Cancer/Radiothérapie, vol. 24, no. 2, p. 143-152, 2020, ISSN: 1278-3218.
@article{LATORZEFF2020143,
title = {Indications et perspectives de l’hormonoradiothérapie des cancers de prostate à haut risque},
author = {I Latorzeff and P Sargos and G Créhange and Y Belkacémi and D Azria and A Hasbini and T Dubergé and A Toledano and P Graff-Cailleaud and O Chapet and C Hennequin and R Crevoisier and S Supiot and D Pasquier},
url = {https://www.sciencedirect.com/science/article/pii/S1278321820300160},
doi = {https://doi.org/10.1016/j.canrad.2019.06.018},
issn = {1278-3218},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Cancer/Radiothérapie},
volume = {24},
number = {2},
pages = {143-152},
abstract = {Résumé
Le cancer de la prostate est un adénocarcinome sensible, dans plus de 80 % des cas, à la castration chimique, en raison de son hormonodépendance. Le cancer localement évolué et/ou à haut risque est défini en fonction du stade clinique, de la valeur initiale de la concentration sérique d’antigène spécifique de la prostate ou du score de Gleason élevé. L’hormonothérapie associée à la radiothérapie est le standard de la prise en charge et améliore le contrôle local, diminue le risque de métastase à distance et améliore les probabilités de survie spécifique et globale. La durée d’hormonothérapie, le niveau de dose de radiothérapie seule ou associée à la curiethérapie sont des données controversées dans la littérature. Le choix thérapeutique, pluridisciplinaire, dépend de l’âge et des maladies associées du patient, des critères pronostiques de la pathologie et de la fonction urinaire du patient. La recherche actuelle est orientée sur l’optimisation du contrôle local et à distance de ces formes agressives et intègre la chimiothérapie néoadjuvante ou adjuvante de même que les nouvelles hormonothérapies.
Prostate cancer is a sensitive adenocarcinoma, in more than 80% of cases, to chemical castration, due to its hormone dependence. Locally advanced and/or high-risk cancer is defined based on clinical stage, initial prostate specific antigen serum concentration value or high Gleason score. Hormone therapy associated with radiation therapy is the standard of management and improves local control, reduces the risk of distant metastasis and improves specific and overall survival. Duration of hormone therapy, dose level of radiation therapy alone or associated with brachytherapy are controversial data in the literature. The therapeutic choice, multidisciplinary, depends on the age and comorbidity of the patient, the prognostic criteria of the pathology and the urinary function of the patient. Current research focuses on optimizing local and distant control of these aggressive forms and incorporates neoadjuvant or adjuvant chemotherapy and also new hormone therapies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Résumé
Le cancer de la prostate est un adénocarcinome sensible, dans plus de 80 % des cas, à la castration chimique, en raison de son hormonodépendance. Le cancer localement évolué et/ou à haut risque est défini en fonction du stade clinique, de la valeur initiale de la concentration sérique d’antigène spécifique de la prostate ou du score de Gleason élevé. L’hormonothérapie associée à la radiothérapie est le standard de la prise en charge et améliore le contrôle local, diminue le risque de métastase à distance et améliore les probabilités de survie spécifique et globale. La durée d’hormonothérapie, le niveau de dose de radiothérapie seule ou associée à la curiethérapie sont des données controversées dans la littérature. Le choix thérapeutique, pluridisciplinaire, dépend de l’âge et des maladies associées du patient, des critères pronostiques de la pathologie et de la fonction urinaire du patient. La recherche actuelle est orientée sur l’optimisation du contrôle local et à distance de ces formes agressives et intègre la chimiothérapie néoadjuvante ou adjuvante de même que les nouvelles hormonothérapies.
Prostate cancer is a sensitive adenocarcinoma, in more than 80% of cases, to chemical castration, due to its hormone dependence. Locally advanced and/or high-risk cancer is defined based on clinical stage, initial prostate specific antigen serum concentration value or high Gleason score. Hormone therapy associated with radiation therapy is the standard of management and improves local control, reduces the risk of distant metastasis and improves specific and overall survival. Duration of hormone therapy, dose level of radiation therapy alone or associated with brachytherapy are controversial data in the literature. The therapeutic choice, multidisciplinary, depends on the age and comorbidity of the patient, the prognostic criteria of the pathology and the urinary function of the patient. Current research focuses on optimizing local and distant control of these aggressive forms and incorporates neoadjuvant or adjuvant chemotherapy and also new hormone therapies.
Le cancer de la prostate est un adénocarcinome sensible, dans plus de 80 % des cas, à la castration chimique, en raison de son hormonodépendance. Le cancer localement évolué et/ou à haut risque est défini en fonction du stade clinique, de la valeur initiale de la concentration sérique d’antigène spécifique de la prostate ou du score de Gleason élevé. L’hormonothérapie associée à la radiothérapie est le standard de la prise en charge et améliore le contrôle local, diminue le risque de métastase à distance et améliore les probabilités de survie spécifique et globale. La durée d’hormonothérapie, le niveau de dose de radiothérapie seule ou associée à la curiethérapie sont des données controversées dans la littérature. Le choix thérapeutique, pluridisciplinaire, dépend de l’âge et des maladies associées du patient, des critères pronostiques de la pathologie et de la fonction urinaire du patient. La recherche actuelle est orientée sur l’optimisation du contrôle local et à distance de ces formes agressives et intègre la chimiothérapie néoadjuvante ou adjuvante de même que les nouvelles hormonothérapies.
Prostate cancer is a sensitive adenocarcinoma, in more than 80% of cases, to chemical castration, due to its hormone dependence. Locally advanced and/or high-risk cancer is defined based on clinical stage, initial prostate specific antigen serum concentration value or high Gleason score. Hormone therapy associated with radiation therapy is the standard of management and improves local control, reduces the risk of distant metastasis and improves specific and overall survival. Duration of hormone therapy, dose level of radiation therapy alone or associated with brachytherapy are controversial data in the literature. The therapeutic choice, multidisciplinary, depends on the age and comorbidity of the patient, the prognostic criteria of the pathology and the urinary function of the patient. Current research focuses on optimizing local and distant control of these aggressive forms and incorporates neoadjuvant or adjuvant chemotherapy and also new hormone therapies.
2019
Supiot, Stéphane; Rousseau, Caroline; Dore, Mélanie; Chèze-Le-Rest, Catherine; Kandel-Aznar, Christine; Potiron, Vincent; Guerif, Stéphane; Paris, François; Ferrer, Ludovic; Campion, Loïc; Meingan, Philippe; Delpon, Grégory; Hatt, Mathieu; Visvikis, Dimitris
Reoxygenation during radiotherapy in intermediate-risk prostate cancer Article de journal
Dans: Radiother Oncol, vol. 133, p. 16–19, 2019, ISSN: 1879-0887.
@article{pmid30935573,
title = {Reoxygenation during radiotherapy in intermediate-risk prostate cancer},
author = {Stéphane Supiot and Caroline Rousseau and Mélanie Dore and Catherine Chèze-Le-Rest and Christine Kandel-Aznar and Vincent Potiron and Stéphane Guerif and François Paris and Ludovic Ferrer and Loïc Campion and Philippe Meingan and Grégory Delpon and Mathieu Hatt and Dimitris Visvikis},
doi = {10.1016/j.radonc.2018.12.022},
issn = {1879-0887},
year = {2019},
date = {2019-04-01},
urldate = {2019-01-01},
journal = {Radiother Oncol},
volume = {133},
pages = {16--19},
abstract = {Hypoxia is a major risk factor of prostate cancer radioresistance. We evaluated hypoxia non-invasively, using F-Misonidazole PET/CT prior to radiotherapy and after a dose of 20 Gy in intermediate-risk prostate cancer patients. Decreased hypoxic volumes were observed in all patients, suggesting that radiotherapy induces early prostate tumor reoxygenation.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hypoxia is a major risk factor of prostate cancer radioresistance. We evaluated hypoxia non-invasively, using F-Misonidazole PET/CT prior to radiotherapy and after a dose of 20 Gy in intermediate-risk prostate cancer patients. Decreased hypoxic volumes were observed in all patients, suggesting that radiotherapy induces early prostate tumor reoxygenation.
Laprie, Anne; Ken, Soléakhéna; Filleron, Thomas; Lubrano, Vincent; Vieillevigne, Laure; Tensaouti, Fatima; Catalaa, Isabelle; Boetto, Sergio; Khalifa, Jonathan; Attal, Justine; Peyraga, Guillaume; Gomez-Roca, Carlos; Uro-Coste, Emmanuelle; Noel, Georges; Truc, Gilles; Sunyach, Marie-Pierre; Magné, Nicolas; Charissoux, Marie; Supiot, Stéphane; Bernier, Valérie; Mounier, Muriel; Poublanc, Muriel; Fabre, Amandine; Delord, Jean-Pierre; Moyal, Elizabeth Cohen-Jonathan
Dans: BMC Cancer, vol. 19, no. 1, p. 167, 2019, ISSN: 1471-2407.
@article{pmid30791889,
title = {Dose-painting multicenter phase III trial in newly diagnosed glioblastoma: the SPECTRO-GLIO trial comparing arm A standard radiochemotherapy to arm B radiochemotherapy with simultaneous integrated boost guided by MR spectroscopic imaging},
author = {Anne Laprie and Soléakhéna Ken and Thomas Filleron and Vincent Lubrano and Laure Vieillevigne and Fatima Tensaouti and Isabelle Catalaa and Sergio Boetto and Jonathan Khalifa and Justine Attal and Guillaume Peyraga and Carlos Gomez-Roca and Emmanuelle Uro-Coste and Georges Noel and Gilles Truc and Marie-Pierre Sunyach and Nicolas Magné and Marie Charissoux and Stéphane Supiot and Valérie Bernier and Muriel Mounier and Muriel Poublanc and Amandine Fabre and Jean-Pierre Delord and Elizabeth Cohen-Jonathan Moyal},
doi = {10.1186/s12885-019-5317-x},
issn = {1471-2407},
year = {2019},
date = {2019-02-01},
urldate = {2019-02-01},
journal = {BMC Cancer},
volume = {19},
number = {1},
pages = {167},
abstract = {BACKGROUND: Glioblastoma, a high-grade glial infiltrating tumor, is the most frequent malignant brain tumor in adults and carries a dismal prognosis. External beam radiotherapy (EBRT) increases overall survival but this is still low due to local relapses, mostly occurring in the irradiation field. As the ratio of spectra of choline/N acetyl aspartate> 2 (CNR2) on MR spectroscopic imaging has been described as predictive for the site of local relapse, we hypothesized that dose escalation on these regions would increase local control and hence global survival.
METHODS/DESIGN: In this multicenter prospective phase III trial for newly diagnosed glioblastoma, 220 patients having undergone biopsy or surgery are planned for randomization to two arms. Arm A is the Stupp protocol (EBRT 60 Gy on contrast enhancement + 2 cm margin with concomitant temozolomide (TMZ) and 6 months of TMZ maintenance); Arm B is the same treatment with an additional simultaneous integrated boost of intensity-modulated radiotherapy (IMRT) of 72Gy/2.4Gy delivered on the MR spectroscopic imaging metabolic volumes of CHO/NAA > 2 and contrast-enhancing lesions or resection cavity. Stratification is performed on surgical and MGMT status.
DISCUSSION: This is a dose-painting trial, i.e. delivery of heterogeneous dose guided by metabolic imaging. The principal endpoint is overall survival. An online prospective quality control of volumes and dose is performed in the experimental arm. The study will yield a large amount of longitudinal multimodal MR imaging data including planning CT, radiotherapy dosimetry, MR spectroscopic, diffusion and perfusion imaging.
TRIAL REGISTRATION: NCT01507506 , registration date December 20, 2011.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Glioblastoma, a high-grade glial infiltrating tumor, is the most frequent malignant brain tumor in adults and carries a dismal prognosis. External beam radiotherapy (EBRT) increases overall survival but this is still low due to local relapses, mostly occurring in the irradiation field. As the ratio of spectra of choline/N acetyl aspartate> 2 (CNR2) on MR spectroscopic imaging has been described as predictive for the site of local relapse, we hypothesized that dose escalation on these regions would increase local control and hence global survival.
METHODS/DESIGN: In this multicenter prospective phase III trial for newly diagnosed glioblastoma, 220 patients having undergone biopsy or surgery are planned for randomization to two arms. Arm A is the Stupp protocol (EBRT 60 Gy on contrast enhancement + 2 cm margin with concomitant temozolomide (TMZ) and 6 months of TMZ maintenance); Arm B is the same treatment with an additional simultaneous integrated boost of intensity-modulated radiotherapy (IMRT) of 72Gy/2.4Gy delivered on the MR spectroscopic imaging metabolic volumes of CHO/NAA > 2 and contrast-enhancing lesions or resection cavity. Stratification is performed on surgical and MGMT status.
DISCUSSION: This is a dose-painting trial, i.e. delivery of heterogeneous dose guided by metabolic imaging. The principal endpoint is overall survival. An online prospective quality control of volumes and dose is performed in the experimental arm. The study will yield a large amount of longitudinal multimodal MR imaging data including planning CT, radiotherapy dosimetry, MR spectroscopic, diffusion and perfusion imaging.
TRIAL REGISTRATION: NCT01507506 , registration date December 20, 2011.
METHODS/DESIGN: In this multicenter prospective phase III trial for newly diagnosed glioblastoma, 220 patients having undergone biopsy or surgery are planned for randomization to two arms. Arm A is the Stupp protocol (EBRT 60 Gy on contrast enhancement + 2 cm margin with concomitant temozolomide (TMZ) and 6 months of TMZ maintenance); Arm B is the same treatment with an additional simultaneous integrated boost of intensity-modulated radiotherapy (IMRT) of 72Gy/2.4Gy delivered on the MR spectroscopic imaging metabolic volumes of CHO/NAA > 2 and contrast-enhancing lesions or resection cavity. Stratification is performed on surgical and MGMT status.
DISCUSSION: This is a dose-painting trial, i.e. delivery of heterogeneous dose guided by metabolic imaging. The principal endpoint is overall survival. An online prospective quality control of volumes and dose is performed in the experimental arm. The study will yield a large amount of longitudinal multimodal MR imaging data including planning CT, radiotherapy dosimetry, MR spectroscopic, diffusion and perfusion imaging.
TRIAL REGISTRATION: NCT01507506 , registration date December 20, 2011.
Potiron, Vincent; Clément-Colmou, Karen; Jouglar, Emmanuel; Pietri, Manon; Chiavassa, Sophie; Delpon, Grégory; Paris, François; Supiot, Stéphane
Tumor vasculature remodeling by radiation therapy increases doxorubicin distribution and efficacy Article de journal
Dans: Cancer Lett, vol. 457, p. 1–9, 2019, ISSN: 1872-7980.
@article{pmid31078733,
title = {Tumor vasculature remodeling by radiation therapy increases doxorubicin distribution and efficacy},
author = {Vincent Potiron and Karen Clément-Colmou and Emmanuel Jouglar and Manon Pietri and Sophie Chiavassa and Grégory Delpon and François Paris and Stéphane Supiot},
doi = {10.1016/j.canlet.2019.05.005},
issn = {1872-7980},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Cancer Lett},
volume = {457},
pages = {1--9},
abstract = {The tumor microenvironment regulates cancer initiation, progression and response to treatment. In particular, the immature tumor vasculature may impede drugs from reaching tumor cells at a lethal concentration. We and others have shown that radiation therapy (RT) induces pericyte recruitment, resembling vascular normalization. Here, we asked whether radiation-induced vascular remodeling translates into improved tissue distribution and efficacy of chemotherapy. First, RT induced vascular remodeling, accompanied by decreased hypoxia and/or increased Hoechst perfusion in prostate PC3 and LNCaP and Lewis lung carcinoma. These results were independent of the RT regimen, respectively 10 × 2 Gy and 2 × 12 Gy, suggesting a common effect. Next, using doxorubicin as a fluorescent reporter, we observed that RT improves intra-tumoral chemotherapy distribution. These effects were not hindered by anti-angiogenic sunitinib. Moreover, sub-optimal doses of doxorubicin had almost no effect alone, but significantly delayed tumor growth after RT. These data demonstrate that RT favors the efficacy of chemotherapy by improving tissue distribution, and could be an alternative chemosensitizing strategy.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The tumor microenvironment regulates cancer initiation, progression and response to treatment. In particular, the immature tumor vasculature may impede drugs from reaching tumor cells at a lethal concentration. We and others have shown that radiation therapy (RT) induces pericyte recruitment, resembling vascular normalization. Here, we asked whether radiation-induced vascular remodeling translates into improved tissue distribution and efficacy of chemotherapy. First, RT induced vascular remodeling, accompanied by decreased hypoxia and/or increased Hoechst perfusion in prostate PC3 and LNCaP and Lewis lung carcinoma. These results were independent of the RT regimen, respectively 10 × 2 Gy and 2 × 12 Gy, suggesting a common effect. Next, using doxorubicin as a fluorescent reporter, we observed that RT improves intra-tumoral chemotherapy distribution. These effects were not hindered by anti-angiogenic sunitinib. Moreover, sub-optimal doses of doxorubicin had almost no effect alone, but significantly delayed tumor growth after RT. These data demonstrate that RT favors the efficacy of chemotherapy by improving tissue distribution, and could be an alternative chemosensitizing strategy.
Lorent, Marine; Maalmi, Haïfa; Tessier, Philippe; Supiot, Stéphane; Dantan, Etienne; Foucher, Yohann
Dans: BMC Med Inform Decis Mak, vol. 19, no. 1, p. 2, 2019, ISSN: 1472-6947.
@article{pmid30616621,
title = {Meta-analysis of predictive models to assess the clinical validity and utility for patient-centered medical decision making: application to the CAncer of the Prostate Risk Assessment (CAPRA)},
author = {Marine Lorent and Haïfa Maalmi and Philippe Tessier and Stéphane Supiot and Etienne Dantan and Yohann Foucher},
doi = {10.1186/s12911-018-0727-2},
issn = {1472-6947},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {BMC Med Inform Decis Mak},
volume = {19},
number = {1},
pages = {2},
abstract = {BACKGROUND: The Cancer of the Prostate Risk Assessment (CAPRA) score was designed and validated several times to predict the biochemical recurrence-free survival after a radical prostatectomy. Our objectives were, first, to study the clinical validity of the CAPRA score, and, second, to assess its clinical utility for stratified medicine from an original patient-centered approach.
METHODS: We proposed a meta-analysis based on a literature search using MEDLINE. Observed and predicted biochemical-recurrence-free survivals were compared to assess the calibration of the CAPRA score. Discriminative capacities were evaluated by estimating the summary time-dependent ROC curve. The clinical utility of the CAPRA score was evaluated according to the following stratified decisions: active monitoring for low-risk patients, prostatectomy for intermediate-risk patients, or radio-hormonal therapy for high risk patients. For this purpose, we assessed CAPRA's clinical utility in terms of its ability to maximize time-dependent utility functions (i.e. Quality-Adjusted Life-Years - QALYs).
RESULTS: We identified 683 manuscripts and finally retained 9 studies. We reported good discriminative capacities with an area under the SROCt curve at 0.73 [95%CI from 0.67 to 0.79], while graphical calibration seemed acceptable. Nevertheless, we also described that the CAPRA score was unable to discriminate between the three medical alternatives, i.e. it did not allow an increase in the number of life years in perfect health (QALYs) of patients with prostate cancer.
CONCLUSIONS: We confirmed the prognostic capacities of the CAPRA score. In contrast, we were not able to demonstrate its clinical usefulness for stratified medicine from a patient-centered perspective. Our results also highlighted the confusion between clinical validity and utility. This distinction should be better considered in order to develop predictive tools useful in practice.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: The Cancer of the Prostate Risk Assessment (CAPRA) score was designed and validated several times to predict the biochemical recurrence-free survival after a radical prostatectomy. Our objectives were, first, to study the clinical validity of the CAPRA score, and, second, to assess its clinical utility for stratified medicine from an original patient-centered approach.
METHODS: We proposed a meta-analysis based on a literature search using MEDLINE. Observed and predicted biochemical-recurrence-free survivals were compared to assess the calibration of the CAPRA score. Discriminative capacities were evaluated by estimating the summary time-dependent ROC curve. The clinical utility of the CAPRA score was evaluated according to the following stratified decisions: active monitoring for low-risk patients, prostatectomy for intermediate-risk patients, or radio-hormonal therapy for high risk patients. For this purpose, we assessed CAPRA's clinical utility in terms of its ability to maximize time-dependent utility functions (i.e. Quality-Adjusted Life-Years - QALYs).
RESULTS: We identified 683 manuscripts and finally retained 9 studies. We reported good discriminative capacities with an area under the SROCt curve at 0.73 [95%CI from 0.67 to 0.79], while graphical calibration seemed acceptable. Nevertheless, we also described that the CAPRA score was unable to discriminate between the three medical alternatives, i.e. it did not allow an increase in the number of life years in perfect health (QALYs) of patients with prostate cancer.
CONCLUSIONS: We confirmed the prognostic capacities of the CAPRA score. In contrast, we were not able to demonstrate its clinical usefulness for stratified medicine from a patient-centered perspective. Our results also highlighted the confusion between clinical validity and utility. This distinction should be better considered in order to develop predictive tools useful in practice.
METHODS: We proposed a meta-analysis based on a literature search using MEDLINE. Observed and predicted biochemical-recurrence-free survivals were compared to assess the calibration of the CAPRA score. Discriminative capacities were evaluated by estimating the summary time-dependent ROC curve. The clinical utility of the CAPRA score was evaluated according to the following stratified decisions: active monitoring for low-risk patients, prostatectomy for intermediate-risk patients, or radio-hormonal therapy for high risk patients. For this purpose, we assessed CAPRA's clinical utility in terms of its ability to maximize time-dependent utility functions (i.e. Quality-Adjusted Life-Years - QALYs).
RESULTS: We identified 683 manuscripts and finally retained 9 studies. We reported good discriminative capacities with an area under the SROCt curve at 0.73 [95%CI from 0.67 to 0.79], while graphical calibration seemed acceptable. Nevertheless, we also described that the CAPRA score was unable to discriminate between the three medical alternatives, i.e. it did not allow an increase in the number of life years in perfect health (QALYs) of patients with prostate cancer.
CONCLUSIONS: We confirmed the prognostic capacities of the CAPRA score. In contrast, we were not able to demonstrate its clinical usefulness for stratified medicine from a patient-centered perspective. Our results also highlighted the confusion between clinical validity and utility. This distinction should be better considered in order to develop predictive tools useful in practice.
Goupy, Flora; Supiot, Stéphane; Pasquier, David; Latorzeff, Igor; Schick, Ulrike; Monpetit, Erik; Martinage, Geoffrey; Hervé, Chloé; Proust, Bernadette Le; Castelli, Joel; de Crevoisier, Renaud
Intensity-modulated radiotherapy for prostate cancer with seminal vesicle involvement (T3b): A multicentric retrospective analysis Article de journal
Dans: PLoS One, vol. 14, no. 1, p. e0210514, 2019, ISSN: 1932-6203.
@article{pmid30682036,
title = {Intensity-modulated radiotherapy for prostate cancer with seminal vesicle involvement (T3b): A multicentric retrospective analysis},
author = {Flora Goupy and Stéphane Supiot and David Pasquier and Igor Latorzeff and Ulrike Schick and Erik Monpetit and Geoffrey Martinage and Chloé Hervé and Bernadette Le Proust and Joel Castelli and Renaud de Crevoisier},
doi = {10.1371/journal.pone.0210514},
issn = {1932-6203},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {PLoS One},
volume = {14},
number = {1},
pages = {e0210514},
abstract = {OBJECTIVES: No study has reported clinical results of external-beam radiotherapy specifically for T3b prostate cancer. The possibility of escalating the dose to the involved seminal vesicles (ISV) while respecting the dose constraints in the organs at risk is thus so far not clearly demonstrated. The objective of the study was to analyze the dose distribution and the clinical outcome in a large series of patients who received IMRT for T3b prostate cancer.
MATERIALS AND METHODS: This retrospective analysis included all patients who received IMRT and androgen deprivation therapy for T3b prostate cancer, between 2008 and 2017, in six French institutions, with available MRI images and dosimetric data.
RESULTS: A total of 276 T3b patients were included. The median follow-up was 26 months. The median (range) prescribed doses (Gy) to the prostate and to the ISV were 77 (70-80) and 76 (46-80), respectively. The dose constraint recommendations were exceeded in less than 12% of patients for the rectum and the bladder. The 5-year risks of biochemical and clinical recurrences and cancer-specific death were 24.8%, 21.7%, and 10.3%, respectively. The 5-year risks of local, pelvic lymph node, and metastatic recurrences were 6.4%, 11.3%, and 15%, respectively. The number of involved lymph nodes (≤ 2 or ≥ 3) on MRI was the only significant prognostic factor in clinical recurrence (HR 9.86) and death (HR 2.78). Grade ≥ 2 acute and 5-year late toxicity rates were 13.2% and 12% for digestive toxicity, and 34% and 31.5% for urinary toxicity, respectively. The dose to the pelvic lymph node and the age were predictive of late digestive toxicity.
CONCLUSION: IMRT for T3b prostate cancer allows delivery of a curative dose in the ISV, with a moderate digestive toxicity but a higher urinary toxicity. Lymph node involvement increases the risk of recurrence and death.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: No study has reported clinical results of external-beam radiotherapy specifically for T3b prostate cancer. The possibility of escalating the dose to the involved seminal vesicles (ISV) while respecting the dose constraints in the organs at risk is thus so far not clearly demonstrated. The objective of the study was to analyze the dose distribution and the clinical outcome in a large series of patients who received IMRT for T3b prostate cancer.
MATERIALS AND METHODS: This retrospective analysis included all patients who received IMRT and androgen deprivation therapy for T3b prostate cancer, between 2008 and 2017, in six French institutions, with available MRI images and dosimetric data.
RESULTS: A total of 276 T3b patients were included. The median follow-up was 26 months. The median (range) prescribed doses (Gy) to the prostate and to the ISV were 77 (70-80) and 76 (46-80), respectively. The dose constraint recommendations were exceeded in less than 12% of patients for the rectum and the bladder. The 5-year risks of biochemical and clinical recurrences and cancer-specific death were 24.8%, 21.7%, and 10.3%, respectively. The 5-year risks of local, pelvic lymph node, and metastatic recurrences were 6.4%, 11.3%, and 15%, respectively. The number of involved lymph nodes (≤ 2 or ≥ 3) on MRI was the only significant prognostic factor in clinical recurrence (HR 9.86) and death (HR 2.78). Grade ≥ 2 acute and 5-year late toxicity rates were 13.2% and 12% for digestive toxicity, and 34% and 31.5% for urinary toxicity, respectively. The dose to the pelvic lymph node and the age were predictive of late digestive toxicity.
CONCLUSION: IMRT for T3b prostate cancer allows delivery of a curative dose in the ISV, with a moderate digestive toxicity but a higher urinary toxicity. Lymph node involvement increases the risk of recurrence and death.
MATERIALS AND METHODS: This retrospective analysis included all patients who received IMRT and androgen deprivation therapy for T3b prostate cancer, between 2008 and 2017, in six French institutions, with available MRI images and dosimetric data.
RESULTS: A total of 276 T3b patients were included. The median follow-up was 26 months. The median (range) prescribed doses (Gy) to the prostate and to the ISV were 77 (70-80) and 76 (46-80), respectively. The dose constraint recommendations were exceeded in less than 12% of patients for the rectum and the bladder. The 5-year risks of biochemical and clinical recurrences and cancer-specific death were 24.8%, 21.7%, and 10.3%, respectively. The 5-year risks of local, pelvic lymph node, and metastatic recurrences were 6.4%, 11.3%, and 15%, respectively. The number of involved lymph nodes (≤ 2 or ≥ 3) on MRI was the only significant prognostic factor in clinical recurrence (HR 9.86) and death (HR 2.78). Grade ≥ 2 acute and 5-year late toxicity rates were 13.2% and 12% for digestive toxicity, and 34% and 31.5% for urinary toxicity, respectively. The dose to the pelvic lymph node and the age were predictive of late digestive toxicity.
CONCLUSION: IMRT for T3b prostate cancer allows delivery of a curative dose in the ISV, with a moderate digestive toxicity but a higher urinary toxicity. Lymph node involvement increases the risk of recurrence and death.
Tensaouti, Fatima; Ducassou, Anne; Chaltiel, Léonor; Bolle, Stéphanie; Habrand, Jean Louis; Alapetite, Claire; Coche-Dequeant, Bernard; Bernier, Valérie; Claude, Line; Carrie, Christian; Padovani, Laetitia; Muracciole, Xavier; Supiot, Stéphane; Huchet, Aymeri; Leseur, Julie; Kerr, Christine; Hangard, Grégorie; Lisbona, Albert; Goudjil, Farid; Ferrand, Régis; Laprie, Anne
Feasibility of Dose Escalation in Patients With Intracranial Pediatric Ependymoma Article de journal
Dans: Front Oncol, vol. 9, p. 531, 2019, ISSN: 2234-943X.
@article{pmid31293971,
title = {Feasibility of Dose Escalation in Patients With Intracranial Pediatric Ependymoma},
author = {Fatima Tensaouti and Anne Ducassou and Léonor Chaltiel and Stéphanie Bolle and Jean Louis Habrand and Claire Alapetite and Bernard Coche-Dequeant and Valérie Bernier and Line Claude and Christian Carrie and Laetitia Padovani and Xavier Muracciole and Stéphane Supiot and Aymeri Huchet and Julie Leseur and Christine Kerr and Grégorie Hangard and Albert Lisbona and Farid Goudjil and Régis Ferrand and Anne Laprie},
doi = {10.3389/fonc.2019.00531},
issn = {2234-943X},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Front Oncol},
volume = {9},
pages = {531},
abstract = { Pediatric ependymoma carries a dismal prognosis, mainly owing to local relapse within RT fields. The current prospective European approach is to increase the radiation dose with a sequential hypofractionated stereotactic boost. In this study, we assessed the possibility of using a simultaneous integrated boost (SIB), comparing VMAT vs. IMPT dose delivery. The cohort included 101 patients. The dose to planning target volume (PTV59.4) was 59.4/1.8 Gy, and the dose to SIB volume (PTV67.6) was 67.6/2.05 Gy. Gross tumor volume (GTV) was defined as the tumor bed plus residual tumor, clinical target volume (CTV59.4) was GTV + 5 mm, and PTV59.4 was CTV59.4 + 3 mm. PTV67.6 was GTV+ 3 mm. After treatment plan optimization, quality indices and doses to target volume and organs at risk (OARs) were extracted and compared with the standard radiation doses that were actually delivered (median = 59.4 Gy [50.4 59.4]). In most cases, the proton treatment resulted in higher quality indices ( < 0.001). Compared with the doses that were initially delivered, mean, and maximum doses to some OARs were no higher with SIB VMAT, and significantly lower with protons ( < 0.001). In the case of posterior fossa tumor, there was a lower dose to the brainstem with protons, in terms of V59 Gy, mean, and near-maximum (D2%) doses. Dose escalation with intensity-modulated proton or photon SIB is feasible in some patients. This approach could be considered for children with unresectable residue or post-operative FLAIR abnormalities, particularly if they have supratentorial tumors. It should not be considered for infratentorial tumors encasing the brainstem or extending to the medulla.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pediatric ependymoma carries a dismal prognosis, mainly owing to local relapse within RT fields. The current prospective European approach is to increase the radiation dose with a sequential hypofractionated stereotactic boost. In this study, we assessed the possibility of using a simultaneous integrated boost (SIB), comparing VMAT vs. IMPT dose delivery. The cohort included 101 patients. The dose to planning target volume (PTV59.4) was 59.4/1.8 Gy, and the dose to SIB volume (PTV67.6) was 67.6/2.05 Gy. Gross tumor volume (GTV) was defined as the tumor bed plus residual tumor, clinical target volume (CTV59.4) was GTV + 5 mm, and PTV59.4 was CTV59.4 + 3 mm. PTV67.6 was GTV+ 3 mm. After treatment plan optimization, quality indices and doses to target volume and organs at risk (OARs) were extracted and compared with the standard radiation doses that were actually delivered (median = 59.4 Gy [50.4 59.4]). In most cases, the proton treatment resulted in higher quality indices ( < 0.001). Compared with the doses that were initially delivered, mean, and maximum doses to some OARs were no higher with SIB VMAT, and significantly lower with protons ( < 0.001). In the case of posterior fossa tumor, there was a lower dose to the brainstem with protons, in terms of V59 Gy, mean, and near-maximum (D2%) doses. Dose escalation with intensity-modulated proton or photon SIB is feasible in some patients. This approach could be considered for children with unresectable residue or post-operative FLAIR abnormalities, particularly if they have supratentorial tumors. It should not be considered for infratentorial tumors encasing the brainstem or extending to the medulla.
Latorzeff, I; Guerif, S; Fraisse, J; Meyer, E; Supiot, S; Lagneau, E; Deniaud-Alexandre, E; Ronchin, P; Benyoucef, A; Cartier, L; Hamidou, H; Hasbini, A; Crehange, G; Pommier, P; Magne, N; Pelissier, S; Gross, E; Fourneret, P; Salomon, L; Sargos, P
Dans: International Journal of Radiation Oncology*Biology*Physics, vol. 105, no. 1, Supplement, p. S134, 2019, ISSN: 0360-3016, (Proceedings of the Amercian Society for Radiation Oncology 61st Annual Meeting).
@article{LATORZEFF2019S134,
title = {Late Toxicity and Quality of Life from GETUG-AFU 22 Study: A Multicenter Randomized Phase II Trial Comparing Radiotherapy +/- 6 Months of Degarelix as a Salvage Treatment for Patients with Detectable PSA after Radical Prostatectomy},
author = {I Latorzeff and S Guerif and J Fraisse and E Meyer and S Supiot and E Lagneau and E Deniaud-Alexandre and P Ronchin and A Benyoucef and L Cartier and H Hamidou and A Hasbini and G Crehange and P Pommier and N Magne and S Pelissier and E Gross and P Fourneret and L Salomon and P Sargos},
url = {https://www.sciencedirect.com/science/article/pii/S0360301619309587},
doi = {https://doi.org/10.1016/j.ijrobp.2019.06.123},
issn = {0360-3016},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {International Journal of Radiation Oncology*Biology*Physics},
volume = {105},
number = {1, Supplement},
pages = {S134},
note = {Proceedings of the Amercian Society for Radiation Oncology 61st Annual Meeting},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Carrie, C; Kieffer, V; Figarella-Branger, D; Masliah-Planchon, J; Bolle, S; Leseur, J; Supiot, S; Laprie, A; Bernier, V; Dufour, C; Huchet, A; Coche-Dequeant, B; Truc, G; Vigneron, C; Alapetite, C; Habrand, JL; Dubray, BM; Colin, C; Ferlay, C; Padovani, L
Dans: International Journal of Radiation Oncology*Biology*Physics, vol. 105, no. 1, Supplement, p. S108, 2019, ISSN: 0360-3016, (Proceedings of the Amercian Society for Radiation Oncology 61st Annual Meeting).
@article{CARRIE2019S108,
title = {Medulloblastoma Molecular Subgroup and Hyperfractionated Radiation Therapy Alone for Standard Risk Medulloblastoma : Results of the Pool Data of MSFOP 1998 and 2007 Studies},
author = {C Carrie and V Kieffer and D Figarella-Branger and J Masliah-Planchon and S Bolle and J Leseur and S Supiot and A Laprie and V Bernier and C Dufour and A Huchet and B Coche-Dequeant and G Truc and C Vigneron and C Alapetite and JL Habrand and BM Dubray and C Colin and C Ferlay and L Padovani},
url = {https://www.sciencedirect.com/science/article/pii/S036030161931435X},
doi = {https://doi.org/10.1016/j.ijrobp.2019.06.600},
issn = {0360-3016},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {International Journal of Radiation Oncology*Biology*Physics},
volume = {105},
number = {1, Supplement},
pages = {S108},
note = {Proceedings of the Amercian Society for Radiation Oncology 61st Annual Meeting},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2018
Loriot, Yohann; Supiot, Stéphane; Beauval, Jean-Baptiste; Schlürmann, Friederike; Pasticier, Gilles; Sargos, Paul; Barthélémy, Philippe; Pignot, Géraldine; Maillet, Denis; Vincendeau, Sébastien; Gross, Emmanuel; Ploussard, Guillaume; Timsit, Marc-Olivier; Borchiellini, Delphine
Management of non-metastatic castrate-resistant prostate cancer: A systematic review Article de journal
Dans: Cancer Treat Rev, vol. 70, p. 223–231, 2018, ISSN: 1532-1967.
@article{pmid30300771,
title = {Management of non-metastatic castrate-resistant prostate cancer: A systematic review},
author = {Yohann Loriot and Stéphane Supiot and Jean-Baptiste Beauval and Friederike Schlürmann and Gilles Pasticier and Paul Sargos and Philippe Barthélémy and Géraldine Pignot and Denis Maillet and Sébastien Vincendeau and Emmanuel Gross and Guillaume Ploussard and Marc-Olivier Timsit and Delphine Borchiellini},
doi = {10.1016/j.ctrv.2018.09.006},
issn = {1532-1967},
year = {2018},
date = {2018-11-01},
urldate = {2018-11-01},
journal = {Cancer Treat Rev},
volume = {70},
pages = {223--231},
abstract = {Management of non metastatic castrate resistant prostate cancer is challenging for clinicians due to the heterogeneity of the disease and to the scarce clinical data available in this setting. Recent results obtained with the new generation hormone therapies (NGHT) apalutamide and enzalutamide bring a new perspective for the treatment strategy. The authors present here a systematic review of the treatment options.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Management of non metastatic castrate resistant prostate cancer is challenging for clinicians due to the heterogeneity of the disease and to the scarce clinical data available in this setting. Recent results obtained with the new generation hormone therapies (NGHT) apalutamide and enzalutamide bring a new perspective for the treatment strategy. The authors present here a systematic review of the treatment options.
Foucher, Yohann; Lorent, Marine; Tessier, Philippe; Supiot, Stéphane; Sébille, Véronique; Dantan, Etienne
A mini-review of quality of life as an outcome in prostate cancer trials: patient-centered approaches are needed to propose appropriate treatments on behalf of patients Article de journal
Dans: Health Qual Life Outcomes, vol. 16, no. 1, p. 40, 2018, ISSN: 1477-7525.
@article{pmid29506537,
title = {A mini-review of quality of life as an outcome in prostate cancer trials: patient-centered approaches are needed to propose appropriate treatments on behalf of patients},
author = {Yohann Foucher and Marine Lorent and Philippe Tessier and Stéphane Supiot and Véronique Sébille and Etienne Dantan},
doi = {10.1186/s12955-018-0870-6},
issn = {1477-7525},
year = {2018},
date = {2018-03-01},
urldate = {2018-03-01},
journal = {Health Qual Life Outcomes},
volume = {16},
number = {1},
pages = {40},
abstract = {BACKGROUND: Patients with prostate cancer (PC) may be ready to make trade-offs between their quantity and their quality of life. For instance, elderly patients may prefer the absence of treatment if it is associated with a low-risk of disease progression, compared to treatments aiming at preventing disease progression but with a substantial deterioration of their Health-Related Quality of Life (HRQoL). Therefore, it seems relevant to compare the treatments by considering both survival and HRQoL. In this mini-review, the aim was to question whether the potential trade-offs between survival and HRQoL are considered in high impact factor journals.
METHODS: The study was conducted from the PubMed database for recent papers published between May 01, 2013, and May 01, 2015. We also restricted our search to nine medical journals with 2013 impact factor > 15.
RESULTS: Among the 30 selected studies, only six collected individual HRQoL as a secondary endpoint by using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire. In four studies, the time to HRQoL change was analyzed, but its definitions varied. In two studies, the mean changes in HRQoL between the baseline and the 12- or 16-week follow-up were analyzed. None of the six studies reported in a single endpoint both the quantity and the quality of life.
CONCLUSIONS: Our mini-review, which only focused on recent publications in journals with high-impact, suggests moving PC clinical research towards patient-centered outcomes-based studies. This may help physicians to propose the most appropriate treatment on behalf of patients. We recommend the use of indicators such as Quality-Adjusted Life-Years (QALYs) as principal endpoint in future clinical trials.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Patients with prostate cancer (PC) may be ready to make trade-offs between their quantity and their quality of life. For instance, elderly patients may prefer the absence of treatment if it is associated with a low-risk of disease progression, compared to treatments aiming at preventing disease progression but with a substantial deterioration of their Health-Related Quality of Life (HRQoL). Therefore, it seems relevant to compare the treatments by considering both survival and HRQoL. In this mini-review, the aim was to question whether the potential trade-offs between survival and HRQoL are considered in high impact factor journals.
METHODS: The study was conducted from the PubMed database for recent papers published between May 01, 2013, and May 01, 2015. We also restricted our search to nine medical journals with 2013 impact factor > 15.
RESULTS: Among the 30 selected studies, only six collected individual HRQoL as a secondary endpoint by using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire. In four studies, the time to HRQoL change was analyzed, but its definitions varied. In two studies, the mean changes in HRQoL between the baseline and the 12- or 16-week follow-up were analyzed. None of the six studies reported in a single endpoint both the quantity and the quality of life.
CONCLUSIONS: Our mini-review, which only focused on recent publications in journals with high-impact, suggests moving PC clinical research towards patient-centered outcomes-based studies. This may help physicians to propose the most appropriate treatment on behalf of patients. We recommend the use of indicators such as Quality-Adjusted Life-Years (QALYs) as principal endpoint in future clinical trials.
METHODS: The study was conducted from the PubMed database for recent papers published between May 01, 2013, and May 01, 2015. We also restricted our search to nine medical journals with 2013 impact factor > 15.
RESULTS: Among the 30 selected studies, only six collected individual HRQoL as a secondary endpoint by using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire. In four studies, the time to HRQoL change was analyzed, but its definitions varied. In two studies, the mean changes in HRQoL between the baseline and the 12- or 16-week follow-up were analyzed. None of the six studies reported in a single endpoint both the quantity and the quality of life.
CONCLUSIONS: Our mini-review, which only focused on recent publications in journals with high-impact, suggests moving PC clinical research towards patient-centered outcomes-based studies. This may help physicians to propose the most appropriate treatment on behalf of patients. We recommend the use of indicators such as Quality-Adjusted Life-Years (QALYs) as principal endpoint in future clinical trials.
Supiot, Stéphane; Rousseau, Caroline; Dore, Mélanie; Cheze-Le-Rest, Catherine; Kandel-Aznar, Christine; Potiron, Vincent; Guerif, Stéphane; Paris, François; Ferrer, Ludovic; Campion, Loïc; Meingan, Philippe; Delpon, Gregory; Hatt, Mathieu; Visvikis, Dimitris
Evaluation of tumor hypoxia prior to radiotherapy in intermediate-risk prostate cancer using F-fluoromisonidazole PET/CT: a pilot study Article de journal
Dans: Oncotarget, vol. 9, no. 11, p. 10005–10015, 2018, ISSN: 1949-2553.
@article{pmid29515786,
title = {Evaluation of tumor hypoxia prior to radiotherapy in intermediate-risk prostate cancer using F-fluoromisonidazole PET/CT: a pilot study},
author = {Stéphane Supiot and Caroline Rousseau and Mélanie Dore and Catherine Cheze-Le-Rest and Christine Kandel-Aznar and Vincent Potiron and Stéphane Guerif and François Paris and Ludovic Ferrer and Loïc Campion and Philippe Meingan and Gregory Delpon and Mathieu Hatt and Dimitris Visvikis},
doi = {10.18632/oncotarget.24234},
issn = {1949-2553},
year = {2018},
date = {2018-02-01},
urldate = {2018-02-01},
journal = {Oncotarget},
volume = {9},
number = {11},
pages = {10005--10015},
abstract = {Purpose: Hypoxia is a major factor in prostate cancer aggressiveness and radioresistance. Predicting which patients might be bad candidates for radiotherapy may help better personalize treatment decisions in intermediate-risk prostate cancer patients. We assessed spatial distribution of F-Misonidazole (FMISO) PET/CT uptake in the prostate prior to radiotherapy treatment.
Materials and Methods: Intermediate-risk prostate cancer patients about to receive high-dose (>74 Gy) radiotherapy to the prostate without hormonal treatment were prospectively recruited between 9/2012 and 10/2014. Prior to radiotherapy, all patients underwent a FMISO PET/CT as well as a MRI and F-choline-PET. F-choline and FMISO-positive volumes were semi-automatically determined using the fuzzy locally adaptive Bayesian (FLAB) method. In FMISO-positive patients, a dynamic analysis of early tumor uptake was performed. Group differences were assessed using the Wilcoxon signed rank test. Parameters were correlated using Spearman rank correlation.
Results: Of 27 patients (median age 76) recruited to the study, 7 and 9 patients were considered positive at 2.5h and 3.5h FMISO PET/CT respectively. Median SUV and SUV tumor to muscle (T/M) ratio were respectively 3.4 and 3.6 at 2.5h, and 3.2 and 4.4 at 3.5h. The median FMISO-positive volume was 1.1 ml.
Conclusions: This is the first study regarding hypoxia imaging using FMISO in prostate cancer showing that a small FMISO-positive volume was detected in one third of intermediate-risk prostate cancer patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Purpose: Hypoxia is a major factor in prostate cancer aggressiveness and radioresistance. Predicting which patients might be bad candidates for radiotherapy may help better personalize treatment decisions in intermediate-risk prostate cancer patients. We assessed spatial distribution of F-Misonidazole (FMISO) PET/CT uptake in the prostate prior to radiotherapy treatment.
Materials and Methods: Intermediate-risk prostate cancer patients about to receive high-dose (>74 Gy) radiotherapy to the prostate without hormonal treatment were prospectively recruited between 9/2012 and 10/2014. Prior to radiotherapy, all patients underwent a FMISO PET/CT as well as a MRI and F-choline-PET. F-choline and FMISO-positive volumes were semi-automatically determined using the fuzzy locally adaptive Bayesian (FLAB) method. In FMISO-positive patients, a dynamic analysis of early tumor uptake was performed. Group differences were assessed using the Wilcoxon signed rank test. Parameters were correlated using Spearman rank correlation.
Results: Of 27 patients (median age 76) recruited to the study, 7 and 9 patients were considered positive at 2.5h and 3.5h FMISO PET/CT respectively. Median SUV and SUV tumor to muscle (T/M) ratio were respectively 3.4 and 3.6 at 2.5h, and 3.2 and 4.4 at 3.5h. The median FMISO-positive volume was 1.1 ml.
Conclusions: This is the first study regarding hypoxia imaging using FMISO in prostate cancer showing that a small FMISO-positive volume was detected in one third of intermediate-risk prostate cancer patients.
Materials and Methods: Intermediate-risk prostate cancer patients about to receive high-dose (>74 Gy) radiotherapy to the prostate without hormonal treatment were prospectively recruited between 9/2012 and 10/2014. Prior to radiotherapy, all patients underwent a FMISO PET/CT as well as a MRI and F-choline-PET. F-choline and FMISO-positive volumes were semi-automatically determined using the fuzzy locally adaptive Bayesian (FLAB) method. In FMISO-positive patients, a dynamic analysis of early tumor uptake was performed. Group differences were assessed using the Wilcoxon signed rank test. Parameters were correlated using Spearman rank correlation.
Results: Of 27 patients (median age 76) recruited to the study, 7 and 9 patients were considered positive at 2.5h and 3.5h FMISO PET/CT respectively. Median SUV and SUV tumor to muscle (T/M) ratio were respectively 3.4 and 3.6 at 2.5h, and 3.2 and 4.4 at 3.5h. The median FMISO-positive volume was 1.1 ml.
Conclusions: This is the first study regarding hypoxia imaging using FMISO in prostate cancer showing that a small FMISO-positive volume was detected in one third of intermediate-risk prostate cancer patients.
Noblet, C; Delpon, G; Supiot, S; Potiron, V; Paris, F; Chiavassa, S
A new tissue segmentation method to calculate 3D dose in small animal radiation therapy Article de journal
Dans: Radiat Oncol, vol. 13, no. 1, p. 32, 2018, ISSN: 1748-717X.
@article{pmid29482652,
title = {A new tissue segmentation method to calculate 3D dose in small animal radiation therapy},
author = {C Noblet and G Delpon and S Supiot and V Potiron and F Paris and S Chiavassa},
doi = {10.1186/s13014-018-0971-8},
issn = {1748-717X},
year = {2018},
date = {2018-02-01},
urldate = {2018-02-01},
journal = {Radiat Oncol},
volume = {13},
number = {1},
pages = {32},
abstract = {BACKGROUND: In pre-clinical animal experiments, radiation delivery is usually delivered with kV photon beams, in contrast to the MV beams used in clinical irradiation, because of the small size of the animals. At this medium energy range, however, the contribution of the photoelectric effect to absorbed dose is significant. Accurate dose calculation therefore requires a more detailed tissue definition because both density (ρ) and elemental composition (Z) affect the dose distribution. Moreover, when applied to cone beam CT (CBCT) acquisitions, the stoichiometric calibration of HU becomes inefficient as it is designed for highly collimated fan beam CT acquisitions. In this study, we propose an automatic tissue segmentation method of CBCT imaging that assigns both density (ρ) and elemental composition (Z) in small animal dose calculation.
METHODS: The method is based on the relationship found between CBCT number and ρ*Z product computed from known materials. Monte Carlo calculations were performed to evaluate the impact of ρZ variation on the absorbed dose in tissues. These results led to the creation of a tissue database composed of artificial tissues interpolated from tissue values published by the ICRU. The ρZ method was validated by measuring transmitted doses through tissue substitute cylinders and a mouse with EBT3 film. Measurements were compared to the results of the Monte Carlo calculations.
RESULTS: The study of the impact of ρZ variation over the range of materials, from ρZ = 2 g.cm (lung) to 27 g.cm (cortical bone) led to the creation of 125 artificial tissues. For tissue substitute cylinders, the use of ρZ method led to maximal and average relative differences between the Monte Carlo results and the EBT3 measurements of 3.6% and 1.6%. Equivalent comparison for the mouse gave maximal and average relative differences of 4.4% and 1.2%, inside the 80% isodose area. Gamma analysis led to a 94.9% success rate in the 10% isodose area with 4% and 0.3 mm criteria in dose and distance.
CONCLUSIONS: Our new tissue segmentation method was developed for 40kVp CBCT images. Both density and elemental composition are assigned to each voxel by using a relationship between HU and the product ρZ. The method, validated by comparing measurements and calculations, enables more accurate small animal dose distribution calculated on low energy CBCT images.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: In pre-clinical animal experiments, radiation delivery is usually delivered with kV photon beams, in contrast to the MV beams used in clinical irradiation, because of the small size of the animals. At this medium energy range, however, the contribution of the photoelectric effect to absorbed dose is significant. Accurate dose calculation therefore requires a more detailed tissue definition because both density (ρ) and elemental composition (Z) affect the dose distribution. Moreover, when applied to cone beam CT (CBCT) acquisitions, the stoichiometric calibration of HU becomes inefficient as it is designed for highly collimated fan beam CT acquisitions. In this study, we propose an automatic tissue segmentation method of CBCT imaging that assigns both density (ρ) and elemental composition (Z) in small animal dose calculation.
METHODS: The method is based on the relationship found between CBCT number and ρ*Z product computed from known materials. Monte Carlo calculations were performed to evaluate the impact of ρZ variation on the absorbed dose in tissues. These results led to the creation of a tissue database composed of artificial tissues interpolated from tissue values published by the ICRU. The ρZ method was validated by measuring transmitted doses through tissue substitute cylinders and a mouse with EBT3 film. Measurements were compared to the results of the Monte Carlo calculations.
RESULTS: The study of the impact of ρZ variation over the range of materials, from ρZ = 2 g.cm (lung) to 27 g.cm (cortical bone) led to the creation of 125 artificial tissues. For tissue substitute cylinders, the use of ρZ method led to maximal and average relative differences between the Monte Carlo results and the EBT3 measurements of 3.6% and 1.6%. Equivalent comparison for the mouse gave maximal and average relative differences of 4.4% and 1.2%, inside the 80% isodose area. Gamma analysis led to a 94.9% success rate in the 10% isodose area with 4% and 0.3 mm criteria in dose and distance.
CONCLUSIONS: Our new tissue segmentation method was developed for 40kVp CBCT images. Both density and elemental composition are assigned to each voxel by using a relationship between HU and the product ρZ. The method, validated by comparing measurements and calculations, enables more accurate small animal dose distribution calculated on low energy CBCT images.
METHODS: The method is based on the relationship found between CBCT number and ρ*Z product computed from known materials. Monte Carlo calculations were performed to evaluate the impact of ρZ variation on the absorbed dose in tissues. These results led to the creation of a tissue database composed of artificial tissues interpolated from tissue values published by the ICRU. The ρZ method was validated by measuring transmitted doses through tissue substitute cylinders and a mouse with EBT3 film. Measurements were compared to the results of the Monte Carlo calculations.
RESULTS: The study of the impact of ρZ variation over the range of materials, from ρZ = 2 g.cm (lung) to 27 g.cm (cortical bone) led to the creation of 125 artificial tissues. For tissue substitute cylinders, the use of ρZ method led to maximal and average relative differences between the Monte Carlo results and the EBT3 measurements of 3.6% and 1.6%. Equivalent comparison for the mouse gave maximal and average relative differences of 4.4% and 1.2%, inside the 80% isodose area. Gamma analysis led to a 94.9% success rate in the 10% isodose area with 4% and 0.3 mm criteria in dose and distance.
CONCLUSIONS: Our new tissue segmentation method was developed for 40kVp CBCT images. Both density and elemental composition are assigned to each voxel by using a relationship between HU and the product ρZ. The method, validated by comparing measurements and calculations, enables more accurate small animal dose distribution calculated on low energy CBCT images.
Tensaouti, F; Ducassou, A; Bolle, S; Habrand, JL; Alapetite, C; Coche-Dequeant, B; Bernier, V; Claude, L; Carrie, C; Padovani, L; Muracciole, X; Supiot, S; Huchet, A; Leseur, J; Kerr, C; Hangard, G; Lisbona, A; Goudjil, F; Ferrand, R; Laprie, A
19 Is dose escalation in intracranial pediatric ependymoma feasible with advanced radiation techniques? Article de journal
Dans: Physica Medica, vol. 56, p. 12, 2018, ISSN: 1120-1797, (Abstracts of the 57èmes Journées Scientifiques de la Société Française de Physique Médicale).
@article{TENSAOUTI201812,
title = {19 Is dose escalation in intracranial pediatric ependymoma feasible with advanced radiation techniques?},
author = {F Tensaouti and A Ducassou and S Bolle and JL Habrand and C Alapetite and B Coche-Dequeant and V Bernier and L Claude and C Carrie and L Padovani and X Muracciole and S Supiot and A Huchet and J Leseur and C Kerr and G Hangard and A Lisbona and F Goudjil and R Ferrand and A Laprie},
url = {https://www.sciencedirect.com/science/article/pii/S1120179718311943},
doi = {https://doi.org/10.1016/j.ejmp.2018.09.032},
issn = {1120-1797},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Physica Medica},
volume = {56},
pages = {12},
note = {Abstracts of the 57èmes Journées Scientifiques de la Société Française de Physique Médicale},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2017
Paul-Gilloteaux, Perrine; Potiron, Vincent; Delpon, Grégory; Supiot, Stéphane; Chiavassa, Sophie; Paris, François; Costes, Sylvain V
Optimizing radiotherapy protocols using computer automata to model tumour cell death as a function of oxygen diffusion processes Article de journal
Dans: Sci Rep, vol. 7, no. 1, p. 2280, 2017, ISSN: 2045-2322.
@article{pmid28536438,
title = {Optimizing radiotherapy protocols using computer automata to model tumour cell death as a function of oxygen diffusion processes},
author = {Perrine Paul-Gilloteaux and Vincent Potiron and Grégory Delpon and Stéphane Supiot and Sophie Chiavassa and François Paris and Sylvain V Costes},
doi = {10.1038/s41598-017-01757-6},
issn = {2045-2322},
year = {2017},
date = {2017-05-23},
urldate = {2017-01-01},
journal = {Sci Rep},
volume = {7},
number = {1},
pages = {2280},
abstract = {The concept of hypofractionation is gaining momentum in radiation oncology centres, enabled by recent advances in radiotherapy apparatus. The gain of efficacy of this innovative treatment must be defined. We present a computer model based on translational murine data for in silico testing and optimization of various radiotherapy protocols with respect to tumour resistance and the microenvironment heterogeneity. This model combines automata approaches with image processing algorithms to simulate the cellular response of tumours exposed to ionizing radiation, modelling the alteration of oxygen permeabilization in blood vessels against repeated doses, and introducing mitotic catastrophe (as opposed to arbitrary delayed cell-death) as a means of modelling radiation-induced cell death. Published data describing cell death in vitro as well as tumour oxygenation in vivo are used to inform parameters. Our model is validated by comparing simulations to in vivo data obtained from the radiation treatment of mice transplanted with human prostate tumours. We then predict the efficacy of untested hypofractionation protocols, hypothesizing that tumour control can be optimized by adjusting daily radiation dosage as a function of the degree of hypoxia in the tumour environment. Further biological refinement of this tool will permit the rapid development of more sophisticated strategies for radiotherapy.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The concept of hypofractionation is gaining momentum in radiation oncology centres, enabled by recent advances in radiotherapy apparatus. The gain of efficacy of this innovative treatment must be defined. We present a computer model based on translational murine data for in silico testing and optimization of various radiotherapy protocols with respect to tumour resistance and the microenvironment heterogeneity. This model combines automata approaches with image processing algorithms to simulate the cellular response of tumours exposed to ionizing radiation, modelling the alteration of oxygen permeabilization in blood vessels against repeated doses, and introducing mitotic catastrophe (as opposed to arbitrary delayed cell-death) as a means of modelling radiation-induced cell death. Published data describing cell death in vitro as well as tumour oxygenation in vivo are used to inform parameters. Our model is validated by comparing simulations to in vivo data obtained from the radiation treatment of mice transplanted with human prostate tumours. We then predict the efficacy of untested hypofractionation protocols, hypothesizing that tumour control can be optimized by adjusting daily radiation dosage as a function of the degree of hypoxia in the tumour environment. Further biological refinement of this tool will permit the rapid development of more sophisticated strategies for radiotherapy.
Peyraga, Guillaume; Lizee, Thibaut; Gustin, Pierre; Clement-Colmou, Karen; Bartolo, Christelle Di; Supiot, Stephane; Mahe, Marc-Andre; François, Sylvie; Mege, Martine
Treatment of cutaneous and/or soft tissue manifestations of corticosteroids refractory chronic graft versus host disease (cGVHD) by a total nodal irradiation (TNI) Article de journal
Dans: Clin Transplant, vol. 31, no. 4, 2017, ISSN: 1399-0012.
@article{pmid28181304,
title = {Treatment of cutaneous and/or soft tissue manifestations of corticosteroids refractory chronic graft versus host disease (cGVHD) by a total nodal irradiation (TNI)},
author = {Guillaume Peyraga and Thibaut Lizee and Pierre Gustin and Karen Clement-Colmou and Christelle Di Bartolo and Stephane Supiot and Marc-Andre Mahe and Sylvie François and Martine Mege},
doi = {10.1111/ctr.12923},
issn = {1399-0012},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {Clin Transplant},
volume = {31},
number = {4},
abstract = {The management of corticosteroids refractory chronic graft versus host disease (cGVHD) remains controversial. Retrospective analysis of patients treated at the Integrated Center of Oncology by total nodal irradiation (TNI) was performed to evaluate its therapy potency. TNI delivers a dose of 1 Gy in a single session. The delimitation of the fields is clinical (upper limit: external auditory meatus; lower limit: mid-femur). No pre-therapeutic dosimetry scanner was necessary. Evaluation of the efficacy was by clinical measures at 6 months after the treatment. Twelve patients were treated by TNI between January 2010 and December 2013. TNI was used in second-line treatment or beyond. The median time between allograft and TNI was 31.2 months, and the median time between the first manifestations of cGVHD and TNI was about 24.2 months. Of the 12 patients, nine had a clinical response at 6 months (75%), including five complete clinical responses (41.6%). Five patients could benefit from a reduction of corticosteroid doses. Three patients had hematologic toxicity. TNI could be considered as an option for the treatment of a cutaneous and/or soft tissues corticosteroids refractory cGVHD. However, prospective randomized and double-blind trials remain essential to answer the questions about TNI safety and effectiveness.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The management of corticosteroids refractory chronic graft versus host disease (cGVHD) remains controversial. Retrospective analysis of patients treated at the Integrated Center of Oncology by total nodal irradiation (TNI) was performed to evaluate its therapy potency. TNI delivers a dose of 1 Gy in a single session. The delimitation of the fields is clinical (upper limit: external auditory meatus; lower limit: mid-femur). No pre-therapeutic dosimetry scanner was necessary. Evaluation of the efficacy was by clinical measures at 6 months after the treatment. Twelve patients were treated by TNI between January 2010 and December 2013. TNI was used in second-line treatment or beyond. The median time between allograft and TNI was 31.2 months, and the median time between the first manifestations of cGVHD and TNI was about 24.2 months. Of the 12 patients, nine had a clinical response at 6 months (75%), including five complete clinical responses (41.6%). Five patients could benefit from a reduction of corticosteroid doses. Three patients had hematologic toxicity. TNI could be considered as an option for the treatment of a cutaneous and/or soft tissues corticosteroids refractory cGVHD. However, prospective randomized and double-blind trials remain essential to answer the questions about TNI safety and effectiveness.
Pra, Alan Dal; Zilli, Thomas; Supiot, Stephane
Editorial: Controversies and Perspectives in the Use of Postoperative Radiotherapy for Prostate Cancer Article de journal
Dans: Front Oncol, vol. 7, p. 275, 2017, ISSN: 2234-943X.
@article{pmid29218299,
title = {Editorial: Controversies and Perspectives in the Use of Postoperative Radiotherapy for Prostate Cancer},
author = {Alan Dal Pra and Thomas Zilli and Stephane Supiot},
doi = {10.3389/fonc.2017.00275},
issn = {2234-943X},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {Front Oncol},
volume = {7},
pages = {275},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Vilotte, Florent; Antoine, Mickael; Bobin, Maxime; Latorzeff, Igor; Supiot, Stéphane; Richaud, Pierre; Thomas, Laurence; Leduc, Nicolas; Guérif, Stephane; Iriondo-Alberdi, Jone; de Crevoisier, Renaud; Sargos, Paul
Post-Prostatectomy Image-Guided Radiotherapy: The Invisible Target Concept Article de journal
Dans: Front Oncol, vol. 7, p. 34, 2017, ISSN: 2234-943X.
@article{pmid28337425,
title = {Post-Prostatectomy Image-Guided Radiotherapy: The Invisible Target Concept},
author = {Florent Vilotte and Mickael Antoine and Maxime Bobin and Igor Latorzeff and Stéphane Supiot and Pierre Richaud and Laurence Thomas and Nicolas Leduc and Stephane Guérif and Jone Iriondo-Alberdi and Renaud de Crevoisier and Paul Sargos},
doi = {10.3389/fonc.2017.00034},
issn = {2234-943X},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {Front Oncol},
volume = {7},
pages = {34},
abstract = {In the era of intensity-modulated radiation therapy, image-guided radiotherapy (IGRT) appears crucial to control dose delivery and to promote dose escalation while allowing healthy tissue sparing. The place of IGRT following radical prostatectomy is poorly described in the literature. This review aims to highlight some key points on the different IGRT techniques applicable to prostatic bed radiotherapy. Furthermore, methods used to evaluate target motion and to reduce planning target volume margins will also be explored.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
In the era of intensity-modulated radiation therapy, image-guided radiotherapy (IGRT) appears crucial to control dose delivery and to promote dose escalation while allowing healthy tissue sparing. The place of IGRT following radical prostatectomy is poorly described in the literature. This review aims to highlight some key points on the different IGRT techniques applicable to prostatic bed radiotherapy. Furthermore, methods used to evaluate target motion and to reduce planning target volume margins will also be explored.
Latorzeff, Igor; Sargos, Paul; Loos, Geneviève; Supiot, Stéphane; Guerif, Stéphane; Carrie, Christian
Delineation of the Prostate Bed: The “Invisible Target“ Is Still an Issue? Article de journal
Dans: Front Oncol, vol. 7, p. 108, 2017, ISSN: 2234-943X.
@article{pmid28620579,
title = {Delineation of the Prostate Bed: The “Invisible Target“ Is Still an Issue?},
author = {Igor Latorzeff and Paul Sargos and Geneviève Loos and Stéphane Supiot and Stéphane Guerif and Christian Carrie},
doi = {10.3389/fonc.2017.00108},
issn = {2234-943X},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {Front Oncol},
volume = {7},
pages = {108},
abstract = {For pathological high-risk prostate cancer, adjuvant irradiation has shown a survival benefit. Phase III studies have highlighted that half men would face biochemical relapse and would be candidate for radiotherapy at adjuvant or salvage times. Despite at least four published international contouring guidelines from different collaborative groups, discrepancies remain for volumes, delineation, and margins to be considered in order to optimize radiotherapy planning. This article from "Groupe d'Etude des Tumeurs UroGénitales (GETUG)" members will focus on controversies to help clinicians to create best volume delineation for adjuvant or salvage post prostatectomy radiotherapy.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
For pathological high-risk prostate cancer, adjuvant irradiation has shown a survival benefit. Phase III studies have highlighted that half men would face biochemical relapse and would be candidate for radiotherapy at adjuvant or salvage times. Despite at least four published international contouring guidelines from different collaborative groups, discrepancies remain for volumes, delineation, and margins to be considered in order to optimize radiotherapy planning. This article from "Groupe d'Etude des Tumeurs UroGénitales (GETUG)" members will focus on controversies to help clinicians to create best volume delineation for adjuvant or salvage post prostatectomy radiotherapy.
Belkacemi, Y; Latorzef, I; Hasbini, A; Pasquier, D; Toledano, A; Hennequin, C; Bossi, A; Chapet, O; Crehange, G; Guerif, S; Duberge, T; Allouache, N; Clavere, P; Gross, E; Supiot, S; Azria, D; Bolla, M; Sargos, P
Patterns of Daily Practice of Hormone Therapy in Unfavorable and Favorable Intermediate-Risk Prostate Cancer: Results of the French PROACT Survey Article de journal
Dans: International Journal of Radiation Oncology*Biology*Physics, vol. 99, no. 2, Supplement, p. E213, 2017, ISSN: 0360-3016, (Proceedings of the American Society for Radiation Oncology).
@article{BELKACEMI2017E213,
title = {Patterns of Daily Practice of Hormone Therapy in Unfavorable and Favorable Intermediate-Risk Prostate Cancer: Results of the French PROACT Survey},
author = {Y Belkacemi and I Latorzef and A Hasbini and D Pasquier and A Toledano and C Hennequin and A Bossi and O Chapet and G Crehange and S Guerif and T Duberge and N Allouache and P Clavere and E Gross and S Supiot and D Azria and M Bolla and P Sargos},
url = {https://www.sciencedirect.com/science/article/pii/S0360301617321673},
doi = {https://doi.org/10.1016/j.ijrobp.2017.06.1113},
issn = {0360-3016},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {International Journal of Radiation Oncology*Biology*Physics},
volume = {99},
number = {2, Supplement},
pages = {E213},
note = {Proceedings of the American Society for Radiation Oncology},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2016
Pra, Alan Dal; Locke, Jennifer A; Borst, Gerben; Supiot, Stephane; Bristow, Robert G
Mechanistic Insights into Molecular Targeting and Combined Modality Therapy for Aggressive, Localized Prostate Cancer Article de journal
Dans: Front Oncol, vol. 6, p. 24, 2016, ISSN: 2234-943X.
@article{pmid26909338,
title = {Mechanistic Insights into Molecular Targeting and Combined Modality Therapy for Aggressive, Localized Prostate Cancer},
author = {Alan Dal Pra and Jennifer A Locke and Gerben Borst and Stephane Supiot and Robert G Bristow},
doi = {10.3389/fonc.2016.00024},
issn = {2234-943X},
year = {2016},
date = {2016-02-16},
urldate = {2016-01-01},
journal = {Front Oncol},
volume = {6},
pages = {24},
abstract = {Radiation therapy (RT) is one of the mainstay treatments for prostate cancer (PCa). The potentially curative approaches can provide satisfactory results for many patients with non-metastatic PCa; however, a considerable number of individuals may present disease recurrence and die from the disease. Exploiting the rich molecular biology of PCa will provide insights into how the most resistant tumor cells can be eradicated to improve treatment outcomes. Important for this biology-driven individualized treatment is a robust selection procedure. The development of predictive biomarkers for RT efficacy is therefore of utmost importance for a clinically exploitable strategy to achieve tumor-specific radiosensitization. This review highlights the current status and possible opportunities in the modulation of four key processes to enhance radiation response in PCa by targeting the: (1) androgen signaling pathway; (2) hypoxic tumor cells and regions; (3) DNA damage response (DDR) pathway; and (4) abnormal extra-/intracell signaling pathways. In addition, we discuss how and which patients should be selected for biomarker-based clinical trials exploiting and validating these targeted treatment strategies with precision RT to improve cure rates in non-indolent, localized PCa. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Radiation therapy (RT) is one of the mainstay treatments for prostate cancer (PCa). The potentially curative approaches can provide satisfactory results for many patients with non-metastatic PCa; however, a considerable number of individuals may present disease recurrence and die from the disease. Exploiting the rich molecular biology of PCa will provide insights into how the most resistant tumor cells can be eradicated to improve treatment outcomes. Important for this biology-driven individualized treatment is a robust selection procedure. The development of predictive biomarkers for RT efficacy is therefore of utmost importance for a clinically exploitable strategy to achieve tumor-specific radiosensitization. This review highlights the current status and possible opportunities in the modulation of four key processes to enhance radiation response in PCa by targeting the: (1) androgen signaling pathway; (2) hypoxic tumor cells and regions; (3) DNA damage response (DDR) pathway; and (4) abnormal extra-/intracell signaling pathways. In addition, we discuss how and which patients should be selected for biomarker-based clinical trials exploiting and validating these targeted treatment strategies with precision RT to improve cure rates in non-indolent, localized PCa.
Delpon, Grégory; Escande, Alexandre; Ruef, Timothée; Darréon, Julien; Fontaine, Jimmy; Noblet, Caroline; Supiot, Stéphane; Lacornerie, Thomas; Pasquier, David
Comparison of Automated Atlas-Based Segmentation Software for Postoperative Prostate Cancer Radiotherapy Article de journal
Dans: Front Oncol, vol. 6, p. 178, 2016, ISSN: 2234-943X.
@article{pmid27536556,
title = {Comparison of Automated Atlas-Based Segmentation Software for Postoperative Prostate Cancer Radiotherapy},
author = {Grégory Delpon and Alexandre Escande and Timothée Ruef and Julien Darréon and Jimmy Fontaine and Caroline Noblet and Stéphane Supiot and Thomas Lacornerie and David Pasquier},
doi = {10.3389/fonc.2016.00178},
issn = {2234-943X},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {Front Oncol},
volume = {6},
pages = {178},
abstract = {Automated atlas-based segmentation (ABS) algorithms present the potential to reduce the variability in volume delineation. Several vendors offer software that are mainly used for cranial, head and neck, and prostate cases. The present study will compare the contours produced by a radiation oncologist to the contours computed by different automated ABS algorithms for prostate bed cases, including femoral heads, bladder, and rectum. Contour comparison was evaluated by different metrics such as volume ratio, Dice coefficient, and Hausdorff distance. Results depended on the volume of interest showed some discrepancies between the different software. Automatic contours could be a good starting point for the delineation of organs since efficient editing tools are provided by different vendors. It should become an important help in the next few years for organ at risk delineation. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Automated atlas-based segmentation (ABS) algorithms present the potential to reduce the variability in volume delineation. Several vendors offer software that are mainly used for cranial, head and neck, and prostate cases. The present study will compare the contours produced by a radiation oncologist to the contours computed by different automated ABS algorithms for prostate bed cases, including femoral heads, bladder, and rectum. Contour comparison was evaluated by different metrics such as volume ratio, Dice coefficient, and Hausdorff distance. Results depended on the volume of interest showed some discrepancies between the different software. Automatic contours could be a good starting point for the delineation of organs since efficient editing tools are provided by different vendors. It should become an important help in the next few years for organ at risk delineation.
2015
Supiot, Stephane; Rio, Emmanuel; Pacteau, Valérie; Mauboussin, Marie-Hélène; Campion, Loïc; Pein, François
OLIGOPELVIS - GETUG P07: a multicentre phase II trial of combined salvage radiotherapy and hormone therapy in oligometastatic pelvic node relapses of prostate cancer Article de journal
Dans: BMC Cancer, vol. 15, p. 646, 2015, ISSN: 1471-2407.
@article{pmid26408012,
title = {OLIGOPELVIS - GETUG P07: a multicentre phase II trial of combined salvage radiotherapy and hormone therapy in oligometastatic pelvic node relapses of prostate cancer},
author = {Stephane Supiot and Emmanuel Rio and Valérie Pacteau and Marie-Hélène Mauboussin and Loïc Campion and François Pein},
doi = {10.1186/s12885-015-1579-0},
issn = {1471-2407},
year = {2015},
date = {2015-09-01},
urldate = {2015-09-01},
journal = {BMC Cancer},
volume = {15},
pages = {646},
abstract = {BACKGROUND: Metastatic prostate cancer remains a common cause of death in Europe, and improvements in management of the disease are urgently needed. The advent of positron-emission tomography (PET) imaging enhanced with fluorocholine has led to the identification of a new sub-group of metastatic prostate cancer patients: those with so-called oligometastatic disease. Presenting with a low burden of metastatic disease (≤5 lesions), this new sub-group lies between true metastatic prostate cancer patients for whom androgen- deprivation therapy (ADT) is the mainstay of treatment, and patients with a rising PSA, but no visible lesion on conventional imaging, in whom intermittent ADT has been shown to be no less effective than continuous ADT. One might conclude that intermittent ADT would also be the standard of care for oligometastatic prostate cancer patients, but radical strategies such as extensive lymphadenectomy or high-dose radiotherapy have been suggested as another means to delay the need for ADT, and increase its effectiveness once initiated. This study will explore the role of salvage pelvic image-guided intensity-modulated radiation therapy (IMRT) combined with ADT administered for 6 months in pelvic oligometastatic patients in prolonging the failure-free interval between two consecutive ADT courses, or even to cure selected patients with limited metastatic burden.
METHODS/DESIGN: We plan to assess the two year outcome in oligometastatic prostate cancer patients (1-5 pelvic oligometastases) treated concomitantly with high-dose IMRT (54 Gy, 30 fractions to the pelvis and 66 Gy, 30 fractions to the lymph nodes) and ADT for six months.
DISCUSSION: This multicenter prospective phase II study will yield new data regarding the safety and efficacy of high-dose radiotherapy combined with ADT and will provide a basis for a larger phase III study to examine the role of radiotherapy in this population currently treated only with hormone therapy.
TRIAL REGISTRATION: NCT02274779 , date of registration: 23/10/14.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Metastatic prostate cancer remains a common cause of death in Europe, and improvements in management of the disease are urgently needed. The advent of positron-emission tomography (PET) imaging enhanced with fluorocholine has led to the identification of a new sub-group of metastatic prostate cancer patients: those with so-called oligometastatic disease. Presenting with a low burden of metastatic disease (≤5 lesions), this new sub-group lies between true metastatic prostate cancer patients for whom androgen- deprivation therapy (ADT) is the mainstay of treatment, and patients with a rising PSA, but no visible lesion on conventional imaging, in whom intermittent ADT has been shown to be no less effective than continuous ADT. One might conclude that intermittent ADT would also be the standard of care for oligometastatic prostate cancer patients, but radical strategies such as extensive lymphadenectomy or high-dose radiotherapy have been suggested as another means to delay the need for ADT, and increase its effectiveness once initiated. This study will explore the role of salvage pelvic image-guided intensity-modulated radiation therapy (IMRT) combined with ADT administered for 6 months in pelvic oligometastatic patients in prolonging the failure-free interval between two consecutive ADT courses, or even to cure selected patients with limited metastatic burden.
METHODS/DESIGN: We plan to assess the two year outcome in oligometastatic prostate cancer patients (1-5 pelvic oligometastases) treated concomitantly with high-dose IMRT (54 Gy, 30 fractions to the pelvis and 66 Gy, 30 fractions to the lymph nodes) and ADT for six months.
DISCUSSION: This multicenter prospective phase II study will yield new data regarding the safety and efficacy of high-dose radiotherapy combined with ADT and will provide a basis for a larger phase III study to examine the role of radiotherapy in this population currently treated only with hormone therapy.
TRIAL REGISTRATION: NCT02274779 , date of registration: 23/10/14.
METHODS/DESIGN: We plan to assess the two year outcome in oligometastatic prostate cancer patients (1-5 pelvic oligometastases) treated concomitantly with high-dose IMRT (54 Gy, 30 fractions to the pelvis and 66 Gy, 30 fractions to the lymph nodes) and ADT for six months.
DISCUSSION: This multicenter prospective phase II study will yield new data regarding the safety and efficacy of high-dose radiotherapy combined with ADT and will provide a basis for a larger phase III study to examine the role of radiotherapy in this population currently treated only with hormone therapy.
TRIAL REGISTRATION: NCT02274779 , date of registration: 23/10/14.
Buge, François; Chiavassa, Sophie; Hervé, Chloé; Rigaud, Jérôme; Delpon, Grégory; Supiot, Stéphane
Preclinical Evaluation of Intraoperative Low-Energy Photon Radiotherapy Using Spherical Applicators in Locally Advanced Prostate Cancer Article de journal
Dans: Front Oncol, vol. 5, p. 204, 2015, ISSN: 2234-943X.
@article{pmid26442216,
title = {Preclinical Evaluation of Intraoperative Low-Energy Photon Radiotherapy Using Spherical Applicators in Locally Advanced Prostate Cancer},
author = {François Buge and Sophie Chiavassa and Chloé Hervé and Jérôme Rigaud and Grégory Delpon and Stéphane Supiot},
doi = {10.3389/fonc.2015.00204},
issn = {2234-943X},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {Front Oncol},
volume = {5},
pages = {204},
abstract = {BACKGROUND: Surgery plus adjuvant radiotherapy is standard care for locally advanced prostate cancer (stage pT3R1). Intraoperative low-energy photon radiotherapy offers several advantages over external beam radiotherapy, and several systems are now available for its delivery, using spherical applicators, which require only limited shielding. The aim of this study was to evaluate the feasibility of this technique for the prostate bed.
MATERIALS AND METHODS: Applicators were assessed using MRI image data and cadaveric dissection. In cadavers, targeted tissues, defined as a urethral section, both neurovascular bundle sections, the bladder neck and the beds of the seminal vesicles, were marked with metallic surgical clips. Distances between clips and applicator were measured using CT. A dosimetric study of the application of 12 Gy at 5 mm depth was performed using CT images of prostatectomized cadavers.
RESULTS: Using MRI images from 34 prostate cancer patients, we showed that the ideal applicator diameter ranges from 45 to 70 mm. Using applicators of different sizes to encompass the prostate bed in nine cadavers, we showed that the distance between target tissues and applicator was <2 mm for all target tissues except the upper extremity of the seminal vesicles (19 mm). Dosimetric study showed a good dose distribution in all target tissues in contact with the applicator, with a low probability of rectum and bladder complication.
CONCLUSION: Intraoperative radiotherapy of the prostate bed is feasible, with good coverage of targeted tissues. Clinical study of safety and efficacy is now required.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Surgery plus adjuvant radiotherapy is standard care for locally advanced prostate cancer (stage pT3R1). Intraoperative low-energy photon radiotherapy offers several advantages over external beam radiotherapy, and several systems are now available for its delivery, using spherical applicators, which require only limited shielding. The aim of this study was to evaluate the feasibility of this technique for the prostate bed.
MATERIALS AND METHODS: Applicators were assessed using MRI image data and cadaveric dissection. In cadavers, targeted tissues, defined as a urethral section, both neurovascular bundle sections, the bladder neck and the beds of the seminal vesicles, were marked with metallic surgical clips. Distances between clips and applicator were measured using CT. A dosimetric study of the application of 12 Gy at 5 mm depth was performed using CT images of prostatectomized cadavers.
RESULTS: Using MRI images from 34 prostate cancer patients, we showed that the ideal applicator diameter ranges from 45 to 70 mm. Using applicators of different sizes to encompass the prostate bed in nine cadavers, we showed that the distance between target tissues and applicator was <2 mm for all target tissues except the upper extremity of the seminal vesicles (19 mm). Dosimetric study showed a good dose distribution in all target tissues in contact with the applicator, with a low probability of rectum and bladder complication.
CONCLUSION: Intraoperative radiotherapy of the prostate bed is feasible, with good coverage of targeted tissues. Clinical study of safety and efficacy is now required.
MATERIALS AND METHODS: Applicators were assessed using MRI image data and cadaveric dissection. In cadavers, targeted tissues, defined as a urethral section, both neurovascular bundle sections, the bladder neck and the beds of the seminal vesicles, were marked with metallic surgical clips. Distances between clips and applicator were measured using CT. A dosimetric study of the application of 12 Gy at 5 mm depth was performed using CT images of prostatectomized cadavers.
RESULTS: Using MRI images from 34 prostate cancer patients, we showed that the ideal applicator diameter ranges from 45 to 70 mm. Using applicators of different sizes to encompass the prostate bed in nine cadavers, we showed that the distance between target tissues and applicator was <2 mm for all target tissues except the upper extremity of the seminal vesicles (19 mm). Dosimetric study showed a good dose distribution in all target tissues in contact with the applicator, with a low probability of rectum and bladder complication.
CONCLUSION: Intraoperative radiotherapy of the prostate bed is feasible, with good coverage of targeted tissues. Clinical study of safety and efficacy is now required.
Goineau, Aurore; d'Aillières, Bénédicte; de Decker, Laure; Supiot, Stéphane
Integrating Geriatric Assessment into Decision-Making after Prostatectomy: Adjuvant Radiotherapy, Salvage Radiotherapy, or None? Article de journal
Dans: Front Oncol, vol. 5, p. 227, 2015, ISSN: 2234-943X.
@article{pmid26528437,
title = {Integrating Geriatric Assessment into Decision-Making after Prostatectomy: Adjuvant Radiotherapy, Salvage Radiotherapy, or None?},
author = {Aurore Goineau and Bénédicte d'Aillières and Laure de Decker and Stéphane Supiot},
doi = {10.3389/fonc.2015.00227},
issn = {2234-943X},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {Front Oncol},
volume = {5},
pages = {227},
abstract = {Despite current advancements in the field, management of older prostate cancer patients still remains a big challenge for Geriatric Oncology. The International Society of Geriatric Oncology (ISGO) has recently updated its recommendations in this area, and these have been widely adopted, notably by the European Association of Urology. This article outlines the principles that should be observed in the management of elderly patients who have recently undergone prostatectomy for malignancy or with a biochemical relapse following prostatectomy. Further therapeutic intervention should not be considered in those patients who are classified as frail in the geriatric assessment. In patients presenting better health conditions, salvage radiotherapy is to be preferred to adjuvant radiotherapy, which is only indicated in certain exceptional cases. Radiotherapy of the operative bed presents a higher risk to the elderly. Additionally, hormone therapy clearly shows higher side effects in older patients and therefore it should not be administered to asymptomatic patients. We propose a decision tree based on the ISGO recommendations, with specific modifications for patients in biochemical relapse. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Despite current advancements in the field, management of older prostate cancer patients still remains a big challenge for Geriatric Oncology. The International Society of Geriatric Oncology (ISGO) has recently updated its recommendations in this area, and these have been widely adopted, notably by the European Association of Urology. This article outlines the principles that should be observed in the management of elderly patients who have recently undergone prostatectomy for malignancy or with a biochemical relapse following prostatectomy. Further therapeutic intervention should not be considered in those patients who are classified as frail in the geriatric assessment. In patients presenting better health conditions, salvage radiotherapy is to be preferred to adjuvant radiotherapy, which is only indicated in certain exceptional cases. Radiotherapy of the operative bed presents a higher risk to the elderly. Additionally, hormone therapy clearly shows higher side effects in older patients and therefore it should not be administered to asymptomatic patients. We propose a decision tree based on the ISGO recommendations, with specific modifications for patients in biochemical relapse.
Pichon, B; Supiot, S; Delpon, G; Ferrer, L; Rauscher, A; Leturnier, M; Libois, V; Goineau, A; Chauvet, A Faivre; Baumgartner, P; Goldenberg, DM; Sharkey, R; Barbet, J; Kraeber-Bodere, F; Mahe, M; Rousseau, C
Dans: International Journal of Radiation Oncology*Biology*Physics, vol. 93, no. 3, Supplement, p. S82-S83, 2015, ISSN: 0360-3016, (Proceedings of the American Society for Radiation Oncology 57th Annual Meeting).
@article{PICHON2015S82,
title = {Impact of Functional and/or Phenotypic PET Imaging on the Determination of Clinical Target Volumes of Vertebral Metastases Before Stereotactic Body Radiation Therapy Compared to MRI},
author = {B Pichon and S Supiot and G Delpon and L Ferrer and A Rauscher and M Leturnier and V Libois and A Goineau and A Faivre Chauvet and P Baumgartner and DM Goldenberg and R Sharkey and J Barbet and F Kraeber-Bodere and M Mahe and C Rousseau},
url = {https://www.sciencedirect.com/science/article/pii/S0360301615009293},
doi = {https://doi.org/10.1016/j.ijrobp.2015.07.198},
issn = {0360-3016},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {International Journal of Radiation Oncology*Biology*Physics},
volume = {93},
number = {3, Supplement},
pages = {S82-S83},
note = {Proceedings of the American Society for Radiation Oncology 57th Annual Meeting},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pichon, B; Mahe, MA; Delpon, G; Thillays, F; Carrie, C; Cellier, P; Pommier, P; Laude, C; Mervoyer, A; Supiot, S
High Dose Hypofractionated Stereotactic Body Radiation Therapy of Non Compressive Vertebral Bone Metastases in Combination With Zoledronic Acid: A Phase 1 Study Article de journal
Dans: International Journal of Radiation Oncology*Biology*Physics, vol. 93, no. 3, Supplement, p. E83, 2015, ISSN: 0360-3016, (Proceedings of the American Society for Radiation Oncology 57th Annual Meeting).
@article{PICHON2015E83,
title = {High Dose Hypofractionated Stereotactic Body Radiation Therapy of Non Compressive Vertebral Bone Metastases in Combination With Zoledronic Acid: A Phase 1 Study},
author = {B Pichon and MA Mahe and G Delpon and F Thillays and C Carrie and P Cellier and P Pommier and C Laude and A Mervoyer and S Supiot},
url = {https://www.sciencedirect.com/science/article/pii/S036030161501487X},
doi = {https://doi.org/10.1016/j.ijrobp.2015.07.756},
issn = {0360-3016},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {International Journal of Radiation Oncology*Biology*Physics},
volume = {93},
number = {3, Supplement},
pages = {E83},
note = {Proceedings of the American Society for Radiation Oncology 57th Annual Meeting},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hennequin, C; Richaud, PM; Roca, L; Silva, M; Latorzeff, I; Beckendorff, V; Carrie, C; Benyoucef, A; Hasbini, A; Supiot, S; Ronchin, P; Wachter, T; Azria, D; Cailleux, PE; Cormier, L; Habibian, M; Delaroche, G
Dans: International Journal of Radiation Oncology*Biology*Physics, vol. 93, no. 3, Supplement, p. S44-S45, 2015, ISSN: 0360-3016, (Proceedings of the American Society for Radiation Oncology 57th Annual Meeting).
@article{HENNEQUIN2015S44,
title = {Randomized Phase 3 Trial of Dose Escalation (80 vs 70 Gy) in High-Risk Prostate Cancers Combined With Long-term Androgen Deprivation: GETUG-AFU 18 Trial, Acute and 1-Year Toxicities},
author = {C Hennequin and PM Richaud and L Roca and M Silva and I Latorzeff and V Beckendorff and C Carrie and A Benyoucef and A Hasbini and S Supiot and P Ronchin and T Wachter and D Azria and PE Cailleux and L Cormier and M Habibian and G Delaroche},
url = {https://www.sciencedirect.com/science/article/pii/S036030161500838X},
doi = {https://doi.org/10.1016/j.ijrobp.2015.07.107},
issn = {0360-3016},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {International Journal of Radiation Oncology*Biology*Physics},
volume = {93},
number = {3, Supplement},
pages = {S44-S45},
note = {Proceedings of the American Society for Radiation Oncology 57th Annual Meeting},
keywords = {},
pubstate = {published},
tppubtype = {article}
}