0000000000122986
AUTHOR
Philippe Maingon
Late neointimal tissue growth behind the stent after intravascular gamma-radiation.
To determine the nature of the changes of the vascular wall after intravascular brachytherapy in stented arteries leading to incomplete stent apposition.Stents were implanted in the infrarenal aortas of rabbits, and gamma-intravascular brachytherapy (18 Gy) or a sham radiation procedure was immediately implemented. The arteries were harvested at 6 months for histologic analyses.The external elastic lamina area, as well as the vascular wall area behind the stent, were significantly greater in irradiated vs. control arteries (8.94 +/- 0.68 mm2 vs. 6.87 +/- 0.40 mm2 [p0.001] and 1.56 +/- 0.13 mm2 vs. 0.72 +/- 0.07 mm2 [p0.001], respectively). The ratio of the intimal area behind the stent rela…
The radiosensitization effect of titanate nanotubes as a new tool in radiation therapy for glioblastoma: A proof-of-concept
Abstract Background and purpose One of the new challenges to improve radiotherapy is to increase the ionizing effect by using nanoparticles. The interest of titanate nanotubes (TiONts) associated with radiotherapy was evaluated in two human glioblastoma cell lines (SNB-19 and U87MG). Materials and methods Titanate nanotubes were synthetized by the hydrothermal treatment of titanium dioxide powder in a strongly basic NaOH solution. The cytotoxicity of TiONts was evaluated on SNB-19 and U87MG cell lines by cell proliferation assay. The internalization of TiONts was studied using Transmission Electron Microscopy (TEM). Finally, the effect of TiONts on cell radiosensitivity was evaluated using …
Prostate Metabolism After the Completion of Exclusive Radiation Is More Depleted After Seeds Brachytherapy Compared to External Beam Radiation Therapy for Prostate Cancer Patients
International audience; Biochemical outcome after radiation therapy requires a protracted time. PSA decreases slowly over time so that it is difficult to differentiate immediately after the completion of radiation the impact of radiation in the prostate using brachytherapy or external radiotherapy. At 3 months, the mean PSA values were similar between the 2 groups: 2.54 ng/mL (±1.59) in the EBRT group and 1.88 ng/mL (±1.14) in the PPI group (p=0.23). For Choline levels, 3-months Choline / Baseline Choline ratios were 1.13 (±0.60) after EBRT vs. 0.45 (±0.23) in the PPI group (p=0.003). Similar results were observed for Citrate levels: 3-months Citrate level / Baseline Citrate level ratios we…
Absolute volume of the rectum and AUC from rectal DVH between 25Gy and 50Gy predict acute gastrointestinal toxicity with IG-IMRT in prostate cancer
International audience; Background: To determine whether dose/volume specific endpoints (DVSE) or Area under the rectal DVH curve (rAUC) better predict acute gastrointestinal (GI) toxicity in prostate cancer patients treated with IMRT in the era of daily image guidance (IG-IMRT). Methods: A set of DVSE was recorded from V25 to V75 (increments of 5Gy) (both in % and in cc) for 180 men. The rAUC was calculated for doses ranging between 25Gy and 50Gy (rAUC(25-50)). Univariate and multivariate logistic regressions were performed to determine the relationship between DVSE or rAUC(25-50) and the appearance of any acute GI toxicity. Results: The rates of acute grade 1 (G1), G2 and G3 GI toxicities…
Mapping of failures after radiochemotherapy in patients with non-metastatic esophageal cancer: A posteriori analysis of the dose distribution in the sites of loco-regional relapse.
Abstract Background and purpose We aimed to evaluate the patterns of loco-regional failure (LRF) after exclusive chemoradiotherapy (eCRT) for esophageal cancer with respect to planned dose and/or the incidental (unplanned) dose outside target volumes. Materials and methods Co-image registration of CT or 18 F-FDG PET-CT at the time of failure (tf) and at the time of CRT (t0) was performed in 34 patients with LRF. Dosimetric parameters with regard to local failure (LF), nodal failure (NF) and involved nodal stations (NS) were derived. Results Twenty-two patients (64.7%) had LF, the majority of which (95.5%) were located at the epicenter of the GTV of the primary tumor. The mean doses recalcul…
Etude LYMPHOREC. Réponse immunitaire intra-tumorale à la radiothérapie préopératoire pour des cancers du rectum de stades II-III: nouveau paramètre pronostic de la survie des patients
National audience
Multiparametric MRI and post implant CT-based dosimetry after prostate brachytherapy with iodine seeds: The higher the dose to the dominant index lesion, the lower the PSA bounce
Abstract Purpose To determine whether post-implant MRI-based dosimetry of the Dominant Intra-prostatic Lesion (DIL) could best predict the occurrence of PSA bounce after prostate brachytherapy. Methods and materials We selected 66 patients with a low risk prostate cancer treated with 125 I prostate brachytherapy as monotherapy. Post-implant dosimetry based on day 30 CT-scan and multiparametric MRI co-registration was generated: planned D 90, D 95, V 100, V 150 values were calculated for each DIL. Bounce was defined as a PSA elevation ⩾0.2ng/mL from the previous baseline value followed by a decrease to or below the prior nadir with no additional treatment. Results After a median follow-up of…
Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?
International audience; PURPOSE: Salvage prostate permanent implant (sPPI) for postradiation local failure provides high rates of biochemical control. The cumulative dose delivered to the prostate and the rectum is still unknown. METHODS AND MATERIALS: We reviewed the postimplant CT-based dosimetry of 18 selected patients who underwent sPPI with I-125 seeds for isolated biopsy-proven local failure several years after external beam radiation therapy. Ten patients had whole-prostate sPPI, and 8 patients had multiparametric MRI-based focal sPPI. In 8 patients, hyaluronic acid (HA) gel was injected into the prostate rectum space. RESULTS: The median cumulative biological effective dose after EB…
Adjuvant treatments for gastric cancer: From practice guidelines to clinical practice
Abstract Background For gastric cancers, the benefits of adjuvant radiochemotherapy and of perioperative chemotherapy have been demonstrated since 2001 and 2006 respectively. The aim of this study was to evaluate the diffusion of adjuvant treatments in a French population. Methods 334 incident gastric cancers UICC Stage IB, II, III or IVM0 resected for cure and recorded in the Burgundy digestive cancer registry were retrospectively included. Patients were classified as having received an effective adjuvant treatment if they had been treated by adjuvant radiochemotherapy since 2001 or perioperative chemotherapy since 2006. Results The proportion of patients treated with an effective adjuvant…
Pattern of occult nodal relapse diagnosed with 18F-fluoro-choline PET/CT in prostate cancer patients with biochemical failure after prostate-only radiotherapy
Abstract Introduction The purpose of this study was to describe the pattern of nodal relapse with 18 F-fluoro-choline (FCH) Positron Emission Tomography/Computerized Tomography (PET/CT) in prostate cancer patients after radiotherapy. Materials and methods Eighty-three patients had a FCH PET/CT at time of biochemical failure. Of 65 patients with positive findings, 33 had positive nodes. This analysis included 31 patients who had undergone prior prostate-only radiotherapy with or without a prior radical prostatectomy. Each FCH positive node was assigned to a lymph node station with respect to the CTV defined by the RTOG guidelines (CTV RTOG ). 3D mapping was performed after each node was manu…
Correlation between clinical prognostic factors and MR spectroscopy-based biomarkers determined at 3.0 T without endorectal coils for patients with localised prostate cancer
International audience
The role of telomeres in predicting individual radiosensitivity of patients with cancer in the era of personalized radiotherapy.
Radiotherapy plays a key role in cancer treatments, but tumor cell death differs from one tumor to another. The response of patients to radiotherapy varies considerably and adverse side effects are difficult to prevent. The mechanisms involved in the heterogeneity of this response are not well understood. In order to enhance the efficacy and safety of radiotherapy, it is important to identify subpopulations most at risk of developing a late adverse response to radiotherapy. Telomeres are composed of multiple repeats of a unique sequence of nucleotides forming a TTAGGG pattern. They protect chromosomes from end-to-end fusion and maintain genomic stability. Telomeres have been shown to be ext…
Multiparametric MRI-based Dosimetric Parameters Best Predict Short-term Time Course of PSA After Iodine 125 Permanent Prostate Implantation for Localized Prostate Cancer
International audience; D90% and V150% of the entire prostate are recognized as the best dosimetric predictors of outcome after 125 I permanent prostate implantation (PPI). The purpose of this study was 2-fold: 1) to determine the relationship between dose-volume parameters of the Dominant Intraprostatic Lesion (DIL) when compared to the prostate and early biochemical outcome after PPI; 2) to define if dose-volume parameters of the central gland (CG), the peripheral zone (PZ) and the DIL could best predict PSA bounce occurrence. The time course of PSA and mechanisms of bounces still remain unclear after PPI. Patients who had a higher dose in the DIL had a worse PSA level at 1 year which is …
Temozolomide and radiotherapy antitumor efficacy evaluation with magnetic resonance imaging and proton magnetic resonance spectroscopy in human glioma models in nude rats
International audience
EARLY CHOLINE LEVELS FROM 3-TESLA MR SPECTROSCOPY AFTER EXCLUSIVE RADIATION THERAPY IN PATIENTS WITH CLINICALLY LOCALIZED PROSTATE CANCER ARE PREDICTIVE OF PLASMATIC LEVELS OF PSA AT 1 YEAR
International audience; Abstract: Purpose: To investigate the time course response of prostate metabolism to irradiation using magnetic resonance spectroscopy (MRS) at 3-month intervals and its impact on biochemical control. Methods and Materials: Between January 2008 and April 2010, 24 patients with localized prostate cancer were prospectively enrolled in the Evaluation of the Response to Irradiation with MR Spectroscopy (ERIS) trial. All the patients had been treated with intensity-modulated radiation therapy with or without long-term adjuvant hormonal therapy (LTHT) and underwent 3-T MRS and prostate-specific antigen (PSA) assays at baseline and every 3 months thereafter up to 12 months.…
Combining Sirolimus-eluting Stents and External Irradiation in Cholesterol-fed Rabbits Increased Incomplete Stent Apposition and Decreased Re-endothelialization
Restenosis after the implantation of a drug-eluting stent or after vascular irradiation therapy shares similar physiopathological mechanisms. No experimental data are currently available on vascular wall behavior after external irradiation on arteries stented with sirolimus-eluting stents (SES). Ten New Zealand white rabbits received a 0.5% cholesterol-enriched chow for 1 month. Bilateral iliac artery stent implantation was then performed with an SES (Cypher; Cordis Corp). The animals were randomized into either an irradiated group (I, 2 Gy external x-ray irradiation, n = 5) or a control group (C, n = 5). The cholesterol-enriched chow was continued for 1 additional month after stent implant…
MR-based biomarkers in the diagnosis and the evaluation of the therapeutic response to radiotherapy (ETRR) in prostatic carcinoma (PCa): Implementation of clinical and experimental approaches
e16136 Background: ETRR in PCa remains a challenging task. New biomarkers in the form of metabolites, detected with Proton Magnetic Resonance Spectroscopy (1H-MRS), and quantitative Apparent Diffusion Coefficient (ADC), determined with Diffusion-Weighted Magnetic Resonance Imaging, could be of value in the ETRR for PCa. Methods: Twenty-one men with biopsy proven localized PCa were examined before external radiotherapy. 3D-1H-MRS was performed at 3.0T without endorectal coils. The delivered radiotherapy dose was 78 Gy in 39 fractions with 6 MV photons. MR follow-up examinations up to 36 months post-radiotherapy were performed. For the pre-clinical study, healthy rat prostate was studied in …
Impact of neoadjuvant chemotherapy on survival in breast cancer patients in daily practice: a population-based study
This population-based study aimed to describe the effects of neoadjuvant chemotherapy (NC) on survival in breast cancer (BC) patients in daily practice. BC patients treated with NC followed by surgery and radiotherapy, were retrospectively selected from 1982 to 2005 using the Cote d’Or BC registry. These patients were matched for the baseline AJCC (American Joint Committee on Cancer) stage, age at diagnosis, date of diagnosis and oestrogens receptors status to those who had undergone surgery followed by adjuvant chemotherapy and radiotherapy. The prognostic effect of NC on survival in BC patients was assessed with relative survival (RS) analyses. From 1982 to 2005, 210 patients with BC diag…