0000000000225691
AUTHOR
O. Chapet
Salvage reirradiation for locoregional failure after radiation therapy for prostate cancer: Who, when, where and how?
Even in the current era of dose-escalated radiotherapy for prostate cancer, biochemical recurrence is not uncommon. Furthermore, biochemical failure is not specific to the site of recurrence. One of the major challenges in the management of prostate cancer patients with biochemical failure after radiotherapy is the early discrimination between those with locoregional recurrence only and those with metastatic disease. While the latter are generally considered incurable, patients with locoregional disease may benefit from emerging treatment options. Ultimately, the objective of salvage therapy is to control disease while ensuring minimal collateral damage, thereby optimizing both cancer and t…
Association de radiothérapie externe et de curiethérapie pour les cancers de la prostate
International audience; Brachytherapy as sole treatment is standard of care for D’Amico classification low-risk prostate cancer. For intermediate and high-risk patients, brachytherapy can be associated to external beam radiation therapy to better take into account the risk of extracapsular effraction and/or seminal vesicle involvement. Three randomized studies have shown that this association increases freedom from relapse survival compared to exclusive external beam radiation therapy. This benefit is not shown for overall survival. The addition of a hormonal therapy to this association is most likely mandatory for high-risk patients, and needs to be confirmed for intermediate risk patients…
Surrogate end points for overall survival and local control in neoadjuvant rectal cancer trials: statistical evaluation based on the FFCD 9203 trial.
Abstract Background In resectable rectal cancer trials, pathological parameters are early preoperative treatment efficacy measures. Their validation as surrogate end points for long-term clinical outcomes would allow to reduce trial duration. The aim was to evaluate potential surrogates for overall survival (OS) and local control (LC) in preoperative T3/T4 rectal cancer trials. Candidate variables included ypT and ypN stages, T downstaging, tumor regression grade (TRG), and circumferential resection margin (CRM) status. Patients and methods In the Federation Francophone de Cancerologie Digestive (FFCD) 9203 trial, 742 eligible patients were randomly assigned to receive preoperative radiothe…
Radiothérapie guidée par l’image des cancers prostatiques : concepts et implications
Resume La radiotherapie conformationnelle avec modulation d’intensite (RCMI) et la radiotherapie guidee par l’image sont deux evolutions technologiques qui, appliquees au modele des cancers prostatiques, ont permis de voir diminuer significativement la toxicite et les sequelles digestives et urinaires de la radiotherapie conformationnelle tridimensionnelle. Le benefice clinique majeur de ces techniques sur la diminution de la toxicite digestive et urinaire est indiscutable puisque les sequelles observees a dix ans sont devenues rares avec ces techniques (2 % de cas de toxicite digestive de grade 2 et 1 % de grade 3, 11 % de cas de toxicite urinaire de grade 2 et 5 % de grade 3). Si ces deux…