Daily Versus Weekly Prostate Cancer Image Guided Radiation Therapy: Phase 3 Multicenter Randomized Trial.

Purpose: The optimal frequency of prostate cancer image guided radiation therapy (IGRT) has not yet been clearly identified. This study sought to compare the safety and efficacy of daily versus weekly IGRT.

Materials And Methods: This phase 3 randomized trial recruited patients with N0 localized prostate cancer.

New approach of ultra-focal brachytherapy for low- and intermediate-risk prostate cancer with custom-linked I-125 seeds: A feasibility study of optimal dose coverage.

Purpose: To present the feasibility study of optimal dose coverage in ultra-focal brachytherapy (UFB) with multiparametric MRI for low- and intermediate-risk prostate cancer.

Methods And Materials: UFB provisional dose plans for small target volumes (<7 cc) were calculated on a prostate training phantom to optimize the seeds number and strength. Clinical UFB consisted in a contour-based nonrigid registration (MRI/Ultrasound) to implant a fiducial marker at the location of the tumor focus.

The Impact of a Small Private Online Course as a New Approach to Teaching Oncology: Development and Evaluation.

Background: Oncology involves complex care and multidisciplinary management of patients; however, misinformation and ineffective communication remain problematic.

Objective: The educational objective of our study was to develop a new teaching method to improve cancer treatment and management by emphasizing the link between hospitals (inpatients) and their surrounding communities (outpatients).

Methods: A team of 22 professionals from public and private institutions developed a small private online course (SPOC).

[Is there a role for pelvic lymphadenectomy before radiation therapy in localized prostate carcinoma?].

Pelvic nodal irradiation has classically been recommended in all patients with a predicted lymph node invasion risk of 15% or greater. However, in view of the results of recent series of extended lymphadenectomy, this rule has been critically discussed. Moreover, the technological progress of radiotherapy has drastically decreased the risk of rectal and urinary injuries secondary to the pelvic irradiation.

Conventional versus automated implantation of loose seeds in prostate brachytherapy: analysis of dosimetric and clinical results.

Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation.

Methods And Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008.

[Choice of optimal margins in prostate conformal radiotherapy].

The planning CT allows the delineation of the prostate (clinical target volume, CTV) but with an imprecision at the apex and the inability to visualize the intraprostatic cancer. MRI enables accurate visualization of the prostate outlines and in some extent the intraprostatic tumour (gross tumour volume [GTV]). The integration of MRI data within the CT remains still complex.

Proposal for a predictive model of erectile function after permanent (125)I prostate brachytherapy for localized prostate cancer.

To determine the risk factors for EDin men treated by prostate brachytherapy (PB) for localized prostate cancer and to propose a model to predict post-implant erectile function. Out of a series of 270 sexually active men treated by PB, 241 (89%) (mean age=66 years (range, 43-80)) accepted to participate in a mail-based study on erectile function. The risk factors for erectile dysfunction were determined by regression analysis and a predictive model was proposed.

Cost of prostate image-guided radiation therapy: results of a randomized trial.

Purpose: This cost analysis aimed to quantify the cost of IGRT in relation to IGRT frequency and modality with Cone Beam Computed Tomography (CBCT) or orthogonal electronic portal imaging with fiducial markers (EPI-FM).

Material And Methods: Patients undergoing IGRT for localized prostate cancer were randomized into two prostate control frequencies (daily or weekly). Costs were calculated based on the micro-costing results according to hospitals' perspectives (in Euros, 2009) and the time horizon was radiation therapy.

Erectile function after permanent 125I prostate brachytherapy for localized prostate cancer.

Background And Purpose: To analyze erectile function in men treated by prostate brachytherapy (PB) for localized prostate cancer.

Material And Methods: Of a series of 270 sexually active men treated by PB, 241 (89%), mean age 65 yr (range, 43-80 yr), participated in a study on erectile function that was evaluated using the International Index of Erectile Function 5-item (IIEF-5) questionnaire before implantation and by postal survey after a mean follow-up of 36 months (range, 6-70 months).

Results: After PB, 27 patients (11%) had no erectile dysfunction (ED), 36 (15%) had mild ED, 58 (24%) had mild to moderate ED, 24 (10%) had moderate ED, 53 (22%) had severe ED and 43 (18%) were not sexually active.

[Prospective economic evaluation of image-guided radiation therapy for prostate cancer in the framework of the national programme for innovative and costly therapies assessment].

Purpose: The main objective of the economical study was to prospectively and randomly assess the additional costs of daily versus weekly patient positioning quality control in image-guided radiotherapy (IGRT), taking into account the modalities of the 3D-imaging: tomography (CBCT) or gold seeds implants. A secondary objective was to prospectively assess the additional costs of 3D versus 2D imaging with portal imaging for patient positioning controls.

Patients And Methods: Economics data are issued from a multicenter randomized medico-economics trial comparing the two frequencies of patient positioning control during prostate IGRT.

[Dosimetric and clinical benefits of respiratory-gated radiotherapy for lung and breast cancers: results of the STIC 2003].

Purpose: To compare respiratory-gated conformal radiotherapy versus conventional conformal radiotherapy for the irradiation of non-small cells lung cancer and breast cancer.

Patients And Methods: The STIC 2003 project was a comparative, non-randomized, multicenter and prospective study that included in 20 French centers between April 2004 and June 2008, 634 evaluable patients, 401 non-small cells lung cancer and 233 breast cancers.

Results: The final results confirmed the feasibility and good reproducibility of the various respiratory-gated conformal radiotherapy systems regardless of tumour location.

[Fertility after prostate brachytherapy with Iode 125 permanent implants for localized prostate cancer].

Objectives: Preservation of fertility in men of middle age is an issue that is experiencing a growing interest. Prostate cancer is the second most common cancer in men and is diagnosed earlier than before. Brachytherapy is a treatment for prostate cancer that preserves ejaculation.

Respiratory gating techniques for optimization of lung cancer radiotherapy.

Purpose: The primary objective of the STIC 2003 project was to compare the clinical and economic aspects of respiratory-gated conformal radiotherapy (RGRT), an innovative technique proposed to limit the impact of respiratory movements during irradiation, versus conventional conformal radiotherapy, the reference radiation therapy for lung cancer.

Methods And Materials: A comparative, nonrandomized, multicenter, and prospective cost toxicity analysis was performed in the context of this project between April 2004 and June 2008 in 20 French centers. Only the results of the clinical study are presented here, as the results of the economic assessment have been published previously.

The prognostic significance of lymphovascular invasion on biopsy specimens in lung cancer treated with definitive chemoradiotherapy.

Purpose: This study aims to determine prognostic factors for patients who have non-small-cell lung cancer (NSCLC) that is treated with definitive chemoradiation therapy.

Materials And Methods: Seventy-eight patients has been treated with radiation therapy and concomitant or sequential chemotherapy between 2000 and 2005. Paraffin-embedded biopsy specimens were obtained before treatment from 73 patients and reviewed by two independent pathologists.

Male pattern baldness and the risk of prostate cancer.

Background: Androgens play a role in the development of both androgenic alopecia, commonly known as male pattern baldness, and prostate cancer. We set out to study if early-onset androgenic alopecia was associated with an increased risk of prostate cancer later in life.

Patients And Methods: A total of 669 subjects (388 with a history of prostate cancer and 281 without) were enrolled in this study.

70 Gy versus 80 Gy in localized prostate cancer: 5-year results of GETUG 06 randomized trial.

Purpose: To perform a randomized trial comparing 70 and 80 Gy radiotherapy for prostate cancer.

Patients And Methods: A total of 306 patients with localized prostate cancer were randomized. No androgen deprivation was allowed.

Quality of life assessment after concurrent chemoradiation for invasive bladder cancer: results of a multicenter prospective study (GETUG 97-015).

Purpose: To evaluate bladder preservation and functional quality after concurrent chemoradiotherapy for muscle-invasive cancer in 53 patients included in a Phase II trial.

Patient And Methods: Pelvic irradiation delivered 45 Gy, followed by an 18-Gy boost. Concurrent chemotherapy with cisplatin and 5-fluorouracil by continuous infusion was performed at Weeks 1, 4, and 7 during radiotherapy.

[PSA kinetics after radiotherapy].

The prostate specific antigen (PSA) is the best marker of the prostate cancer today although not very specific of this pathology. The dynamic interpretation of this marker always has to prevail over that of overtaking a threshold. After radiotherapy, PSA can decrease after a mean interval of one to two years to a value less than 1 microg/L (predictive of recurrence-free survival).

Basic fibroblast growth factor-2/beta3 integrin expression profile: signature of local progression after chemoradiotherapy for patients with locally advanced non-small-cell lung cancer.

Purpose: No biologic signature of chemoradiotherapy sensitivity has been reported for patients with locally advanced non-small-cell lung cancer (NSCLC). We have previously demonstrated that basic fibroblast growth factor (FGF-2) and alphavbeta3 integrin pathways control tumor radioresistance. We investigated whether the expression of the proteins involved in these pathways might be associated with the response to treatment and, therefore, the clinical outcome.

Ejaculatory function after permanent 125I prostate brachytherapy for localized prostate cancer.

Purpose: Ejaculatory function is an underreported aspect of male sexuality in men treated for prostate cancer. We conducted the first detailed analysis of ejaculatory function in patients treated with permanent (125)I prostate brachytherapy for localized prostate cancer.

Patients And Methods: Of 270 sexually active men with localized prostate cancer treated with permanent (125)I prostate brachytherapy, 241 (89%), with a mean age of 65 years (range, 43-80), responded to a mailed questionnaire derived from the Male Sexual Health Questionnaire regarding ejaculatory function.

[Pathological stage T3 prostate cancer after radical prostatectomy: a retrospective study of 246 cases].

Objective: To determine the survival and prognosis criteria of pT3NxM0 prostate tumours (TNM 2002) after radical retropubic prostatectomy (RRP).

Material And Methods: Between 1988 and 2000, 606 consecutive RRP were performed for T1-3 tumours, whose 246 (40.6%) specimens were classified pT3, followed in 53 cases by adjuvant radiotherapy and in 71 cases by salvage radiotherapy.