Publications by authors named "Crehange G"

Purpose: This review systematically investigates the role of radiomics in radiotherapy, with a particular emphasis on the use of quantitative imaging biomarkers for predicting clinical outcomes, assessing toxicity, and optimizing treatment planning. While the review encompasses various applications of radiomics in radiotherapy, it particularly highlights its potential for guiding reirradiation of recurrent cancers.

Methods: A systematic review was conducted based on a Medline search with the search engine PubMed using the keywords "radiomics or radiomic" and "radiotherapy or reirradiation".

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Article Synopsis
  • Proton Minibeam Radiation Therapy (pMBRT) is a unique technique that modulates radiation dose delivery to potentially enhance anti-tumor immune responses while impacting treatment outcomes through specific dosimetric parameters like peak and valley doses.* -
  • The study used an orthotopic rat model of glioblastoma to explore how different pMBRT configurations influence survival and immune response, finding that higher dose heterogeneity and maintaining a minimum valley dose improved overall outcomes.* -
  • Results indicated that optimizing both peak doses and valley doses led to better tumor eradication and less immunosuppression, contrasting with traditional proton therapy that usually creates uniform dose distributions.*
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Herein, we provide a non-exhaustive selection of the main clinical trials presented in 2023-2024 related to radiation-oncology used in the treatment of urological cancers including prostate cancer (radiotherapy of localized prostate cancer, post-prostatectomy irradiation, reirradiation, biochemical recurrence following local treatment, radiotherapy for metastatic cancer), muscle invasive bladder cancer and primary kidney cancer.

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  • Metastatic urothelial carcinoma (mUC) is a dangerous cancer with few treatment options, and its genetic makeup is not fully understood unlike non-metastatic urothelial carcinoma (UC).
  • A study analyzing genetic data from 111 mUC biopsies found that common genetic changes are similar to those seen in primary UC and highlighted mutational signatures related to APOBEC, platinum sensitivity, and homologous recombination deficiency.
  • The research revealed that a significant portion of mUC patients have potential therapeutic targets, with the most common being FGFR3, ERBB2, TSC1, and PIK3CA, and noted that certain genes like NECTIN4 and TACSTD2 are consistently highly expressed across different
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Purpose: Prostate cancer is the most frequent cancer among men and radiotherapy hypofractionation regimens have become standard treatments for the localized stages, but the absence of increased risk of acute and late genitourinary or gastrointestinal toxicity of the dose escalation still must be demonstrated.

Material And Methods: The study population included all patients with localized prostatic adenocarcinoma treated at the institut Curie from February 2016 to March 2018 by external radiation delivered by a linear accelerator using an image-guided conformal intensity modulation technique at a total dose of 75Gy in 30 fractions of 2.5Gy in the planning target volume that included the prostate and the proximal seminal vesicles, and could be paired with a prophylactic lymph node radiotherapy at 46Gy in 23 fractions with simultaneous integrated boost.

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Purpose: The optimal management of locally recurrent prostate cancer after definitive irradiation is still unclear but local salvage treatments are gaining interest. A retrospective, single-institution analysis of clinical outcomes and treatment-related toxicity after salvage I-125 low-dose-rate (LDR) brachytherapy (BT) for locally-recurrent prostate cancer was conducted in a Comprehensive Cancer Center.

Patients And Methods: A total of 94 patients treated with salvage LDR-BT between 2006 and 2021 were included.

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Purpose: The occurrence of genitourinary (GU) toxicity is a common adverse event observed after external beam radiation therapy (EBRT) for prostate cancer (PCa). Recent findings suggest that the dose delivered to specific urinary organs at risk (OARs) such as the ureters, bladder trigone, and urethra is involved in the development of GU toxicity.

Methods And Materials: A multidisciplinary task force including 3 radiation oncologists, a uroradiologist, and a urologist was created in 2022.

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Purpose: The increased risk of second cancer after prostate radiotherapy is a debated clinical concern. The objective of the study was to assess the risk of occurrence of second cancers after prostate radiation therapy based on the analysis the literature, and to identify potential factors explaining the discrepancies in results between studies.

Materials And Methods: A review of the literature was carried out, comparing the occurrence of second cancers in patients all presenting with prostate cancer, treated or not by radiation.

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Despite several improvements in outcomes, metastatic prostate cancer remains deadly. Alterations in the homologous recombination repair (HRR) pathway are associated with more aggressive disease. Olaparib and rucaparib, two poly-ADP-ribose polymerase (PARP) inhibitors, have received approval from the authorities of several countries for their anti-tumoral effects in patients with metastatic castration-resistant prostate cancers harboring HRR gene alterations, in particular .

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  • The study evaluates the effectiveness of a combination treatment involving abiraterone acetate plus prednisone, prostate bed radiotherapy, and goserelin in men experiencing biochemical recurrence after prostatectomy, focusing on the potential role of circulating tumor cells (CTCs).
  • Conducted as a phase 2 trial with 46 participants over a median follow-up of 47 months, the results reported a 3-year biochemical recurrence-free survival rate of 81.5% and an alternative rate of 95.6%.
  • Common side effects included acute issues like pollakiuria during radiotherapy and long-term effects like urinary incontinence, while non-radiotherapy-related side effects included hot flashes and hypertension, with a CTC count ≥5 linked to
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Introduction: This document is a summary of the French intergroup guidelines of the management of biliary tract cancers (BTC) (intrahepatic, perihilar and distal cholangiocarcinomas, and gallbladder carcinomas) published in September 2023, available on the website of the French Society of Gastroenterology (SNFGE) (www.tncd.org).

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  • Androgen deprivation therapy (ADT) combined with elective nodal radiotherapy (ENRT) shows promising long-term outcomes for men with limited prostate cancer recurrence, specifically targeting pelvic lymph nodes.
  • In a trial involving 67 patients, after a median follow-up of over 6 years, a significant proportion experienced prolonged tumor control with manageable levels of toxicities.
  • After 5 years, about one-third of patients remained free from biochemical relapse, highlighting ENRT's effectiveness in maintaining remission and delaying disease progression.
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  • Radiation therapy is important for treating advanced lung cancer, but it can cause a problem called radiation pneumonitis (RP), which affects breathing.
  • A study looked at 80 articles to find out how doctors can use tests to predict who might get RP and to help plan better treatments.
  • The study found that older patients and those with certain lung conditions had a higher risk of RP, and they suggested a checklist to help identify patients at risk before treatment starts.
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  • Standard care for non-metastatic squamous cell carcinoma of the anus involves chemoradiotherapy, but there's limited data on how elderly patients (≥75 years) respond compared to younger patients (<75 years).
  • A study analyzed 1015 patients from the FFCD-ANABASE cohort; 202 were elderly, revealing that they had different demographics and treatment characteristics but similar outcomes (overall survival, recurrence-free survival, and colostomy-free survival) to younger patients.
  • The results suggest that age does not significantly affect treatment outcomes for non-metastatic SCCA, indicating that elderly patients should receive optimal curative treatment similar to younger patients.
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The aim of this study was to systematically review the current evidence regarding the oncological and functional outcomes of salvage radical prostatectomy (sRP) for recurrent prostate cancer. A systematic review was conducted throughout September 2022 using the PubMed, Science Direct, Scopus, and Embase databases. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies.

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Prostate cancer is the most common cancer and the third leading cause of cancer mortality in men. Each year, approximately 10% of prostate cancers are diagnosed metastatic at initial presentation. The standard treatment option for de-novo metastatic prostate cancer is androgen deprivation therapy with novel hormonal agent or with chemotherapy.

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Prostate cancer (PCa) is a public health issue. The diagnostic strategy for PCa is well codified and assessed by digital rectal examination, PSA testing and multiparametric MRI, which may or may not lead to prostate biopsies. The formal benefit of organized PCa screening, studied more than 10 years ago at an international scale and for all incomers, is not demonstrated.

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Up to 50% of patients treated with radical surgery for localized prostate cancer may experience biochemical recurrence that requires appropriate management. Definitions of biochemical relapse may vary, but, in all cases, consist of an increase in a PSA without clinical or radiological signs of disease. Molecular imaging through to positron emission tomography has taken a preponderant place in relapse diagnosis, progressively replacing bone scan and CT-scan.

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Context: Erectile dysfunction represents a major side effect of prostate cancer (PCa) treatment, negatively impacting men's quality of life. While radiation therapy (RT) advances have enabled the mitigation of both genitourinary and gastrointestinal toxicities, no significant improvement has been showed in sexual quality of life over time.

Objective: The primary aim of this review was to assess sexual structures' dose-volume parameters associated with the onset of erectile dysfunction.

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Purpose: During prostatic radiotherapy, damage to several anatomical structures could be the cause of erectile dysfunction: corpora cavernosa, internal pudendal arteries, penile bulb, and neurovascular bundles. Numerous studies have analysed the correlations between the dose received by these structures and erectile function. The objective of this article is to make a systematic review on current knowledge.

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Background: To investigate the outcomes of patients who underwent curative reirradiation (reRT), with intensity-modulated radiation therapy (IMRT) or proton therapy (PT) for unresectable recurrent or second primary head and neck adenoid cystic carcinoma (HNACC).

Methods: Ten patients, mostly KPS 90%, were reirradiated (3/10 with IMRT and 7/10 with PT) at a median maximum dose to the CTV of 64.2 Gy from July 2011 to November 2021.

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Purpose: Clinical target volume (CTV) delineation for pelvic lymph nodes in prostate cancer is currently based on 3 consensus guidelines with some inherent discrepancies. To improve the reproducibility in nodal delineation, the Francophone Group of Urological Radiotherapy (Groupe Francophone de Radiothérapie Urologique [GFRU]) worked toward proposing an easily applicable, reproducible, and practice-validated contouring guideline for pelvic nodal CTV.

Methods And Materials: The nodal CTV data sets of a high-risk node-negative prostate cancer clinical case contoured by 86 radiation oncologists participating in a GFRU contouring workshop were analyzed.

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Article Synopsis
  • The study looked at how doctors treat a type of brain cancer called primary central nervous system lymphoma (PCNSL) using radiation therapy.
  • Researchers checked the records of 79 patients who had this treatment between 2011 and 2018, and found that many doctors didn’t follow the recommended radiation doses and areas that should be treated.
  • The study suggests that doctors should better follow guidelines for radiation to help patients survive longer and avoid cancer coming back, and they recommend updating these guidelines.
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