Publications by authors named "D Williaume"

Purpose: The optimal neoadjuvant treatment for resectable carcinoma of the thoracic esophagus (TE) or gastroesophageal junction (GEJ) remains a matter of debate. We performed an individual participant data (IPD) network meta-analysis (NMA) of randomized controlled trials (RCTs) to study the effect of chemotherapy or chemoradiotherapy, with a focus on tumor location and histology subgroups.

Patients And Methods: All, published or unpublished, RCTs closed to accrual before December 31, 2015 and having compared at least two of the following strategies were eligible: upfront surgery (S), chemotherapy followed by surgery (CS), and chemoradiotherapy followed by surgery (CRS).

View Article and Find Full Text PDF

The development of stereotaxic body radiotherapy in the last decade has forced the radiotherapy departments to redouble their efforts in the fields of quality and risk management. For this purpose, increasingly complex and rigorous controls of high performance machines as well as a solid team training must be put in place. Extreme hypofractionation requires both increased vigilance at the treatment desk and well-defined and known procedures.

View Article and Find Full Text PDF

External beam radiotherapy is extensively used to treat cervical carcinomas. A single planning CT scan enables the calculation of the dose distribution. The treatment is delivered over five weeks.

View Article and Find Full Text PDF

Purpose: In the context of adaptive radiation therapy (ART) for locally advanced cervical carcinoma (LACC), this study proposed an original cone-beam computed tomography (CBCT)-guided "Evolutive library" and evaluated it against four other known radiotherapy (RT) strategies.

Material And Methods: For 20 patients who underwent intensity-modulated radiation therapy (IMRT) for LACC, three planning CTs [with empty (EB), intermediate (IB), and full (FB) bladder volumes], a CT scan at 20 Gy and bi-weekly CBCTs for 5 weeks were performed. Five RT strategies were simulated for each patient: "Standard RT" was based on one IB planning CT; "internal target volume (ITV)-based RT" was an ITV built from the three planning CTs; "RT with one mid-treatment replanning (MidTtReplan)" corresponded to the standard RT with a replanning at 20 Gy; "Pretreatment library ART" using a planning library based on the three planning CTs; and the "Evolutive library ART", which was the "Pretreatment library ART" strategy enriched by including some CBCT anatomies into the library when the daily clinical target volume (CTV) shape differed from the ones in the library.

View Article and Find Full Text PDF

Purpose: To describe the evolution and to assess the predictive value of metabolic parameters with different SUV threshold segmentations calculated from two 18F-FDG-PET/CT, one prior to and the other one during concomitant chemoradiation therapy (CCRT), for locally-advanced cervical cancer (LACC).

Material And Methods: 53 patients treated for LACC by CCRT underwent FDG-PET/CT before treatment (PET1) and another one at 40Gy (PET2). The PET analyzed parameters were: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG).

View Article and Find Full Text PDF