Publications by authors named "Emmanuel Rio"
Introduction: The impact of pelvic irradiation on kidney transplant surgery is still unclear. The main objective of our study is to evaluate the feasibility and the safety of renal transplantation following pelvic radiotherapy.
Methods: We collected characteristics and kidney transplant data from patients with a history of pelvic cancer treated with pelvic irradiation between 2005 and 2021.
Article Synopsis
- 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
Cryotherapy is an ablative therapy that can be used to treat localized prostate cancer. In case of recurrence, treatment options are not well-defined, and their outcomes are unknown. We therefore collected all patients treated with radiotherapy after cryotherapy for prostate cancer recurrence in Nantes (France) between 2012 and 2019.
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- * Evidence suggests SRT is feasible and can effectively manage biochemical control with acceptable late toxicity rates.
- * The lack of comparative trials and the variability in patient treatment underscore the importance of careful decision-making and advocate for patient participation in clinical trials to better evaluate SRT's safety and effectiveness.
Article Synopsis
- The study investigates the risk of coronary artery disease (CAD) in prostate cancer patients requiring androgen deprivation therapy (ADT), highlighting the lack of clear guidelines for cardiology referrals.
- A systematic cardio-onco evaluation at the Western Cancer Institute found that 20.6% of evaluated patients were newly diagnosed with CAD, often while being asymptomatic.
- The results suggest a significant need for CAD screening in this patient group, as more than half of those evaluated required therapeutic interventions without any recorded cardiac deaths during the follow-up period.
Background: Results from the phase 3 PRODIGE 23 study showed that neoadjuvant chemotherapy (NAC) with mFOLFIRINOX and preoperative chemoradiotherapy improved disease-free survival compared with preoperative chemoradiotherapy in patients with locally advanced rectal cancer. We aimed to assess the health-related quality of life (HRQOL) outcomes from this study.
Patients And Methods: A total of 461 patients (231 versus 230 patients) from 35 French hospitals were randomly assigned to either NAC with FOLFIRINOX (oxaliplatin 85 mg/m, irinotecan 180 mg/m, leucovorin 400 mg/m, fluorouracil 2400 mg/m over 46 h intravenously every 2 weeks for 6 cycles) followed by preoperative chemoradiotherapy or chemoradiotherapy only.
Article Synopsis
- - Patients with oligometastatic prostate cancer (having up to 5 metastases) generally have a better prognosis than those with more extensive disease, making this a crucial area for treatment investigation.
- - The study investigates whether combining stereotactic body radiotherapy (SBRT) with the immune checkpoint inhibitor durvalumab can improve progression-free survival in these patients compared to SBRT alone.
- - This multicenter phase II trial will evaluate various outcomes, including quality of life and immune response, by enrolling 96 participants over three years, aiming to provide insights into better treatment strategies for prostate cancer.
Article Synopsis
- Transcatheter arterial chemoembolisation (TACE) is used for treating liver cancer patients who can't undergo curative therapies; this study compared TACE alone with TACE combined with external conformal radiotherapy (CRT).
- The trial involved 120 participants, mostly older males with alcohol-related liver issues, and aimed to assess liver progression-free survival (PFS) over 12 and 18 months.
- Results indicated that while the combined treatment (TACE + CRT) showed better local control, it did not significantly improve PFS or overall survival compared to TACE alone, and led to more serious liver-related side effects.
Article Synopsis
- The study aimed to assess the occurrence of the abscopal response (AR) in metastatic melanoma patients undergoing palliative radiotherapy, focusing on those receiving specific conditions of systemic treatments.
- Out of 118 patients analyzed, 15 (12.7%) exhibited an AR, showing significantly improved overall survival and progression-free survival compared to those without an AR.
- The findings suggest that AR is a rare but important indicator of better prognosis and may be enhanced by concurrent treatments like immunotherapy and infections during radiotherapy.
: Our objective was to develop a radiomics model based on magnetic resonance imaging (MRI) and contrast-enhanced computed tomography (CE-CT) to predict pathological complete response (pCR) to neoadjuvant treatment in locally advanced rectal cancer (LARC). All patients treated for a LARC with neoadjuvant CRT and subsequent surgery in two separate institutions between 2012 and 2019 were considered. Both pre-CRT pelvic MRI and CE-CT were mandatory for inclusion.
View Article and Find Full Text PDFBackground: Treatment of locally advanced rectal cancer with chemoradiotherapy, surgery, and adjuvant chemotherapy controls local disease, but distant metastases remain common. We aimed to assess whether administering neoadjuvant chemotherapy before preoperative chemoradiotherapy could reduce the risk of distant recurrences.
Methods: We did a phase 3, open-label, multicentre, randomised trial at 35 hospitals in France.
: Stereotactic body radiotherapy (SBRT) is a recognized treatment for colorectal cancer (CRC) metastases. We postulated that local responses could be improved by SBRT with a concomitant radiosensitizing agent (irinotecan). : RADIOSTEREO-CAMPTO was a prospective multi-center phase 2 trial investigating SBRT (40-48 Gy in 4 fractions) for liver and/or lung inoperable CRC oligometastases (≤3), combined with two weekly intravenous infusions of 40 mg/m Irinotecan.
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- - Oligometastatic prostate cancer (PCa) is being researched heavily with new PET tracers like F-choline and Ga-PSMA, showing promise in treatment by identifying limited metastases.
- - Treatment options like Stereotactic Body Radiation Therapy (SBRT) and lymph node dissection have demonstrated positive outcomes, including PSA response, lower toxicity, and benefits like delaying androgen deprivation therapy.
- - Despite promising findings, particularly for hormone-sensitive cases, there's limited data on treating oligoprogressive metastatic castration-resistant PCa, prompting ongoing studies and updated recommendations from key medical organizations to favor metastasis-directed therapies over observation.
Due to the heterogeneity of tumour mass segmentation methods and lack of consensus, our study evaluated the prognostic value of pretherapeutic positron emission tomography with fluorodeoxyglucose (FDG-PET) metabolic parameters using different segmentation methods in patients with localized anal squamous cell carcinoma (SCC). Eighty-one patients with FDG-PET before radiochemotherapy were retrospectively analyzed. Semiquantitative data were measured with three fixed thresholds (35%, 41% and 50% of Maximum Standardized Uptake Value (SUVmax)) and four segmentation methods based on iterative approaches (Black, Adaptive, Nestle and Fitting).
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- Among 202 patients analyzed, 57 were selected for having a high risk of lymph node involvement; the results revealed that a significant number of SLNs were missed by conventional treatment planning.
- Personalized targeting could ensure that more SLNs receive adequate radiation doses, potentially improving treatment outcomes by addressing lymph nodes likely to harbor cancerous cells.
Background: Recurrence and distant metastases remain a significant issue in locally advanced rectal cancer (LARC). Several multimodal strategies are assessed in clinical trials.
Patients And Methods: Patients with mid/low magnetic resonance imaging-defined high-risk LARC were randomized to arm A (12-week bevacizumab + FOLFOX-4 then bevacizumab-5-fluorouracil [5-FU]-radiotherapy [RT] before total mesorectal excision [TME]) or arm B (bevacizumab-5-FU-RT then TME).
Purpose: The ongoing phase 2/3 PRODIGE 26/CONCORDE trial compares chemoradiation therapy with and without dose escalation in patients with locally advanced or unresectable esophageal cancer. The results of a benchmark case procedure are reported here to evaluate the protocol compliance of participating centers as part of quality assurance for radiation therapy.
Methods And Materials: Volume delineation, target coverage, and dose constraints to the organs at risk (OARs) were assessed on treatment plans of a common benchmark case performed by each participating center.
Background And Purpose: Intensity-modulated radiation therapy (IMRT) is currently indicated to treat anal squamous cell carcinoma (ASCC). Conformal dose delivery and steep dose gradients may cause marginal misses. We analyzed patterns of locoregional recurrences (LRR) and delineation quality to determine IMRT-specific predictive factors.
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- - The BLINDED trial explored high-dose salvage pelvic radiation therapy for prostate cancer and assessed its early toxicity, considering the challenges of limited pelvic nodal relapse and concerns about treatment side effects.
- - A total of 67 patients participated in the study with a median age of 67.7 years; the trial found that acute urinary toxicity was experienced by 13.4% of patients, while 14.9% experienced acute digestive toxicity.
- - Overall, early toxicity rates were manageable, and quality of life assessments at one year post-treatment did not show significant deterioration among patients.
Background: To establish the maximum tolerated dose of abiraterone acetate plus prednisone (AA) combined with salvage radiotherapy (SRT) and goserelin in a phase 1 study in men with rising PSA following radical prostatectomy.
Methods: AA was given during one month before SRT at 1000 mg PO once daily, then 750 mg (Dose Level 1, DL1) or 1000 mg (DL2) during 5 months combined with 6-months goserelin by injection on the first day of irradiation (scheme NEO) or one month before starting SRT (scheme CONCO).
Results: In scheme NEO at DL1, 2/9 patients did not achieve castration levels of testosterone.
Background And Purposes: Early biomarkers of tumour response are needed to discriminate between responders and non-responders to radiotherapy. We evaluated the ability of ceramide, a bioactive sphingolipid, to predict tumour sensitivity in patients treated by hypofractionated stereotactic body radiation therapy (SBRT) combined with irinotecan chemotherapy.
Materials And Methods: Plasma levels of total ceramide and of its subspecies were measured before and during treatment in 35 patients with liver and lung oligometastases of colorectal cancer included in a phase II trial.
Background: Metastatic prostate cancer remains a common cause of death in Europe, and improvements in management of the disease are urgently needed. The advent of positron-emission tomography (PET) imaging enhanced with fluorocholine has led to the identification of a new sub-group of metastatic prostate cancer patients: those with so-called oligometastatic disease. Presenting with a low burden of metastatic disease (≤5 lesions), this new sub-group lies between true metastatic prostate cancer patients for whom androgen- deprivation therapy (ADT) is the mainstay of treatment, and patients with a rising PSA, but no visible lesion on conventional imaging, in whom intermittent ADT has been shown to be no less effective than continuous ADT.
View Article and Find Full Text PDFLow response rate after cetuximab combined with conventional chemoradiotherapy in patients with locally advanced anal cancer: long-term results of the UNICANCER ACCORD 16 phase II trial.
Radiother Oncol
March 2015
Aim: To develop novel biomarkers of rectal radiotherapy, we measured gene expression profiles on biopsies taken before and during preoperative radiotherapy.
Methods: Six patients presenting with a locally advanced rectal cancer (T>T2, N0/Nx, M0) eligible for preoperative radiotherapy (45 Gy in 25 fractions) were selected in a pilot study. Six tumor and 3 normal tissues biopsies were taken before and during radiotherapy, after a dose of 7.