Publications by authors named "Jean Michel Grellard"

Background: Proton therapy (PRT) is an innovative radiotherapeutic modality for the treatment of cancer with unique ballistic properties. The depth-dose distribution of a proton beam reduces exposure of healthy tissues to radiations, compared with photon-therapy (XRT). To date, only few indications for proton-therapy, like pediatric cancers, chordomas, or intra-ocular neoplasms, are reimbursed by Health systems.

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Background: Radiotherapy has both immunostimulant and immunosuppressive effects, particularly in radiation-induced lymphopenia. Proton therapy has demonstrated potential in mitigating this lymphopenia, yet the mechanisms by which different types of radiation affect the immune system function are not fully characterized. The Circulating Immunes Cells, Cytokines and Brain Radiotherapy (CYRAD) trial aims to compare the effects of postoperative X-ray and proton radiotherapy on circulating leukocyte subpopulations and cytokine levels in patients with head and neck (CNS and ear nose throat) cancer.

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Background: Patients with breast cancer (BC) exhibit circadian rhythm disruptions, mainly of rest-activity rhythm (RAR), of which sleep is an essential component, and cortisol rhythm. Sleep complaints such as insomnia and cognitive impairments are prevalent in BC. In general population, sleep is known to contribute greatly to cognition.

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  • The study investigates whether F18-choline (FCH) PET/CT can effectively replace Tc99m-sestaMIBI (MIBI) SPECT/CT for preoperative imaging of parathyroid adenomas in patients with primary hyperparathyroidism (PHPT).
  • It involves a randomized trial across multiple centers in France, enrolling adults eligible for surgery from November 2019 to May 2022, excluding those with prior parathyroid surgery or certain genetic conditions.
  • The primary goal is to compare the success rates of minimally invasive parathyroidectomy guided by these imaging techniques, focusing on patients achieving normal calcium levels one month after surgery.
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Objective: This multicenter study aimed to retrospectively evaluate the impact of high boost simultaneous integrated boost (SIB) to pathologic lymph nodes compared to Sequential boost (Seq) in patients with locally advanced cervical cancer (LACC).

Materials And Methods: 97 patients with pelvic and/or para-aortic (PAo) node-positive LACC treated by definitive chemoradiation were included. Two groups were analyzed: Sequential boost group and simultaneous integrated boost (SIB) group.

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  • Elderly cancer patients, especially those over 70, can have trouble with thinking clearly, which affects their daily lives.
  • This study looked at how well these patients could use a digital brain training app and whether they liked it.
  • Out of 240 patients checked, about 145 were able to participate in the study to see if the app helped them improve their memory and thinking skills.
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Background: Many patients treated for breast cancer (BC) complain about cognitive difficulties affecting their daily lives. Recently, sleep disturbances and circadian rhythm disruptions have been brought to the fore as potential contributors to cognitive difficulties in patients with BC. Yet, studies on these factors as well as their neural correlates are scarce.

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  • The study focuses on the psychological impact of COVID-19 on older versus younger cancer patients, specifically looking at PTSD symptoms and Quality of Life (QoL).
  • It included 579 patients and used various standardized questionnaires to assess mental health and QoL over a year, with data collected at multiple points during lockdowns and release periods in France.
  • Results showed older patients reported fewer PTSD symptoms and insomnia at the beginning, but cognitive complaints increased over time, eventually matching those of younger patients, with no major differences in the overall mental health trajectory between the two age groups.
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Background: Triple negative breast cancers (TNBC) account for approximately 15% of all breast cancers and are associated with a shorter median survival mainly due to locally advanced tumor and high risk of metastasis. The current neoadjuvant treatment for TNBC consists of a regimen of immune checkpoint blocker and chemotherapy (chemo-ICB). Despite the frequent use of this combination for TNBC treatment, moderate results are observed and its clinical benefit in TNBC remains difficult to predict.

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Background: Non-metastatic breast cancer treatment is mainly based on surgery, with or without chemotherapy, radiotherapy and/or hormone therapy. To reduce the risk of hormone receptor positive (HR+) disease recurrence, hormone therapy is prescribed for at least 5 years. It may induce adverse drug reactions (ADRs) as joint pain, sexual dysfunction, weight increase, fatigue, mood disorders and vasomotor symptoms.

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Introduction: COVID-19 outbreak rapidly spread since early 2020 leading to the implementation of nationwide lockdowns. To cope with this sudden change, management guidelines were quickly published to adapt oncological care, with potential impact on cancer outcomes.

Methods: We conducted a retrospective comparative cohort study to assess the impact of the COVID-19 outbreak in 2020 on cancer outcomes in metastatic patients.

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Background: Radiotherapy is one of the cornerstones of the treatment of Head and Neck Squamous Cell Carcinomas (HNSCC). However, radioresistance is associated with a high risk of recurrence. To propose strategies (such as combinations with drugs) that could over intrinsic radioresistance, it is crucial to predict the response to treatment.

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Background: Patients with cancer may be particularly vulnerable to psychological consequences of the COVID-19 pandemic. We studied the prevalence and evolution of posttraumatic stress symptoms (PTSS) in patients with cancer during the pandemic waves, and we investigated factors associated with high symptoms.

Methods: COVIPACT is a 1-year longitudinal prospective study of French patients with solid/hematologic malignancies receiving treatment during the first nationwide lockdown.

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Background: Previous reports showed limited efficacy of immune checkpoint inhibitors as single-agent treatment for non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation or ALK/ROS1 fusion. We aimed at evaluating the efficacy and safety of immune checkpoint inhibitor combined with chemotherapy and bevacizumab (when eligible) in this patient subgroup.

Methods: We conducted a French national open-label multicentre non-randomised non-comparative phase II study in patients with stage IIIB/IV NSCLC, oncogenic addiction (EGFR mutation or ALK/ROS1 fusion), with disease progression after tyrosine kinase inhibitor and no prior chemotherapy.

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Background: Urothelial carcinoma (UC) is the ninth most commonly diagnosed cancer worldwide, with a 3.8/1 male to female ratio. Platinum-based chemotherapy is the first line standard of care for fit patients with advanced UC.

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Introduction: We aimed to study post-traumatic stress disorder (PTSD) symptoms in breast cancer (BC) patients during the coronavirus disease (COVID-19) pandemic.

Materials And Methods: We included BC patients receiving medical treatment during the first COVID-19 lockdown in France. PTSD symptoms were evaluated using the Impact of Event Scale-Revised (IES-R) questionnaire.

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Article Synopsis
  • The study investigates the relationship between sleep quality and prospective memory (PM) performance in breast cancer (BC) patients, who often experience sleep disturbances and PM impairments.
  • A virtual reality task was used to assess PM in 37 early-stage BC patients and 21 healthy controls (HC), measuring their memory performance after a period of sleep versus wakefulness.
  • Results showed that sleep improved PM for both groups, but BC patients reported more sleep issues, which correlated with poorer ability to retrieve intentions and higher levels of psychological distress, fatigue, and lower well-being.
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  • Germ cell tumors and sex cord stromal tumors are rare ovarian cancers primarily affecting young women, generally treated with conservative surgery and chemotherapy (BEP), which may lead to long-term health issues.
  • The GINECO-VIVROVAIRE study aims to evaluate chronic fatigue, quality of life, and long-term side effects of chemotherapy, especially concerning cardiovascular and pulmonary health in survivors.
  • The study involves comparing 134 ovarian cancer survivors treated with surgery and chemotherapy to control groups, and further medical evaluations will be conducted on a subgroup to assess long-term effects and associated costs.
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Cancer-related cognitive impairment (CRCI) is a frequent side-effect of cancer treatment, with important consequences on patients' quality of life. Cognitive stimulation and physical activity are the most efficient in improving cognitive impairment, but they are challenging to generalize in hospitals' routine and to patients' needs and schedules. Moreover, the added value of a combination of these interventions needs to be more investigated.

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Rest-activity rhythm (RAR) disruptions are frequently associated with chemotherapy in breast cancer (BC), but they are less known in BC with endocrine therapy (ET). The aim of this ancillary study was to characterize the RAR and estimated sleep characteristics from actigraphy in BC patients either treated (ET+) or untreated with ET (ET-), compared to healthy controls (HC) and using a cross-sectional design. Eighteen ET+, 18 ET-, and 16 HC completed questionnaires and wore wrist actigraphs at home for 2 weeks.

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Article Synopsis
  • The study investigated the impact of the COVID-19 pandemic on patients with cancer, focusing on the occurrence of PTSD symptoms and changes in their medical care during lockdown.
  • Conducted in France, the research involved 734 patients and found that 21% experienced PTSD, with higher rates among women and those with treatment adjustments.
  • Results showed that PTSD symptoms negatively affected patients’ quality of life, cognition, and increased insomnia, highlighting the need for support during such traumatic events.
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Background: The common endocrine disorder primary hyperparathyroidism (PHPT) can be cured by surgery. Preoperative localization of parathyroid adenoma (PTA) by imaging is a prerequisite for outpatient minimally invasive parathyroidectomy (MIP). Compared to inpatient bilateral cervical exploration (BCE) which is performed if imaging is inconclusive, MIP is superior in terms of cure and complication rates and less costly.

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Refining the risk of malignancy in patients presenting with thyroid nodules with indeterminate cytology (IC) is a critical challenge. We investigated the performances of F-fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) to predict malignancy. Between May 2016 and March 2019, 107 patients presenting with a thyroid nodule ≥15 mm with IC and eligible for surgery were included in this prospective study.

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Cognitive complaints are common adverse effects in cancer patients. Identifying subjects at risk could make it possible to limit their impact. We aimed to explore the relationship between current cognitive complaints and demographic and psychological factors in a group of breast cancer survivors.

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Background: There is no treatment for cancer-related cognitive impairment, an important adverse effect that negatively impacts quality of life (QOL). We conducted a 3-arm randomized controlled trial to evaluate the impact of computer-assisted cognitive rehabilitation (CR) on cognition, QOL, anxiety, and depression among cancer patients treated with chemotherapy.

Methods: Patients who reported cognitive complaints during or after completing chemotherapy were randomly assigned to 1 of 3 12-week CR programs: computer-assisted CR with a neuropsychologist (experimental group A), home cognitive self-exercises (active control group B), or phone follow-up (active control group C).

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