Publications by authors named "Noel Georges"

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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  • * Factors like tumor heterogeneity, genomic instability, angiogenesis, and chronic hypoxia contribute to this recurrence by making GBM more resistant to therapies.
  • * The review will explore how chronic hypoxia leads to genetic and epigenetic changes that aid GBM survival and will also propose personalized treatment strategies using a proteomics-based hypoxia signature.
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Neuroendocrine pituitary tumor, a benign cells proliferation, can cause significant morbidity due to its local invasiveness and secretory properties. Historically, radiotherapy has been employed as a second or third-line treatment option, with studies dating back to the mid-20th century. However, advancements in radiotherapy techniques, such as intensity-modulated radiation therapy (IMRT), stereotactic radiosurgery, and proton therapy, have revolutionized treatment approaches.

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  • Brain radiation necrosis (BRN) is a serious complication of stereotactic radiotherapy, making it crucial to differentiate it from tumor recurrence using advanced diagnostic techniques.
  • BRN often appears months to years after treatment, with symptoms and MRI changes, influenced by factors like the amount of brain tissue irradiated and radiation dose.
  • Management strategies vary; asymptomatic cases may require monitoring, while symptomatic BRN typically responds to corticosteroids, and emerging treatments like bevacizumab show promise; ongoing research aims to improve outcomes for patients.
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Purpose: Patients with IDH-mutant 1p/19q-codeleted grade 3 oligodendroglioma (O3) benefit from adding alkylating agent chemotherapy to radiotherapy (RT). However, the optimal chemotherapy regimen between procarbazine, 1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), and vincristine (PCV) and temozolomide (TMZ) remains unclear given the lack of randomized trial data comparing both regimens.

Methods: The objective was to assess the overall survival (OS) and progression-free survival (PFS) associated with first-line PCV/RT versus TMZ/RT in patients newly diagnosed with O3.

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Unlabelled: The EORTC 22922/10925 trial aimed to investigate the impact on overall survival (OS) of elective internal mammary and medial supraclavicular (IM-MS) radiation therapy (RT) in breast cancer stage I-III. Surgery for the primary tumour and axillary lymph nodes, chest wall RT, boost RT after whole breast RT in breast conserving therapy (BCT), RT to operated axilla, and systemic therapy were per physician's preference. The aim of the current analysis is to assess breast cancer outcomes according to different locoregional and systemic therapy used in the trial.

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The radiobiology of tumor reirradiation is poorly understood. It pertains to tumors and their sensitivity at the time of relapse, encompassing primary tumors, metastases, or secondary cancers developed in or proximal to previously irradiated tissues. The ability to control the pathology depends, in part, on understanding this sensitivity.

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Autophagy is an innate cellular process characterized by self-digestion, wherein cells degrade or recycle aged proteins, misfolded proteins, and damaged organelles via lysosomal pathways. Its crucial role in maintaining cellular homeostasis, ensuring development and survival is well established. In the context of cancer therapy, autophagy's importance is firmly recognized, given its critical impact on treatment efficacy.

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Radiotherapy (RT) is an integral part of managing pediatric brain tumors, yet many patients develop tumor radioresistance, leading to recurrence and poor clinical outcomes. In addition, neurocognitive impairment is a common long-term side effect of RT, significantly impairing quality of life. Indeed, increasing evidence suggests that the developing child's brain is particularly vulnerable to the neurotoxic effects of ionizing radiation.

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  • Dedicated brain imaging for cancer patients is rarely recommended unless symptoms arise, and brain metastases are often difficult to identify on non-enhanced CT (NE-CT).
  • This research aims to create a 3D Convolutional Neural Network (3D-CNN) using NE-CT scans to effectively distinguish between cancer patients with and without brain metastases.
  • The study utilized a dataset of 200 patients (100 with and 100 without brain abnormalities), achieving high accuracy (ACC of 0.983) and sensitivity (0.983) in detecting brain metastases, indicating the potential for a reliable diagnostic tool with further validation needed.
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Purpose: Neurocytomas represent 0.25 to 0.5% of primary brain tumours and are mainly found in young adults.

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Background: Brain metastases (BMs) frequently occur in cancer patients, and stereotactic radiation therapy (SRT) is a preferred treatment option. In this retrospective study, we analyzed patients treated by SRT for a single BM during their first SRT session and we compared two subgroups: "Cohort 1" with patients did not undergo cerebral re-irradiation and "Cohort 2" with patients received at least one subsequent SRT session for cerebral recurrence.

Methods: We included patients who received SRT for a single BM between January 2010 and June 2020.

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Glioblastoma multiforme (GBM) is the most common adult primary brain tumor. The standard clinical treatment of GBM includes a maximal surgical resection followed by concomitant radiotherapy (RT) and chemotherapy sessions with Temozolomide (TMZ) in addition to adjuvant TMZ cycles. Despite the severity of this protocol, GBM is highly resistant and recurs in almost all cases while the protocol remains unchanged since 2005.

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  • Sclerosing epithelioid fibrosarcoma (SEF) is a rare type of cancer characterized by specific cell arrangements and unique traits, including a distinct immunohistochemical pattern and gene rearrangements involving EWSR1 and CREB3L genes.
  • Although typically found in deep soft tissues, SEF can also occur in bones and other organs; however, this report highlights a rare case of SEF originating in the brain, specifically the left occipital region.
  • The study discusses the necessary differential diagnoses for brain tumors and provides a detailed genetic and epigenetic comparison of this brain tumor to more common systemic cases of SEF.
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Introduction: Soft tissue sarcomas of the extremities (ESTSs) pose significant challenges in treatment and management due to their diverse nature and potential complications. This study aimed to assess complications associated with multimodal treatments involving surgery and radiotherapy (RT) and to identify potential risk factors.

Methods: We retrospectively analyzed nonmetastatic ESTS patients treated with surgery and pre- or post-operative RT between 2007 and 2020 in Strasbourg, France.

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Background And Purpose: Stereotactic radiation therapy (SRT) is commonly used to treat brain metastases (BMs). This retrospective study compared two SRT techniques, dynamic conformal arc therapy (DCAT) and volumetric modulated arc therapy (VMAT), for single BM treatments.

Material And Methods: Data of patients treated between January 2010 and June 2020 were considered.

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Background: Radio(chemo)therapy is often required in pelvic malignancies (cancer of the anus, rectum, cervix). Direct irradiation adversely affects ovarian and endometrial function, compromising the fertility of women. While ovarian transposition is an established method to move the ovaries away from the radiation field, surgical procedures to displace the uterus are investigational.

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  • * A total of 169 patients were analyzed, with a median age of 64; results showed high local control (91.7% at 5 years) but indicated worse survival rates for those with deeper or higher-grade tumors.
  • * The findings concluded that RT combined with surgery was effective and well-tolerated, with IMRT improving local control compared to conventional methods, while patients with liposarcoma showed better overall survival rates.
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Purpose: High-risk (HR) prostate cancer patients usually receive high-dose radiotherapy (RT) using a two-phase sequential technique, but data on a simultaneous integrated boost (SIB) technique are lacking. We prospectively evaluated the long-term results of urinary (GU) and digestive (GI) toxicity and survival data for high-dose RT using a SIB technique in HR and very high-risk (VHR) prostate cancer.

Methods: Patients were treated using an SIB technique in 34 fractions, at a dose of 54.

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Background: The main advantages of stereotactic radiotherapy (SRT) are to delay whole-brain radiotherapy (WBRT) and to deliver ablative doses. Despite this efficacy, the risk of distant brain metastases (BM) one year after SRT ranges from 26% to 77% and 20 to 40% of patients required salvage treatment. The role and consequences of reirradiation remain unclear, particularly in terms of survival.

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Introduction: Radiotherapy has significantly improved cancer survival rates, but it also comes with certain unavoidable complications. Breast and thoracic irradiation, for instance, can unintentionally expose the heart to radiation, leading to damage at the cellular level within the myocardial structures. Detecting and monitoring radiation-induced heart disease early on is crucial, and several radionuclide imaging techniques have shown promise in this regard.

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Soft tissue sarcomas of the extremities are rare tumors with various prognostic factors. Their management is debatable due to their inconsistent results within the literature and the lack of large prospective studies. The objective of this systematic review is to analyze the available scientific data on prognostic factors concerning the characteristics of the patients, the disease and the treatments performed, as well as their potential complications, on studies with a median follow-up of 5 years at minimum.

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Background: Glioblastoma (GBM) is a malignant primary brain cancer, among the most devastating and lethal diseases of the central nervous system. Similarly, malignant melanoma (MM) is responsible for most skin cancer-related deaths. A link between those 2 aggressive cancers has not yet been established.

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