Publications by authors named "Stephane Supiot"
Article Synopsis
- * A systematic review of recent literature (2022-2024) was undertaken to evaluate diagnostic and treatment methods, providing evidence-based recommendations.
- * Key recommendations include using MRI before biopsies, considering transperineal biopsies to lower infection risks, and active surveillance for low-risk tumors to enhance patient management.
Purpose Of This Document: The Oncology Committee of the French Urology Association is proposing updated recommendations for the management of recurrent and/or metastatic prostate cancer (PCa).
Methods: A systematic review of the literature from 2022 to 2024 was conducted by the CCAFU on the therapeutic management of recurrent PCa following local or metastatic treatment, assessing the references based on their level of evidence.
Results: Molecular imaging is the standard approach for assessing recurrence after local treatment and should not delay early salvage treatment.
Background: The 2 × 2 PEACE-1 study showed that combining androgen-deprivation therapy with docetaxel and abiraterone improved overall and radiographic progression-free survival in patients with de novo metastatic castration-sensitive prostate cancer. We aimed to examine the efficacy and safety of adding radiotherapy in this population.
Methods: We conducted an open-label, randomised, controlled, phase 3 trial with a 2 × 2 factorial design (PEACE-1) at 77 hospitals across Europe.
Background And Objective: The role of anatomical factors in predicting outcomes after radical prostatectomy (RP) remains unclear. This review aims to evaluate the impact of various anatomical factors on the perioperative outcomes of patients undergoing RP for localized prostate cancer (PCa).
Methods: A comprehensive literature search was conducted through January 2024 using the PubMed/Medline, Embase, and Web of Science databases.
Radiotherapy represents a major curative treatment for prostate cancer (PCa), but some patients will develop radioresistance (RR) and relapse. The underlying mechanisms remain poorly understood, and miRNAs might be key players in the acquisition and maintenance of RR. Through their encapsulation in small extracellular vesicles (EVs), they can also be relevant biomarkers of radiation response.
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- The study evaluates the carbon footprint of external beam radiation therapy (EBRT) across four centers, identifying key factors that contribute to COeq emissions, such as treatment methods and patient transportation.
- Findings show that a typical EBRT treatment can emit between 185 kgCOeq and 2066 kgCOeq, with major contributors being accelerator maintenance, patient transportation, and medical supplies, along with notable variability between centers.
- Hypofractionation is highlighted as a significant strategy to reduce emissions, and incorporating COeq emissions into health technology assessments can positively influence the promotion of more environmentally friendly treatment regimens.
Purpose: This retrospective study was conducted to ensure that irradiation of the pelvic lymph node areas associated with simultaneous hypofractionated boost to the prostate according to the protocol implemented at the university hospital of Tours (France) does not result in excess urinary and digestive toxicity in the short and medium term.
Materials And Methods: The study population included patients with localized unfavourable intermediate or high-risk prostate cancer. The dose delivered was 65Gy in 25 fractions of 2.
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.
Background: The onset of castration-resistance is associated with dismal outcomes in patients with prostate cancer (PCa). Metastasis directed therapy has been investigated in multiple disease settings and may improve outcomes in selected patients. Our systematic review aims to summarize evidence with stereotactic body radiotherapy (SBRT) in castration-resistant prostate cancer (CRPC).
View Article and Find Full Text PDFIntroduction: 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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- The study investigates the combination of atezolizumab (a PD-L1 inhibitor) and stereotactic body radiation therapy (SBRT) in patients with advanced colorectal cancer (CRC) as part of the SABR-PDL1 trial.
- A group of 60 pretreated patients from five centers participated, receiving atezolizumab and follow-up SBRT, with a focus on measuring progression-free survival (PFS) and collecting immune profiling data.
- Results showed a median overall survival of 8.4 months and a PFS of 1.4 months, with the treatment being relatively well-tolerated; some patients exhibited significant responses, including stable disease and a few partial or
Article Synopsis
- 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.
BACKGROUND: EMBARK, a controlled trial reported elsewhere, showed enzalutamide plus leuprolide (combination) and enzalutamide monotherapy prolonged metastasis-free survival versus placebo plus leuprolide (alone) in patients with high-risk biochemically recurrent prostate cancer. Health-related quality of life was also analyzed but not reported. METHODS: In EMBARK, patients with biochemical recurrence (prostate-specific antigen doubling time of ≤9 months) were randomly assigned (1:1:1) to combination (n=355), leuprolide-alone (n=358), or enzalutamide monotherapy (n=355).
View Article and Find Full Text PDFBackground: Treatment summaries and a personalized survivorship care plans based on internationally approved, organ-specific follow-up care recommendations are essential in preserving the health and quality of life for cancer survivors. Cohorts made up of survivors of childhood cancer have made significant contributions to the understanding of early mortality, somatic late complications, and psychosocial outcomes among former patients. New treatment protocols are needed to enhance survival and reduce the potential risk and severity of late effects, and working with treatment databases is crucial in doing so.
View Article and Find Full Text PDFThere are currently no accurate rules for manually delineating the subregions of the heart (cavities, vessels, aortic/mitral valves, Planning organ at Risk Volumes for coronary arteries) with the perspective of deep-learning based modeling. Our objective was to present a practical pictorial view for radiation oncologists, based on the RTOG atlas and anatomical complementary considerations for the cases where the RTOG guidelines are missing.
View Article and Find Full Text PDFPurpose: 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.
Context: Despite the lack of level 1 evidence, metastasis-directed therapy (MDT) is used widely in the management of metastatic prostate cancer (mPCa) patients. Data are continuously emerging from well-designed prospective studies.
Objective: To summarise and report the evidence on oncological and safety outcomes of MDT in the management of mPCa patients.
Article Synopsis
- * 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.
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.
View Article and Find Full Text PDFPurpose: Around 40% of men with intermediate-risk or high-risk prostate cancer will experience a biochemical recurrence after radical prostatectomy (RP). The aim of this review is to describe both toxicity and oncological outcomes following stereotactic body radiation therapy (SBRT) delivered to the prostate bed (PB).
Method: In april 2023, we performed a systematic review of studies published in MEDLINE or ClinicalTrials.
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.