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Article ; Online: Escalade de dose dans les cancers de l’œsophage : revue de la littérature.

Boustani, J / Créhange, G

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2022 Volume 26, Issue 6-7, Page(s) 884–889

Abstract: For non-operable, localized esophageal cancer, definitive concurrent chemoradiotherapy is the standard treatment. Currently, the radiation dose recommended is 50 to 50,4Gy. However, the optimal radiation dose remains controversial. Many studies have ... ...

Title translation	Dose-escalated radiotherapy in esophageal cancer: A review of the literature.
Abstract	For non-operable, localized esophageal cancer, definitive concurrent chemoradiotherapy is the standard treatment. Currently, the radiation dose recommended is 50 to 50,4Gy. However, the optimal radiation dose remains controversial. Many studies have demonstrated that locoregional failure remains a common failure pattern, most likely to occur within the original gross tumor volume. Several retrospective studies have indicated that higher radiation dose may improve local control and survival while others failed to demonstrate improved oucomes. In three randomized trials (INT0123, ARTDECO, and CONCORDE), dose escalation did not improve locoregional control nor survival, establishing 50Gy as the standard chemoradiation dose for patients who will not undergo surgery. Here, we reviewed the results of dose escalation in the literature in the neoadjuvant and definitive settings.
MeSH term(s)	Chemoradiotherapy/methods ; Esophageal Neoplasms/drug therapy ; Esophageal Neoplasms/radiotherapy ; Humans ; Neoadjuvant Therapy ; Radiotherapy Dosage ; Retrospective Studies
Language	French
Publishing date	2022-08-23
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2022.06.021
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Article ; Online: Radiothérapie en hypofractionnement extrême appliquée au traitement du cancer localisé de la prostate : résultats, limites et perspectives.

Graff, P / Crehange, G

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2021 Volume 25, Issue 6-7, Page(s) 684–691

Abstract: Still an emerging approach a few years ago, stereotactic body radiation therapy (SBRT) has ranked as a valid option for the treatment of localized prostate cancer. Inherent properties of prostatic adenocarcinoma (low α/β) make it the perfect candidate. ... ...

Title translation	Ultra-hypofractionated radiotherapy for the treatment of localized prostate cancer: Results, limits and prospects.
Abstract	Still an emerging approach a few years ago, stereotactic body radiation therapy (SBRT) has ranked as a valid option for the treatment of localized prostate cancer. Inherent properties of prostatic adenocarcinoma (low α/β) make it the perfect candidate. We propose a critical review of the literature trying to put results into perspective to identify their strengths, limits and axes of development. Technically sophisticated, the stereotactic irradiation of the prostate is well tolerated. Despite the fact that median follow-up of published data is still limited, ultra-hypofractionated radiotherapy seems very efficient for the treatment of low and intermediate risk prostate cancers. Data seem satisfying for high-risk cancers as well. New developments are being studied with a main interest in treatment intensification for unfavorable intermediate risk and high-risk cancers. Advantage is taken of the sharp dose gradient of stereotactic radiotherapy to offer safe reirradiation to patients with local recurrence in a previously irradiated area.
MeSH term(s)	Adenocarcinoma/pathology ; Adenocarcinoma/radiotherapy ; Humans ; Male ; Neoplasm Recurrence, Local/radiotherapy ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy ; Radiation Dose Hypofractionation ; Radiosurgery/methods ; Re-Irradiation/methods ; Risk ; Treatment Outcome
Language	French
Publishing date	2021-07-14
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2021.06.028
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Zs.A 4832: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Innovations thérapeutiques en radiothérapie du cancer de la prostate localisé.

Créhange, G / Cormier, L

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2017 Volume 21, Issue 6-7, Page(s) 454–461

Abstract: Intensity-modulated radiation therapy, image-guided radiation therapy with fiducial markers and prostate brachytherapy allow the delivery of dose escalation for localized prostate cancer with very low rates of long-term toxicity and sequelae. Nowadays, ... ...

Title translation	Therapeutic innovations in radiation oncology for localized prostate cancer.
Abstract	Intensity-modulated radiation therapy, image-guided radiation therapy with fiducial markers and prostate brachytherapy allow the delivery of dose escalation for localized prostate cancer with very low rates of long-term toxicity and sequelae. Nowadays, modern radiotherapy techniques make it possible to shorten treatment time with hypofractionation, to better protect surrounding healthy tissues and to escalate the dose even further. Advances in radiotherapy are closely linked to advances in magnetic resonance imaging (MRI) and/or PET imaging. Functional imaging makes it possible to deliver personalised pelvic nodal radiotherapy, targeting the nodal areas at higher risk of microscopic involvement. In patients with an index lesion at baseline or at failure, MR-based focal therapy or focal dose escalation with brachytherapy or stereotactic body radiation therapy is also currently investigated. MR-based adaptive radiotherapy, which makes it possible to track prostate shifts during radiation delivery, is another step forward in the integration of MR imaging in radiation delivery.
MeSH term(s)	Humans ; Inventions ; Male ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy ; Radiation Dosage ; Radiation Oncology
Language	French
Publishing date	2017-10
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2017.07.037
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Zs.A 4832: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Curiethérapie prostatique de rattrapage : solution pour les rechutes localisées après irradiation ?

Cosset, J-M / Créhange, G

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2017

Abstract: Salvage brachytherapy after a first prostate radiation therapy is an emerging technique, which has to be considered in the therapeutic armamentarium in the clinically challenging context of patients with isolated local failure from prostate cancer who ... ...

Title translation	Salvage prostate brachytherapy: A solution for local failures after a primary radiation therapy?
Abstract	Salvage brachytherapy after a first prostate radiation therapy is an emerging technique, which has to be considered in the therapeutic armamentarium in the clinically challenging context of patients with isolated local failure from prostate cancer who may still be considered for cure. These occult failures are more and more frequently diagnosed at an early stage, thanks to targeted biopsies and advances in imaging modalities, such as multiparametric MRI and PET-CT. Salvage brachytherapy benefits from the implantation accuracy of brachytherapy procedures using 3D dosimetry and has resulted in more than 50% tumour control rates with long-term. Incontinence rates are always below those of other salvage treatments such as radical prostatectomy, HIFU or cryotherapy. Today, a consensus has been reached to better define good candidates for salvage brachytherapy with respect to disease characteristics at baseline and at failure. No consensus has been clearly defined yet regarding the choice of the technique (low or high dose rate), the total dose to be delivered, or the volume to be implanted (whole gland or focal). While we await robust data from recently completed phase II studies and given the heterogeneous results in the literature, this technique (although already included in the last 2016 NCCN guidelines) remains to be precisely evaluated, optimally within the frame of controlled trials.
Language	French
Publishing date	2017-11-06
Publishing country	France
Document type	English Abstract ; Journal Article
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2017.04.009
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Zs.A 4832: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Relations entre doses dans les structures anatomiques et dysfonction érectile après radiothérapie pour un cancer de la prostate : revue systématique de la littérature.

Ailloud, A / Udrescu, C / Horn, S / Enachescu, C / Créhange, G / Sargos, P / Supiot, S / Zilli, T / Lapierre, A / Chapet, O

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2023 Volume 27, Issue 6-7, Page(s) 548–561

Abstract: Purpose: During prostatic radiotherapy, damage to several anatomical structures could be the cause of erectile dysfunction: corpora cavernosa, internal pudendal arteries, penile bulb, and neurovascular bundles. Numerous studies have analysed the ... ...

Title translation	Relationship between doses to anatomical structures and erectile dysfunction after radiotherapy for prostate cancer: A systematic review.
Abstract	Purpose: During prostatic radiotherapy, damage to several anatomical structures could be the cause of erectile dysfunction: corpora cavernosa, internal pudendal arteries, penile bulb, and neurovascular bundles. Numerous studies have analysed the correlations between the dose received by these structures and erectile function. The objective of this article is to make a systematic review on current knowledge. Materials and methods: A systematic review was performed in the Medline database using the search engine PubMed. Keywords for the search included: erectile dysfunction, penile bulb, corpora cavernosa, cavernosum, neurovascular bundles, radiation therapy, cancer, prostate cancer. The selected articles must study a correlation between erectile dysfunction and the dose received by anatomical structures. A total of 152 articles were identified. Of these 152 articles, 45 fulfilled the defined selection criteria. Results: For corpora cavernosa, seven studies were identified, only two studies demonstrated a significant correlation between the dose received by corpora cavernosa and the occurrence of erectile dysfunction. For penile bulb, only 15 of 23 studies showed a correlation. A mean dose on the penile bulb greater than 20Gy was found to be predictive of erectile dysfunction. None of the eight trials concerning neurovascular bundles succeeded to show a correlation between dose and erectile dysfunction. Only one study evaluated the relationship between the dose received by internal pudendal arteries and erectile dysfunction but was found to be negative. However, vessels-sparing studies showed good results on erectile function preservation without compromising the target volume. Conclusion: We currently have little data to show a correlation between erectile dysfunction and sexual structures. It would be necessary to have additional prospective studies evaluating the impact of an optimization on these sexual structures on erectile dysfunction.
MeSH term(s)	Male ; Humans ; Erectile Dysfunction/etiology ; Prospective Studies ; Radiation Oncology ; Prostatic Neoplasms/radiotherapy ; Databases, Factual
Language	French
Publishing date	2023-08-16
Publishing country	France
Document type	Systematic Review ; English Abstract ; Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2023.07.010
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Zs.A 4832: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Nouvelles techniques dans le cancer de la prostate localisé : chirurgie et radiothérapie.

Cormier, L / Créhange, G

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2017 Volume 21, Issue 6-7, Page(s) 442–446

Abstract: The management of localized prostate cancer has been marked over these last years by the importance of Active Surveillance for low risk forms. Indeed, the long follow-up and the quality of the results are now sufficient to offer this option even in ... ...

Title translation	Therapeutic innovations in urology for localized prostate cancer.
Abstract	The management of localized prostate cancer has been marked over these last years by the importance of Active Surveillance for low risk forms. Indeed, the long follow-up and the quality of the results are now sufficient to offer this option even in relatively young people. However, the question is still under investigation concerning intermediate risk of prostate cancer. Patients' selection and follow-up management are of very high importance. Another major evolution is the robotic assistance for radical prostatectomy. Even if the level of evidence is still low, the global utilization all over the world of robotic assistance is a major fact of these last years mostly explained by the difficulty to correctly perform manual laparoscopic surgical procedure. Lastly, the focal therapy of prostate cancer is a new concept. The development of this approach is authorized by the improvement of the quality of prostate MRI and the accuracy of prostate biopsy. Presently, the focal treatment has to be performed in clinical trials or maybe with the help of national database validated by all the actors concerned by the treatment of prostate cancer.
MeSH term(s)	Humans ; Inventions ; Male ; Prostatectomy ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/therapy
Language	French
Publishing date	2017-10
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2017.08.107
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Zs.A 4832: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Limites de la définition des contraintes de dose pour les organes à risque spécifiques à la radiothérapie stéréotaxique.

Beddok, A / Loi, M / Rivin Del Campo, E / Dumas, J-L / Orthuon, A / Créhange, G / Huguet, F

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2023 Volume 27, Issue 4, Page(s) 341–348

Abstract: Stereotactic radiotherapy is a very hypofractionated radiotherapy (>7.5Gy per fraction), and therefore is more likely to induce late toxicities than conventional normofractionated irradiations. The present study examines four frequent and potentially ... ...

Title translation	Limits of dose constraint definition for organs at risk specific to stereotactic radiotherapy.
Abstract	Stereotactic radiotherapy is a very hypofractionated radiotherapy (>7.5Gy per fraction), and therefore is more likely to induce late toxicities than conventional normofractionated irradiations. The present study examines four frequent and potentially serious late toxicities: brain radionecrosis, radiation pneumonitis, radiation myelitis, and radiation-induced pelvic toxicities. The critical review focuses on the toxicity scales, the definition of the dose constrained volume, the dosimetric parameters, and the non-dosimetric risk factors. The most commonly used toxicity scales remain: RTOG/EORTC or common terminology criteria for adverse events (CTCAE). The definition of organ-at-risk volume requiring protection is often controversial, which limits the comparability of studies and the possibility of accurate dose constraints. Nevertheless, for the brain, whatever the indication (arteriovenous malformation, benign tumor, metastasis of solid tumors...), the association between the volume of brain receiving 12Gy (V12Gy) and the risk of cerebral radionecrosis is well established for both single and multi-fraction stereotactic irradiation. For the lung, the average dose received by both lungs and the V20 seem to correlate well with the risk of radiation-induced pneumonitis. For the spinal cord, the maximum dose is the most consensual parameter. Clinical trial protocols are useful for nonconsensual dose constraints. Non-dosimetric risk factors should be considered when validating the treatment plan.
MeSH term(s)	Humans ; Organs at Risk/radiation effects ; Radiosurgery/adverse effects ; Radiosurgery/methods ; Lung Neoplasms/radiotherapy ; Carcinoma, Non-Small-Cell Lung/pathology ; Lung/radiation effects ; Radiation Pneumonitis/etiology ; Radiation Pneumonitis/prevention & control ; Radiation Injuries/prevention & control ; Radiation Injuries/complications ; Radiotherapy Dosage
Language	French
Publishing date	2023-05-17
Publishing country	France
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2023.01.006
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Zs.A 4832: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Stereotactic Radiation Therapy versus Brachytherapy: Relative Strengths of Two Highly Efficient Options for the Treatment of Localized Prostate Cancer.

Kissel, Manon / Créhange, Gilles / Graff, Pierre

Cancers

2022 Volume 14, Issue 9

Abstract: Stereotactic body radiation therapy (SBRT) has become a valid option for the treatment of low- and intermediate-risk prostate cancer. In randomized trials, it was found not inferior to conventionally fractionated external beam radiation therapy (EBRT). ... ...

Abstract	Stereotactic body radiation therapy (SBRT) has become a valid option for the treatment of low- and intermediate-risk prostate cancer. In randomized trials, it was found not inferior to conventionally fractionated external beam radiation therapy (EBRT). It also compares favorably to brachytherapy (BT) even if level 1 evidence is lacking. However, BT remains a strong competitor, especially for young patients, as series with 10-15 years of median follow-up have proven its efficacy over time. SBRT will thus have to confirm its effectiveness over the long-term as well. SBRT has the advantage over BT of less acute urinary toxicity and, more hypothetically, less sexual impairment. Data are limited regarding SBRT for high-risk disease while BT, as a boost after EBRT, has demonstrated superiority against EBRT alone in randomized trials. However, patients should be informed of significant urinary toxicity. SBRT is under investigation in strategies of treatment intensification such as combination of EBRT plus SBRT boost or focal dose escalation to the tumor site within the prostate. Our goal was to examine respective levels of evidence of SBRT and BT for the treatment of localized prostate cancer in terms of oncologic outcomes, toxicity and quality of life, and to discuss strategies of treatment intensification.
Language	English
Publishing date	2022-04-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14092226
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Article ; Online: Quel rapport alpha/bêta pour le cancer prostatique en 2019 ?

Cosset, J-M / Chargari, C / Créhange, G

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2019 Volume 23, Issue 4, Page(s) 342–345

Abstract: In 1999, Brenner and Hall reported for prostate cancer a very low alpha/beta ratio (1.5Gy). In the following years, this value has been confirmed by a large series of papers, so that this very low alpha/beta ratio became a "dogma", on which a large ... ...

Title translation	Which alpha/beta ratio for prostate cancer in 2019?
Abstract	In 1999, Brenner and Hall reported for prostate cancer a very low alpha/beta ratio (1.5Gy). In the following years, this value has been confirmed by a large series of papers, so that this very low alpha/beta ratio became a "dogma", on which a large number of hypofractionated schemes were being built. This was logical, since this very low value strongly suggested a beneficial advantage of hypofractionation for prostate cancer. However, more recently, several questions arose; first, a number of authors reported, from the analysis of their own data, values of alpha/beta ratio which were higher than the "dogma". Secondly, the three modern "superiority trials", aiming at demonstrating the advantages of hypofractionated schemes, actually failed to show such a superiority, in spite of high equivalent doses (calculated with an alpha/beta of 1.5Gy), reaching up to 84 - 90Gy. In 2018, three review papers/metanalyses shed a new light on what could be the value of the alpha/beta ratio for prostate cancer. In particular, those studies took into account a "time factor" (for repopulation), a parameter which had been either forgotten or underestimated before. In those three studies, the alpha/beta ratio was ranging from 2.7Gy to 4.9Gy. Those data do confirm the sensitivity to the fraction dose variation of prostate cancer, but this sensitivity could be lower than suggested by an alpha/beta ratio of 1.5Gy.
MeSH term(s)	Dose Fractionation, Radiation ; Humans ; Male ; Prostatic Neoplasms/radiotherapy
Language	French
Publishing date	2019-05-20
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2019.01.004
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Article ; Online: Réirradiations : quels critères décisionnels ?

Cosset, J-M / Chargari, C / Créhange, G

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

2019 Volume 23, Issue 6-7, Page(s) 526–530

Abstract: The decision to reirradiate a volume which had been previously irradiated remains in 2019 one of the most difficult challenge for a radiation oncologist. Such a decision has to be based on a number of clinical and technological criteria, and the ... ...

Title translation	Reirradiations: Which decision-making criteria?
Abstract	The decision to reirradiate a volume which had been previously irradiated remains in 2019 one of the most difficult challenge for a radiation oncologist. Such a decision has to be based on a number of clinical and technological criteria, and the radiation oncologist will have to answer three main questions: i) can the patient clinically tolerate a second irradiation in the same previously irradiated area? While waiting for fully reliable individual tests of radiosensitivity, one has to take into account the tolerance of the first irradiation, as well as the comorbidities and/or habits which could impact the patient intrinsic radiosensitivity; ii) do the technical data of the first radiotherapy allow a re-irradiation? Unfortunately, and essentially when the discussion of re-irradiating the patient occurs many years (or even decades) after the first treatment, those precise technical data can be missing; iii) which technique should be used for the re-irradiation? In such a specific situation, the patient should be offered the more precise modern technology: stereotactic radiotherapy, protons, brachytherapy (low-, high-, or pulsed-dose rate). The indisputable improvement of the ballistic precision linked to our new technologies should lead to refine and to develop the indications of re-irradiation in the next future.
MeSH term(s)	Brachytherapy/methods ; Clinical Decision-Making ; Humans ; Proton Therapy ; Radiation Tolerance ; Radiotherapy ; Radiotherapy Dosage ; Re-Irradiation/methods ; Time Factors
Language	French
Publishing date	2019-08-07
Publishing country	France
Document type	Journal Article
ZDB-ID	1397169-4
ISSN	1769-6658 ; 1278-3218
ISSN (online)	1769-6658
ISSN	1278-3218
DOI	10.1016/j.canrad.2019.06.007
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