Lesur A.,Institute Of Cancerologie Of Lorraine
Oncologie | Year: 2014
Genetic or epidemiological tests can be used to determine a person’s risk of developing a new or recurrent familial breast cancer. Not only cognitive but factors such as anxiety influence understanding of and confidence in the results, decision-making, and satisfaction with testing. Emotion plays a strong role in the perception of risk information but is frequently underemphasized in the medical communication. We discuss and put into context several reflections that explore the whole setting and course of life after being labeled as a person at high risk. © 2014, Springer-Verlag France.
Demoor-Goldschmidt C.,Institute Of Cancerologie Of Louest |
Bernier V.,Institute Of Cancerologie Of Lorraine
Bulletin du Cancer | Year: 2015
Pediatric radiotherapy did not differ technically from adult radiotherapy but its characteristics, its difficulties and challenges are specific. Thanks in part to this treatment, overall survival of French children with cancer is around 80%. It is therefore important to integrate in the elaboration of the treatment planning potential side long-term effects. Indeed, whatever the technique is, even the most sophisticated, it is usually inevitable that healthy nearby organs receive a dose of radiation. Dose limits on organs at risk come from adult data and are adapted for children. After the treatment, it is important to graduate the potential risks of side effects to propose a personalized monitoring protocol avoiding excessive medicalization. This article presents the medical thinking concerning radiotherapy in different anatomical areas (brain, head and neck, chest, abdomen) including concepts of dose level corresponding to side effects usually described. In parallel, we present follow-up recommendations with the aim to preserve an optimal quality of life for the adults cured of a childhood cancer, currently called survivors. © 2015 Société Française du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.
Gangler A.,Institute Of Cancerologie Of Louest |
Lesur A.,Institute Of Cancerologie Of Lorraine |
Dalenc F.,Institute Claudius Regaud
Oncologie | Year: 2016
The growing number of breast cancer survivors challenges healthcare organizations, particularly oncology specialty and primary care providers. Currently, in France, the follow-up care is based on detection of recurrences, of second primary contralateral breast cancer, of long-term treatment sequelae, in addition to psychosocial consequences of cancer and its treatment. This review will discuss the evidence base and intents of breast cancer survivorship care plans (CSCPs) as a wellness model for cancer survivors in clinical setting, mainly providing health promotion recommendations such as regular exercise. The CPCPs involve multidisciplinary approach and patient–physician communication. Therefore, this comprehensive care will improve their quality of life, treatment compliance, and general health care maintenance. This article offers innovative guidance to implement the post-cancer patient care and includes the relevant templates to be submitted to the patients. © 2016, Springer-Verlag France.
Huertas A.,Institute Of Cancerologie Of Lorraine |
Baumann A.-S.,Institute Of Cancerologie Of Lorraine |
Saunier-Kubs F.,Institute Of Cancerologie Of Lorraine |
Salleron J.,Data Management |
And 6 more authors.
Radiotherapy and Oncology | Year: 2015
Purpose: To describe efficacy and safety of stereotactic body radiation therapy (SBRT) for the treatment of inoperable hepatocellular carcinoma. Methods: The records of 77 consecutive patients treated with SBRT for 97 liver-confined HCC were reviewed. A total dose of 45 Gy in 3 fractions was prescribed to the 80% isodose line. Local control (LC), overall survival (OS), progression-free survival (PFS) and toxicity were studied. Results: The median follow-up was 12 months. The median tumor diameter was 2.4 cm. The LC rate was 99% at 1 and 2 years. The 1 and 2-year OS were 81.8% and 56.6% respectively. The median time to progression was 9 months (0-38). The rate of hepatic toxicity was 7.7% [1.6-13.7], 14.9% [5.7-23.2] and 23.1% [9.9-34.3] at 6 months, 1 year and 2 years respectively. In multivariate analysis, female gender (HR 7.87 [3.14-19.69]), a BCLC B-C stage (HR 3.71 [1.41-9.76]), a sum of all lesion diameters ≥2 cm (HR 7.48 [2.09-26.83]) and a previous treatment (HR 0.10 [0.01-0.79]) were independent prognostic factors of overall survival. Conclusion: SBRT allows high local control for inoperable hepatocellular carcinomas. It should be considered when an ablative treatment is indicated in Child A patients. © 2015 Elsevier Ireland Ltd. All rights reserved.
Marchal S.,Nancy Research Center for Automatic Control |
Marchal S.,Institute Of Cancerologie Of Lorraine |
Hor A.E.,Institute Of Cancerologie Of Lorraine |
Hor A.E.,University of Lorraine |
And 4 more authors.
Drugs | Year: 2015
The development of chemotherapy using conventional anticancer drugs has been hindered due to several drawbacks related to their poor water solubility and poor pharmacokinetics, leading to severe adverse side effects and multidrug resistance in patients. Nanocarriers were developed to palliate these problems by improving drug delivery, opening the era of nanomedicine in oncology. Liposomes have been by far the most used nanovectors for drug delivery, with liposomal doxorubicin receiving US FDA approval as early as 1995. Antibody drug conjugates and promising drug delivery systems based on a natural polymer, such as albumin, or a synthetic polymer, are currently undergoing advanced clinical trials or have received approval for clinical applications. However, despite attractive results being obtained in preclinical studies, many well-designed nanodrugs fell short of expectations when tested in patients, evidencing the gap between nanoparticle design and their clinical translation. The aim of this review is to evaluate the extent of nanotherapeutics used in oncology by providing an insight into the most successful concepts. The reasons that prevent nanodrugs from expanding to clinic are discussed, and the efforts that must be taken to take full advantage of the great potential of nanomedicine are highlighted. © 2015 Springer International Publishing Switzerland.
Helle M.,Nancy Research Center for Automatic Control |
Helle M.,Institute Of Cancerologie Of Lorraine |
Rampazzo E.,University of Bologna |
Monchanin M.,Nancy Research Center for Automatic Control |
And 10 more authors.
ACS Nano | Year: 2013
Near-infrared (NIR) imaging of the lymphatic system offers a sensitive, versatile, and accurate lymph node mapping to locate the first, potentially metastatic, draining nodes in the operating room. Many luminescent nanoprobes have received great attention in this field, and the design of nontoxic and bright nanosystems is of crucial importance. Fluorescent NIR-emitting dye doped silica nanoparticles represent valuable platforms to fulfill these scopes, providing sufficient brightness, resistance to photobleaching, and hydrophilic nontoxic materials. Here, we synthesized these highly stable core-shell nanoparticles with a programmable surface charge positioning and determined the effect of these physicochemical properties on their in vivo behavior. In addition, we characterized their fluorescence kinetic profile in the right axillary lymph node (RALN) mapping. We found that nanoparticles with negative charges hidden by a PEG shell are more appropriate than those with external negative charges in the mapping of lymph nodes. We also demonstrated the efficient excretion of these nanostructures by the hepatobiliary route and their nontoxicity in mice up to 3 months postinjection. These results indicate the potential future development of these fluorescent nanosystems for LN mapping. © 2013 American Chemical Society.
Hannoun-Levi J.-M.,Center Antoine Lacassagne |
Hannoun-Levi J.-M.,University of Nice Sophia Antipolis |
Peiffert D.,Institute Of Cancerologie Of Lorraine
Cancer/Radiotherapie | Year: 2013
For more than a century, brachytherapy has been a treatment of choice for delivering a high dose in a small volume. However, over the past 15years, this irradiation technique has stalled. Even so, brachytherapy allows the delivery of the right dose at the right place by dispensing with target volume motion and repositioning. The evolution of brachytherapy can be based on a road-map including at least the following three points: the acquisition of clinical evidence, teaching and valuation of the procedures. The evolution of brachytherapy will be also impacted by technological considerations (end of the production of low dose rate 192 iridium wires). Regarding the evolution toward a personalized treatment, brachytherapy of the future should take its place as a partner of other modern external beam radiation techniques, be performed by experimented actors (physicians, physicists, technicians, etc.) who received adequate training, and be valued in proportion to the delivered medical service. © 2013 Société française de radiothérapie oncologique (SFRO).
Bressenot A.,University of Lorraine |
Salleron J.,Institute Of Cancerologie Of Lorraine |
Bastien C.,University of Lorraine |
Danese S.,Humanitas Clinical and Research Hospital |
And 2 more authors.
Gut | Year: 2015
Background: Assessment of disease activity in UC is important for designing an optimal therapeutic strategy. No single histology score is considered optimum. The aim of this study was to compare intraobserver reproducibility and the interobserver agreement of available histological UC activity indexes. Methods: One hundred and two biopsy specimens (collected between 2003 and 2014) were scored blindly by three pathologists by determining Geboes, Riley, Gramlich and Gupta indexes and global visual evaluation (GVE). Intraobserver reproducibility and interobserver agreements for index and items of index were studied by intraclass correlation coefficient for quantitative parameter and by ê values and Krippendorff index for qualitative parameters. Relationship between indexes was studied by computation of Pearson's and Spearman's correlation coefficients. Results: Geboes, Riley, Gramlich and Gupta indexes and GVE showed good intraobserver reproducibility and a good interobserver agreement. Histological items that showed the best interobserver agreement were 'erosion/ulceration or surface epithelial integrity' and 'acute inflammatory cells infiltrate/neutrophils in lamina propria'. The five scores were strongly correlated. Conclusions: Correlation between indexes is strong. Intraobserver reproducibility and interobserver agreement for all indexes is very good. Histological items that showed the best interobserver agreement are 'erosion/ulceration' and 'acute inflammatory cells infiltrate/neutrophils in lamina propria'.
PubMed | University of Lorraine and Institute Of Cancerologie Of Lorraine
Type: | Journal: Molecular diagnosis & therapy | Year: 2017
Metastatic or unresectable melanoma is a serious and deadly disease. Anti-BRAF and immunotherapy improved overall survival in patients with metastatic disease. Thus, BRAF genotyping is important to choose the right therapy.In our study, we assessed and compared BRAF mutations in 59 formalin-fixed and paraffin-embedded tumor samples of patients with metastatic melanoma with next-generation sequencing (NGS), CobasThirty-one samples were found bearing a BRAF mutation with NGS (52.5%), 28 with Cobas
Peiffert D.,Institute Of Cancerologie Of Lorraine |
Baumann A.-S.,Institute Of Cancerologie Of Lorraine |
Marchesi V.,Institute Of Cancerologie Of Lorraine
Journal of visceral surgery | Year: 2014
Cyberknife(®) is a dedicated stereotactic radiotherapy device. This new technology permits precise delivery of high dose gradient radiation therapy while sparing the surrounding organs at risk. Hepatic metastases of colorectal cancer (HMCRC) are an example of a lesion where treatment with Cyberknife(®) is indicated because they are located in a radio-sensitive organ and curative treatment is based on focal eradication (resection, radiofrequency ablation,...). The local control rate at one year is reported to be 70 to 100% depending on the study. Tolerance is excellent with less than a 5% rate of acute grade 3 or 4 side effects (nausea, vomiting, gastro-duodenal ulcer). The specific hepatotoxicity of radiotherapy, so-called radiation-induced liver disease (RILD), was found in only one study. Candidates for stereotactic radiotherapy are patients in whom disease is controlled except for intrahepatic disease with 1-3 hepatic metastases ≤ 6 cm in size who have contraindications for surgery, a WHO stage ≤ 2, a volume of healthy liver ≥ 700 cm(3) and normal liver function. It is actually a very simple treatment that results in very good local control with few contraindications. Its place in the management strategy of liver metastases needs further clarification. Copyright © 2014 Elsevier Masson SAS. All rights reserved.