Satge D.,Institut Universitaire de France |
Sauleau E.-A.,University of Strasbourg |
Jacot W.,Institute Regional Du Cancer Of Montpellier Icm |
Raffi F.,Obstetrics and Gynecology |
And 2 more authors.
BMC Cancer | Year: 2014
Background: Breast cancer has been poorly studied in women with intellectual disability (ID), which makes designing a policy for screening the nearly 70 million women with ID in the world difficult. As no data is available in the literature, we evaluated breast cancer at diagnosis in women with ID.Methods: Women with ID were searched retrospectively among all women treated for invasive breast cancer in a single hospital over 18 years. Age at diagnosis was compared among the whole group of women. Tumor size, lymph node involvement, SBR grade, TNM classification, and AJCC stage were compared to controls matched for age and period of diagnosis using conditional logistic regression.Results: Among 484 women with invasive breast cancer, 11 had ID. The mean age at diagnosis was 55.6 years in women with ID and 62.4 years in the other women. The mean tumor size in women with ID was 3.53 cm, compared to 1.80 cm in 44 random controls from among the 473 women without ID. Lymph node involvement was observed in 9 of the 11 women with ID compared to 12 of the controls (OR = 11.53, p = 0.002), and metastases were found in 3 of the 11 women with ID compared to 1 of the 44 controls (OR = 12.00, p = 0.031). The AJCC stage was higher in women with ID compared to controls (OR = 3.19, p = 0.010).Conclusions: Women with ID presented at an earlier age with tumors of a higher AJCC stage than controls despite no significant differences in tumor grade and histological type. Thus, delayed diagnosis may be responsible for the differences between disabled and non-disabled women. © 2014 Satgé et al.; licensee BioMed Central Ltd.
Pinguet F.,Institute Regional Du Cancer Of Montpellier Icm |
Milano G.,Center Antoine Lacassagne
Oncologie | Year: 2014
Subcutaneous (SC) administration of injectable medications allows an improved quality of life of patients and contributes to the development of alternatives to hospitalization. However, this route has long been limited to certain drugs because it requires the crossing of the extracellular matrix which is a barrier to the diffusion of fluids in the SC space. After the discovery of hyaluronidase, which improves the diffusion of molecules, a recombinant version (rHuPH20) has been developed. In association with the medication, rHuPH20 allowed to extend the use of the SC route to bigger molecules. When anticancer monoclonal antibodies were developed, dosage was initially adjusted based on criteria such as the patient's weight, thereby leading theoretically to a better patient's exposure to the drug. However, numerous authors reported that a fixed-dose administration was globally more relevant for the majority of monoclonal antibodies. In this review, we detail the example of the trastuzumab (Herceptin®) as standard treatment of amplified or overexpressed HER2 breast cancer, usually administered intravenously (IV). Several studies assessed the benefit of the SC route (patient's weight) associated with rHuPH20 when compared with an IV administration (patient's weight). Others compared a SC fixed dose of trastuzumab (+ rHuPH20) to an IV dose adapted to the patient's weight. Overall, the different administration modalities seem equivalent in terms of efficacy (neoadjuvant), pharmacokinetics (including area under the curve and residual concentration) and toxicity. © 2014 Springer-Verlag.
Fenoglietto P.,Institute Regional Du Cancer Of Montpellier Icm |
Khodri M.,Institute Of Cancerologie Of La Loire Icl |
Nguyen D.,Groupe ORLAM |
Josserand-Pietri F.,Groupe ORLAM |
Ailleres N.,Institute Regional Du Cancer Of Montpellier Icm
Radiation Oncology | Year: 2016
Purpose: To verify the accuracy of volumetric arc therapy (VMAT) using the RapidArc™ device when switching patients from one single linear accelerator (linac) to a paired energy and mechanics "twin" linac without reoptimization of the original treatment plan. Patients and Methods: Four centers using 8 linacs were involved in this study. Seventy-four patients previously treated with the 6MV photon RapidArc™ technique were selected for analysis, using 242 measurements. In each institution, all patients were planned on linac A, and their plans were verified both on linac A and on the twin linac B. Verifications were done using the amorphous silicium electronic portal imager (EPID) of the linacs and were analyzed with the EpiQa software (Epidos, Bratislavia, Slovakia). The gamma index formalism was used for validation with a double threshold of 3 % and 3 mm with a measurement resolution of 0.39 mm/pixel, and a smoothed resolution of approximately 2.5 mm. Results: The number of points passing the gamma criteria between the measured and computed doses was 94.79 ± 2.57 % for linac A and 94.61 ± 2.46 % for linac B. Concerning the smoothed measurement analysis, 98.67 ± 1.26 % and 98.59 ± 1.20 % points passing the threshold were obtained for linacs A and B, respectively. The difference between the 2 dose matrices acquired on the EPID was very small, with 99.92 ± 0.06 % of the points passing the criteria. Conclusion: For linacs sharing the same mechanical and energy parameters, this study tends to indicate that patients may be safely switched from treatment with one linac to treatment with its twin linac using the same VMAT plan. © 2016 Fenoglietto et al.
Samalin E.,Institute Regional Du Cancer Of Montpellier Icm |
Ychou M.,Institute Regional Du Cancer Of Montpellier Icm
World Journal of Clinical Oncology | Year: 2016
Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. While the incidence of gastric adenocarcinoma is decreasing, the incidence of gastroesophageal junction adenocarcinoma is rising rapidly in Western countries. Considering that surgical resection is currently the major curative treatment, and that the 5-year survival rate highly depends on the pTNM stage at diagnosis, gastroesophageal adenocarcinoma management is very challenging for oncologists. Several treatment strategies are being evaluated, and among them systemic chemotherapy, to decrease recurrences and improve overall survival. The MAGIC and FNCLCC-FFCD trials showed a survival benefit of perioperative chemotherapy in patients with operable gastric and lower esophageal cancer, and these results had an impact on the European clinical practice. New strategies, including induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies in combination with perioperative chemotherapy and the new cytotoxic regimens, are currently assessed to improve current standards and help developing patienttailored therapeutic interventions. © The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Senesse P.,Institute Regional Du Cancer Of Montpellier Icm |
Senesse P.,Montpellier University |
Tadmouri A.,Clin Search |
Culine S.,Hospital Henri Mondor |
And 5 more authors.
Journal of Pain and Symptom Management | Year: 2015
Context Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL). Objectives The purpose of this study was 1) to evaluate the impact of HPN on QoL, 2) to assess changes in nutritional status, and 3) to assess proxy perception of patient well-being. Methods We conducted a prospective, observational, and a multicenter study. Inclusion criteria were adult patients with gastrointestinal cancer, for whom HPN was indicated and prescribed for at least 14 days. The physician, the patient, and a family member completed questionnaires at inclusion and 28 days later. The QoL was assessed by the patients using the Functional Assessment of Cancer Therapy-General questionnaire, at inclusion and 28 days later. Results The study included 370 patients with gastrointestinal cancer. The HPN was indicated for cancer-related undernutrition in 89% of the patients and was used as a complement to oral intake in 84%. After 28 days of parenteral intake, global QoL was significantly increased (48.9 at inclusion vs. 50.3, P = 0.007). The patients' weight improved significantly by 2.7% (P < 0.001). The nutrition risk screening also decreased significantly (3.2 ± 1.1 vs. 2.8 ± 1.3, P = 0.003). Conclusion HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile.