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Vergnenegre A.,Limoges University Hospital Center | Monnet I.,Service de pneumologie | Chouaid C.,Service de pneumologie | Hureaux J.,Angers University Hospital Center | And 8 more authors.
Lung Cancer

Context: Erlotinib therapy for non small-cell lung cancer (NSCLC) has mainly been evaluated in randomized trials. Method: OBSTAR was a multicenter, retrospective, observational study involving all patients treated with erlotinib in 18 French centers between June 2005 and September 2007. The analyses focused on the patients' characteristics, previous treatments, and treatment efficacy during a three-year follow-up period. Results: 534 patients were included in this study. The median survival times were respectively 5.2 [3.7-7.4] and 4.7 [4.1-5.7] months, depending to whether erlotinib was used as second- (n= 190), or ≥third-line treatment (n= 305). The disease control rate were 39.1% [30.2-48.7] and 29.9% [29.6-36.9] according to the line of treatment. Factors predictive of an objective response were gender, age, and smoking status. Factors predictive of progression were age, sex, smoking status, the line of treatment, and the number of metastases. Treatment had to be interrupted for toxicity in 8.5% of cases. Conclusion: This study of erlotinib therapy in 2005-2007 confirms, in the general NSCLC patient population, the results of pivotal trials. © 2011 Elsevier Ireland Ltd. Source

Jansen N.,Service de radiotherapie oncologie | Coucke P.,University of Liege | Janvary Z.,Debrecen University
Revue Medicale de Liege

Soft tissue sarcomas are rare tumours requiring a multidisciplinary approach of the diagnostic process, the treatment and the follow up. Radical surgery remains the basis of the oncological treatment. Adjuvant radiotherapy is often added to surgery because of a high risk of local recurrence for specified patient groups. Nowadays, the adjuvant approach is often replaced by a neo-adjuvant approach as this pre-operative radiotherapy offers several advantages. We will also discuss the adaptation of the surgery to the radiotherapy and vice versa, and we present the clinical pathway for most of soft tissue sarcoma patients. We conclude with a series of technical innovations. Source

Boughalia A.,Center de Recherche Nucleaire de Draria | Marcie S.,Center Antoine Lacassagne | Fellah M.,University of Science and Technology Houari Boumediene | Chami S.,Service de radiotherapie oncologie | Mekki F.,Service de radiotherapie oncologie
British Journal of Radiology

Objective: The aim of this study is to assess and quantify patients' set-up errors using an electronic portal imaging device and to evaluate their dosimetric and biological impact in terms of generalized equivalent uniform dose (gEUD) on predictive models, such as the tumour control probability (TCP) and the normal tissue complication probability (NTCP). Methods: 20 patients treated for nasopharyngeal cancer were enrolled in the radiotherapy-oncology department of HCA. Systematic and random errors were quantified. The dosimetric and biological impact of these set-up errors on the target volume and the organ at risk (OARs) coverage were assessed using calculation of dose-volume histogram, gEUD, TCP and NTCP. For this purpose, an in-house software was developed and used. Results: The standard deviations (1SDs) of the systematic set-up and random set-up errors were calculated for the lateral and subclavicular fields and gave the following results: Σ = 0.63 ± (0.42) mm and σ 5 3.75 ± (0.79) mm, respectively. Thus a planning organ at risk volume (PRV) margin of 3 mm was defined around the OARs, and a 5-mm margin used around the clinical target volume. The gEUD, TCP and NTCP calculations obtained with and without set-up errors have shown increased values for tumour, where ΔgEUD (tumour) = 1.94% Gy (p = 0.00721) and ΔTCP = 2.03%. The toxicity of OARs was quantified using gEUD and NTCP. The values of ΔgEUD (OARs) vary from 0.78% to 5.95% in the case of the brainstem and the optic chiasm, respectively. The corresponding ΔNTCP varies from 0.15% to 0.53%, respectively. Conclusion: The quantification of set-up errors has a dosimetric and biological impact on the tumour and on the OARs. The developed in-house software using the concept of gEUD, TCP and NTCP biological models has been successfully used in this study. It can be used also to optimize the treatment plan established for our patients. Advances in knowledge: The gEUD, TCP and NTCP may be more suitable tools to assess the treatment plans before treating the patients. © 2015 The Authors. Published by the British Institute of Radiology. Source

Background.- Cisplatin-based chemotherapy and concurrent radiotherapy are the standard treatments for locally advanced unresectable NSCLC. New therapeutic combinations using molecular targeted drugs are needed. Methods.- Eligible patients with previously untreated stage III non squamous, NSCLC will receive thoracic radiation (66 Gy) along with cisplatin (75mg/m2) and pemetrexed (500mg/m2) on day 1 administered intravenously every 21 days for four cycles; weekly cetuximab will be added from the first week of therapy. The primary objective of this phase II study (IFCT 0803) is to assess the disease control rate at the 16th week, one month after the completion of the treatment. Based on a two-stage Simon approach, a total of 106 patients are required with an interim analysis of the first 34 planned. Expected results.- This trial will provide information on the feasibility, efficacy and tolerability of this new therapeutic combination. Should the primary objective be achieved, a phase III randomised study testing the position of cetuximab could be considered. © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved. Source

Henni M.,Service de radiotherapie oncologie | Ali D.,Service de radiotherapie oncologie
Revue du Praticien

More than half of all people with cancer are treated with radiation therapy. Over the last decade the technical advances, both in therapy beam precision and imaging, have greatly improved the therapeutic ratio and accuracy of modern radiotherapy. However, damaging healthy tissues near the tumor leads to radiation induced injury that develops immediately and continue to progress long after exposure to radiation. Recently dramatic advances have been made in understanding the determinant of tissue response to radiation exposure. Source

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