Cancer Radiotherapie最新文献

{"title":"Escalade de dose en radiothérapie modérément hypofractionnée pour les cancers de la prostate localisés, ESHYPRO : résultats d’une série monocentrique rétrospective évaluant la toxicité et l’efficacité","authors":"K. Quintin,&nbsp;G. Créhange,&nbsp;P. Graff","doi":"10.1016/j.canrad.2024.01.005","DOIUrl":"10.1016/j.canrad.2024.01.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Prostate cancer is the most frequent cancer among men and radiotherapy hypofractionation regimens have become standard treatments for the localized stages, but the absence of increased risk of acute and late genitourinary or gastrointestinal toxicity of the dose escalation still must be demonstrated.</p></div><div><h3>Material and methods</h3><p>The study population included all patients with localized prostatic adenocarcinoma treated at the institut Curie from February 2016 to March 2018 by external radiation delivered by a linear accelerator using an image-guided conformal intensity modulation technique at a total dose of 75<!--> <!-->Gy in 30 fractions of 2.5<!--> <!-->Gy in the planning target volume that included the prostate and the proximal seminal vesicles, and could be paired with a prophylactic lymph node radiotherapy at 46<!--> <!-->Gy in 23 fractions with simultaneous integrated boost.</p></div><div><h3>Results</h3><p>A total of 166 patients were included. Among them, 68.6% were unfavourable intermediate or (very) high risk. The median age and follow-up were 71.4<!--> <!-->years and 3.96<!--> <!-->years. One hundred and forty-nine patients received prophylactic lymph node radiotherapy (89.8%). One hundred and thirty-one patients received hormonotherapy (78.9%). Genito-urinary toxicity events of grades 2 or above during radiotherapy, at 6<!--> <!-->months, 1<!--> <!-->year and 5<!--> <!-->years were respectively 36.7%, 8.8%, 3.1% and 4.7%. Two patients had late grade 4 toxicity at 5<!--> <!-->years (1.6%). Grade 2 gastrointestinal toxicity events during radiotherapy, 6<!--> <!-->months, 1<!--> <!-->year and 5<!--> <!-->years were respectively 15.1%, 1.9%, 14.6% and 9.3%. Of these, eight patients had grade 3 toxicity (6.2%). There was no grade 4 toxicity. Analyses did not reveal any predictive factor for toxicity. The 5-year overall, progression-free, and specific survival rates were respectively 82.4%, 85.7%, and 93.3%. Serum prostate specific antigen concentration and cardiovascular risk factors were found to be predictive factors of deterioration in overall survival (<em>P</em> <!-->=<!--> <!-->0.0028 for both).</p></div><div><h3>Conclusion</h3><p>External radiotherapy for localized prostatic cancer with our moderately hypofractionated dose escalation regimen is well tolerated. In the absence of increased late toxicity, the analysis of the modes of long-term relapses will be interesting to determine the benefit of this dose escalation on local and distant relapses.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 4","pages":"Pages 333-340"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the response to neoadjuvant chemoradiation for rectal cancer using nomograms based on MRI tumour regression grade","authors":"","doi":"10.1016/j.canrad.2024.01.004","DOIUrl":"10.1016/j.canrad.2024.01.004","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to develop nomograms that combine clinical factors and MRI tumour regression grade to predict the pathological response of mid-low locally advanced rectal cancer to neoadjuvant chemoradiotherapy.</p></div><div><h3>Methods</h3><p>The retrospective study included 204 patients who underwent neoadjuvant chemoradiotherapy and surgery between January 2013 and December 2021. Based on pathological tumour regression grade, patients were categorized into four groups: complete pathological response (pCR, <em>n</em> <!-->=<!--> <!-->45), non-complete pathological response (non-pCR; <em>n</em> <!-->=<!--> <!-->159), good pathological response (pGR, <em>n</em> <!-->=<!--> <!-->119), and non-good pathological response (non-pGR, <em>n</em> <!-->=<!--> <!-->85). The patients were divided into a training set and a validation set in a 7:3 ratio. Based on the results of univariate and multivariate analyses in the training set, two nomograms were respectively constructed to predict complete and good pathological responses. Subsequently, these predictive models underwent validation in the independent validation set. The prognostic performances of the models were evaluated using the area under the curve (AUC).</p></div><div><h3>Results</h3><p>The nomogram predicting complete pathological response incorporates tumour length, post-treatment mesorectal fascia involvement, white blood cell count, and MRI tumour regression grade. It yielded an AUC of 0.787 in the training set and 0.716 in the validation set, surpassing the performance of the model relying solely on MRI tumour regression grade (AUCs of 0.649 and 0.530, respectively). Similarly, the nomogram predicting good pathological response includes the distance of the tumour's lower border from the anal verge, post-treatment mesorectal fascia involvement, platelet/lymphocyte ratio, and MRI tumour regression grade. It achieved an AUC of 0.754 in the training set and 0.719 in the validation set, outperforming the model using MRI tumour regression grade alone (AUCs of 0.629 and 0.638, respectively).</p></div><div><h3>Conclusions</h3><p>Nomograms combining MRI tumour regression grade with clinical factors may be useful for predicting pathological response of mid-low locally advanced rectal cancer to neoadjuvant chemoradiotherapy. The proposed models could be applied in clinical practice after validation in large samples.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 4","pages":"Pages 341-353"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation exposure of the glandular mammary tissue in women patients with mediastinal Hodgkin lymphoma treated with protons","authors":"Pierre Loap,&nbsp;Farid Goudjil,&nbsp;Youlia Kirova","doi":"10.1016/j.canrad.2024.04.002","DOIUrl":"10.1016/j.canrad.2024.04.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Secondary breast cancer is a frequent late adverse event of mediastinal Hodgkin lymphoma radiotherapy. Secondary breast cancers overwhelmingly correspond to ductal carcinoma and develop from the glandular mammary tissue. In addition, during childhood, radiation overexposure of the glandular tissue may lead to a late breast hypotrophy at adult age. The aim of this study was to evaluate the radiation exposure to the glandular tissue in patients treated for mediastinal Hodgkin lymphoma with intensity-modulated proton therapy, in order to evaluate the potential dosimetric usefulness of its delineation for breast sparing.</p></div><div><h3>Materials and methods</h3><p>Sixteen consecutive intermediate-risk mediastinal female patients with Hodgkin lymphoma treated with consolidation radiation with deep inspiration breath hold intensity-modulated proton therapy to the total dose of 30<!--> <!-->Gy were included. Breasts were delineated according to the European Society for Radiotherapy and Oncology guidelines for treatment optimization (“clinical organ at risk”). The glandular tissue (“glandular organ at risk”) was retrospectively contoured on the initial simulation CT scans based on Hounsfield unit (HU) values, using a range between −80<!--> <!-->HU and 500<!--> <!-->HU.</p></div><div><h3>Results</h3><p>The mean and maximum doses delivered to the glandular organ at risk were significantly lower than the mean and maximum doses delivered to the clinical organ at risk, but were statistically correlated. Glandular organ at risk volumes were significantly smaller.</p></div><div><h3>Conclusion</h3><p>Optimizing the treatment plans on the clinical breast contours will systematically lead to overestimation of the dose received to the glandular tissue and, consequently, to an indistinct and involuntary improved glandular tissue sparing. As such, our findings do not support the consideration of the glandular tissue as an additional organ at risk when planning intensity-modulated proton therapy for mediastinal Hodgkin lymphoma in female patients.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 4","pages":"Pages 380-384"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1278321824000945/pdfft?md5=40e57c777d364c8d0fe17eed1aa36f63&pid=1-s2.0-S1278321824000945-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinetics of plasma cell-free DNA as a prospective biomarker to predict the prognosis and radiotherapy effect of esophageal cancer","authors":"Y. Li ,&nbsp;J. Wu ,&nbsp;Y. Feng ,&nbsp;D. Wang ,&nbsp;H. Tao ,&nbsp;J. Wen ,&nbsp;F. Jiang ,&nbsp;P. Qian ,&nbsp;Y. Liu","doi":"10.1016/j.canrad.2023.11.002","DOIUrl":"10.1016/j.canrad.2023.11.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The lack of reliable biomarkers for the prognosis and radiotherapy efficacy in esophageal cancer (EC) necessitates further research. The aim of our study was to investigate the predictive utility of plasma cell-free DNA (cfDNA) kinetics in patients with EC.</p></div><div><h3>Materials and methods</h3><p>We retrospectively analyzed the clinical data and cfDNA levels (pre-radiotherapy [pre-RT] and post-radiotherapy [post-RT]) and the cfDNA kinetics (cfDNA ratio: post-RT cfDNA/pre-RT cfDNA) of 88 patients. We employed Kaplan-Meier curves to examine the relationship between cfDNA and overall survival (OS) as well as progression-free survival (PFS). Univariate and multivariate Cox regression analyses were executed to ascertain the independent risk factors in EC.</p></div><div><h3>Results</h3><p>The pre-RT cfDNA levels were positively correlated with clinical stage (<em>P</em> <!-->=<!--> <!-->0.001). The pre-RT cfDNA levels (cutoff value<!--> <!-->=<!--> <!-->16.915<!--> <!-->ng/mL), but not the post-RT cfDNA levels, were linked to a diminished OS (<em>P</em> <!-->&lt;<!--> <!-->0.001) and PFS (<em>P</em> <!-->=<!--> <!-->0.0137). CfDNA kinetics (cutoff value<!--> <!-->=<!--> <!-->0.883) were positively associated with OS (<em>P</em> <!-->=<!--> <!-->0.0326) and PFS (<em>P</em> <!-->=<!--> <!-->0.0020). Notably, we identified independent risk factors for OS in EC treated with RT, including cfDNA ratio (high/low) (HR<!--> <!-->=<!--> <!-->0.447 [0.221–0.914] <em>P</em> <!-->=<!--> <!-->0.025), ECOG (0/1/2) (HR<!--> <!-->=<!--> <!-->0.501 [0.285–0.880] <em>p</em> <!-->=<!--> <!-->0.016), and histological type (esophagal squamous cell carcinoma [ESCC]/non-ESCC) (HR<!--> <!-->=<!--> <!-->3.973 [1.074–14.692] <em>P</em> <!-->=<!--> <!-->0.039).</p></div><div><h3>Conclusion</h3><p>Plasma cfDNA kinetics is associated with prognosis and radiotherapy effect in EC undergoing RT, suggesting potential clinical application of a cheap and simple blood-based test.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 242-250"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1278321824000568/pdfft?md5=fbd41567fbdbacdc390fb110c6412ec7&pid=1-s2.0-S1278321824000568-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective observational study evaluating two patient immobilisation methods in lung stereotactic radiotherapy","authors":"S. Boisbouvier,&nbsp;I. Martel-Lafay,&nbsp;R. Tanguy,&nbsp;M. Ayadi-Zahra","doi":"10.1016/j.canrad.2023.08.012","DOIUrl":"10.1016/j.canrad.2023.08.012","url":null,"abstract":"<div><h3>Purpose</h3><p>The main objective of this study was to assess inter- and intrafraction errors for two patient immobilisation devices in the context of lung stereotactic body radiation therapy: a vacuum cushion and a simple arm support.</p></div><div><h3>Materials and methods</h3><p>Twenty patients who were treated with lung stereotactic body radiation therapy in supine position with arms above their head were included in the study. Ten patients were setup in a vacuum cushion (Bluebag™, Elekta) and ten other patients with a simple arm support (Posirest™, Civco). A pretreatment four-dimensional cone-beam computed tomography and a post-treatment three-dimensional cone-beam computed tomography were acquired to compare positioning and immobilisation accuracy. Based on a rigid registration with the planning computed tomography on the spine at the target level, translational and rotational errors were reported.</p></div><div><h3>Results</h3><p>The median number of fractions per treatment was 5 (range: 3–10). Mean interfraction errors based on 112 four-dimensional cone-beam computed tomographies were similar for both setups with deviations less than or equal to 1.3<!--> <!-->mm in lateral and vertical direction and 1.2° in roll and yaw. For longitudinal translational errors, mean interfraction errors were 0.7<!--> <!-->mm with vacuum cushion and –3.9<!--> <!-->mm with arm support. Based on 111 three-dimensional cone-beam computed tomographies, mean lateral, longitudinal and vertical intrafraction errors were –0.1<!--> <!-->mm, –0.2<!--> <!-->mm and 0.0<!--> <!-->mm respectively (SD: 1.0, 1.2 and 1.0<!--> <!-->mm respectively) for the patients setup with vacuum cushion, and mean vertical, longitudinal and lateral intrafraction errors were –0.3<!--> <!-->mm, –0.7<!--> <!-->mm and 0.1<!--> <!-->mm respectively (SD: 2.3, 1.8 and 1.4<!--> <!-->mm respectively) for the patients setup with arm support. Intrafraction errors means were not statistically different between both positions but standard deviations were statistically larger with arm support.</p></div><div><h3>Conclusion</h3><p>The results of our study showed similar inter and intrafraction mean deviations between both positioning but a large variability in intrafraction observed with arm support suggested a more accurate immobilization with vacuum cushion.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 229-235"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative radiotherapy: New prognostic factors for patients with bone metastasis","authors":"I.N. Steinvoort-Draat,&nbsp;L. Otto-Vollaard,&nbsp;S. Quint,&nbsp;J.L. Tims,&nbsp;I.M.N. de Pree,&nbsp;J.J. Nuyttens","doi":"10.1016/j.canrad.2023.09.003","DOIUrl":"10.1016/j.canrad.2023.09.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Many cancer patients develop bone metastases, however the prognosis of overall survival differs. To provide an optimal treatment for these patients, especially towards the end of life, a reliable prediction of survival is needed. The goal of this study was to find new clinical factors in relation to overall survival.</p></div><div><h3>Materials and methods</h3><p>Prospectively 22 clinical factors were collected from 734 patients. The Kaplan–Meier and Cox regression models were used.</p></div><div><h3>Results</h3><p>Most patients were diagnosed with lung cancer (29%), followed by prostate (19.8%) and breast cancer (14.7%). Median overall survival was 6.4<!--> <!-->months. Fourteen clinical factors showed significance in the univariate analyses. In the multivariate analyses 6 factors were found to be significant for the overall survival: Karnofsky performance status, primary tumor, gender, total organs affected, morphine use and systemic treatment options after radiotherapy.</p></div><div><h3>Conclusion</h3><p>Morphine use and systemic treatment options after radiotherapy, Karnofsky performance status, primary tumor, gender and total organs affected are strong prediction factors on overall survival after palliative radiotherapy in patients with bone metastasis. These factors are easily applicable in the clinic.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 236-241"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1278321824000581/pdfft?md5=faebc9b9aa82934282638c2c8e9998d5&pid=1-s2.0-S1278321824000581-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consentement aux soins en radiothérapie","authors":"C. Sire ,&nbsp;A. Ducteil ,&nbsp;J.-L. Lagrange ,&nbsp;P. Maingon ,&nbsp;F. Lorchel ,&nbsp;I. Latorzeff ,&nbsp;C. Hennequin ,&nbsp;P. Giraud ,&nbsp;T. Leroy ,&nbsp;V. Vendrely ,&nbsp;J.-M. Hannoun-Lévi ,&nbsp;C. Chargari ,&nbsp;N. Pourel ,&nbsp;Y. Elhouat ,&nbsp;J.-J. Mazeron ,&nbsp;V. Marchesi ,&nbsp;F. Huguet ,&nbsp;É. Monpetit ,&nbsp;D. Azria","doi":"10.1016/j.canrad.2024.04.001","DOIUrl":"10.1016/j.canrad.2024.04.001","url":null,"abstract":"<div><p>Obtaining consent to care requires the radiation oncologist to provide loyal information and to ensure that the patient understands it. Proof of such an approach rests with the practitioner. The French Society for Radiation Oncology (SFRO) does not recommend the signature of a consent form by the patient but recommends that the radiation oncologist be able to provide all the elements demonstrating the reality of a complete information circuit.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 290-292"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence solution to accelerate the acquisition of MRI images: Impact on the therapeutic care in oncology in radiology and radiotherapy departments","authors":"R. Lemaire ,&nbsp;C. Raboutet ,&nbsp;T. Leleu ,&nbsp;C. Jaudet ,&nbsp;L. Dessoude ,&nbsp;F. Missohou ,&nbsp;Y. Poirier ,&nbsp;P.-Y. Deslandes ,&nbsp;A. Lechervy ,&nbsp;J. Lacroix ,&nbsp;I. Moummad ,&nbsp;S. Bardet ,&nbsp;J. Thariat ,&nbsp;D. Stefan ,&nbsp;A. Corroyer-Dulmont","doi":"10.1016/j.canrad.2023.11.004","DOIUrl":"10.1016/j.canrad.2023.11.004","url":null,"abstract":"<div><h3>Purpose</h3><p>MRI is essential in the management of brain tumours. However, long waiting times reduce patient accessibility. Reducing acquisition time could improve access but at the cost of spatial resolution and diagnostic quality. A commercially available artificial intelligence (AI) solution, SubtleMR™, can increase the resolution of acquired images. The objective of this prospective study was to evaluate the impact of this algorithm that halves the acquisition time on the detectability of brain lesions in radiology and radiotherapy.</p></div><div><h3>Material and methods</h3><p>The T1/T2 MRI of 33 patients with brain metastases or meningiomas were analysed. Images acquired quickly have a matrix divided by two which halves the acquisition time. The visual quality and lesion detectability of the AI images were evaluated by radiologists and radiation oncologist as well as pixel intensity and lesions size.</p></div><div><h3>Results</h3><p>The subjective quality of the image is lower for the AI images compared to the reference images. However, the analysis of lesion detectability shows a specificity of 1 and a sensitivity of 0.92 and 0.77 for radiology and radiotherapy respectively. Undetected lesions on the IA image are lesions with a diameter less than 4<!--> <!-->mm and statistically low average gadolinium-enhancement contrast.</p></div><div><h3>Conclusion</h3><p>It is possible to reduce MRI acquisition times by half using the commercial algorithm to restore the characteristics of the image and obtain good specificity and sensitivity for lesions with a diameter greater than 4<!--> <!-->mm.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 251-257"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is neoadjuvant folfox an effective treatment only in a very selected favorable subgroup of locally advanced rectal cancer?","authors":"O. Riou ,&nbsp;F. Castan ,&nbsp;T. Conroy","doi":"10.1016/j.canrad.2023.12.002","DOIUrl":"10.1016/j.canrad.2023.12.002","url":null,"abstract":"","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 280-281"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La radiothérapie du cancer de la prostate augmente-t-elle le risque de seconds cancers ?","authors":"A. Boué-Raflé ,&nbsp;A. Briens ,&nbsp;S. Supiot ,&nbsp;P. Blanchard ,&nbsp;M. Baty ,&nbsp;C. Lafond ,&nbsp;I. Masson ,&nbsp;G. Créhange ,&nbsp;J.-M. Cosset ,&nbsp;D. Pasquier ,&nbsp;R. de Crevoisier","doi":"10.1016/j.canrad.2023.07.018","DOIUrl":"10.1016/j.canrad.2023.07.018","url":null,"abstract":"<div><h3>Purpose</h3><p>The increased risk of second cancer after prostate radiotherapy is a debated clinical concern. The objective of the study was to assess the risk of occurrence of second cancers after prostate radiation therapy based on the analysis the literature, and to identify potential factors explaining the discrepancies in results between studies.</p></div><div><h3>Materials and methods</h3><p>A review of the literature was carried out, comparing the occurrence of second cancers in patients all presenting with prostate cancer, treated or not by radiation.</p></div><div><h3>Results</h3><p>This review included 30 studies reporting the occurrence of second cancers in 2,112,000 patients treated or monitored for localized prostate cancer, including 1,111,000 by external radiation therapy and 103,000 by brachytherapy. Regarding external radiation therapy, the average follow-up was 7.3<!--> <!-->years. The majority of studies (80%) involving external radiation therapy, compared to no external radiation therapy, showed an increased risk of second cancers with a hazard ratio ranging from 1.13 to 4.9, depending on the duration of the follow-up. The median time to the occurrence of these second cancers after external radiotherapy ranged from 4 to 6<!--> <!-->years. An increased risk of second rectal and bladder cancer was observed in 52% and 85% of the studies, respectively. Considering a censoring period of more than 10 years after irradiation, 57% and 100% of the studies found an increased risk of rectal and bladder cancer, without any impact in overall survival. Studies of brachytherapy did not show an increased risk of second cancer. However, these comparative studies, most often old and retrospective, had many methodological biases.</p></div><div><h3>Conclusion</h3><p>Despite numerous methodological biases, prostate external radiation therapy appears associated with a moderate increase in the risk of second pelvic cancer, in particular bladder cancer, without impacting survival. Brachytherapy does not increase the risk of a second cancer.</p></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 3","pages":"Pages 293-307"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}