Les essais cliniques français GETUG et AFU en cours concernant les carcinomes urothéliaux et les cancers du rein et de prostate

Négrier, Sylvie; Fizazi, Karim; Pignot, G.; Fegoun, A. Benchikh El; Guillotreau, J.; Culine, Stéphane

doi:10.1016/s1166-7087(10)70035-x

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…This study did not allow definitive conclusions, as the results were positive for freedom from biochemical relapse, but no differences were observed for overall survival, distant failure, and local control [56]. With regard to salvage treatment, one study from the French group GETUG (GETUG 16) is addressing this question, and results are pending [57]. Initial results from the RTOG 96-01 trial presented at ASTRO meeting 2010 evaluating the benefit of adding bicalutamide to RT for salvage treatment tend to indicate an advantage for freedom from progression.…”

Section: Discussionmentioning

confidence: 99%

Three Years of Salvage IMRT for Prostate Cancer: Results of the Montpellier Cancer Center

et al. 2012

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Background. To assess the feasibility of salvage intensity-modulated radiation Therapy (IMRT) and to examine clinical outcome. Patients and Methods. 57 patients were treated with salvage IMRT to the prostate bed in our center from January, 2007, to February, 2010. The mean prescription dose was 68 Gy in 34 fractions. Forty-four patients received concomitant androgen deprivation. Results. Doses to organs at risk were low without altering target volume coverage. Salvage IMRT was feasible without any grade 3 or 4 acute gastrointestinal or urinary toxicity. With a median follow-up of 21 months, one grade 2 urinary and 1 grade ≥2 rectal late toxicities were reported. Biological relapse-free survival was 96.5% (2.3% (1/44) relapsed with androgen suppression and 7.7% (1/13) without). Conclusion. Salvage IMRT is feasible and results in low acute and chronic side-effects. Longer follow-up is warranted to draw conclusions in terms of oncologic control.

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Section: Discussionmentioning

confidence: 99%

Three Years of Salvage IMRT for Prostate Cancer: Results of the Montpellier Cancer Center

et al. 2012

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Simultaneous integrated boost plan comparison of volumetric‐modulated arc therapy and sliding window intensity‐modulated radiotherapy for whole pelvis irradiation of locally advanced prostate cancer

Riou

Mothe

Azria

et al. 2013

J Applied Clin Med Phys

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Concurrent radiotherapy to the pelvis plus a prostate boost with long‐term androgen deprivation is a standard of care for locally advanced prostate cancer. IMRT has the ability to deliver highly conformal dose to the target while lowering irradiation of critical organs around the prostate. Volumetric‐modulated arc therapy is able to reduce treatment time, but its impact on organ sparing is still controversial when compared to static gantry IMRT. We compared the two techniques in simultaneous integrated boost plans. Ten patients with locally advanced prostate cancer were included. The planning target volume (PTV) 1 was defined as the pelvic lymph nodes, the prostate, and the seminal vesicles plus setup margins. The PTV2 consisted of the prostate with setup margins. The prescribed doses to PTV1 and PTV2 were 54 Gy in 37 fractions and 74 Gy in 37 fractions, respectively. We compared simultaneous integrated boost plans by means of either a seven coplanar static split fields IMRT, or a one‐arc (RA1) and a two‐arc (RA2) RapidArc planning. All three techniques allowed acceptable homogeneity and PTV coverage. Static IMRT enabled a better homogeneity for PTV2 than RapidArc techniques. Sliding window IMRT and VMAT permitted to maintain doses to OAR within acceptable levels with a low risk of side effects for each organ. VMAT plans resulted in a clinically and statistically significant reduction in doses to bladder (mean dose IMRT: 50.1±4.6.2emGy vs. mean dose RA2: 47.1±3.9.2emGy,p=0.037), rectum (mean dose IMRT: 44±4.5 vs. mean dose RA2:41.6±5.5.2emGy,p=0.006), and small bowel (V30IMRT:76.47±14.91.2em% vs. V30.2emRA2:47.49±16.91.2em%,p=0.002). Doses to femoral heads were higher with VMAT but within accepted constraints. Our findings suggest that simultaneous integrated boost plans using VMAT and sliding window IMRT allow good OAR sparing while maintaining PTV coverage within acceptable levels.PACS number: 87.53.Jw

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Improving the pre-screening of eligible patients in order to increase enrollment in cancer clinical trials

Campillo‐Gimenez

Buscail

Zékri

et al. 2015

Trials

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BackgroundThe performance of randomized controlled trials (RCTs) is often hindered by recruitment difficulties. This study aims to explore the pre-screening phase of four prostate cancer RCTs to identify the impact of a systematic pre-selection of eligible patients for RCT recruitment.MethodsThe pre-screening of four RCTs opened at the Comprehensive Cancer Center in Rennes was analyzed retrospectively (French Genitourinary Tumor Group (GETUG) 14, 15, 16, and 17). Data were extracted from electronic multidisciplinary cancer (MDC) reports and manually completed by physicians and medical secretaries. These data were the main source of information for clinicians to discuss treatment alternatives during MDC sessions. The pre-screening decisions made by the clinicians during these MDC meetings were compared with those made after a systematic review of the MDC reports by a clinical research assistant (CRA). Any inconsistencies in decisions between the CRA and the MDC physicians were corrected by the principal investigator (PI).ResultsThe pre-screening rate was 9.1% during the MDC meetings, while it was estimated to be 12.9% after the final review by the PI, and 29% after the systematic review by the CRA. The study showed that 77% and 67% of the MDC reports did not mention clinical and pathological Tumor, lymph node and metastasis classification of malignant tumors (TNM) staging, respectively, and that 35 of the CRA’s 47 proposals rejected by the PI concerned implicit information (not specified in the MDC reports). Only one patient was proposed by the PI, and none by the CRA.ConclusionsThese results confirm that pre-screening could be improved by a systematic review of the medical reports. They also highlight the fact that missing data in electronic MDC reports leads to over-enrollment of non-eligible patients, but not to over-exclusion of eligible patients. Thus, our study confirms the potential gain in using semi-automated pre-selection of MDC reports, in order to avoid missing out on patients eligible for RCTs.Trial registrationThe trials evaluated in this study were previously registered with clinicaltrials.gov (registration number: NCT00104741 on 3 March 2005; NCT00104715 on 3 March 2005; NCT00423475 on 16 January 2007; and NCT00667069 on 24 April 2008).

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Les essais cliniques français GETUG et AFU en cours concernant les carcinomes urothéliaux et les cancers du rein et de prostate

Cited by 3 publications

References 6 publications

Three Years of Salvage IMRT for Prostate Cancer: Results of the Montpellier Cancer Center

Three Years of Salvage IMRT for Prostate Cancer: Results of the Montpellier Cancer Center

Simultaneous integrated boost plan comparison of volumetric‐modulated arc therapy and sliding window intensity‐modulated radiotherapy for whole pelvis irradiation of locally advanced prostate cancer

Improving the pre-screening of eligible patients in order to increase enrollment in cancer clinical trials

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