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AbstractAbstract
[en] Prostate cancer with initial node involvement is associated with poorer prognosis, and no specific recommendations are established. 1.3 to 12% of patients will be diagnosed with initial node involvement and are excluded from international studies. Radiation modulated intensity and imagery guided radiation allow to increase doses of radiation by using simultaneous integrated boost, with acceptable toxicities. Our review showed few data on this specific topic. To evaluate the impact of radiation and hormone-therapy with simultaneous integrated boost on synchron pelvic pathological nodes, we designed a mono-centric, retrospective study proceeded in Francois Baclesse anti-cancer center, Caen. The primary outcome was biological progression free survival, secondary outcomes were radiologic progression free survival, overall survival, acute and chronic toxicities, on both gastro-intestinal and genito-urinary systems. Forty-one patients were included, 83% received radiation and hormone therapy, 17% had surgery, radiation and hormone therapy as initial sequential treatment. With 20.3-month follow-up (75% IQR: 12.6-55.2), 11 patients experienced metastatic relapse and 5 of them died. Median biological progression free survival was 43.9 months (CI95 = 25.7-NA), median radiological-progression-free survival was 44.9 months (CI95 = 31.0-NA) and median overall survival wasn't reached. There was no relapse in irradiated fields. There was no grade 3 toxicity described. Initial radiation-therapy of prostate cancer with integrated boost to pathologic pelvic nodes seems to be efficient, with acceptable toxicities. Prospective and large studies are needed. (author)
[fr]
Un a 12% des patients presentent un cancer de prostate avec adenopathies pelviennes synchrones, au pronostic defavorable et sans standard de prise en charge. Les nouvelles techniques de permettent d'augmenter les doses de rayonnement aux volumes cibles avec realisation de boost integre au plan de traitement. Peu de donnees sont disponibles dans cette situation. Nous avons realise une etude retrospective, uni-centrique au centre Francois Baclesse de Caen, pour evaluer l'impact de la radio-hormonotherapie avec surimpression integre aux adenopathies pelviennes pour la prise en charge de cancer de prostate avec atteinte ganglionnaire d'emblee. L'objectif principal etait la survie sans progression; les objectifs secondaires etaient la survie sans progression biologique, radiologique, la survie globale et le recueil des toxicites urinaires et digestives, aigües et chroniques post-traitement. Avec 20,3 mois de suivi median (75% IQR: 12,6-55,2 mois), quarante et un patients ont ete inclus, 83% traite par radio-hormonotherapie et 17% par chirurgie puis radio-hormonotherapie dans le cadre de la sequence initiale de traitement. Onze patients ont recidive et 5 sont decedes. La mediane de survie sans progression biologique etait de 43,9 mois (CI95 = 25,7-NA mois). La survie mediane sans progression radiologique etait de 44,3 mois (CI95 = 31,0-NA mois), la survie globale mediane n'a pas ete atteinte. Il n'y a pas eu de recidive dans le champ d'irradiation. Aucune toxicite de grade 3 n'a ete constatee. La radio-hormonotherapie avec boost integre des adenopathies pelviennes semble etre un traitement efficace, avec peu d'effets secondaires. Des essais prospectifs sont necessaires. (auteur)Original Title
Etude Retrospective evaluant la radio-hormonotherapie chez les patients atteints d'un cancer de prostate avec atteinte ganglionnaire pelvienne synchrone: l'experience du centre Francois Baclesse de Caen
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6 Jul 2020; 65 p; 70 refs.; Available from the INIS Liaison Officer for France, see the INIS website for current contact and E-mail addresses; These de docteur en medecine
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