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Quality assurance and safety of hippocampal avoidance prophylactic cranial irradiation in the multicenter randomized phase III trial(NCT01780675)

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Journal of the National Cancer Center 2023年第2期3卷 135-140页

作者： Oscar Candiff JoséBelderbos Anne Lisa Wolf Eugène Damen Paul van Haaren Wouter Crijns Sandra Hol Leen Paelinck Zdenko van Kesteren Jaap Jaspers Geert de Kerf Wouter van Elmpt Fred Ubbels Sanne Schagen Dirk de Ruysscher Michiel de Ruiter Department of Radiation Oncology the Netherlands Cancer InstituteAmsterdamthe Netherlands Department of Radiation Oncology Catharina HospitalEindhoventhe Netherlands Department of Radiation Oncology/Department of Oncology Laboratory of Experimental RadiotherapyKU LeuvenBelguimthe Netherlands Department of Radiation Oncology Institute VerbeetenTilburgthe Netherlands Department of Radiation Oncology Ghent University Hospital and Ghent UniversityGentBelgium Department of Radiation Oncology Amsterdam UMC-Location University of AmsterdamAmsterdamthe Netherlands Department of Radiation Oncology Erasmus Mc Cancer Institute-Erasmus Mc University Medical CenterRotterdamthe Netherlands Department of Radiation Oncology Antwerp University and Antwerp University Hospital/Iridium NetwerkAntwerpBelgium Department of Radiation Oncology University of Groningen-University Medical Center GroningenGroningenthe Netherlands Division of Psychosocial Research and Epidemiology the Netherlands Cancer InstituteAmsterdamthe Netherlands Radiation Oncology(Maastro) School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastrichtthe Netherlands

Objective:NCT01780675,a multicenter randomized phase III trial of prophylactic cranial irradiation(PCI)versus PCI with hippocampal sparing in small cell lung cancer(SCLC)investigated neurocognitive decline and *** part of quality assurance,we evaluated if hippocampal avoidance(HA)-PCI was performed according to the NCT01780675 trial protocol instructions,and performed a safety analysis to study the incidence and location of brain metastases for patients treated with ***:This retrospective analysis evaluated the quality of the irradiation given in the randomized controlled trial(RCT)comparing SCLC patients receiving PCI with or without hippocampal avoidance,using intensity mod-ulated radiotherapy(IMRT)or volumetric modulated arc therapy(VMAT).The dose distribution for each patient receiving HA-PCI was retrieved and analyzed to evaluate if the treatment dose constraints were met.A ques-tionnaire was sent out to all participating sites,and data on radiotherapy technique,pre-treatment dummy runs,phantom measurements and treatment electronic portal imaging device(EPID)dosimetry were collected and *** part of the safety analysis,the follow-up magnetic resonance imaging(MRI)or computerized to-mography(CT)scans on which cranial disease progression was first diagnosed were collected and matched to the radiotherapy planning dose *** matched scans were reviewed to analyze the location of the brain metastases in relation to the prescribed ***:A total of 168 patients were randomized in the NCT01780675 trial in 10 centers in the Netherlands and Belgium from April 2013 until March *** two patients receiving HA-PCI without evidence of brain metastases were *** patients were treated with 25 Gy in 10 *** runs and phantom measurements were performed in all institutions prior to enrolling patients into the *** radiotherapy(RT)plans showed a median mean bilateral hippocampal dose of 8.0 Gy,range 5.4-11.4(c

关键词： Hippocampus-avoidance profylactic cranial irradiation Small cell lung cancer Quality assurance NCT01780675 Neurocognition

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Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma:A Rare Cancer Network study

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Chinese Journal of Cancer Research 2017年第6期29卷 521-532页

作者： Alessandra Franzetti Pellanda Berardino De Bari Elisabeth Deniaud-Alexandre MarcoKrengli Paul Van Houtte Antonella Riehetti Salvador Villa Hadassah Goldberg EwaSzutowiez-Zielifiska Michel Bolla Heidi Rutten Marc Van Eijkeren Philip Poortmans Guido Henke Yavuz Anaeak Steve Chan Christine Landmann Carine Kirkove LueianoScandolaro Jacques Bernier Rene-Olivier Mirimanof Mahmut Ozsahin Centre Hospitalier Universitaire Vaudois(CHUV) 1011 LausanneSwitzerland Clinica Luganese Moncucco 6903 LuganoSwitzerland Centre Hospitalier R6gional Universitaire"Jean Minjoz" INSERMUMR109825030 BesangonFrance Hopital Tenon 75970 ParisFrance Centre Hospitalier Departemental 85925 VendeeFrance degli Studi del Piemonte Orientale e Ospedale Maggiore della Carifi 28100 NovaraItaly University Institut Jules Bordet 1000 BrusselsBelgium 8Ospedale di Circolo 21100 VareseItaly Ospedale di Circolo 21100 VareseItalyt Istituto Oncologico della Svizzera Italiana EOC6500 BellinzonaSwitzerland Catalan institute of Oncology Universitat Autbnoma de Barcelona08916 Barcelona 08916Spain Rambam Medical Center 31096 HaifaIsrael Medical University 80210 GdanskPoland Hopital Michallon BP21738043Grenoble cedex 09France Radboud University Medical Center 6525 NijmegenThe Netherlands Ghent University Hospital 9000 GentBelgium institute verbeeten 90120 TilburgThe Netherlands Kantonsspital St.Gallen 9007St.GallenSwitzerland Karadeniz Technical University 61080 TrabzonTurkey Nottingham University Hospital NHS trustNG5 1PB NottinghamUnited Kingdom Kantonsspital Basel 4031 BaselSwitzerland UCL St.Luc 1200 BrusselsBelgium presidio Ospedaliero Sant'Anna 22100 ComoItaly Ospedale San Giovanni 6500 BellinzonaSwitzerland Clinique de Genolier Genolier1272 Switzerland Department of Radiation Oncology Centre Hospitalier Universitaire Vaudois(CHUV)University of LausanneSwitzerland

Objective： Primary uterine leiomyosarcomas （ULMS） are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS. Methods： We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network （RCN）. Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics （FIGO） stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control （LC） and locoregional control （LRC）, overall survival （OS） and disease-free survival （DFS） rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model. Results： All patients underwent surgery. Seventy-five patients （68%） received adjuvant radiotherapy （RT）, including brachytherapy in 18 （I 6%）. Seventeen patients （15 %） received adjuvant chemotherapy. Median follow-up was 58 （range, 6-240） months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity. Conclusions： In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim p

关键词： Uterine leiomyosarcoma prognostic factors radiotherapy overall survival local control

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Trends in treatment and overall survival among patients with proximal esophageal cancer

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World Journal of Gastroenterology 2019年第47期25卷 6835-6846页

作者： Judith de Vos-Geelen Sandra ME Geurts Liselot BJ Valkenburg-van Iersel Evelien JM de Jong Vivianne CG Tjan-Heijnen Margreet van Putten Valery EPP Lemmens Heike I Grabsch Nadia Haj Mohammad Frank JP Hoebers Chantal V Hoge Paul M Jeene Hanneke WM van Laarhoven Tom Rozema Marije Slingerland Grard AP Nieuwenhuijzen Department of Internal Medicine Division of Medical OncologyGROW-School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastricht 6202 AZNetherlands Department of Research Netherlands Comprehensive Cancer Organization(IKNL)Eindhoven 5612 HZNetherlands Department of Pathology GROW-School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastricht 6202 AZNetherlands Pathology and Data Analytics Leeds Institute of Medical Research at St James”sUniversity of LeedsLeeds LS97TFUnited Kingdom Department of Medical Oncology University Medical Center UtrechtUtrecht 3584 CXNetherlands Department of Radiation Oncology(MAASTRO clinic) GROW-School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastricht 6229 ETNetherlands Department of Internal Medicine Division of GastroenterologyMaastricht University Medical CenterMaastricht 6202 AZNetherlands Department of Radiotherapy RadiotherapiegroepDeventer 7416 SENetherlands Department of Medical Oncology Amsterdam University Medical CentersUniversity of AmsterdamAmsterdam 1105 AZNetherlands Department of Radiotherapy Insituut VerbeetenTilburg 5042 SBNetherlands Department of Medical Oncology Leiden University Medical CenterLeiden 2333 ZANetherlands Department of Surgery Catharina Hospital EindhovenEindhoven 5623 EJNetherlands Department of Public Health Erasmus Medical Center RotterdamRotterdam 3015 GDNetherlands

BACKGROUND The management of proximal esophageal cancer differs from that of tumors located in the mid and lower part of the esophagus due to the close vicinity of vital ***-surgical treatment options like radiotherapy and definitive chemoradiation(CRT)have been *** trends in(non-)surgical treatment and its impact on overall survival(OS)in patients with proximal esophageal cancer are unclear,related to its rare disease *** optimize treatment strategies and counseling of patients with proximal esophageal cancer,it is therefore essential to gain more insight through real-life *** To establish trends in treatment and OS in patients with proximal esophageal *** In this population-based study,patients with proximal esophageal cancer diagnosed between 1989 and 2014 were identified in the Netherlands Cancer *** proximal esophagus consists of the cervical esophagus and the upper thoracic section,extending to 24 cm from the *** in radiotherapy,chemotherapy,and surgery,and OS were *** were stratified by presence of distant *** Cox proportional hazards regression analyses was performed to assess the effect of period of diagnosis on OS,adjusted for patient,tumor,and treatment *** In total,2783 patients were *** the study period,the use of radiotherapy,resection,and CRT in non-metastatic disease changed from 53%,23%,and 1%in 1989-1994 to 21%,9%,and 49%in 2010-2014,*** metastatic disease,the use of chemotherapy and radiotherapy increased over *** OS of the total population increased from 7.3 mo[95%confidence interval(CI):6.4-8.1]in 1989-1994 to 9.5 mo(95%CI:8.1-10.8)in 2010-2014(logrank P<0.001).In non-metastatic disease,5-year OS rates improved from 5%(95%CI:3%-7%)in 1989-1994 to 13%(95%CI:9%-17%)in 2010-2014(logrank P<0.001).Multivariable regression analysis demonstrated a significant treatment effect over time on ***

关键词： Esophagus Esophageal cancer Proximal Cervical Upper thoracic Trends Treatment Survival Outcome

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