Vicentini C., Abi-Rached H., Thecua E., Deleporte P., Lecomte F., Mortier L., Vignion A. S., Szeimies R. M., Mordon S.
PHOS-ISTOS: A NEW SOLUTION FOR PHOTODYNAMIC TREATMENT OF ACTINIC KERATOSIS.
Lasers Surg. Med..
Vermandel M., Leroy H. A., Dupont C., Mordon S. R., Reyns N.
MAGNETIC RESONANCE IMAGING TO ASSESS PHOTODYNAMIC THERAPY EFFECTS ON A PRECLINICAL MODEL: PRELIMINARY RESULTS ON DIFFUSION/PERFUSION MRI TO EVALUATE PDT RESPONSE.
Lasers Surg. Med..
Vermandel M., Dupont C., Lecomte F., Quidet M., Le Rhun E., Mordon S. R., Reyns N.
AN INTRODUCTION TO INDYGO: SET-UP AND PRELIMINARY RESULTS OF THE FIRST PILOT CLINICAL TRIAL ON INTRAOPERATIVE 5-ALA PDT FOR THE TREATMENT OF NEWLY DIAGNOSED GLIOBLASTOMA.
Lasers Surg. Med..
Dupont C., Vignion A. S., Mordon S., Reyns N., Vermandel M.
Photodynamic therapy for glioblastoma: A preliminary approach for practical application of light propagation models.
Lasers Surg Med.
PURPOSE: Photodynamic therapy (PDT) is a promising treatment modality to be added in the management of glioblastoma multiforme (GBM). Light distribution modeling is required for planning and optimizing PDT. Several models have been developed to predict the light propagation inside biological tissues. In the present study, two analytical methods of light propagation emitted from a cylindrical fiber source were evaluated: a discrete and a continuous method. METHODS: The two analytical approaches were compared according to their fluence rate results. Several cylindrical diffuse lengths were evaluated, and the relative deviation in the fluence rates was estimated. Moreover, a sensitivity analysis was conducted to compute the variance of each analytical model. RESULTS: The discrete method provided fluence rate estimations closer to the Monte-Carlo simulations than the continuous method. The sensitivity study results did not reveal significant differences between the variance of the two analytical models. CONCLUSIONS: Although the discrete model provides relevant light distribution, the heterogeneity of GBM tissues was not considered. With the improvement in parallel computing that drastically decreased the computing time, replacing the analytical model by a Monte-Carlo GPU-accelerated code appeared relevant to the GBM case. Nonetheless, the analytical modeling may still function in the optimization algorithms, which might be used in the Photodynamic treatment planning system. Lasers Surg. Med. 50:523-534, 2018. (c) 2017 Wiley Periodicals, Inc.
Kerbage Y., Betrouni N., Collinet P., Azaïs H., Mordon S., Dewalle-Vignion A. S., Merlot B.
Laser interstitial thermotherapy application for breast surgery: Current situation and new trends.
While breast specialists debate on therapeutic de-escalation in breast cancer, the treatment of benign lesions is also discussed in relation to new percutaneous ablation techniques. The purpose of these innovations is to minimize potential morbidity. Laser Interstitial ThermoTherapy (LITT) is an option for the ablation of targeted nodules. This review evaluated the scientific publications investigating the LITT approach in malignant and benign breast disease. Three preclinical studies and eight clinical studies (2 studies including fibroadenomas and 6 studies including breast cancers) were reviewed. Although the feasibility and safety of LITT have been confirmed in a phase I trial, heterogeneous inclusion criteria and methods seem to be the main reason for LITT not being yet an extensively used treatment option. In conclusion, further development is necessary before this technique can be used in daily practice.
Isnard J., Taussig D., Bartolomei F., Bourdillon P., Catenoix H., Chassoux F., Chipaux M., Clémenceau S., Colnat-Coulbois S., Denuelle M., Derrey S., Devaux B., Dorfmüller G., Gilard V., Guenot M., Job-Chapron A. S., Landré E., Lebas A., Maillard L., McGonigal A., Minotti L., Montavont A., Navarro V., Nica A., Reyns N., Scholly J., Sol J. C., Szurhaj W., Trebuchon A., Tyvaert L., Valenti-Hirsch M. P., Valton L., Vignal J. P., Sauleau P.
French guidelines on stereoelectroencephalography (SEEG).
Stereoelectroencephalography (SEEG) was designed and developed in the 1960s in France by J. Talairach and J. Bancaud. It is an invasive method of exploration for drug-resistant focal epilepsies, offering the advantage of a tridimensional and temporally precise study of the epileptic discharge. It allows anatomo-electrical correlations and tailored surgeries. Whereas this method has been used for decades by experts in a limited number of European centers, the last ten years have seen increasing worldwide spread of its use. Moreover in current practice, SEEG is not only a diagnostic tool but also offers a therapeutic option, i.e., thermocoagulation. In order to propose formal guidelines for best clinical practice in SEEG, a working party was formed, composed of experts from every French centre with a large SEEG experience (those performing more than 10 SEEG per year over at least a 5 year period). This group formulated recommendations, which were graded by all participants according to established methodology. The first part of this article summarizes these within the following topics: indications and limits of SEEG; planning and management of SEEG; surgical technique; electrophysiological technical procedures; interpretation of SEEG recordings; and SEEG-guided radio frequency thermocoagulation. In the second part, those different aspects are discussed in more detail by subgroups of experts, based on existing literature and their own experience. The aim of this work is to present a consensual French approach to SEEG, which could be used as a basic document for centers using this method, particularly those who are beginning SEEG practice. These guidelines are supported by the French Clinical Neurophysiology Society and the French chapter of the International League Against Epilepsy.
Thecua E., Vicentini C., Vignion A. S., Lecomte F., Deleporte P., Mortier L., Szeimies R. M., Mordon S.
LIGHT EMITTING FABRIC FOR PHOTODYNAMIC TREATMENT OF ACTINIC KERATOSIS.
De Wolf J., Bellier J., Lepimpec-Barthes F., Tronc F., Peillon C., Bernard A., Le Rochais J. P., Tiffet O., Sage E., Chapelier A., Porte H.
Exhaustive preoperative staging increases survival in resected adrenal oligometastatic non-small-cell lung cancer: a multicentre studyaEuro.
Eur. J. Cardio-Thorac. Surg..
OBJECTIVES: Adrenal oligometastatic non-small-cell lung cancer is rare, and surgical management remains controversial. METHODS: We performed a multicentre, retrospective study from January 2004 to December 2014. The main objective was to evaluate survival in patients who had undergone adrenalectomy after resection of primary lung cancer. Secondary objectives were to determine prognostic, survival and recurrence factors. RESULTS: Fifty-nine patients were included. Forty-six patients (78%) were men. The median age was 58 years [39-75 years]. Twenty-six cases (44%) showed synchronous presentation, and 33 cases (56%) had a metachronous presentation. The median time to onset of metastasis was 18.3 months [6-105 months]. The 5-year overall survival rate was 59%; the median survival time was 77 months [0.6-123 months]. A recurrence was observed in 70% of the population. Mediastinal lymph node invasion (P = 0.035) is a detrimental prognostic factor of survival. CONCLUSIONS: After exhaustive staging, patients with adrenal oligometastatic non-small-cell lung cancer benefit from bifocal surgery.
Rousselin A., Bendifallah S., Timoh K. N., Ouldamer L., Canlorbe G., Raimond E., Hudry N., Coutant C., Graesslin O., Touboul C., Collinet P., Bricou A., Huchon C., Darai E., Ballester M., Leveque J., Lavoue V.
Patterns of care and the survival of elderly patients with high-risk endometrial cancer: A case-control study from the FRANCOGYN group.
BACKGROUND: The standard of care of endometrial cancer involves complex procedures such as pelvic and para-aortic lymphadenectomy and omentectomy, particularly for high-risk endometrial cancer. Few data are available about these complex surgical procedures and adjuvant therapy in elderly women. We aim to examine treatment and survival of elderly women diagnosed with high-risk endometrial cancer. STUDY DESIGN: We performed a case-control study of women diagnosed between 2001 and 2013 with high-risk endometrial cancers. Women older than 70 years (n = 198) were compared with patients <70 years (n = 198) after matching on high-risk for recurrence and LVSI status. RESULTS: Elderly patients had lymphadenectomies less frequently compared with younger patients (76% vs 96%, p < 0.001) and no adjuvant treatment more frequently (17% vs 8%, p = 0.005) due to less chemotherapy being administered (23% vs 46%, p < 0.001). The 3-year DFS, CSS and OS of patients >/=70 years was 52% (43-61), 81% (74-88) and 61% (53-70), respectively. These were significantly lower than the 3-year DFS, CSS, and OS of younger patients, which was 75% (68-82) (p < 0.001), 92% (87-96) (p < 0.008) and 75% (69-82) (p = 0.018), respectively. Cox proportional hazard models found that elderly women had 57% increased risk of recurrence (hazard ratio 1.57, 95% CI 1.04-2.39) compared with younger patients. CONCLUSION: Although we found an independently significant lower DFS in elderly patients with high-risk endometrial cancer when compared with young patients, elderly women are less likely to be treated with lymphadenectomy and chemotherapy. Specific guidelines for management of elderly patients with high-risk endometrial cancer are required to improve their prognosis.
Guerin C., Pattou F., Brunaud L., Lifante J. C., Mirallie E., Haissaguerre M., Huglo D., Olivier P., Houzard C., Ansquer C., Hindie E., Loundou A., Archange C., Tabarin A., Sebag F., Baumstarck K., Taieb D.
Performance of F-18-FDG PET/CT in the Characterization of Adrenal Masses in Noncancer Patients: A Prospective Study.
J. Clin. Endocrinol. Metab..
Context: Few prospective studies have evaluated the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the characterization of adrenal masses. Objective: To assess the performance of 18F-FDG PET/CT in the malignancy diagnosis of adrenal masses in noncancer patients. Design: Prospective multicenter study. Material and Methods: The study population consisted of 87 patients (87 adrenal masses) referred to endocrine surgeons: 56 with mass diameter >/=40 mm and 31 with a diameter <40 mm and of indeterminate nature based on unenhanced and washout CT attenuation densities. Fourteen patients had hypercortisolism. Adrenal masses were characterized by 18F-FDG PET/CT. Histology was the gold standard for the diagnosis of malignancy. In the absence of pathological proof (n = 23), the nature of the lesion was based on the 12-month imaging follow-up. Results: Fifteen adrenal masses were classified as malignant (including 11 adrenocortical carcinomas) and 72 as benign. Compared with benign lesions, malignant lesions were larger in size (P = 0.003), had higher unenhanced densities (P = 0.002), lower relative washout values (P = 0.007), and higher 18F-FDG uptake parameters (P < 10-3). The optimal threshold value of (Tumor SUVmax:Liver SUVmax) the ratio for malignancy was >1.5 with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 86.7%, 86.1%, 56.5%, 96.9%, and 86.2%, respectively. Conclusions: Our results show that 18F-FDG PET/CT complements adrenal washout CT in the evaluation of adrenal masses and should be recommended in the evaluation of large and/or indeterminate adrenal masses.