Prognostic impact of epidermal growth factor receptor (EGFR) expression on loco-regional recurrence after preoperative radiotherapy in rectal cancer

BACKGROUND: Epidermal growth factor receptor (EGFR) represents a major target for current radiosensitizing strategies. We wished to ascertain whether a correlation exists between the expression of EGFR and treatment outcome in a group of patients with rectal adenocarcinoma who had undergone preoperative radiotherapy (RT). METHODS: Within a six-year period, 138 patients underwent preoperative radiotherapy and curative surgery for rectal cancer (UICC stages II-III) at our institute. Among them, 77 pretherapeutic tumor biopsies were available for semi-quantitative immunohistochemical investigation evaluating the intensity and the number (extent) of tumor stained cells. Statistical analyses included Cox regression for calculating risk ratios of survival endpoints and logistic regression for determining odds ratios for the development of loco-regional recurrences. RESULTS: Median age was 64 years (range: 30–88). Initial staging showed 75% and 25% stage II and III tumors, respectively. RT consisted of 44-Gy pelvic irradiation in 2-Gy fractions using 18-MV photons. In 25 very low-rectal-cancer patients the primary tumor received a boost dose of up to 16 Gy for a sphincter-preservation approach. Concomitant chemotherapy was used in 17% of the cases. All patients underwent complete total mesorectal resection. Positive staining (EGFR+) was observed in 43 patients (56%). Median follow-up was 36 months (range: 6–86). Locoregional recurrence rates were 7 and 20% for EGFR extent inferior and superior to 25%, respectively. The corresponding locoregional recurrence-free survival rate at two years was 94% (95% confidence interval, CI, 92–98%) and 84% (CI 95%, 58–95%), respectively (P = 0.06). Multivariate analyses showed a significant correlation between the rate of loco-regional recurrence and three parameters: EGFR extent superior to 25% (hazard ratio = 7.18, CI 95%, 1.17–46, P = 0.037), rectal resection with microscopic residue (hazard ratio = 6.92, CI 95%, 1.18–40.41, P = 0.032), and a total dose of 44 Gy (hazard ratio = 5.78, CI 95%, 1.04–32.05, P = 0.045). CONCLUSION: EGFR expression impacts on loco-regional recurrence. Knowledge of expression of EGFR in rectal cancer could contribute to the identification of patients with an increased risk of recurrences, and to the prediction of prognosis

Prise en charge initiale des cancers épidermoïdes de l'oesophage (qualité du compte rendu d'endoscopie)

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Alimentation et cancérogénèse colorectale (de l'adénome au cancer)

MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

La Nutrition parentérale à domicile en soins palliatifs terminaux de pathologies néoplastiques (Comment aider les praticiens et les médecins généralistes à la décision de l'interrompre?)

Devant une augmentation de l'incidence des pathologies chroniques en général, :et du cancer en particulier, couplé au vieillissement de la population, la médecine se réorganise et demande à ses médecins généralistes de prendre en charge à domicile des cas de plus en plus complexes. De la gestion de la fin de vie à domicile en passant par la prise en charge nutritionnelle et la nutrition parentérale, les situations émotionnellement difficiles sont laissées à la charge du praticien libéral et de ses aides. La réflexion de se travail s'oriente vers une discussion sur l'existence et 'utilisation, dans un cadre des plus éthiques, d'un score clinico-biologique d'aide à la décision concernant l'assistance nutritionnelle. Les items les plus majeurs de la littérature dans le domaine de l'évaluation nutritionnelle, du soin palliatif et de l'accompagnement, ont été recensés aboutissant ainsi à l'ébauche d'un score qui restera à valider sur des études cliniques prospectivesTo an increasein the incidence of chronic diseases in general and cancer in particular, coupled with an aging population, the medicine was reorganized and ask to general practitioner to support home cases more complex. Management of end of life through home care and nutritional parenteral nutrition) emotionally difficult situations are left to the responsibility of the practitioner and his liberal aid. Reflection ta work towards a discussion of the existence and use, in a most ethical score a clinico-biological decision support on nutritional assistance. The most significant items of literature in the field of nutritional assessment of palliative care and support,-have been identified thus resulting in a draft that will score on ta validate prospective clinical studiesMONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Nutrition chez le patient adulte atteint de cancer : Place de la nutrition artificielle dans la prise en charge des patients atteints de cancer

Groupe de travail : Patrick Bachmann, CRLCC Léon Bérard, 28, rue Laennec, 69008 Lyon, France ; René Jean Bensadoun, CHU de Poitiers, BP 577, 86021 Poitiers cedex, France ; Isabelle Besnard, CHU de Nice et faculté de médecine, université de Nice Sophia-Antipolis, 06202 Nice cedex 03, France ; Isabelle Bourdel-Marchasson, centre Henri-Choussat, hôpital Xavier-Arnozan, 33604 Pessac cedex, France ; François Goldwasser, AP–HP, 27, rue du Faubourg-Saint-Jacques, 750014 Paris, France ; Olivier Guérin, CHU de Nice et faculté de médecine, université de Nice Sophia-Antipolis, 06202 Nice cedex 03, France ; Xavier Hébuterne, CHU de Nice et faculté de médecine, université de Nice Sophia-Antipolis, 06202 Nice cedex 03, France ; Paule Latino-Martel, INRA, CRJ, bâtiment 400, 78352 Jouy-en-Josas cedex, France Jocelyne Meuric, Institut Curie, 26, Rue D’Ulm, 75005 Paris, France ; Françoise May-Levin, Ligue Nationale contre le cancer, 14, rue Corvisart, 75013 Paris, France ; Marie Paule Vasson, CRLCC Jean Perrin 58, rue Montalembert BP 392, 63000 Clermont Ferrand, France.absen

Jeûne et thérapie du cancer

International audienc

Jeûne et thérapie du cancer

International audienc

Reply to Caccialanza et al.

International audienceA double-blind phase III trial of immunomodulating nutritional formula during adjuvant chemoradiotherapy in head and neck cancer patients: IMPATOX. Boisselier P, Kaminsky MC, Thézenas S, Gallocher O, Lavau-Denes S, Garcia-Ramirez M, Alfonsi M, Cupissol D, de Forges H, Janiszewski C, Geoffrois L, Sire C, Senesse P; Head and Neck Oncology and Radiotherapy Group (GORTEC). Am J Clin Nutr. 2020 Dec 10;112(6):1523-1531. doi: 10.1093/ajcn/nqaa227. PMID: 32936874 Clinical Trial. Immunonutrition in head and neck cancer patients undergoing chemoradiotherapy: an alternative approach for overcoming potential bias. Caccialanza R, Cereda E, Orlandi E, Filippi AR, Comoli P, Alberti A, Imarisio I, Pedrazzoli P, Bossi P. Am J Clin Nutr. 2021 Apr 6;113(4):1053-1054. doi: 10.1093/ajcn/nqaa421. PMID: 33822867 No abstract available