Florence Keime-Guibert

Publications (4)66.63 Total impact

• Article: Radiotherapy for glioblastoma in the elderly.

  Florence Keime-Guibert, Olivier Chinot, Luc Taillandier, Stéphanie Cartalat-Carel, Marc Frenay, Guy Kantor, Jean-Sébastien Guillamo, Eric Jadaud, Philippe Colin, Pierre-Yves Bondiau, Philippe Meneï, Hugues Loiseau, Valérie Bernier, Jérôme Honnorat, Maryline Barrié, Karima Mokhtari, Jean-Jacques Mazeron, Anne Bissery, Jean-Yves Delattre
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  ABSTRACT: There is no community standard for the treatment of glioblastoma in patients 70 years of age or older. We conducted a randomized trial that compared radiotherapy and supportive care with supportive care alone in such patients. Patients 70 years of age or older with a newly diagnosed anaplastic astrocytoma or glioblastoma and a Karnofsky performance score of 70 or higher were randomly assigned to receive supportive care only or supportive care plus radiotherapy (focal radiation in daily fractions of 1.8 Gy given 5 days per week, for a total dose of 50 Gy). The primary end point was overall survival; secondary end points were progression-free survival, tolerance of radiotherapy, health-related quality of life, and cognition. We randomly assigned 85 patients from 10 centers to receive either radiotherapy and supportive care or supportive care alone. The trial was discontinued at the first interim analysis, which showed that with a preset boundary of efficacy, radiotherapy and supportive care were superior to supportive care alone. A final analysis was carried out for the 81 patients with glioblastoma (median age, 73 years; range, 70 to 85). At a median follow-up of 21 weeks, the median survival for the 39 patients who received radiotherapy plus supportive care was 29.1 weeks, as compared with 16.9 weeks for the 42 patients who received supportive care alone. The hazard ratio for death in the radiotherapy group was 0.47 (95% confidence interval, 0.29 to 0.76; P=0.002). There were no severe adverse events related to radiotherapy. The results of quality-of-life and cognitive evaluations over time did not differ significantly between the treatment groups. Radiotherapy results in a modest improvement in survival, without reducing the quality of life or cognition, in elderly patients with glioblastoma. (ClinicalTrials.gov number, NCT00430911 [ClinicalTrials.gov].).
  New England Journal of Medicine 05/2007; 356(15):1527-35. · 53.30 Impact Factor
• Article: [Standards, Options and Recommendations 2002 for the management of adult patients with intracranial gliomas (summary report)].

  Didier Frappaz, Olivier Chinot, Anne Bataillard, Mohamed Ben Hassel, Laurent Capelle, Stéphane Chanalet, Marcel Chatel, Dominique Figarella-Branger, Yvan Guegan, Jacques Guyotat, Hoang-Xuan Khé, Emmanuel Jouanneau, Florence Keime-Guibert, Céline Laforêt, Claude Linassier, Hugues Loiseau, Philippe Menel, Sophie Rousmans, Marc Sanson, Marie-Pierre Sunyach
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  ABSTRACT: The "Standards, Options and Recommendations" (SOR) project, which started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French Regional Cancer Centers, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. To define clinical practice guidelines for the management of adult patients with intracranial glioma in collaboration with the Association of French-speaking Neuro-oncologists (Anocef) and the French society of neurosurgeons (SNCLF). These recommendations cover diagnosis, classification, treatment and follow-up of patients with these tumors. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGs according to the definitions of the Standards, Options and Recommendations project. Once the guidelines has been defined, the document is submitted for review by independent reviewers. This article is a summary version of the full document presenting the clinical practice guidelines with algorithms. The main recommendations concern the place of the surgery, radiotherapy, chemiotherapy, imagery and concomitant medical treatments in the specific treatment strategy of grade III and IV glioma, grade II glioma, gliomatosis cerebri, pilocytic astrocytoma, subependymoma, xanthoastrocytoma, intracranial ependymoma and brain stem glioma.
  Bulletin du cancer 11/2003; 90(10):873-86. · 0.67 Impact Factor
• Article: Spectrum of paraneoplastic neurologic disorders in women with breast and gynecologic cancer.

  Iñigo Rojas-Marcos, Audrey Rousseau, Florence Keime-Guibert, Ramón Reñé, Stéphanie Cartalat-Carel, Jean Yves Delattre, Francesc Graus
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  ABSTRACT: We conducted the current review of the paraneoplastic neurologic syndromes (PNSs) associated with gynecologic and breast carcinomas to describe their clinical and immunologic characteristics and their relative frequency. We retrospectively reviewed 92 patients whose serum was sent to our laboratories to detect onconeural antibodies and who were diagnosed as having PNSs associated with breast or gynecologic tumors. PNSs were defined as "definitive" and "possible" (atypical PNS, no onconeural antibodies, and no improvement after tumor treatment). Forty-nine patients had breast and 43 had gynecologic cancer. Sixty-three patients had onconeural antibodies (50 Yo-ab, 5 Hu-ab, 5 Ri-ab, and 3 amphiphysin-ab). Cerebellar ataxia represented 57 (62%) of all PNSs and was associated with anti-Yo in 88%. All Yo-abnegative patients had breast cancer; 4 of them had a mild cerebellar syndrome that improved after tumor treatment. Sensorypredominant neuropathies were present in 17 (18%) patients. Seven of them had Hu-ab (5) or amphiphysin-ab (2). Other PNSs were opsoclonus-myoclonus syndrome (4 cases, Ri-ab in 2), sensorimotor neuropathy (4 cases), paraneoplastic encephalomyelitis (4 cases, Ri-ab in 3), paraneoplastic retinopathy (2 cases), amyotrophic lateral sclerosis (2 cases), stiff-person syndrome (1 with amphiphysin-ab), and limbic encephalitis (1 case). All patients with gynecologic cancer presented definitive PNS, and onconeural antibodies were diagnosed in 93% of them. In contrast, 20% of PNSs associated with breast cancer were defined as possible and the incidence of onconeural antibodies was 51%, excluding the 2 patients with paraneoplastic retinopathy in whom antiretinal antibodies were not analyzed. In patients with possible PNS, a coincidental association between the tumor and the neurologic disorder cannot be excluded.
  Medicine 06/2003; 82(3):216-23. · 4.35 Impact Factor
• Article: Dramatic response to chemotherapy in oligodendroglial gliomatosis cerebri.

  Elie Louis, Florence Keime-Guibert, Jean-Yves Delattre, Marc Sanson
  Neurology 02/2003; 60(1):151. · 8.31 Impact Factor