J Bourhis

Institut de Cancérologie Gustave Roussy, Île-de-France, France

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Publications (222)642.79 Total impact

  • 2014 ASCO Annual Meeting - J Clin Oncol 32:5s 2014 (suppl; abstr # TPS6097^); 05/2014
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    ABSTRACT: Squamous cell carcinoma of larynx with subglottic extension (sSCC) is a rare location described to carry a poor prognosis. The aim of this study was to analyze outcomes and feasibility of larynx preservation in sSCC patients. Between 1996 and 2012, 197 patients with sSCC were treated at our institution and included in the analysis. Stage III-IV tumors accounted for 76 %. Patients received surgery (62 %), radiotherapy (RT) (18 %), or induction chemotherapy (CT) (20 %) as front-line therapy. The 5-year actuarial overall survival (OS), locoregional control (LRC), and distant control rate were 59 % (95 % CI 51-68), 83 % (95 % CI 77-89), and 88 % (95 % CI 83-93), respectively, with a median follow-up of 54.4 months. There was no difference in OS and LRC according to front-line treatments or between primary subglottic cancer and glottosupraglottic cancers with subglottic extension. In the multivariate analysis, age > 60 years and positive N stage were the only predictors for OS (HR 2, 95 % CI 1.2-3.6; HR1.9, 95 % CI 1-3.5, respectively). A lower LRC was observed for T3 patients receiving a larynx preservation protocol as compared with those receiving a front-line surgery (HR 14.1, 95 % CI 2.5-136.7; p = 0.02); however, no difference of ultimate LRC was observed according to the first therapy when including T3 patients who underwent salvage laryngectomy (p = 0.6). In patients receiving a larynx preservation protocol, the 5-year larynx-preservation rate was 55 % (95 % CI 43-68), with 36 % in T3 patients. The 5-year larynx preservation rate was 81 % (95 % CI 65-96) and 35 % (95 % CI 20-51) for patients who received RT or induction CT as a front-line treatment, respectively. Outcomes of sSCC are comparable with other laryngeal cancers when managed with modern therapeutic options. Larynx-preservation protocols could be a suitable option in T1-T2 (RT or chemo-RT) and selected T3 sSCC patients (induction CT).
    Strahlentherapie und Onkologie 03/2014; · 4.16 Impact Factor
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    ABSTRACT: Squamous cell carcinoma of larynx with subglottic extension is a rare location described to carry a poor prognosis. The aim of this study was to analyze outcomes and feasibility of definitive radiotherapy in patients with squamous cell carcinoma. Between 1998 and 2012, 56 patients with squamous cell carcinoma were treated at our institution and included in the analysis. Patients received definitive radiotherapy/chemoradiotherapy alone (63%) or after induction chemotherapy (37%) at our institute. The 5-year actuarial overall survival, progression-free survival and specific survival were 64% (CI 95%: 48-90), 45% (CI 95%: 28-61), 88% (CI 95%: 78-98), respectively, with median follow-up of 74months. The 5-year locoregional control was 69% (CI 95%: 56-83) and the 5-year distant control was 95% (CI 95%: 89-100). There was no difference in overall survival and locoregional control according to front-line treatments or between primary subglottic cancer and glotto-supraglottic cancers with subglottic extension. In the multivariate analysis, performance status of at least 1 and positive N stage were the only predictors for overall survival (hazard ratio [HR] [CI 95%]: 6.5 [1.3-34; P=0.03] and 11 [1.6-75; P=0.02], respectively). No difference of locoregional control was observed according to the first received therapy. The univariate analysis retrieved that T3-T4 patients had a lower locoregional control (HR: 3.1; CI 95%: 1.1-9.2, P=0.04), but no prognostic factor was retrieved in the multivariate analysis. In patients receiving a larynx preservation protocol, 5-year larynx preservation rate was 88% (CI 95%: 78-98), and 58% in T3 patients. The 5-year larynx preservation rate was 91% (CI 95%: 79-100) and 83% (CI 95%: 66-100) for patients who received radiotherapy/chemoradiotherapy or induction chemotherapy as a front-line treatment, respectively. This analysis suggests that the results for squamous cell carcinoma patients treated with radiotherapy/chemoradiotherapy are comparable to those obtained for other laryngeal tumors. This thus suggests the feasibility of laryngeal preservation protocols for infringement subglottic for selected cases. Further studies are needed to clarify these preliminary data.
    Cancer/Radiothérapie 12/2013; · 1.48 Impact Factor
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    ABSTRACT: Head and neck cancers are the fifth among the most common cancers in France. Two thirds of cases occur at an advanced stage. For advanced disease, progression-free survival, despite undeniable progress, remains below 50% at three years. The last 20 years have been marked by the necessity to identify situations where less intense surgery and/or radiotherapy and/or chemotherapy is possible without jeopardizing the prognosis, and situations where a therapeutic intensification is necessary and results in a gain in survival while better preserving function with less toxicity. French cooperative groups gathering radiation oncologists (GORTEC), surgeons (GETTEC) and medical oncologists or physicians involved in the management of systemic treatments in head and neck cancers (GERCOR) are now belonging to the INCa-labelled Intergroup ORL to deal with the challenges of head and neck cancers.
    Bulletin du cancer 10/2013; · 0.61 Impact Factor
  • Annals of Oncology 07/2013; · 7.38 Impact Factor
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    ABSTRACT: PURPOSE/OBJECTIVES: To analyze the clinical features, treatment modalities and outcome of patients treated for a localized esthesioneuroblastoma (ENB). MATERIALS AND METHODS: Forty-three consecutive patients with biopsy proven ENB treated at two referral cancer centers between 1998 and 2010 were retrospectively reviewed. RESULTS: Overall, 5 patients had stage A disease, 13 stage B, 16 stage C and 9 stage D according to the modified Kadish classification. Neo-adjuvant chemotherapy was performed in 23 patients leading to a 74 % response rate. Thirty-one patients were treated by surgery. Thirty-nine patients (90.6%) underwent radiation therapy. Twelve patients received bilateral cervical lymph node irradiation (LNI). After a median follow-up of 77months, the 5-year overall and progression free survival were 65% and 57%. Twelve patients (28%) had a locoregional relapse leading to 10 ENB-related deaths. The major prognostic factor was the modified Kadish stage with a 3-year survival for stage A-B, C and D of 100%, 48% and 22% respectively (p<0.0001). Two (9%) isolated cervical lymph node relapses occurred among staged B and C patients treated without elective LNI and none after elective or adjuvant LNI. CONCLUSION: The high risk of locoregional failure in ENB justifies the use of multimodal therapy. Induction chemotherapy leads to a high response rate. Elective LNI might prevent regional failure in locally advanced disease.
    Oral Oncology 06/2013; · 2.70 Impact Factor
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    ABSTRACT: Background Squamous cell carcinoma of larynx with subglottic extension is a rare location described to carry a poor prognosis. The aim of this study was to analyze outcomes and feasibility of definitive radiotherapy in patients with squamous cell carcinoma. Patients and methods Between 1998 and 2012, 56 patients with squamous cell carcinoma were treated at our institution and included in the analysis. Patients received definitive radiotherapy/chemoradiotherapy alone (63%) or after induction chemotherapy (37%) at our institute. Results The 5-year actuarial overall survival, progression-free survival and specific survival were 64% (CI 95%: 48–90), 45% (CI 95%: 28–61), 88% (CI 95%: 78–98), respectively, with median follow-up of 74 months. The 5-year locoregional control was 69% (CI 95%: 56–83) and the 5-year distant control was 95% (CI 95%: 89–100). There was no difference in overall survival and locoregional control according to front-line treatments or between primary subglottic cancer and glotto-supraglottic cancers with subglottic extension. In the multivariate analysis, performance status of at least 1 and positive N stage were the only predictors for overall survival (hazard ratio [HR] [CI 95%]: 6.5 [1.3–34; P = 0.03] and 11 [1.6–75; P = 0.02], respectively). No difference of locoregional control was observed according to the first received therapy. The univariate analysis retrieved that T3–T4 patients had a lower locoregional control (HR: 3.1; CI 95%: 1.1–9.2, P = 0.04), but no prognostic factor was retrieved in the multivariate analysis. In patients receiving a larynx preservation protocol, 5-year larynx preservation rate was 88% (CI 95%: 78–98), and 58% in T3 patients. The 5-year larynx preservation rate was 91% (CI 95%: 79–100) and 83% (CI 95%: 66–100) for patients who received radiotherapy/chemoradiotherapy or induction chemotherapy as a front-line treatment, respectively. Conclusion This analysis suggests that the results for squamous cell carcinoma patients treated with radiotherapy/chemoradiotherapy are comparable to those obtained for other laryngeal tumors. This thus suggests the feasibility of laryngeal preservation protocols for infringement subglottic for selected cases. Further studies are needed to clarify these preliminary data.
    Cancer/Radiothérapie 01/2013; · 1.48 Impact Factor
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    ABSTRACT: Lapatinib is a dual inhibitor of epidermal growth factor receptor (EGFR) and human EGFR-2 (HER-2) tyrosine kinases. This study investigated the pharmacodynamic and clinical effects of lapatinib in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). In total, 107 therapy-naive patients with locally advanced SCCHN were randomised (2 : 1) to receive lapatinib or placebo for 2-6 weeks before chemoradiation therapy (CRT). Endpoints included apoptosis and proliferation rates, clinical response, and toxicity. Versus placebo, lapatinib monotherapy did not significantly increase apoptosis detected by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick-end labelling or caspase-3 assays. A statistically significant decrease in proliferation using Ki67 assay was observed (P=0.030). In a subset of 40 patients that received 4 weeks of lapatinib or placebo, objective response rate (ORR) was 17% (n=4/24) vs 0% (n=0/16). In the lapatinib single-agent responders, all had EGFR overexpression, 50% had EGFR amplification, and 50% had HER2 expression by immunohistochemistry (including one patient with HER2 amplification). However, these patients showed variable modulation of apoptosis, proliferation, and phosphorylated EGFR on drug treatment. Following CRT, there was a statistically non-significant difference in ORR between lapatinib (70%) and placebo (53%). There was no clear correlation between changes in apoptosis or proliferation and response to chemoradiation. Mucosal inflammation, asthenia, odynophagia, and dysphagia were the most commonly reported adverse events with lapatinib. Short-term lapatinib monotherapy did not demonstrate apoptotic changes, but provided evidence of clinical activity in locally advanced SCCHN, and warrants further investigation in this disease.
    British Journal of Cancer 08/2011; 105(5):618-27. · 5.08 Impact Factor
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    ABSTRACT: After normal tissue exposure to radiation therapy, late side effects can occur and may reduce patients’ quality of life due to their progressive nature. Late toxicities occurrence is the main limiting factor of radiotherapy. Various biological disorders related to irradiation are involved in the development of late toxicities including fibrosis. The present review will focus on the recent physiopathological and molecular mechanisms described to be involved in the development of late radio-induced toxicities, that provide therapeutic perspective for pharmacomodulation.
    Cancer/Radiothérapie 08/2011; 15(5):383-389. · 1.48 Impact Factor
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    ABSTRACT: Intensity-modulated radiation therapy (IMRT) is an evolution of 3D conformal radiation therapy, which is the current standard radiation therapy technique in head-and-neck cancer. Modulating the radiation intensity of each beam by dynamic interposition of the computer-assisted collimator leaves yields dose distributions that are particularly well adapted to head-and-neck tumor volumes. It is thus possible to predetermine dose per element: i.e., the minimum effective dose to be delivered to tumor areas, and the maximum to be safely delivered to organs at risk. The technique thereby enables complex tumoral targets to be optimally covered, while sparing healthy tissue, and salivary glands in particular. In addition, the technique allows dose-escalation, with a higher dose per session delivered to the macroscopic tumor than to other irradiated areas. The first results of ongoing randomized trials confirmed those of earlier comparative studies, showing marked improvement in side effects, including post-radiation xerostomia. Although the positive impact of this technique on tumor control remains to be proven, salivary function conservation currently makes IMRT the standard treatment in most head-and-neck cancer.
    European Annals of Otorhinolaryngology, Head and Neck Diseases 07/2011; 128(5):241-7.
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    ABSTRACT: The central role of p53 after exposure to ionizing radiation has been widely demonstrated. Mdm2, the main cellular regulator of p53, is a promising target for radiosensitizing purposes. In this article, we review the most recent data on the pharmacological targeting of Mdm2, with focus on strategies of radiosensitization. Antitumor activity of Mdm2 inhibitors has been related with activation of p53-dependant apoptosis, action on DNA repair systems, and antiangiogenic activity. Preliminary data suggested a synergic interaction between Mdm2 inhibitors and ionizing radiations. However, no clinical data has been published yet on the pharmacological targeting of Mdm2. Given their new mechanisms of action, these new molecules should be subject to careful clinical assessment. Although promising, these strategies expose to unexpected toxicities.
    Cancer/Radiothérapie 06/2011; 15(4):316-22. · 1.48 Impact Factor
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    ABSTRACT: To assess the potential dosimetric gain of presegmentation modulated radiotherapy (OAPS, DosiSoft™) of breast, compared to routine 3D conformal radiotherapy. Twenty patients treated with conservative surgery for breast cancer (9 right and 11 left sided) with various breast volume (median 537 cm(3); range [100-1049 cm(3)]) have been selected. For each patient, we have delineated a breast volume and a compensation volume (target volumes), as well as organs at risk (lungs and heart). Two treatment plans have been generated: one using the routine 3D conformal technique and the other with the presegmentation algorithm of DosiSoft™ (OAPS). The dose distribution were analyzed using the conformity index for target volumes, mean dose and V30 Gy for the heart, and mean dose, V20 Gy and V30 Gy for lungs. Over the 20 patients, the conformity index increased from 0.897 with routine technique to 0.978 with OAPS (P<0,0001). For heart and lung, OAPS decreased irradiation (mean cardiac dose 1,3 vs 1,6 Gy [P<0,0001] and pulmonary V20 Gy 6,6 vs 7,1 [P<0,0001]). OAPS (DosiSoft™) is an original method of segmentation of breast. It is automatic, fast and easy, and is able to increase the conformity index, while sparing organ at risk.
    Cancer/Radiothérapie 06/2011; 15(8):663-9. · 1.48 Impact Factor
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    ABSTRACT: After normal tissue exposure to radiation therapy, late side effects can occur and may reduce patients' quality of life due to their progressive nature. Late toxicities occurrence is the main limiting factor of radiotherapy. Various biological disorders related to irradiation are involved in the development of late toxicities including fibrosis. The present review will focus on the recent physiopathological and molecular mechanisms described to be involved in the development of late radio-induced toxicities, that provide therapeutic perspective for pharmacomodulation.
    Cancer/Radiothérapie 05/2011; 15(5):383-9. · 1.48 Impact Factor
  • Radiotherapy and Oncology - RADIOTHER ONCOL. 01/2011; 99.
  • European Journal of Cancer - EUR J CANCER. 01/2011; 47.
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    ABSTRACT: La radiothérapie conformationnelle en modulation d’intensité (RCMI) ou Intensity Modulated Radiation Therapy (IMRT) est une évolution de la radiothérapie conformationnelle 3D qui constitue le standard technique actuel de la radiothérapie des cancers ORL. La modulation de l’intensité de l’irradiation pour chaque faisceau utilisé par l’interposition dynamique des lames d’un collimateur asservi par ordinateur permet d’obtenir des distributions de dose particulièrement bien adaptées aux volumes tumoraux cervicofaciaux. Il est ainsi possible de prescrire a priori un niveau de dose à atteindre pour chaque élément concerné, la dose minimale que l’on peut délivrer aux zones tumorales, et la dose maximale que l’on peut délivrer sans danger aux organes à risque. La technique permet ainsi de couvrir de façon optimale des cibles tumorales complexes tout en épargnant certains tissus sains, notamment salivaires. En outre, la technique permet une escalade de dose en apportant à la tumeur macroscopique une dose par séance plus élevée que celle délivrée aux autres zones irradiées. Les premiers résultats des essais randomisés en cours confirment ceux des comparaisons historiques montrant une amélioration nette des effets secondaires de l’irradiation cervicofaciale, et notamment de la xérostomie. Même si l’impact positif de la RCMI sur le contrôle tumoral reste à démontrer, l’avantage thérapeutique conséquent représenté par la protection salivaire en fait la technique actuelle de référence lors de l’irradiation de la plupart des cancers cervicofaciaux.
    Tribology International - TRIBOL INT. 01/2011; 128(5):284-291.
  • Radiotherapy and Oncology - RADIOTHER ONCOL. 01/2011; 99.
  • European Journal of Cancer - EUR J CANCER. 01/2011; 47.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The central role of p53 after exposure to ionizing radiation has been widely demonstrated. Mdm2, the main cellular regulator of p53, is a promising target for radiosensitizing purposes. In this article, we review the most recent data on the pharmacological targeting of Mdm2, with focus on strategies of radiosensitization. Antitumor activity of Mdm2 inhibitors has been related with activation of p53-dependant apoptosis, action on DNA repair systems, and antiangiogenic activity. Preliminary data suggested a synergic interaction between Mdm2 inhibitors and ionizing radiations. However, no clinical data has been published yet on the pharmacological targeting of Mdm2. Given their new mechanisms of action, these new molecules should be subject to careful clinical assessment. Although promising, these strategies expose to unexpected toxicities.
    Cancer Radiotherapie - CANCER RADIOTHER. 01/2011; 15(4):316-322.
  • European Journal of Cancer - EUR J CANCER. 01/2011; 47:4-4.

Publication Stats

4k Citations
642.79 Total Impact Points

Institutions

  • 1990–2013
    • Institut de Cancérologie Gustave Roussy
      • Department of Radiotherapy
      Île-de-France, France
  • 2006
    • Hôpital Foch
      Lutetia Parisorum, Île-de-France, France
  • 1997–2002
    • Centre Jean Perrin
      Clermont, Auvergne, France
    • Centre Hospitalier Lyon Sud
      Lyons, Rhône-Alpes, France