J F Bosset

University of Franche-Comté, Becoinson, Franche-Comté, France

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Publications (167)459.06 Total impact

  • Cancer/Radiothérapie 10/2015; 19(6-7):682. DOI:10.1016/j.canrad.2015.07.113 · 1.41 Impact Factor
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    ABSTRACT: Personalized treatments based on predictions for patient outcome require early characterization of a rectal cancer patient's sensitivity to treatment. This study has two aims: (1) identify the main patterns of recurrence and response to the treatments (2) evaluate pathologic complete response (pCR) and two-year disease-free survival (2yDFS) for overall survival (OS) and their potential to be relevant intermediate endpoints to predict. Pooled and treatment subgroup analyses were performed on five large European rectal cancer trials (2795 patients), who all received long-course radiotherapy with or without concomitant and/or adjuvant chemotherapy. The ratio of distant metastasis (DM) and local recurrence (LR) rates was used to identify patient characteristics that increase the risk of recurrences. The DM/LR ratio decreased to a plateau in the first 2years, revealing it to be a critical follow-up period. According to the patterns of recurrences, three patient groups were identified: 5-15% had pCR and were disease free after 2years (excellent prognosis), 65-75% had no pCR but were disease free (good prognosis) and 15-30% had neither pCR nor 2yDFS (poor prognosis). Compared with pCR, 2yDFS is a stronger predictor of OS. To adapt treatment most efficiently, accurate prediction models should be developed for pCR to select patients for organ preservation and for 2yDFS to select patients for more intensified treatment strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Radiotherapy and Oncology 02/2015; 114(3). DOI:10.1016/j.radonc.2015.02.001 · 4.36 Impact Factor
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    ABSTRACT: Background: In T3 rectal cancer (RC), preoperative chemoradiotherapy [5-fluorouracil (5-FU-RT)] reduces local recurrences, but does not affect overall survival. New therapeutic options are still necessary to improve clinical outcomes. Patients and methods: This randomized, noncomparative, open-label, multicenter, two arms, phase II study was conducted in MRI-defined locally advanced T3 resectable RC. In arm A, patients received 12-week bevacizumab plus 5-FU, leucovorin and oxaliplatin (Folfox-4) followed with bevacizumab-5-FU-RT before total mesorectal excision (TME). In arm B, patients received only bevacizumab-5-FU-RT before TME. Primary end point was pathological complete response (pCR) rate. Results: Forty-six patients were randomized in arm A and 45 patients in arm B. In arm A, the rate of pCR was 23.8% [95% confidence interval (CI) 12.1% to 39.5%] statistically superior to the defined standard rate of 10%, P = 0.015. In arm B, the rate of pCR of 11.4% (95% CI 3.8% to 24.6%) was not different from 10%, P = 0.906. No death occurred during the study period, from the start until 8 weeks following surgery. Postoperative fistulas were reported for 16 patients (7 in arm A and 9 in arm B). Conclusion: Even if the addition of bevacizumab induced manageable toxicities including an increased risk of postoperative fistula and no treatment-related death, arm B did not achieve the expected pCR rate in the population of patients included. Induction bevacizumab-Folfox-4 followed by bevacizumab-5-FU-RT is promising. It is however necessary to continue investigations in the management of locally advanced RC. Clinical trialsgov identifier: NCT 00865189.
    Annals of Oncology 08/2014; 25(11). DOI:10.1093/annonc/mdu377 · 7.04 Impact Factor
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    A. Lépinoy · N. Lescut · C. Lassabe · J.-F. Bosset · S. Servagi-Vernat ·
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    ABSTRACT: The main histological types of cervix cancer are squamous cell carcinoma and adenocarcinoma. The glassy cell carcinoma is a rare form found in less than 2% of cases and it is an entity, aggressive and unknown, of worse prognosis, whose current treatment is not distinguished from other histological types. We report the cases of two patients with glassy cell carcinoma of the cervix with a review of the literature.
    Cancer/Radiothérapie 06/2014; 18(3). DOI:10.1016/j.canrad.2014.04.001 · 1.41 Impact Factor
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    ABSTRACT: The present study investigates the properties of the French version of the OUT-PATSAT35 questionnaire, which evaluates the outpatients' satisfaction with care in oncology using classical analysis (CTT) and item response theory (IRT). This cross-sectional multicenter study includes 692 patients who completed the questionnaire at the end of their ambulatory treatment. CTT analyses tested the main psychometric properties (convergent and divergent validity, and internal consistency). IRT analyses were conducted separately for each OUT-PATSAT35 domain (the doctors, the nurses or the radiation therapists and the services/organization) by models from the Rasch family. We examined the fit of the data to the model expectations and tested whether the model assumptions of unidimensionality, monotonicity and local independence were respected. A total of 605 (87.4 %) respondents were analyzed with a mean age of 64 years (range 29-88). Internal consistency for all scales separately and for the three main domains was good (Cronbach's α 0.74-0.98). IRT analyses were performed with the partial credit model. No disordered thresholds of polytomous items were found. Each domain showed high reliability but fitted poorly to the Rasch models. Three items in particular, the item about "promptness" in the doctors' domain and the items about "accessibility" and "environment" in the services/organization domain, presented the highest default of fit. A correct fit of the Rasch model can be obtained by dropping these items. Most of the local dependence concerned items about "information provided" in each domain. A major deviation of unidimensionality was found in the nurses' domain. CTT showed good psychometric properties of the OUT-PATSAT35. However, the Rasch analysis revealed some misfitting and redundant items. Taking the above problems into consideration, it could be interesting to refine the questionnaire in a future study.
    Quality of Life Research 03/2014; 23(7). DOI:10.1007/s11136-014-0658-z · 2.49 Impact Factor
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    ABSTRACT: Squamous cell carcinoma of the anal canal (SCCA) is a rare disease, mostly diagnosed at early stage. After concurrent chemoradiation (CRT) with mitomycin C and 5-fluorouracil (5FU), local or metastatic recurrences occur in >20% of the patients. After treatment failure, cisplatin (CDDP)-based chemotherapy is the standard option, but complete response (CR) is a rare event and the prognosis remains poor. Eight consecutive patients with advanced recurrent SCCA after CRT were treated with DCF regimen (docetaxel 75 mg/m(2) day 1, CDDP 75 mg/m(2) day 1 and 5FU at 750 mg/m(2)/day for 5 days every 3 weeks). Tumour samples were analysed for human papillomavirus (HPV) genotyping, as well as p16 and p53 expression. After a median follow-up of 41 months, the overall survival rate at 12 months was 62.5% (95% CI 22.9-86.1 months). Four patients achieved a complete remission and remain relapse-free at the time of analysis with a progression-free survival of 19, 33, 43 and 88 months. Three of these patients underwent surgery for all involved metastatic sites. For all of them, pathological CR was confirmed. DCF regimen appeared feasible in these patients previously exposed to pelvic CRT, and no grade IV toxicity occurred. All patients in complete remission had HPV-16-positive SCCA, while HPV could only be detected among 50% of the non-responding patients. Of interest, immunohistochemical study revealed a p16(+)/p53(-) phenotype in these patients, while none of non-responders expressed p16. The high level of complete and long-lasting remission among SCCA patients treated with DCF regimen supports the assessment of this strategy in prospective cohorts.
    Annals of Oncology 10/2013; 24(12). DOI:10.1093/annonc/mdt396 · 7.04 Impact Factor

  • Cancer/Radiothérapie 10/2013; 17(5-6):581. DOI:10.1016/j.canrad.2013.06.017 · 1.41 Impact Factor
  • X.S. Sun · N. Guevara · N. Fakhry · S.-R. Sun · P.-Y. Marcy · J. Santini · J.-F. Bosset · J. Thariat ·
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    ABSTRACT: Anaplastic thyroid cancers represent 1–2% of all thyroid tumours and are of very poor prognosis even with multimodality treatment including external beam radiation therapy. Conversely, differentiated thyroid carcinomas (at least 80% of thyroid cancers) hamper good prognosis with surgery with or without radioiodine and there is hardly any room for external beam radiation therapy. Insular and medullar carcinomas have intermediary prognosis and are rarely irradiated. We aimed to update recommendations for external beam irradiation in these different clinical situations and put in light the benefits of new irradiations techniques. A search of the French and English literature was performed using the following keywords: thyroid carcinoma, anaplastic, chemoradiation, radiation therapy, surgery, histology and prognostic. Non-mutilating surgery (often limited to debulking) followed by systematic external beam radiation therapy is the standard of care in anaplastic thyroid cancers (hyperfractionated-accelerated radiation therapy with low-dose weekly doxorubicin with or without cisplatin if possible). Given anaplastic thyroid cancers’ median survival of 10 months or less, neoadjuvant and adjuvant chemotherapy may also be discussed. Ten-year survival rates for patients with papillary, follicular and Hürthle-cell carcinomas are 93%, 85%, and 76%, respectively. Massive primary incompletely resected iodine-negative disease indicates external beam radiation therapy. Older age (45 or 60-year-old), poor-prognosis histological variants (including tall cell cancers) and insular cancers are increasingly reported as criteria for external beam radiation therapy. Massive extracapsular incompletely resected nodal medullary disease suggests external beam radiation therapy. Radiation therapy morbidity has been an important limitation. However, intensity modulated radiation therapy (IMRT) offers clear dosimetric advantages on tumour coverage and organ sparing, reducing late toxicities to less than 5%. The role of radiation therapy is evolving for anaplastic thyroid cancers using multimodal strategies and new chemotherapy molecules, and for differentiated cancers using minor criteria, such as histological variants, with IMRT becoming a standard of care.
    Cancer/Radiothérapie 06/2013; 17(3):233–243. DOI:10.1016/j.canrad.2012.12.003 · 1.41 Impact Factor
  • X.S. Sun · N. Guevara · N. Fakhry · S.R. Sun · P.Y. Marcy · J. Santini · J.F. Bosset · J. Thariat ·

    Cancer/Radiothérapie 06/2013; 17(3):258. DOI:10.1016/j.canrad.2013.01.001 · 1.41 Impact Factor
  • X.S. Sun · N. Guevara · N. Fakhry · S.R. Sun · P.Y. Marcy · J. Santini · J.F. Bosset · J. Thariat ·

    Cancer/Radiothérapie 06/2013; 17(3):255–256. DOI:10.1016/j.canrad.2013.01.002 · 1.41 Impact Factor
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    ABSTRACT: Background: ATC represents 1-2% of all thyroid carcinomas. Median survival is poor (3-10 months). Our goal is to update recommendations for RT in the context of new irradiation techniques. Materials and methods: A search of the French and English literature was performed with terms: thyroid carcinoma, anaplastic, chemoradiation, radiation therapy and surgery. Level-based evidence remains limited in the absence of prospective studies and the small size of retrospective series of this rare tumor. Results: Surgery when possible should be as complete as possible but without mutilation given the 8-month median survival of ATC. It should be followed by systematic chemoradiation in ATC. Initiation of treatment is an emergency given fast tumor doubling time. The most promising results of chemoradiation to date have been shown in series of radiation therapy (+/- acceleration) combined with doxorubicin +/- taxanes or cisplatin. Adjuvant chemotherapy (doxorubicin, cisplatine and/or taxane-based) may also be recommended given the metastatic potential of ATC and warrants further investigations. Data on neoadjuvant chemotherapy are missing. Intensity modulated radiation therapy offers clear dosimetric advantages and has the potential to improve tumor and nodal (posterior neck, mediastinum) coverage, i.e., locoregional control while optimally sparing the spinal cord, larynx, parotids, trachea and esophagus. PET-CT and MRI may be used for RT planning. Conclusion: Chemoradiation with debulking surgery whenever possible is the mainstay of treatment of anaplastic thyroid carcinomas (ATC). EBRT using IMRT has the potential to improve local control. Taxane-doxorubicin concomitant chemoradiotherapy is worth further investigation.
    Critical reviews in oncology/hematology 12/2012; 86(3). DOI:10.1016/j.critrevonc.2012.10.006 · 4.03 Impact Factor
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    De Bari B · Bosset JF · Gérard JP · Maingon P · Valentini V. ·

    Cancer/Radiothérapie 12/2012; 16(8):711-20. · 1.41 Impact Factor
  • B. De Bari · J.-F. Bosset · J.-P. Gérard · P. Maingon · V. Valentini ·
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    ABSTRACT: In the last 10 years, a number of important European randomized published studies investigated the optimal management of rectal cancer. In order to define an evidence-based approach of the clinical practice based, an international consensus conference was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO) and European Society of Therapeutic Radiation Oncology (ESTRO). The aim of this article is to present highlights of multidisciplinary rectal cancer management and to compare the conclusions of the international conference on ‘Multidisciplinary Rectal Cancer Treatment: looking for an European Consensus’ (EURECA-CC2) with the new National Comprehensive Cancer Network (NCCN) guidelines.
    Cancer/Radiothérapie 12/2012; 16(8):711–720. DOI:10.1016/j.canrad.2012.10.007 · 1.41 Impact Factor

  • Annales de Pathologie 11/2012; 32(5):S159-S160. DOI:10.1016/j.annpat.2012.09.045 · 0.29 Impact Factor
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    ABSTRACT: Purpose The purpose of this study was to establish a pre-therapeutic score that could predict which patients would be at high risk of enteral tube feeding during (chemo)-radiotherapy for head and neck cancer. Patients and methods A monocentric study was conducted retrospectively on patients receiving a radiotherapy or concurrent chemoradiotherapy for a head and neck cancer. A logistic model was performed in order to assess clinical or therapeutic risk factors for required artificial nutrition during treatment. Significant parameters, issued from multivariate analysis, were summed and weighted in a score aiming at estimating a malnutrition risk during radiotherapy. Results Among the 127 evaluated patients, 59 patients required artificial nutrition during radiotherapy. In multivariate analysis, predictive factors for malnutrition were weight loss superior to 5% in the 3 months before radiotherapy, advanced tumor stage (III–IV vs. I–II), and pain requiring strong analgesics (step II–III vs. I). Concurrent chemotherapy was identified as a significant risk factor also, but it was strongly correlated with the tumor stage. The score, estimated from these previous factors, allowed a prediction of a risk of enteral feeding with a sensitivity of 90% and a specificity of 85%. Conclusion A predictive score of enteral nutrition before radiotherapy of head and neck cancer should be a useful clinical tool to target the patients who would need a prophylactic gastrostomy. Our study evidenced some risk factors of malnutrition requiring artificial feeding. However, we need a prospective study to confirm the validity of this score.
    Cancer/Radiothérapie 09/2012; 16(s 5–6):515. DOI:10.1016/j.canrad.2012.07.005 · 1.41 Impact Factor
  • T.V.F. Nguyen · A. Brédart · J.-F. Bosset · A. Monnier · M. Mercier ·

    Cancer/Radiothérapie 09/2012; 16(5-6):544. DOI:10.1016/j.canrad.2012.07.081 · 1.41 Impact Factor
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    ABSTRACT: Two phase III trials of neoadjuvant treatment in T3-4 rectal cancer established that adding chemotherapy (CRT) to radiotherapy (RT) improves pathological complete response (pCR) and local control (LC). We combined trials to assess the clinical benefit of CRT on overall (OS) and progression free survival (PFS) and to explore the surrogacy of pCR and LC. Individual patient data from European Organisation for Research and Treatment of Cancer (EORTC) 22921 (1011 patients) and FFCD 9203 (756 patients) were pooled. Meta-analysis methodology was used to compare neoadjuvant CRT to RT for OS, PFS LC and distant progression (DP). Weighted linear regression was used to estimate trial-level association (surrogacy R(2)) between treatment effects on candidate surrogate (pCR, LC, DP) and OS. The median follow-up was 5.6 years. Compared to RT (881 pts), CRT (886 pts) did not prolong OS, DP or PFS. The 5-y OS-rate was 66.3% with CRT versus 65.9% in RT (hazard ratios (HR) = 1.04 {0.88-1.21}). CRT significantly improved LC (HR = 0.54, 95%confidence interval (CI): 0.41-0.72). PFS was validated as surrogate for OS with R(2) = 0.88. Neoadjuvant treatment effects on LC (R(2) = 0.17) or DP (R(2) = 0.31) did not predict effects on OS. Preoperative CRT does not prolong OS or PFS. pCR or LC do not qualify as surrogate for PFS or OS while PFS is surrogate. Phase III trials should use OS or PFS as primary endpoint.
    European journal of cancer (Oxford, England: 1990) 04/2012; 48(12):1781-90. DOI:10.1016/j.ejca.2012.03.016 · 5.42 Impact Factor
  • G. Créhange · J.-F. Bosset · P. Maingon ·
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    ABSTRACT: Protracted preoperative radiochemotherapy with a 5-FU-based scheme, or a short course of preoperative radiotherapy without chemotherapy, are the standard neoadjuvant treatments for resectable stage II–III rectal cancer. Local failure rates are low and reproducible, between 6 and 15% when followed with a “Total Mesorectal Excision”. Nevertheless, the therapeutic strategy needs to be improved: distant metastatic recurrence rates remain stable around 30 to 35%, while both sphincter and sexual sequels are still significant. The aim of the present paper was to analyse the ongoing trials listed on the following search engines: the Institut National du Cancer in France, the National Cancer Institute and the National Institute of Health in the United States, and the major cooperative groups. Keywords for the search were: “rectal cancer”, “preoperative radiotherapy”, “phase II–III”, “preoperative chemotherapy”, “adjuvant chemotherapy” and “surgery”. Twenty-three trials were selected and classified in different groups, each of them addressing a question of strategy: (1) place of adjuvant chemotherapy; (2) optimization of preoperative radiotherapy; (3) evaluation of new radiosensitization protocols and/or neoadjuvant chemotherapy; (4) optimization of techniques and timing of surgery; (5) place of radiotherapy for non resectable or metastatic tumors.
    Cancer/Radiothérapie 10/2011; 15(6):440-444. DOI:10.1016/j.canrad.2011.05.006 · 1.41 Impact Factor
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    ABSTRACT: Since the implementation of preoperative chemoradiotherapy and mesorectal excision, the 5-year rates of locoregional failures in T3-T4 N0-N1 M0 rectal cancer fell from 25–30% thirty years ago to 5–8% nowadays. A critical analysis of the locoregional failures sites and mechanisms, as well as the identification of nodal extension, helps the radiation oncologist to optimize the radiotherapy target definition. The upper limit of the clinical target volume is usually set at the top of the third sacral vertebra. The lateral pelvic nodes should be included when the tumor is located in the distal part of the rectum. The anal sphincter and the levator muscles should be spared when a conservative surgery is planned. In case of abdominoperineal excision, the ischiorectal fossa and the sphincters should be included in the clinical target volume. A confrontation with radiologist and surgeon is mandatory to improve the definition of the target volumes to be treated.
    Cancer/Radiothérapie 10/2011; 15(6):431-435. DOI:10.1016/j.canrad.2011.07.236 · 1.41 Impact Factor

Publication Stats

4k Citations
459.06 Total Impact Points


  • 2012-2014
    • University of Franche-Comté
      Becoinson, Franche-Comté, France
    • Centre Hospitalier Belfort-Montbéliard
      Montoeliard, Franche-Comté, France
  • 2013
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 1986-2013
    • Centre Hospitalier Régional et Universitaire de Besançon
      Becoinson, Franche-Comté, France
  • 2010
    • Institut Curie
      Lutetia Parisorum, Île-de-France, France
  • 2002
    • Institut Sainte Catherine
      Avinyó, Provence-Alpes-Côte d'Azur, France
  • 1999
    • Centre Hospitalier Lyon Sud
      Lyons, Rhône-Alpes, France
  • 1997
    • Netherlands Cancer Institute
      • Department of Radiotherapy
      Amsterdamo, North Holland, Netherlands
  • 1992
    • Clinique Saint Augustin
      Naoned, Pays de la Loire, France