C. Massabeau

Institut Claudius Regaud, Tolosa de Llenguadoc, Midi-Pyrénées, France

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Publications (23)55.95 Total impact

  • International journal of radiation oncology, biology, physics 09/2014; 90(1):S270. DOI:10.1016/j.ijrobp.2014.05.929 · 4.18 Impact Factor
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    ABSTRACT: Recent improvements in the detection of breast cancer at an early stage have resulted in a rising incidence of breast ductal carcinoma in situ with microinvasion. So far, there is no consensus regarding its optimal management. We hereby report on our 10-year single institutional experience in breast ductal carcinoma in situ with microinvasion including pathological reviewing. All consecutive patients treated for a ductal carcinoma in situ with microinvasion at the Institut Claudius-Regaud (Toulouse, France) over a 10-year period were included in this study. We reviewed all available histological materials. Sixty-three patients were eligible for this study. Two patients presented with a lymph node invasion at diagnosis. Each patient benefited from initial surgical management, which consisted either in mastectomy (n=25) or conservative resection (n=37). Axillary exploration was performed in 52 patients (82%). After a median follow-up of 61.3 months [46.9;69], the 5-year overall survival and disease free survival were 98.2 (95% CI=[88.2;99.7]) and 89.5% (95% CI=[76.3;95.6]) respectively. Two delayed invasive relapses occurred leading to one specific death. The pathological review highlighted a trend towards a loss of HR and HER2 expression (9%) in the microinvasive component in comparison with its surrounded in situ carcinoma. The risk of initial lymph node involvement and delayed invasive local relapse deserve an optimal locoregional management including lymph node evaluation. The non-negligible discrepancy's rate between in situ and microinvasive components justifies HR status and HER2 expression assessment on the microinvasive component.
    Cancer/Radiothérapie 03/2014; · 1.11 Impact Factor
  • European Journal of Cancer 03/2014; 50:S28-S29. DOI:10.1016/S0959-8049(14)70066-8 · 4.82 Impact Factor
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    ABSTRACT: Purpose Recent improvements in the detection of breast cancer at an early stage have resulted in a rising incidence of breast ductal carcinoma in situ with microinvasion. So far, there is no consensus regarding its optimal management. We hereby report on our 10-year single institutional experience in breast ductal carcinoma in situ with microinvasion including pathological reviewing. Patients and methods All consecutive patients treated for a ductal carcinoma in situ with microinvasion at the Institut Claudius-Regaud (Toulouse, France) over a 10-year period were included in this study. We reviewed all available histological materials. Results Sixty-three patients were eligible for this study. Two patients presented with a lymph node invasion at diagnosis. Each patient benefited from initial surgical management, which consisted either in mastectomy (n = 25) or conservative resection (n = 37). Axillary exploration was performed in 52 patients (82%). After a median follow-up of 61.3 months [46.9;69], the 5-year overall survival and disease free survival were 98.2 (95% CI = [88.2;99.7]) and 89.5% (95% CI = [76.3;95.6]) respectively. Two delayed invasive relapses occurred leading to one specific death. The pathological review highlighted a trend towards a loss of HR and HER2 expression (9%) in the microinvasive component in comparison with its surrounded in situ carcinoma. Conclusion The risk of initial lymph node involvement and delayed invasive local relapse deserve an optimal locoregional management including lymph node evaluation. The non-negligible discrepancy's rate between in situ and microinvasive components justifies HR status and HER2 expression assessment on the microinvasive component.
    Cancer/Radiothérapie 03/2014; DOI:10.1016/j.canrad.2013.12.007 · 1.11 Impact Factor
  • C. Massabeau · J. Mazières
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    ABSTRACT: Les techniques de radiothérapie ont été optimisées afin de permettre une délivrance de dose la plus précise possible au prix d’une toxicité moindre. L’escalade de dose était considérée comme la clef du contrôle locorégional, mais les récents résultats du RTOG 0618, très décevants, semblent plaider pour une infériorité du bras de traitement à 74 Gy par rapport au bras à 60 Gy. Ceci met en lumière les limites de la dose physique de l’irradiation et les nécessaires progrès à accomplir au niveau des traitements associés à la radiothérapie. Le concept de dose biologique doit continuer à se développer pour une meilleure potentialisation de l’action locale de la radiothérapie grâce aux traitements associés. Les molécules de dernière génération en chimiothérapie et les thérapies ciblant les anomalies moléculaires ont permis des progrès considérables dans le traitement des cancers bronchiques de stade IV. Leur association à la radiochimiothérapie des cancers bronchiques est une suite logique à leur développement, tout comme des molécules dédiées radiosensibilisantes.
    Revue des Maladies Respiratoires Actualites 09/2013; 5(5):513-518. DOI:10.1016/S1877-1203(13)70449-X
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    ABSTRACT: Treatment of chestwall with lymph nodes (internal mammary and clavicular nodes) is achieved in most of the centers with conventional radiotherapy using photons and electrons beams with junctions. The aim of this study is to do a dosimetric comparative study between two technics using modulation irradiation:Tomotherapy and Rapid Arc (RA).Material and methodsSeven patients (5 left, 2 right) were treated using Tomotherapy. For these patients a RA plan was prepared retrospectively. Patients were positioned supine with two arms above the head. The prescribed dose was 50 Gy for the chestwall and 46–50 Gy for the lymph nodes. Optimisation constraints were increased until the PTV coverage was acceptable. Tomotherapy plans were computed with a 2.5–5 cm collimation and a 0.287 pitch. RA plans were computed using a 5 mmbolus on the chestwall, 2 arcs (60–180°) and a +/-10° collimator rotation. Doses delivered to targets, heart and both lungs are reported.ResultsFor the 7 patients the heart mean dose was 7.1–8.6 Gy (mean 7.5 Gy) with Tomotherapy and 4.4–18.1 Gy (mean 9.9 Gy) for RA. For the ipsilateral lung, the mean dose, V5, V20 and V30 were respectively 10.1–14.7 Gy, 56.4–85.7%, 14.8–25.9% and 6.2–16.6% for Tomotherapy. For RA, these values were 10.5–16.0 Gy, 65.3–96.0%, 14.8–30.0% and 6.2–16.6%.Conclusion For 5/7 patients RA plans were acceptable but the OAR doses were generally higher than Tomotherapy plans (in particular V5 of lungs and lung mean dose). For 2/7 patients (left side) RA plans were not acceptable.
    Physica Medica 06/2013; 29:e16-e17. DOI:10.1016/j.ejmp.2013.08.054 · 1.85 Impact Factor
  • A Modesto · J Giron · C Massabeau · N Sans · J Berjaud · J Mazieres
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    ABSTRACT: BACKGROUND: Radiofrequency thermal ablation is an alternative option to manage primary or metastatic lung malignancies. It is particular useful for unresectable lesions because of the disease's location, prior resection, or comorbidities. Patients presenting with a lung tumor that occurs in a single lung due to a prior pneumonectomy are difficult to manage with a curative intent due to the risk of complications after local treatment. MATERIALS AND METHODS: We hereby report on treatment of a primary non-small-cell lung cancer in a previously contralateral pneumonectomised patient using per-cutaneous pulmonary radiofrequency thermal ablation. We also discuss literature that describes similar alternative minimally invasive procedures. CONCLUSION: Despite being a high-risk procedure, radiofrequency should be considered for patients with a single lung particularly when ineligible to surgery or stereotactic ablative radiation therapy. The procedure should be ideally associated with a pre-operative preventive chest tube.
    Lung cancer (Amsterdam, Netherlands) 03/2013; 80(3). DOI:10.1016/j.lungcan.2013.02.003 · 3.74 Impact Factor
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    ABSTRACT: To evaluate the benefits and limitations of helical tomotherapy (HT) for loco-regional irradiation of patients after a mastectomy and immediate implant-based reconstruction. Ten breast cancer patients with retropectoral implants were randomly selected for this comparative study. Planning target volumes (PTVs) 1 (the volume between the skin and the implant, plus margin) and 2 (supraclavicular, infraclavicular, and internal mammary nodes, plus margin) were 50 Gy in 25 fractions using a standard technique and HT. The extracted dosimetric data were compared using a 2-tailed Wilcoxon matched-pair signed-rank test. Doses for PTV1 and PTV2 were significantly higher with HT (V95 of 98.91 and 97.91%, respectively) compared with the standard technique (77.46 and 72.91%, respectively). Similarly, the indexes of homogeneity were significantly greater with HT (p = 0.002). HT reduced ipsilateral lung volume that received ≥20 Gy (16.7 vs. 35%), and bilateral lungs (p = 0.01) and neighboring organs received doses that remained well below tolerance levels. The heart volume, which received 25 Gy, was negligible with both techniques. HT can achieve full target coverage while decreasing high doses to the heart and ipsilateral lung. However, the low doses to normal tissue volumes need to be reduced in future studies.
    Medical dosimetry: official journal of the American Association of Medical Dosimetrists 04/2012; 37(4). DOI:10.1016/j.meddos.2012.03.006 · 0.95 Impact Factor
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    ABSTRACT: The goal of the present study was to evaluate the role of the tyrosine kinase receptor fibroblast growth factor-1 (FGFR1) and its ligand, the fibroblast growth factor 2 (FGF2) in determining the response to chemoradiotherapy of breast cancers. S14 was a phase II neoadjuvant study carried out at the Institut Curie that recruited 59 patients between November 2001 and September 2003. This prospective study aimed to assess the pathological response after preoperative radiochemotherapy (5FU-Navelbine-radiotherapy) for large breast cancers. The expression of FGFR1 and FGF2 in tumor cells were assessed by immunohistochemistry. Tumors in which no staining was seen, were considered as negative for that protein. We used the Khi-2 test or the Fisher test to compare the qualitative variables and the Student t test or the non-parametric Wilcoxon test for the quantitative variables. We included in the present study all the 32 patients from the S14 cohort for whom the tissue blocks from the biopsy specimens were available with sufficient tumoral tissue. FGFR1 and FGF2 staining were observed respectively in 17 (56%) and 22 (68%) of the 32 tumoral biopsies. The expression of FGFR1 was associated with the hormone receptor positive status (p=0.0191). Only 11% (1/9) of the high grade tumors failed to respond to chemoradiotherapy compared to 68 % resistant tumors (15/22) among the low/intermediate grade tumors (p=0.0199). Among the low/intermediate grade tumors, FGFR1 negative tumors did not respond to chemoradiotherapy (0/9), compared with tumors expressing FGFR1 among which, almost one half had a good response (6/13) (p=0.0167). Among the low and intermediate grade breast cancers, the FGFR1 negative tumors were resistant to chemoradiotherapy. The expression of FGFR1 in patients' biopsies may serve as a marker of response to chemoradiotherapy.
    Breast Cancer Research and Treatment 03/2012; 134(1):259-66. DOI:10.1007/s10549-012-2027-3 · 4.20 Impact Factor
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    ABSTRACT: To assess the benefits of using cardiac gated images for treatment planning of breast and internal mammary nodes. Inspiration breath hold computed tomography (CT) series acquired at prospectively gated diastolic phase were used for planning. Three different techniques were compared. Technique A used tangents and an internal mammary nodes field covering the three first inter-rib spaces; technique B used an extended internal mammary nodes including part of the medial breast in junction with tangential fields; the 3(rd) technique used helical tomotherapy. For each technique, two treatment plans were performed: one plan (plan-01) where mean dose and V(25) to the heart were considered for plan evaluation and a second plan (plan-02) where the irradiation of the left anterior descending artery was minimized. V(25) to the heart was found to be less than 5% for all six plans. Mean doses to the heart were within 4.8 to 7.2 Gy. By attempting to lower the dose to the left anterior descending artery, heart D(mean) was decreased by 20-30% for the two techniques A and B while being unchanged for tomotherapy. Regarding target coverage, there was no marked difference between plans where only heart dose was considered (plans-01) and plans where the left anterior descending artery dose was minimized (plans-02). When the left anterior descending artery dose was part of plan evaluation, D(mean) to the left anterior descending artery could be decreased by 24, 19 and 9% for techniques A, B and tomotherapy respectively. The three techniques exposed segments of the left coronary to different levels of dose. This study showed that evaluation of the dose to the left anterior descending artery coronary may change the treatment strategy. Cardiac gated images without IV contrast permitted a good visualization of the coronaries in order to optimize the dose on these structures. In addition to heart V(25,) the dose to the coronaries should be included in prospective studies on radiotherapy related heart toxicity in association with all additional risk factors.
    Cancer/Radiothérapie 11/2011; 16(1):44-51. DOI:10.1016/j.canrad.2011.07.244 · 1.11 Impact Factor
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    ABSTRACT: This study aims to determine prognostic factors for patients who have non-small-cell lung cancer (NSCLC) that is treated with definitive chemoradiation therapy. Seventy-eight patients has been treated with radiation therapy and concomitant or sequential chemotherapy between 2000 and 2005. Paraffin-embedded biopsy specimens were obtained before treatment from 73 patients and reviewed by two independent pathologists. Complete follow-up data were collected. The impact of clinical and pathological factors and treatment modality on survival was studied using the χ(2) and Fisher exact tests. A multivariate analysis was performed using the Cox proportional hazard model. Seventy-three patients were evaluated, 58 men and 15 women. Median age was 62 years. Most had locally advanced disease (42 stage IIIB and 24 stage IIIA), whereas 7 were medically inoperable stage I-II patients. Lymphovascular invasion (LVI) was identified in 20 biopsy specimens (27.4 %). Radiotherapy delivered a median dose of 66 Gy (range, 60 to 70 Gy). The median overall survival was 20.5 months. Relapse-free and overall survival were significantly higher in the concomitant arm than in the sequential arm (P = .025 and P = .031, respectively). We found an independent association between the presence of LVI and both the risk of death with an adjusted hazard ratio (HR) of 2.69 (95% confidence interval [CI] 1.50-4.83) and the risk of metastatic progression (adjusted HR = 3.01; 95% CI 1.58-5.72). The presence of LVI on stage III NSCLC biopsy specimens was the only independent prognostic factor for poor outcome and may, therefore, be helpful in identifying patients at high risk of metastatic disease.
    Clinical Lung Cancer 08/2011; 13(1):59-67. DOI:10.1016/j.cllc.2011.06.011 · 3.22 Impact Factor
  • Radiotherapy and Oncology 05/2011; 99. DOI:10.1016/S0167-8140(11)70883-0 · 4.86 Impact Factor
  • Breast (Edinburgh, Scotland) 04/2011; 20(2):196-7. DOI:10.1016/j.breast.2010.12.002 · 2.58 Impact Factor
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    ABSTRACT: Helical tomotherapy (HT), an image-guided, intensity-modulated, radiation therapy technique, allows for precise targeting while sparing normal tissues. We retrospectively assessed the feasibility and tolerance of the hepatobiliary HT in 9 patients. A total dose of 54 to 60 Gy was prescribed (1.8 or 2 Gy per fraction) with concurrent capecitabine for 7 patients. There were 1 hepatocarcinoma, 3 cholangiocarcinoma, 4 liver metastatic patients, and 1 pancreatic adenocarcinoma. All but one patient received previous therapies (chemotherapy, liver radiofrequency, and/or surgery). The median doses delivered to the normal liver and to the right kidney were 15.7 Gy and 4.4 Gy, respectively, below the recommended limits for all patients. Most of the treatment-related adverse events were transient and mild in severity. With a median followup of 12 months, no significant late toxicity was noted. Our results suggested that HT could be safely incorporated into the multidisciplinary treatment of hepatobiliary or pancreatic malignant disease.
    01/2011; 2011. DOI:10.1155/2011/545267
  • Fuel and Energy Abstracts 11/2009; 75(3). DOI:10.1016/j.ijrobp.2009.07.1008
  • Cancer/Radiothérapie 10/2009; 13(6):684-684. DOI:10.1016/j.canrad.2009.08.107 · 1.11 Impact Factor
  • Cancer/Radiothérapie 10/2009; 13(6):689-689. DOI:10.1016/j.canrad.2009.08.118 · 1.11 Impact Factor
  • C. Massabeau · A. Laprie · J.-M. Bachaud
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    ABSTRACT: In their last 15 years advances in computers have allowed parallel advances in imaging technologies. The improvements in imaging have in turn resulted in a higher level of complexity being incorporated into radiotherapy treatment planning systems. As a result of these changes, the delivery of radiotherapy has evolved from therapy designed on two dimensional X-ray images and hand calculations to three dimensional X-ray based images from computerized tomography (CT), incorporating increasingly complex computer algorithms leading to intensity modulated radiation therapy (IMRT). The incorporation of multimodality imaging (PET-FDG) is used increasingly for radiotherapy planning. In addition, greater awareness of the challenges to the accuracy of the treatment planning process, such as problems with set-up error and organ movement, have begun to be addressed systematically, ushering in an era of so-called Four-Dimensional Radiotherapy.
    Revue des Maladies Respiratoires Actualites 10/2009; 1(4):386–392. DOI:10.1016/S1877-1203(09)72511-X
  • EJC Supplements 09/2009; 7(2):40-40. DOI:10.1016/S1359-6349(09)70141-7 · 9.39 Impact Factor
  • Radiotherapy and Oncology 08/2009; 92:S141. DOI:10.1016/S0167-8140(12)72956-0 · 4.86 Impact Factor