C. Massabeau

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

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Publications (19)22.51 Total impact

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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; · 1.48 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 01/2014; · 1.48 Impact Factor
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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; · 3.14 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; · 1.26 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. · 4.47 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. · 1.48 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. · 2.04 Impact Factor
  • Breast (Edinburgh, Scotland) 01/2011; 20(2):196-7. · 2.09 Impact Factor
  • Radiotherapy and Oncology - RADIOTHER ONCOL. 01/2011; 99.
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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.
    Case Reports in Hepatology. 01/2011; 2011.
  • 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.
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    ABSTRACT: No biologic signature of chemoradiotherapy sensitivity has been reported for patients with locally advanced non-small-cell lung cancer (NSCLC). We have previously demonstrated that basic fibroblast growth factor (FGF-2) and alphavbeta3 integrin pathways control tumor radioresistance. We investigated whether the expression of the proteins involved in these pathways might be associated with the response to treatment and, therefore, the clinical outcome. FGF-2, beta3 integrin, angiopoietin-2, and syndecan-1 expression was studied using immunohistochemistry performed on biopsies obtained, before any treatment, from 65 patients exclusively treated with chemoradiotherapy for locally advanced NSCLC. The response to treatment was evaluated according to the Response Evaluation Criteria in Solid Tumors criteria using computed tomography at least 6 weeks after the end of the chemoradiotherapy. Local progression-free survival, metastasis-free survival, and disease-free survival were studied using the log-rank test and Cox proportional hazard analysis. Among this NSCLC biopsy population, 43.7% overexpressed beta3 integrin (beta3(+)), 43% FGF-2 (FGF-2(+)), 41.5% syndecan-1, and 59.4% angiopoietin-2. Our results showed a strong association between FGF-2 and beta3 integrin expression (p = .001). The adjusted hazard ratio of local recurrence for FGF-2(+)/beta3(+) tumors compared with FGF-2(-)/beta3(-) tumors was 6.1 (95% confidence interval, 2.6-14.6, p = .005). However, the risk of local recurrence was not increased when tumors overexpressed beta3 integrin or FGF-2 alone. Moreover, the co-expression of these two proteins was marginally associated with the response to chemoradiotherapy and metastasis-free survival. The results of this study have identified the combined profile FGF-2/beta3 integrin expression as a signature of local control in patients treated with chemoradiotherapy for locally advanced NSCLC.
    International journal of radiation oncology, biology, physics 05/2009; 75(3):696-702. · 4.59 Impact Factor
  • Fuel and Energy Abstracts 01/2009; 75(3).
  • Cancer Radiotherapie - CANCER RADIOTHER. 01/2009; 13(6):684-684.
  • Cancer Radiotherapie - CANCER RADIOTHER. 01/2009; 13(6):689-689.
  • Ejc Supplements - EJC SUPPL. 01/2009; 7(2):40-40.
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    ABSTRACT: Purpose: No biological signature of chemo-radiotherapy sensitivity has been reported for patients with locally advanced non-small cell lung cancer (NSCLC). We have previously demonstrated that basic fibroblast growth factor (FGF-2) and alphavbeta3 integrin pathways control tumor radioresistance. We now investigate whether the expression of the proteins involved in these pathways may be associated with the response to treatment and, therefore, the clinical outcome. Methods: FGF-2, alpha3 integrin, angiopoietin-2 and syndecan-1 expressions were studied using immunohistochemistry performed on biopsies obtained, before any treatment, from 65 patients exclusively treated with chemo-radiotherapy for locally advanced NSCLC. Response to treatments was evaluated according to the RECIST criteria by CT-scan at least 6 weeks after the end of the chemo-radiotherapy. Local progression, metastasis and disease-free survivals were studied using log rank test and Cox proportional hazard analysis. Results: Among this NSCLC biopsy population, 43.7% over- expressed alpha3 integrin (alpha 3+), 43% FGF-2 (FGF-2+), 41.5% syndecan-1 and 59.4% angiopoietin-2. Our results show a strong association between FGF-2 and alpha 3 integrin expression (P=0,001). The adjusted hazard ratio of local recurrence of alpha3 +/ FGF-2+ tumors compared to FGF-2-/ alpha 3- tumors was 6.1 (95% confidential interval=2.6 to 14.6, P=0,005) whereas the risk of local recurrence was not increased when tumors overexpressed alpha 3 or FGF-2 alone. Moreover, the co-expression of these two proteins is marginally associated with the response to chemo-radiotherapy and to metastasis free survival. Conclusion: This study identifies the combined profile FGF-2/alpha 3 integrin expression as a signature of the local control in patients treated with chemo-radiotherapy for locally-advanced NSCLC.
    Revue des Maladies Respiratoires 12/2008; 25(9):1176. · 0.50 Impact Factor
  • Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2008; 25(9):1176-1176.
  • Cancer Radiotherapie - CANCER RADIOTHER. 01/2007; 11(6):419-420.