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Background: To investigate whether patients treated for a localized prostate cancer (PCa) require a radical prostatectomy followed by postoperative radiotherapy or exclusive radiotherapy, in the modern era of image guided IMRT. Methods: 178 patients with PCa were referred for daily exclusive image guided IMRT (IG-IMRT) using an on-line 3D ultra-sound based system and 69 patients were referred for postoperative IMRT without image guidance after radical prostatectomy (RP + IMRT). Patients were matched in a 1:1 ratio according to their baseline risk group before any treatment. Late toxicity was scored using the CTV v3.0 scale. Biochemical failure was defined as a postoperative PSA ≤ 0.1 ng/mL followed by 1 consecutive rising PSA for the postoperative group of patients and by the Phoenix definition (nadir + 2 ng/mL) for the group of patients treated with exclusive radiotherapy. Results: A total of 98 patients were matched (49:49). From the start of any treatment, the median follow-up was 56.6 months (CI 95% = [49.6-61.2], range [18.2-115.1]). No patient had late gastrointestinal grade ≥ 2 toxicity in the IG-IMRT group vs. 4% in the RP + IMRT group. Forty two percent of the patients in both groups had late grade ≥ 2 genitourinary toxicity. The 5-year FFF rates in the IG-IMRT group and in the RP + IMRT groups were 93.1% [80.0-97.8] and 76.5% [58.3-87.5], respectively (p = 0.031). Conclusions: Patients with a localized PCa treated with IG-IMRT had better oncological outcome than patients treated with RP + IMRT. Further improvements in postoperative IMRT using image guidance and dose escalation are urgently needed. [ABSTRACT FROM AUTHOR]

aims to assess the association between baseline HRQOL and occurrence of major toxicities in patients with head and neck cancer (HNC). The present study analyzed data from randomized study investigating the utility of HRQoL assessment. Patients with HNC treated by radiotherapy were included from May 2009 to September 2014 in 4 centers in France. At baseline and during follow-up patients were completed QLQ-C30 questionnaire. According to NCI-CTCAE classification, we defined major toxicities as adverse events of grade ≥3 including skin, digestive, general, hematological head/neck toxicities and death related to an adverse event. Cox proportional-hazards regression analyses were performed in two step to assess association between baseline HRQoL score and major toxicities. Firstly Manual backward selection was performed to determine clinical and sociodemographic factors associated with major toxicities with a p-value <0.05 by multivariable analysis. Secondly each baseline HRQOL dimension selected in univariable have been adjusted on variables included in multivariable model based on clinical and sociodemographic data to determine predictive value of HRQOL on major toxicities and value of p <0.05 was considered as statistically significant. The HRQOL scores were included as continuous variables and hazard ratios were calculated for each increase of 10 points in HRQOL. Out of 200 patients included, the median age was 59.6 years, 79.5% had comorbidities, 55.6% received adjuvant chemotherapy and 90.4% underwent surgery. At baseline, global health status mean score was 67.03 (SD=19.28), the best functioning score was physical functioning (FP) with means of 87.92 (24.35) and the worst symptom score was insomnia with mean score of 31.67 (32.06). The median follow-up was 24 months (range 1.91 to 28.5 months). During follow up, 41 patients (20.5%) developed at least one major toxicity. In multivariable analyses, for each significant HRQoL scales adjusted on model based on clinical and sociodemographic data (age, Center with at least 30 patients included, cancer site, cancer stage, chemotherapy and surgery), a 10-point increase score in the FP (HR: 0.76, 95% CI [0.62 to 0.94], p=0.009), role functioning (HR: 0.87, 95% CI [0.77 to 0.98], p=0.032) and social functioning (HR: 0.88, 95% CI [0.77 to 0.99], p=0.047) were associated with a lower risk of occurrence of major toxicities, while a 10-point increase score in dyspnea (HR: 1.15, 95% CI [1.03 to 1.30], p=0.014), and loss of appetite (HR: 1.16, 95% CI [1.03 to 1.32], p=0.013) were associated with an increased risk of occurrence of major toxicities Some baseline HRQoL scores were predictive factors of major toxicities and HRQOL should be assessed before treatment to identify patients at risk to develop radiotherapy related toxicities in patients with HNC. [ABSTRACT FROM AUTHOR]

Introduction Les cathéters à chambre implantable (CCI) sont utilisés en oncologie pour l’administration de chimiothérapies, de traitement intraveineux ou d’une nutrition parentérale (NP). Les infections liées au cathéter (ILC) et les thromboses sont les complications les plus fréquentes. Étude du taux d’incidence des infections sur CCI et de la corrélation avec l’utilisation d’une NP à la suite d’une politique de réduction de la NP. Matériels et méthodes Étude observationnelle rétrospective en oncologie générale au CHP Saint-Grégoire et comparative avec l’étude réalisée en 2013. Recueil des ILC sur CCI de janvier 2015 à avril à 2016 chez les patients ayant bénéficié de la pose d’une CCI de janvier 2015 à décembre 2015. Résultats L’étude a duré de janvier 2015 à avril 2016 permettant d’inclure 403 patients. Pas de différence significative entre les caractéristiques des cohortes de 2013 et 2015. Diminution de la proportion des ILC sur CCI en 2015 à 8,9 % vs 14 % en 2013 et de la NP 8,68 % vs 15,8 %. Différence significative de la densité d’incidence (DI) globale entre 2013 et 2015 avec une diminution de celle-ci en 2015 : 0,39 vs 0,7 (ILC pour 1000 jours-cathéter) en 2013 et de la DI avec NP : 2,65 en 2015 vs 3,59 en 2013. Parmi tous les facteurs de risque étudiés, la NP reste le seul facteur de risque indépendant important en analyse univariée et multivariée. Les staphylocoques sont responsables de 50 % des infections, 1/3 proviennent du groupe coagulase negative, 14 % par E.coli . Conclusion La NP est un facteur de risque important d’ILC sur CCI. Les nouvelles recommandations ont permis une diminution de la survenue des ILC mais le risque persiste. Une prise en charge nutritionnelle optimisée avec l’appui d’un médecin nutritionniste, la formation du personnel de soins et l’utilisation de verrous de solutions non-antibiotiques en prophylaxie secondaire sont proposés pour réduire ce risque. [ABSTRACT FROM AUTHOR]