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1. Impact of new generation hormone-therapy on cognitive function in elderly patients treated for a metastatic prostate cancer: Cog-Pro trial protocol

Author

Martine Dubois, Aurélie Capel, Laure Pierard, Elodie Coquan, Bénédicte Giffard, Bénédicte Clarisse, Sophie Gouérant, Natacha Heutte, Hélène Castel, Karim Fizazi, Philippe Bartélémy, Alexandra Leconte, Heidi Laviec, Florence Joly, Frédéric Di Fiore, Isabelle Léger, Marie Lange, Centre de recherche clinique [CHU Caen] (CRC), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER, Unité de coordination en oncogériatrie de Basse-Normandie [Caen] (UCOG Basse-Normandie), Différenciation et communication neuronale et neuroendocrine (DC2N), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’études des transformations des activités physiques et sportives (CETAPS), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Unité de Recherche clinique [Caen], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), École nationale supérieure des sciences de l'information et des bibliothèques (ENSSIB), Université de Lyon, Service d'Oncologie Médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Département d'Oncologie Médicale et d'Hématologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), New York University School of Medicine (NYU), New York University School of Medicine, NYU System (NYU)-NYU System (NYU), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Normandie Université (NU)-Normandie Université (NU)-Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de psycho-oncologie (UPO), Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie [Gustave Roussy] (DISSPO), Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine, Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité d'Oncologie Digestive, CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR), Service d'Oncologie médicale [CHU Caen], CHU Caen, This work is supported by the French Institut National du Cancer (InCA_9528) for the collection of data and by a specific donation from ASTELLAS., Eustache, Francis, and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Oncology, Quality of life, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, lcsh:RC254-282, Androgen deprivation therapy, 03 medical and health sciences, chemistry.chemical_compound, Prostate cancer, Study Protocol, 0302 clinical medicine, Internal medicine, Genetics, medicine, Clinical endpoint, Enzalutamide, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], 030212 general & internal medicine, Hormone therapy, ComputingMilieux_MISCELLANEOUS, Cognitive reserve, business.industry, Abiraterone acetate, Correction, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 3. Good health, Ageing, chemistry, Adherence, 030220 oncology & carcinogenesis, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], business, Cognitive impairments
Abstract

Background New generation hormone-therapies (NGHT) targeting the androgen signalling pathway are nowadays proposed to elderly patients with metastatic castration-resistant prostate cancer (CRPCa). The impact of these treatments on cognitive function has never been evaluated whereas cognitive impairment may have an impact on the autonomy and the treatment adherence. The aim of this study is to prospectively assess the incidence of cognitive impairment in elderly men after treatment by NGHT for a metastatic CRPCa. Methods/design The Cog-Pro study is a multicentre longitudinal study including CRPCa patients ≥70 years old treated with NGHT (n = 134), control metastatic prostate cancer patients without castration resistance treated with first generation androgen deprivation therapy (n = 55), and healthy participants (n = 33), matched on age and education. Cognitive, geriatric and quality of life assessment and biological tests will be performed at baseline, 3, 6 and 12 months after start of the treatment (inclusion time). The primary endpoint is the proportion of elderly patients receiving a NGHT who will experience a decline in cognitive performances within 3 months after study enrollment. Secondary endpoints concern: autonomy, quality of life, anxiety, depression, cognitive reserve, adherence to hormone-therapy, comparison of the cognitive impact of 2 different NGHT (abiraterone acetate and enzalutamide), impact of co-morbidities and biological assessments. Discussion Evaluating, understanding and analyzing the incidence, severity of cognitive impairments and their impact on quality of life, autonomy and adherence in this group of patients with advanced disease is a challenge. This study should help to improve cancer care of elderly patients and secure the use of oral treatments as the risk of non-observance does exist. Our results will provide up-to date information for patients and caregivers on impact of these treatments on cognitive function in order to help the physicians in the choice of the treatment. Trial registration NCT02907372, registered: July 26, 2016.

Published
2017
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2. Cognitive Changes After Adjuvant Treatment in Older Adults with Early‐Stage Breast Cancer

Author

Bénédicte Giffard, Nadine Longato, Johan Lefel, Francis Eustache, Alexandra Leconte, Jean-Emmanuel Kurtz, Florence Joly, Bénédicte Clarisse, Olivier Rigal, Corinne Veyret, Christelle Levy, Hélène Castel, Philippe Barthélémy, Natacha Heutte, Laure Tron, D. Allouache, Marie Lange, Chantal Rieux, Sabine Noal, Bodescot, Myriam, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Plateforme Cancer et Cognition, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Ligue Nationale Contre le Cancer (LNCC)-Cancéropole Nord-Ouest, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Département d'Oncologie et Hématologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), Différenciation et communication neuronale et neuroendocrine (DC2N), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychologie et imagerie de la mémoire humaine (NIMH), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work was supported by a national grant (Programme Hospitalier de Recherche Clinique, grant APN 2008 no 06–08) and Sanofi. The Northwest Data Center (CTD-CNO) is acknowledged for managing the data. It is supported by grants from the French National League Against Cancer (LNC) and the French National Cancer Institute (INCa)., Centre de recherche clinique [CHU Caen] (CRC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Centre d’études des transformations des activités physiques et sportives (CETAPS), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Comité Sein [Caen], UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Service d'Oncologie médicale [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de Recherche clinique [Caen], Service d'Oncologie médicale [Rouen], ChemBioPharm, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine, École nationale supérieure des sciences de l'information et des bibliothèques (ENSSIB), Université de Lyon, Normandie Université (NU)-Normandie Université (NU)-Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Cancéropole Nord-Ouest-Ligue Nationale Contre le Cancer (LNCC), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)

Subjects
Cancer Research, medicine.medical_specialty, Aging, Cognition disorders, [SDV]Life Sciences [q-bio], [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease, Systemic therapy, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Adjuvant therapy, Humans, Chemotherapy, 030212 general & internal medicine, Cognitive skill, Cognitive decline, ComputingMilieux_MISCELLANEOUS, Aged, business.industry, Cancer, Cognition, medicine.disease, 3. Good health, Geriatric Oncology, Oncology, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cognitive changes, Female, Breast neoplasms, business
Abstract

Background Group-based trajectory modeling is particularly important to identify subgroups of patients with pathological cognitive changes after cancer treatment. To date, only one study has explored cognitive trajectories in older patients with cancer. The present article describes objective cognitive changes before to after adjuvant treatment in older adults with early-stage breast cancer (EBC) after adjuvant treatment compared with healthy controls. Patients and Methods Participants were patients ≥65 years of age with newly diagnosed EBC and healthy controls (age-, sex-, and education-matched). The pretreatment assessment was conducted before adjuvant therapy, and the post-treatment assessment after the end of the first adjuvant treatment. Objective cognitive changes before to after treatment were evaluated based on the Reliable Change Index for cognitive decline accounting for cognitive impairment status. Results The sample consisted of women newly diagnosed with EBC (n = 118) and healthy controls (n = 62). Five patterns of changes before to after treatment were identified based on the presence of cognitive decline and cognitive impairment. The distribution of these five change patterns was statistically significant (p = .0001). Thirty-six percent of patients had phase shift changes, 31% without initial objective cognitive impairment developed impairment, 15% had a normal aging, 12% had a nonpathological decline, and 6% experienced accelerated cognitive decline. Conclusion This study described for the first time objective cognitive changes before to after treatment of older adults with EBC immediately after the end of adjuvant treatment. A longer-term remote follow-up of adjuvant treatment is needed to better understand the cognitive trajectories of older patients with EBC. Implications for Practice After the end of adjuvant treatment, 31% of older adults with early-stage breast cancer without initial objective cognitive impairment developed impairment, and 6% experienced accelerated cognitive decline. Initial cognitive functioning should be included in the balance of benefits and harms of systemic therapy for patients who are likely to be at highest risk for cognitive decline after cancer treatments. Regular cognitive follow-up of patients who had cognitive impairment before cancer treatment should monitor symptoms suggestive of neurodegenerative disease and avert the effect of cognitive disorders on patients’ autonomy.

Published
2019
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3. Construction et évaluation d’un programme d’éducation thérapeutique du patient dans le domaine de la douleur liée au cancer

Author

Nathalie Roux, Maryline Feuillet, Anne-Laure Millet, Franck Lecaer, Bénédicte Clarisse, Joelle Le Garrec, Virith Sep Hieng, Marie-Claude Ropartz, Cécile Bisson, Maud Gicquère, Rachel Bignon, Virginie Prevost, Sonia Cauchin, Aline Le Chevalier, Alexandra Leconte, Carole Van Delook, Cyril Guillaumé, Marie-Christine Grach, Constance Bechet, Claire Delorme, Sylvie Gehanne, Christine Le Gal, Natacha Heutte, Isabelle Lepleux, Bodescot, Myriam, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Aunay-Bayeux (CH Aunay-Bayeux), Réseau Régional Douleur en Basse-Normandie (RRDBN), Centre Hospitalier Robert Bisson (CH Robert Bisson), Centre Hospitalier Intercommunal Alençon-Mamers (CHICAM), Centre Hospitalier Mémorial France États-Unis de Saint-Lô (CH Saint-Lô), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Fernand-Léger d'Argentan (CH Argentan), Centre Hospitalier Jacques-Monod de Flers (CH Flers), CH Centre Hospitalier Public du Cotentin (CHPC), Centre Hospitalier Avranches-Granville (CH Avranches-Granville), Pharmacie de la Croix d'Or [Paris], Les auteurs remercient pour leur soutien financier la Fondation Apicil et l'Association ARDCOM (étape 1), la société TAKEDA (étape 2), le Comité départemental de la Ligue contre le cancer de Basse-Normandie (étape 4) et l'INCa (appel d'offres RISP15-007_FP, étape 5)., Unité de Recherche clinique [Caen], UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), and Centre Hospitalier de Bayeux

Subjects
Cancer Research, Research program, Pain assessment, media_common.quotation_subject, Éducation thérapeutique du patient, Context (language use), [SDV.CAN]Life Sciences [q-bio]/Cancer, Therapeutic patient education, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Nursing, [SDV.CAN] Life Sciences [q-bio]/Cancer, Originality, Douleur liée au cancer, Gestion de la douleur, Radiology, Nuclear Medicine and imaging, Quality (business), National level, 030212 general & internal medicine, Cancer pain, Health policy, ComputingMilieux_MISCELLANEOUS, media_common, Hematology, General Medicine, Pain management, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Évaluation de la douleur, Psychology
Abstract

Pain, one of the most feared symptoms for patients with cancer, remains insufficiently alleviated and impairs quality of life. Therapeutic patient education (TPE) is a relevant approach to this problem while allowing patients to develop skills to better manage their pain. In the "Basse-Normandie" French region, the management of pain relies on two organized networks, thus allowing proximity and accessibility for all concerned. In this context, our team has begun a broad five-step research program that is part of a regional health policy: (1) training in TPE of 10 doctor/nurse pairs; (2) identification of educational expectations of patients and their relatives in the field of cancer pain; (3) design and optimization of a TPE program dedicated to cancer pain; (4) regional pilot study aiming to assess the feasibility, quality and transferability of the program; (5) evaluation of the TPE program by interventional comparative randomization at the national level. This article aims to present the program which originality and strengths are based on collaborative work between health stakeholders. Objectives, methodology and expected results of the research phase (stages 2, 4, 5) are notably developed. The main expected outcomes are to prove the effectiveness of the program in improving the knowledge and skills of patients in the field of pain cancer in order to promote their adherence to treatment and, consequently, to enable them to better manage it. The long-term objective is to disseminate the educational approach by modifying practices that provide a mutual benefit for caregivers and patients., La douleur est l'un des symptômes les plus redoutés par les patients atteints de cancer. Elle reste insuffisamment soulagée et retentit sur leur qualité de vie. L'éducation thérapeutique du patient (ETP) constitue une approche pertinente pour répondre à cette problématique en permettant au patient de développer des compétences pour mieux gérer sa douleur. En Basse-Normandie, la prise en charge de la douleur liée au cancer s'appuie notamment sur deux réseaux structurés permettant ainsi la proximité et l'accessibilité pour tous. Dans ce contexte, nous avons construit un large programme de recherche s'inscrivant dans une politique régionale de santé, en cinq étapes : (1) formation à l'ETP de 10 binômes médecins/infirmières ; (2) identification des attentes éducatives des patients et des proches dans le domaine de la douleur ; (3) conception et optimisation d'un programme ETP ; (4) étude pilote régionale permettant d'évaluer la faisabilité, la qualité et la transférabilité du programme ; (5) évaluation du programme d'ETP par randomisation comparative interventionnelle menée à l'échelle nationale. L'objectif de cet article est de présenter la stratégie de notre approche et plus particulièrement les objectifs, la méthodologie et les résultats attendus des phases de recherche (étapes 2, 4, 5). À l'issue des cinq étapes, notre ambition est de démontrer l'efficacité du programme éducatif pour améliorer les compétences des patients leur permettant de mieux gérer leur douleur. La finalité à long terme est de diffuser la démarche éducative avec une modification des pratiques apportant un bénéfice réciproque pour les soignants et les patients.

Published
2018
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4. Shear Wave Elastography in Thyroid Nodules with Indeterminate Cytology: Results of a Prospective Bicentric Study

Author

Dominique De Raucourt, Jean-Jacques Michels, D. Blanchard, Stéphane Bardet, Alexandra Leconte, Bénédicte Clarisse, Camille Buffet, Fabrice Menegaux, Yves Reznik, Hervé Monpeyssen, Laurence Leenhardt, A. Rouxel, Claire Pellot-Barakat, Frédérique Tissier, Natacha Heutte, Frédérique Brenac, Renaud Ciappuccini, Muriel Lefort, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Imagerie Moléculaire in Vivo (IMIV - U1023 - ERL9218), Service Hospitalier Frédéric Joliot (SHFJ), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Américain de Paris, Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de recherche Mathématiques et Informatique Appliquées (MIA), Institut National de la Recherche Agronomique (INRA), Sorbonne Université - Faculté de Médecine - Département d'Enseignement et de Recherche en Médecine Générale, Sorbonne Université (SU), Laboratoire d'Imagerie Biomédicale (LIB), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Œstrogènes, reproduction, cancer (OeReCa), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Service de médecine nucléaire [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Radiologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de médecine nucléaire, Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Médecine nucléaire et Unité Thyroïde [Caen], Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Thyroid Unit [Neuilly sur Seine], American Hospital [Neuilly sur Seine], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Service de chirurgie générale, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de chirurgie de la tête et du cou [Caen], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Unité de Recherche clinique [Caen], Université Paris-Sorbonne (UP4), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Caen, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Thyroid nodules, Adult, Male, elastography, medicine.medical_specialty, endocrine system diseases, diagnosis, Endocrinology, Diabetes and Metabolism, Biopsy, [SDV]Life Sciences [q-bio], 030209 endocrinology & metabolism, [SDV.CAN]Life Sciences [q-bio]/Cancer, Malignancy, 030218 nuclear medicine & medical imaging, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Predictive Value of Tests, Cytology, Medicine, Humans, Prospective Studies, Thyroid Neoplasms, Thyroid Nodule, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Aged, Observer Variation, medicine.diagnostic_test, ultrasound, business.industry, thyroid nodules, Thyroid, Ultrasound, Reproducibility of Results, Middle Aged, medicine.disease, 3. Good health, medicine.anatomical_structure, Elasticity Imaging Techniques, Female, Radiology, Elastography, France, business, Indeterminate
Abstract

International audience; Background: The clinical management of thyroid nodules with indeterminate cytology (IC) remains challenging. The role of shear wave elastography (SWE) in this setting is controversial. The aim of the study was to assess the performances of SWE in terms of prediction of malignancy, reproducibility, and combined analysis with ultrasound (US) examination in thyroid nodules with IC.Methods: This prospective study was conducted in two referral centers. Eligible patients had a thyroid nodule ≥15 mm with IC (Bethesda class III–V) for which surgery had been recommended. Patients underwent a standardized US evaluation combined with a SWE exam followed by surgery. SWE parameters included mean (meanEI; kPa) and max (maxEI) elasticity values, and ratio (meanEI nodule/parenchyma).Results: One hundred and thirty-one nodules (median size 30 mm) in 131 patients were studied. IC was class III in 28%, class IV in 64%, and class V in 8% of cases. After surgery, 21 (16%) nodules were malignant, including nine papillary thyroid cancers (PTC), six follicular thyroid cancers, five poorly differentiated carcinomas, and one large B-cell lymphoma. SWE parameters were similar in benign and malignant nodules, including meanEI (20.2 vs. 19.6 kPa), maxEI (34.3 vs. 32.5 kPa), and ratio (1.57 vs. 1.38). In malignant nodules, meanEI, maxEI, and ratio were higher in the classic PTC variants (n = 4) than in the other PTC variants (n = 5; p

Published
2017
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5. Prospective Evaluation of the Impact of Antiangiogenic Treatment on Cognitive Functions in Metastatic Renal Cancer

Author

Laurence Desrues, Chantal Rieux, Sabine Noal, Nadine Houede, Hélène Castel, Nadine Longato, Emmanuel Sevin, Bernard Escudier, Bénédicte Clarisse, Brigitte Duclos, Florence Joly, Isabelle Léger-Hardy, Natacha Heutte, Sarah Dauchy, Marie Lange, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'Oncologie et Hématologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie [Gustave Roussy] (DISSPO), Institut Gustave Roussy (IGR), Différenciation et communication neuronale et neuroendocrine (DC2N), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Oncologie génito-urinaire, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Centre d’études des transformations des activités physiques et sportives (CETAPS), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Comité Sein [Caen], UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Département d'oncologie médicale, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Centre de recherche clinique [CHU Caen] (CRC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Unité de Recherche clinique [Caen], Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER

Subjects
0301 basic medicine, Oncology, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Urology, Antiangiogenic therapy, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Cognition, Quality of life, Renal cell carcinoma, Internal medicine, medicine, Cognitive decline, Adverse effect, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Fisher's exact test, Fatigue, business.industry, medicine.disease, 3. Good health, Clinical trial, 030104 developmental biology, Renal cancer, 030220 oncology & carcinogenesis, Physical therapy, symbols, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; BACKGROUND:Little is known about the cognitive effects of antiangiogenic therapies (AATs) in metastatic renal cell carcinoma (mRCC) and their relation with fatigue.OBJECTIVE:To evaluate the impact of AATs on cognition and its connection with fatigue and quality of life (QoL) in patients with mRCC.DESIGN, SETTING, AND PARTICIPANTS:This prospective study enrolled 75 patients starting AAT as first or second line for mRCC and assessed them at 3 mo (n=58) and 6 mo (n=50).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:We assessed objective cognitive decline with a neuropsychological battery of tests and cognitive complaint, fatigue, and QoL with validated self-reported questionnaires using the Fisher exact test, Wilcoxon test, and Spearman correlation coefficient.RESULTS AND LIMITATIONS:A decline of cognitive functions was observed in 18 patients (31%) including 13 without cognitive impairment at baseline. The score of fatigue was increased in all patients except one. A relationship between cognitive complaints and fatigue was observed (p

Published
2016
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6. Decline in Cognitive Function in Older Adults With Early-Stage Breast Cancer After Adjuvant Treatment

Author

Philippe Barthélémy, Chantal Rieux, Sabine Noal, Francis Eustache, D. Allouache, Jean-Emmanuel Kurtz, Natacha Heutte, Marie Lange, Christelle Levy, Bénédicte Giffard, Nadine Longato, Bénédicte Clarisse, Olivier Rigal, Corinne Veyret, Johan Lefel, Hélène Castel, Florence Joly, Centre de recherche clinique [CHU Caen] (CRC), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Comité Sein [Caen], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Département d'Oncologie et Hématologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), Service d'Oncologie médicale [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de Recherche clinique [Caen], Service d'Oncologie médicale [Rouen], ChemBioPharm, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Différenciation et communication neuronale et neuroendocrine (DC2N), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine, Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), École nationale supérieure des sciences de l'information et des bibliothèques (ENSSIB), Université de Lyon, UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Lange, Marie, Cancers et préventions, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), This work was supported by a national grant (Programme Hospitalier de Recherche Clinique, Grant APN 2008 n°06-08) and Sanofi., UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-Normandie Université (NU)-Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER, and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)

Subjects
Cancer Research, Pediatrics, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Adjuvant therapy, medicine, Cognitive decline, education, ComputingMilieux_MISCELLANEOUS, education.field_of_study, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Neuropsychology, Cognition, medicine.disease, Comorbidity, 3. Good health, Geriatric Oncology, Oncology, Docetaxel, 030220 oncology & carcinogenesis, Physical therapy, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

International audience; Background. The impact of chemotherapy on cognition among elderly patients has received little attention, although such patients are more prone to presenting with age-related cognitive deficits and/or cognitive decline during chemotherapy. The present study assessed the cognitive function in older adults treated for early-stage breast cancer (EBC). Patients and Methods. The participants were newly diagnosed EBC patients aged $65 years without previous systemic treatment or neurological or psychiatric disease and matched healthy controls. They underwent two assessments: before starting adjuvant therapy and after the end of chemotherapy (including doxorubicin 6 docetaxel [CT1 group], n 5 58) or radiotherapy for patients who did not receive chemotherapy (CT2 group, n 5 61), and at the same interval for the healthy controls (n 5 62). Neuropsychological and geriatric assessments were performed. Neuropsychological data were analyzed using the Reliable Change Index. Results. Forty-nine percent of the patients (mean age, 70 6 4 years) had objective cognitive decline after adjuvant treatment that mainly concerned working memory. Among these patients, 64% developed a cognitive impairment after adjuvant treatment. Comorbidity was not associated with cognitive decline. No significant difference in objective cognitive decline was found between the two groups of patients; however, the CT1 group had more subjective cognitive complaints after treatment (p 5 .008). The oldest patients (aged 70–81 years) tended to have more objective decline with docetaxel (p 5 .05). Conclusion. This is the largest published study assessing cognitive function in older adults with EBC that included a group of patients treated with modern chemotherapy regimens. Approximately half the patients had objective cognitive decline after adjuvant treatment. The oldest patients were more likely to have cognitive decline with chemotherapy, particularly with docetaxel. The Oncologist 2016;21:1–12 Implications for Practice: This is the largest published study assessing cognitive function in older adults with early-stage breast cancer that included a group of patients treated with modern chemotherapy regimens. Approximately half the patients had objective cognitive decline after adjuvant treatment. The oldest patients were more likely to have cognitive decline with che-motherapy, particularly with docetaxel. Cognitive deficits could affect patients' quality of life and their compliance to treatment. Assessing cognitive dysfunctions in the elderly cancer population is a challenge in clinical practice, but it could influence the choice of the most appropriate therapy, including the use of oral drugs.

Published
2016
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7. Baseline cognitive functions among elderly patients with localised breast cancer

Author

Johan Le Fel, Francis Eustache, Aurélie Daireaux, Chantal Rieux, Sabine Noal, Natacha Heutte, Bénédicte Giffard, D. Allouache, Nadine Longato, Bénédicte Clarisse, Christelle Levy, Jean-Emmanuel Kurtz, Olivier Rigal, Philippe Barthélémy, Corinne Veyret, Florence Joly, Marie Lange, Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cancers et préventions, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Université de Caen Normandie - UFR Santé - Département d'orthophonie (UNICAEN Orthophonie), Normandie Université (NU)-Normandie Université (NU), Les Hôpitaux Universitaires de Strasbourg (HUS), Service d'Oncologie médicale [CHU Caen], This work was supported by a National gran t ( Programme Hospitalier de Recherche Clinique , PHRC ) and Sanofi., Centre de recherche clinique [CHU Caen] (CRC), Normandie Université (NU)-Normandie Université (NU)-Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), École nationale supérieure des sciences de l'information et des bibliothèques (ENSSIB), Université de Lyon, Comité Sein [Caen], Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Département d'Oncologie et Hématologie [Strasbourg], Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Unité de Recherche clinique [Caen], Unité de Recherche Clinique, Service d'Oncologie médicale [Rouen], ChemBioPharm, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Eustache, Francis, Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Normandie Université (NU)-Normandie Université (NU)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, and UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)

Subjects
Cancer Research, medicine.medical_specialty, Cognition disorders, [SDV]Life Sciences [q-bio], Population, neuropsychology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Neuropsychological Tests, Breast cancer, Cognition, Quality of life, Internal medicine, Surveys and Questionnaires, medicine, Adjuvant therapy, breast neoplasms, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Risk factor, Psychiatry, Prospective cohort study, education, ComputingMilieux_MISCELLANEOUS, Aged, education.field_of_study, business.industry, Age Factors, Cancer, medicine.disease, Executive functions, 3. Good health, Oncology, quality of life, ageing, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], business
Abstract

International audience; PURPOSE: Cognitive deficits (CD) are reported among cancer patients receiving chemotherapy, but may also be observed before treatment. Though elderly patients are expected to be more prone to present age-related CD, poor information is available regarding the impact of cancer and chemotherapy on this population. This study assessed baseline cognitive functions (before adjuvant treatment) in elderly early stage breast cancer (EBC) patients. METHODS: Women >65years-old with newly diagnosed EBC were included in this prospective study. Episodic memory, working memory, executive functions and information processing speed were assessed by neuropsychological tests. Questionnaires were used to assess subjective CD, anxiety, depression, fatigue, quality of life and geriatric profile. Objective CD were defined using International Cognition and Cancer Task Force criteria. A group of elderly women without cancer coupled with published data related to healthy women were used for comparison (respectively to subjective and objective CD). RESULTS: Among the 123 elderly EBC patients (70±4years) included, 41% presented objective CD, which is greater than expected in healthy population norms (binomial test P

Published
2014
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8. One-year longitudinal study of fatigue, cognitive functions, and quality of life after adjuvant radiotherapy for breast cancer

Author

Christelle Levy, C. Segura, Fabienne Collet, C. Delcambre, Agnès Hardouin, Odile Switsers, Thierry Delozier, Chantal Rieux, Sabine Noal, Natacha Heutte, Michel Henry-Amar, D. Allouache, Florence Joly, Comité Sein [Caen], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Service d'Oncologie médicale [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Laboratoire de biologie clinique et oncologique, Unité de Recherche clinique [Caen], Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), and Calvados Cancer Registry

Subjects
Oncology, Cancer Research, Longitudinal study, Time Factors, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 0302 clinical medicine, Cognition, Quality of life, Clinical Protocols, Risk Factors, Surveys and Questionnaires, 030212 general & internal medicine, Longitudinal Studies, ComputingMilieux_MISCELLANEOUS, Fatigue, Aged, 80 and over, Radiation, Depression, Middle Aged, 3. Good health, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, Analysis of variance, France, Adult, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, Breast Neoplasms, 03 medical and health sciences, Breast cancer, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, Chemotherapy, Analysis of Variance, business.industry, Cancer, medicine.disease, Radiation therapy, Physical therapy, Quality of Life, Radiotherapy, Adjuvant, business, Cognition Disorders
Abstract

Most patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life.Fatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional Assessment of Cancer Therapy-General questionnaires, including breast and fatigue modules.At baseline, 60% of the CT-RT patients expressed fatigue vs. 33% of the RT patients (p0.001). Corresponding values at the end of RT were statistically similar (61% and 53%), and fatigue was still reported at 1 year by more than 40% of patients in both groups. Risk factors for long-term fatigue included depression (odds ratio [OR] = 6), which was less frequent in the RT group at baseline (16% vs. 28 %, respectively, p = 0.01) but reached a similar value at the end of RT (25% in both groups). Initial mild cognitive impairments were reported by RT (34 %) patients and CT-RT (24 %) patients and were persistent at 1 year for half of them. No biological disorders were associated with fatigue or cognitive impairment.Fatigue was the main symptom in LBC patients treated with RT, whether they received CT previously or not. The correlation of persistent fatigue with initial depressive status favors administering medical and psychological programs for LBC patients treated with CT and/or RT, to identify and manage this main quality-of-life-related symptom.

Published
2010
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9. Quality of life after successful treatment of early-stage Hodgkin's lymphoma: 10-year follow-up of the EORTC-GELA H8 randomised controlled trial

Author

Heutte, Natacha, Flechtner, Henning H., Mounier, Nicolas, Mellink, Wilhelmina A. M., Meerwaldt, Jacobus H., Eghbali, Houchingue, van't Veer, Mars B., Noordijk, Evert M., Kluin-Nelemans, Johanna C., Lampka, Elzbieta, Thomas, Jose, Lugtenburg, Pieternella J., Viterbo, Luisa, Carde, Patrice, Hagenbeek, Anton, van der Maazen, Richard W.M., Smit, Wilma G.J.M., Brice, Pauline, van Kooy, Marinus Marwijk, Baars, Johanna W., Poortmans, Philip, Tirelli, Umberto, Leeksma, Onno C., Tomsic, Radka, Feugier, Pierre, Salles, Gilles, Gabarre, Jean, Kersten, Marie Jose, Van Den Neste, Eric, Creemers, Geert-Jan M., Gaillard, Isabelle, Meijnders, Paul, Tertian, Gerard, Reman, Oumedaly, Muller, Hein P., Troncy, Jacques, Blanc, Michel, Voogt, Paul J., Wijermans, Pierre, Rieux, Chantal, Ferme, Christophe, Henry-Amar, Michel, Schroyens, Wilfried, EORTC-GELA H8 Trial Group, Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg] (OVGU), Gvh et Gvl : Physiopathologie Chez l'Homme et Chez l'Animal, Incidence et Role Therapeutique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Plateforme de génétique moléculaire des cancers d'Aquitaine, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Curie [Paris], Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire de Biologie Moléculaire de la Cellule (LBMC), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Cliniques Universitaires Saint-Luc [Bruxelles], Université Pierre Mendès France - Grenoble 2 (UPMF), Middelheim Hospital, Hématologie, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Henri Mondor [Créteil], École polytechnique (X), Unité de Recherche clinique [Caen], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Calvados Cancer Registry, Otto-von-Guericke University [Magdeburg] (OVGU), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Service d'Hématologie clinique [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Henri Mondor, Hematology, CCA -Cancer Center Amsterdam, Clinical Haematology, AII - Amsterdam institute for Infection and Immunity, and EORTC-GELA H8 Trial Group

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], MEDLINE, [SDV.CAN]Life Sciences [q-bio]/Cancer, Logistic regression, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Quality of life, SDG 3 - Good Health and Well-being, law, Translational research [ONCOL 3], medicine, Humans, 030212 general & internal medicine, Cognitive skill, Stage (cooking), ComputingMilieux_MISCELLANEOUS, Aged, business.industry, Odds ratio, Middle Aged, Hodgkin's lymphoma, medicine.disease, Hodgkin Disease, humanities, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Physical therapy, Quality of Life, Female, Human medicine, business, Follow-Up Studies
Abstract

Background Little is known about the longitudinal course of health-related quality of life (HRQoL) in patients with Hodgkin's lymphoma during their post-treatment follow-up and re-adaptation to normal life. We report on the HRQoL of patients treated in the randomised H8 trial of the European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and the Groupe d'Études des Lymphomes de l'Adulte (GELA). We aimed to assess HRQoL and fatigue following treatment, to analyse relations with treatment, and to identify factors that predict persistent fatigue. Methods Patients received HRQoL questionnaires at the end of primary therapy and during follow-up. The EORTC QLQ-C30 was used to assess HRQoL, and the Multidimensional Fatigue Inventory (MFI-20) was used to assess fatigue. Changes of mean HRQoL scores over time were analysed with mixed models. Multiple polytomic nominal logistic regression was done to identify independent baseline predictors of fatigue within MFI-20 dimensions. Analyses were done on an intention-to-treat basis. This study is registered with www.ClinicalTrials.gov, number NCT00379041. Findings 2666 assessments from 935 patients were analysed. Mean follow-up was 90 months (range 52118). Age affected all functioning and symptom scores except emotional functioning, with younger age associated with higher functioning and lower severity of symptoms; improvement with time showed similar patterns between age groups. Women reported lower HRQoL and higher symptom scores than did men. Overall, 3·2% (14/439 for role functioning) to 9·7% (43/442 for social functioning) and 5·8% (29/498 for reduced motivation) to 9·9% (49/498 for general fatigue) of patients reported impairments of 10 points or more (on a 0100 scale) in QLQ-C30 and MFI-20 scores, respectively, independent of age and sex. Emotional domains were more affected than physical ones. There was no relation between HRQoL outcome and type of treatment. Fatigue (MFI-20 scores) at the end of treatment was the only predictive variable for persistent fatigue, with odds ratios varying from 2·58 (95% CI 1·006·67) to 41·51 (12·02143·33; p≤0·0001). Sensitivity analyses adjusting for missing data were much the same as the main results. Interpretation HRQoL data after treatment for early-stage Hodgkin's lymphoma show that patients experience strain and limitations in all subdomains apart from cognitive functioning (QLQ-C30), and also have reduced motivation (MFI-20). Differences in HRQoL improvement with time were linked to age and sex, but not type of treatment. Fatigue status at the end of treatment seems to predict subsequent HRQoL. Abstract: Background little is known about the longitudinal course of health-related quality of life (HRQoL) in patients with Hodgkin's lymphoma during their post-treatment follow-up and re-adaptation to normal life. We report on the HRQoL of patients treated in the randomised H8 trial of the European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and the Groupe dEtudes des Lymphomes de I'Adulte (GELA). We aimed to assess HRQoL and fatigue following treatment, to analyse relations with treatment, and to identify factors that predict persistent fatigue. Methods Patients received HRQoL questionnaires at the end of primary therapy and during follow-up. The EORTC QLQ-C30 was used to assess HRQoL, and the Muiltidimensional Fatigue Inventory (MFI-20) was used to assess fatigue. Changes of mean HRQoL scores over time were analysed with mixed models. Multiple polytomic: nominal logistic regression was done to identify independent baseline predictors of fatigue within MFI-20 dimensions. Analyses were done on an intention-to-treat basis. This study is registered with www.ClinicalTrials.gov, number NCT00379041. Findings 2666 assessments from 935 patients were analysed. Mean follow-up was 90 months (range 52-118). Age affected all functioning and symptom scores except emotional functioning, with younger age associated with higher functioning and lower severity of symptoms; improvement with time showed similar patterns between age groups. Women reported lower HRQoL and higher symptom scores than did men. Overall, 3.2% (14/439 for role functioning) to 9.7% (43/442 for social functioning) and 5.8% (29/498 for reduced motivation) to 9.9% (49/498 for general fatigue) of patients reported impairments of 10 points or more (on a 0-100 scale) in QLQ-C30 and MFI-20 scores, respectively, independent of age and sex. Emotional domains were more affected than physical ones. There was no relation between HRQoL outcome and type of treatment. Fatigue (MFI-20 scores) at the end of treatment was the only predictive variable for persistent fatigue, with odds ratios varying from 2.58 (95% CI 1.00-6.67) to 41.51 (12.02-143.33; p

Published
2009
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10. Cognitive complaints in cancer: The French version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), normative data from a healthy population.

Author

Lange M, Heutte N, Morel N, Eustache F, Joly F, and Giffard B

Subjects
Adult, Aged, Aged, 80 and over, Cognition Disorders etiology, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychometrics, Quality of Life, Reproducibility of Results, Self Report, Surveys and Questionnaires, Cognition Disorders diagnosis, Neoplasms complications
Abstract

Cancer patients often report cognitive changes after chemotherapy. The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) is a self-report questionnaire that assesses these changes. The aims of the present study were (1) to establish normative data, and (2) to compare the scores of patients and healthy controls to assess whether or not the questionnaire is able to discriminate between these populations. The normative sample included 213 healthy participants. The patient group included 63 cancer patients treated with chemotherapy, who were compared to a subsample of 63 matched healthy controls. The questionnaire had good internal consistency reliability (Cronbach's alphas = .74-.91). The oldest patients had significantly more cognitive complaints (p < .001). Cognitive complaints were significantly related with Trail Making Test scores (p < .001). Furthermore, the FACT-Cog subscales correlated significantly with anxiety and depression. Patients had more complaints than matched controls on the subscales Perceived Cognitive Impairments (p = .01), Impact on Quality of Life (p = .001) and Perceived Cognitive Abilities (p = .027). The reference values from the healthy population reported here could be used for comparison with the values measured in French-speaking cancer patients. The values provide a benchmark against which clinicians can evaluate the impact of the disease and/or the treatments on cognitive complaints and help to improve quality of life by providing appropriate care.

Published
2016
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