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Melanoma: HELP
Articles by Juliette Thariat
Based on 30 articles published since 2010
(Why 30 articles?)
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Between 2010 and 2020, J. Thariat wrote the following 30 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline [Locoregional treatments of brain metastases for patients with metastatic cutaneous melanoma: French national guidelines]. 2014

Lubrano, V / Derrey, S / Truc, G / Mirabel, X / Thariat, J / Cupissol, D / Sassolas, B / Combemale, P / Modiano, P / Bedane, C / Dygai-Cochet, I / Lamant, L / Mourrégot, A / Rougé Bugat, M-È / Siegrist, S / Tiffet, O / Mazeau-Woynar, V / Verdoni, L / Planchamp, F / Leccia, M-T / Anonymous620807. ·Service de neurochirurgie, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France. · Département de neurochirurgie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Département de radiothérapie-curiethérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France. · Pôle de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France. · Service d'oncologie médicale, ICM, institut du cancer de Montpellier Val-d'Aurelle, 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier, France. · Service de dermatologie, hôpital Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. · Unité onco-dermatologie, centre Léon Bérard, 28, rue Laennec, 69008 Lyon, France. · Service de dermatologie, hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France. · Service de dermatologie, hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. · Service de médecine nucléaire, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Service d'anatomie pathologique, hôpital Purpan, place Baylac, 31059 Toulouse, France. · Service de chirurgie oncologique, ICM, institut du cancer de Montpellier Val-d'Aurelle, 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier, France. · Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France. · Cabinet médical, 3, rue Saint-Sigisbert, 57050 le Ban-Saint-Martin, France. · Service de chirurgie générale et thoracique, centre hospitalier universitaire, 42055 Saint-Étienne, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. Electronic address: recommandations@institutcancer.fr. · Clinique de dermatolo-vénéréologie, photobiologie et allergologie, pôle pluridisciplinaire de médecine, hôpital Michallon, 38043 Grenoble, France. ·Neurochirurgie · Pubmed #25241016.

ABSTRACT: INTRODUCTION: The management of metastatic cutaneous melanoma is changing, marked by innovative therapies. However, their respective use and place in the therapeutic strategy continue to be debated by healthcare professionals. OBJECTIVE: The French national cancer institute has led a national clinical practice guideline project since 2008. It has carried out a review of these modalities of treatment and established recommendations. METHODS: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by experts. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery. RESULTS: This article presents the results of bibliographic search, the conclusions of the literature and the recommendations concerning locoregional treatments of brain metastases for patients with metastatic cutaneous melanoma.

2 Guideline [Management of patients with metastatic cutaneous melanoma: French national guidelines. French National Cancer Institute]. 2014

Leccia, M-T / Planchamp, F / Sassolas, B / Combemale, P / Modiano, P / Bedane, C / Cupissol, D / Derrey, S / Dygai-Cochet, I / Lamant, L / Lubrano, V / Mirabel, X / Mourrégot, A / Rougé Bugat, M-E / Siegrist, S / Thariat, J / Tiffet, O / Truc, G / Verdoni, L / Mazeau-Woynar, V. ·Pôle pluridisciplinaire de médecine, clinique de dermatolo-vénéréologie, photobiologie et allergologie, hôpital Michallon, 38043 Grenoble, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. Electronic address: recommandations@institutcancer.fr. · Service de dermatologie, hôpital Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. · Unité onco-dermatologie, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France. · Service de dermatologie, hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France. · Service de dermatologie, hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. · Service d'oncologie médicale, ICM, institut du cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France. · Département de neurochirurgie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Service de médecine nucléaire, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Service d'anatomie pathologique, hôpital Purpan, place Baylac, 31059 Toulouse, France. · Service de neurochirurgie, hôpital de Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France. · Département de radiothérapie-curiethérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France. · Service de chirurgie oncologique, ICM, institut du cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France. · Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France. · Cabinet médical, 3, rue Saint-Sigisbert, 57050 Le Ban-Saint-Martin, France. · Pôle de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France. · Service de chirurgie générale et thoracique, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne, France. · Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. ·Ann Dermatol Venereol · Pubmed #24507205.

ABSTRACT: BACKGROUND: Recent years have seen the emergence of new molecules for the treatment of patients with metastatic cutaneous melanoma, with significant benefits in terms of survival and the opening of new therapeutic perspectives. In addition, many techniques are currently being developed for locoregional treatment of metastatic sites. Management of metastatic melanoma is thus fast-changing and is marked by innovative therapeutic approaches. However, the availability of these new treatments has prompted debate among healthcare professionals concerning their use and their place in therapeutic strategy. AIMS: Since 2008, the French National Cancer Institute (INCa) has been leading a project to define and diffuse national clinical practice guidelines. It has performed a review of these treatment methods, which it aims to circulate, and it is seeking to develop recommendations in order to allow nationwide implementation of innovative approaches while promoting good use thereof. METHODS: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by experts within a multidisciplinary working group, with feedback from specialists in cancer care delivery. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery. RESULTS: This article presents the national recommendations for first- and second-line systemic treatment and for locoregional treatment of metastatic sites in patients presenting metastatic cutaneous melanoma.

3 Guideline [Loco-regional treatments of the metastatic sites for patients with pauci-metastatic cutaneous melanoma (without brain metastasis): French national guidelines]. 2014

Sassolas, Bruno / Mourrégot, Anne / Thariat, Juliette / Tiffet, Olivier / Dygai-Cochet, Inna / Mirabel, Xavier / Truc, Gilles / Cupissol, Didier / Modiano, Philippe / Combemale, Patrick / Bedane, Christophe / Derrey, Stéphane / Lamant, Laurence / Lubrano, Vincent / Siegrist, Sophie / Rougé-Bugat, Marie-Ève / Mazeau-Woynar, Valérie / Verdoni, Laëtitia / Planchamp, François / Leccia, Marie-Thérèse. ·Hôpital Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. · Institut du Cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France. · Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France. · Centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne, France. · Centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France. · Hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France. · Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France. · Hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoge, France. · Hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Hôpital Purpan, place Baylac, 31059 Toulouse, France. · Hôpital de Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France. · Cabinet médical, 3, rue Saint-Sigisbert, 57050Le Ban-Saint-Martin, France. · Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France. · Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. · Hôpital Michallon, 38043 Grenoble, France. ·Bull Cancer · Pubmed #24369290.

ABSTRACT: INTRODUCTION: The last years are marked by the emergence of new molecules for the treatment of metastatic cutaneous melanoma with a significant benefit on the survival. Besides, some techniques are in development for the loco-regional treatment of the metastatic sites, bringing new therapeutic perspectives. However, their respective use and place in the therapeutic strategy are debated by healthcare professionals. OBJECTIVE: The French National Cancer Institute leads a national clinical practice guidelines project since 2008. It realized a review of these modalities of treatment and developed recommendations. METHODS: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by a multidisciplinary expert workgroup. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery. RESULTS: This article presents recommendations for loco-regional treatments of the pulmonary, bone, cutaneous, hepatic and digestive metastatic sites for patients with pauci-metastatic cutaneous melanoma.

4 Review [Management of uveal melanomas, guidelines for oncologists]. 2018

Mathis, Thibaud / Cassoux, Nathalie / Tardy, Magali / Piperno, Sophie / Gastaud, Lauris / Dendale, Rémi / Maschi, Celia / Nguyen, Anh-Minh / Meyer, Laurent / Bonnin, Nicolas / Baillif, Stephanie / Tick, Sarah / Mouriaux, Fréderic / Jaspart, Franck / Dellis, Josette / Rosier, Laurence / Desjardins, Laurence / Herault, Joel / Caujolle, Jean Pierre / Thariat, Juliette. ·Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69004 Lyon, France. · Institut Curie, 26, rue de l'ulm, 75248 Paris cedex 05, France. · Hôpital Pasteur, 30, voie romaine, 06000 Nice, France. · Hôpitaux civils de Colmar, 39, avenue de la liberté, 68024 Colmar, France. · Centre d'ophtalmologie du Zénith, 63800 Cournon D'auvergne, France. · CHNO des XV-XX, 28, rue de Charenton, 75012 Paris, France. · Centre hospitalier universitaire Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes, France. · Polyclinique du Parc, route d'Assevent, 59600 Maubeuge, France. · Association nationale des patients atteints du cancer de l'œil, ANPACO, 5, rue de Fontfrède, 15230 Pierrefort, France. · Centre Retine Gallien, 68, rue du palais-Gallien, 33000 Bordeaux, France. · Centre Lacassagne, 227, avenue Valombrose, 06200 Nice, France. · Centre François Baclesse, ARCHADE, service de radiothérapie, 3, avenue du général-Harris, 14000 Caen, France. Electronic address: jthariat@gmail.com. ·Bull Cancer · Pubmed #30217336.

ABSTRACT: Uveal melanomas are the most frequent primary malignant eye tumor. Enucleation was historically the gold standard. Since then, several studies showed that conservative treatments did not increase the risk of metastasis or survival. Choroidal melanomas are both radioresistant and located close to visual structures (the optic nerve and macula) of the eye, which may be preserved in some settings without compromising tumor control, as this is the first priority. Different types of radiation therapy may be used for such tumors: brachytherapy and charged particles, including proton beam therapy. If visual prognosis is dependent to the local treatment, the vital prognosis is dependent on the metastatic risk, with a risk of liver involvement in 20 to 50% of patients, depending on tumor size and genomics. Median survival after the discovery of liver metastases is about 15 months. The management of these patients is often complex. Systemic therapies (chemotherapy, targeted therapies, immunotherapy, etc.) yield limited response rates and although local treatments of liver metastases are promising, they are only feasible in selected patients. The mission of the MELACHONAT national network is to improve the management of patients regardless of the stage of the disease. The patient association ANPACO is dedicated to help uveal melanoma patients in their health care path and to promote knowledge dissemination within the patient community. The aim of this review is to focus on the local treatments of uveal melanomas as well as the management of their metastatic evolution.

5 Review [Focus on clinical and pathological management of conjunctival melanocytic tumors]. 2018

Lassalle, Sandra / Caujolle, Jean-Pierre / Leger, François / Maschi, Célia / Gastaud, Lauris / Nahon-Esteve, Sacha / Thariat, Juliette / Baillif, Stéphanie / Hofman, Paul. ·Laboratoire de pathologie clinique et expérimentale, pavillon J, hôpital Pasteur, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France; Institute of research on cancer and aging de Nice (IRCAN), Inserm U1081/CNRS UMR7284, UFR de médecine, 28, avenue Valombrose, 06107 Nice cedex 2, France; FHU OncoAge Nice, 30, avenue de la voie Romaine, CS 51069, 06001 Nice cedex 1, France. Electronic address: lassalle.s@chu-nice.fr. · Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France. · Service de pathologie, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France. · Département d'oncologie médicale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France. · Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France. · Laboratoire de pathologie clinique et expérimentale, pavillon J, hôpital Pasteur, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France; Institute of research on cancer and aging de Nice (IRCAN), Inserm U1081/CNRS UMR7284, UFR de médecine, 28, avenue Valombrose, 06107 Nice cedex 2, France; FHU OncoAge Nice, 30, avenue de la voie Romaine, CS 51069, 06001 Nice cedex 1, France. ·Ann Pathol · Pubmed #29803361.

ABSTRACT: Conjunctival-pigmented tumors are rare, but they are one of the most commonly encountered by the pathologist working with the department of ophthalmology. Nevus and melanoma can be encountered and have some histological difference compared to their cutaneous counterpart. Primary acquired melanosis (PAM) is a conjunctival specific entity. This clinical term includes several histological lesions ranging from benignity to melanoma precursor lesion. Histologic examination determines the therapy and the risk of progression to melanoma. We present here a histopathological, clinical and therapeutic synthesis of conjunctival-pigmented lesions, emphasizing the importance of a good understanding between clinicians and pathologists.

6 Review Mechanisms of phosphenes in irradiated patients. 2017

Mathis, Thibaud / Vignot, Stephane / Leal, Cecila / Caujolle, Jean-Pierre / Maschi, Celia / Mauget-Faÿsse, Martine / Kodjikian, Laurent / Baillif, Stéphanie / Herault, Joel / Thariat, Juliette. ·Department of Ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France. · Department of Medical Oncology, Jean Godinot Institute, 51100 Reims, France. · Department of Ophthalmology, Pasteur II Hospital, 06000 Nice, France. · Rothschild Ophthalmologic Foundation, 75019 Paris, France. · Proton Therapy Center, Université Nice Sophia Antipolis, 06200 Nice, France. · Department of Radiation Therapy, Centre Francois Baclesse, ARCHADE, 14000 Caen, France. ·Oncotarget · Pubmed #28969095.

ABSTRACT: Anomalous visual perceptions have been reported in various diseases of the retina and visual pathways or can be experienced under specific conditions in healthy individuals. Phosphenes are perceptions of light in the absence of ambient light, occurring independently of the physiological and classical photonic stimulation of the retina. They are a frequent symptom in patients irradiated in the region of the central nervous system (CNS), head and neck and the eyes. Phosphenes have historically been attributed to complex physical phenomena such as Cherenkov radiation. While phosphenes are related to Cherenkov radiation under high energy photon/electron irradiation conditions, physical phenomena are unlikely to be responsible for light flashes at energies used for ocular proton therapy. Phosphenes may involve a direct role for ocular photoreceptors and possible interactions between cones and rods. Other mechanisms involving the retinal ganglion cells or ultraweak biophoton emission and rhodopsin bleaching after exposure to free radicals are also likely to be involved. Despite their frequency as shown in our preliminary observations, phosphenes have been underreported probably because their mechanism and impact are poorly understood. Recently, phosphenes have been used to restore the vision and whether they might predict vision loss after therapeutic irradiation is a current field of investigation. We have reviewed and also investigated here the mechanisms related to the occurrence of phosphenes in irradiated patients and especially in patients irradiated by proton therapy for ocular tumors.

7 Review [Operative therapy and irradiation of conjunctival melanoma]. 2015

Westekemper, H / Meller, D / Darawsha, R / Scholz, S L / Flühs, D / Steuhl, K-P / Hérault, J / Thariat, J / Sauerwein, W. ·Klinik für Erkrankungen des vorderen Augenabschnitts, Zentrum für Augenheilkunde, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland. henrike.westekemper@uk-essen.de. · Klinik für Erkrankungen des vorderen Augenabschnitts, Zentrum für Augenheilkunde, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland. · Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland. · Cyclotron Biomédical, Centre Antoine-Lacassagne, Nice, France. ·Ophthalmologe · Pubmed #26475337.

ABSTRACT: BACKGROUND: Radiotherapy of conjunctival melanoma has gained in importance in recent years compared to less invasive therapeutic approaches. This is due to the high recurrence rates achieved by omitting adjuvant therapy and to the increasing availability of suitable radiotherapeutic methods, so that tumors formerly not amenable to organ-preserving therapy can now be treated. OBJECTIVE: This article presents the current radiotherapeutic options for conjunctival melanoma. The aim is to describe the diagnostic and therapeutic strategies and the course of therapy of malignant conjunctival melanoma. It is the authors' intention to justify the necessity of the adjuvant therapy of conjunctival melanoma and to emphasize the need for interdisciplinary cooperation during the course of tumor therapy. METHODS: The article is based on results published in the literature as well as on data collected and experience gained in our centre.

8 Article Ultra-widefield fundus photography for radiation therapy planning of ocular tumours. 2020

Mathis, Thibaud / Espensen, Charlotte A / Caujolle, Jean-Pierre / Herault, Joel / Fog, Lotte S / Maschi, Celia / Kodjikian, Laurent / Baillif, Stephanie / Kiilgaard, Jens F / Thariat, Juliette. ·Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France. · UMR-CNRS 5510, Matéis, Villeurbane, France. · Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark. · Department of Oncology, Section of Radiotherapy, Rigshospitalet, Copenhagen, Denmark. · Department of Ophthalmology, Pasteur II University Hospital, Nice, France. · Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France. · Department of Radiation Oncology, Centre Francois Baclesse/ARCHADE- Normandie Univeristy, Caen, France. ·Acta Ophthalmol · Pubmed #31518055.

ABSTRACT: PURPOSE: The use of planar ultra-widefield fundus photography (UWF) may result in distortions and inaccurate measurement. The aim of the study was to evaluate the accuracy of UWF instead of the standard narrow field (SF) for the treatment planning phase of ocular tumours. METHODS: Distortions between conformal SF and UWF were assessed in 43 patients with choroidal melanoma treated with either proton therapy or brachytherapy. imagej software was used to measure distortion. RESULTS: The median interquartile range ([IQR]) distortion for all cases was 3.7% [1.7-10.8]. For cases with tumours within 6 mm of the optic disc, distortions appeared clinically nonsignificant. For peripheral and/or large tumours, significantly larger distortions were observed on UWF (median 4.4% [2.7-22.6] for tumours ≥6 mm from the optic disc versus 3.3% [1.6-9.9] for those <6 mm, p = 0.04). Images can be subdivided into three groups: minimal distortion (79.1% of eyes), similar level of major distortion for both measured distances (11.6%) and distortion with unequal level of distortion between the measured distances (9.3%). CONCLUSION: Distortions with UWF appeared minimal in posterior regions of the fundus and increased with the distance from the posterior pole. UWF could therefore be used for treatment planning of ocular tumours as the planned radiation dose to the macula and optic disc are not impacted.

9 Article Oncologic and visual outcomes after postoperative proton therapy of localized conjunctival melanomas. 2019

Thariat, Juliette / Salleron, Julia / Maschi, Celia / Fevrier, Edouard / Lassalle, Sandra / Gastaud, Lauris / Baillif, Stephanie / Claren, Audrey / Baumard, Florent / Herault, Joel / Caujolle, Jean Pierre. ·Department of Radiation Oncology, Francois Baclesse Cancer ARCHADE Center, Normandie Universite-Unicaen, 3 Av General Harris, 14000, Caen, France. jthariat@gmail.com. · Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534, 3 Av Genenral Harris, 14000, Caen, France. jthariat@gmail.com. · Department of Biostatistics, Institut de Cancérologie de Lorraine, Université de Lorraine, F-54500, Vandœuvre-lès-Nancy, France. · Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France. · Department of biopathology, Pasteur 2 Teaching Hospital, Nice, France. · Department of Medical Oncology, Antoine-Lacassagne Cancer Center, Nice, France. · Department of Radiation Oncology, Antoine-Lacassagne Cancer Center, Nice, France. ·Radiat Oncol · Pubmed #31881977.

ABSTRACT: INTRODUCTION: conjunctival melanomas have high local relapse rates. Oncologic and visual outcomes can be improved with proton therapy and no-touch surgery. MATERIAL AND METHODS: a monocentric retrospective study of consecutive patients treated with surgery and proton therapy for conjunctival melanoma was conducted. Proton therapy was performed to a total dose of 45 Grays physical dose delivered in eight fractions over two weeks. RESULTS: Ninety-two patients were included. The mean age was 63-year-old. 65.2% of patients had primary acquired melanosis. The mean tumor thickness and diameter was 2.5 mm and 7.0 mm respectively. The clinical stage was T1 in 71.6% of cases, with a quadrangular involvement of more than 90° in 69% of cases. Conjunctival melanomas were of epithelioid cell-type in 40% of cases. Mean follow-up was 4.7 years. Five-year local failure rate was 33.2%. Of 25 local recurrences, 14 were marginal/out-of-field, 4 in-field, others were undetermined. First surgery at expert center resulted in 24.3% of local failure at 5 years versus 38.7% if performed elsewhere (p = 0.41). Salvage exenteration was performed in 13 patients. Tumor stage and quadrangular involvement were significant factors for local failure. Five-year progression-free survival and cause-specific death rates were 61.5 and 3.6%. Stage and epithelioid type were associated with poorer progression-free survival. Trophic toxicity occurred in 22.9% of patients and was treated locally, with grafts in 7 patients. Glaucoma and cataract occurred in 13 and 22 patients respectively. Prognostic factors for visual deterioration were age, tumor extent (multifocality, quadrangular involvement > 180°) and cryotherapy. CONCLUSIONS: 5-year local failure rate after postoperative proton therapy for conjunctival melanoma was of 33.2%. Radiation-induced complications were overall manageable.

10 Article Improving 2019

Le Goas, Marine / Paquet, Marie / Paquirissamy, Aurélie / Guglielmi, Julien / Compin, Cathy / Thariat, Juliette / Vassaux, Georges / Geertsen, Valérie / Humbert, Olivier / Renault, Jean-Philippe / Carrot, Géraldine / Pourcher, Thierry / Cambien, Béatrice. ·NIMBE, Commissariat à l'Energie Atomique, Centre National Recherche Scientifique UMR 3685, Université Paris-Saclay, Gif-sur-Yvette, France. · Laboratory Transporter in Imaging and Radiotherapy in Oncology (TIRO), Institut de Biosciences et Biotechnologies d'Aix-Marseille (BIAM), Commissariat à l'Energie Atomique, Nice, France. · Laboratory Transporter in Imaging and Radiotherapy in Oncology (TIRO), University Nice Sophia Antipolis, Nice, France. · Laboratory Transporter in Imaging and Radiotherapy in Oncology (TIRO), University Côte d'Azur, Nice, France. · Nuclear Medicine Department, Centre Antoine Lacassagne, Nice, France. · Department of Radiation Oncology, Centre François Baclesse, Université de Normandie, Caen, France. ·Int J Nanomedicine · Pubmed #31686819.

ABSTRACT: Background: Human trials combining external radiotherapy (RT) and metallic nanoparticles are currently underway in cancer patients. For internal RT, in which a radioisotope such as radioiodine is systemically administered into patients, there is also a need for enhancing treatment efficacy, decreasing radiation-induced side effects and overcoming radio-resistance. However, if strategies vectorising radioiodine through nanocarriers have been documented, sensitizing the neoplasm through the use of nanotherapeutics easily translatable to the clinic in combination with the standard systemic radioiodine treatment has not been assessed yet. Method and materials: The present study explored the potential of hybrid poly(methacrylic acid)-grafted gold nanoparticles to improve the performances of systemic Results: In vitro clonogenic assays performed on melanoma and colorectal cancer cells showed that poly(methacrylic acid)-grafted gold nanoparticles (PMAA-AuNPs) could efficiently lead to a marked tumor cell mortality when combined to a low activity of radioiodine, which alone appeared to be essentially ineffective on tumor cells. In vivo, tumor enrichment with PMAA-AuNPs significantly enhanced the killing potential of a systemic radioiodine treatment. Conclusion: This is the first report of a simple and reliable nanomedicine-based approach to reduce the dose of radioiodine required to reach curability. In addition, these results open up novel perspectives for using high-Z metallic NPs in additional molecular radiation therapy demonstrating heterogeneous dose distributions.

11 Article Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France. 2019

Moya-Plana, A / Aupérin, A / Obongo, R / Baglin, A / Ferrand, F R / Baujat, B / Saroul, N / Casiraghi, O / Vergez, S / Herman, P / Janot, F / Thariat, J / Vérillaud, B / de Gabory, L / Anonymous5561201. ·Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: antoine.moya-plana@gustaveroussy.fr. · Biostatistics Department, Gustave Roussy Cancer Campus, Villejuif, France. · Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France. · Department of Pathology, Lariboisière Hospital, Paris, France. · Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France; Medical Oncology Department, HIA Begin, Saint Mandé, France. · Head and Neck Surgery Department, Tenon Hospital, Paris, France. · Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. · Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France. · Head and Neck Surgery Department, Toulouse University Hospital Center, Toulouse, France. · Head and Neck Surgery Department, Lariboisière Hospital, Paris, France. · Radiation Oncology Department, Baclesse Cancer Center, Caen, France. · Head and Neck Surgery Department, Pellegrin Hospital, Centre Michelet, Bordeaux, France. ·Eur J Cancer · Pubmed #31670075.

ABSTRACT: BACKGROUND: Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established. MATERIAL & METHODS: Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed. RESULTS: In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10 CONCLUSION: Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.

12 Article Predicting Visual Acuity Deterioration and Radiation-Induced Toxicities after Brachytherapy for Choroidal Melanomas. 2019

Espensen, Charlotte A / Appelt, Ane L / Fog, Lotte S / Gothelf, Anita B / Thariat, Juliette / Kiilgaard, Jens F. ·Department of Oncology, Section of Radiotherapy, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark. · Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark. · Leeds Institute of Medical Research at St James's, University of Leeds, Leeds LS9 7TF, UK. · Department of Physical Sciences, The Peter MacCallum Cancer Centre, Melbourne 3000, Australia. · Department of Radiation Oncology, Centre Francois Baclesse, 14000 Caen, France. · Laboratoire de Physique Corpusculaire IN2P3/ENSICAEN, 14000 Caen, France. · Laboratoire de Physique Corpusculaire IN2P3/ENSICAEN-UMR6534, Unicaen-Normandy University, 14000 Caen, France. · Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark. jens.folke.kiilgaard@regionh.dk. ·Cancers (Basel) · Pubmed #31390850.

ABSTRACT: Ruthenium-106 (Ru-106) brachytherapy is an established modality for eye-preserving treatment of choroidal melanoma. To achieve optimal treatment outcomes, there should be a balance between tumour control and the risk of healthy tissue toxicity. In this retrospective study, we examined normal tissue complication probability (NTCP) for visual acuity deterioration and late complications to aid the understanding of dose-dependence after Ru-106 treatments. We considered consecutive patients diagnosed with choroidal melanoma and primarily treated at a single institution from 2005-2014. Treatment plans were retrospectively recreated using dedicated software and image guidance to contour the tumour and determine the actual plaque position. Dose distributions were extracted from each plan for all relevant anatomical structures. We considered visual acuity deterioration and late complications (maculopathy, optic neuropathy, ocular hypertension, vascular obliteration, cataract and retinal detachment). Lasso statistics were used to select the most important variables for each analysis. Outcomes were related to dose and clinical characteristics using multivariate Cox regressions analysis. In total, 227 patients were considered and 226 of those were eligible for analysis. Median potential follow-up time was 5.0 years (95% CI: 4.5-6.0). Visual acuity deterioration was related to optic disc-tumour distance and dose metrics from the retina and the macula, with retina V10Gy showing the strongest correlation. Macula V10Gy was the only dose metric impacting risk of maculopathy, while optic disc-tumour distance also proved important. Optic disc V50Gy had the largest impact on optic neuropathy along with optic disc-tumour distance. Optic disc V20Gy was the only variable associated with vascular obliteration. Lens D2% had the largest impact on the risk of cataract along with older age and the largest base dimension. We found no variables associated with the risk of ocular hypertension and retinal detachment. Visual acuity deterioration and most late complications demonstrated dependence on dose delivered to healthy structures in the eye after Ru-106 brachytherapy for choroidal melanomas.

13 Article Proton radiotherapy in advanced malignant melanoma of the conjunctiva. 2019

Scholz, Simone L / Hérault, Joel / Stang, Andreas / Griewank, Klaus G / Meller, Daniel / Thariat, Juliette / Steuhl, Klaus-Peter / Westekemper, Henrike / Sauerwein, Wolfgang. ·Department of Ophthalmology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. Simone.Scholz@uk-essen.de. · Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06100, Nice, France. · Center of Clinical Epidemiology, Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. · Department of Epidemiology, School of Public Health, Boston University, Boston, USA. · Department of Dermatology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. · Dermapathologie bei Mainz, Nieder-Olm, Bahnhofstrasse 2B, 55268, Nieder-Olm, Germany. · Department of Ophthalmology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany. · Department of Ophthalmology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. · Department of Radiation Therapy, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. ·Graefes Arch Clin Exp Ophthalmol · Pubmed #30919076.

ABSTRACT: BACKGROUND: The management of conjunctival melanoma is challenging and frequently ends in exenteration. The aim of this retrospective study was to evaluate the long-term results of proton beam radiation with regard to various clinical parameters. METHODS: Eighty-nine patients with extended conjunctival melanoma (≥T2) and multifocal bulbar located tumors (T1c/d) were treated consecutively with proton radiotherapy (dose 45 Gy). The following parameters were assessed: TNM stage, tumor origin, local recurrence, performance of exenteration, occurrence of metastases, overall survival, and potential complications. A time-to-event analysis was preformed to the primary endpoints: relapse, metastasis, exenteration, and death by use of Kaplan-Meier cumulative survival estimates and Cox proportional hazards regression that provides hazard ratios and 95% confidence intervals. RESULTS: The median follow-up time was 4.2 years (max. 21.7 years). Local recurrence and metastatic disease occurred in 33% and 16% of patients, respectively. Exenteration-free survival and overall survival tended to be worse in T3 melanoma. No association between tumor origin and local recurrence, metastatic disease, or overall survival was observed. Main complications after proton radiotherapy were sicca-syndrome (30%), secondary glaucoma (11%), and limbal stem cell deficiency (8%). CONCLUSIONS: In summary, proton radiotherapy in conjunctival melanoma is an effective alternative to exenteration, with a 5-year cumulative probability of eye preservation of 69%.

14 Article The Lens Opacities Classification System III Grading in Irradiated Uveal Melanomas to Characterize Proton Therapy-Induced Cataracts. 2019

Mathis, Thibaud / Rosier, Laurence / Meniai, Fatima / Baillif, Stéphanie / Maschi, Celia / Herault, Joël / Caujolle, Jean-Pierre / Kodjikian, Laurent / Salleron, Julia / Thariat, Juliette. ·Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France; UMR-CNRS 5510 Matéis, Villeurbane, France. · Eye Clinic, Centre d'Exploration et de Traitement de la Retine et de la Macula, Bordeaux, France. · Department of Radiation Oncology, Centre Oscar Lambret, Lille, France. · Department of Ophthalmology, University Hospital Pasteur 2, Nice, France. · Department of Radiation Oncology-Proton Therapy, Nice, France. · Department of Biostatistics, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France. · Department of Radiation Oncology. Centre Francois Baclesse / ARCHADE - Normandie Université, Caen, France. Electronic address: jthariat@gmail.com. ·Am J Ophthalmol · Pubmed #30721686.

ABSTRACT: PURPOSE: To evaluate the use of the Lens Opacities Classification System III grading (LOCS III) for the characterization of radiation-induced cataract, and to correlate the proton beam projection onto the lens with cataract location and grade as defined by the LOCS III. DESIGN: Prospective, interventional case series. METHODS: Fifty-two consecutive patients with cataract following proton therapy were included. All cataracts were graded using LOCS III. Relationships between proton beam and cataract subtypes, as well as between dose, proportion of lens irradiated, and extent of cataracts, were assessed. RESULTS: Tumor diameter, volume, stage, and equatorial tumor location were associated with extent of posterior subcapsular cataracts (PSC) that were diagnosed at a median (interquartile range) 36 months (22;83) after treatment. In multivariate analysis, the tumor volume (P < .01) and an equatorial tumor location (P = .01) were risk factors for extensive PSC. Lens irradiation was avoided in 10 patients. In the remaining 42 patients (81%), the extent of PSC significantly correlated with the dose to the lens receiving 10, 26, and 47 Gy (P = .03, P = .03, and P = .04, respectively), the dose to the lens periphery receiving 10 and 26 Gy (P = .02 and P = .02, respectively), and the dose to the ciliary body receiving 10 and 26 Gy (P = .03 and P = .02, respectively). Nuclear color significantly correlated with the dose to the ciliary body receiving 10 Gy (P = .03) and 26 Gy (P = .02). After adjustment of the results on tumor volume and tumor location, the volume of lens receiving 10 Gy (P = .04) and 26 Gy (P = .03) remained significantly associated with the extent of PSC. CONCLUSIONS: Proton dose correlated with the occurrence of PSC and nuclear color cataracts as defined by LOCS III grading. Better characterization of cataracts with the LOCS III after irradiation may help to further fill gaps in the current understanding of the mechanisms of radiation-induced cataracts.

15 Article Regression rate of choroidal melanoma following iodine-125 brachytherapy is not associated with metastatic spread. 2019

Pépin, François / Julien, Anne-Sophie / Fugaru, Ioana / Lihimdi, Nadia / Thariat, Juliette / Landreville, Solange / Mouriaux, Frédéric. ·Centre universitaire d'ophtalmologie (CUO). · Département d'ophtalmologie. · Plateforme de recherche clinique, Centre de Recherche FRQS du CHU de Québec-Université Laval. · CUO-Recherche et Axe médecine régénératrice. · Centre de recherche sur le cancer. · Centre de recherche en organogénèse expérimentale, Faculté de Médecine, Université Laval, Québec, Canada. · Département de radio-oncologie, Centre François Baclesse, Caen. · Univ Rennes, INSERM, INRA, Institut NUMECAN (Nutrition Metabolisms and Cancer). · Service d'ophtalmologie, CHU de Rennes, Rennes, France. ·Melanoma Res · Pubmed #30383721.

ABSTRACT: Nearly half of choroidal melanomas progress to the metastatic stage at 15 years. The purpose of our study was to evaluate the prognostic value of tumour-height regression rate in medium-sized choroidal melanomas treated with iodine-125 brachytherapy. A retrospective cohort study was performed on 128 patients with medium-sized choroidal melanoma who were treated with iodine-125 brachytherapy. Tumour characteristics including tumour apical height at baseline and after irradiation, recurrence, metastasis and mortality were collected from patients' records. Regression rate was defined in mm/month or in percentage of baseline apical height. Patients were statistically stratified in three groups of regression rate at 6 months using the Ward's method and Euclidian distance (slow, medium and fast regression groups). Mean initial apical height was of 5.71±1.79 mm. At 6 months, the average regression rate was 0.02±0.12 mm/month in the slow group (n=60), 0.32±0.11 mm/month in the medium group (n=52) and 0.67±0.21 mm/month in the fast group (n=16). Cox regression analysis for the recurrence, metastasis and mortality rates according to the three groups did not show any statistically significant difference. Sensitivity analyses with the regression rates at 12 months showed similar associations. Exudative retinal detachment resolved with treatment at 5.9±4.0 months, and it was more common at presentation in the fast regression rate group. The regression rate at 6 and 12 months after iodine-125 brachytherapy is not associated with a higher metastatic rate in medium-sized choroidal melanoma.

16 Article Radiosurgery or hypofractionated stereotactic radiotherapy for brain metastases from radioresistant primaries (melanoma and renal cancer). 2018

Lesueur, Paul / Lequesne, Justine / Barraux, Victor / Kao, William / Geffrelot, Julien / Grellard, Jean-Michel / Habrand, Jean-Louis / Emery, Evelyne / Marie, Brigitte / Thariat, Juliette / Stefan, Dinu. ·Radiotherapy department, Centre François Baclesse, Caen, France. Paul.LESUEUR89@gmail.com. · Laboratoire d'accueil et de recherche avec les ions accélérés, CEA-CIMAP, Caen, France. Paul.LESUEUR89@gmail.com. · Medical university of Caen, Caen, France. Paul.LESUEUR89@gmail.com. · Clinical research department, Centre François Baclesse, Caen, France. · Medical physics department, Centre François Baclesse, Caen, France. · Radiotherapy department, Centre François Baclesse, Caen, France. · Medical university of Caen, Caen, France. · Neurosurgery department, CHU Côte de Nacre, Caen, France. · Imaging department, Centre François Baclesse, Caen, France. ·Radiat Oncol · Pubmed #30055640.

ABSTRACT: BACKGROUND: Until 50% of patients with renal cancer or melanoma, develop brain metastases during the course of their disease. Stereotactic radiotherapy has become a standard of care for patients with a limited number of brain metastases. Given the radioresistant nature of melanoma and renal cancer, optimization of the fractionation of stereotactic radiotherapy is needed. The purpose of this retrospective study was to elucidate if hypofractionated stereotactic radiotherapy (HFSRT) impacts local control of brain metastases from radioresistant tumors such as melanoma and renal cancer, in comparison with radiosurgery (SRS). METHODS: Between 2012 and 2016, 193 metastases, smaller than 3 cm, from patients suffering from radioresistant primaries (melanoma and renal cancer) were treated with HFSRT or SRS. The primary outcome was local progression free survival (LPFS) at 6, 12 and 18 months. Overall survival (OS) and cerebral progression free survival (CPFS) were secondary outcomes, and were evaluated per patient. Objective response rate and radionecrosis incidence were also reported. The statistical analysis included a supplementary propensity score analysis to deal with bias induced by non-randomized data. RESULTS: After a median follow-up of 7.4 months, LPFS rates at 6, 12 and 18 months for the whole population were 83, 74 and 70%, respectively. With respect to fractionation, LPFS rates at 6, 12 and 18 months were 89, 79 and 73% for the SRS group and 80, 72 and 68% for the HFSRT group. The fractionation schedule was not statistically associated with LPFS (HR = 1.39, CI95% [0.65-2.96], p = 0.38). Time from planning MRI to first irradiation session longer than 14 days was associated with a poorer local control rate. Over this time, LPFS at 12 months was reduced from 86 to 70% (p = 0.009). Radionecrosis occurred in 7.1% for HFSRT treated metastases to 9.6% to SRS treated metastases, without any difference according to fractionation (p = 0.55). The median OS was 9.6 months. Six, 12 and 18 months CPFS rates were 54, 24 and 17%, respectively. CONCLUSION: Fractionation does not decrease LPFS. Even for small radioresistant brain metastases (< 3 cm), HFSRT, with 3 or 6 fractions, leads to an excellent local control rate of 72% at 1 year with a rate of 7.1% of radionecrosis. HFSRT is a safe and efficient alternative treatment to SRS.

17 Article Occurrence of Phosphenes in Patients Undergoing Proton Beam Therapy for Ocular Tumor. 2018

Mathis, Thibaud / Hofverberg, Petter / Caujolle, Jean-Pierre / Hérault, Joël / Leal, Cécilia / Maschi, Celia / Delaunay, Benoit / Baillif, Stéphanie / Kodjikian, Laurent / Thariat, Juliette. ·Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France; UMR-CNRS 5510 Matéis, Villeurbane, France. Electronic address: mathisthibaud@hotmail.fr. · Department of Radiation Therapy, Proton Therapy Center, Centre Antoine Lacassagne, Nice, France. · Department of Ophthalmology, Pasteur II Hospital, Nice, France. · Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France. · Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France; UMR-CNRS 5510 Matéis, Villeurbane, France. · Department of Radiation Therapy, Centre François Baclesse - ARCHADE, Unicaen - Normandie University, Caen, France. ·Am J Ophthalmol · Pubmed #29753854.

ABSTRACT: PURPOSE: Phosphenes are frequently reported by patients irradiated in the head and neck area. The aim of the present study was to characterize and investigate potential mechanisms of proton beam therapy (PBT)-induced phosphenes in a large population of patients undergoing PBT for ocular tumors. DESIGN: Prospective cohort study. METHODS: Consecutive patients who underwent PBT in a single center were included. Immediately after the first session, all patients completed a questionnaire collecting information about the presence of phosphenes as well as their color, shape, and duration. Patient, tumor and treatment characteristics (dose volume histograms) were also collected. RESULTS: Among the 474 patients included, 62.8% reported phosphenes during the first session of PBT. Reported colors were mainly blue-violet (70.5%) and white (14.1%). The prevalence of phosphenes was higher in younger patients (P = .003); other patient or ocular characteristics were not associated with the occurrence of phosphenes. Irradiation of the macula (P < .001) and/or optic disc (P < .001) were significantly associated with the presence of phosphenes, whereas blue-violet color was only associated with young age and irradiation of macular area (P = .04). Pupillary constriction was reported for 57.1% of patients with phosphenes vs 18.5% of patients without (P < .001). Blue-violet phosphenes (P < .001) and irradiation of macula (P = .001) were statistically associated with pupillary constriction. CONCLUSIONS: The present study reported a high rate of phosphenes in patients irradiated by PBT for ocular tumor. Their blue-violet color and their association with a pupillary constriction probably indicates the stimulation of S-cones and retinal ganglion cells that reflects the activation of the afferent visual pathway.

18 Article Proton Beam Therapy for Iris Melanomas in 107 Patients. 2018

Thariat, Juliette / Rahmi, Ahmed / Salleron, Julia / Mosci, Carlo / Butet, Benjamin / Maschi, Celia / Lanza, Francesco / Lanteri, Sara / Baillif, Stephanie / Herault, Joel / Mathis, Thibaud / Caujolle, Jean Pierre. ·Department of Radiation Oncology, Cancer Centre Francois Baclesse, Normandie Universite-Unicaen, Caen, France; Department of Radiation Oncology, Cancer Centre Antoine Lacassagne, Nice, France. Electronic address: jthariat@gmail.com. · Department of Ophthalmology, Croix-Rousse University Hospital, University Claude Bernard Lyon 1, Lyon, France. · Department of Biostatistics and Data Management, Institut de Cancerologie de Lorraine, Vandoeuvre-Les-Nancy, France. · Department of Ophthalmology, Ocular Oncology Center, E.O. Ospedali Galliera, Genoa, Italy. · Department of Ophthalmology, University Hospital Pasteur 2, Nice, France. · Department of Radiation Oncology, Cancer Centre Antoine Lacassagne, Nice, France. ·Ophthalmology · Pubmed #29128229.

ABSTRACT: PURPOSE: To report on the clinical characteristics and outcomes for patients with iris melanoma using proton therapy. DESIGN: Retrospective study. PARTICIPANTS: One hundred seven patients with iris melanoma from 3 regional ophthalmologic centers. METHODS: A retrospective study was conducted for iris melanoma patients from 3 regional ophthalmologic centers referred to and treated at a single proton therapy facility between 1996 and 2015. MAIN OUTCOME MEASURES: At each follow-up visit, examinations included measurement of best-corrected VA, slit-lamp, examination, indirect ophthalmoscopy, and ultrasound biomicroscopy. RESULTS: With a median follow-up of 49.5 months, 5 of 107 patients experienced a local relapse within a median of 36.3 months. The cumulative incidence of relapse was 7.5% at 5 years. All 5 patients showed involvement of the iridocorneal angle (P = 0.056). Diffuse iris melanoma showed a higher risk of relapse (P = 0.044). Four patients showed out-of-field relapse and 1 showed angular relapse. Three patients were retreated with proton therapy, whereas 2 other patients, one with T1b disease and another with diffuse T3 disease, underwent secondary enucleation. None of the patients experienced metastases nor died of iris melanoma. Vision improved in 59.4% of patients (n = 60/101). However, cataracts occurred in 57.4% of the 54 patients (n = 31) without cataract or implant at diagnosis. Secondary glaucoma was reported in 7.6% of the patients (n = 8), uveitis in 4.7% (n = 5), and hyphema in 3.7% (n = 4). All but 5 cases of complications were mild, transient, and not sight limiting after treatment. Five cases of glaucoma, including 1 with uveitis, were severe and associated with visual deterioration. CONCLUSIONS: Proton therapy showed efficacy and limited morbidity in iris melanomas.

19 Article Cataract Avoidance With Proton Therapy in Ocular Melanomas. 2017

Thariat, Juliette / Jacob, Sophie / Caujolle, Jean-Pierre / Maschi, Celia / Baillif, Stéphanie / Angellier, Gaelle / Mathis, Thibaud / Rosier, Laurence / Carnicer, Adela / Hérault, Joel / Salleron, Julia. ·Institution, Department of Radiation Oncology-Proton Therapy, Nice, France. · Centre Francois Baclesse, Department of Radiation Oncology, Normandie Universite - Unicaen, Caen, France. · Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, LEPID, Fontenay-aux-Roses, France. · Department of Ophthalmology, University Hospital Pasteur 2, Nice, France. · Department of Ophthalmology, Eye University Clinic la Croix Rousse, Lyon, France. · Eye Clinic, Centre d'Exploration et de Traitement de la Retine et de la Macula, Bordeaux, France. · Department of Biostatistics, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France. ·Invest Ophthalmol Vis Sci · Pubmed #29049739.

ABSTRACT: Purpose: The lens is a radiosensitive organ. Any dose of cephalic irradiation can give rise to radiation-induced cataracts. Contrary to other forms of radiotherapy, proton therapy (PT) can spare all or part of the lens due to accurate dose deposition. We investigated whether a lens-sparing approach was relevant to avoid cataracts in uveal melanoma patients. Methods: Patients were referred for PT from onco-ophthalmologists of private and academic institutions. Patients without preexisting cataracts or implants were entered in a prospective database. Dose thresholds responsible for cataracts were investigated in volumes of lens or lens periphery. Lens opacifications and de novo vision-impairing cataracts (VICs) had biannual follow up by ophthalmologists blinded to lens dose. Correlations between dose-volume relationships and VICs were assessed using univariate/multivariate regressions. Results: Between 1991 and 2015, 1696 uveal melanoma patients were consecutively treated with PT. After a median follow up of 48 months, 14.4% and 8.7% of patients had cataracts and VIC within median times of 19 and 28 months, respectively. Median values of mean lens and lens periphery doses were 1.1 (radiobiologically effective [RBE] dose in photon-equivalent grays [GyRBE]) and 6.5 GyRBE, respectively. The lens received no dose in 25% of the patients. At an irradiated lens volume of ≤5%, there was no significantly increased risk for VIC below a dose of 10 GyRBE. Conclusions: A lens-sparing approach is feasible and results not only in reduced need for cataract surgery but also in better fundus-based tumor control. Reassessment of radioprotection rules for lens dose thresholds may follow.

20 Article Dry Eye Syndrome After Proton Therapy of Ocular Melanomas. 2017

Thariat, Juliette / Maschi, Celia / Lanteri, Sara / Peyrichon, Marie Laure / Baillif, Stephanie / Herault, Joel / Salleron, Julia / Caujolle, Jean Pierre. ·Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, Nice, France. Electronic address: jthariat@gmail.com. · Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice, France. · Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, Nice, France. · Department of Biostatistics, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France. ·Int J Radiat Oncol Biol Phys · Pubmed #28586953.

ABSTRACT: PURPOSE: To investigate whether proton therapy (PT) performs safely in superotemporal melanomas, in terms of risk of dry-eye syndrome (DES). METHODS AND MATERIALS: Tumor location, DES grade, and dose to ocular structures were analyzed in patients undergoing PT (2005-2015) with 52 Gy (prescribed dose, not accounting for biologic effectiveness correction of 1.1). Prognostic factors of DES and severe DES (sDES, grades 2-3) were determined with Cox proportional hazard models. Visual acuity deterioration and enucleation rates were compared by sDES and tumor locations. RESULTS: Median follow-up was 44 months (interquartile range, 18-60 months). Of 853 patients (mean age, 64 years), 30.5% had temporal and 11.4% superotemporal tumors. Five-year incidence of DES and sDES was 23.0% (95% confidence interval [CI] 19.0%-27.7%) and 10.9% (95% CI 8.2%-14.4%), respectively. Multivariable analysis showed a higher risk for sDES in superotemporal (hazard ratio [HR] 5.82, 95% CI 2.72-12.45) and temporal tumors (HR 2.63, 95% CI 1.28-5.42), age ≥70 years (HR 1.90, 95% CI 1.09-3.32), distance to optic disk ≥5 mm (HR 2.71, 95% CI 1.52-4.84), ≥35% of retina receiving 12 Gy (HR 2.98, 95% CI 1.54-5.77), and eyelid rim irradiation (HR 2.68, 95% CI 1.49-4.80). The same risk factors were found for DES. Visual acuity deteriorated more in patients with sDES (0.86 ± 1.10 vs 0.64 ± 0.98 logMAR, P=.034) but not between superotemporal/temporal and other locations (P=.890). Enucleation rates were independent of sDES (P=.707) and tumor locations (P=.729). CONCLUSIONS: Severe DES was more frequent in superotemporal/temporal melanomas. Incidence of vision deterioration and enucleation was no higher in patients with superotemporal melanoma than in patients with tumors in other locations. Tumor location should not contraindicate PT.

21 Article Conservative Treatments of Ocular Melanomas: Technology Used Wisely. 2017

Thariat, Juliette / Herault, Joel / Mouriaux, Frederic. ·Department of Radiation Oncology, Centre Francois Baclesse, University of Nice, Sophia Antipolis, France. Electronic address: jthariat@gmail.com. · Department of Radiation Oncology and Physics, Centre Francois Baclesse, University of Nice, Sophia Antipolis, France. · Department of Ophthalmology, University Hospital, Rennes, France. ·Int J Radiat Oncol Biol Phys · Pubmed #28454734.

ABSTRACT: -- No abstract --

22 Article Practice Patterns Analysis of Ocular Proton Therapy Centers: The International OPTIC Survey. 2016

Hrbacek, Jan / Mishra, Kavita K / Kacperek, Andrzej / Dendale, Remi / Nauraye, Catherine / Auger, Michel / Herault, Joel / Daftari, Inder K / Trofimov, Alexei V / Shih, Helen A / Chen, Yen-Lin E / Denker, Andrea / Heufelder, Jens / Horwacik, Tomasz / Swakoń, Jan / Hoehr, Cornelia / Duzenli, Cheryl / Pica, Alessia / Goudjil, Farid / Mazal, Alejandro / Thariat, Juliette / Weber, Damien C. ·Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland. Electronic address: Jan.hrbacek@psi.ch. · Ocular Tumor Proton Therapy Program, University of California San Francisco, San Francisco, California. · National Proton Therapy Centre, Clatterbridge Cancer Centre, Bebington, United Kingdom. · Centre de Protonthérapie d'Orsay, Institut Curie, Orsay, France. · Centre Lacassagne, Nice, France. · F. H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. · Protons for Therapy, Helmholtz-Zentrum Berlin, Berlin, Germany. · BerlinProtonen am HZB, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Institute of Nuclear Physic, Polish Academy of Sciences, Krakow, Poland. · BC Cancer Agency - TRIUMF, Vancouver, Canada. · Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland. ·Int J Radiat Oncol Biol Phys · Pubmed #27084651.

ABSTRACT: PURPOSE: To assess the planning, treatment, and follow-up strategies worldwide in dedicated proton therapy ocular programs. METHODS AND MATERIALS: Ten centers from 7 countries completed a questionnaire survey with 109 queries on the eye treatment planning system (TPS), hardware/software equipment, image acquisition/registration, patient positioning, eye surveillance, beam delivery, quality assurance (QA), clinical management, and workflow. RESULTS: Worldwide, 28,891 eye patients were treated with protons at the 10 centers as of the end of 2014. Most centers treated a vast number of ocular patients (1729 to 6369). Three centers treated fewer than 200 ocular patients. Most commonly, the centers treated uveal melanoma (UM) and other primary ocular malignancies, benign ocular tumors, conjunctival lesions, choroidal metastases, and retinoblastomas. The UM dose fractionation was generally within a standard range, whereas dosing for other ocular conditions was not standardized. The majority (80%) of centers used in common a specific ocular TPS. Variability existed in imaging registration, with magnetic resonance imaging (MRI) rarely being used in routine planning (20%). Increased patient to full-time equivalent ratios were observed by higher accruing centers (P=.0161). Generally, ophthalmologists followed up the post-radiation therapy patients, though in 40% of centers radiation oncologists also followed up the patients. Seven centers had a prospective outcomes database. All centers used a cyclotron to accelerate protons with dedicated horizontal beam lines only. QA checks (range, modulation) varied substantially across centers. CONCLUSIONS: The first worldwide multi-institutional ophthalmic proton therapy survey of the clinical and technical approach shows areas of substantial overlap and areas of progress needed to achieve sustainable and systematic management. Future international efforts include research and development for imaging and planning software upgrades, increased use of MRI, development of clinical protocols, systematic patient-centered data acquisition, and publishing guidelines on QA, staffing, treatment, and follow-up parameters by dedicated ocular programs to ensure the highest level of care for ocular patients.

23 Article Visual Outcomes of Parapapillary Uveal Melanomas Following Proton Beam Therapy. 2016

Thariat, Juliette / Grange, Jean-Daniel / Mosci, Carlo / Rosier, Laurence / Maschi, Celia / Lanza, Francesco / Nguyen, Anh Minh / Jaspart, Franck / Bacin, Franck / Bonnin, Nicolas / Gaucher, David / Sauerwein, Wolfgang / Angellier, Gaelle / Hérault, Joel / Caujolle, Jean-Pierre. ·Department of Radiation Therapy, Cancer Center Antoine Lacassagne-Nice Sophia Antipolis University Hospital, Nice, France. Electronic address: jthariat@gmail.com. · Department of Ophthalmology, Eye University Clinic la Croix Rousse, Lyon, France. · Department of Ophthalmology, National Institute for Cancer Research, Mura Delle Cappucine, Genova, Italy. · Eye Clinic, Centre d'Exploration et de Traitement de la Retine et de la Macula, Bordeaux, France. · Department of Ophthalmology, Eye University Clinic Pasteur 2, Nice, France. · Department of Ophthalmology, Eye University Clinic Gabriel Montpied, Clermont Ferrand, France. · Department of Ophthalmology, Eye University Clinic, Hopital Civil, Strasbourg, France. · Department of Radiation Therapy, NCTeam, Strahlenklinik, Universitätsklinikum Essen, Essen, Germany. · Department of Radiation Therapy, Cancer Center Antoine Lacassagne-Nice Sophia Antipolis University Hospital, Nice, France. ·Int J Radiat Oncol Biol Phys · Pubmed #27084650.

ABSTRACT: PURPOSE: In parapapillary melanoma patients, radiation-induced optic complications are frequent and visual acuity is often compromised. We investigated dose-effect relationships for the optic nerve with respect to visual acuity after proton therapy. METHODS AND MATERIALS: Of 5205 patients treated between 1991 and 2014, those treated using computed tomography (CT)-based planning to 52 Gy (prescribed dose, not accounting for relative biologic effectiveness correction of 1.1) in 4 fractions, with minimal 6-month follow-up and documented initial and last visual acuity, were included. Deterioration of ≥0.3 logMAR between initial and last visual acuity results was reported. RESULTS: A total of 865 consecutive patients were included. Median follow-up was 69 months, mean age was 61.7 years, tumor abutted the papilla in 35.1% of patients, and tumor-to-fovea distance was ≤3 mm in 74.2% of patients. Five-year relapse-free survival rate was 92.7%. Visual acuity was ≥20/200 in 72.6% of patients initially and 47.2% at last follow-up. A wedge filter was used in 47.8% of the patients, with a positive impact on vision and no impact on relapse. Glaucoma, radiation-induced optic neuropathy, maculopathy were reported in 17.9%, 47.5%, and 33.6% of patients, respectively. On multivariate analysis, age, diabetes, thickness, initial visual acuity and percentage of macula receiving 26 Gy were predictive of visual acuity. Furthermore, patients irradiated to ≥80% of their papilla had better visual acuity when limiting the 50% (30-Gy) and 20% (12-Gy) isodoses to ≤2 mm and 6 mm of optic nerve length, respectively. CONCLUSIONS: A personalized proton therapy plan with optic nerve and macular sparing can be used efficiently with good oncological and functional results in parapapillary melanoma patients.

24 Article Outcomes After Proton Beam Therapy for Large Choroidal Melanomas in 492 Patients. 2016

Bensoussan, Elsa / Thariat, Juliette / Maschi, Célia / Delas, Jérôme / Schouver, Elie Dan / Hérault, Joël / Baillif, Stéphanie / Caujolle, Jean-Pierre. ·Department of Ophthalmology, Pasteur Hospital, Nice Teaching Hospital, Nice, France. · Department of Radiation Oncology, Protontherapy Center, Centre Antoine Lacassagne, Nice, France. · Department of Cardiology, Pasteur Hospital, Nice Teaching Hospital, Nice, France. · Department of Ophthalmology, Pasteur Hospital, Nice Teaching Hospital, Nice, France. Electronic address: jeanpierre.caujolle@neuf.fr. ·Am J Ophthalmol · Pubmed #26940166.

ABSTRACT: PURPOSE: To evaluate proton beam therapy (PBT) as a means to preserve the eye and spare some vision while not deteriorating survival in patients with large choroidal melanomas. DESIGN: This is a retrospective, consecutive cohort study of patients with T3-4 choroidal melanomas according to the 7th edition of the American Joint Cancer Classification treated with PBT over a 24-year period. RESULTS: A total of 492 patients were included. Mean (range) tumor thickness and diameter were 8.77 (2-15) mm and 14.91 (7-24.1) mm, respectively. Mean macular and optic disc distance were 4.56 (0-19.9) mm and 4.59 (0-22.1) mm, respectively. Mean follow-up was 61.9 months. Rates of neovascular glaucoma (NVG) and enucleation (mainly for local recurrence or NVG) were 27.0% and 19.5%, respectively. Enucleation rates decreased over time. The 5-year local control was 94%. Mean baseline visual acuity was 20/63, and visual acuity ≥20/200 was preserved in 20% of patients. At 5 years, 25% of T3 patients presented with metastasis; overall and specific survival rates were 65% and 75%, respectively. CONCLUSION: Local control after PBT remained good with increasingly manageable complications and fewer secondary enucleations over time for these large melanomas. As PBT does not seem to deteriorate survival in these patients having a high risk of metastasis, PBT may be considered as a safe and efficient alternative to enucleation in patients with large choroidal melanoma, and may help to spare some vision.

25 Article Tumour Response in Uveal Melanomas Treated with Proton Beam Therapy. 2016

Maschi, C / Thariat, J / Herault, J / Caujolle, J-P. ·Department of Ophthalmology, Pasteur 2 Hospital, Nice Teaching Hospital, Nice, France. Electronic address: celia.maschi@gmail.com. · Department of Radiation Oncology, Centre Lacassagne, Proton Therapy Center, Nice, France. · Department of Ophthalmology, Pasteur 2 Hospital, Nice Teaching Hospital, Nice, France. ·Clin Oncol (R Coll Radiol) · Pubmed #26385821.

ABSTRACT: AIMS: Post-proton therapy surveillance of uveal melanomas relies on decreased thickness on repeat ultrasound B every 6 months for 2 years and yearly thereafter. Earlier pseudoprogression, a phenomenon described in other tumour types within the first months of irradiation, can also be observed in uveal melanomas and may lead to inappropriate enucleation. The Collaborative Ocular Melanoma Study (COMS) has defined ultrasound criteria to identify tumour progression after brachytherapy. We aimed to determine the reliability of ultrasound as a means to measure tumour height after proton therapy and predict local relapse. MATERIALS AND METHODS: All 1992-2012 consecutive patients with at least three ultrasound B measurements during follow-up were included. RESULTS: There were 55 local relapses of 886 patients (6.2%). Ultrasound B reliability was highest at 24 months, with specificity higher than 95% starting at 18 months. CONCLUSION: Before 18 months post-proton therapy, the risk of falsely concluding in favour of a relapse exceeds 5% and should prompt repeat measurements 3 and 6 months later but should not prompt enucleation without further clinical assessment.

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