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4 ème Journée et Prix de la Recherche Clinique – 19 mai 2011 Présentations posters
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P60b
THE INTERDEPENDENCE BETWEEN HYPERTENSION, OTHER METABOLIC SYNDROME
COMPONENTS AND LOW-GRADE INFLAMMATION EVOLVES WITH AGING
Dionysios Adamopoulos, Gregory Vyssoulis, Ulrich M. Vischer
Service de Gériatrie Hôpital des Trois-Chêne
Introduction: The prognostic significance, interdependence and hierarchy of cardio-vascular risk
factors may evolve with advancing age. Our study reports the interdependence of hypertension, other
metabolic syndrome components and high sensitivity CRP according to age in hypertensive subjects.
Méthode: 5712 consecutive non-diabetic patients (50.1 % males, age range: 40-95 years) evaluated
in outpatient hypertension clinics were included and divided into five age groups (40-49, 50-59, 60-69,
70-79, >80 years old). BP evaluated by both office and 24H ambulatory blood pressure monitoring
(ABPM) measurements, metabolic and inflammation parameters were determined after a > two week
drug washout period.
Résultats: The prevalence of the metabolic syndrome (ATP-III definition) remained stable across age
groups. We observed a stable or increased association between waist circumference and insulin
resistance and fasting plasma glucose. However, the association between waist circumference and
ABPM systolic BP (ABPM-SBP; r2 from 9.9% to 1.0%, p80 years old, whereas its association with
waist circumference markedly decreased.
Conclusion: Hypertension and dyslipidemia dissociate from central obesity with advancing age. They
are increasingly determined by low-grade inflammation, independent of central obesity. These
changing associations may underlie the weakening of both obesity and the metabolic syndrome as
cardiovascular risk factors in older persons.
P61
TWICE-WEEKLY HYPOFRACTIONATED INTENSITY-MODULATED RADIOTHERAPY FOR
LOCALIZED PROSTATE CANCER WITH LOW-RISK NODAL INVOLVEMENT: TOXICITY AND
OUTCOME FROM A DOSE ESCALATION PILOT STUDY
THOMAS ZILLI, SANDRA JORCANO, MICHEL ROUZAUD, GIOVANNA DIPASQUALE, PHILIPPE
NOUET, JOSÉ IGNACIO TOSCAS, NATHALIE CASANOVA, HUI WANG, LLUÍS ESCUDÉ,
MERITXELL MOLLÀ, DOLORS LINERO, DAMIEN C. WEBER, RAYMOND MIRALBELL
Service de Radio-Oncologie
Introduction: To evaluate the toxicity and preliminary outcome of patients with localized prostate
cancer treated with twice-weekly hypofractionated intensity-modulated radiotherapy (IMRT).
Méthode: Between 2003 and 2006, 82 prostate cancer patients with a nodal involvement risk ≤ 20%
(Roach index) have been treated to the prostate ± seminal vesicles with 56 Gy (4 Gy/fraction twiceweekly)
and an overall treatment time of 6.5 weeks. Acute and late genitourinary (GU) and
gastrointestinal (GI) toxicities were scored according to the Radiation Therapy Oncology Group
(RTOG) grading system. Median follow-up was 48 months (range, 9-67).
Résultats: All patients completed the treatment without interruptions. No patient presented with ≥
Grade 3 acute GU or GI toxicity. Only 4% presented with Grade 2 GU or GI persistent acute toxicity 6
weeks after treatment completion. The estimated 4-year probability of ≥ Grade 2 late GU and GI
toxicity-free survival were 94.2% ± 2.9% and 96.1% ± 2.2%, respectively. One patient presented with
Grade 3 GI and another one with Grade 4 GU late toxicity, transitory in both cases. The 4-year
actuarial biochemical relapse-free survival according to the nadir plus 2ng/mL definition was 91.3% ±
5.9%, 76.4% ± 8.8 and 77.5% ± 8.9% for low-, intermediate-, and high-risk groups, respectively.
Conclusion: In patients with localized prostate cancer, acute and late toxicity was mini mal after doseescalation
administering twice-weekly 4 Gy to a total dose of 56 Gy, with IMRT. Further prospective
trials are warranted to further assess the best fractionation schemes for these patients.
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