TEACHING TASKS

University teaching and training project of the radiotherapy oncology department of the PRC (2010)

The Poitiers CHU is a regional and interregional reference center in cancerology teaching.

In the area of radiotherapy oncology, the teaching project combines participation in cancerology teaching at the Poitiers faculty of medicine and development of regional and interregional courses (DES, DESC, DU, DIU), particularly as regards the role of radiotherapy in cancer treatment, the techniques of radiotherapy and brachytherapy, and overall patient treatment.

Improvement and formalization of  the welcoming of medical students in the Poitiers CHU is another priority. .

The teaching given to specialist interns, interns in oncology-radiotherapy, and also to interns in medical oncology and organ specialties, is highly developed in collaboration with neighboring teams in Bordeaux, Tours, Angers, Limoges and Nantes … And since the emergence of the Poitiers-based PRC (regional cancerology center), each year there are several new interns specialized in oncology-radiotherapy for whom this field may be considered as a vocation.  Indeed, it is highly important to “pass the torch” to young specialists, to transmit our experience to them, and to organize high-quality practical “companionship” as well as classroom teaching.

Other teaching activities

•  Teaching students in the hospital. Preparation for the nationwide “ranking” examination: twice-weekly one-hour courses in the department, mandatory presence (clinical cases, exam/ENC-type folders).

• Teaching of the DES in oncology in the Grand-Ouest inter-regional network (with the medicine faculties of Nantes, Rennes, Tours, Angers and Brest). In the Poitou-Charentes region, we are responsible for the DES in oncology, oncology-radiotherapy option (coordonnateur Inter-région Grand-Ouest interregional coordinator: Pr G. Calais): organization of teaching modules in Poitiers (6 of them, from 2009 to 2012), creation of new modules on innovative techniques and supportive care, etc.

• Participation in teaching for the DESC in cancerology.

• Cancerology courses in the DECM modules (organ pathologies).

• Participation in the D.U. in cancerology for the para-medical staff created in 2007  (Pr Tourani, the only D.U – university diploma – of this type in France): Teaching addressed to nurses, assistant nurses, secretaries and radiology technicians, organized in 4 modules each week associated with a 35-hour training program in the cancerology department of the Poitiers CHU.

• As regards continued medical training, we organize annual, coordinated cycles, particularly  in  the Poitou-Charentes oncology network (oncology and supportive care in collaboration with AFSOS, the French-speaking association for supportive oncology care; along with Pr Zelek from Bobigny, we are responsible for university training.

• We also carry on our participation in teaching for the “licence” of dosimetry and radioprotection recently created by Pr HACHEM in Nice, and in the teaching in anatomy and human physiology for the  MASTER 2 in biomedical engineering of l’UNSA, once again coordinated by Pr S. Hachem.

• Different subjects are taught, particularly in the context of paramedical training: IFSI, DTS and DU in radiological and therapeutic medical imagery, etc.  

• Finally, we carry on our participation in the D.I.U. of high-tech radiotherapy organized at the medicine faculty of  Nice Sophia-Antipolis since 2008 (courses on the RCMI – conformal modulated-intensity radiotherapy and supportive care)  and in the DIU of onco-rhumatology (Pr Debiais) set up in 2012.

RESEARCH TASKS

Clinical research projects of the PRC radiotherapy oncology department

In the overall framework of the Plan national cancer and the Cancéropôle Grand-Ouest, the regional cancerology center of the Poitiers CHU continues to propel dynamic, coordinated and effective clinical research with satisfactory readability, while retaining realistic objectives of performance and development over the coming years.

Clinical research in the establishment is facilitated by the presence of a CIC (clinical investigation center) specialized in hematological and cancer diseases, and coordinated by Professor François Guilhot.

These activities are complemented by our national (cancerology federation of the CHUs, GORTEC, GETTEC, FNCLCC) and et international (EORTC, ESTRO, MASCC/ISOO, etc.) collaborations.

Virtually all clinical research and transfer in radiotherapy oncology can be grouped together under a common theme: “Optimization of a global, diagnostic and therapeutic cancer strategy”, going from the pre-clinical phase and the search for prognostic and predictive factors in sensitivity to treatments to optimized management of oncological treatments (specific care, supportive care, or therapeutic optimization).    .

Our main short and middle-term projects in clinical research and transfer are:

• Study of the impact of irradiation in intensity modulation with the VMAT technique (volumetric modulated arc therapy) on loco-regional control and on radiotherapy sequelae in the evolution of ENT cancers.  The  VMAT technique, which is being put into place in our department, enables is to develop a clinical research program in partnership with the manufacturer ELEKTA.
  We are planning to organize a cohort study on one hundred patients treated in the department since March 2011 and monitored for at least 3 years (evaluation of the carcinological result and, more particularly, reduction of therapeutic sequelae +++). On a parallel track,  a medical and economic study compares the cost of VMAT treatment with that of classical radiotherapy (particularly “costs” in terms of medical + paramedical staff and radiophysics). This study is conducted in collaboration with teams from the Centre Eugène-Marquis in Rennes (Pr De Crevoisier) in the framework of a large-scale research program in   « PAIR VADS 2011 » (integrated research action program) on adaptive radiotherapy for ENT cancers.  We are coordinating the clinical part of this research program.
• Study of the intrinsic radiosensitivity of cancer stem cells (or stem cells initiating a tumor) isolated from Glioblastomes. In collaboration with the molecular oncology department headed by Pr Karayan, and in conjunction with the neurosurgery department of the Poitiers CHU (Pr M Wager, Pr B Bataille),  we have initiated at the Poitiers CHU a study on cancer stem cells (CMCs) isolated from glioblastomes. The objective of this study is to measure the intrinsic radiosensitivity of the CSCs by applying the linear quadratic model, in view of correlating these results with tumor radiocurability and of underlining the prognostic value of intrinsic radiosensitivity in glioblastome stem cells.
• Finally, a multicenter randomized clinical trail is being coordinated by Dr Guérif on radio-hormone therapy for prostate cancers in cases of biological failure of initial surgical treatment  (GETUG trial). Dr Guérif is concurrently setting up clinical evaluation of high dose rate (HDR) brachytherapy in localized prostate cancers. Several French teams have shown interest in participating in this type of study, particularly in Nice and Bordeaux.