Many scholars, activists and NGOs consider that our planet has now entered into a new era where human activities have a decisive effect on the earth’s ecosystem: the anthropocene. A situation which means global warming, disappearance of plants and animal species, the melting of glaciers, rising sea levels and pollution. If nature” is drying up and rebelling, it is as much the material basis of industrial societies that is breaking up as the cosmogony supporting this regime of knowledge and actions: modernity. In the first part of this lecture, I would like to show that one of the main registers that has accompanied and embodied the rise of modernity has been expressed in art. Focusing on music and performing arts I will firstly argue that the injunction of progress is at the core of our sensibility and most of artistical practices. Secondly, I will briefly show that, in term of ecological print, live shows and music consumption are not different from other social spheres. Thirdly, I will try to show than some elements of modernity, for instance sound reproduction, can be compatible with a socio ecological transition. To conclude, I will argue that we need new narratives for rethinking history of arts and our common future.
LBA259 Background: Radiotherapy (RT) delivered in combination with androgen deprivation therapy (ADT) improve survival for patients with prostate adenocarcinoma. RT given at a dose of 80 Gy is generally well tolerated but the occurrence of grade 3-4 toxicities is significantly more frequent than at a dose of 70 Gy. Furthermore, ADT has been reported to increase RT-related toxicity. Thus, we aimed to evaluate the efficacy and safety of dose escalation in combination with long term ADT in high-risk prostate cancer patients. Methods: The GETUG-AFU 18 study, sponsored by Unicancer, is a phase III randomized trial. Eligible patient had high-risk (cT3-T4 or PSA≥ 20 ng/ml or Gleason score ≥ 8-10) prostate adenocarcinoma with negative lymph-nodes status on CT-scan or MRI. Patients were randomly assigned to dose-escalated RT (80 Gy) or conventional-dose (70 Gy) with 3 years of ADT in both arms. Randomization (1:1) was stratified on pelvic lymph-nodes dissection (PLND; yes or no) and institution. Pelvic nodal irradiation (46 Gy) was performed for all patients except in case of negative PLND. The primary endpoint is the biochemical or clinical progression-free survival (bcPFS) at 5 years following ASTRO-Phoenix definition. Secondary endpoints are overall survival (OS), acute and late toxicity (CTCAE v3), and quality of life. To improve bcPFS from 65 to 75% (Hazard Ratios [HR] = 0.67), 500 patients were required (a= 5% and 1-b= 80%) with 197 events at 5 years. Results: 505 patients were included between June 2009 and January 2013. Main characteristics of the population were median age of 70.6 years (range 52-80); 268 (53.1%) patients with a Gleason score ≥ 8; median PSA value of 13.8 ng/ml (0.4-109.9); 62.3% of patient with cT3, and 16.4% with PLND. There was no imbalance between groups for major prognostic factors. The bcPFS was significantly improved in the dose-escalated RT arm compared with conventional RT arm (HR = 0.56, [95% CI, 0.40-0.76], p = 0.0005). The 5-year bcPFS was 91.4% (95% CI, 87.0-94.4) and 88.1% (95% CI, 83.2-91.6), and the 7-year bcPFS 88.1% (95% CI, 83.1-91.7) and 79.2% (95% CI, 73.1-84.0) in dose-escalated RT and conventional RT, respectively. We did observe significant differences in prostate cancer-specific survival (HR = 0.48 [95% CI, 0.27-0.83], p = 0.0090) and overall survival (HR = 0.61 [95% CI, 0.44-0.85], p = 0.0039). No prognostic factors were identified for bcPFS. Regarding late toxicities, there was no significant difference between arms with 78.2% and 76.1% of ≥Grade 2 toxicity with dose-escalated RT and conventional RT, respectively. Conclusions: Dose-escalation RT in combination with long-term ADT is effective and safe, increasing not only the bcPFS rate but also specific survival and overall survival in high-risk prostate cancer patients without increasing long-term toxicity. Clinical trial information: NCT00967863 .
Bourcier, Tristan MD, PhD; Dhubhghaill, Sorcha Ní MD, PhD; Yaïci, Rémi MD; Sanogo, Massira JD; Lefebvre, François MD; Aclimandos, Wagih MB, BCh, FRCS, FRCOphth, DO, FEBO; Asoklis, Rimvydas MD; Atilla, Huban MD; Creuzot-Garcher, Catherine MD, PhD; Curtin, Denise FRCSI, FEBO; Cvenkel, Barbara MD, PhD; Flanagan, Lisa; Kivelä, Tero T. MD, FEBO; Costa, Rafael Martinez MD, PhD, FEBO; Priglinger, Siegfried MD, PhD; Filipe, Helena Prior MD, MMEd; Stopa, Marcin MD, PhD; Strong, Brendan MA, FLPI; Sturmer, Joerg MD, PhD; Tassignon, Marie José MD, PhD, FEBO; Ivekovic, Renata MD, PhD; Maino, Anna FRCOphth, FEBO, PGCert Author Information
