Radiation Oncology Program

JORDI GIRALT MD PhD, GROUP LEADER

Jordi Giralt is the head of the Radiation Oncology Service at Vall d’Hebron University Hospital in Barcelona, Spain, and Associate Professor of Medicine at the Universidad Autónoma, Barcelona. He is chairman of the Spanish Pediatric Cancer Group and a founder member of the Spanish Group for Clinical Research GICOR. He has published over 50 peer-reviewed articles, in addition to over 200 abstracts and book chapters. His research interests are in pediatric, gastrointestinal and head and neck cancer. Dr. Giralt holds a Ph.D. from the Universidad Autonoma, Barcelona.

CLINICAL MEMBERS

Attending Physicians
Xavier Maldonado
Begoña Navalpotro
Victoria Reyes
Sergio Benavente
Ramona Verges
Ramón Bodi
Monica Ramos
Meritxell Molla

CLINICAL ACTIVITY

New  targets for cancer therapy in combination with radiation and chemotherapy, and the prevention of radiation-induced toxicity were the two lines of clinical research in 2008. We are conducting a phase II study in esophageal cancer with Erbitux administered  concurrently with radiation and carboplatin and a second study of Erbitux, radiation and capecitabine in locally advanced rectal cancer. We have conducted a randomized double-blind trial with the aim of studying the use of probiotics in preventing radiation-induced enteritis. In head and neck we are participating in a phase III trial comparing radiation and cisplatin with lapatinib or placebo in the postoperative context. We also are working on a KGF for the treatment of mucositis in combination.

Regarding breast cancer we have focused on the prevention of skin toxicity. In pediatric cancer we participated in a phase III trial comparing standard craniospinal irradiation by hyperfractionated radiation therapy. This was a multi-institutional study conducted by the International Society for Pediatric Oncology (SIOP) and Dr Giralt was a member of the steering committee. In prostate cancer we are participating in 2 phase III studies, one in the intermediate risk group and one in the post-operative setting.

SCIENTIFIC ACTIVITY

a) Clinical Research

New targets:

• Panitumumab plus radiotherapy in locally advanced head and neck cancer. Randomized phase II trial ongoing
• Radiation plus cisplatin +/- lapatinib in the postoperative setting. Phase III trial ongoing
• Cetuximab in the treatment of locally advanced esophageal cancer. Phase II trial ongoing

Mucositis / epithelitis:

• Palifermin (Recombinant Human Keratinocyte Growth Factor, rHuKGF) for the reduction of oral mucositis in patients receiving radiotherapy Presented at ESTRO 08, manuscript in preparation
• Soluble Beta-1,3/1,6-glucan for mucositis prevention in patients receiving  radiotherapy. Double blind phase III trial ongoing
• 3% urea lotion prevents dehydration and desquamation after radiotherapy in breast cancer. Double blind phase III trial, presented at ESTRO 08, manuscript in preparation

Others:

• Selective use of postoperative radiotherapy after mastectomy. Phase III trial ongoing
• Short course versus long course androgenic blockade combined with high-dose radiotherapy in intermediate and high-risk prostate cancer. Phase III trial ongoing
• Intermittent androgenic blockade in biochemical relapse prostate cancer. Phase III trial ongoing

b) Translational Research

• Differential Activation of Protein Translation is Associated with Aggressive Phenotype of Cervical Cancers
• Presented at ASTRO 08, manuscript accepted by the International Journal of  Radiation  Oncology Biology Physics
• Radiotherapy versus temozolomide in low grade gliomas after stratification for genetic 1p loss. Phase III trial ongoing

Technological Developments:

–Highly conformal radiotherapy in pediatric tumors: stereotactic techniques
–IMRT in prostate and head and neck cancer
–Quality assurance: portal imaging guided treatment deviations
–Stereotactic radiotherapy in brain tumors
–New techniques under evaluation:

• Breast cancer irradiation in prone position
• Volume changes during RT in H&NC
• Fiducial marks in prostate cancer for treatment guidance
• PET imaging for target delineation in pediatric Hodgkin disease

PUBLICATIONS

Giralt J, Regadera JP, Verges R, Romero J, de la Fuente I, Biete A, Villoria J, Cobo JM, Guarner F. Effects of Probiotic Lactobacillus Casei DN-114 001 in Prevention of Radiation-Induced Diarrhea: Results from Multicenter, Randomized, Placebo-Controlled Nutritional Trial. Int J Radiat Oncol Biol Phys, 2008 Jul 15;71(4):1213-9.
(IF: 4.290, 1 cuartil, oncology)

Bernier J, Bonner J, Vermorken JB, Bensadoun RJ, Dummer R, Giralt J, Kornek G, Hartley A, Mesia R, Robert C, Segaert S, Ang KK. Consensus guidelines for the management of radiation dermatitis and coexisting acne-like rash in patients receiving radiotherapy plus EGFR inhibitors for the treatment of squamous cell carcinoma of the head and neck. Ann Oncol, 2008 Jan;19(1):142-9. Epub 2007 Sep 4.
(IF: 4.875, 1 cuartil, oncology)

Giralt J, Benavente S, Arguis M. Optimizing approaches to head and neck cancer: strengths and weaknesses in multidisciplinary treatments of locally advanced disease. Ann Oncol. 2008 Sep;19 Suppl 7:vii195-9.
(IF: 4.875, 1 cuartil, oncology)

Giralt J, Tabernero J, Navalpotro B, Capdevila J, Espin E, Casado E, Mañes A, Landolfi S, Sanchez-Garcia JL, de Torres I, Armengol M. Pre-operative chemoradiotherapy with UFT and Leucovorin in patients with advanced rectal cancer: a phase II study. Radiother Oncol. 2008 Dec;89(3):263-9. Epub 2008 Sep 1.
(IF: 4.074, 2 cuartil, oncology)

Giralt J, Benavente S. Controversies surrounding the use of neoadjuvant chemotherapy in locally advanced head and neck cancer. Expert Rev Anticancer Ther. 2008 Sep;8(9):1359-63.
(IF: 1.988, 2 cuartil, oncology)

Manichanh C, Varela E, Martinez C, Antolin M, Llopis M, Doré J, Giralt J, Guarner F, Malagelada JR. The gut microbiota predispose to the pathophysiology of acute postradiotherapy diarrhea. Am J Gastroenterol. 2008 Jul;103(7):1754-61. Epub 2008 Jun 28.
(IF: 6.101, 1 cuartil, gastroenterology & hepatology)

Wheeler DL, Huang S, Kruser TJ, Nechrebecki MM, Armstrong EA, Benavente S, Gondi V, Hsu KT, Harari PM. Mechanisms of acquired resistance to cetuximab: role of HER (ErbB) family members. Oncogene. 2008 Jun 26;27(28):3944-56. Epub 2008 Feb 25.
(IF: 6.440, 1 cuartil, oncology science)

Gil-Moreno A, Franco-Camps S, Díaz-Feijoo B, Pérez-Benavente A, Martínez-Palones JM, Del Campo JM, Parera M, Verges R, Castellví J, Xercavins J. Usefulness of extraperitoneal laparoscopic paraaortic lymphadenectomy for lymph node recurrence in gynecologic malignancy. Acta Obstet Gynecol Scand. 2008;87(7):723-30.
(IF: 1.274, 2 cuartil, obstetrics & gynecology science)

MAIN RESEARCHER

Giralt, Jordi

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