References of "Coucke, Philippe"
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See detailVers une radiothérapie chirurgicale :nécessité d’une radiothérapie guidée par l’imagerie
COUCKE, Philippe ULg; WITHOFS, Nadia ULg; JANSEN, Nicolas ULg et al

in Revue Médicale de Liège (2010), 65(supp 1), 17-22

résumé : L’évolution extrêmement rapide en robotique et en informatique a permis l’avènement de techniques telles que le CcyberKnife®, capables d’appliquer en radiothérapie des doses dites «ablatives» et ... [more ▼]

résumé : L’évolution extrêmement rapide en robotique et en informatique a permis l’avènement de techniques telles que le CcyberKnife®, capables d’appliquer en radiothérapie des doses dites «ablatives» et ceci avec une précision chirurgicale. Ce type de traitement ablatif n’est pas réellement concevable avec des techniques conventionnelles en radiothérapie et des changements <br />majeurs de paradigmes ont eu lieu, particulièrement dans la méthodologie de définition de la cible et des marges ainsi que dans la manière dont on fractionne le traitement. Ggrâce à ces changements, on est à même de proposer aux patients des traitements <br />qui représentent un doublement au niveau de l’efficacité <br />biologique. Ppour obtenir une couverture optimale au niveau de la cible, tout en évitant les structures saines avoisinantes, il est donc impératif d’obtenir la meilleure définition possible de la cible tant au niveau de la l’extension de la lésion qu’au niveau de son «contenu», c’est-à-dire les caractéristiques métaboliques et fonctionnelles. Lla révolution technologique en cours dans le monde de l’imagerie métabolique et fonctionnelle va permettre d’utiliser l’information numérisée pour individualiser les traitements <br />et les adapter aux caractéristiques mêmes de la lésion ainsi qu’à son évolution au décours du traitement. [less ▲]

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See detailDoes radiation treatment delay affect survival in glioblastoma
Robe, Pierre ULg; Nguyen-Khac, Minh-Tuan ULg; Lenelle, Jacques ULg et al

in Surgical Neurology (2009), 72(5), 519

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See detailLa visio conférence pour combattre le cancer
Coucke, Philippe ULg

Article for general public (2009)

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See detailSymptom attribution and radiation thérapy for breast cancer : changes over time and associated psychological factors
Bonamis, O.; Liénard, A.; Coucke, Philippe ULg et al

in Psycho-oncology (2009, June), 18 (Suppl. 2)

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See detailANTICORPS MONOCLONAUX ET CANCER DU SEIN: Actualités thérapeutiques
Collignon, Joëlle ULg; Gennigens, Christine ULg; Rorive, Andrée ULg et al

in Revue Médicale de Liège (2009), 64(5-6), 279-83

About 9,500 new breast cancers are diagnosed in Belgium every year. Improvement of our knowledge of altered molecular events leading to the proliferation of tumor cells has resulted in the development of ... [more ▼]

About 9,500 new breast cancers are diagnosed in Belgium every year. Improvement of our knowledge of altered molecular events leading to the proliferation of tumor cells has resulted in the development of targeted therapies in subgroups of cancers. One of the first validation of targeted therapy is the anti-HER-2 monoclonal antibody trastuzumab (Herceptin) in patients with overexpression of human epidermal growth factor receptor type 2 (HER2) occurring in 20 to 25% of invasive breast carcinoma. Trastuzumab binds the extracellular juxtamembrane domain and is only active in tumor with HER2 gene amplification detected by fluorescence in situ hybridization (FISH). The results from randomized trials have rapidly lead to the approvement of the drug in the metastatic and then in the adjuvant setting. Another targeted therapy, also approved in the treatment of breast cancer, is the monoclonal antibody bevacizumab with an anti-VEGF (Vascular Endothelial Growth Factor) activity. We will review the benefit of these targeted therapies in breast cancer and their role in the treatment of breast cancer. [less ▲]

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See detailDoes radiation treatment delay affect survival in glioblastoma ?
Robe, Pierre ULg; Nguyen Khac, Minh-Tuan ULg; Lenelle, Jacques ULg et al

Conference (2009, March 21)

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See detailA dosimetric selectivity intercomparison of HDR brachytherapy, IMRT and helical tomotherapy in prostate cancer radiotherapy
Hermesse, Johanne ULg; Biver, Sylvie; JANSEN, Nicolas ULg et al

in Strahlentherapie und Onkologie (2009), 185(11), 736-742

Background and Purpose: Dose escalation in order to improve the biochemical control in prostate cancer requires the application of irradiation techniques with high conformality. The dosimetric selectivity ... [more ▼]

Background and Purpose: Dose escalation in order to improve the biochemical control in prostate cancer requires the application of irradiation techniques with high conformality. The dosimetric selectivity of three radiation modalities is compared: high-dose-rate brachytherapy (HDR-BT), intensity-modulated radiation radiotherapy (IMRT), and helical tomotherapy (HT). <br />Patients and Methods: Ten patients with prostate adenocarcinoma treated by a 10-Gy HDR-BT boost after external-beam radiotherapy were investigated. For each patient, HDR-BT, IMRT and HT theoretical treatment plans were realized using common contour sets. A 10-Gy dose was prescribed to the planning target volume (PTV). The PTVs and critical organs’ dose-volume histograms obtained were compared using Student’s t-test. <br />Results: HDR-BT delivers spontaneously higher mean doses to the PTV with smaller cold spots compared to IMRT and HT. 33% of the rectal volume received a mean HDR-BT dose of 3.86 ± 0.3 Gy in comparison with a mean IMRT dose of 6.57 ± 0.68 Gy and a mean HT dose of 5.58 ± 0.71 Gy (p < 0.0001). HDR-BT also enables to better spare the bladder. The hot spots inside the urethra are greater with HDR-BT. The volume of healthy tissue receiving 10% of the prescribed dose is reduced at least by a factor of 8 with HDR-BT (p < 0.0001). <br />Conclusion: HDR-BT offers better conformality in comparison with HT and IMRT and reduces the volume of healthy tissue receiving a low dose. [less ▲]

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See detailA dosimetric study comparing breast radiotherapy planned in the prone versus supine positions and via conformal 3D versus IMRT techniques
Coucke, Philippe ULg

in Belgian Journal of Medical Oncology [=BJMO] (2009), 3(3), 117

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See detailDans l'ère des traitements systematiques efficaces, il devient primordial d'assurer le controle local
Coucke, Philippe ULg

in Onco : Revue Multidisciplinaire d'Oncologie (2009), 3(6), 206-207

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See detailTumor Margin after conservative breast cancer surgery for early disease: an issue or not ?
Coucke, Philippe ULg; Vavassis, Peter; Vanderick, JEAN ULg et al

in Belgian Journal of Medical Oncology [=BJMO] (2009), 3(3), 93-100

Summary is standard of care. However, the question is Conservative breast surgery (CBS), i.e. tumorec- whether this approach is able to consolidate local tomy (TUM), has replaced more radical surgical ... [more ▼]

Summary is standard of care. However, the question is Conservative breast surgery (CBS), i.e. tumorec- whether this approach is able to consolidate local tomy (TUM), has replaced more radical surgical control irrespective of the extent of the surgical approaches such as mastectomy (MAST) and margin. No consensus exists in the literature con-quadrantectomy (QUAD). The aim of surgeons is cerning what should be considered as a minimal to avoid recurrence and still obtain a good cos-and hence a safe margin. This review will summetic result. After CBS for early disease, adjuvant marize the published data in order to try to define radiation consisting of whole breast irradiation a pragmatic treatment approach. followed by a boost dose on the surgical bed is standard of care. However, the question is whether this approach is able to consolidate local control irrespective of the extent of the surgical margin. No consensus exists in the literature concerning what should be considered as a minimal and hence a safe margin. This review will summarize the published data in order to try to define a pragmatic treatment approach. [less ▲]

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See detailLa vieille dame qui prend un coup de jeune
Coucke, Philippe ULg

in Onco : Revue Multidisciplinaire d'Oncologie (2009), 3(3), 79-81

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See detailA phase I trial of sunitinib, a tyrosine kinase inhibitor (TKI) combined with ionizing irradiation in rectal cancer
Coucke, Philippe ULg

in Belgian Journal of Medical Oncology [=BJMO] (2009), 3(3), 117

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See detailCarninome intracanalaire (in situ) du sein : pouvons-nous raisonnablement éviter la radiothérapie pour certaines patientes opérées ?
Coucke, Philippe ULg; Barthelemy, Nicole ULg; Jansen, Nicolas ULg et al

in Revue Médicale de Liège (2008), 63(2), 75-81

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de ... [more ▼]

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de renoncer à la radiothérapie complémentaire après un geste de chirurgie conservatrice. S’il est vrai que la radiothérapie, dans ce contexte, n’apporte pas de bénéfice en survie, il n’en reste pas moins qu’on observe à long terme un effet bénéfique en contrôle local. Il existe un effet significativement marqué sur le taux de rechute de type DCIS et de type invasif dans les différentes études randomisées destinées à éclaircir la problématique du rôle de la radiothérapie. La question est de savoir si on peut distinguer un sous-groupe de patientes pour qui le contrôle local n’est pas modifié par l’adjonction d’une radiothérapie adjuvante. Pour l’instant, nous ne sommes pas à même de définir ce sous-groupe, car les critères de sélection n’ont pas été mis à l’épreuve dans le cadre d’un essai randomisé. Faute de ces données, il nous semble plus adéquat de proposer jusqu’à preuve du contraire, une radiothérapie aux patientes opérées, même si l’intervention est a priori radicale, mais conservatrice, et même si les facteurs pronostiques semblent plutôt favorables. Cependant, la radiothérapie n’est pas indiquée après une mastectomie. [less ▲]

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See detailRisk adaptive treatment in Hodgkin's lympoma: reduction of radiation dose and irradiated volume
Coucke, Philippe ULg; Barthelemy, Nicole ULg; Hustinx, Roland ULg et al

in Belgian Journal of Medical Oncology [=BJMO] (2008), 2(2), 85-97

Treatment–related late complications on nontarget normal tissues and appearance of secondary malignancies are well known side-effects induced by effective treatment regimens currently used in the curative ... [more ▼]

Treatment–related late complications on nontarget normal tissues and appearance of secondary malignancies are well known side-effects induced by effective treatment regimens currently used in the curative approach of early and advanced Hodgkin’s lymphoma. Radiotherapy (RT) and chemotherapy (CT) can lead to these late complications. Efforts have been conducted to reduce the morbidity and mortality related to these treatments. In particular there has been a progressive shift from radiotherapy used as sole modality to chemotherapy as first line followed by consolidation radiotherapy. As the side-effects of radiotherapy are linked to dose, volume and interaction with chemotherapy, trials have been launched to assess the impact of modifying the characteristics of the radiation treatment. For early-stage Hodgkin’s lymphoma radiotherapy cannot be avoided but dose and volume can be reduced. In advanced Hodgkin’s lymphoma omitting radiotherapy seems reasonable only in case of complete response (CR). The clinical trials allowing such a paradigm shift are highlighted in this review. [less ▲]

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See detailHow much is enough?
Coucke, Philippe ULg

in Onco : Revue Multidisciplinaire d'Oncologie (2008), 2(6), 221-222

Le traitement conservateur est une constante dans l’approche oncologique. Des efforts ont été développés afin de conserver au maximum l’intégrité de la fonction et/ou de l’image corporelle. Ce souci de ... [more ▼]

Le traitement conservateur est une constante dans l’approche oncologique. Des efforts ont été développés afin de conserver au maximum l’intégrité de la fonction et/ou de l’image corporelle. Ce souci de sauvegarde se traduit par des approches thérapeutiques non mutilantes: un exemple typique est le changement de paradigme thérapeutique au moment de l’introduction de la chirurgie conservatrice de la glande mammaire en lieu et place de la mastectomie. Ce concept de chirurgie non radicale a été possible grâce à l’association avec la radiothérapie externe postopératoire. Des essais randomisés ont permis de valider le concept et de démontrer que le risque de rechute loco-régionale et ultérieurement la survie ne sont pas modifiés comparés à une approche chirurgicale potentiellement délabrante. Ces essais randomisés ne se sont fort heureusement pas limités aux aspects purement oncologiques. De façon prospective on a pu déterminer l’excellence des résultats cosmétiques à moyen et à long terme. Il est vrai que cette approche par essais randomisés était un passage indispensable et a permis de valider ce concept thérapeutique. Il aurait été pour le moins étonnant de prôner d’emblée une approche chirurgicale non mutilante mais oncologiquement complète, si à terme le résultat esthétique aurait été inférieur à celui que l’on aurait pu escompter après mastectomie radicale suivie de reconstruction. [less ▲]

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See detailIs an evidence-based approach unrealistic in NSCLC?
Coucke, Philippe ULg; Barthelemy, Nicole ULg; Bosquee, Léon ULg et al

in Belgian Journal of Medical Oncology [=BJMO] (2008), volume 2(6), 326-333

Summary Non-small cell lung cancer (NSCLC) is a heterogeneous tumour. A wide variety of treatment options is currently available. Surgery remains the mainstay of curative treatment and an operative ... [more ▼]

Summary Non-small cell lung cancer (NSCLC) is a heterogeneous tumour. A wide variety of treatment options is currently available. Surgery remains the mainstay of curative treatment and an operative approach will be selected in function of disease stage, tumour resectability and performance status of the patient. Adjuvant chemotherapy is considered standard at least for stage II and III disease. In stage III disease, resectability should be decided in function of the cytological/histological confirmation of N2 disease. If N2-disease cannot be highlighted at work-up, the patients are submitted to surgery followed by adjuvant chemotherapy. If patients are staged pN0-pN1 after surgery, ostoperative radiotherapy should not be given. However, if pN2 is discovered at surgery, there might be a place for postoperative radiotherapy but this still needs confirmation. In case of cytological/histological confirmation of pN2 disease prior to surgery, patients should not be operated but treated with a combination of oncomitant chemoradiotherapy. This treatment algorithm will be evaluated by reviewing the published evidence issued from randomized controlled trials. [less ▲]

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See detailThe role of COX-2 in rectal cancer treated with preoperative radiotherapy
Bouzourene, H.; Pu, Yan; Sandmeier, Dominique et al

in Virchows Archiv : An International Journal of Pathology (2008), 452(5), 499-505

Radiotherapy is one of the principal modalities of rectal cancer treatment, and the ability to predict radio resistance could potentially improve survival through a targeted treatment approach ... [more ▼]

Radiotherapy is one of the principal modalities of rectal cancer treatment, and the ability to predict radio resistance could potentially improve survival through a targeted treatment approach. Cyclooxygenase-2 (COX-2) may protect against damage by irradiation that would justify the use of COX-2 inhibitors. The purpose of this study was to investigate the potential role of COX-2 in tumor response and outcome of patients with rectal cancer treated preoperatively with radiotherapy. Using immunohistochemistry, we examined COX-2 expression in 88 surgical specimens of rectal cancer treated preoperatively and in 26 pretherapeutic biopsies. We tested whether COX-2 expression was correlated with clinico-pathologic parameters and with survival and local recurrence. COX-2 was expressed in 50% of the pretherapeutic tumor biopsies and in 88.6% of post-irradiated surgical samples. COX-2 expression was correlated only with enhanced tumor inflammation (p=0.03) and with tumor volume exceeding 30 cc (p=0.05). COX-2 was not significantly correlated with patient survival, but none of the patients with COX-2 negative tumors did recur locally, whereas 80% of patients with local recurrences have COX-2 positive tumors. We conclude that COX-2 expression is overexpressed in the majority of rectal cancers treated with radiotherapy and likely plays a role in local relapse. [less ▲]

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