References of "Coucke, Philippe"
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See detailA treatment planning intercomparison of proton and intensity modulated photon radiotherapy.
Lomax, T; Goitein, G; Debus, J et al

in Radiotherapy & Oncology (1999), 51(3)

Abstract Purpose: A comparative treatment planning study has been undertaken between standard photon delivery techniques,b intensity modulated photon methods and spot scanned protons in order to ... [more ▼]

Abstract Purpose: A comparative treatment planning study has been undertaken between standard photon delivery techniques,b intensity modulated photon methods and spot scanned protons in order to investigate the merits and limitations of each of these treatment approaches. Methods: Plans for each modality were performed using CT scans and planning information for nine patients with varying indications and lesion sites and the results have been analysed using a variety of dose and volume based parameters. Results: Over all cases, it is predicted that the use of protons could lead to a reduction of the total integral dose by a factor three compared to standard photon techniques and a factor two compared to IM photon plans. In addition, in all but one Organ at Risk (OAR) for one case, protons are predicted to reduce both mean OAR dose and the irradiated volume at the 50% mean target dose level compared to both photon methods. However, when considering the volume of an OAR irradiated to 70% or more of the target dose, little difference could be shown between proton and intensity modulated photon plans. On comparing the magnitude of dose hot spots in OARs resulting from the proton and IM photon plans, more variation was observed, and the ranking of the plans was then found to be case and OAR dependent. Conclusions: The use of protons has been found to reduce the medium to low dose load (below about 70% of the target dose) to OARs and all non-target tissues compared to both standard and inversely planned photons, but that the use of intensity modulated photons can result in similar levels of high dose conformation to that afforded by protons. However, the introduction of inverse planning methods for protons is necessary before general conclusions on the relative efficacy of photons and protons can be drawn. [less ▲]

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See detailSimultaneous Determination of Deoxyribonucleoside in the Presence of Ribonucleoside Triphosphates in Human Carcinoma Cells by High-Performance Liquid Chromatography
Decoster, L-A; Chen, X; Lejeune, F et al

in Analytical Biochemistry (1999), 270

Simultaneous determination of ribonucleoside and deoxyribonucleoside triphosphates in cells by HPLC is an analytical challenge since the concentration of dNTP present in mammalian cells is several orders ... [more ▼]

Simultaneous determination of ribonucleoside and deoxyribonucleoside triphosphates in cells by HPLC is an analytical challenge since the concentration of dNTP present in mammalian cells is several orders of magnitude lower than the corresponding NTP. Hence, the quantitation of dNTP in cells is generally performed after selective oxidation or removal of the major NTP. The procedures reported so far are lengthy and cumbersome and do not enable the simultaneous determination of NTP. We report the development of a simple, direct HPLC method for the simultaneous determination of dNTP and NTP in colon carcinoma WiDr cell extracts using a stepwise gradient elution ion-pairingHPLCwith uv detection at 260 nm and with a minimal chemical manipulation of cells. Exponentially growing WiDr cells were harvested by centrifugation, rinsed with phosphate- buffered saline, and carefully counted. The pellets were suspended in a known volume of ice-cold water and deproteinized with an equal volume of 6% trichloroacetic acid. The acid cell extracts (corresponding to 2.53 106 cells/100 ml) were centrifuged at 13,000g for 10 min at 4°C. The resulting supernatants were stored at 280°C prior to analysis. Aliquots (100 ml) were neutralized with 4.3 ml saturated Na2CO3 solution prior the injection of 40 ml onto the HPLC column (injection speed 250 ml/min). Chromatographic separations were performed using two Symmetry C18 3.5-mm (2 3 3.9 3 150 mm) columns (Waters), connected in series equipped with a Sentry guard column (3.9 3 20 mm i.d.) filled with the same packing material. The HPLC columns were kept at 30°C. The mobile phase was delivered at a flow rate of 0.5 ml/min, with the following stepwise gradient elution program: % solvent A/solvent B, 100/0 at 0 min 3 100/0 at 1 min 3 36/64 at 5 min 3 31/69 at 90 min 3 31/69 at 105 min 3 0/100 at 106 min 3 0/100 at 120 min; 50/50 MeOH/solvent B from 121 to 130 min; 100% solvent A from 131 to 160 min. Solvent A contained 0.01 M KH2PO4, 0.01 M tetrabutylammonium chloride, and 0.25% MeOH and was adjusted to pH 7.0 (550 ml 10 N NaOH for 1 liter solvent A). Solvent B consisted of 0.1 MKH2PO4, 0.028Mtetrabutylammonium chloride, and 30% MeOH and was neutralized to pH 7.0 (1.4 ml 10 N NaOH for 1 liter solvent B). Even though dNTPs are minor components of cell extracts, satisfactory regression coefficients were obtained for their calibration curves (r2 > 0.99) established with the addition–calibration methods up to 120 pmol/40-ml injection. The applicability of the method was demonstrated by in vitro studies of the modulation of NTP and dNTP pools in WiDr colon carcinoma cell lines exposed to various pharmacological concentrations of cytostatic drugs (i.e., FMdC, IUdR, gemcitabine). In conclusion, this optimized, simplified, analytical method enables the simultaneous quantitation of NTP and dNTP and may represent a valuable tool for the detection of minute alterations of cellular dNTP/NTP pools induced by anticancer/ antiviral drugs and diseases. © 1999 Academic Press [less ▲]

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See detailHyperfractionated accelerated radiotherapy (HART) for inoperable, non metastatic non-small-cell lung carcinoma of the lung (NSCLC): result of a phase II study for patients ineligible for combination radio-chemotherapy.
Koutaissoff, S; Wellmann, D; COUCKE, Philippe ULg et al

in International Journal of Radiation, Oncology, Biology, Physics (1999), 45(5), 1151-1156

Purpose: To evaluate a hyperfractionated and accelerated radiotherapy (HART) protocol in patients with inoperable non-small cell lung carcinoma (NSCLC) who were ineligible for combination ... [more ▼]

Purpose: To evaluate a hyperfractionated and accelerated radiotherapy (HART) protocol in patients with inoperable non-small cell lung carcinoma (NSCLC) who were ineligible for combination radiochemotherapy studies. Methods and Materials: From February 1989 through August 1994, 23 patients ineligible for available combined modality protocols in our institution were enrolled and treated with HART, consisting of 63 Gy given in 42 fractions of 1.5 Gy each, twice daily, with a minimum time interval of 6 h between fractions, 5 days a week, over an elapsed time of 4.2 weeks, or 29 days. There was no planned interruption. Results: The 1-, 2-, and 3-year survival rates were 61%, 39%, and 19%, respectively, with a median survival of 16.8 months. At the time of analysis, 4 patients are alive and 19 have died, 16 from NSCLC and 3 from cardiacdisease. Overall response rate was 48%, with 22% of patients achieving a complete response and 26% a partial response. Correlation between acute response rate and survival was poor. First site of relapse was local-regional in 8 patients (35%), distant in 6 patients (26%), and local-regional and distant in 4 (17%) patients. One patient had Grade IV and 2 had Grade III esophagitis. One patient presented with chronic Grade III lung toxicity. There were no treatment-related deaths. Conclusion: In this group of 23 patients ineligible for radiochemotherapy, this HART regime was quite feasible and was followed by little toxicity. Results in this particularly poor prognosis NSCLC patient category should be compared to series with a similar patient profile; however, median survival is at least similar to that obtained in recent series of combination radiochemotherapy. © 1999 Elsevier Science Inc. [less ▲]

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See detailRadiothérapie externe ou anti-inflammatoire non-stéroïdien pour la prévention des ossifications hétérotopiques après prothèse totale de hanche?
Zouhair, A; Ozsahin, M; Mouhsine, E et al

in Schweizerische Medizinische Wochenschrift (1999), 129(9), 370-376

External radiotherapy or non-steroid antiinflammatory drugs for prevention of heterotopic ossification following total hip replacement Heterotopic ossification (HO) is defined as the development of ... [more ▼]

External radiotherapy or non-steroid antiinflammatory drugs for prevention of heterotopic ossification following total hip replacement Heterotopic ossification (HO) is defined as the development of abnormal ossification in soft tissues. HO is a common disease after total hip replacement. Many therapeutic modalities have been proposed to prevent HO. The most commonly used modalities are nonsteroidal anti-inflammatory drugs (NSAID) or ionizing radiation administered just before or immediately after total hip replacement. As far as external radiation therapy is concerned, there are several published randomized studies aimed at investigating its efficacy and timing related to surgery, and at comparing ionizing irradiation to NSAID. In this article we review the published data in order to define guidelines which could be used in daily practice for the choice of prophylactic treatment against HO. [less ▲]

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See detailThe value of pretreatment cell kinetic parameters as predictors for radiotherapy outcome in head and neck cancer : a multicenter analysis.
Begg, A-C; Hart, AAM; Dische, S et al

in Radiotherapy & Oncology (1999), 50

Purpose: The aim of this study was to assess the potential of pre-treatment cell kinetic parameters to predict outcome in head and neck cancer patients treated by conventional radiotherapy. Materials and ... [more ▼]

Purpose: The aim of this study was to assess the potential of pre-treatment cell kinetic parameters to predict outcome in head and neck cancer patients treated by conventional radiotherapy. Materials and methods: Data from 11 different centers were pooled. Inclusion criteria were such that the patients received radiotherapy alone, and that the radiotherapy was given in an overall time of at least 6 weeks with a dose of at least 60 Gy. All patients received a tracer dose of either iododeoxyuridine (IdUrd) or bromodeoxyuridine (BrdUrd) intravenously prior to treatment and a tumor biopsy was taken several hours later. The cell kinetic parameters labeling index (LI), DNA synthesis time (Ts) and potential doubling time (Tpot) were subsequently calculated from flow cytometry data, obtained on the biopsies using antibodies against I/BrdUrd incorporated into DNA. Each center carried out their own flow cytometry analysis. Results: From the 11 centers, a total of 476 patients conforming to the inclusion criteria were analyzed. Median values for overall time and total dose were 49 days and 69 Gy, respectively. Fifty one percent of patients had local recurrences and 53% patients had died, the majority from their disease. Median follow-up was 20 months; being 30 months for surviving patients. Multivariate analysis revealed that T-stage, maximum tumor diameter, differentiation grade, N-stage, tumor localization and overall time correlated with locoregional control, in decreasing order of significance. For the cell kinetic parameters, univariate analysis showed that only LI was significantly associated with local control (P=0.02), with higher values correlating with a worse outcome. Ts showed some evidence that patients with longer values did worse, but this was not significant (P=0.06). Tpot showed no trend (P=0.8). When assessing survival in a univariate analysis, neither LI nor Tpot associated with outcome (P=0.4, 0.4, respectively). Surprisingly, Ts did correlate with survival, with longer values being worse (P=0.02). In the multivariate analysis of local control, LI lost its significance (P=0.16). Conclusions: The only pretreatment kinetic parameter for which some evidence was found for an association with local control (the best end-point for testing the present hypothesis) was LI, not Tpot, and this evidence disappeared in a multivariate analysis. It therefore appears that pretreatment cell kinetic measurements carried out using flow cytometry, only provide a relatively weak predictor of outcome after radiotherapy in head and neck cancer. [less ▲]

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See detailReproducibility of measurements of potential doubling time of tumor cells in the multicenter NCI protocol T92-0045
Wilson, G-D; Paschoud, N; Pavy, J-J et al

in British Journal of Cancer (1999), 79(2), 323-332

Summary We compared the flow cytometric measurement and analysis of the potential doubling time ( Tpot) between three centres involved in the National Cancer Institute (NCI) protocol T92-0045. The primary ... [more ▼]

Summary We compared the flow cytometric measurement and analysis of the potential doubling time ( Tpot) between three centres involved in the National Cancer Institute (NCI) protocol T92-0045. The primary purpose was to understand and minimize the variation within the measurement. A total of 102 specimens were selected at random from patients entered into the trial. Samples were prepared, stained, run and analysed in each centre and a single set of data analysed by all three centres. Analysis of the disc data set revealed that the measurement of labelling index (LI) was robust and reproducible. The estimation of duration of S-phase ( Ts) was subject to errors of profile interpretation, particularly DNA ploidy status, and analysis. The LI dominated the variation in Tpot such that the level of final agreement, after removal of outliers and ploidy agreement, reached correlation coefficients of 0.9. The sample data showed poor agreement within each of the components of the measurement. There was some improvement when ploidy was in agreement, but correlation coefficients failed to exceed values of 0.5 for Tpot. The data suggest that observer-associated analysis of Ts and tissue processing and tumour heterogeneity were the major causes of variability in the Tpot measurement. The first two aspects can be standardized and minimized, but heterogeneity will remain a problem with biopsy techniques. [less ▲]

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See detailPotentiation of cytotoxicity and radiosensitization of (E)-2'-deoxy-2' (fluoromethylene) cytidine by pentoxifylline in vitro.
LI, Y-X; Sun, L-Q; Paschoud, N et al

in International Journal of Cancer = Journal International du Cancer (1999), 80

(E)-28-deoxy-28-(fluoromethylene) cytidine (FMdC), a novel inhibitor of ribonucleotide-diphosphate reductase, has been shown to have anti-tumor activity against solid tumors and sensitize tumor cells to ... [more ▼]

(E)-28-deoxy-28-(fluoromethylene) cytidine (FMdC), a novel inhibitor of ribonucleotide-diphosphate reductase, has been shown to have anti-tumor activity against solid tumors and sensitize tumor cells to ionizing radiation. Pentoxifylline (PTX) can potentiate the cell killing induced by DNAdamaging agents through abrogation of DNA-damagedependent G2 checkpoint. We investigated the cytotoxic, radiosensitizing and cell-cycle effects of FMdC and PTX in a human colon-cancer cell line WiDr. PTX at 0.25–1.0 mM enhanced the cytotoxicity of FMdC and lowered the IC50 of FMdC from 79 6 0.1 to 31.2 6 2.1 nM, as determined by MTT assay. Using clonogenic assay, pre-irradiation exposure of exponentially growing WiDr cells to 30 nM FMdC for 48 hr or post-irradiation to 0.5 to 1.0 mM PTX alone resulted in an increase in radiation-induced cytotoxicity. Moreover, there was a significant change of the radiosensitization if both drugs were combined as compared with the effect of either drug alone. Cell-cycle analysis showed that treatment with nanomolar FMdC resulted in S-phase accumulation and that such an S-phase arrest can be abrogated by PTX. Treatment with FMdC prior to radiation increased post-irradiation-induced G2 arrest, and such G2 accumulation was also abrogated by PTX. These results suggest that pharmacological abrogation of S and G2 checkpoints by PTX may provide an effective strategy for enhancing the cytotoxic and radiosensitizing effects of FMdC. Int. J. Cancer 80:155–160, 1999. [less ▲]

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See detailOncologie gastro-intestinale
Coucke, Philippe ULg; FREI; FELLEY et al

in Médecine et Hygiène (1999), 57(2240), 213-217

Même si aucune acquisition nouvelle n'est venue embaumer l'atmosphère encore trop souvent grisâtre de l'oncologie gastro-intestinale en 1998, la nécessité d'un consilium préthérapeutique associant ... [more ▼]

Même si aucune acquisition nouvelle n'est venue embaumer l'atmosphère encore trop souvent grisâtre de l'oncologie gastro-intestinale en 1998, la nécessité d'un consilium préthérapeutique associant chirurgiens, endoscopeurs, oncologues et radio-oncologues s'impose avec encore plus de fermeté, pour tous les cancers digestifs. Les patients devraient autant que possible être inclus dans des protocoles d'études bien conduits et bénéficier d'une chirurgie oncologique optimale. [less ▲]

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See detailReproducibility of measurements of potential doubling time of tumour cells in the multicentre National Cancer Institute protocol
COUCKE, Philippe ULg; Paschoud, N; Pavy, J-J et al

in British Journal of Cancer (1999)

We compared the flow cytometric measurement and analysis of the potential doubling time ( Tpot) between three centres involved in the National Cancer Institute (NCI) protocol T92-0045. The primary purpose ... [more ▼]

We compared the flow cytometric measurement and analysis of the potential doubling time ( Tpot) between three centres involved in the National Cancer Institute (NCI) protocol T92-0045. The primary purpose was to understand and minimize the variation within the measurement. A total of 102 specimens were selected at random from patients entered into the trial. Samples were prepared, stained, run and analysed in each centre and a single set of data analysed by all three centres. Analysis of the disc data set revealed that the measurement of labelling index (LI) was robust and reproducible. The estimation of duration of S-phase ( Ts) was subject to errors of profile interpretation, particularly DNA ploidy status, and analysis. The LI dominated the variation in Tpot such that the level of final agreement, after removal of outliers and ploidy agreement, reached correlation coefficients of 0.9. The sample data showed poor agreement within each of the components of the measurement. There was some improvement when ploidy was in agreement, but correlation coefficients failed to exceed values of 0.5 for Tpot. The data suggest that observer-associated analysis of Ts and tissue processing and tumour heterogeneity were the major causes of variability in the Tpot measurement. The first two aspects can be standardized and minimized, but heterogeneity will remain a problem with biopsy techniques. [less ▲]

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See detailFocalized external radiotherapy for resected solitary brain metastasis: does the dogma stand?
Coucke, Philippe ULg; Zouhair, Abderrahim; Ozsahin, Mahmut et al

in Radiotherapy & Oncology (1998), 47(1), 99-101

To investigate whether whole brain irradiation might be replaced by focalized irradiation after resection of a single brain metastasis in patients where extracranial tumor control is deemed to be obtained ... [more ▼]

To investigate whether whole brain irradiation might be replaced by focalized irradiation after resection of a single brain metastasis in patients where extracranial tumor control is deemed to be obtained. Patients and methods: Twelve patients were introduced in a phase I/II prospective study of conformal postoperative external irradiation after resection of a solitary brain metastasis. The radiation treatment consisted of 50.4 Gy (1.8 Gy per fraction, five fractions per week). The planning target volume consisted of the tumor bed and a 2 cm safety margin. All treatments were optimized with head immobilization, dedicated tomodensitometry and computer assisted three-dimensional treatment planning. Results: The median survival was 7.2 months (range 2.4–50.4 months). Eleven of the 12 patients died. Eight of the 12 patients presented intracranial recurrence and seven died as a consequence of intracranial tumor progression. Conclusions: Focalized external irradiation cannot serve as a reasonable alternative to whole brain radiotherapy (WBRT) even for patients with apparently one single resected brain metastasis. The dogma of ‘one metastasis=multiple metastases' seems to be confirmed. [less ▲]

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See detaila new methylxanthine lisofylline increases radiosensitivity in air and hypoxia
Coucke, Philippe ULg; Crompton; Greiner et al

Scientific conference (1998, March 04)

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See detailradiosensitizers FMdC and idUrd: HPLC-analysis in vitro
COUCKE, Philippe ULg; Cottin, E; Chen, X et al

in Radiotherapy & Oncology (1998), 48(Supp 1),

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See detailProfils apoptotiques altérés chez les patients irradiés montrant une hypersensibilité
Ozsahim, M; Mirabell, R; Emery, G-C et al

Conference (1998)

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See detailA case of spermatic cord liposarcoma
Zouhair, A; Ozsahin, M; Monney, M et al

Conference (1998)

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See detailSystemic capillary leak syndrome and localized breast cancer: a treatment dilemma
Monney, M; Pica, A; Spertini, F et al

Conference (1998)

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See detailWhen thyroid cell meet colon cells: the history of a tumor collision resulting in coexistence
Bosman, F-T; Jeanneret, W; Monney, M et al

Conference (1998)

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See detail(E)-2'-Deoxy-2'-(Fluoromethylene)cytidine potentiates radioresponse of two human solid tumor xenografts.
Sun, L-Q; Li, Y-X; Guillou, L et al

in Proceedings of the American Association for Cancer Research (1998)

Antitumor and radiosensitizing effects of (E)-2'-deoxy-2'-(fluoromethylene) cytidine (FMdC), a novel inhibitor of ribonucleotide reducÃase, were evaluated on nude mice bearing s.c. human C33-A cervix ... [more ▼]

Antitumor and radiosensitizing effects of (E)-2'-deoxy-2'-(fluoromethylene) cytidine (FMdC), a novel inhibitor of ribonucleotide reducÃase, were evaluated on nude mice bearing s.c. human C33-A cervix cancer and I -H7 MG glioblastoma xenografts. FMdC given once daily has a dosedependent antitumor effect. The maximum tolerated dose in the mice was reached with 10 daily i.p. administrations of 10 mg/kg over 12 days. In the case of radiotherapy (RT) alone (10 fractions over 12 days), the radiation dose required to produce local tumor control in 50% of the treated C33-A xenografts was 51.0 Gy. When combined with FMdC, the radiation dose required to produce local tumor control was reduced to 41.4 and 38.2 Gy, at respective doses of 5 and 10 mg/kg given i.p. l h before each irradiation. The corresponding enhancement ratios (ERs) were 1.2 and 1.3, respec tively. In U-87 MG xenografts, when 5-20 mg/kg FMdC combined with 30 or 40 Gy of RT, the combination treatment produced a significantly increased growth delay as compared with RT alone (P £0.002). The ERs of 5, 10, and 20 mg/kg FMdC at a dose of 30 Gy were 2.0, 1.4, and 1.8, respectively. At the 40-Gy level, ERs of 10 and 20 mg/kg FMdC were 1.4 and 1.7. When FMdC was combined with 50 Gy of RT, an increased long-term remission rate of 80-88.9% was observed, as compared with 25% for RT alone (P <0.05). FMdC produced moderate myelosuppression in the mice bearing cervix cancer, whereas leukocytosis occurred in the mice bearing glioblastoma at a low dose. Slightly increased skin toxicity (only with U-87 MG tumor) was observed, as compared with RT alone. In conclusion, FMdC is a potent cytotoxic agent and able to modify the radiation response of C33-A and U-87 MG xenografts. [less ▲]

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See detailEffect of pentoxifylline on radiation-induced G2-phase delay and radiosensitivity of human colon and cervical cancer cells.
Li, Y-X; Weber-Johnson, K; Sun, L-Q et al

in Radiation Research (1998), 149(4),

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See detailPrimary non-Hodgkin's lymphoma of the nasal cavity: prognostic significance of paranasal extension and role of radiotherapy and chemotherapy
Li, Y-X; COUCKE, Philippe ULg; Li, J-Y et al

in International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society (1998), 83(3), 449-456

BACKGROUND. This study was conducted to determine whether the paranasal extension of a primary non-Hodgkin’s lymphoma (NHL) of the nasal cavity has any deleterious effect on patient outcome. METHODS. One ... [more ▼]

BACKGROUND. This study was conducted to determine whether the paranasal extension of a primary non-Hodgkin’s lymphoma (NHL) of the nasal cavity has any deleterious effect on patient outcome. METHODS. One hundred and seventy-five patients with previously untreated nasal NHL were reviewed. There were 2 with low grade, 107 with intermediate grade, 17 with high grade, and 49 with unclassifiable lymphomas. In 48 cases the immunophenotype was available and 46 were T-cell lymphoma. According to the Ann Arbor system, there were 133 patients with Stage IE, 28 with Stage IIE, 4 with Stage IIIE, and 10 with Stage IVE lymphomas. Stage IE was subdivided into limited Stage IE (i.e., confined to the nasal cavity [67 patients]) or extensive Stage IE (i.e., presenting with extension beyond the nasal cavity [66 patients]). For patients with limited Stage IE disease the treatment of choice was radiotherapy with or without chemotherapy. In patients with extensive Stage IE disease, treatment was comprised of a combination of chemotherapy and radiotherapy or radiotherapy alone. For patients with a more advanced stage of disease (IIE–IVE), chemotherapy was an integral part of the treatment and was completed by irradiation, especially for patients with Stage IIE disease. RESULTS. The actuarial overall survival (OS) and disease free survival (DFS) rates at 5 years for the whole group were 65% and 57%, respectively. The 5-year OS and DFS rates were influenced by stage, with a gradual decrease from 75% and 68% for Stage IE disease to 35% and 28% for Stage IIE disease, and 31% and 19% for Stage IIIE/IVE disease. Patients with limited Stage IE disease survived significantly longer (90% 5-year OS) compared with those with extensive Stage IE disease (57% 5-year OS; P , 0.001). For 67 patients with limited Stage IE disease, the 5-year OS was 89% with radiotherapy alone and 92% with radiotherapy and chemotherapy, whereas for 66 patients with extensive Stage IE disease, the 5-year OS was 54% with radiotherapy and 58% with combined modality therapy or chemotherapy (P . 0.05). CONCLUSIONS. The prognosis of patients with primary NHL of the nasal cavity is stage dependent. In this large cohort of Stage IE patients, it was demonstrated that the paranasal local extension was a significant prognostic factor associated with poorer treatment outcome. The authors believe that Ann Arbor Stage IE should be subclassified further into limited and extensive Stage IE. The addition of chemotherapy did not appear to modify significantly the survival of patients with either limited or extensive Stage IE disease. The extranodal progression observed in patients with extensive Stage IE and Stage IIE-IVE disease clearly illustrates the need for improvement of systemic treatment. Cancer 1998;83:449–56. [less ▲]

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See detailFocalized external radiotherapy for resected solitary brain metastasis: the dogma stands
Coucke, Philippe ULg; Zouhair, A; Ozsahin, M et al

in Radiotherapy & Oncology (1998), 47

Abstract Purpose: To investigate whether whole brain irradiation might be replaced by focalized irradiation after resection of a single brain metastasis in patients where extracranial tumor control is ... [more ▼]

Abstract Purpose: To investigate whether whole brain irradiation might be replaced by focalized irradiation after resection of a single brain metastasis in patients where extracranial tumor control is deemed to be obtained. Patients and methods: Twelve patients were introduced in a phase I/II prospective study of conformal postoperative external irradiation after resection of a solitary brain metastasis. The radiation treatment consisted of 50.4 Gy (1.8 Gy per fraction, five fractions per week). The planning target volume consisted of the tumor bed and a 2 cm safety margin. All treatments were optimized with head immobilization, dedicated tomodensitometry and computer assisted three-dimensional treatment planning. Results: The median survival was 7.2 months (range 2.4–50.4 months). Eleven of the 12 patients died. Eight of the 12 patients presented intracranial recurrence and seven died as a consequence of intracranial tumor progression. Conclusions: Focalized external irradiation cannot serve as a reasonable alternative to whole brain radiotherapy (WBRT) even for patients with apparently one single resected brain metastasis. The dogma of ‘one metastasis=multiple metastases' seems to be confirmed. [less ▲]

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