References of "Jansen, Nicolas"
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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 detailLe cas clinique du mois. Reaction de rappel d'irradiation induite par l'administration de cyclophosphamide.
Mievis, Carole ULg; Jansen, Nicolas ULg; Schleich, FLorence ULg et al

in Revue Médicale de Liège (2009), 64(4), 179-81

Radiation recall dermatitis is an inflammatory skin reaction occurring in a previously irradiated field following the delivery of a promoting agent. It has been described after a number of antineoplastic ... [more ▼]

Radiation recall dermatitis is an inflammatory skin reaction occurring in a previously irradiated field following the delivery of a promoting agent. It has been described after a number of antineoplastic agents such as gemcitabine, taxanes, anthracyclines. We report the case of a 50-year-old man with metastatic prostate cancer who developed two consecutive radiation recall dermatitis episodes triggered by oral cyclophosphamide. They occurred 4 to 5 weeks after palliative radiotherapy on bone metastasis. Spontaneous resolution was observed within 6 weeks after discontinuation of cyclophosphamide and with local supportive care. To our knowledge this is the first reported case of radiation recall dermatitis after oral cyclophosphamide. [less ▲]

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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 detailAnalysis of Dose Volume Histogram Differences between High Dose Rate Brachytherapy and Intensity Modulated Radiotherapy for Prostate Treatment
Hermesse, Johanne ULg; Thissen, Benedicte ULg; Warlimont, Bernard ULg et al

in International Journal of Radiation, Oncology, Biology, Physics (2008), 72(1 (supplément)), 566

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

in Revue Médicale de Liège (2008), 63 (2)

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 detailAdjuvant stereotactic permanent seed breast implant: A boost series in view of partial breast irradiation
Jansen, Nicolas ULg; Deneufbourg, Jean-Marie ULg; Nickers, Philippe ULg

in International Journal of Radiation, Oncology, Biology, Physics (2007), 67(4), 1052-1058

Purpose: The aim of this study was to use permanent seed implants in the breast and describe our experience with 15 cases, using iodine seed implants as a tumor bed boost. Methods and Materials: Breasts ... [more ▼]

Purpose: The aim of this study was to use permanent seed implants in the breast and describe our experience with 15 cases, using iodine seed implants as a tumor bed boost. Methods and Materials: Breasts were fixed with a thermoplastic sheet, a template bridge applied, the thorax scanned and the images rotated to be perpendicular to the implant axis. Skin, heart, and lung were delineated. A preplan was made, prescribing 50 Gy to the clinical target volume (CTV), consisting in this boost series of nearly a quadrant. Iodine (125) seeds were stereotactically implanted through the template, and results were checked with a postplan computed tomographic (CT) scan. Results: The breast was immobilized reproducibly. Simulation, scanning, and implant were performed without difficulties. Preplan CTV D90% (the dose delivered to 90% of the CTV) was 66 Gy, and postoperative fluoroscopic or CT scan checks were satisfactory. Pre- and postplan dose-volume histogram showed good organ sparing: mean postplan skin, heart, and lung V30 Gy (the organ volume receiving a dose of 30 Gy) of 2 +/- 2.2 mL, 0.24 +/- 0.34 mL, and 3.5 +/- 5 mL, respectively. No short-term toxicity above Grade I was noted, except for transient Grade 3 neuropathy in 1 patient. Conclusions: Seeds remained in the right place, as assessed by fluoroscopy, absence of significant pre- to postplan dose-volume histogram change for critical organs, and total irradiated breast volume. The method could be proposed as a boost when high dosimetric selectivity is required (young patients after cardiotoxic chemotherapy for left-sided cancer). This boost series was a preliminary step before testing partial breast irradiation by permanent seed implant in a prospective trial. (c) 2007 Elsevier Inc. [less ▲]

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See detailA new technique of stereotactic permanent breast seed implantation
Jansen, Nicolas ULg; Nickers, Philippe ULg

in Radiotherapy & Oncology (2006, October), 81(Suppl. 1), 249-250

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See detailPlace de la radiotherapie dans le traitement du cancer du sein. Indications actuelles et perspectives
Meyns, Mia ULg; Jansen, Nicolas ULg; Deneufbourg, Jean-Marie ULg

in Revue Médicale de Liège (2006), 61(9), 623-31

Radiotherapy is an important part of breast cancer treatment. After breast conserving surgery, a dose of 50 Grays (Gy) is administered to the entire breast. Boost by external radiotherapy or brachytherapy ... [more ▼]

Radiotherapy is an important part of breast cancer treatment. After breast conserving surgery, a dose of 50 Grays (Gy) is administered to the entire breast. Boost by external radiotherapy or brachytherapy improves local control especially for women under fifty. For lobular in situ lesions, no additional treatment is required, while intraductal lesions are treated with post-operative radiotherapy in case of Van Nuys score of 7, 8 or 9. After mastectomy, irradiation is proposed in case of skin involvement, invasion of pectoral muscle, positivity of at least 3 axillary lymph nodes, SBR III grade, T3 stage or multifocality where the sum of tumour diameters are >5 cm. Irradiation of the axilla has become exceptional. In node positive patients, the supraclavicular region receives 50 Gy with low energy photons, whereas the internal mammary chain is treated at the same dose but half is administered by low energy photons et half by electrons. Exclusive or preoperative irradiation is rare, because of new chemotherapy schedules, new drugs and hormonotherapy developments. Neoadjuvant chemotherapy enhances possibilities of conservative surgery it is followed by radiotherapy depending on the same indiciations listed above. Re-irradiation is possible but one must be aware of the higher risk of late toxicity. Nowadays, major side-effects are rare but close follow-up during and after treatment is required from the radiation oncologist to detect, evaluate, prevent and even treat possible complications. [less ▲]

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See detail192ir Low Dose Rate Brachytherapy for Boosting Locally Advanced Prostate Cancers after External Beam Radiotherapy: A Phase Ii Trial
Nickers, Philippe ULg; Coppens, Luc ULg; De Leval, Jean ULg et al

in Radiotherapy & Oncology (2006), 79(3), 329-34

BACKGROUND AND PURPOSE: To evaluate on 201 locally advanced prostatic cancers prospectively treated in a phase II trial, the efficacy of a combination of external beam radiotherapy (39.6 Gy) and (192)Ir ... [more ▼]

BACKGROUND AND PURPOSE: To evaluate on 201 locally advanced prostatic cancers prospectively treated in a phase II trial, the efficacy of a combination of external beam radiotherapy (39.6 Gy) and (192)Ir low dose rate brachytherapy (Bt) (40-45 Gy). PATIENTS AND METHODS: Sixty-four patients were included in the intermediate prognosis group with only one of the following adverse factors (PSA > 10 ng/ml, Gleason score > or = 7 or clinical stage > or =T2b) and 137 in the unfavourable group when at least two of these factors were present. RESULTS: The actuarial 4 years biochemical no evidence of disease is 82.8% for the entire population. It is, respectively, 97 and 76% in the intermediate and unfavourable prognosis groups (P < 0.0001). Grade > or =3 late urinary complications occurred in 13 patients (6.5%). Eight patients (4%) presented late grade 2 rectal complications but no grades 3-5 was observed. CONCLUSIONS: Even if an alpha/beta of 1.5-3 Gy theoretically favours the use of a high dose rate mode of irradiation, the early results presented here are as good as those reported for similar groups of patients with high dose rate treatments. Late toxicity is identical but our urinary toxicity is within the less favourable and rectal toxicity within the most favourable results. We can postulate that while inducing very high hyperdosage regions (V150) mainly focused on the peripheral zone, most of the Bt techniques consist of a more ablative treatment. Many of the radiobiological studies on Bt did not in fact take into account the heterogeneity of irradiation inside the CTV. This study highlights the need to explore pulsed dose rate therapies, permanent implant and new available radioisotopes such as (169)Ytterbium that will offer the safety of low and lower dose rates. The actual late toxicity of the different Bt techniques is not yet inexistent indeed. [less ▲]

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See detailL'irradiation partielle du sein et le role de la curietherapie: une nouvelle approche therapeutique pour les carcinomes mammaires de bon pronostic
Jansen, Nicolas ULg; Nickers, Philippe ULg; Deneufbourg, Jean-Marie ULg

in Revue Médicale de Liège (2006), 61(2), 97-103

Early breast cancer can be treated by conservative surgery followed by partial breast irradiation. This recent treatment replaces classical external beam whole breast radiotherapy. Several techniques are ... [more ▼]

Early breast cancer can be treated by conservative surgery followed by partial breast irradiation. This recent treatment replaces classical external beam whole breast radiotherapy. Several techniques are available but most experience does exist with interstitial catheter based brachytherapy. This well tolerated treatment shortens the treatment time and offers a good local control and cosmetic outcome, comparable to the best classical treatments, as confirmed by the first published results. These good results can only be obtained by rigorous patient selection and very precise 3D imaging and source implantation techniques. [less ▲]

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See detail192-Ir or 125-I Prostate Brachytherapy as a Boost to External Beam Radiotherapy in Locally Advanced Prostatic Cancer: A Dosimetric Point of View
Nickers, Philippe ULg; Thissen, Benedicte ULg; Jansen, Nicolas ULg et al

in Radiotherapy & Oncology (2006), 78(1), 47-52

PURPOSE: This work aims at comparing the dosimetric possibilities of 125I or 192Ir prostate brachytherapy (Bt) as a boost to external beam radiotherapy in the treatment of locally advanced adenocarcinoma ... [more ▼]

PURPOSE: This work aims at comparing the dosimetric possibilities of 125I or 192Ir prostate brachytherapy (Bt) as a boost to external beam radiotherapy in the treatment of locally advanced adenocarcinoma. METHODS AND MATERIALS: From 1/1997 to 12/2002, 260 patients were treated. Until 12/2001 a low dose rate (LDR) treatment with 192Ir wires was used, later replaced by a high dose rate (HDR) delivered with an 192Ir stepping source technology. For the present work, we selected 40 patients including the last 20 treated, respectively, by LDR and HDR. The planning CT Scans of all these 40 patients were transferred into the 3D Prowess system for 125I permanent implants design according to the Seattle method. The reference data for dosimetric comparisons were the V100 and the prescribed dose for 192Ir as well as the dose delivered with 125I techniques to the 192Ir V100. We compared V100-150 data as well as doses to the organs at risks (OR) and cold spots (CS). RESULTS: The V100 is 85.3+/-8% for 192Ir LDR and 96+/-2% for HDR techniques (P < 0.0001). In comparison with 125I, the 192Ir LDR mode induces higher hyperdosage volumes inside the CTV but also more CS, while maximal doses to urethra and rectum are, respectively, 17 and 39% less with 125I (P < 0.0001). In comparison with the 192Ir HDR mode, 125I Bt induces higher hyperdosage volumes and slightly more CS deliberately planned around the bladder neck. If delivered doses to urethra are identical, those to the 20% anterior part of the rectum are 33% less with 125I (P < 0,0001). The 125I Bt technique was only possible in 24 out of the 40 patients studied due to pelvic bone arch interference. CONCLUSIONS: At the present time, there is no evident dosimetric superiority of one Bt method when all the criteria are taken into account. However, improving Bt techniques to implant any prostatic size could found the superiority of the 125I or permanent implants. 125I indeed allows large hyperdosage volumes inside the CTV in comparison with 192Ir HDR techniques while lowering doses to OR and minimizing CS. [less ▲]

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See detailRadiothérapie - Une explication pas à pas de l'irradiation
Jansen, Nicolas ULg

Book published by Garant (2004)

Livre compact qui explique aux patients traités par radiothérapie les modalités pratiques de ce traitement.

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See detailRadiotherapie - Stap-voor-stap uitleg over bestraling
Jansen, Nicolas ULg

Book published by Garant (2001)

This compact book describes the steps proposed to a patient going for a radiotherapy treatment (second revised edition)

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See detailRadiotherapie - Stap-voor-stap uitleg over bestraling
Jansen, Nicolas ULg

Book published by Garant (2000)

This compact book describes the steps proposed to a patient going for a radiotherapy treatment.

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See detailLa douleur pelvienne chez le patient oncologique
Jansen, Nicolas ULg; Nickers, Philippe ULg; Devoghel, Jean-Claude ULg

in Oncologie (2000), 2(4), 187-200

Pelvic pain is a common problem in the general population. In cancer patients this pain can be secondary to tumor activity or recent tumor related interventions (surgery, radiotherapy, chemotherapy). On ... [more ▼]

Pelvic pain is a common problem in the general population. In cancer patients this pain can be secondary to tumor activity or recent tumor related interventions (surgery, radiotherapy, chemotherapy). On the other hand cancer patients can also suffer from not cancer related pain. Cancer related pain is often chronic. Whatever the cause of this pain, an important psychological factor is often present, if not attributing to the pathogenesis of the pain, then as an secondary effect from the pain. Managing pelvic pain requires knowledge of the regional anatomy. A general overview is given of the approach to an oncological patient presenting with pelvic pain. Three different possibilities are discussed: (1) pain in a patient without a presently known pelvic or abdominal malignancy, (2) pain in a patient treated recently for a tumor in the pelvic area or lower abdomen, (3) pain in an so far untreated patient with a known tumor. Finally an overview of treatment options is presented. [less ▲]

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