Intérêt clinique de la tomographie à émission de positons dans la détection et le bilan d'extension des lymphomes non Hodgkiniens de malignité intermédiaire ou élevée

in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (1999), 23

Accurate staging of non-Hodkin's lymphoma (NHL) is important for treatment management. We studied 53 patients (40 patients at initial diagnosis and 13 patients at disease recurrence) with ... [more ▼]

Accurate staging of non-Hodkin's lymphoma (NHL) is important for treatment management. We studied 53 patients (40 patients at initial diagnosis and 13 patients at disease recurrence) with histopathologically proven aggressive NHL to assess the value of whole-body FDG positron emission tomography (PET) as an imaging modality for staging and restaging NHL. All patients in this comparative analysis were submitted to clinical examination ; computed tomography (CT) and whole-body PET studies before starting the treatment. Results : whole-body FDG-PET seems to be more sensitive than clinical examination and CT imaging for detection of lymph node regions infiltrated by NHL : there were 98 abnormal peripheral lymph node regions senn by FDG-PET : 59 observed by clinical examination and 39 clinically undetected. The clinical examination showed 9 additional nodal lesions not seen by PET. Of 77 thoracic and abdominopelvic trated by CT. The CT studies showed 5 additional nodal lesions. Extranodal lymphomatous localisations in the liver (n=5), spleen (n=14), lungs (n=8), pleura (n=9), digestive tract (n=4), pelvis (n=2) and other sites (n=9) were identified by PET. Bone marrow infiltration demonstrated by PET was confirmed by biopsy in 6/10 patients, however known medullary invasion was not seen by PET imaging in 5 patients. Conclusion : whole-body FDG-PET without attenuation correction is an efficient, non-invasive method for staging and restaging aggressive NHL but marrow biopsy remains to be performed in addition to PET. [less ▲]

Traitement du cancer colorectal. Aspects pharmaco-économiques

in Revue Médicale de Liège (1998), 53(5), 276-8

Cancer patients care is mainly based on scientific studies, but sometimes approaches are empiric. Rapid growth of health care expenses force the physician to take pharmacoeconomic aspects into ... [more ▼]

Cancer patients care is mainly based on scientific studies, but sometimes approaches are empiric. Rapid growth of health care expenses force the physician to take pharmacoeconomic aspects into consideration. New clinical studies have to analyse clinical benefits but also cost-effectiveness. We will review the various aspects of colorectal cancer from primary prevention to post-treatment follow-up. Scientific data are integrated in a pharmacoeconomic analysis. [less ▲]

Epidermal Calprotectin Expression in Lymphocyte-Depleted Cutaneous Graft-versus-Host Reaction

in Archivos Argentinos de Dermatologia (1998), 48

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates ... [more ▼]

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates the severity of cutaneous lesions to a peculiar lymphocyto-depleted GVHR (LD-GVHR) with scant recognizable inflammatory cells and almost absence of epidermal injury. The recently revisited histological criteria for cutaneous GVHR are of little help in diagnosing such LD-GVHR. As calprotectin (L1-protein) has been reported to be expressed in several types of stressed epithelia, we assessed the epidermal calprotectin expression during LD-GVHR. Calprotectin expression was studied by immuno-histochemistry using the Mac 287 moAb in 50 cases of LD-GVHR and 40 cases of toxic reactions due to the conditioning regimens or to post-transplant drugs. Calprotectin was evidenced in normal looking keratinocytes of all cutaneous LD-GVHR cases and in the vast majority of cytotoxic drug-induced dermatitis. It is concluded that calprotectin immunoreactivity appears to be a diagnostic clue in LD-GVHR. The epidermal calprotectin expression occurs early in GVHD, irrespective of the histological grading. However, it cannot be used alone to distinguish early LD-GVHR from drug-induced dermatitis. [less ▲]

Problèmes diagnostiques, thérapeutiques et socio-économiques en oncologie gériatrique

in Revue Médicale de Liège (1997), 52(4), 255-7

Les taxanes : un nouvelle classe d'agents cytotoxiques

in Médecine et Hygiène (1997), 55

Paclitaxel et docetaxel sont de novueaux agents cytotoxiques qui présentent un mécanisme d'action tout à fait original. Les taxanes favorisent la polymérisation des dimères alpha et bêta de la tubuline et ... [more ▼]

Paclitaxel et docetaxel sont de novueaux agents cytotoxiques qui présentent un mécanisme d'action tout à fait original. Les taxanes favorisent la polymérisation des dimères alpha et bêta de la tubuline et sont responsables d'anomalies stables de la structure des microtubules ainsi que de la formation anarchique de nombreux astères non fonctionnels. Des résultats encourageants sont observés dans le traitement de deuxième ligne d'une grande variété de cancers. La toxicité est acceptable si l'on utilise une prémédication anti-allergique. Le paclitaxel est indiqué dans le traitement de première ligne du cancer ovarien avancé et de deuxième ligne du cancer du sein métastatique réfractaire aux anthracyclines. Le remboursement dans d'autres indications est à l'étude dans les années à venir. [less ▲]

Actualisation du traitement des cancers du sein. Chimiothérapie myéloblastique et greffes de cellules souches hématopoiétiques.

in Revue Médicale de Liège (1997), 52(2), 76-9

Approche thérapeutique du cancer épithélial de l'ovaire au CHU Sart Tilman : Conclusions de la réunion interdisciplinaire du 22 mars 1995

in Revue Médicale de Liège (1995), 50

Notre but est de définir une approche multidisciplinaire permettant d'offrir les meilleures chances de guérison ou de survie prolongée aux patientes. Nous nous sommes basés sur notre expérience ... [more ▼]

Notre but est de définir une approche multidisciplinaire permettant d'offrir les meilleures chances de guérison ou de survie prolongée aux patientes. Nous nous sommes basés sur notre expérience personnelle et les données actuelles de la littérature, tout en intégrant les approches innovatrices (ex : chimiothérapie intrapéritonéale précoce). Pour certaines patientes, le pronostic reste trop sombre avec un traitement standard et il nous semble important de leur proposer un traitement potentiellement plus efficace. [less ▲]