References of "JERUSALEM, Guy"
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See detailPersonnel soignant et âgisme: quelles conséquences cliniques ?
Schroyen, Sarah ULg; Missotten, Pierre ULg; JERUSALEM, Guy ULg et al

Conference (2014, December 16)

Introduction : Le cancer est un problème de santé majeur dont l’âge constitue un facteur de risque avéré1. Paradoxalement, les personnes âgées souffrant d’un cancer sont souvent exclues des essais ... [more ▼]

Introduction : Le cancer est un problème de santé majeur dont l’âge constitue un facteur de risque avéré1. Paradoxalement, les personnes âgées souffrant d’un cancer sont souvent exclues des essais cliniques et sous-traitées comparativement à des patients plus jeunes1. Un élément explicateur de ces constats est la stigmatisation liée à l’âge² (c.à.d. nos stéréotypes liés à l’âge, et donc l’âgisme). Méthodologie : Nous avons interrogé 76 infirmiers (-ères) travaillant en oncologie. A l’aide de fiches cli-niques, nous leur avons demandé s’ils encourageraient à des patients un traitement expérimental (40 vs 70 ans), une chimiothérapie ou une reconstruction mammaire (35, 55 ou 75 ans), tout paramètres cliniques étant équivalents par ailleurs. Résultats : L’encouragement d’un traitement expérimental est moins fréquente pour une personne de 70 ans comparativement à une personne de 40 ans (p<.001). De plus, le personnel soignant encourage moins fréquemment une chimiothérapie pour une personne de 75 ans comparativement aux per-sonnes de 55 et 35 ans (p<.001). Au niveau de la reconstruction mammaire, une différence est vi-sible dès 55 ans : la reconstruction mammaire est moins encouragée pour une personne de cet âge par rapport à une personne de 35 ans (p=.02) et encore moins encouragée pour une personne de 75 ans comparativement à une personne de 55 ans (p<.001). L’âge des infirmiers (M = 35.8) a une influence sur ces encouragement : plus ils sont âgés, plus ils encouragent le traitement chimiothérapeutique d’une per-sonne de 75 ans (p = .005) de même que le traitement expérimental pour une personne de 70 ans (p = .01). Conclusion : A l’instar d’autres études3, 4, nous confirmons que tant du point de vue esthétique que cura-tif, le personnel médical encourage moins fréquemment un traitement aux patients plus âgés compa-rativement aux plus jeunes. 1. Hurria, A., et al. (2012). J Natl Compr Canc Netw, 10, 162-209. 2. Penson, R. T., et al. (2004). The Oncologist, 9, 343-352. 3. Madan, A. K., et al. (2001). Acad Med, 76, 282-284. 4. Protière, C., et al. (2010). Crit Rev Oncol Hematol, 75, 138-150. [less ▲]

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See detailDouble stigmatization influence in oncogeriatry
Schroyen, Sarah ULg; Adam, Stéphane ULg; JERUSALEM, Guy ULg et al

in Psycho-oncology (2014, October 24)

Introduction Cancer is a major health problem widespread in elderly, which is inscribed in ageism context1. Negative influence of the vision that older people possess on aging on mental and physical ... [more ▼]

Introduction Cancer is a major health problem widespread in elderly, which is inscribed in ageism context1. Negative influence of the vision that older people possess on aging on mental and physical health2 is well established within “normal” aging. Consequently, we can ask ourselves what consequences age stigmas have in the realm of oncogeriatry. Moreover, cancerous patients face pathology-related stigmas because nowadays cancer still conveys a lot of negative representations. Method A group of 120 patients aged of 65 years old and more suffering from cancer (lung, breast or gynecological) will be followed during one year (0-3-6-12 months). Different instruments measuring quality of life, depression, symptoms, etc. are used as well as questions about their vision of aging and of cancer. Clinical parameters (weight, biologicals values, comorbidity…) are recorded too. Currently, we have 63 patients (31 breast cancer, 14 gynecological cancer and 18 lung cancer with distinction between smokers and non-smokers). Our analysis is only on the baseline at this moment, without any distinction between kinds of cancers. Results Double ANOVAs were used to analyze the data. A positive vision of aging is linked to a lower level of depression in comparison to a negative vision of aging (p = .04). Vision of pathology approach significance: less depression when vision is positive (p = .077). Concerning daily functioning (physical, emotional, social...), a positive vision of aging is related to a better functioning (p = .03) whereas vision of pathology has no effect. Eventually, a positive vision of aging and of cancer is related to a better quality of life (respectively p=.02, p=.002). Concerning clinical parameters, no results are observed. Conclusion These first results suggest that the vision patients have themselves of the age and of cancer is in relation with subjective mental and physical health. As we observe influence on vision of aging as well as pathology, we can talk about “double stigmatization”. Needless to say, more studies are needed to analyze the direction of these observation and longitudinal data analysis could bring some answers: is stigmatization provoke a less good mental and physical health or is it because I have health problem that I have a negative vision of aging and of my disease? 1. Penson, R. T., et al. (2004). The Oncologist, 9, 343-352. 2. Levy, B. (2009). Curr Dir Psychol Sci, 18, 332-336. [less ▲]

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See detailMulticenter implementation of geriatric assessment in Belgian patients with cancer: A survey on treating physicians' general experiences and expectations.
Kenis, Cindy; Heeren, Pieter; Bron, Dominique et al

in Journal of geriatric oncology (2014), 5(4), 431-438

OBJECTIVES: The aim of this study is to identify treating physicians' general experiences and expectations regarding geriatric assessment (GA) in older patients with cancer. MATERIALS AND METHODS: A ... [more ▼]

OBJECTIVES: The aim of this study is to identify treating physicians' general experiences and expectations regarding geriatric assessment (GA) in older patients with cancer. MATERIALS AND METHODS: A survey was carried out in 9 Belgian hospitals, which participated in a national GA implementation project focusing on older patients with cancer. A newly developed questionnaire was completed by their treating physicians. Data collection comprised of reviewing hospital data, general respondent data, and treating physicians' general experiences and expectations regarding GA. Descriptive statistics were calculated. RESULTS: Eighty-two physicians from 9 hospitals participated. The GA team composition can vary substantially, with a nurse as core member. Ideally, all older patients with cancer in whom a treatment decision is necessary, should benefit from the GA. Nearly all GA domains are reported as very important. Availability of GA results can be improved. Treating physicians want geriatricians to coordinate geriatric recommendations related to the identified GA problems, and expect from trained healthcare workers (THCWs) to collect GA data, to report GA results, and to follow-up the implementation of geriatric recommendations. CONCLUSION: This study identifies relevant information for improving the implementation of GA in older patients with cancer in Belgium and reveals priorities for a THCW from the treating physician's point of view. To increase the effectiveness of GA, further efforts are needed to improve the implementation of geriatric recommendations. [less ▲]

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See detailEGFR activation and signaling in cancer cells are enhanced by the membrane-bound metalloprotease MT4-MMP.
Paye, Alexandra ULg; Truong, Alice ULg; Yip, Cassandre ULg et al

in Cancer research (2014)

MT4-MMP (MMP-17) is a GPI-anchored matrix metalloprotease expressed on the surface of cancer cells which promotes tumor growth and metastasis. In this report, we identify MT4-MMP as an important driver of ... [more ▼]

MT4-MMP (MMP-17) is a GPI-anchored matrix metalloprotease expressed on the surface of cancer cells which promotes tumor growth and metastasis. In this report, we identify MT4-MMP as an important driver of cancer cell proliferation through CDK4 activation and retinoblastoma protein (Rb) inactivation. We also determine a functional link between MT4-MMP and the growth factor receptor EGFR. Mechanistic experiments revealed direct association of MT4-MMP and its positive effects on EGFR phosphorylation in response to TGF- and EGF in cancer cells. Notably, the effects of MT4-MMP on proliferation and EGFR activation did not rely on metalloprotease activity. Clinically, MT4-MMP and EGFR expression were correlated in human triple negative breast cancer specimens. Altogether our results identify MT4-MMP as a positive modifier of EGFR outside-in signaling that acts to cooperatively drive cancer cell proliferation. [less ▲]

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See detailL'âgisme en oncogériatrie
Schroyen, Sarah ULg; Missotten, Pierre ULg; JERUSALEM, Guy ULg et al

Conference (2014, September 18)

Introduction (800 caractères): Le cancer est un problème de santé majeur dont l’âge constitue un facteur de risque avéré. Paradoxalement, les personnes âgées souffrant d’un cancer sont souvent sous ... [more ▼]

Introduction (800 caractères): Le cancer est un problème de santé majeur dont l’âge constitue un facteur de risque avéré. Paradoxalement, les personnes âgées souffrant d’un cancer sont souvent sous-traitées comparativement à des patients plus jeunes : à situation clinique équivalente, des futurs médecins recommandent moins fréquemment une reconstruction mammaire (Madan et al., 2004) et des médecins recommandent moins souvent une chimiothérapie (Protière et al., 2010) chez les personnes âgées par rapport aux jeunes. Un élément d’explication avancé par les auteurs est la stigmatisation liée à l’âge (c.à.d. nos stéréotypes liés à l’âge, et donc l’âgisme), bien qu’elle n’ait pas été analysée dans ces études. Dès lors, le lien entre la vision de l’âge et les recommandations cliniques constitue l’objectif de notre étude. Méthodologie (1500 caractères) : Nous avons interrogé 76 infirmiers (-ères) travaillant en oncologie et étant en contact régulier avec des patients âgés (67 femmes, 9 hommes, M âge = 33,88 ans). Il leur a été proposé de donner leur avis sur quatre fiches cliniques et de compléter deux questionnaires. La première fiche clinique concernait une nouvelle immunothérapie contre le cancer du poumon. A sa lecture, il était demandé aux infirmiers de noter, sur une échelle de 1 à 7, dans quelle mesure ils recommanderaient à leur patient (40 vs 70 ans) de suivre ce traitement expérimental. Les 3 autres fiches cliniques concernaient une patiente en bon état général atteinte d’un cancer du sein et ayant été traité par mastectomie. Les paramètres cliniques étaient strictement équivalents dans les 3 cas : seul l’âge de la patiente changeait (35, 55 ou 75 ans). Pour chaque fiche, les infirmiers devaient noter sur une échelle de 1 à 7 à quel point ils encourageraient le patient à suivre un traitement chimiothérapeutique et à demander une reconstruction mammaire Les infirmiers étaient également interrogés sur leur vision de l’âge de manière explicite via un questionnaire (FSA-R ; Boudjemad & Gana, 2009) et de manière implicite sur base des 5 premiers mots qui leur venaient à l’esprit lorsqu’ils pensaient à une personne âgée (informations récoltées au sein du questionnaire anamnestique global). Résultats (1500 caractères): Concernant le traitement expérimental, sa recommandation est moins fréquente pour une personne de 70 ans comparativement à une personne de 40 ans (p<.001). Cette moindre recommandation est associée à une tendance à citer plus de mots négatifs relatifs à la personne âgée (p =.09). Aucun résultat n’a été trouvé en lien avec la mesure explicite de l’âgisme. De plus, le personnel soignant recommande moins fréquemment une chimiothérapie pour une personne de 75 ans comparativement aux personnes de 55 et 35 ans (p<.001). Ce résultat ne semble pas influencer par la vision de l’âge du personnel soignant. Au niveau de la reconstruction mammaire, une différence est visible dès 55 ans : la reconstruction mammaire est moins recommandée pour une personne de cet âge par rapport à une personne de 35 ans (p=.02). Elle l’est encore moins pour une personne de 75 ans comparativement à une personne de 55 ans (p<.001). De plus, la différence de recommandation entre une personne de 75 et 35 ans semble être influencée par la vision de l’âge du personnel (mesurée par le test du FSA-R) : une vision plus négative est associée à un encouragement moins fréquent pour une personne de 75 ans comparativement à une personne de 35 ans (p = .01). Nous n’avons pas trouvé de lien avec la mesure implicite de l’âgisme. Conclusion (800 caractères): Nos données confirment que les recommandations cliniques telles qu’une reconstruction mammaire ou une chimiothérapie sont moins fréquente chez les personnes âgées que chez les jeunes. De plus, nos résultats montrent qu’une vision négative de l’âge est associée à une moindre propension à proposer une reconstruction mammaire. A l’inverse, la vision de l’âge ne semble pas influencer l’encouragement pour un traitement chimiothérapeutique : des attitudes âgistes sont observées même quand le personnel a une vision positive de l’âge. Ces résultats doivent cependant être confirmés par d’autres études notamment menées auprès d’autres professionnels en oncologie gériatrique. Lors de celles-ci, l’ajout d’autres mesures implicites de l’âgisme nous paraitrait intéressant. [less ▲]

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See detailNeoadjuvant chemotherapy in breast cancer induces miR-34a and miR-122 expression
FRERES, Pierre ULg; JOSSE, Claire ULg; Bovy, Nicolas ULg et al

in Journal of Cellular Physiology (2014)

Circulating microRNAs (miRNAs) have been extensively studied in cancer as biomarkers but little is known regarding the influence of anti-cancer drugs on their expression levels. In this article, we ... [more ▼]

Circulating microRNAs (miRNAs) have been extensively studied in cancer as biomarkers but little is known regarding the influence of anti-cancer drugs on their expression levels. In this article, we describe the modifications of circulating miRNAs profile after neoadjuvant chemotherapy (NAC) for breast cancer. The expression of 188 circulating miRNAs was assessed in the plasma of 25 patients before and after NAC by RT-qPCR. Two miRNAs, miR- 34a and miR-122, that were significantly increased after NAC, were measured in tumor tissue before and after chemotherapy in 7 patients with pathological partial response (pPR) to NAC. These 2 chemotherapy-induced miRNAs were further studied in the plasma of 22 patients with adjuvant chemotherapy (AC) as well as in 12 patients who did not receive any chemotherapy. Twenty-five plasma miRNAs were modified by NAC. Among these miRNAs, miR-34a and miR-122 were highly upregulated, notably in pPR patients with aggressive breast cancer. Furthermore, miR-34a level was elevated in the remaining tumor tissue after NAC treatment. Studying the kinetics of circulating miR-34a and miR-122 expression during NAC revealed that their levels were especially increased after anthracycline-based chemotherapy. Comparisons of the plasma miRNA profiles after NAC and AC suggested that chemotherapy-induced miRNAs originated from both tumoral and non-tumoral compartments. This study is the first to demonstrate that NAC specifically induces miRNA expression in plasma and tumor tissue, which might be involved in the anti-tumor effects of chemotherapy in breast cancer patients. [less ▲]

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See detailImpact de la double stigmatisation en oncogériatrie : Etat des lieux
Schroyen, Sarah ULg; Adam, Stéphane ULg; JERUSALEM, Guy ULg et al

in Gériatrie et Psychologie Neuropsychiatrie du Vieillissement (2014), 12(2), 131-8

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See detailUse of mTOR inhibitors in the treatment of breast cancer: an evaluation of factors that influence patient outcomes.
Jerusalem, Guy ULg; RORIVE, Andrée ULg; COLLIGNON, Joëlle ULg

in Breast Cancer (2014), 6

Many systemic treatment options are available for advanced breast cancer, including endocrine therapy, chemotherapy, anti-human epidermal growth factor receptor 2 (HER2) therapy, and other targeted agents ... [more ▼]

Many systemic treatment options are available for advanced breast cancer, including endocrine therapy, chemotherapy, anti-human epidermal growth factor receptor 2 (HER2) therapy, and other targeted agents. Recently, everolimus, a mammalian target of rapamycin (mTOR) inhibitor, combined with exemestane, an aromatase inhibitor, has been approved in Europe and the USA for patients suffering from estrogen receptor-positive, HER2-negative advanced breast cancer previously treated by a nonsteroidal aromatase inhibitor, based on the results of BOLERO-2 (Breast cancer trials of OraL EveROlimus). This study showed a statistically significant and clinically meaningful improvement in median progression-free survival. Results concerning the impact on overall survival are expected in the near future. This clinically oriented review focuses on the use of mTOR inhibitors in breast cancer. Results reported with first-generation mTOR inhibitors (ridaforolimus, temsirolimus, everolimus) are discussed. The current and potential role of mTOR inhibitors is reported according to breast cancer subtype (estrogen receptor-positive HER2-negative, triple-negative, and HER2-positive ER-positive/negative disease). Everolimus is currently being evaluated in the adjuvant setting in high-risk estrogen receptor-positive, HER2-negative early breast cancer. Continuing mTOR inhibition or alternatively administering other drugs targeting the phosphatidylinositol-3-kinase/protein kinase B-mTOR pathway after progression on treatments including an mTOR inhibitor is under evaluation. Potential biomarkers to select patients showing a more pronounced benefit are reviewed, but we are not currently using these biomarkers in routine practice. Subgroup analysis of BOLERO 2 has shown that the benefit is consistent in all subgroups and that it is impossible to select patients not benefiting from addition of everolimus to exemestane. Side effects and impact on quality of life are other important issues discussed in this review. Second-generation mTOR inhibitors and dual mTOR-phosphatidylinositol-3-kinase inhibitors are currently being evaluated in clinical trials. [less ▲]

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See detailEuropean inter-institutional impact study of MammaPrint.
Cusumano, P. G.; Generali, D.; Ciruelos, E. et al

in Breast (Edinburgh, Scotland) (2014), 23(4), 423-8

AIM: To measure the impact of MammaPrint on adjuvant treatment decisions and to analyze the agreement in treatment decisions between hospitals from 4 European countries for the same patient cohort ... [more ▼]

AIM: To measure the impact of MammaPrint on adjuvant treatment decisions and to analyze the agreement in treatment decisions between hospitals from 4 European countries for the same patient cohort. METHODS: Breast cancer patients were prospectively enrolled and MammaPrint was assessed. Patients' clinical data without and then with MammaPrint results were sent to the different multidisciplinary teams and treatment advice was provided for each patient. RESULTS: Using MammaPrint, chemotherapy treatment advice for ER+/HER2- breast cancer patients was changed in 37% of patients by the Dutch, 24% by the Belgian, 28% by the Italian and 35% by the Spanish teams. MammaPrint increased the inter-institutional agreement in treatment advice (chemotherapy or no chemotherapy) from 51% to 75%. CONCLUSION: The results of this study indicate that MammaPrint impacts adjuvant chemotherapy recommendation. MammaPrint can decrease inter-institutional and inter-country variability in adjuvant treatment advice for breast cancer patients. [less ▲]

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See detailExpert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Plana, Juan Carlos; Galderisi, Maurizio; Barac, Ana et al

in European heart journal cardiovascular Imaging (2014), 15(10), 1063-93

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See detailL'âgisme et ses conséquences cliniques en oncogériatrie: état des lieux et pistes d'interventions
Schroyen, Sarah ULg; Adam, Stéphane ULg; Jerusalem, Guy ULg et al

in Revue Médicale de Liège (2014), 69(5-6), 395-401

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See detailFinal Overall Survival: Fulvestrant 500 mg vs 250 mg in the Randomized CONFIRM Trial.
Leo, Angelo Di; Jerusalem, Guy ULg; Petruzelka, Lubos et al

in Journal of the National Cancer Institute (2014), 106(1), 337

BACKGROUND: At the time of the initial analysis of overall survival (OS) for the Comparison of Faslodex in Recurrent or Metastatic Breast Cancer (CONFIRM) randomized, double-blind, phase III trial ... [more ▼]

BACKGROUND: At the time of the initial analysis of overall survival (OS) for the Comparison of Faslodex in Recurrent or Metastatic Breast Cancer (CONFIRM) randomized, double-blind, phase III trial, approximately 50% of patients had died. A final analysis of OS was subsequently planned for when 75% of patients had died. METHODS: Patients were randomly assigned 1:1 to fulvestrant 500 mg administered as two 5-mL intramuscular injections on days 0, 14, and 28 and every 28 (+/-3) days thereafter or fulvestrant 250 mg administered as two 5-mL intramuscular injections (one fulvestrant and one placebo [identical in appearance to study drug]) on days 0, 14 (two placebo injections only), and 28 and every 28 (+/-3) days thereafter. OS was analyzed using an unadjusted log-rank test. No adjustments were made for multiplicity. Serious adverse events (SAEs) and best response to subsequent therapy were also reported. All statistical tests were two-sided. RESULTS: In total, 736 women (median age = 61.0 years) were randomly assigned to fulvestrant 500mg (n = 362) or 250mg (n = 374). At the final survival analysis, 554 of 736 (75.3%) patients had died. Median OS was 26.4 months for fulvestrant 500mg and 22.3 months for 250mg (hazard ratio = 0.81; 95% confidence interval = 0.69-0.96; nominal P = .02). There were no clinically important differences in SAE profiles between the treatment groups; no clustering of SAEs could be detected in either treatment group. Type of first subsequent therapy and objective responses to first subsequent therapy were well balanced between the two treatment groups. CONCLUSIONS: In patients with locally advanced or metastatic estrogen receptor-positive breast cancer, fulvestrant 500mg is associated with a 19% reduction in risk of death and a 4.1-month difference in median OS compared with fulvestrant 250mg. Fulvestrant 500mg was well tolerated, and no new safety concerns were identified. [less ▲]

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See detailPhase Ib study of Buparlisib plus Trastuzumab in patients with HER2-positive advanced or metastatic breast cancer that has progressed on Trastuzumab-based therapy.
Saura, Cristina; Bendell, Johanna; Jerusalem, Guy ULg et al

in Clinical cancer research : an official journal of the American Association for Cancer Research (2014), 20(7), 1935-45

PURPOSE: Phosphoinositide 3-kinase (PI3K)/AKT/mTOR pathway activation in patients with HER2-positive (HER2(+)) breast cancer has been implicated in de novo and acquired trastuzumab resistance. The purpose ... [more ▼]

PURPOSE: Phosphoinositide 3-kinase (PI3K)/AKT/mTOR pathway activation in patients with HER2-positive (HER2(+)) breast cancer has been implicated in de novo and acquired trastuzumab resistance. The purpose of this study was to determine the clinical activity of the PI3K inhibitor buparlisib (BKM120) in patients with HER2(+) advanced/metastatic breast cancer resistant to trastuzumab-based therapy. EXPERIMENTAL DESIGN: In the dose-escalation portion of this phase I/II study, patients with trastuzumab-resistant locally advanced or metastatic HER2(+) breast cancer were treated with daily oral doses of buparlisib and weekly intravenous trastuzumab (2 mg/kg). Dose escalation was guided by a Bayesian logistic regression model with overdose control. RESULTS: Of 18 enrolled patients, 17 received buparlisib. One dose-limiting toxicity of grade 3 general weakness was reported at the 100-mg/day dose level (the single-agent maximum tolerated dose) and this dose level was declared the recommended phase II dose (RP2D) of buparlisib in combination with trastuzumab. Common (>25%) adverse events included rash (39%), hyperglycemia (33%), and diarrhea (28%). The pharmacokinetic profile of buparlisib was not affected by its combination with trastuzumab. At the RP2D, there were two (17%) partial responses, 7 (58%) patients had stable disease (>/=6 weeks), and the disease control rate was 75%. Pharmacodynamic studies showed inhibition of the PI3K/AKT/mTOR and RAS/MEK/ERK pathways. CONCLUSIONS: In this patient population, the combination of buparlisib and trastuzumab was well tolerated, and preliminary signs of clinical activity were observed. The phase II portion of this study will further explore the safety and efficacy of this combination at the RP2D. Clin Cancer Res; 20(7); 1935-45. (c)2014 AACR. [less ▲]

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See detailLE DÉFI DU CONTRÔLE LOCAL DANS LE CANCER PULMONAIRE NON A PETITES CELLULES, LOCALEMENT AVANCE, NON OPERABLE
BARTHELEMY, Nicole ULg; LENNERTS, Evelyne ULg; MEYNS, Mia ULg et al

in Revue Médicale de Liège (2014), 69(Supp 1), 75-80

Le cancer broncho-pulmonaire non à petites cellules (CBNPC) est fréquent. Pour près d’un patient sur cinq, au moment du diagnostic, la maladie est déjà localement avancée et inopérable. A ce stade, le ... [more ▼]

Le cancer broncho-pulmonaire non à petites cellules (CBNPC) est fréquent. Pour près d’un patient sur cinq, au moment du diagnostic, la maladie est déjà localement avancée et inopérable. A ce stade, le pronostic de cette affection est mauvais, caractérisé, entre autres, par un taux élevé de réci - dive locale, malgré la chimiothérapie et la radiothérapie. Le but de cette revue est de décrire l’hétérogénéité de ce groupe de patients, de clarifier les modalités de traitement combinant la chimiothérapie et la radiothérapie et de préciser l’intérêt des techniques modernes de radiothérapie pour améliorer le contrôle local [less ▲]

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