Effects of an artificial hypercaloric and hyperproteic feeding on nutritionnal status in post-surgery head and neck cancer patients.
MALHERBE, Christian ; DE FLINES, Jenny ; VERBRUGGE, Anne-Marie et al
Poster (2012, July)Detailed reference viewed: 19 (1 ULg)
Chimiothérapie néoadjuvante dans les cancers "tête et cou"
Piret, Pascal ; Demez, Pierre ; Moreau, Pierre et al
in Revue Médicale de Liège (2010)
Les cancers de la sphère oto-rhino-laryngologique représentent 5 % des cancers et sont assez souvent diagnostiqués à un stade avancé. Leur traitement nécessite une approche multidisciplinaire comprenant ... [more ▼]
Les cancers de la sphère oto-rhino-laryngologique représentent 5 % des cancers et sont assez souvent diagnostiqués à un stade avancé. Leur traitement nécessite une approche multidisciplinaire comprenant la chirurgie, la radiothérapie et/ ou la chimiothérapie. La chimiothérapie permet d'améliorer la survie lorsqu'elle est appliquée en association avec la radiothérapie (6,5% de bénéfice absolu en survie globale) dans les maladies localement avancées. La chimiothérapie d'induction ou néoadjuvante a fait l'objet de nombreuses études, mais n'a jamais clairement montré de bénéfice excepté dans le but d'une préservation laryngée. Les nouveaux schémas de chimiothérapie comprenant un taxane ont fait renaître un intérêt pour le traitement d'induction. Quelques études randomisées ont montré un bénéfice en termes de taux de réponse, survie sans maladie ou survie globale lorsque le docetaxel est associé au cisplatine-5FU. Cependant, le bénéfice de l'ajout d'un traitement d'induction à la radiochimiothérapie concomitante reste controversé. De nouvelles études sont en cours. A l'heure actuelle, la chimiothérapie d'induction n'est recommandée en routine que dans la perspective d'une préservation laryngée. [less ▲]Detailed reference viewed: 79 (5 ULg)
Place des anticorps monoclonaux dans le traitement des tumeurs de la tete et du cou.
Sautois, Brieuc ; Martin, Marie ; Demez, Pierre et al
in Revue Médicale de Liège (2009), 64(5-6), 284-6
Monoclonal antibodies are now part of the armamentarium available for the treatment of head and neck cancer. Cetuximab, a monoclonal antibody targeting EGFR, improves overall survival as compared with ... [more ▼]
Monoclonal antibodies are now part of the armamentarium available for the treatment of head and neck cancer. Cetuximab, a monoclonal antibody targeting EGFR, improves overall survival as compared with radiotherapy alone as radical treatment of locally advanced head and neck cancer. It is now reimbursed in Belgium after multidisciplinary discussion if cisplatin is contra-indicated. In the metastatic setting adding cetuximab to platinum based chemotherapy improves overall survival as compared with chemotherapy alone, a first-time event over a 30-year period, unfortunately not yet accessible to the Belgian patients. Other monoclonal antibodies targeting EGFR or VEGF are also currently under investigation while cetuximab is being explored in the induction, the maintenance or the post-operative radiotherapy settings. [less ▲]Detailed reference viewed: 58 (7 ULg)
Perception of head and neck cancer quality of life within the medical world: a multicultural study.
Demez, Pierre ; Moreau, Pierre
in Head & Neck (2009), 31(8), 1056-67
BACKGROUND: Physician's perception of quality of life of patients with cancer is unclear. No reports have evaluated its influence on patient management. METHODS: Five hundred otolaryngologists completed a ... [more ▼]
BACKGROUND: Physician's perception of quality of life of patients with cancer is unclear. No reports have evaluated its influence on patient management. METHODS: Five hundred otolaryngologists completed a questionnaire regarding the quality of life of patients with head and neck cancer. RESULTS: Seventy-eight percent of responders thought that quality of life must be considered when choosing treatment, even if this meant decreased survival. Seventy-five percent thought it justified to withhold curative treatment if this would lead to impaired quality of life. Pain and breathing were the most important symptoms to consider. The perception was worse for physicians practicing in Latin culture, working in private practice, or with no personal acquaintance with a head and neck cancer victim and was better after radiotherapy than after surgery and chemotherapy. CONCLUSION: Quality of life is important for physicians and is considered as essential as survival by many physicians. The perception of patient's quality of life influences the treatment choice. [less ▲]Detailed reference viewed: 27 (4 ULg)
Les tumeurs de la sphere ORL: standards de traitement et nouvelles approches en radiotherapie.
Coucke, Philippe ; Piret, Pascal ; Werenne, Xavier et al
in Revue Médicale de Liège (2008), 63(3), 141-8
We intend to review the general value of radiotherapy in the management of head and neck cancer. Our aim is to define a treatment protocol which is evidence-based and therefore of use in daily clinical ... [more ▼]
We intend to review the general value of radiotherapy in the management of head and neck cancer. Our aim is to define a treatment protocol which is evidence-based and therefore of use in daily clinical practice. There is general agreement on the efficacy of the concomitant schedules combining radiotherapy and chemotherapy, both in the adjuvant setting as well as in the exclusive non-surgical approach. This however does not preclude further research aiming at optimizing the therapeutic index. As far as neoadjuvant chemotherapy is concerned, applied prior to radical local treatment, there are no conclusive data available which allows us to implement this treatment option in routine clinical practice. This approach deserves further investigations and patients should be entered in well designed prospective randomized trials. [less ▲]Detailed reference viewed: 132 (16 ULg)
La loi Onkelinx du 26 avril 2007 modifiant le Code judiciaire en vue de lutter contre l'arriéré judiciaire
Georges, Frédéric ; de Leval, Georges ; Moreau, Pierre
in Le droit judiciaire en mutation (2007)Detailed reference viewed: 62 (5 ULg)
Whole-body tumor imaging using PET and 2-F-18-fluoro-L-tyrosine : Preliminary evaluation and comparison with F-18-FDG
Hustinx, Roland ; Lemaire, Christian ; Jerusalem, Guy et al
in Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine (2003), 44(4), 533-539
18F-FDG PET imaging is now established as a valuable tool for evaluating cancer patients. However, a limitation of 18F-FDG is its absence of specificity for tumor. Both protein synthesis and amino acid ... [more ▼]
18F-FDG PET imaging is now established as a valuable tool for evaluating cancer patients. However, a limitation of 18F-FDG is its absence of specificity for tumor. Both protein synthesis and amino acid transport are enhanced in most tumor cells, but their metabolism is less affected in inflammation. We therefore decided to evaluate the ability of PET with 2-18F-fluoro-L-tyrosine (18F-TYR) to visualize cancer lesions in patients compared with 18F-FDG PET. Methods: 18F-FDG PET and 18F-TYR PET were performed on 23 patients with histologically proven malignancies (11 non-small cell lung cancers (NSCLCs), 10 lymphomas, and 2 head and neck carcinomas). Fully corrected, whole-body PET studies were obtained on separate days. 18F-FDG studies were performed after routine clinical fashion. 18F-TYR studies were started 36 ± 6 min after tracer injection and a second scan centered over a reference lesion was acquired after completion of the whole-body survey-on average, 87 min after injection. Standardized uptake values (SUVs) were calculated for all abnormal foci and for various normal structures. Results were compared with pathologic or correlative studies. Results: 18F-FDG PET correctly identified 54 malignant lesions, among which 36 were also visualized with 18F-TYR (67%). 18F-TYR did not detect any additional lesion. Tumor SUVs (SUVbw, 5.2 vs. 2.5), tumor-to-muscle (7.4 vs. 2.7), and tumor-to-mediastinum activity ratios (3 vs. 1.4) were higher with 18F-FDG than with 18F-TYR. Two of 11 NSCLCs and 4 of 10 lymphomas were understaged with 18F-TYR compared with 18F-FDG. Although the NSCLC lesions missed by 18F-TYR PET were small, several large lymphoma lesions did not accumulate the tracer. In 4 patients, 18F-TYR-positive lesions coexisted with 18F-TYR-negative lesions. There was a high physiologic 18F-TYR uptake by the pancreas (average SUVbw, 10.3) and the liver (average SUVbw, 6.3). Muscle and bone marrow uptakes were also higher with 18F-TYR than with 18F-FDG: average SUVbw, 1 versus 0.7 and 2.6 versus 1.8, respectively. There was no change over time in the 18F-TYR uptake by the tumors or the normal structures. Conclusion: 18F-TYR PET is not superior to 18F-FDG PET for staging patients with NSCLC and lymphomas. [less ▲]Detailed reference viewed: 88 (5 ULg)
18fdg-Pet for the Assessment of Primary Head and Neck Tumors: Clinical, Computed Tomography, and Histopathological Correlation in 38 Patients
; ; et al
in Laryngoscope (1998), 108(10), 1578-83
OBJECTIVES: To evaluate the clinical usefulness of FDG-PET (fluoro-2-deoxy-glucose-positron emission tomography) in the detection of lymph node involvement and recurrences in patients with head and neck ... [more ▼]
OBJECTIVES: To evaluate the clinical usefulness of FDG-PET (fluoro-2-deoxy-glucose-positron emission tomography) in the detection of lymph node involvement and recurrences in patients with head and neck cancer. STUDY DESIGN: Retrospective review of 38 patients with biopsy-proven head and neck cancers who underwent clinical, computed tomography (CT), and FDG-PET examinations. Twenty-five patients were studied prior to therapy and 13 patients were evaluated for disease recurrence. METHODS: All patients were operated and clinical data, CT, and FDG-PET results were correlated with histopathological findings. RESULTS: All primary tumors in 25 patients were detected, with the exception of one small superficial localization of the epiglottis. Histopathological examination showed lymph node involvement in 10 patients; PET detected lymph node involvement in five. FDG-PET found one case of nodal disease not identified by clinical and CT examination. With so few cases, this could be anecdotal. Five false-negative results (microscopic lymph node involvement) and two false positives were noted. Twelve of 13 patients with recurrent disease were correctly identified with FDG-PET. FDG-PET was the only imaging technique to identify local recurrence in two patients and lymph node involvement in two others. One false-positive result occurred in a patient with a foreign body granuloma. CONCLUSIONS: FDG-PET is a useful diagnostic modality for the detection of recurrent tumors and, in selected cases, precise lymph node involvement. The best way to further investigate the utility of clinical FDG-PET is in the follow-up of treated patients. [less ▲]Detailed reference viewed: 36 (1 ULg)