References of "Nickers, Philippe"
     in
Bookmark and Share    
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 82 (4 ULg)
Full Text
Peer Reviewed
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

Detailed reference viewed: 41 (7 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 98 (12 ULg)
Full Text
Peer Reviewed
See detailPrognostic value of PSA nadir < or =4 ng/ml within 4 months of high-dose radiotherapy for locally advanced prostate cancer
Nickers, Philippe ULg; Albert, Adelin ULg; Waltregny, David ULg et al

in International Journal of Radiation, Oncology, Biology, Physics (2006), 65(1), 73-77

PURPOSE: To investigate early prostate-specific antigen (PSA) kinetics after high radiation doses of 85 Gy on locally advanced prostate cancer. METHODS AND MATERIALS: A total of 201 patients were ... [more ▼]

PURPOSE: To investigate early prostate-specific antigen (PSA) kinetics after high radiation doses of 85 Gy on locally advanced prostate cancer. METHODS AND MATERIALS: A total of 201 patients were prospectively and consecutively treated with external beam radiotherapy and a brachytherapy boost. Of the 201 patients, 104 received concomitant hormonal therapy on the decision of the referring urologist and were excluded, yielding a study population of 97 patients. The first posttreatment PSA analysis was performed not earlier than 1 month after treatment completion but within the first 4 months, and then every 4 months. Analysis of PSA kinetics included the PSA nadir (nPSA) at values of < or =4 ng/mL to < or =0.5 ng/mL. The nPSA at < or =4 ng/mL within 4 months (nPSA < or =4/4m) was the variable of interest. RESULTS: We established highly significant associations between an nPSA of < or =1 and < or =0.5 ng/mL and the nPSA < or =4/4m (p <0.0001). A hazard ratio of 0.33 (95% Confidence Interval (CI), 0.12-0.91) underlined the lower risk of recurrence related to nPSA < or =4/4m achievement (p = 0.033). Using time-dependent covariate models for patients who did not reach an nPSA < or =4/4m, an nPSA of < or =1 ng/mL remained without prognostic significance (p = 0.06). However, for patients who reached an nPSA < or =4/4m, an nPSA of < or =1 ng/mL did significantly improve the prognosis (p <0.001), but much later after treatment. The same analysis was repeated for nPSA < or =0.5 ng/mL with similar conclusions as when nPSA < or =4/4m was obtained (p <0.01). CONCLUSION: The nPSA < or =4/4m has been demonstrated to be a significant predictor of biochemical no evidence of disease after high radiation doses of 85 Gy. Its major advantage is that it was available earlier than the other nadirs. [less ▲]

Detailed reference viewed: 102 (3 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 64 (7 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 148 (13 ULg)
Full Text
Peer Reviewed
See detailContribution of whole-body (18)FDG PET imaging in the management of cervical cancer
Belhocine, T.; Thille, Alain ULg; Fridman, Viviana ULg et al

in Gynecologic Oncology (2002), 87(1), 90-97

OBJECTIVE: The objective of this study was to assess the contribution of [(18)F]fluoro-2-deoxy-D-glucose positron emission tomography ((18)FDG PET) imaging in the management of cervical cancer. METHODS ... [more ▼]

OBJECTIVE: The objective of this study was to assess the contribution of [(18)F]fluoro-2-deoxy-D-glucose positron emission tomography ((18)FDG PET) imaging in the management of cervical cancer. METHODS: Fully corrected whole-body PET was performed in 60 patients (pts) with proven cervical cancer. In pretreatment staging, 22 pts underwent PET in addition to routine protocol including International Federation of Obstetrics and Gynecology (FIGO) staging and pelvic magnetic resonance imaging (MRI). Eighteen of them had pelvic lymphadenectomy. After treatment, PET was performed in 38 pts routinely followed up by clinical and radiological examinations. Results of PET and routine protocols were compared to final diagnoses, including histological findings in 31 pts and clinical outcomes in the other cases. Median follow-up time was 12 +/- 7.3 months. RESULTS: In all but 2 patients (FIGO stage IA), both PET and MRI detected the primary tumor. In 6 pts, MRI alone noted loco-regional tumor spread but PET localized 9 unsuspected extrapelvic nodal sites (6 para-aortic, 2 mediastinal, and 1 supra-clavicular). However, PET missed 8 microscopic pelvic nodal metastases. In 18% of the patients, PET staging significantly influenced the treatment choices. In follow-up, PET accurately diagnosed a recurrent disease in 13 pts with falsely negative or equivocal conventional imaging (CI). Ten patients with a negative PET were still in complete remission after a minimal follow-up time of 12 months. Overall, the agreement of PET with final diagnosis was significantly better than that of routine protocol (P < 0.05). CONCLUSIONS: Whole-body (18)FDG PET appears useful in the management of cervical cancer, in particular for staging extrapelvic metastases or optimally detecting a recurrence. MRI is better indicated for evaluating the loco-regional status of the disease. [less ▲]

Detailed reference viewed: 22 (1 ULg)
Full Text
Peer Reviewed
See detailPSA kinetics after external beam radiotherapy alone or combined with an iridium brachytherapy boost to deliver 85 grays to prostatic adenocarcinoma.
Nickers, Philippe ULg; Coppens, Luc ULg; Beauduin, M. et al

in Strahlentherapie und Onkologie (2001), 177(2), 90-5

PURPOSE: Increasing the dose to prostatic adenocarcinoma in conformal external beam therapy (EBT) has resulted in increased levels of PSA normalization and increased percentage of biochemical disease-free ... [more ▼]

PURPOSE: Increasing the dose to prostatic adenocarcinoma in conformal external beam therapy (EBT) has resulted in increased levels of PSA normalization and increased percentage of biochemical disease-free survival rates. However technical problems due to prostate motion inside the pelvis or patients' set-up make difficult the realization of the EBT boost fields above 72 Gy. Brachytherapy which overcomes these problems was investigated to deliver the boost dose to achieve 85 Gy. PSA nadir which has been identified as the strongest independent predictor of any failure in many studies has been used as the end point for early evaluation of this work. PATIENTS AND METHODS: In a retrospective way we report on 163 patients' PSA kinetics after EBT alone to 68 Gy or EBT first and a brachytherapy boost up to 75 or 85 Gy. RESULTS: At 12 months follow-up, PSA nadirs percentage < or = 0.5 or < or = 1 ng/ml increased from 7.5 and 20.7% after 68 Gy EBT to 49.8 and 71.2% after a brachytherapy boost to deliver 85 Gy (p < 0.0001). In the Cox PH model analysis, the total dose remained the most important factor for predicting PSA normalization. CONCLUSIONS: These results are in accordance with the most recent results published after conformal EBT at the same 80 Gy level of dose. If confirmed on a higher number of patients they could place brachytherapy among the most accurate methods of boosting in the radiation treatment of prostatic carcinoma. [less ▲]

Detailed reference viewed: 30 (4 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 129 (4 ULg)