BJMO - volume 9, issue 3, july 2015
D. De Ruysscher MD, PhD, W. de Neve MD, PhD
Heavy ion therapy is an emerging technique in radiotherapy. It provides highly conformal dose distributions compared to those currently used with photons. These superior beam properties allow increasing the target dose without enhancing the dose to critical structures and/or offer the possibility to reduce the dose to critical structures without compromising the dose to the target. Proton therapy infrastructure is being implemented and carbon or other ion therapy, which, in addition to its physical conformity is also biologically very attractive, has become available as well.
(BELG J MED ONCOL 2015;9(3):87–94)
Read moreBJMO - volume 9, issue 2, may 2015
I. Elalamy MD, PhD, J-L. Canon MD, A. Bols MD, PhD, W. Lybaert MD, L. Duck MD, K. Jochmans MD, L. Bosquée MD, PhD, M. Peeters MD, PhD, A. Awada MD, PhD, P. Clement MD, PhD, S. Holbrechts MD, PhD, J-F. Baurain MD, PhD, J. Mebis MD, J. Nortier MD, PhD
Venous thromboembolism is a frequent cause of mortality and morbidity in patients with malignancy. Thrombosis is one of the leading causes of death in patients with malignancy after cancer itself. As such, prompt recognition and treatment of venous thromboembolism are required in order to reduce the risk of venous thromboembolism-related mortality. This report reviews the interrelationship between cancer, renal insufficiency and venous thromboembolism. The working group behind this review article concludes that low molecular weight heparins decrease the risk of recurrent venous thrombosis in cancer patients without increasing major bleeding complications. Low molecular weight heparins are therefore recommended as first line antithrombotic treatment in cancer patients with a clear clinical benefit. In patients with renal dysfunction, who are at increased risk of bleeding and of thrombotic complications, preference should be given to unfractionated heparin or a low molecular weight heparin with a mean molecular weight such as tinzaparin, having less risk of plasma accumulation and offering the possibility to maintain full therapeutic dose.
(BELG J MED ONCOL 2015;9(2):53–60)
Read moreBJMO - volume 9, issue 2, may 2015
D. Schrijvers MD, PhD
The androgen receptor plays a role as a nuclear transcription factor after activation by its ligands. It is an essential component in the development and progression of prostate cancer. The different factors that play a role in relation to the androgen receptor and prostate cancer are discussed. The different treatment strategies in relation to prostate cancer are addressed.
(BELG J MED ONCOL 2015;9(2):61–4)
Read moreBJMO - volume 9, issue 1, february 2015
W. Den Hengst MD, J. Hendriks MD, PhD, F. Lardon PhD, P. Van Schil MD, PhD
The golden standard for the treatment of lung metastases remains complete surgical resection. Prognostic factors for patients with lung metastases are histology, number of metastases and disease-free interval. However, the chance of recurrent disease in the treated lung remains high after complete resection, even in combination with systemic chemotherapy. Systemic toxicity limits the dose of the latter, resulting in only limited local pulmonary control. Therefore, new techniques are developed to deliver a high-dose of chemotherapy selectively into the lung, reducing the risk of systemic toxicity. One of these techniques is isolated lung perfusion, which is comparable with isolated limb perfusion. This experimental surgical technique allows delivery of a very high-dose of chemotherapy with or without biological response modifiers to the lung, without the risk of systemic exposure. Experimental studies with this technique have shown its superiority in achieving higher tissue concentrations of chemotherapy in the target organ as well as improved survival in comparison with systemic chemotherapy. As shown in several phase I studies, this technique is technically feasible with minimal morbidity and minimal impact on pulmonary function. In a recent phase II study, an improved local pulmonary control was found in comparison with the literature. This review discusses the current status of isolated lung perfusion as well as newer, less invasive techniques to deliver high-dose chemotherapy selectively to the lung.
(BELG J MED ONCOL 2015;9(1):5–10)
Read moreBJMO - volume 9, issue 1, february 2015
E. Zikos MSc, C. Coens MSc, A. Bottomley PhD
A short review on health-related quality of life, including patient reported outcomes measurements in oncology to help increase awareness in the Belgian oncological community. This review is also meant for educational purposes and to highlight the benchmarks that the work of EORTC has contributed to the field.
(BELG J MED ONCOL 2015;9(1):11–15)
Read moreBJMO - volume 8, issue 5, december 2014
B. Hiddinga MD, P. Van Schil MD, PhD, J. Van Meerbeeck MD, PhD
Malignant pleural mesothelioma remains a lethal disease and its incidence is expected to increase until the 2020’s. Disease extent and performance status at diagnosis are the clinical prognostic factors, besides epithelioid subtype which confers a better outcome than the less common sarcomatoid one. Currently, only administration of palliative chemotherapy has a proven impact on outcome. Treatment of early stage malignant pleural mesothelioma should be offered in a multimodality setting, including at least a systemic and a locoregional treatment. The role of radical surgery remains controversial. Optimal treatment schedules are not defined yet. The standard first line palliative treatment consists of platinum in combination with an antifolate, either pemetrexed or raltitrexed. As the outcome in first line remains modest, it is ethical to include these patients in clinical trials comprising a chemotherapy backbone. For maintenance therapy there’s still no standard in malignant pleural mesothelioma. In second line treatment, referral of patients for inclusion in trials is highly recommended.
(BELG J MED ONCOL 2014;8(5):197–205)
Read moreBJMO - volume 8, issue 5, december 2014
F. Cornélis MD, R. Moor , P. Cornette MD, PhD, L. Decoster MD, PhD, H. Wildiers MD, PhD
As in other developed countries, the management of older cancer patients has become a major public health concern in Belgium owing to an increasing incidence and to other challenging specificities of this population. Since 2009, the Cancer Plan has played a leading role in the development of geriatric oncology in our country by supporting numerous pilot projects. By the year 2015, a scientific analysis of each of these projects will provide important information to the public authorities and care givers in order to organise the management of older cancer patients in an optimal way in Belgium. In this article, we describe the present landscape of geriatric oncology in Belgium focusing on epidemiological data and pilot projects supported by the Cancer Plan 2009–2011 and 2012–2015.
(BELG J MED ONCOL 2014;8(5):206–12)
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