Publications by authors named "Nicolas Cote"
Clinical Outcomes, Patterns of Failure, and Salvage Therapies of a Large Modern Cohort of Patients With Anal Squamous Cell Carcinoma Treated With Definitive-Intent Intensity-Modulated Radiation Therapy.
Int J Radiat Oncol Biol Phys
March 2025
Article Synopsis
- Patterns of failure and salvage treatment options for anal squamous cell carcinoma (ASCC) post-definitive IMRT were investigated, revealing limited data on patient outcomes after recurrence.
- A study of 375 ASCC patients showed significant locoregional failure (12%) and distant failure (13%) rates, with 73% progression-free survival and 80% overall survival at six years, emphasizing poorer outcomes for those with locoregional failure.
- Salvage therapies improved survival chances significantly, with 30% of patients alive after ten years, contrasting sharply with those receiving only chemotherapy or supportive care.
Article Synopsis
- New technologies like the adapt-to-position (ATP) workflow on the Unity MR-Linac enhance daily treatment by adapting to variations but complicate the workflow, necessitating effective risk assessment to prevent errors.* -
- A failure modes and effects analysis (FMEA) was conducted as part of a quality management program, involving a multidisciplinary team to identify and address potential failures in the ATP treatment workflow.* -
- Implementing mitigations for high-ranking failure modes improved the workflow's robustness, demonstrating the importance of proactive evaluations in clinical settings.*
Purpose: The purpose of this study was to examine the effect of departmental planning techniques on appropriate in-vivo source tracking error thresholds for high dose rate (HDR) prostate brachytherapy (BT) treatments, and to determine if a single in-vivo source tracking error threshold would be appropriate for the same patient anatomy.
Methods: The prostate, rectum, and urethra were contoured on a single patient transrectal ultrasound (TRUS) dataset. Anonymized DICOM files were disseminated to 16 departments who created an HDR prostate BT treatment plan on the dataset with a prescription dose of 15 Gy in a single fraction.
Purpose To compare cardiac doses of different whole-breast optimization schemes including free-breathing (FB) tangential radiotherapy (TRT), deep-inspiration breath-hold (DIBH) TRT, and FB helical tomotherapy (HT). Methods Early-stage left-sided breast cancer patients who underwent breast-conserving surgery followed by adjuvant radiotherapy were included in the study. Planning images included FB and DIBH CT scans acquired in the same supine treatment position with both arms abducted.
View Article and Find Full Text PDFA 43-year-old premenopausal female presented with a multicentric infiltrating lobular carcinoma of the left breast with axillary nodes metastasis. She underwent modified radical mastectomy with axillary lymph node dissection (level I and II) followed by a mixed autologous latissimus dorsi flap reconstruction with the addition of prosthesis. The final pathological analysis revealed a 6 cm invasive lobular carcinoma pT3N2aM0, grade III/III, estrogen and progesterone positive, human epidermal growth factor receptor 2 (HER2) negative, with 5/16 positive lymph nodes.
View Article and Find Full Text PDFPurpose: An improvement in tissue assignment for low-dose rate brachytherapy (LDRB) patients using more accurate Monte Carlo (MC) dose calculation was accomplished with a metallic artifact reduction (MAR) method specific to dual-energy computed tomography (DECT).
Methods: The proposed MAR algorithm followed a four-step procedure. The first step involved applying a weighted blend of both DECT scans (I H/L) to generate a new image (I Mix).
Purpose: To identify factors associated with decisions to withdraw life-sustaining therapies in patients with severe traumatic brain injury (TBI).
Materials And Methods: We conducted a 2-year multicenter retrospective cohort study (2005-2006) in mechanically ventilated patients aged 16 years and older admitted to the intensive care units (ICUs) of six Canadian level I trauma centers following severe TBI. One hundred and twenty charts were randomly selected at each center (n = 720).