Evaluating pain management practices for cancer patients among health professionals in cancer and supportive/palliative care units: a Belgian survey.

Background: Pain is reported in 66% of cancer patients with advanced disease. Adequate pain management is a cornerstone of comprehensive supportive cancer care.

Purpose: The purpose of this study was to assess pain management in Oncology Units in Belgium.

Pre-OPerative accelerated radiotherapy for early stage breast cancer patients (POPART): A feasibility study.

Pre-operative 5-fraction breast radiotherapy followed by immediate breast-sparing surgery and sentinel node procedure was feasible in 14 patients with 15 clinical early-stage breast cancers. However wound problems occurred frequently and was documented in 5 of the 14 patients: 2 patients with a mastitis needing antibiotics, 2 patients developed a fistula with exudate needing antibiotics and local disinfection and 1 patient developed a fistula needing surgical reintervention. Other acute and late iatrogenic events were rather limited.

Localized Fournier's Gangrene in "End-Stage" Renal Failure: Multidisciplinary Approach and Integration of Palliative Care.

. Penile gangrene is a rare entity with significant morbidity and mortality. There are only few case reports of isolated penile Fournier's gangrene in literature.

Randomized Clinical Trial on Reduction of Radiotherapy Dose to the Elective Neck in Head and Neck Squamous Cell Carcinoma: Results on the Quality of Life.

Purpose: A randomized trial was initiated to investigate whether a reduction of the dose to the elective nodal sites would result in less toxicity and improvement in Quality of Life (QoL) without compromising tumor control. This paper aimed to compare QoL in both treatment arms.

Methods: Two-hundred head and neck cancer patients treated with radiotherapy (RT) or chemo-RT were randomized (all stages, mean age: 60 years, M/F: 82%/18%).

Reduction of the dose of radiotherapy to the elective neck in head and neck squamous cell carcinoma; a randomized clinical trial. Effect on late toxicity and tumor control.

Background And Purpose: A multi-center prospective randomized clinical trial has been performed investigating whether a reduction of the dose to the elective nodal sites in head and neck cancer delivered by intensity modulated radiotherapy (IMRT) would result in a reduction of late side effects without compromising tumor control.

Materials And Methods: Two hundred patients were included. The prescription dose to the elective nodal volumes was a normalized iso-effective dose in 2Gy fractions (NID) of 50Gy in the standard arm and of 40Gy in the experimental arm.

HPV-related oropharyngeal cancers in Flanders (Belgium): a multicenter study.

Introduction: Human papilloma virus (HPV) was recently reported to play a major role in oropharyngeal carcinoma. Large geographical differences in the disease prevalence have been described. Until now, no data have been reported for Flanders (Belgium).

Reduction of the dose to the elective neck in head and neck squamous cell carcinoma, a randomized clinical trial using intensity modulated radiotherapy (IMRT). Dosimetrical analysis and effect on acute toxicity.

Background And Purpose: A randomized trial was initiated to investigate whether a reduction of the dose to the elective nodal sites and the swallowing apparatus delivered by IMRT would result in a reduction of acute and late side effects without compromising tumor control. The aim of this paper is to report on dosimetrical analysis and acute toxicity.

Materials & Methods: Two-hundred patients were randomized.

Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy.

Background: Health-related quality of life (HRQOL) assessment is a key component of clinical oncology trials. However, few breast cancer trials comparing adjuvant conventional radiotherapy (CR) and hypofractionated tomotherapy (TT) have investigated HRQOL. We compared HRQOL in stage I-II breast cancer patients who were randomized to receive either CR or TT.

Early contralateral shoulder-arm morbidity in breast cancer patients enrolled in a randomized trial of post-surgery radiation therapy.

Introduction: Shoulder/arm morbidity is a common complication of breast cancer surgery and radiotherapy (RT), but little is known about acute contralateral morbidity.

Methods: Patients were 118 women enrolled in a RT trial. Arm volume and shoulder mobility were assessed before and 1-3 months after RT.

Parotid gland sparing with helical tomotherapy in head-and-neck cancer.

Purpose: This study evaluated the ability of helical tomotherapy to spare the function of the parotid glands in patients with head-and-neck cancer by analyzing dose-volume histograms, salivary gland scintigraphy, and quality of life assessment.

Methods And Materials: Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at the University Hospital Brussel were analyzed. During planning, priority was given to planning target volume (PTV) coverage: ≥ 95% of the dose must be delivered to ≥ 95% of the PTV.

Diagnostic and prognostic correlates of preoperative FDG PET for breast cancer.

Purpose: To explore the preoperative utility of FDG PET for the diagnosis and prognosis in a retrospective breast cancer case series.

Methods: In this retrospective study, 104 patients who had undergone a preoperative FDG PET scan for primary breast cancer at the UZ Brussel during the period 2002-2008 were identified. Selection criteria were: histological confirmation, FDG PET performed prior to therapy, and breast surgery integrated into the primary therapy plan.

Scapula alata in early breast cancer patients enrolled in a randomized clinical trial of post-surgery short-course image-guided radiotherapy.

Background: Scapula alata (SA) is a known complication of breast surgery associated with palsy of the serratus anterior, but it is seldom mentioned. We evaluated the risk factors associated with SA and the relationship of SA with ipsilateral shoulder/arm morbidity in a series of patients enrolled in a trial of post-surgery radiotherapy (RT).

Methods: The trial randomized women with completely resected stage I-II breast cancer to short-course image-guided RT, versus conventional RT.

Can 18-FDG-PET during radiotherapy replace post-therapy scanning for detection/demonstration of tumor response in head-and-neck cancer?

Purpose: In routine practice, the tumor response in head-and-neck cancer (HNC) is assessed 3-4 months after radiotherapy (RT). We compared the results of fluorodeoxyglucose-positron emission tomography (FDG-PET) during (47 Gy) and 4 months after RT.

Methods And Materials: In 40 patients with HNC, PET was performed before (PET1), at the end of Week 4 (47 Gy) (PET2), and 4 months after RT (PET3).

Pattern of failure after helical tomotherapy in head and neck cancer.

Background And Purpose: Helical tomotherapy (HT, Hi-Art TomoTherapy(®)) is a recently developed radiation device delivering highly conformal dose with a rotational gantry resulting in more uniform target doses and better avoidance of organs at risk. Treatment failure patterns in head and neck cancer (HNC) patients treated with HT were analyzed.

Patients And Methods: 63 patients with a biopsy-proven HNC were treated with HT.

Can 18F-FDG-PET response during radiotherapy be used as a predictive factor for the outcome of head and neck cancer patients?

Objectives: We investigated if (18F) fluoro-2-deoxy-D-glucose positron emission tomography (F-FDG-PET) during radiotherapy or concurrent chemoradiotherapy adds information about the treatment outcome compared with an FDG-PET study before treatment.

Methods: Forty-three patients with head and neck cancer were treated with helical tomotherapy. F-FDG-PET was performed at baseline and during the treatment after 47 Gy.

Survival benefit with radiation therapy in node-positive breast carcinoma patients.

Background And Purpose: Postoperative radiation therapy (RT) has been the subject of discussion, especially in patients with one to three positive lymph nodes (< or = 3 pN+) in the axillary dissection. The authors investigated whether postoperative RT provides a survival benefit for pT1-2 pN+ breast cancer patients.

Patients And Methods: Patients included were selected from the SEER database (NCI--Surveillance, Epidemiology and End Results, release 2000; n = 24,410) and the UZ Brussel database (1984-2002; n = 1,011) according to the following criteria: women aged 25-95, no previous cancer, unilateral pT1-pT2 breast tumors, total mastectomy (ME) or breast-conserving surgery (BCS), postoperative RT, and an axillary dissection showing at least one pathologic lymph node.

Longitudinal assessment of parotid function in patients receiving tomotherapy for head-and-neck cancer.

Background And Purpose: Conventional radiotherapy is associated with high doses to the salivary glands which causes xerostomia and adverse effects on quality of life. The study aims to investigate the potential of helical tomotherapy (Hi-Art Tomotherapy) to preserve parotid function in head-and-neck cancer patients.

Patients And Methods: Seven consecutive patients treated with helical tomotherapy at the UZ Brussel, Belgium, were included.

An assessment of the use of skin flashes in helical tomotherapy using phantom and in-vivo dosimetry.

Background And Purpose: In helical tomotherapy the nature of the optimizing and planning systems allows the delivery of dose on the skin using a build-up compensating technique (skin flash). However, positioning errors or changes in the patient's contour can influence the correct dosage in these regions. This work studies the behavior of skin-flash regions using phantom and in-vivo dosimetry.

Modeling the effect of age in T1-2 breast cancer using the SEER database.

Background: Modeling the relationship between age and mortality for breast cancer patients may have important prognostic and therapeutic implications.

Methods: Data from 9 registries of the Surveillance, Epidemiology, and End Results Program (SEER) of the United States were used. This study employed proportional hazards to model mortality in women with T1-2 breast cancers.

Statistical interaction in the survival analysis of early breast cancer using registry data: role of breast conserving surgery and radiotherapy.

Purpose: To identify subgroup effects that might influence the survival results of postoperative radiotherapy.

Patients And Methods: Women selected from the Surveillance, Epidemiology, and End Results database, aged 40-69 years, with non-metastasized T1-T2 breast carcinoma, in whom axillary lymph node dissection was performed. Subgroup analyses were performed using proportional hazards models with interactions.

Ratios of involved nodes in early breast cancer.

Introduction: The number of lymph nodes found to be involved in an axillary dissection is among the most powerful prognostic factors in breast cancer, but it is confounded by the number of lymph nodes that have been examined. We investigate an idea that has surfaced recently in the literature (since 1999), namely that the proportion of node-positive lymph nodes (or a function thereof) is a much better predictor of survival than the number of excised and node-positive lymph nodes, alone or together.

Methods: The data were abstracted from 83,686 cases registered in the Surveillance, Epidemiology, and End Results (SEER) program of women diagnosed with nonmetastatic T1-T2 primary breast carcinoma between 1988 and 1997, in whom axillary node dissection was performed.

The lymph node ratio as prognostic factor in node-positive breast cancer.

Background And Purpose: The clinical records of the node-positive breast cancer patients treated at our department were reviewed, to evaluate if there is a correlation between the ratio of involved axillary lymph nodes and the overall and cause specific survival.

Patients And Methods: From 1984 until July 2001, 2073 files from patients with an invasive breast carcinoma were submitted to retrospective analyses. In 810 cases, a node positive status was diagnosed.