BJMO - volume 13, issue 6, october 2019
P. Ost MD, PhD, D. Schrijvers MD, PhD, L. Duck MD, PhD, M. Gizzi MD, K. Goffin MD, PhD, S. Joniau MD, PhD, S. Rottey MD, PhD, T. Roumeguère MD, E. Seront MD, PhD, N. Withofs MD, PhD, B. Tombal MD, PhD
The treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) has changed dramatically with the approval of a variety of therapeutic agents including abiraterone acetate, cabazitaxel, docetaxel, enzalutamide and radium-223 dichloride and the introduction of docetaxel and abiraterone acetate in combination with androgen deprivation therapy in newly diagnosed metastatic prostate cancer. Evidence on the optimal sequence of these therapies is scarce. In practice, the most appropriate treatment (sequence) depends on patient and disease characteristics. This article summarises the recommendations of a multidisciplinary group of Belgian experts in sequencing treatments for patients with mCRPC, with a focus on radium-223 dichloride.
(BELG J MED ONCOL 2019;13(6): 240–250)
Read moreBJMO - volume 13, issue 4, june 2019
Q. Binet MD, L. Duck MD, PhD
Malignant bowel obstruction is the clinical and imaging evidence of bowel obstruction beyond the ligament of Treitz in the setting of an incurable cancer with intraperitoneal spread. A multi-detector computed tomography scan with multiplanar reconstructions is the gold standard for diagnosis confirmation and treatment orientation. Treatment is challenging and can either be surgical, endoscopic or most likely medical. In the following manuscript, we discuss the current place of each treatment modality in end-stage malignant bowel obstruction management.
(BELG J MED ONCOL 2019;13(4):123–128)
Read moreBJMO - volume 12, issue 3, may 2018
S. Demartin , L. Duck MD, PhD, L. Carestia , T. Connerotte , R. Poncin MD, N. Whenham MD
This review proposes to go through reasonable systemic therapy options in brain metastases, notably immune checkpoint inhibitors and oncogen-driven targeted therapies. We deliberately focus on drugs currently available in Belgium in clinical practice. In the large majority of cases, clinical trials – in particular registration trials – exclude patients with brain metastases. Therefore we have to deal with small size non-randomised phase II trials or retrospective analysis with the known caveats of highly selected patients and numerous biases.
(BELG J MED ONCOL 2018:12(3):96–102)
Read moreBJMO - volume 11, issue 1, february 2017
C. Quaghebeur MD, N. Whenham MD, J.P. Machiels MD, PhD, J-P. Haxhe MD, A-P. Schillings MD, E. Laterre MD, X. Catteau MD, R. Poncin MD, L. Duck MD, PhD
Breast phyllodes tumours account for less than 0.5% of breast tumours, their diagnosis is therefore often made after pathological exam. They are fibroepithelial lesions of the breast, and are classified as benign, borderline or malignant. For malignant phyllodes tumours, aggressive behaviour with risk of local and distant recurrence may be seen. Therefore, at least one centimetre free-margins, or mastectomy, should be preferred for local malignant tumours. No prospective randomised data exist to elucidate the role of adjuvant chemotherapy, but radiotherapy should probably be offered after breast conservative surgery for borderline and malignant tumours. For metastatic disease, there is no standard chemotherapy regimen. Doxorubicin is the main recommended drug, based on scarce data. Palliative surgery or radiotherapy may also be offered. We present here a patient with lung metastatic disease who partially responded to a platin-etoposide regimen after doxorubicin failure, and make a short review of the literature.
(BELG J MED ONCOL 2017;11(1):26–28)
Read moreBJMO - volume 10, issue 2, april 2016
L. Duck MD, PhD, J.F. Baurain MD, PhD, C. Kirkove MD, R. Poncin MD, A. Barbeaux MD, V. Malvaux MD, J-C. Verougstraete MD, J-L. Squifflet MD, PhD, M. Luyckx MD
To date, the main treatment of loco-regional uterine cancer is surgery. The benefit of adjuvant treatment depends on the subtype of cancer, stage, and risk factors. We describe here the current evidence-based data supporting the administration of adjuvant treatment after surgery, with a focus on chemotherapy.
(BELG J MED ONCOL 2016;10(2):63–68)
Read moreBJMO - volume 9, issue 2, may 2015
I. Elalamy MD, PhD, J-L. Canon MD, PhD, A. Bols MD, PhD, W. Lybaert MD, L. Duck MD, PhD, K. Jochmans MD, PhD, 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, PhD, 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)
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