Articles

Traveling the prostate cancer timeline in chase of treatment paradigms: Can we cure the incurable?

BJMO - volume 16, issue 7, november 2022

C. Berghen MD, PhD, S. Joniau MD, PhD, K. Rans MD, G. De Meerleer MD, PhD

SUMMARY

When prostate cancer (PCa) patients are diagnosed as ‘incurable’, most patients still have many years to live and often undergo a continuum of burdensome and expensive systemic treatments that can impair quality of life. Due to the active promotion of new systemic therapies in the treatment of metastatic and/or castrationrefractory PCa patients, other treatment modalities such as modern radiotherapy (RT) have been considered as therapies that relieve symptoms, without offering any possibility of cure or additional quality of life-adjusted life years. This PhD thesis investigated whether the implementation of modern RT in previously non-RT indications could prove otherwise. To achieve this, the PCa timeline was followed in search of treatment paradigms, and re-introduced RT in different disease settings. Firstly, the addition of elective para-aortic lymph node radiotherapy was investigated in patients diagnosed with locally advanced pN1 prostate cancer, with local treatment of the prostate (bed) and pelvic lymph nodes, along with 24 months of ADT, in the prospective multicentric PART study. Secondly, a large retrospective study was performed, focused on patients with oligorecurrent prostate cancer who were treated with metastasis-directed therapy (MDT). Finally, the use of MDT was investigated in patients diagnosed with oligoprogressive metastatic castration-resistant prostate cancer (mCRPC), while continuing otherwise successful ongoing systemic treatment. Will this approach lead to a substantial postponement of next-line systemic treatment (NEST)?

(BELG J MED ONCOL 2022;16(7):363–6)

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Repeated stereotactic body radiotherapy (SBRT) in a patient presenting with oligometastatic prostate cancer while treated with anti-androgens: a case report

BJMO - volume 15, issue 6, october 2021

S. Allaert , M. Bangia , K. Rans MD, C. Berghen MD, PhD, S. Joniau MD, PhD, G. Devos MD, H. Dumez MD, PhD, S. Jentjens MD, PhD, G. De Meerleer MD, PhD

SUMMARY

This case report of an 80-year-old patient, who presented with up to six manifestations of oligorecurrent prostate cancer (PCa) over a time period of nine years, shows that repeated treatment with metastasis directed therapy (MDT) in this setting is feasible and nearly atoxic.

(BELG J MED ONCOL 2021;15(6):325-30)

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Immune Checkpoint Inhibition for metastatic penile cancer: a case report and review of the literature

BJMO - 2020, issue Special, december 2020

K. Dewulf MD, A-S. Van Rompuy MD, PhD, G. De Meerleer MD, PhD, K. Goffin MD, PhD, C. Mai MD, H. erlinde Dumez MD, PhD, M. Albersen MD, PhD

Metastatic penile cancer patients have a poor prognosis of six to twelve months with conventional therapies including surgery, cytotoxic chemotherapy and radiotherapy. We present the promising result of the use of an immune checkpoint inhibitor in a metastatic penile cancer patient. A review of the potential for immuno-therapy in penile cancer is presented.

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Case report of a patient treated locally for bone metastatic renal cell carcinoma

BJMO - volume 13, issue 7, november 2019

C. Soenens MD, G. De Meerleer MD, PhD, M. Albersen MD, PhD, H. Van Poppel MD, PhD, B. Beuselinck MD, PhD

SUMMARY

Based on a case report of a 47-year old male with primary bone metastatic renal cell carcinoma, the current treatment options are reviewed in this article.

(BELG J MED ONCOL 2019;13(7):305–8)

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Highlights of Scientific Summits Meeting

BJMO - volume 12, issue 2, march 2018

M. Waterschoot , B. Hermans , M. Claessens , K. Decaestecker PhD, G. De Meerleer MD, PhD, L. Goeman , S. Joniau MD, PhD

Summary

Since last year a board of respectively three urologists and one radiation oncologist created the ‘Scientific Summits’. This is a scientifically independent Belgian congress for urologists, radiation oncologists, medical oncologists and radiologists with special interest in urology and more specifically in urologic oncology. The aim of Scientific Summits is providing up-to-date scientific information based on the highlights of the most recent international congresses. The 4th edition took place in the charming city of Durbuy, Belgium.

The first day of the meeting focussed on the treatment and prevention of side effects of various anticancer treatments in urologic oncology. Experts in the field shared practical tips and tricks, based on interactive case discussions. They illustrated difficult situations and how to deal with them. On the second day of the meeting, interactive state-of-the-art lectures provided us with up-to-date information on how to evaluate and manage advanced and recurrent prostate cancer.

(BELG J MED ONCOL 2018;12(2):82–85)

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Oligometastatic ovarian cancer successfully treated with stereotactic radiotherapy

BJMO - volume 8, issue 3, july 2014

S. Jeurissen MD, S. Bral MD, PhD, K. Vandecasteele MD, PhD, G. De Meerleer MD, PhD, H. Denys MD, PhD

A 53-year old woman presented with an ovarian cancer, FIGO stage IIIc, for which she received a (suboptimal) debulking. Chemotherapy was started, consisting of three-weekly carboplatin-paclitaxel. After four cycles, an interval-debulking was done, which revealed one positive lymph node (out of 21) located interaortocaval. Chemotherapy was resumed, until seven cycles. She had a complete remission, but after four years, she developed positive mediastinal and interaortocaval lymph nodes. She was treated with stereotactic radiotherapy, which resulted in resolution of the lesions and normalisation of the tumour marker. She has no signs of relapse after nearly two years.

This case illustrates that radiotherapy can be an important treatment option in selected patients with oligometastases.

(BELG J MED ONCOL 2014;8(3):87–90)

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Introducing Intensity-Modulated Arc Therapy in the multimodality treatment of pelvic gynaecological tumours: thinking out of the box

BJMO - volume 7, issue 2, may 2013

K. Vandecasteele MD, PhD, G. De Meerleer MD, PhD

Summary

The need for an efficient, fast technique to irradiate large concave targets lead to the introduction of intensity-modulated arc therapy in the multimodality treatment of pelvic gynaecological tumours. Postoperatively irradiated cervical and endometrial cancer patients benefit by reduced toxicity rates. In locally advanced cervical cancer the use of intensity-modulated arc therapy with a simultaneously integrated boost allows for a safe hysterectomy, resulting in promising control and survival rates. In chemotherapy-resistant ovarian cancer patients with peritoneal carcinomatosis, the use of intensity-modulated arc therapy facilitates a safe whole abdominopelvic irradiation, one of the few effective solutions for patients with bowel obstruction. Continuing efforts should be made to further decrease toxicity and increase response rates and survival in the multimodality treatment of pelvic gynaecological tumours.

(BELG J MED ONCOL 2013;7(2):53–56)

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