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. Patterns of increased metabolism were recorded according to the involved locations: breast, ipsilateral axillary region, internal mammary chain, or distant organs. The end-point for the survival analysis using Cox proportional hazards was disease-free survival. The contribution of prognostic factors was evaluated using the Akaike information criterion and the Nagelkerke index. Results: PET positivity was associated with age, gender, tumour location, tumour size >2 cm, lymphovascular invasion, oestrogen and progesterone receptor status. Among 63 patients with a negative axillary PET status, 56 (88.9%) had three or fewer involved nodes, whereas among 41 patients with a positive axillary PET status, 25 (61.0%) had more than three positive nodes (P < 0.0001). In the survival analysis of preoperative characteristics, PET axillary node positivity was the foremost statistically significant factor associated with decreased disease-free survival (hazard ratio 2.81, 95% CI 1.17-6.74). Conclusion: Preoperative PET axillary node positivity identified patients with a higher burden of nodal involvement, which might be important for treatment decisions in breast cancer patient

A randomised wait-list controlled trial to evaluate Emotional Freedom Techniques for self-reported cancer-related cognitive impairment in cancer survivors (EMOTICON)

Background Cancer-related cognitive impairment (CRCI) is a prevalent source of comprised quality of life in cancer survivors. This study evaluated the efficacy of Emotional Freedom Techniques (EFT) on self-reported CRCI (sr-CRCI). Methods In this prospective multicentre randomised wait-list controlled study (ClinicalTrials.gov Identifier: NCT02771028), eligible cancer survivors had completed curative treatment, were 18 years or older and screened positive for sr-CRCI with ≥ 43 on the Cognitive Failures Questionnaire (CFQ). Participants were randomised to the immediate treatment group (ITG) or wait-list control (WLC) group, based on age (< or ≥ 65 years), gender, treatment (chemotherapy or not), and centre. The ITG started to apply EFT after inclusion and performed this for 16 weeks. The WLC group could only start the application of EFT after 8 weeks of waiting. Evaluations took place at baseline (T0), 8 weeks (T1) and 16 weeks (T2). The primary outcome was the proportion of patients with sr-CRCI according to the CFQ score. Findings Between October 2016 and March 2020, 121 patients were recruited with CFQ ≥ 43 indicating sr-CRCI. At T1, the number of patients scoring positive on the CFQ was significantly reduced in the ITG compared to the WLC group (40.8% vs. 87.3% respectively; p<0.01). For the WLC group, a reduction in CFQ scores was observed at T2, comparable to the effect of the ITG at T1. Linear mixed model analyses indicated a statistically significant reduction in the CFQ score, distress, depressive symptoms, fatigue and also an improvement in quality of life. Interpretation This study provides evidence for the application of EFT for sr-CRCI in cancer survivors and suggests that EFT may be useful for other symptoms in cancer survivors

Selective serotonin reuptake inhibitors in the treatment of generalized anxiety disorder

Selective serotonin reuptake inhibitors have proven efficacy in the treatment of panic disorder, obsessive–compulsive disorder, post-traumatic stress disorder and social anxiety disorder. Accumulating data shows that selective serotonin reuptake inhibitor treatment can also be efficacious in patients with generalized anxiety disorder. This review summarizes the findings of randomized controlled trials of selective serotonin reuptake inhibitor treatment for generalized anxiety disorder, examines the strengths and weaknesses of other therapeutic approaches and considers potential new treatments for patients with this chronic and disabling anxiety disorder

Reprogramming of endothelial gene expression by tamoxifen inhibits angiogenesis and ERα-negative tumor growth.

peer reviewedRationale: 17β-estradiol (E2) can directly promote the growth of ERα-negative cancer cells through activation of endothelial ERα in the tumor microenvironment, thereby increasing a normalized tumor angiogenesis. ERα acts as a transcription factor through its nuclear transcriptional AF-1 and AF-2 transactivation functions, but membrane ERα plays also an important role in endothelium. The present study aims to decipher the respective roles of these two pathways in ERα-negative tumor growth. Moreover, we delineate the actions of tamoxifen, a Selective Estrogen Receptor Modulator (SERM) in ERα-negative tumors growth and angiogenesis, since we recently demonstrated that tamoxifen impacts vasculature functions through complex modulation of ERα activity. Methods: ERα-negative B16K1 cancer cells were grafted into immunocompetent mice mutated for ERα-subfunctions and tumor growths were analyzed in these different models in response to E2 and/or tamoxifen treatment. Furthermore, RNA sequencings were analyzed in endothelial cells in response to these different treatments and validated by RT-qPCR and western blot. Results: We demonstrate that both nuclear and membrane ERα actions are required for the pro-tumoral effects of E2, while tamoxifen totally abrogates the E2-induced in vivo tumor growth, through inhibition of angiogenesis but promotion of vessel normalization. RNA sequencing indicates that tamoxifen inhibits the E2-induced genes, but also initiates a specific transcriptional program that especially regulates angiogenic genes and differentially regulates glycolysis, oxidative phosphorylation and inflammatory responses in endothelial cells. Conclusion: These findings provide evidence that tamoxifen specifically inhibits angiogenesis through a reprogramming of endothelial gene expression via regulation of some transcription factors, that could open new promising strategies to manage cancer therapies affecting the tumor microenvironment of ERα-negative tumors

Editorial: Supportive care in cancer patients: a constantly evolving field

SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Elaboration et caractérisation par le procédé sol-gel d'architectures d'électrodes de nickelates de lanthane sous forme de films minces (inférieurs à 1 micron) (application pile à combustible à oxyde solide fonctionnant à température intermédiaire)

TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF

Adjuvant and neoadjuvant chemotherapy regimens in breast cancer: Summary from the BSMO breast cancer task force meeting

Knowledge on adjuvant and neoadjuvant chemotherapy regimens in breast cancer is increasing rapidly. Many different regimens are available: some have been compared with each other, but still many questions remain to be answered. At the breast cancer task force meeting of the Belgian Society of Medical Oncology (BSMO) in Brussels, on February 21st 2014, 41 medical oncologists involved in breast cancer management reviewed the most important recent data. The task force discussed a framework for regimen selection in clinical practice. The authors of this paper summarised the literature and meeting discussion, highlighting controversial areas.http://www.ariez.nl/DownloadFile.lynkx?guid=ebf20a3b-511c-48bc-b1ed-332edf53f14a.info:eu-repo/semantics/publishe

Savene® (dexrazoxane) use in clinical practice

Introduction Anthracycline extravasation (ACEV) is a rare but potentially devastating event which can result in severe injuries including ulceration and necrosis, slow-healing lesions, serious joint damage and permanent disfigurement. It can delay further scheduled chemotherapy and affect cancer treatment outcome. Savene (R) (dexrazoxane) is the only approved antidote for ACEV in Europe (Totect (R) in the USA) and is administered by intravenous infusion. Its efficacy has been demonstrated in clinical trials with biopsy-verified ACEV with a 98% success rate (no need for surgical debridement) allowing for immediate continuation of chemotherapy in 71% of patients. Adverse events, mainly haematological toxicity, were rapidly reversible. The objective of the study was to assess, in clinical practice, the efficacy and safety profile of Savene (R) for ACEV in different Belgian hospitals. Patients and methods A survey of Savene (R) use was conducted in Belgium from 2007 to 2010 by using a questionnaire sent to 44 hospitals. Main results Data were obtained for 41 cancer patients, 68% (28/41) had ACEV from central venous catheters. Surgical debridement due to ACEV could be avoided in 26 out of 28 extravasations from a central venous access and in 95% (39/41) of the total population treated with Savene (R). Planned chemotherapy was maintained in 73% (30/41) of patients. Eight adverse events were reported in four patients treated with Savene (R), six events were assessed to be of common toxicity criteria grades 1-2 (nausea, leucopenia and arm pain) and two events (neutropenia and pancytopenia) were assessed to be grade 3. Conclusion These data are comparable with the data from previous clinical trials and confirm the efficacy and safety profile of Savene (R) in clinical practice for the treatment of anthracycline extravasation, including extravasations from central venous catheters

NIDCAP renforcé pour améliorer la prévention des troubles de l’oralité en néonatologie :résultats du projet PARENTALIM

Introduction et objectif : Améliorer la prévention des risques de troubles de l’oralité reste essentielpour limiter les conséquences néfastes sur la prise alimentaire, la relation parents-nouveau-néprématuré, et sur leur développement somatique, socio-émotionnel, verbal et cognitif. En effet, prèsde 40% des enfants nés prématurés manifestent encore de telles conséquences à l’âge de 5 ans et leurprise en charge reste longue et coûteuse. L‘application de protocoles standardisés de de stimulationsoro-faciales (SOF) est controversée aujourd’hui. De plus, les études ne prennent pas en compte lecumul des risques individuels. L’objectif de cette étude est donc de comparer l’efficacité d’unrenforcement du NIDCAP par un accompagnement parental individualisé centré sur l’oralité(PARENTALIM) et d’un protocole de SOF, tout en tenant compte du cumul de risques périnataux.Participants, matériel et méthode : Une étude observationnelle monocentrique a été menée auprèsde deux groupes d’enfants. Un groupe (n=15) a bénéficié d’un renforcement du NIDCAP parPARENTALIM, incluant 5 entretiens orthophoniques individualisés étayés d’un livret centré sur lessoins de développement. Un groupe rétrospectif (n=28), a bénéficié de SOF. Pour chaque participant,ont été relevés, l’âge corrigé à autonomie alimentaire (AcAA) en semaines d’aménorrhée et l’indice derisque périnatal (IRPO), s’appuyant un inventaire (Sheiner et Sexton, 1991). Le rapport AcAA/IRPO aété considéré comme critère de jugement.Résultats : Le test U de Mann-Whitney révèle une différence intergroupe significative (p<0,01). Parcomparaison aux enfants stimulés par SOF, les enfants intégrés dans une prévention couplant NIDCAPet PARENTALIM deviennent autonomes plus précocement malgré le cumul de risques périnataux etmanifestent une moindre variabilité interindividuelles du rapport AcAA/IRPO.Conclusions : Ainsi, le renforcement du NIDCAP par accompagnement PARENTALIM favorise un accèsà l’autonomie alimentaire plus précoce malgré les risques périnataux par comparaison aux SOF. Lesuivi sur plusieurs années d’une cohorte émanant de plusieurs centres s’avère nécessaire pour évaluerles bénéfices à long terme de cette intervention précoce de prévention