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Yvoir, Belgium

Guigay J.,Center Antoine Lacassagne | Guigay J.,CNRS Gustave Roussy Institute | Fayette J.,University of Lyon | Dillies A.F.,Center Jean Perrin | And 9 more authors.
Annals of Oncology | Year: 2015

Background: Cetuximab in combination with platinum and 5-fluorouracil is the standard of care in the first-line treatment of patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC). Cetuximab and taxane combinations have shown promising activity. This study evaluated the efficacy and safety of four cycles of docetaxel associated with cisplatin and cetuximab (TPEx), followed by maintenance with cetuximab every 2 weeks. Patients and methods: Patients with a histologically confirmed HNSCC with metastasis or recurrence unsuitable for locoregional curative treatment received docetaxel and cisplatin (75 mg/m2 both) at day 1 and weekly cetuximab 250 mg/m2 (loading dose of 400 mg/m2), repeated every 21 days for four cycles, followed by maintenance cetuximab 500 mg/m2 every 2 weeks until progression or unacceptable toxicity. Prophylactic administration of granulocyte colony-stimulating factor was done systematically after each chemotherapy cycle. Patients had a good general status (performance status ≤1) and were under 71 years. Prior total doses of cisplatin exceeding 300 mg/m2 were not allowed. The primary end point was objective response rate (ORR) after four cycles. Results: Fifty-four patients were enrolled. The primary end point was met with an ORR of 44.4% (95% CI 30.9-58.6). Median overall and progression-free survivals were, respectively, 14 months (95% CI 11.3-17.3) and 6.2 months (95% CI 5.4-7.2). The most common grade 3/4 adverse events were skin rash (16.6%) and non-febrile neutropenia (20.4%). There were one pulmonary embolism and two infectious events leading to death. Conclusions: The TPEx regimen showed promising activity as first-line treatment in fit patients with recurrent/metastatic HNSCC. Further studies are needed to compare the TPEx versus EXTREME regimen in this population. ClinicalTrial.gov: NCT01289522. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source

Riahi S.,University of Aalborg | Arbelo E.,University of Barcelona | Brugada J.,University of Barcelona | Maggioni A.P.,EURObservational Research Programme | And 9 more authors.
Europace | Year: 2016

Aims Ablation is an effective treatment of symptomatic and drug refractory atrial fibrillation (AF). Using data from the European AF Ablation Pilot Registry comprising 1410 patients from 10 European countries, we prospectively investigated regional differences in AF ablation regarding patient selection, ablation strategy, and outcome. Methods and results Countries were divided into three regions: South (Greece, Italy, Spain), East (Czech Republic, Poland), and West/North (Belgium, Denmark, France, Germany, and the Netherlands). One-year success was defined as patient survival free from atrial arrhythmia, with or without antiarrhythmic drugs (AAD). In all regions, patients were symptomatic and treated extensively with beta-blockers and AAD pre-ablation. Patients in East had more co-morbidity, increased thromboembolic risk, were more likely to have paroxysmal AF, and they underwent more left atrial linear ablations. Adverse events remained within expected levels, albeit with a significantly higher reporting of adverse cardiovascular events in the West/North (4.7 vs. 1.4 and 1.5% in South and East, P = 0.0032). There was no significant difference in peripheral/vascular, neurological, pulmonary, gastrointestinal, or general adverse events. The 1-year success rate after ablation differed non-statistically between regions ranging from 69.1 to 74.7%. A second ablation was performed in 23.2% in West/North compared with 10.5 and 16.5% in South and East. The proportion of patients still on AADs was highest in the South region (51.6 vs. 42.3 and 38.8% in East and West/North). Conclusion This study with all-comer patients shows that patient selection for ablation follows current guidelines but reveals significant differences regarding co-morbidity, medication, and ablation strategy. Despite this, 1-year outcomes are without significant differences and in line with previously published clinical trials. © 2015 The Author. Source

Nicolas J.B.,CHU Dinant Godinne UCL
Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine | Year: 2015

Hantaviruses are responsible for various types of hemorrhagic fevers depending on the involved subtype. In Europe, Puumala virus is responsible for an epidemic nephropathy. This infection can be complicated by severe abdominal pain. A rarely reported cause of this presenting symptom is acalculous cholecystitis, which must be integrated in the clinicobiological spectrum and should not lead to a surgical sanction. Its presence seems to be correlated with the severity of the disease, whose main pathophysiological phenomenon is plasma leakage induced by a microvascular endothelial dysfunction. We report the case of a young male patient who presented with severe hantavirus infection complicated by acalculous cholecystitis. © Acta Clinica Belgica 2015. Source

Jonas C.,CHU Dinant Godinne UCL | Rosiere A.,Service de chirurgie | Michel L.,Service de chirurgie | Donckier J.E.,CHU Dinant Godinne UCL
Louvain Medical | Year: 2013

We herein report the case of a phaeochromocytoma occurring in a young woman, with an initial presentation of meningeal haemorrhage and hyperglycaemia. We briefly describe the clinical symptoms In relation with the type of catecholamines secreted, the genetic testing to be performed, and the preoperative management to be implemented. Source

Gauthier S.,CHU Dinant Godinne UCL | Martinet J.-P.,CHU Dinant Godinne UCL | Damoiseaux Ph.,CHU Dinant Godinne UCL
Louvain Medical | Year: 2013

Cronkhite-Canada syndrome is a rare syndrome characterized by hamartomatous gastric polyps and ectodermal abnormalities. The condition is sporadic and not hereditary. Prognosis is often poor and depends on the disease's main complications, such as malnutrition, digestive bleeding, and infection. To date, optimal therapy has not yet been established, but several treatment options have been proposed, such as antibiotics, histamine receptor antagonists, or surgery for complications. However, the two therapeutic approaches that appear to be the most effective are nutritional support and corticosteroid therapy. We herein report the case of an 80-year-old patient diagnosed with Cronkhite-Canada syndrome in 2006, based on a clinical picture of rapid weight loss, anorexia, alopecia, and onychodystrophy. Following treatment initiation, the patient experienced a 6-year remission, which was followed by another disease surge in 2008, which is now under control. Source

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