ONCOLOGIE

CENTRUM ONCOLOGIE

ARTIKELS

ABSTRACT 1

Effectiveness of adjunctive analgesics in head and neck cancer patients receiving curative (chemo-) radiotherapy: a systematic review

Lefebvre T, Tack L, Lycke M, Goethals L, et al. Pain Medicine, 2021, 22(1), 152-164

ABSTRACT Objective: Our aim was to give an overview of the effectiveness of adjunctive analgesics in head and neck cancer (HNC) patients receiving (chemo-) radiotherapy.

This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov were searched for studies concerning "head neck cancer," "adjunctive analgesics," "pain," and "radiotherapy."

Pain outcome, adverse events, and toxicity and other reported outcomes, for example, mucositis, quality of life, depression, etc.

Nine studies were included in our synthesis. Most studies were of low quality and had a high risk of bias on several domains of the Cochrane Collaboration tool. Only two studies comprised high-quality randomized controlled trials in which pregabalin and a doxepin rinse showed their effectiveness for the treatment of neuropathic pain and pain from oral mucositis, respectively, in HNC patients receiving (chemo-) radiotherapy.

More high-quality trials are necessary to provide clear evidence on the effectiveness of adjunctive analgesics in the treatment of HNC (chemo-) radiation-induced pain.

ABSTRACT 2

The multicenter, randomized, phase 2 PEACE V-STORM trial: defining the best salvage treatment for oligorecurrent nodal prostate cancer metastases

Zilli T, Dirix P, Liefhooghe N, Stellamans K, et al. European Urology Focus, 2021, 7(2), 241-244

ABSTRACT Optimal local treatment for nodal oligorecurrent prostate cancer is unknown. The randomized phase 2 PEACE V-STORM trial will explore the best treatment approach in this setting. Early results on the acute toxicity profile are projected to be published in quarter 3, 2021.

ABSTRACT 3

C-reactive protein and neutrophil-lymphocyte ratio are prognostic in metastatic clear-cell renal cell carcinoma patients treated with nivolumab

Roussel E, Kinget L, Verbiest A, Debruyne P, et al. Urologic oncology, 2021, 39(4), 239.e17-239.e25

ABSTRACT To evaluate the impact of markers of systemic inflammation such as C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) on outcomes of metastatic clear-cell renal cell carcinoma (m-ccRCC) patients treated with nivolumab. We retrospectively evaluated m-ccRCC patients treated with nivolumab and collected known prognostic factors and survival data.

We used Kaplan-Meier survival analysis and cox proportional hazards regression analysis to study prognostic factors for overall survival (OS) and progression-free survival (PFS) since start of nivolumab. Harrell's C-index was used to evaluate the models. We included 113 patients. Median OS and PFS after initiation of nivolumab was 15 (interquartile range 7-28) and 4 months (interquartile range 3-11), respectively. Elevated baseline CRP was associated with worse OS (HR per 25 mg/l 1.35, 95% CI 1.16-1.52, P < 0.001) and PFS (HR per 25 mg/l 1.19, 95% CI 1.08-1.35, P = 0.001), independent from the international metastatic renal cell carcinoma database consortium (IMDC) prognostic criteria, increasing the model's C-index from 0.72 to 0.77 for OS and 0.59 to 0.62 for PFS. Elevated NLR was associated with worse OS (HR 1.10, 95% CI 1.04-1.17, P = 0.002) and PFS (HR 1.06, 95% CI 1.01-1.11, P = 0.03) independent from the other IMDC prognostic criteria. The model's C-index decreased from 0.72 to 0.70 for OS and increased from 0.59 to 0.60 for PFS. Elevated baseline CRP and NLR predict worse OS and PFS on nivolumab in m-ccRCC patients.

Including baseline CRP in the IMDC prognostic model improves its discriminatory power to predict OS and PFS since start of nivolumab.

ABSTRACT 4

A randomised wait-list controlled trial to evaluate emotional freedom techniques for self-reported cancer-related cognitive impairment in cancer survivors (EMOTICON)

Tack L, Lefebvre T, Lycke M, Debruyne P, et al. EClinicalMedicine by the Lancet Discovery, 2021, 39, 101081

ABSTRACT 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).

In this prospective multicentre randomised wait-list controlled study, 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. 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.

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. Items for Sys, and Cochrane, searching for prospective and retrospective studies, where SBRT was a treatment component of OMD. Availability of the OMD characteristics as described in the EORTC/ESTRO consensus

PRESENTATIES/ CONGRESSEN

ABSTRACT 1

Application of the ESTRO/EORTC oligometastatic disease classification system to current evidence

Nevens D, Jongen A, Kindts I, et al. 2021, Madrid, Spanje

ABSTRACT There is increasing evidence for the integration of locally ablative therapy into multimodality treatment of oligometastatic disease (OMD); however, the non-standardized definition of OMD has hindered comparison of individual studies and their translation into clinical practice. To support standardised data collection, analysis, and reporting, a consensus for OMD classification has previously been established: this study aims to apply the OMD classification system to current evidence on stereotactic body radiotherapy (SBRT) as identified in a systematic review. A systematic literature review was performed in Medline, Embase,