53 results on '"De Bree, Remco"'
Search Results
2. Treatment of the neck in residual/recurrent disease after chemoradiotherapy for advanced primary laryngeal cancer.
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Rodrigo, Juan P., López-Álvarez, Fernando, Medina, Jesús E., Silver, Carl E., Robbins, K Thomas, Hamoir, Marc, Mäkitie, Antti, de Bree, Remco, Takes, Robert P., Golusinski, Pawel, Kowalski, Luiz P., Forastiere, Arlene A., Homma, Akihiro, Hanna, Ehab Y., Rinaldo, Alessandra, and Ferlito, Alfio
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LARYNGEAL cancer ,CHEMORADIOTHERAPY ,NECK dissection ,LYMPHATIC metastasis ,PRESERVATION of organs, tissues, etc. ,NECK - Abstract
Concomitant chemoradiotherapy (CRT) is extensively used as primary organ preservation treatment for selected advanced laryngeal squamous cell carcinomas (LSCC). The oncologic outcomes of such regimens are comparable to those of total laryngectomy followed by adjuvant radiotherapy. However, the management of loco-regional recurrences after CRT remains a challenge, with salvage total laryngectomy being the only curative option. Furthermore, the decision whether to perform an elective neck dissection (END) in patients with rN0 necks, and the extent of the neck dissection in patients with rN + necks is still, a matter of debate. For rN0 patients, meta-analyses have reported occult metastasis rates ranging from 0 to 31 %, but no survival advantage for END. In addition, meta-analyses also showed a higher incidence of complications in patients who received an END. Therefore, END is not routinely recommended in addition to salvage laryngectomy. Although some evidence suggests a potential role of END for supraglottic and locally advanced cases, the decision to perform END should weigh benefits against potential complications. In rN + patients, several studies suggested that selective neck dissection (SND) is oncologically safe for patients with specific conditions: when lymph node metastases are not fixed and are absent at level IV or V. Super-selective neck dissection (SSND) may be an option when nodes are confined to one level. In conclusion, current evidence suggests that in rN0 necks routine END is not necessary and that in rN + necks with limited nodal recurrences SND or a SSND could be sufficient. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Dual targeting of cancer metabolome and stress antigens affects transcriptomic heterogeneity and efficacy of engineered T cells
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Hernández-López, Patricia, van Diest, Eline, Brazda, Peter, Heijhuurs, Sabine, Meringa, Angelo, Hoorens van Heyningen, Lauren, Riillo, Caterina, Schwenzel, Caroline, Zintchenko, Marina, Johanna, Inez, Nicolasen, Mara J. T., Cleven, Astrid, Kluiver, Thomas A., Millen, Rosemary, Zheng, Jiali, Karaiskaki, Froso, Straetemans, Trudy, Clevers, Hans, de Bree, Remco, Stunnenberg, Hendrik G., Peng, Weng Chuan, Roodhart, Jeanine, Minguet, Susana, Sebestyén, Zsolt, Beringer, Dennis X., and Kuball, Jürgen
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Few cancers can be targeted efficiently by engineered T cell strategies. Here, we show that γδ T cell antigen receptor (γδ TCR)-mediated cancer metabolome targeting can be combined with targeting of cancer-associated stress antigens (such as NKG2D ligands or CD277) through the addition of chimeric co-receptors. This strategy overcomes suboptimal γ9δ2 TCR engagement of αβ T cells engineered to express a defined γδ TCR (TEGs) and improves serial killing, proliferation and persistence of TEGs. In vivo, the NKG2D-CD28WTchimera enabled control only of liquid tumors, whereas the NKG2D-4-1BBCD28TMchimera prolonged persistence of TEGs and improved control of liquid and solid tumors. The CD277-targeting chimera (103-4-1BB) was the most optimal co-stimulation format, eradicating both liquid and solid tumors. Single-cell transcriptomic analysis revealed that NKG2D-4-1BBCD28TMand 103-4-1BB chimeras reprogram TEGs through NF-κB. Owing to competition with naturally expressed NKG2D in CD8+TEGs, the NKG2D-4-1BBCD28TMchimera mainly skewed CD4+TEGs toward adhesion, proliferation, cytotoxicity and less exhausted signatures, whereas the 103-4-1BB chimera additionally shaped the CD8+subset toward a proliferative state.
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- 2023
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4. Development and external validation of a prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer.
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Willemsen, Anna C.H., Kok, Annemieke, Baijens, Laura W.J., de Boer, Jan Paul, de Bree, Remco, Devriese, Lot A., Driessen, Chantal M.L., van Herpen, Carla M.L., Hoebers, Frank J.P., Kaanders, Johannes H.A.M., Karsten, Rebecca T., van Kuijk, Sander M.J., Lalisang, Roy I., Navran, Arash, Pereboom, Susanne R., Schols, Annemie M.W.J., Terhaard, Chris H.J., and Hoeben, Ann
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Patients who receive chemoradiotherapy or bioradiotherapy (CRT/BRT) for locally advanced head and neck squamous cell carcinoma (LAHNSCC) often experience high toxicity rates interfering with oral intake, causing tube feeding (TF) dependency. International guidelines recommend gastrostomy insertion when the expected use of TF exceeds 4 weeks. We aimed to develop and externally validate a prediction model to identify patients who need TF ≥ 4 weeks and would benefit from prophylactic gastrostomy insertion. A retrospective multicenter cohort study was performed in four tertiary head and neck cancer centers in the Netherlands. The prediction model was developed using data from University Medical Center Utrecht and the Netherlands Cancer Institute and externally validated using data from Maastricht University Medical Center and Radboud University Medical Center. The primary endpoint was TF dependency ≥4 weeks initiated during CRT/BRT or within 30 days after CRT/BRT completion. Potential predictors were extracted from electronic health records and radiotherapy dose–volume parameters were calculated. The developmental and validation cohort included 409 and 334 patients respectively. Multivariable analysis showed predictive value for pretreatment weight change, texture modified diet at baseline, ECOG performance status, tumor site, N classification, mean radiation dose to the contralateral parotid gland and oral cavity. The area under the receiver operating characteristics curve for this model was 0.73 and after external validation 0.62. Positive and negative predictive value for a risk of 90% or higher for TF dependency ≥4 weeks were 81.8% and 42.3% respectively. We developed and externally validated a prediction model to estimate TF-dependency ≥4 weeks in LAHNSCC patients treated with CRT/BRT. This model can be used to guide personalized decision-making on prophylactic gastrostomy insertion in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Image-guided surgery in oral cancer: toward improved margin control
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Noorlag, Rob, de Bree, Remco, and Witjes, Max J.H.
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- 2022
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6. Sarcopenia and its impact in head and neck cancer treatment
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de Bree, Remco, van Beers, Maartje A., and Schaeffers, Anouk W.M.A.
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- 2022
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7. Validation of the G8 screening tool in older patients with cancer considered for surgical treatment.
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Bruijnen, Cheryl P., Heijmer, Anne, van Harten-Krouwel, Diny G., van den Bos, Frederiek, de Bree, Remco, Witteveen, Petronella O., and Emmelot-Vonk, Mariëlle H.
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The Geriatric 8 (G8) has proven to be one of the most sensitive frailty-screening tools for older patients with cancer undergoing systemic treatment. In this study we validated whether the G8 is also suitable for identifying impairments in their comprehensive geriatric assessment (CGA) in older patients with cancer undergoing surgery. Thereby, we investigated the differences in postoperative outcomes between the fit and frail patients classified by the G8. Patients ≥70 years with a surgery indication because of a (suspected) malignant disease were prospectively enrolled. In all patients, a CGA was performed. The G8 results were assessed in parallel. The diagnostic value of the G8 was determined by comparing the result with the CGA as a reference test. Deficits in CGA was defined as ≥ two impairments of the CGA. Postoperative complications were retrospectively obtained from the medical record and compared between the fit and frail patients. In total, 143 patients were enrolled. The sensitivity, specificity, and negative predictive value of the G8 were 82% (95% CI 70–91), 63% (95% CI 52–73), and 85% (95% CI 75–91). In the patients with an impaired G8, a significantly prolonged hospital stay, higher rate of delirium, and higher 1-year mortality rate were seen. The G8 is a simple and useful screening tool for identifying deficits in CGA in older patients with cancer requiring surgery. Second, we concluded that patients with an impaired G8 are more at risk for a complicated recovery from surgery. [ABSTRACT FROM AUTHOR]
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- 2021
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8. Sarcopenia measured with handgrip strength and skeletal muscle mass to assess frailty in older patients with head and neck cancer.
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Meerkerk, Christiaan D.A., Chargi, Najiba, de Jong, Pim A., van den Bos, Frederiek, and de Bree, Remco
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Patients with head and neck cancer (HNC) have a risk of sarcopenia which is associated with adverse health outcomes. Frailty is also associated with adverse outcomes and is diagnosed by a comprehensive geriatric assessment (CGA). Because a CGA is time-consuming and not all patients benefit from it, frailty screening questionnaires are used to select patients for CGA. Sarcopenia measurement may be a biomarker for frailty. Our objective was to examine the association between sarcopenia and a frailty screening questionnaire. In this single-center retrospective study, 150 patients (≥ 60-years old) with HNC were reviewed. Sarcopenia was defined as the combination of reduced handgrip strength and loss of skeletal muscle mass, calculated as skeletal muscle index (SMI), according to the EWGSOP-criteria. Frailty screening was performed using the Geriatrics 8 (G8) questionnaire. The 150 patients included 101 men and 49 women. Frail patients were more likely to be sarcopenic at diagnosis. G8 frailty score showed a significant though weak correlation with SMI. Univariate regression analysis with frailty as a dependent variable distinguished comorbidity score, handgrip strength, SMI, and sarcopenia as significant. These variables were subjected to a multivariate analysis in which comorbidity score and SMI remained significant. There is an association between sarcopenia and the G8 frailty screening questionnaire. Therefore, sarcopenia measurement could be interchangeable with the G8 frailty screening questionnaire. Further research should compare the gold standard for frailty, i.e. CGA, with sarcopenia. [ABSTRACT FROM AUTHOR]
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- 2021
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9. Detecting Bone Invasion of the Maxilla by Oral Squamous Cell Carcinoma: Diagnostic Accuracy of Preoperative Computed Tomography Versus Magnetic Resonance Imaging.
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Slieker, Fons Joeri Bernard, Dankbaar, Jan Willem, de Bree, Remco, and Van Cann, Ellen Maria
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Purpose: For planning of the surgical resection, computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used for the preoperative assessment of bone invasion of the maxilla. The purpose of this study was to compare the diagnostic test accuracy of CT and MRI for detecting bone invasion of the maxilla in patients with squamous cell carcinoma of the maxilla (MSCC).Materials and Methods: We conducted a retrospective cross-sectional study and enrolled a consecutive number of patients with primary MSCC between 2000 and 2017 who underwent either preoperative CT or MRI scans. The outcome variable was the absence or presence of bone invasion, with histopathologic examination of the resection specimen as the gold standard. The predictor variable was the imaging technique (CT and MRI). The imaging results on bone invasion were compared with the histopathologic results. Sensitivity and specificity were calculated, and the 2-sided Fisher exact test was used to calculate statistically significant differences between the unpaired CT and MRI results. Receiver operating characteristic curves were computed, and the area under the curve (AUC) was calculated.Results: The study included 72 patients (29 male and 43 female patients) with a mean age of 72 years. A total of 41 CT scans and 31 MRI scans were available. Histopathologic examination showed bone invasion in 45 cases: 26 of 41 patients with CT scans (63%) and 19 of 31 patients with MRI scans (61%). CT yielded 2 false-positive and 2 false-negative results, with a sensitivity of 92%, specificity of 87%, and AUC of 0.895. MRI yielded 5 false-positive and 2 false-negative results, with a sensitivity of 89%, specificity of 58%, and AUC of 0.739. No significant differences were observed for sensitivity (P > .999) and specificity (P = .185).Conclusions: In the absence of metallic dental restorations, CT could detect bone invasion more accurately than MRI in this study; however, the difference was not statistically significant. The imaging method of choice may depend on other situational factors. [ABSTRACT FROM AUTHOR]- Published
- 2020
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10. Prediction model for tube feeding dependency during chemoradiotherapy for at least four weeks in head and neck cancer patients: A tool for prophylactic gastrostomy decision making.
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Willemsen, Anna C.H., Kok, Annemieke, van Kuijk, Sander M.J., Baijens, Laura W.J., de Bree, Remco, Devriese, Lot A., Hoebers, Frank J.P., Lalisang, Roy I., Schols, Annemie M.W.J., Terhaard, Chris H.J., and Hoeben, Ann
- Abstract
Chemoradiation and bioradiation (CRT/BRT) for locally advanced head and neck squamous cell carcinoma (LAHNSCC) often comes with high toxicity rates, interfering with oral intake and leading to temporary tube feeding (TF) dependency. High-quality scientific evidence for indicators of prophylactic gastrostomy insertion is not available. The aim of this retrospective cohort study was to develop a prediction model to identify patients who need prophylactic gastrostomy insertion, defined as the expected use of TF for at least four weeks. Four-hundred-fifty LAHNSCC patients receiving CRT/BRT with curative intent between 2013 and 2016 were included in the study. Primary outcome was TF-dependency for four weeks or longer. Patient, tumor, and treatment characteristics were extracted from the medical records and their effects on the use of TF were analyzed using univariable and multivariable analysis. The prediction model was internally validated using bootstrapping techniques. Sixty-five percent (294/450 patients) required TF for four weeks or longer. Variables included in the model were: body mass index and adjusted diet at start of CRT/BRT, percentage weight change at baseline, World Health Organization performance status, tumor subsite, TNM-classification, CRT/BRT, mean radiation dose on the contralateral submandibular and parotid gland. The corrected Area Under the Curve after internal validation was 72.3%, indicating good discriminative properties of the prediction model. We developed and internally validated a prediction model that is intended to estimate TF-dependency for at least four weeks in LAHNSCC patients treated with CRT/BRT. This model can be used as a tool to support personalized decision making on prophylactic gastrostomy insertion. [ABSTRACT FROM AUTHOR]
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- 2020
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11. High CXCR4 expression in adenoid cystic carcinoma of the head and neck is associated with increased risk of locoregional recurrence
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Klein Nulent, Thomas J W, van Es, Robert J J, Valstar, Matthijs H, Smeele, Ludwig E, Smit, Laura A, Klein Gunnewiek, Raquel, Zuithoff, Nicolaas P A, de Keizer, Bart, de Bree, Remco, and Willems, Stefan M
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AimTreatment options for head and neck adenoid cystic carcinoma (AdCC) are limited in advanced disease. Chemokine receptor type 4 (CXCR4) is present in various tumour types, including AdCC. Upregulation is associated with tumour recurrence and metastasis. New CXCR4-specific diagnostic and therapeutic target agents have recently been available. This study aimed to analyse CXCR4 expression in a cohort of primary head and neck AdCC.MethodsAfter histopathological revision, tumour tissues of 73 consecutive patients with AdCC over 1990–2016 were sampled on a tissue microarray. Slides were immunohistochemically stained for CXCR4 and semiquantitatively scored. Associations between protein expression and cliniopathological parameters were tested. HRs were calculated using a Cox proportional hazard model.ResultsSixty-six tumours could be analysed. CXCR4 expression was present in 81% of the tumours with a median of 29% (IQR 1–70) positive cells. Expression was univariately correlated to perineural growth (Spearman ρ .26, p=0.04) and bone invasion (Spearman ρ .32, p=0.01), but not with tumour grade.CXCR4 expression in the primary tumour was significantly higher in tumours that recurred as compared with those that did not recur (median 60%, IQR 33–72 vs 12%, IQR 1–70, Kruskal-Wallis p=0.01). After dichotomisation, >25% of CXCR4 expressions proved an independent prognosticator for a reduced recurrence-free survival (RFS) (HR 7.2, 95% CI 1.5 to 72.4, p=0.04).ConclusionCXCR4 is expressed in the majority of primary AdCCs and independently correlated to worse RFS, suggesting CXCR4 as a target for imaging and therapy purposes in patients with advanced AdCC.
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- 2020
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12. Physiologic distribution of PSMA-ligand in salivary glands and seromucous glands of the head and neck on PET/CT.
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Klein Nulent, Thomas J.W., Valstar, Matthijs H., de Keizer, Bart, Willems, Stefan M., Smit, Laura A., Al-Mamgani, Abrahim, Smeele, Ludwig E., van Es, Robert J.J., de Bree, Remco, and Vogel, Wouter V.
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Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is used for detection and (re)staging of prostate cancer. However, healthy salivary, seromucous, and lacrimal glands also have high PSMA-ligand uptake. This study aimed to describe physiologic PSMA-ligand uptake distribution characteristics in the head and neck to aid in PSMA PET/CT interpretation and to identify possible new clinical applications for PSMA-ligand imaging.Study Design: Thirty consecutive patients who underwent PSMA PET/CT for prostate cancer were evaluated. Tracer maximum standardized uptake values (SUVmax) in the salivary, seromucous, and lacrimal glands were determined visually and quantitatively. Overall and intraindividual variations were reported.Results: All gland locations had increased tracer uptake. The mean SUVmax ± standard deviation varied: parotid 12.3 ± 3.9; submandibular 11.7 ± 3.5; sublingual 4.5 ± 1.9; soft palate 2.4 ± 0.5; pharyngeal wall 4.3 ± 1.3; nasal mucosa 3.4 ± 0.9; supraglottic larynx 2.7 ± 0.7; and lacrimal 6.2 ± 2.2. The parotid had the largest overall variation in SUVmax (5.2-22.9), and the sublingual glands had the largest mean intraindividual difference (18.1%).Conclusions: Major and minor salivary and seromucous glands consistently have high PSMA-ligand uptake. Minor gland locations can be selectively visualized by this technique for the first time. This provides potential new applications such as quantification of present salivary gland tissues and individualization of radiotherapy for head and neck cancer or lutetium-177-PSMA radionuclide treatment. [ABSTRACT FROM AUTHOR]- Published
- 2018
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13. Selective neck dissection in surgically treated head and neck squamous cell carcinoma patients with a clinically positive neck: Systematic review.
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Rodrigo, Juan P., Grilli, Gianluigi, Shah, Jatin P., Medina, Jesus E., Robbins, K. Thomas, Takes, Robert P., Hamoir, Marc, Kowalski, Luiz P., Suárez, Carlos, López, Fernando, Quer, Miquel, Boedeker, Carsten C., de Bree, Remco, Coskun, Hakan, Rinaldo, Alessandra, Silver, Carl E., and Ferlito, Alfio
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NECK dissection ,HEAD & neck cancer treatment ,SQUAMOUS cell carcinoma ,SYSTEMATIC reviews ,LYMPH node surgery - Abstract
Adequate treatment of lymph node metastases is essential for patients with head and neck squamous cell carcinoma (HNSCC). However, there is still no consensus on the optimal surgical treatment of the neck for patients with a clinically positive (cN+) neck. In this review, we analyzed current literature about the feasibility of selective neck dissection (SND) in surgically treated HNSCC patients with cN + neck using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. From the reviewed literature, it seems that SND is a valid option in patients with cN1 and selected cN2 neck disease (non-fixed nodes, absence of palpable metastases at level IV or V, or large volume ->3 cm-multiple lymph nodes at multiple levels). Adjuvant (chemo) radiotherapy is fundamental to achieve good control rates in pN2 cases. The use of SND instead a comprehensive neck dissection (CND) could result in reduced morbidity and better functional results. We conclude that SND could replace a CND without compromising oncologic efficacy in cN1 and cN2 cases with the above-mentioned characteristics. [ABSTRACT FROM AUTHOR]
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- 2018
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14. Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography After Concurrent Chemoradiotherapy in Locally Advanced Head-and-Neck Squamous Cell Cancer: The ECLYPS Study.
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Van den Wyngaert, Tim, Helsen, Nils, Carp, Laurens, Hakim, Sara, Martens, Michel J., Hutsebaut, Isabel, Debruyne, Philip R., Maes, Annelies L. M., van Dinther, Joost, Van Laer, Carl G., Hoekstra, Otto S., De Bree, Remco, Meersschout, Sabine A. E., Lenssen, Olivier, Vermorken, Jan B., Van den Weyngaert, Danielle, Stroobants, Sigrid, and ECLYPS investigators
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- 2017
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15. Parameters Associated With Mandibular Osteoradionecrosis
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Mendenhall, William M., Suárez, Carlos, Genden, Eric M., de Bree, Remco, Strojan, Primož, Langendijk, Johannes A., Mäkitie, Antti A., Smee, Robert, Eisbruch, Avraham, Lee, Anne W.M., Rinaldo, Alessandra, and Ferlito, Alfio
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The objective of this review is to discuss factors related to the risk of osteoradionecrosis (ORN) and how to minimize the likelihood of this complication. A PubMed search for publications pertaining to ORN within the last 3 years was conducted revealing 44 publications. The bibliographies of these publications were reviewed to identify additional references spanning a longer time period. The incidence of ORN is 5% to 10% with a median latency period of 1 to 2 years or less. The likelihood of ORN depends on a number of factors including primary site and extent of disease, dental status, treatment modality, radiotherapy (RT) dose, volume of mandible included in the planning target volume, RT fractionation schedule and technique, and teeth extractions. The risk of ORN may be reduced by limiting the RT dose and volume of mandible irradiated without increasing the risk of a local-regional recurrence due to a marginal miss.
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- 2018
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16. [ 18 F]FDG-PET to identify pathological responses upon neoadjuvant immune checkpoint blockade in cutaneous squamous cell carcinoma.
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Breukers, Sabine, Crommelin, Robert D., Smit, Laura, De Boer, J.P., Navran, Arash, van Houdt, Winan J., de Bree, Remco, Devriese, Lot A., Haanen, John B. A. G., Zuur, Charlotte L., and Wondergem, Maurits
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- 2023
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17. Towards organ preservation and cure via 2 infusions of immunotherapy only, in patients normally undergoing extensive and mutilating curative surgery for cutaneous squamous cell carcinoma: An investigator-initiated randomized phase II trial—The...
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Zuur, Charlotte L., Breukers, Sabine, Machuca-Ostos, Mercedes, Boere, Thomas, Smit, Laura, De Boer, J.P., Cornelissen, Sten, Navran, Arash, van Houdt, Winan J., Westerink, Bram, Wondergem, Maurits, de Bree, Remco, Devriese, Lot A., Thommen, Daniela, Traets, Joleen, and Haanen, John B. A. G.
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- 2023
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18. Cost-Utility of Stepped Care Targeting Psychological Distress in Patients With Head and Neck or Lung Cancer.
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Jansen, Femke, Krebber, Anna M. H., Coupé, Veerle M. H., Cuijpers, Pim, de Bree, Remco, Becker-Commissaris, Annemarie, Smit, Egbert F., van Straten, Annemieke, Eeckhout, Guus M., Beekman, Aartjan T. F., Leemans, C. René, and Verdonck-de Leeuw, Irma M.
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- 2017
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19. Prognostic role of tumour-associated macrophages and regulatory T cells in EBV-positive and EBV-negative nasopharyngeal carcinoma
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Ooft, Marc L, van Ipenburg, Jolique A, Sanders, Maxime E, Kranendonk, Mariette, Hofland, Ingrid, de Bree, Remco, Koljenović, Senada, and Willems, Stefan M
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AimsTumour-associated macrophages (TAMs) and regulatory T cells (Tregs) form a special niche supporting tumour progression, and both correlate with worse survival in head and neck cancers. However, the prognostic role of TAM and Tregs in nasopharyngeal carcinoma (NPC) is still unknown. Therefore, we determined differences in TAMs and Tregs in different NPC subtypes, and their prognostic significance.MethodsTissue of 91 NPCs was assessed for TAMs and Tregs by determination of CD68, CD163, CD206 and FOXP3 expression in the tumour microenvironment. Clinicopathological correlations were assessed using Pearson X2test, Fisher’s exact test, analysis of variance and Mann-Whitney U test. Survival was analysed using Kaplan-Meier curves and Cox regression.ResultsCD68 and FOXP3 counts were higher in Epstein-Barr virus (EBV)-positive NPC, while CD68−/FOXP3−, CD163+/FOXP3− and CD206+/FOXP3− infiltrates were more common in EBV-negative NPC. In the whole NPC group, CD68−/FOXP3− correlated with worse overall survival (OS), and after multivariate analysis high FOXP3 count showed better OS (HR 0.352, 95% CI 0.128 to 0.968). No difference in M2 counts existed between EBV-positive and negative NPC.ConclusionsFOXP3, a Treg marker, seems to be an independent prognostic factor for better OS in the whole NPC group. Therefore, immune-based therapies targeting Tregs should be carefully evaluated. M2 spectrum macrophages are probably more prominent in EBV-negative NPC with also functional differences compared with EBV-positive NPC.
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- 2018
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20. Molecular profile of nasopharyngeal carcinoma: analysing tumour suppressor gene promoter hypermethylation by multiplex ligation-dependent probe amplification
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Ooft, Marc L, van Ipenburg, Jolique, van Loo, Rob, de Jong, Rick, Moelans, Cathy, Braunius, Weibel, de Bree, Remco, van Diest, Paul, Koljenović, Senada, Baatenburg de Jong, Rob, Hardillo, Jose, and Willems, Stefan M
- Abstract
AimsTo assess differences in methylation profiles, and thus pathogenesis, between Epstein-Barr virus (EBV)-positive and negative nasopharyngeal carcinomas (NPCs). Also, promoter hypermethylation is a common phenomenon in early carcinogenesis to inactivate tumour suppressor genes. Since epigenetic changes are reversible, the therapeutic application of methylation inhibitors could provide treatment options.MethodsWe evaluated promoter hypermethylation profiles of 22 common tumour suppressor genes in 108 NPCs using methylation-specific multiplex ligation-dependent probe amplification. Correlation between methylation, clinicopathological features (including EBV) and survival was examined. Cluster analysis was also performed.ResultsHypermethylation of RASSF1A and ESR1 was significantly more frequent in EBV-positive NPC, while hypermethylation of DAPK1 was more frequent in EBV-negative NPC. In logistic regression, age, with EBV-positive NPC occurring at earlier age, and RASSF1, with RASSF1 hypermethylation being more frequent in EBV-positive NPC, remained significant. In EBV-positive NPC, hypermethylation of RASSF1A predicted worse overall survival (OS) (HR 3.058,95% CI 1.027 to 9.107). In EBV-negative NPC, hypermethylated adenomatous polyposis coli (APC) was a predictor of poor disease-free survival (DFS) (HR 6.868, 95% CI 2.142 to 22.022).ConclusionThere are important epigenetic differences between EBV-negative and EBV-positive NPCs, with EBV-negative NPC having a more similar hypermethylation profile to other head and neck squamous cell carcinomas than EBV-positive NPC. Hypermethylation of RASSF1A might contribute to worse OS in EBV-positive NPC, and may be an important event in the pathogenesis of EBV-infected NPC. Hypermethylation of APC might contribute to worse DFS in EBV-negative NPC.
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- 2018
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21. Patient-derived head and neck cancer organoids allow treatment stratification and serve as a tool for biomarker validation and identification
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Millen, Rosemary, De Kort, Willem W.B., Koomen, Mandy, van Son, Gijs J.F., Gobits, Roán, Penning de Vries, Bas, Begthel, Harry, Zandvliet, Maurice, Doornaert, Patricia, Raaijmakers, Cornelis P.J., Geurts, Maarten H., Elias, Sjoerd G., van Es, Robert J.J., de Bree, Remco, Devriese, Lot A., Willems, Stefan M., Kranenburg, Onno, Driehuis, Else, and Clevers, Hans
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Organoids are in vitrothree-dimensional structures that can be grown from patient tissue. Head and neck cancer (HNC) is a collective term used for multiple tumor types including squamous cell carcinomas and salivary gland adenocarcinomas.
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- 2023
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22. Patients' perspective on the impact of sentinel node biopsy in oral cancer treatment.
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Flach, Géke B., Verdonck-de Leeuw, Irma M., Witte, Birgit I., Klop, W. Martin C., van Es, Robert J.J., Schepman, Kees-Pieter, and de Bree, Remco
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Objective: Assessment of the impact of a sentinel node biopsy (SNB)-based strategy in cT1/T2 N0 oral cancer on the course of health related quality of life, psychological distress, and shoulder disability, and evaluation of the patients' perspective on neck management strategies.Study Design: Fifty-two patients (39 SNB negative; 13 SNB positive) completed the European Organization for Research and Treatment of Cancer (EORTC) questionnaires-QLQ-C30 and QLQ-H&N35, and the HADS, IES, and SDQ questionnaires at baseline, after SNB diagnosis and at 6 months of follow-up. Objective shoulder measurements were performed after 2 years and interviews were conducted after 4.5 months of follow-up.Results: All the scores of the questionnaires were not significantly different between SNB negative and SNB positive patients. Objective shoulder functioning was similar. Most patients preferred a SNB-based strategy to an elective neck dissection strategy.Conclusions: The impact of a SNB-based strategy in patients with cT1/T2 N0 oral cancer is comparable for SNB-negative and SNB-positive patients in terms of health-related quality of life, psychological distress and shoulder functioning. Most patients preferred the SNB-based strategy over the elective neck dissection strategy. [ABSTRACT FROM AUTHOR]- Published
- 2016
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23. An international comparison of the management of the neck in early oral squamous cell carcinoma in the Netherlands, UK, and USA.
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Govers, Tim M., de Kort, Tijs B.H., Merkx, Matthias A.W., Steens, Stefan C.A., Rovers, Maroeska M., de Bree, Remco, and Takes, Robert P.
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SQUAMOUS cell carcinoma ,HEAD & neck cancer ,BIOLOGICAL variation ,MAXILLOFACIAL surgery ,EVIDENCE-based medicine - Abstract
Background Early oral cavity squamous cell carcinoma (OCSCC) management appears to vary both within and between countries. Variation in practice can be an indicator of absence of evidence-based management and may negatively influence survival and morbidity. The exact variation and the relationship to differences in guidelines are unknown. This study aimed to report on these variations in the Netherlands, UK, and USA, and to evaluate them. Methods Information regarding the variation in OCSCC management strategies was obtained from a questionnaire sent to representatives of head and neck cancer centers in the Netherlands, UK, and USA. Within-country and between-country variations were also assessed in light of the different guidelines. Results In total, representatives of 45 centers completed the questionnaire; 10 from the Netherlands, 26 from the UK and 9 from the USA. Our results demonstrate a distinct variation in the diagnoses, treatment and follow-up of OCSCC, both within and between countries. Only a small amount of variation between countries could be linked to differences in guidelines. Conclusions There is high variation in the management of the neck in OCSCC. There seem to be a need for direct evidence about optimal management decisions to establish more evidence-based management and uniform practice. [ABSTRACT FROM AUTHOR]
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- 2016
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24. The role of systemic therapy in the management of sinonasal cancer: A critical review.
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Bossi, Paolo, Saba, Nabil F., Vermorken, Jan B., Strojan, Primoz, Pala, Laura, de Bree, Remco, Rodrigo, Juan Pablo, Lopez, Fernando, Hanna, Ehab Y., Haigentz, Missak, Takes, Robert P., Slootweg, Piet J., Silver, Carl E., Rinaldo, Alessandra, and Ferlito, Alfio
- Abstract
Purpose: Due to the rarity and the variety of histological types of sinonasal cancers, there is a paucity of data regarding strategy for their optimal treatment. Generally, outcomes of advanced and higher grade tumors remain unsatisfactory, despite the employment of sophisticated surgical approaches, technical advances in radiation techniques and the use of heavy ion particles. In this context, we critically evaluated the role of systemic therapy as part of a multidisciplinary approach to locally advanced disease.Results: Induction chemotherapy has shown encouraging activity and could have a role in the multimodal treatment of patients with advanced sinonasal tumors. For epithelial tumors, the most frequently employed chemotherapy is cisplatin, in combination with either 5-fluorouracil, taxane, ifosfamide, or vincristine. Only limited experiences with concurrent chemoradiation exist with sinonasal cancer. The role of systemic treatment for each histological type (intestinal-type adenocarcinoma, sinonasal undifferentiated carcinoma, sinonasal neuroendocrine carcinoma, olfactory neuroblastoma, sinonasal primary mucosal melanoma, sarcoma) is discussed.Conclusions: The treatment of SNC requires a multimodal approach. Employment of systemic therapy for locally advanced disease could result in better outcomes, and optimize the therapeutic armamentarium. Further studies are needed to precisely define the role of systemic therapy and identify the optimal sequencing for its administration in relation to local therapies. [ABSTRACT FROM AUTHOR]- Published
- 2015
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25. Diagnostic and Treatment-Related Challenges in Sinonasal Teratocarcinosarcoma: A Report of Three Cases
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F. Julius Scheurleer, W., W. Braunius, Weibel, M. Tijink, Bernard, M. Janssen, Luuk, A. Pameijer, Frank, E. Breimer, Gerben, J. Smid, Ernst, de Bree, Remco, A. Devriese, Lot, and A. Rijken, Johannes
- Abstract
Background. Sinonasal teratocarcinosarcoma is a rare, aggressive malignancy located almost exclusively in the nasal cavity, paranasal sinuses, or anterior skull base. Histopathological diagnosis can be challenging due to the heterogeneous composition. Methods. Retrospective analysis of 3 patients with sinonasal teratocarcinosarcoma diagnosed and treated at the University Medical Center Utrecht was conducted. Results. Patients presented with nasal obstruction, epistaxis, headaches, or behavioral changes. All three patients had locally advanced disease, and one had lymph node metastases. Two patients underwent surgery followed by radiotherapy, and one underwent neoadjuvant chemotherapy followed by surgery. The follow-up duration ranged from 3 to 32 months. All three patients died due to progression of their disease. Conclusion. Sinonasal teratocarcinosarcoma is characterized by rapid, aggressive local expansion. The prognosis is poor due to a high risk of metastases and locally recurrent disease. Multimodality treatment consisting of surgery, followed by (chemo)‐radiotherapy, is essential for optimizing outcomes. Neoadjuvant therapy offers a promising treatment option.
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- 2023
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26. Removing the Taboo on the Surgical Violation (Cut-Through) of Cancer
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Robbins, K. Thomas, Bradford, Carol R., Rodrigo, Juan P., Suárez, Carlos, de Bree, Remco, Kowalski, Luiz P., Rinaldo, Alessandra, Silver, Carl E., Lund, Valerie J., Nibu, Ken-ichi, and Ferlito, Alfio
- Abstract
IMPORTANCE: The surgical dictum of en bloc resection without violating cancer tissue has been challenged by novel treatments in head and neck cancer. OBSERVATIONS: An analysis of treatment outcomes involving piecemeal removal of sinonasal, laryngeal, oropharyngeal, and hypopharyngeal cancer shows that it did not compromise tumor control. The rationale for the evolution toward use of this technique is outlined. CONCLUSIONS AND RELEVANCE: While complete resection with clear margins remains a key end point in surgical oncology, we believe it is time to acknowledge that this time-honored dictum of avoiding tumor violation is no longer valid in selected situations.
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- 2016
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27. Sentinel Node in Oral Cancer
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Tartaglione, Girolamo, Stoeckli, Sandro J., de Bree, Remco, Schilling, Clare, Flach, Geke B., Bakholdt, Vivi, Sorensen, Jens Ahm, Bilde, Anders, von Buchwald, Christian, Lawson, Georges, Dequanter, Didier, Villarreal, Pedro M., Forcelledo, Manuel Florentino Fresno, Amezaga, Julio Alvarez, Moreira, Augusto, Poli, Tito, Grandi, Cesare, Vigili, Maurizio Giovanni, O’Doherty, Michael, Donner, Davide, Bloemena, Elisabeth, Rahimi, Siavash, Gurney, Benjamin, Haerle, Stephan K., Broglie, Martina A., Huber, Gerhard F., Krogdah, Annelise l., Sebbesen, Lars R., Odell, Edward, Junquera Gutierrez, Luis Manuel, Barbier, Luis, Santamaria-Zuazua, Joseba, Jacome, Manuel, Nollevaux, Marie-Cecile, Bragantini, Emma, Lothaire, Philippe, Silini, Enrico M., Sesenna, Enrico, Dolivet, Giles, Mastronicola, Romina, Leroux, Agnes, Sassoon, Isabel, Sloan, Philip, Colletti, Patrick M., Rubello, Domenico, and McGurk, Mark
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- 2016
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28. Accelerated Radiotherapy With Carbogen and Nicotinamide for Laryngeal Cancer: Results of a Phase III Randomized Trial.
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Janssens, Geert O., Rademakers, Saskia E., Terhaard, Chris H., Doornaert, Patricia A., Bijl, Hendrik P., Van den Ende, Piet, Chin, Alim, Marres, Henri A., de Bree, Remco, van der Kogel, Albert J., Hoogsteen, Ilse J., Bussink, Johannes, Span, Paul N., and Kaanders, Johannes H.
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- 2012
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29. Percutaneous Irreversible Electroporation for Recurrent Thyroid Cancer--A Case Report.
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Meijerink, Martijn R, Scheffer, Hester J, de Bree, Remco, and Sedee, Robert-Jan
- Abstract
A 74-year-old man presented with a small locoregional, histopathologically proven, fluorodeoxyglucose positron emission tomography/computed tomography-avid recurrence of follicular thyroid carcinoma in the left subglottic space after extensive surgical resection, adjuvant radioactive iodine therapy, and external beam radiation therapy. Because all established focal therapies were contraindicated, percutaneous irreversible electroporation was performed without complications. Follow-up imaging at 7 months showed a small ablation scar without signs for residual vital tumor tissue. Irreversible electroporation may be a viable treatment option for selected cases of recurring head and neck tumors that are unsuitable for other local treatments. [ABSTRACT FROM AUTHOR]
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- 2015
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30. Percutaneous Irreversible Electroporation for Recurrent Thyroid Cancer—A Case Report.
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Meijerink, Martijn R., Scheffer, Hester J., de Bree, Remco, and Sedee, Robert-Jan
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A 74-year-old man presented with a small locoregional, histopathologically proven, fluorodeoxyglucose positron emission tomography/computed tomography–avid recurrence of follicular thyroid carcinoma in the left subglottic space after extensive surgical resection, adjuvant radioactive iodine therapy, and external beam radiation therapy. Because all established focal therapies were contraindicated, percutaneous irreversible electroporation was performed without complications. Follow-up imaging at 7 months showed a small ablation scar without signs for residual vital tumor tissue. Irreversible electroporation may be a viable treatment option for selected cases of recurring head and neck tumors that are unsuitable for other local treatments. [ABSTRACT FROM AUTHOR]
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- 2015
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31. Visualization of the sentinel node in early-stage oral cancer
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Heuveling, Derrek A., Flach, Géke B., van Schie, Annelies, van Weert, Stijn, Karagozoglu, K. Hakki, Bloemena, Elisabeth, Leemans, C. René, and de Bree, Remco
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Various lymphoscintigraphic imaging protocols exist for sentinel node (SN) identification in early-stage oral cancer. This study aimed to evaluate the clinical value of performing additional late lymphoscintigraphic imaging.
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- 2012
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32. Recent advances in surgery for head and neck cancer
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de Bree, Remco and Leemans, Charles René
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This paper reviews the advances in surgery in head and neck cancer patients.
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- 2010
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33. Repeated Botulinum Toxin Type A Injections to Treat Patients With Frey Syndrome
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de Bree, Remco, Duyndam, Jeff E., Kuik, Dirk J., and Leemans, C. René
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OBJECTIVE To determine the effectiveness of repeated intracutaneous injections of botulinum toxin A to treat Frey syndrome. PATIENTS Between January 6, 1999, and July 1, 2005, 22 patients with Frey syndrome (12 men and 10 women) received repeated intracutaneous injections of botulinum toxin type A. MAIN OUTCOME MEASURES Before each treatment, the time since the previous treatment; the size of the affected area, as determined by a starch-iodine test; and subjective quantification of symptoms, as assessed by the previously used Frey Questionnaire Card, were recorded. RESULTS All patients underwent at least 3 treatments. Univariate analysis of variance showed a significant difference (P <.001) in the between-treatment interval. Univariate analysis of variance showed a significant difference in the size of the affected area in accordance with the number of treatments received (P <.001). The mean Frey Questionnaire Card score also decreased with repeated treatments. CONCLUSIONS In patients with Frey syndrome, repeated treatment with intracutaneous injection of botulinum toxin type A lowered subjective symptom scores, decreased the size of the affected area, and increased the duration of the effect.Arch Otolaryngol Head Neck Surg. 2009;135(3):287-290--
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- 2009
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34. Molecular detection of minimal residual cancer in surgical margins of head and neck cancer patients
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Graveland, A. Peggy, de Maaker, Michiel, Braakhuis, Boudewijn J.M., de Bree, Remco, Eerenstein, Simone E.J., Leemans, C. René, and Brakenhoff, Ruud H.
- Abstract
A great disappointment in head and neck cancer surgery is that 10–30% of head and neck squamous cell carcinoma (HNSCC) patients develop local recurrences despite histopathologically tumor-free surgical margins. These recurrences result from either minimal residual cancer (MRC) or preneoplastic lesions that remain behind after tumor resection. Distinguishing MRC from preneoplasic lesions is important to tailor postoperative radiotherapy more adequately. Here we investigated the suitability of quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) using human Ly-6D (hLy-6D) transcripts as molecular marker to detect MRC in surgical margins.Submucosal samples of deep surgical margins were collected from 18 non-cancer control patients and 67 HNSCC patients of whom eight had tumor-positive surgical margins. The samples were analyzed with hLy-6D qRT-PCR, and the data were analyzed in relation to the clinicohistological parameters.A significant difference was shown between the group of patients with histopathological tumor-positive surgical margins and the non-cancer control group (p<0.001), and the group of patients with histopathological tumor-free surgical margins (p=0.001).This study shows a novel approach for molecular analysis of deep surgical margins in head and neck cancer surgery. The preliminary data of this approach for detection of MRC in deep margins of HNSCC patients are promising.
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- 2009
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35. The need for patients' endocrine function vigilance following treatment of head and neck cancer
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de Bree, Remco, Lips, Paul, and Leemans, C René
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The aim of this article is to examine the need for screening of endocrine dysfunction following treatment of head and neck cancer.
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- 2008
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36. Gangplank Flap Reconstruction of the Nose
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Bas van Hemert, Frits Jan, de Bree, Remco, Leemans, Charles Rene, and Middelweerd, Marinus Johannes
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In subtotal nose reconstruction, different tissues have to be reconstructed. We report the case of a 51-year-old man with a severe deformity of the nose (shortening and collapse of the nose, retraction of the right alar area, and a total septal defect after surgery and radiotherapy for a septum nasi carcinoma). Reconstruction with good results was performed with a “gangplank” flap technique (using a U-shaped skin flap for inner lining and for lengthening), rib cartilage for the nasal skeleton, and skin coverage with a paramedian forehead flap.
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- 2007
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37. Distress in Spouses and Patients After Treatment for Head and Neck Cancer
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Verdonck‐de Leeuw, Irma M., Eerenstein, Simone E., Van der Linden, Mecheline H., Kuik, Dirk J., de Bree, Remco, and Leemans, C. Rene
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Background:The objective of this study is to obtain insight into distress in spouses and patients treated for head and neck cancer.
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- 2007
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38. Results of postoperative reirradiation for recurrent or second primary head and neck carcinoma
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Kasperts, Nicolien, Slotman, Ben J., Leemans, C. Rene, de Bree, Remco, Doornaert, Patricia, and Langendijk, Johannes A.
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In this prospective study, the effects of a second course of postoperative radiation therapy on locoregional control, survival, toxicity, and quality of life were investigated in patients who underwent resection of a second primary or locoregional recurrent head and neck tumor in a previously irradiated area.In total, 39 patients who underwent surgery for second primary tumors (n = 19 patients) or for recurrent locoregional tumors (n = 20 patients) were retreated with postoperative radiotherapy (RE‐PORT). Indications for RE‐PORT were extranodal spread (49%), positive surgical margins (44%), and/or other risk factors (8%). The target volume for RE‐PORT was confined to the high‐risk area. No elective radiotherapy was applied in regions that were situated in the formerly high‐dose area. A total dose of 46 grays (Gy) was given to elective areas with boosts from 60 Gy to 66 Gy to the high‐risk region with conventional fractionation. The results of RE‐PORT were compared with the results from patients who were treated in the same period with primary adjuvant radiotherapy (PRI‐PORT) at the authors' institution.The mean follow‐up was 32 months (range, 3‐84 mos). The locoregional control rate after 3 years in the RE‐PORT group was 74%, and the 3‐year overall survival rate was 44%. This did not differ significantly compared with survival rates in the PRI‐PORT group. Although a higher rate of late radiation‐induced morbidity and more head and neck symptoms were observed in the RE‐PORT group compared with the PRI‐PORT group, no differences were observed with regard to the more general dimensions of quality of life.RE‐PORT after surgery for recurrent locoregional tumors and/or second primary tumors should be considered in patients who have high‐risk histopathologic features. Cancer 2006. © 2006 American Cancer Society.
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- 2006
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39. Screening for Distant Metastases in Patients With Head and Neck Cancer: Is Chest Computed Tomography Sufficient?
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Brouwer, Jolijn, de Bree, Remco, Hoekstra, Otto S., Golding, Richard P., Langendijk, Johannes A., Castelijns, Jonas A., and Leemans, C René
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Objectives/Hypothesis:The detection of distant metastases during screening influences the choice of treatment in patients with head and neck squamous cell carcinoma. A previous study in the authors' institution showed that chest computed tomography (CT) scan was the most important screening technique. Different clinical risk factors in patients with head and neck squamous cell carcinoma for the development of distant metastases were identified.
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- 2005
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40. Hospital-acquired sinusitis is a common cause of fever of unknown origin in orotracheally intubated critically ill patients
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van Zanten, Arthur, Dixon, J Mark, Nipshagen, Martine, de Bree, Remco, Girbes, Armand, and Polderman, Kees
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Introduction Sinusitis is a well recognised but insufficiently understood complication of critical illness. It has been linked to nasotracheal intubation, but its occurrence after orotracheal intubation is less clear. We studied the incidence of sinusitis in patients with fever of unknown origin (FUO) in our intensive care unit with the aim of establishing a protocol that would be applicable in everyday clinical practice.Methods Sinus X-rays (SXRs) were performed in all patients with fever for which an initial screening (physical examination, microbiological cultures and chest X-ray) revealed no obvious cause. All patients were followed with a predefined protocol, including antral drainage in all patients with abnormal or equivocal results on their SXR.Results Initial screening revealed probable causes of fever in 153 of 351 patients (46.4%). SXRs were taken in the other 198 patients (56.4%); 129 had obvious or equivocal abnormalities. Sinus drainage revealed purulent material and positive cultures (predominantly Pseudomonas and Klebsiella species) in 84 patients. Final diagnosis for the cause of fever in all 351 patients based on X-ray results, microbiological cultures, and clinical response to sinus drainage indicated sinusitis as the sole cause of fever in 57 (16.2%) and as contributing factor in 48 (13.8%) patients with FUO. This will underestimate the actual incidence because SXR and drainage were not performed in all patients.Conclusion Physicians treating critically ill patients should be aware of the high risk of sinusitis and take appropriate preventive measures, including the removal of nasogastric tubes in patients requiring long-term mechanical ventilation. Routine investigation of FUO should include computed tomography scan, SXR or sinus ultrasonography, and drainage should be performed if any abnormalities are found.
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- 2005
41. Prognostic Importance of Paratracheal Lymph Node Metastases
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Plaat, Robin E., de Bree, Remco, Kuik, Dirk J., van den Brekel, Michiel W. M., van Hattum, Alexander H., Snow, Gordon B., and Leemans, C René
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Objectives:The aim of this retrospective study was to evaluate the prognostic significance of paratracheal lymph node (PTLN) metastases for tumor recurrence and survival for patients treated with total laryngectomy (TL) and PTLN dissection.
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- 2005
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42. Evaluation of Donor Site Function and Morbidity of the Fasciocutaneous Radial Forearm Flap
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de Bree, Remco, Hartley, Chris, Smeele, Ludwig E., Kuik, Dirk J., Quak, Jasper J., and Leemans, C René
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Objective:To assess the results of the use of the free radial forearm flap in terms of objective morbidity and subjective patient response.
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- 2004
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43. Tracheal and Laryngeal Rupture in Neonates: Complication of Delivery or of Intubation?
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Mahieu, Hans, de Bree, Remco, Sibarani-Ponsen, Renate, Ekkelkamp, Seine, and Haasnoot, Krijn
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Neonatal tracheal or laryngeal rupture is a rare but life-threatening condition that is attributable to traumatic endotracheal intubation or traumatic delivery. We present a review of the literature and 6 new cases of laryngeal or tracheal rupture following complicated delivery. High-risk groups were identified as 1) low-birth weight neonates, for intubation trauma, and 2) extremely high-birth weight neonates with shoulder dystocia, for trauma due to delivery. Two specific types of ruptures can be distinguished. The less-rare type involves a partial anterior rupture in the subglottic area, which can occur after traumatic intubation or traumatic delivery. The rarer type involves a distal circumferential tracheal rupture that gives rise to ventilatory problems, usually after a delay of several days. This type of rupture was only observed following traumatic delivery. Early diagnosis, optically guided orotracheal intubation, and timely treatment can reduce the risks of mortality and morbidity.
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- 2004
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44. Comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and oropharynx with microvascular soft tissue reconstruction
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Borggreven, Pepijn A., Kuik, Dirk J., Quak, Jasper J., de Bree, Remco, Snow, Gordon B., and Leemans, C. René
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- 2003
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45. Assessment of patency of the internal jugular vein following neck dissection and microvascular flap reconstruction by power Doppler ultrasound
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de Bree, Remco, van den Berg, Fred G., van Schaik, Cors, Beerens, Aad-Jan F., Manoliu, Radu A., Castelijns, Jonas A., Snow, Gordon B., and Leemans, C. René
- Abstract
The objective of this study was to assess patency of the internal jugular vein following modified radical or selective neck dissection and microvascular flap reconstruction by power Doppler ultrasound and its impact on free flap survival. In 23 patients who underwent selective or modified radical neck dissection and microvascular flap reconstruction the patency of the internal jugular vein was examined by power Doppler ultrasound on the first post-operative day and after follow-up of at least four months. On the first post-operative day in one patient partial thrombosis was found, while in the other 22 patients the internal jugular vein was normal patent. During follow-up in 17 (74 per cent) patients a normal patent internal jugular vein was found, while partial and complete thrombosis were found in three (13 per cent) patients each. On the first post-operative day 22 of the 23 (96 per cent) free flap veins were visualized. There was no free flap loss during follow-up. Power Doppler ultrasound is a valuable diagnostic technique for determination of internal jugular vein patency and may be useful as screening method or in case of clinical suspicion of thrombosis to determine internal jugular vein patency. Late internal jugular vein thrombosis may probably not effect free flap survival due to neovascularization.
- Published
- 2002
46. Radioimmunotherapy in patients with head and neck squamous cell carcinoma: Initial experience
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Colnot, David R., Quak, Jasper J., Roos, Jan C., de Bree, Remco, Wilhelm, Abraham J., Snow, Gordon B., and van Dongen, Guus A. M. S.
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- 2001
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47. Screening for Distant Metastases in Patients With Head and Neck Cancer
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de Bree, Remco, Deurloo, Eline E., Snow, Gordon B., and Leemans, Charles R.
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ObjectivesThe detection of distant metastases at initial evaluation may alter the selection of therapy in patients with head and neck squamous cell carcinoma (HNSCC). In this study the value of screening for distant metastases is evaluated.
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- 2000
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48. Magnetic sentinel lymph node biopsy procedure in oral cancer.
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Nieuwenhuis, Eliane, Kolenaar, Barry, Hof, Jurrit, Bemmel, Xander, Baarlen, Joop, Haken, Bennie ten, de Bree, Remco, and Alic, Lejla
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SENTINEL lymph node biopsy ,SUPERPARAMAGNETIC materials ,ORAL cancer - Abstract
B Background: b Reliable identification of lymph node (LN) metastases is one of the most important prognostic factors to stratify the treatment in oral cancer (OC). This pilot study identifies LN metastases in OC patients using a magnetic approach for sentinel lymph node biopsy (SLNB) procedure. A total of 26 SLN were pathologically evaluated (8 LN in 0.4ml, and 18 in 0.8ml dose group), and yielded three patients with a metastatic LN (3/26 LN in total). [Extracted from the article]
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- 2021
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49. The impact of tumour volume and other characteristics on uptake of radiolabelled monoclonal antibodies in tumour tissue of head and neck cancer patients
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de Bree, Remco, Kuik, Dirk J., Quak, Jasper J., Roos, Jan C., van den Brekel, Michiel W. M., Castelijns, Jonas A., van Wagtendonk, Frank W., Greuter, Henri, Snow, Gordon B., and van Dongen, Guus A. M. S.
- Abstract
Abstract.: Radioimmunotherapy (RIT) seems to be a realistic option for eradication of minimal residual squamous cell carcinoma of the head and neck (HNSCC), although uptake levels of radiolabelled monoclonal antibodies (MAbs) in tumour tissue vary strongly. The aim of this study was to obtain greater insight into the factors influencing the accumulation of MAbs in HNSCC. Twenty-seven HNSCC patients were injected with radiolabelled MAb E48 or U36 and underwent surgery 2 days after injection. Radioactivity was measured in tumour biopsies taken from the surgical specimen. Uptake levels were correlated with various patient, tumour and MAb characteristics, including age, sex, site, TNM stage, volume as assesssed by computed tomography or magnetic resonance imaging, degree of differentiation, antigen expression of the tumour, the particular MAb that had been injected and the MAb dose. A stepwise regression multivariate analysis showed that tumour volume is the most significant prognostic factor (P=0.01) for MAb uptake. In conclusion, a significantly higher MAb uptake is found in small tumours as compared to larger tumours. Therefore, RIT may be particularly effective in head and neck cancer patients when used in an adjuvant setting.
- Published
- 1998
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50. Severe Granulomatous Inflammatory Response Induced by Injection of Polyacrylamide Gel Into the Facial Tissue.
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De Bree, Remco, Middelweerd, J. René, Van der Waal, Isaác, and Park, Stephen S.
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Facial soft tissue augmentation has been performed using different materials. We describe a woman who received polyacrylamide gel injections for cosmetic reasons and developed a severe granulomatous inflammation paranasally. Because the patient did not mention the cosmetic intervention, the diagnosis of polyacrylamide gel–induced granuloma was complicated. The distinctive histopathological findings led to the correct diagnosis despite sparse clinical information. Since complete surgical excision was not feasible, she was treated with repeated multiple local injections of triamcinolone acetonide. Polyacrylamide gel may have favorable properties for facial tissue augmentation, but a severe granulomatous inflammatory response induced by injection of polyacrylamide gel may occur. Before treatment with polyacrylamide gel injection this complication should be disclosed to the patient. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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