Glioblastoma in Tunisia: a retrospective study about 41 cases

Background: Glioblastoma [GB] is the most common and lethal primary brain tumor in adults representing 25% of primary brain tumors in adults. The objective of our study was to report the epidemiologic, clinical and therapeutic features of GB in Tunisia.

Methods:Our retrospective study included 41 patients with histologically confirmed GB treated between 2006 and 2012 at the medical oncology departments of Abderrahmane Mami hospital in Ariana and the military hospital in Tunis

Results: Median age was 54 years [13 to 72 years] and sex-ratio was 2.3. Karnofsky performance status [KPS] was <70% in 31.7% of cases, while Recursive partitioning analysis radiation therapy oncology group [RTOG-RPA] classification was III in 11 [26.8%], IV in 19 [46.3%], V in 10 [24.3%] and VI in 1 [2.4%] cases. Complete resection [CR] was achieved in 29 patients [70.7%], partial resection [PR] or tumor debulking in 5 patients [12.2%] and biopsy alone [BA] in 7 patients [17.1%]. All patients received brain radiotherapy [RT] at a dose of 60 Gy combined with concurrent temozolomide [TMZ]. Nineteen patients [46.3%] received adjuvant TMZ, 8 of them completed 6 cycles. Median overall survival [OS] was 12 months [2 to 56 months]. Six, 12, 18 and 24-months OS rates were 84.6%, 57.6%, 35.4% and 20.7%, OS being correlated to age, KPS, RPA and quality of resection

Conclusion: Our retrospective study is the first African GB series. Despite it included predominantly poor prognosis patients with impaired neurocognitive function and adjuvant treatment discontinuation, our median OS was comparable to Stupp data

[Juvenile granulosa cell tumor of the ovary: a case report]

Juvenile granulosa cell tumors of the ovary [JGCTs] are a rare form of neoplasm that makes up less than 5% of ovarians tumors in childhood and adolescence. About 90% are diagnosed in stage I [FIGO] with a favorable prognosis, whereas those at higher stages have a less favorable outcome. The authors describe a juvenile granulosa cell tumor expressed by an early pseudopuberty occurring in a 6 year old child. Clinically, an endocrine syndrome was associated with a pelvic mass. Hyperoestrogenia and serum alphafoetoprotein level were biologically detected. Tumor was localized strictly to the ovary, so conservative surgery was applied and proved sufficient to remove all tumor tissue. Histological examination showed typical microscopic aspect of a juvenile.granulosa cell tumor. The patient is well, 14 years after surgery with a normal growth and mental development

[Total body irradiation: techniques and main indications]

The radiotherapy department at Salah Azaiz institute had started, in March 2000, a new sophisticated technique of irradiation consisting in total body irradiation [TBI]. TBI is used in many preparative regimens before bone marrow transplantation in the treatment of haematological malignancies. TBI aims to destroy immunocompetent tissues in order to avoid graft rejection and to eradicate residual tumor cells. In this article, we review different TBI techniques and its main indications. We also describe the acute and late effects of TBI

radiochimiotherapie concomitante preoperatoire dans le cancer du col uterin: resultats preliminaires

This is a retrospective study of patients treated for cancer cervix staged IB2, IIA or lIB with bulky tumor [>4cm]. Treatment was concurrent radiotherapy [45Gy with I,8Gy daily fraction] and chemotherapy [5 cycles of Platinum 40mg/m2/week]. All patients. underwent Brachytherapy [l5Gy on the reference isodose according to Paris system] followed by surgery [radical abdominal hysterectomy and bilateral pelvic lymphadenectomy: Piver 3]. Between October 1999 and December 2002, forty five patients were treated in this protocol. Median age was 46 years [21- 68]. Histology was squamous cell carcinoma in 93% and glandular carcinoma in 7%. Average external radiation dose was 44Gy [20-50]. Ninety three% of patients had at least 3 cycles of chemotherapy and 46,5% received the planned 5 cycles. On the operative specimens, there was 62,5% complete response and only 7 pelvic node involvement [17,5%]. Four postoperative complications were noted [one vascular injury, one urinary fistula, one phlebitis and one lymph collection]. Preoperative combined radiotherapy and chemotherapy in the early bulky stages of uterine cervix cancer is well tolerated and "gives" a high rate of sterilisation. There was no increase in surgical morbidity