Harnessing drug/radiation interaction through daily routine practice: Leverage medical and methodological point of view (MORSE 02-17 study).

BACKGROUND: Safety profile of the interaction between anticancer drugs and radiation is a recurrent question. However, there are little data regarding the non-anticancer treatment (NACT)/radiation combinations. The aim of the present study was to investigate concomitant NACTs in patients undergoing radiotherapy in a French comprehensive cancer center. METHODS: A prospective cross-sectional study was conducted. All cancer patients undergoing a palliative or curative radiotherapy were consecutively screened for six weeks in 2016. Data on NACTs were collected. RESULTS: Out of 214 included patients, a NACT was concomitantly prescribed to 155 patients (72%), with a median number of 5 NACTs per patient (range: 1-12). The most prescribed drugs were anti-hypertensive drugs (101 patients, 47.2%), psychotropic drugs (n = 74, 34.6%), analgesics (n = 78, 36.4%), hypolipidemic drugs (n = 57, 26.6%), proton pump inhibitors (n = 46, 21.5%) and antiplatelet drugs (n = 38, 17.8%). Although 833 different molecules were reported, only 20 possible modifiers of cancer biological pathways (prescribed to 74 patients (34.5%)) were identified. Eight out of the 833 molecules (0.9%), belonging to six drug families, have been investigated in 28 ongoing or published clinical trials in combo with radiotherapy. They were prescribed to 63 patients (29.4%). CONCLUSION: Drug-radiation interaction remains a subject of major interest, not only for conventional anticancer drugs, but also for NACTs. New trial designs are thus required.

Undifferentiated carcinoma of nasopharyngeal type in children: Clinical features and outcome.

OBJECTIVES: To describe the epidemiology, clinical features and treatment of undifferentiated carcinoma of nasopharyngeal type in children. MATERIAL AND METHODS: Retrospective study of 40 patients under the age of 17 years managed for undifferentiated carcinoma of nasopharyngeal type in two oncology centres in the central region of Tunisia between 1995 and 2012. RESULTS: Patients had a median age of 14 years with a sex ratio of 1.3. The mean time to presentation was 5 months. The presenting complaint was cervical lymphadenopathy in 90% of cases. Thirty-seven patients received curative treatment, according to a sequential mode in 85% of cases, starting with chemotherapy followed by radiotherapy to the nasopharynx and cervical lymph nodes. The median dose delivered to the nasopharynx was 70.4Gy. Two cases of local recurrence and five cases of metastatic relapse (all involving bone), were observed during follow-up. After a mean follow-up of 80.5 months (range: 1 to 180), 29 patients (72.5%) were in complete remission, eight had died and three were lost to follow-up. The 5-year overall survival was 77.7%. CONCLUSION: Undifferentiated carcinoma of nasopharyngeal type in children represents 6% of all cases of UCNT managed in our institutions. It is often discovered at an advanced stage. Sequential treatment combining chemotherapy and radiotherapy achieves an excellent local control rate.

[Fetal pathology study of 88 cases of letal spina bifida]. / Etude foeto-pathologique de 88 cas de spina bifida létaux.

Lethal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida: 1.05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia (46 cases) and hydrocephaly (21 cases). Prevention is based on obstetric health care and hygiene dietetic advices to avoid alimentary deficit.