Therapeutic results of laryngeal preservation: a retrospective study.

AIM: The objective of this study is to report the therapeutic results of the preservation strategy in locally advanced laryngeal cancers. PATIENTS AND METHODS: Between January 2008 and December 2015, 24 patients with locoregional advanced non-metastatic laryngeal cancer (T2-4/N0-2) were collected retrospectively. Different therapeutic sequences were used: either induction chemotherapy followed by concurrent chemoradiotherapy or induction chemotherapy followed by radiotherapy or concurrent chemoradiotherapy or radiotherapy alone. RESULTS: The objective response rate was 85.7%. Overall survival rates at 1 year, 3 years and 5 years were 91.3%, 80.2% and 53.5%, respectively. Administration of induction chemotherapy did not improve overall survival. The 1-year overall survival was 83.3% in the induction chemotherapy group vs 94.1% for those who did not received induction chemotherapy (p = 0.7). CONCLUSION: Our study showed the feasibility of this preservation strategy in clinical practice, with acceptable term toxicity.

Prognostic factors in metastatic gastric carcinoma.

Although its incidence has declined over last half-century, gastric cancer remains the second most frequent cause of cancer death in the world. The ⅔ of the patients are metastatic at diagnosis. The current study aimed to identify some determinants of survival in patients with metastatic gastric carcinoma. MATERIALS AND METHODS: It was a retrospective study that involved 49 patients treated with palliative chemotherapy between January 2000 and December 2010. Factors included: age, gender, performance status, metastatic diagnosis onset (at diagnosis or later); specific metastatic sites, number of metastatic localizations, response to chemotherapy, and hemoglobin rate. RESULTS: In univariate analysis, factors associated to a better survival were: metastasis at diagnosis, good performance status, response to chemotherapy and single metastatic site. Independent factors in multivariate analysis were: metastasis at diagnosis and single metastatic site. CONCLUSION: Our study confirmed many determinants on survival described in the literature.

Buschke - Lowenstein anal tumor: an ambiguous entity.

The Buschke - Lowenstein tumor is a rare sexually transmitted disease. Its location at the anal margin is also very rare. The most incriminated risk factor is human papillomavirus infection. Its clinical form may be confusing with other tumor and infectious lesions. Histologically, it is characterized by a well-differentiated malpighian proliferation. It represents local aggressive behavior. The treatment of reference remains the surgery with healthy margins of excision. Other treatments have been tested, but their effectiveness remains uncertain. We report here a new case of anal margin Buschke - Lowenstein tumor with a review of the literature.

Psychoaffective repercussions of pain in cancer patients.

PURPOSE: Pain often induces in cancer patient emotional disorders such as anxiety, depression and alteration of quality of life. The purpose of our work was to assess the impact of the intensity of pain and those characteristics on anxiety, depression state and quality of life of cancer patients. MATERIAL AND METHODS: This is an analytical cross-sectional study including 106 cancer patients with pain. We evaluated four parameters: pain intensity by visual analogue scale, the presence of anxiety and of depression using the Hospital Anxiety and Depressive Scale, and the alteration of quality of life by 36-item Short-Form Health Survey. RESULTS: Patients' average age was 55 years old. The sex ratio was 0.79. Pain intensity was low in 16%, moderate in 49.1% and intense in 34.9% of patients. The prevalence of anxiety and depression was 49.1% and 54% of patients, respectively. The independent factors correlated to the occurrence of anxiety were: pain intensity, bone localization, continuous progression, chronicity of pain, advanced stage, hospitalization at day hospital, the partial or no response to analgesic treatment. The independent factors correlated to the onset of depression were: intensity of pain, advanced stage of the disease, bone localization, step 2 or 3 of analgesic, and partial or no response to analgesic treatment. CONCLUSION: The prevalence of anxiety and depression in our patients was slightly higher than those reported in the literature. The main factors correlated with the onset of depression and anxiety were: severe pain, bone location, and advanced stage of the disease.

[Contribution and limits of intensity-modulated reirradiation of nasopharyngeal carcinomas]. / Apports et limites de la réirradiation conformationnelle avec modulation d'intensité des carcinomes nasopharyngés.

PURPOSE: We report in this study, the dosimetric and carcinologic results of intensity-modulated technique for the reirradiation of nasopharyngeal carcinomas. PATIENTS AND METHODS: Eight patients reirradiated with intensity-modulation technique between January 2015 and December 2017 were included. We noted for each patient: the minimum, maximum and average doses, the dose received by 95% (D95%), 98% (D98%) and 2% (D2%) of the volume to be irradiated, the homogeneity and conformity indices and doses to the organs at risk. RESULTS: Target volume coverage was satisfactory with a median of D95% greater than 57Gy (95% of the prescribed dose). The median maximum dose received by the spinal cord and brainstem were 8.2Gy and 18.25Gy, respectively. After a median follow-up of 14.5 months [1-29 months], five patients were in complete remission of their disease. Overall survival at 2 years was 66.7%. An increase in preexisting late toxicity after the first irradiation (now grade 2 or above) was found in four patients (50% of cases). CONCLUSION: Intensity-modulation is an attractive technique for reirradiation of the nasopharynx. It allows a better conformity of the dose to the target and a reduction of the doses on the already irradiated critical organs. This offers good control of the disease with fewer severe late toxicities.

Gastric signet-ring cell carcinoma with hypersecretion of ß-Human chorionic gonadotropin and review of the literature.

ß-Human chorionic gonadotropin (ß-HCG) is an embryonic protein secreted by the syncytiotrophoblast of the placenta. The determination of the plasma ß-HCG level is routinely used for the diagnosis and the follow-up of germ cell tumors. Some adenocarcinomas have been described as being rarely associated with ß-HCG hypersecretion. We report a case of gastric signet-ring cell carcinoma with ß-HCG hypersecretion and propose hypotheses to explain the pathogenesis of such hypersecretion.

TPF induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma: Long term results of a Tunisian series.

PURPOSE: We represent in this study the long term results of docetaxel, cisplatin and 5-fluorouracil induction chemotherapy followed by concurrent chemoradiotherapy in Tunisian patients with locally advanced nasopharyngeal carcinoma. The objective of our study is to analyse the efficacy as well as the toxicity of this therapeutic protocol. PATIENTS AND METHODS: Between January 2004 and December 2008, 32 patients with locoregional advanced non metastatic disease (T2b or above and/or N1 or above AJCC 2002) were treated in our institution by three cycles of docetaxel, cisplatin and 5-fluorouracil induction chemotherapy every 21 days followed by concurrent chemoradiotherapy. Conventional radiotherapy was delivered using a cobalt 60 machine during 7 weeks with weekly cisplatin (40mg/m2). RESULTS: Twenty-nine patients (90%) had presented an objective clinical response in lymph nodes after neoadjuvant chemotherapy, with a complete response in 28%. Acute toxicity of docetaxel, cisplatin and 5-fluorouracil induction chemotherapy was dominated by vomiting (59%), asthenia (40.6%), diarrhea (34.4%) and febrile neutropenia (15.6%). The complete response rate after the end of treatment was around 80%. The 5 years overall survival and disease-free survival were respectively 68.2% and 67.5%. CONCLUSION: Our results, in this field of study, are encouraging with acceptable toxicity despite the lack of intensity-modulated radiotherapy technique in our institution during the period of study.

A long survival of a patient with brain metastasis of unknown site of the primary tumor.

Eighty percent of brain metastases (BM) are diagnosed in patients with known primary site of cancer. BM of unknown primary represents a difficult diagnosis. In up to 15% of patients with BM, the site of the primary tumor will not be detected despite investigations. The prognosis of this entity is very poor. We report here a case of a long survival of a patient with brain metastasis of unknown primary. The conclusion that can be drawn is that within BM of unknown primary exist patients with a very good prognosis that must be collected and published in order to base recommendations.

[Rectal stromal tumor: about a case]. / Tumeur stromale rectale: à propos d'une observation.

Gastro-intestinal stromal tumors are uncommon mesenchymal tumors. There are localized preferentially in the stomach. The rectal localization is exceedingly rare. Through a new case of rectal stromal tumour as well as a review of the literature, we propose to focus on clinical, radiological and therapeutic particularities of this rare entity.

Acute pancreatitis induced by anticancer chemotherapy.

Drug-induced pancreatitis is rare (1.4-2%). This report describes a 20-year-old female patient who developed acute pancreatitis while being treated for neurosarcoma of abdominal wall with the ifosfamide and doxorubicin regimen. Although it is unusual, it is important to consider chemotherapeutic agents as a possible etiology for acute pancreatitis in patients presenting with gastrointestinal symptoms.