[Standards and Options for the use of radiation therapy in the management of patients with osteosarcoma. Update 2004]. / Recommandations pour la pratique clinique: Standards et Options 2004 pour la prise en charge par radiothérapie des patients atteints d'ostéosarcome. Mise à jour.

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French regional cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVE: To update the SOR recommendations for the use of radiation therapy in the management of patients with osteosarcoma. This work was performed in collaboration with the French society against cancers in children and adolescent (SFCE). METHODS: Data have been identified by literature search using Medline (from January 1992 to October 2003). In addition several Internet sites were searched in October 2003. RESULTS: The 3 mains standards are: 1) local and exclusive curative irradiation is not indicated as primary treatment for osteosarcoma or for local and operable recurrence, except for lesion in inaccessible sites or if the patient refuses surgery; 2) local and prophylactic adjuvant irradiation is not indicated for the treatment of osteosarcoma after chemotherapy (neoadjuvant and/or adjuvant) and complete macro or microscopic surgery, except for non-operable R1 or R2 surgical resection; 3) whole-lung prophylactic irradiation is not indicated in non-metastatic osteosarcoma. Systemic metabolic radiotherapy for pain treatment, using samarium-153 ethylenediaminetetramethylene phosphonic acid (Sm-153-EDTMP) can be offered to patients with painful metastatic osteosarcoma or in case of recurrent bone sites inaccessible to local therapies (surgery, external irradiation).

Gender influence on emotional responses to primary tastes.

Several studies have examined the gender differences in the area of emotion, but few data are available in the field of gustation. Yet, such differences are observed in clinical manifestations of nutritional disorders, such as a greater incidence of carbohydrate cravings in women. The aim of this study was consequently to examine the influence of gender on emotional responses to taste, by comparing autonomic responses and basic emotions associated with primary tastes between men and women. Thirty-four subjects (17 males, 17 females, mean age=28) participated in the experiment. Taste stimuli were solutions of 0.3 M sucrose (sweet), 0.15 M NaCl (salty), 0.02 M citric acid (sour) and 0.00015 M quinine sulfate (bitter). Evian mineral water served as the diluent and control (neutral taste). Five autonomic parameters [skin potential (SP) and resistance (SR), skin blood flow (SBF) and temperature (ST), instantaneous heart rate (IHR)] were simultaneously and continuously recorded when subjects tasted the five solutions. The patterns of autonomic responses, obtained for each primary taste and each subject, were transcribed into one of the six basic emotions defined by Ekman (happiness, surprise, sadness, fear, anger and disgust), according to a previously described method for odorants. Results evidenced that the mean variations of each autonomic parameter did not significantly differ between men and women, even if skin resistance and cardiac responses were stronger in men than in women. Concerning the basic emotions associated with each primary taste, a similar distribution for men and women was obtained for sweet, bitter and control solutions, whereas more differences were observed for salt (P=.02) and sour solutions.

Autonomic nervous system responses associated with primary tastes.

The hedonic dimension of the taste sensation plays a crucial role in the control of many taste-mediated responses related to food ingestion or rejection. The purpose of this study was to evaluate the emotional reactivity associated with each primary taste (sweet, salty, sour and bitter) through analysis of the variations of autonomic nervous system (ANS) parameters. Thirty-four healthy non-smoker volunteer subjects (17 males and 17 females, mean age = 28 years) participated in the experiment. Taste stimuli were solutions of 0.3 M sucrose (sweet), 0.15 M NaCl (salty), 0.02 M citric acid (sour) and 0.00015 M quinine sulfate (bitter). Evian mineral water was used as the diluent and control (neutral taste). Throughout the test, five ANS parameters (skin potential and skin resistance, skin blood flow and skin temperature, and instantaneous heart rate) were simultaneously and continuously recorded. Results of the ANOVA evidenced a significant effect of primary taste on skin resistance amplitude (P: < 0.001) and duration (P: < 0.0001), skin temperature amplitude (P: < 0.001), skin blood flow amplitude (vasoconstriction) (P: < 0.0001) and instantaneous heart rate increase (P: < 0.0001). Skin resistance and cardiac responses were the most relevant ANS parameters to distinguish among the taste solutions. The four primary tastes could be associated with significantly different ANS responses in relation to their hedonic valence: the pleasantly connoted and innate-accepted sweet taste induced the weakest ANS responses whereas the unpleasant connoted tastes (salty, sour and bitter) induced stronger ANS responses, the innate-rejected bitter taste inducing the strongest ones. Such a neurovegetative characterization of each primary taste could provide references for the hedonic analysis of the more complex gustative sensation attached to foods.