[Epidermoid cancer of the esophagus: overview]. / Cancer épidermoïde de l'oesophage: mise au point.

Numerous extrinsic factors are involved in the pathogenesis of esophageal cancer. The disease exhibits clinical symptoms only at the advanced stage, often when no further curative possibilities exist; this delay is one of the main causes of the poor prognosis still associated with esophageal cancer. To secure early diagnosis, contrast GI series and endoscopy should be performed immediately whenever esophageal symptoms are present. Initial assessment of esophageal cancer should in any case include thoraco-abdominal scan. Bronchoscopy is indicated when the tumor is localized in the middle third of the organ. Surgery has long been considered the only valid treatment for esophageal cancer. However, the rule today is a multidisciplinary approach which offers either curative or palliative treatment designed to optimize therapy and minimize side effects. Promising results have recently been obtained with a combination of radiotherapy-chemotherapy followed by esophagectomy.

[The toxicity/efficacy relationship in polychemotherapy of lung neoplasms]. / Etude de la relation toxicité/efficacité dans la polychimiothérapie des cancers pulmonaires.

Although it is generally accepted that anti-cancer chemotherapy should be administered at the maximum tolerable dose, it is not clearly established that the therapeutic results at dosage levels involving maximum tolerable toxicity are really superior to those with lower, better tolerated doses. 392 patients with advanced primary lung cancer were treated with 5 chemotherapy regimens including cyclophosphamide, methotrexate, vincristine, procarbazine, hydroxyurea, adriamycin and CCNU, in combinations of 3 to 7 agents. Response rates of 50% and over were registered after 8 weeks of treatment. During the same time the intensity of leukopenia, thrombocytopenia, vomiting, other digestive toxicity, neurologic disorders and alopecia was graded according to the worst observation from 0 to 4. The results show that there is no correlation between the grade of toxicity and the rate of response either for the whole group or for subgroups of patients as defined by cell type, degree of dissemination, age, or performance status. They demonstrate that the search for maximum tolerable toxicity is not a sine qua non for the best possible response to chemotherapy in primary lung cancer.