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Bull Cancer [journal]
- Desmoid tumors in children: current strategy. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 16.
Desmoid tumor (DT) or aggressive fibromatosis is a histologically benign-appearing neoplasms of the soft tissues, arising from connective tissues, the fascial sheaths and musculoaponevrotic structures of muscles. DT is a non-metastasizing tumor but has a potential for local invasion and local recurrence. DT can be seen in all age groups including young children. The overall incidence is reported as 2-4 cases per million per year. The etiology of DT is unknown. However, a genetic predisposition, familial adenomatous polyposis and Gardner's syndrome, has been implicated in 2% of the cases. The histological diagnosis has to be confirmed by biopsy in order to eliminate other sarcomas. The clinical behavior of DT seems unpredictable with a high rate of local recurrence. Treatment depends on the aggressiveness of the disease. A "wait-and-see" strategy is, at the present time, preferred in case of asymptomatic or non-progressive disease. Complete resection after surgery is rare, that is why first-line surgery should be seriously questioned and only considered when a complete resection can be feasible without functional or cosmetic damage. If not, medical treatments (cytotoxic or not) are rather discussed. Radiation therapy is rarely an option in children in this benign tumor. Authors present accurate knowledge of this disease in children.
- Medicinal plants in cancer patients: current practices and evaluation data. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 16.
Many complementary and alternatives medicines are offered to patients with cancer. Among them, herbal medicines have a substantial place. These plants are mainly used to reduce adverse effects of anticancer treatments and for specific anticancer properties. Our review shows that only few clinical data support medicinal plants effectiveness in cancer patients. Arguments rely mainly on usual indications and pharmacological data for minimization of treatments toxicity while for the anticancer properties, on epidemiological and preclinical data. To inform and counsel patients and people around, healthcare professionals need to evaluate benefit-risk balance on evidence-based information. Because the medical decision should be shared with the patient, his beliefs and preferences have to be considered. When no adverse effect or drug interaction is associated with herbal medicine, we state that their use is acceptable. This paper discuss of potential risk and benefit of the most used medicinal plants by cancer patients.
- Triple-negative breast cancer: histoclinical and molecular features, therapeutic management and perspectives. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 16.
Triple-negative breast cancer (TNBC), as defined by the absence of estrogen and progesterone receptor expression, as well as the lack of HER2 overexpression/amplification, corresponds to 15% of breast cancer and represents an aggressive form of the disease. TNBC are frequently confounded with basal subtype in the molecular classification of breast cancer and also share some similarities with BRCA1-mutated tumors. Epidemiological and clinical characteristics are distinct from other subtypes, including a younger age at diagnosis, a higher risk of relapse in spite of increased chemosensitivity, and a higher incidence of lung and brain metastatic relapses. Conventional cytotoxics remain the mainstay of current systemic management but recent evaluation of more targeted therapeutics, including specific cytotoxics (such as the use of platinum salts), PARP and EGFR inhibition, and antiangiogenics have been performed, providing contrasted but rather disappointing results. Recent data indicate that TNBC represent a heterogeneous entity composed of multiple and distinct molecular subtypes, which should deserve specific targeted therapeutics.
- Pharmaco and diet based prostate cancer prevention. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 16.
In 2010, in France, 8,790 men died from prostate cancer despite a low and decreasing mortality rate. The individual risk/benefit ratio of prostate cancer screening is the focus of controversy and currently not in favor of a systematic screening program. Therefore, only prevention could reduce incidence, side effects of treatment and related mortality. Interestingly, prostate cancer prevention is also a field of controversy mainly about 5-alpha-reductase inhibitors. However, it could be expected that pharmaco- or diet-based prevention will be a huge tool for cancer control, even more for prostate cancer burden. This review comprehensively analyses which molecules or compounds could be used in preventive trials. With regard to pharmaco-prevention, three different kinds of drugs could be identified. First drugs, which aim at mainly or even solely reduce prostate cancer risk such as 5-alpha-reductase inhibitors and selective estrogen receptor modulators. Drugs, which aim at wider preventive impact such as: nonsteroidal anti-inflammatory drugs or difluoromethylornithine. Lastly, drugs for which reducing prostate cancer incidence is merely a side effect such as statins, metformin or histones desacetylase inhibitors. With regard to diet-based prevention, two main approaches could be identified: aliments and nutriments, on one hand, and vitamin and minerals, on the other. Interestingly if compounds reach experimental plausibility, natural foods or even global diet seem to have a higher impact. Lastly, besides assessment of efficacy, effectiveness required the critical step of compliance, which might actually be the weakest link of the prevention chain.
- Anticancer drug adherence. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 16.
A large number of anticancer drugs have been introduced during the two last decades with significant impact for survival, making cancer a chronic disease in a growing number of indications. However, these drugs are costly, induce adverse effects and their efficacy frequently depends on the dose. For all these reasons, adherence in cancer therapy is critical for an optimal benefit-risk ratio. Patient adherence remains virtually unexplored in many cancers, such as malignant blood diseases. When measured, adherence is poor, especially when the drug is administered as oral and prolonged therapy (hormonotherapy in breast cancer, imatinib). Physician nonadherence represents another form of drug misadministration; poorly documented, its mechanism remains obscure. Adherence may be measured by a panel of methods, each of them displaying limits and pitfalls, suggesting that several complementary methods should be used in the context of prospective studies. Risk factors are age, socio-educative profile, disease stage and physician profile. This review emphasizes some methods to prevent nonadherence. Finally, this review argues for prospective studies, which should integrate a social pharmacology approach, including medicine, psycho-sociology and economics.
- Cutaneous adverse reactions of EGFR (epidermal growth factor receptor)-inhibitors: therapeutic algorithm of the French PROCUR group. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 20.
The epidermal growth factor receptors (EGFR)-inhibitors are frequently responsible for cutaneous adverse drug reactions that may alter the patients' quality of life and hamper the continuation of treatment. We present here the experience of a group of French multidisciplinary experts - the PROCUR group (PRise en charge de la tOxicité CUtanée des anti-EGFR) - created in order to establish a therapeutic algorithm. It was built in three steps under the responsibility of a steering committee: (1) a systematic literature review was performed by a group of three dermatologists and one oncologist; (2) regional meetings evaluated practical aspect of the treatments in France; (3) a final meeting confrontating the practices in France and the evidence-based medicine including the steering committee, the bibliographic group, and oncologists, radiotherapists, dermatologists and hepato-gastroenterologists involved in regional scientific committees, resulted in a therapeutic algorithm, resulting in the collegial writing of this algorithm. This multidisciplinary study should facilitate the standardised, optimised management of skin toxicity associated with EGFR-inhibitors.
- [From quality of life to palliative care in cancerology]. [Journal Article]
- Bull Cancer 2013 Mar; 100(3):183-9.
- New advances in the management of thoracolumbar spine metastasis. [JOURNAL ARTICLE]
- Bull Cancer 2013 Apr 29.
Vertebral metastases affect 20 to 50% of cancer patients and represent a major turning point in the disease from the functional impact they generate. Early treatment is mandatory to prevent or treat any neurological compression. Due to the high variability of clinical and radiological presentations, best care requires a multidisciplinary team, involving oncologists, radiation oncologists, interventional radiologists and spine surgeons. Recent advances in radiotherapy and interventional radiology have offered various efficient therapeutic solutions with relatively low morbidity rate in the management of symptomatic spine metastases. However, surgery remains the standard treatment for patients with rapidly progressive spinal cord compression or significant osteolytic lesion leading to a high risk of fracture. However, conventional surgical strategies are associated with significant morbidity and contraindicated in patients in poor general condition. In addition, postoperative complications are likely to affect patient's quality of life and delay the initiation of anticancer therapies. In order to reduce iatrogenic lesions, new "minimally invasive" techniques were developed to achieve immediate stabilisation and decompression while reducing the morbidity of the approach. We aim to inform the reader of the existence of these techniques so that each patient can benefit from treatment best suited to their situation.
- Malignant biliary obstruction, general review and clinical practice. [JOURNAL ARTICLE]
- Bull Cancer 2013 Apr 30.
This review recalls the clinical, anatomic, physiopathological and etiological features necessary in the management of patients with neoplastic bile duct obstruction and exposes the current practice concerning endoscopic and radiologic palliative drainage. Clinical practice according to the clinical situations is explained. This review exposes complications management for patients having undergone an endoscopic or percutaneous drainage of the biliary ducts, the particular case of periportal stenosis, the respective indications of endoscopic and transhepatic percutaneous drainage, usual immediate evolution according to the type of the stenosis and the technique used as well as the management in case of stent obstruction.
- Cancer surveillance in Spain: regional inequalities and peculiarities of temporal trends. [JOURNAL ARTICLE]
- Bull Cancer 2013 Apr 24.
Despite the tendency to confluence that shows the frequency of cancer in European countries, Spain presents some peculiarities that are discussed briefly. On the basis of low rates of incidence and mortality by most common tumours in men and women, in women, lung cancer mortality, from 1994 shows a 3% annual increase. Bladder cancer mortality in men is a somewhat special case. While in most European countries, there is a clear decrease in their rates, in Spain the evolution pattern is different, showing the highest rates since 2000. Geographical distribution of mortality patterns is very marked and shows great stability to over the years. However, there are some changes that are discussed briefly, as well as the possible influence of industrial pollution in these patterns.