Bulletin du cancer
-
Practice Guideline Guideline
[Standards, options and recommendations for the use of medical analgesics for the treatment of pain arising from excess nociception in adults with cancer (update 2002)].
The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of french cancer centers (FNCLCC), the 20 French cancer centers, 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. ⋯ For this update, only a few randomised clinical trials were identified, and their conclusions were generally weak. Thus much of the information in this document is based on the World Health Organisation (WHO) guidelines and represents the "state of the art" on this subject in France and is supported by expert agreement. Some changes to the original SOR are presented, eg. methods of titration, prescription of new opioids, opioid rotation. We also present a synthesis of recent pharmacological and regulatory data. The integral version is available on the FNCLCC web site (http://www.fnclcc.fr/sor.htm).
-
Gemcitabine has demonstrated a good efficacy in number of tumor types. Thanks to its favourable toxicity profile, gemcitabine can be used in combination with a number of drugs. Single agent gemcitabine and gemcitabine-based combinations have been evaluated in metastatic breast cancer. ⋯ Some of the combinations tested deserve further evaluation in phase III trials. Several phase III trials are in progress in Europe and in the USA. Final judgment on the contribution of gemcitabine will not be made until the results of these further studies become available.
-
Prospective analysis of local tumour control, survival and treatment complications in 67 consecutive patients treated with fractionated photon and proton radiation for a chordoma or a chondrosarcoma of the base of the skull and of the cervical spine. ⋯ In base of skull chordomas and chondrosarcomas, the combined photon and proton therapy offers excellent chances of cure at the price of an acceptable toxicity. These results should be confirmed with a longer follow-up.