Bulletin du cancer
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Pain is the most common symptom in patients suffering from cancer, in particular for advanced diseases. Unfortunately, one third of the patient do not benefit from optimal pain control. ⋯ This thorough evaluation can help to formulate a proper strategy for a treatment of pain that could be adapted to the disease evolution. A multidisciplinary approach with respect to the WHO prescribing criteria is the most appropriate way to control severe cancer pain syndromes.
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Randomized Controlled Trial Meta Analysis Comparative Study Clinical Trial
[Small cell lung carcinoma: role of thoracic irradiation and its timing in relation to chemotherapy].
Combined modality therapy is of great importance in the management of small cell lung cancer. Randomized studies of the design chemotherapy with or without thoracic irradiation are required to demonstrate the impact of radiotherapy on rates of survival, local control and adverse effects. The method of meta-analysis allows one to analyse in a single study a set of different clinical trials of the same design. ⋯ The overall survival rate was better in the "early radiotherapy" arm, with a median survival of 21 months and on overall survival rate of 20% at 5 years, compared to a median of 16 months and a 5 years survival of 11% in the "late radiotherapy" arm. The survival curves are significantly different by the log rank (P = 0.008) and Wilcoxon (P = 0.005) tests, in favour of "early radiotherapy". After allowing for prognostic factors (sex, ECOG performance status) by the Cox model, the "early" arm retains a statistically significant advantage (P = 0.006).(ABSTRACT TRUNCATED AT 400 WORDS)
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Review
[Cutaneous malignant melanoma in New Caledonia (South Pacific) 1973-1991. A study of 97 cases].
The Cancer Registries have been operational in the South Pacific since 1958 (Papua New Guinea), Fiji (1965) and New Caledonia (1977) and complete cancer incidence rates are available, based on histologic data. We studied 97 melanomas, histologically confirmed, which were diagnosed in New Caledonia from 1973 to 1991. New Caledonia is located in the same latitude as Queensland in Australia, known for having the highest incidence of melanoma in the world. ⋯ Screening for melanoma has been more effective in the last 6 years, a period in which we diagnosed half the total cases and generally at earlier stages. Prognosis was poor for this period (1973-1991): the five year survival rates were 64% +/- 8%, not as good as in Europe or Australia, but these lesions were diagnosed between 1973 and 1985 and were generally more invasive. A better prognosis will probably be observed in a few years, and another evaluation of melanoma screening should be made in the future as well the study of precursors and early lesions.
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In terms of pharmacology, drug delivery is an important obstacle in the development of brain tumor chemotherapy. The blood-brain barrier limits the drug penetration in normal brain tissue around the tumor and at distant potential metastatic sites. ⋯ The knowledge of the blood-brain barrier physiology and the definition of the laws that govern the drug delivery to the central nervous system allow the development of new strategies to increase drug delivery to the tumor. In pediatric oncology, the more appropriate methods are the use of anticancer agents that easily cross the blood-brain barrier and the development of high-dose systemic chemotherapy regimens with or without bone marrow rescue.