[Prognostic and predictive factors in lung cancer]. / Facteurs pronostiques et prédictifs des cancers bronchiques.

An impressive number of publications refer to prognostic and predictive factors in lung cancer. TNM classification and performance status significantly influence the choice of treatment and strongly predict patients' survival. Depending on the population studied (small cell or non-small cell cancer, operable or not) other independent factors improve the prediction of prognosis; they are clinical, biological, radiological or molecular and pertain to the tumor or the patient. Molecular targeted therapies development has renewed the interest towards predictive factors. New strategies are developed to explore individual response to treatment such as EGFR tyrosine-kinase inhibitors, without success for anti-angiogenic treatments. Conventional cytotoxic agents may also be customized with predictive factors (i.e. ERCC1 or RRM1). Large multicenter studies are needed to validate new independent prognostic factors and increase our current knowledge aiming at separating patients who will really benefit from therapies of those who will only experience the side effects.

[Postoperative treatment of malignant tumors of the parotid gland: radiotherapy, concomitant chemotherapy and radiation therapy?]. / Tumeurs malignes de la parotide: prise en charge multidisciplinaire, rôle de la radiothérapie.

The low incidence, the wide histological spectrum and the natural, sometimes slow, evolution of malignant parotid gland tumours do not allow to easily establish the impact of their treatments. At present, clinical data come from retrospective cohort analysis, whereas randomized phase II-III trials are confidential. Moreover conclusions from these studies are controversial. We present here the therapeutic highlights of parotid cancers: surgery, with the particular concern of facial nerve preservation; and adjuvant treatment essentially based on radiotherapy. This review focused on adjuvant care explores the indications and the technical aspects of radiation, as well as the role of concurrent chemotherapy.

[Central serous chorioretinopathy and systemic diseases report of 2 cases associated with corticotherapy]. / Choriorétinopathie séreuse centrale et maladies systémiques: deux cas observés sous corticothérapie.

INTRODUCTION: Central serous chorioretinopathy is an uncommon retinal disease, whose pathogenesis is largely unknown. It is characterized by an accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal detachment. It manifests generally as a visual loss or an abnormal colour vision. It is often idiopathic but may also be associated with numerous pathological situations, with frequent exposure to corticosteroids. EXEGESIS: We report on two patients with central serous chorioretinopathy. The first female patient had been treated with steroids for a systemic lupus erythematosus for fifteen years, and the second male patient had been treated with steroids for an idiopathic hypereosinophilic syndrome for a few months. Visual loss led to a diagnosis of central serous chorioretinopathy. Lowering of steroids doses was followed by a clinical improvement in both cases. CONCLUSION: Similarly to cataract or glaucoma, central serous chorioretinopathy belongs to the potential ocular side-effect of steroid treatment, and thus deserves to be known by internists.