[Standards, options and recommendations for nutritional support in bone marrow transplant patients]. / Standards, options et Recommandations pour la nutrition artificielle au cours et au décours de la greffe de cellules souches hématopoïétiques (CSH).

CONTEXT: 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 university and general hospitals and private clinics. Its main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To develop, according to the definitions of the Standards, Options and Recommendations, clinical practice guidelines for nutritional support in bone marrow transplant patients. METHODS: Data were identified by searching Medline , web sites and the personal reference lists of members of the expert groups, then submitted for review to 75 independent reviewers. RESULTS: The main recommendations for nutritional support in bone marrow transplant patients are: 1) Nutritional evaluation and monitoring may be proposed to bone-marrow transplant recipients (options). 2) Nutritional evaluation consists of body weight assessment and percent weight loss evaluation (standard, expert agreement). 3) Nutritional monitoring should include daily weight monitoring, clinical monitoring of hydration and assessment of daily dietary intake (standard, expert agreement). 4) Artificial nutrition is recommended in immuno-suppressed bone marrow transplant patients. This is not systematically indicated in other situation (standard). 5) Artificial nutrition, intravenous hydration and oral nutrition can be proposed to bone-marrow transplant recipients (option). 6) There is no standard modality for artificial nutrition (level of evidence B 1). Exclusive enteral or parenteral nutrition and enteral plus parenteral nutrition may be proposed to bone-marrow transplant patients (options). 7) Lipid intake representing up to 30% of the non-protein caloric intake should be supplied to patients undergoing bone marrow transplantation (standard, level of evidence B1). 8) Oral supplementation with nitrogen substrates or glutamine is not recommended. Parenteral glutamine supplementation may be proposed (option).

[2003 Update of Standards, Options and Recommendations for management of patients with salivary gland malignant tumors (excluding lymphoma, sarcoma and melanoma) (summary report)]. / Standards, Options et Recommations 2003 pour la prise en charge des patients atteints de tumeurs malignes des glandes salivaires (lymphomes, sarcomes et mélanomes exclus), mise à jour (rapport abrégé).

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, which started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French Regional 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. OBJECTIVES: To update clinical practice guidelines for the management of patients with salivary gland malignant tumors previously validated in 1997. These recommendations cover diagnosis, classification, treatment and follow-up of patients with these tumors. METHODS: The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPG s according to the definitions of the Standards, Options and Recommendations project. Once the guidelines has been defined, the document is submitted for review by independent reviewers. RESULTS: This article is a summary version of the full document presenting the updated clinical practice guidelines with algorithms. The main questions addressed by the expert group in this update concern the place of fine needle aspiration biopsy in preoperative diagnosis, the place of cervical lymph node area surgical treatment, the place of postoperative irradiation and neutron therapy in the treatment of unresectable tumors and also the place of medical imaging, especially RMI, for the diagnosis of these tumors.

[Clinical Practice Guidelines 2004. Standards, Options and Recommendations for the management of patient with adenocarcinoma of the stomach: radiotherapy (therapeutic evaluation)]. / Recommandations pour la pratique clinique. Standards, Options et Recommandations 2004 pour la prise en charge des patients atteints d'adénocarcinomes de l'estomac, cancers du cardia, autres types histologiques exclus (évaluation des thérapeutiques).

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French regional 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. OBJECTIVES: To elaborate clinical practice guidelines for patients with stomach adenocarcinoma. These recommendations cover the diagnosis, treatment and follow-up of these tumors. METHODS: 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. The Standards, Options and Recommendations are thus based on the best available evidence and expert agreement. RESULTS: This guidelines presents the synthesis of the data concerning the evaluation of the therapeutic ones. The main questions concern the type of gastrectomy to realize (Total Gastrectomy or gastrectomy subtotal), the extent of the lymphadenectomy (D2, D3 versus D1, D3, D2 versus D4) and the role of postoperative chemotherapy and adjuvant concomitant chemoradiotherapy.

[Clinical practice guideline: 2003 update of Standards, Options et Recommendations for first line palliative chemotherapy in patients with metastatic colorectal cancer (summary report)]. / Recommandations pour la pratique clinique: mise à jour 2003 des Standards, Options et Recommandations pour la chimiothérapie palliative de première ligne des patients atteints d'un cancer colorectal métastatique (rapport abrégé).

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, which started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French Regional Cancer Centres, 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. OBJECTIVES: To update clinical practice guidelines for first line palliative chemotherapy in patients with metastatic colorectal cancer previously validated in 1995, then updated in 1997 and published again in 1998. These recommendations do not cover second line treatment. METHODS: The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGs according to the definitions of the Standards, Options and Recommendations project. Once the guidelines have been developed, they are reviewed by independent reviewers. RESULTS: This article is a summary version of the updated clinical practice guidelines with algorithms. The main questions addressed by the expert group in this update concerned (1) Which patients should be treated? (2) What is the best treatment duration? (3) Which treatment should be administered? The new data identified concerning which patients to treat and the duration of treatment were consistent with the data presented in the initial report and did not modify the original recommendations from 1997. The new data available represent stronger evidence than those in the original report (Two good-quality meta-analyses published since 1997). A new guideline concerning patients who are 75 years old or more has been added. Concerning, the new evidence identified has modified the guidelines for the therapeutic schema to adopt from 1997. These modifications concern irinotecan, oxaliplatin, oral fluoropyrimidines and methotrexate. Treatment with irinotecan or oxaliplatin associated with continuous 5FU infusion, modulated with folinic acid (LV5FU2-like) has become a standard. The use of oral fluoropyrimidines has become an option for patients who refuse hospitalisation or treatment by infusion. The use of methotrexate combined with 5FU is no longer recommended.