Pharmacological modulation of radiation-induced oral mucosal complications.

Radiation-induced mucositis is a common toxicity, especially in patients with head and neck cancers. Despite recent technological advances in radiation therapy, such as intensity-modulated radiotherapy, radiation-induced mucositis is still causing treatment disruptions, negatively affecting patients' long and short term quality of life, and impacting medical resources use with economic consequences. The objective of this article was to review the latest updates in the management of radiation-induced mucositis, with a focus on pharmaceutical strategies for the prevention or treatment of mucositis. Although numerous studies analysing the prevention and management of oral radiation-induced mucositis have been conducted, there are still few reliable data to guide daily clinical practice. Furthermore, most of the tested drugs have shown no (anti-inflammatory cytokine, growth factors) or limited (palifermin) effect. Therapies for acute oral mucositis are predominantly focused on improving oral hygiene and providing symptoms control. Although low-level laser therapy proved efficient in preventing radiation-induced oral mucositis in patients with head and neck cancer, this intervention requires equipment and trained medical staff, and is therefore insufficiently developed in clinical routine. New effective pharmacological agents able to prevent or reverse radio-induced mucositis are required.

[Management of endocrine dysfunctions after allogeneic hematopoietic stem cell transplantation: a report of the SFGM-TC on adrenal insufficiency and osteoporosis]. / Suivi et prise en charge des troubles endocriniens en post-greffe de cellules souches hématopoïétiques: insuffisance corticotrope et ostéoporose.

In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding the management of short and long-term endocrine dysfunction following allogeneic stem cell transplantation. The key aim of this workshop was to give an overview on secondary adrenal insufficiency and osteoporosis post-transplant.

Transcatheter therapy for hepatic malignancy: standardization of terminology and reporting criteria.

The field of interventional oncology includes tumor ablation as well as the use of transcatheter therapies such as embolization, chemoembolization, and radioembolization. Terminology and reporting standards for tumor ablation have been developed. The development of standardization of terminology and reporting criteria for transcatheter therapies should provide a similar framework to facilitate the clearest communication among investigators and provide the greatest flexibility in comparing established and emerging technologies. An appropriate vehicle for reporting the various aspects of catheter directed therapy is outlined, including classification of therapies and procedure terms, appropriate descriptors of imaging guidance, and terminology to define imaging and pathologic findings. Methods for standardizing the reporting of outcomes toxicities, complications, and other important aspects that require attention when reporting clinical results are addressed. It is the intention of the group that adherence to the recommendations will facilitate achievement of the group's main objective: improved precision and communication for reporting the various aspects of transcatheter management of hepatic malignancy that will translate to more accurate comparison of technologies and results and, ultimately, to improved patient outcomes.

[Granulomatous mycosis fungoides histologically simulating cutaneous sarcoidosis]. / Mycosis fongoïde granulomateux simulant histologiquement une sarcoïdose cutanée.

BACKGROUND: Granulomatous mycosis fungoïdes is an uncommon mycosis fungoïdes. We report a misleading case initially thought to be cutaneous sarcoidosis. CASE REPORT: A 34-year-old man developed stationary erythematous plaques on the trunk and members. Pathology reported a sarcoidal aspect. No extracutaneous sarcoidal lesions were found. The lesions resolved with puvatherapy. Five years later, the patient developed a voluminous skin tumor in the scapular area. Pathology reported granulomatous mycosis fungoides. Radiotherapy was given. Other plaques developed on the skin with the same histological aspect as initially and disappeared after local applications of chlormethine. During the clinical course, the patient developed visceral localizations of mycosis fungoides in the abdomen and pelvic nodes which responded to polychemotherapy. DISCUSSION: Histologically, granulomatous mycosis fungoïdes is defined as the association of epidermotropic T-cell lymphoma with epitheloid and giant cell dermal granulomas and no necrosis. Variants may be misleading when the epitheloid and giant cell aspect predominates, as in our observation. An analysis of 28 reported cases showed no disinction between the clinical features. Clinical course or treatment for granulomatous fungoides mycosis or classical fungoid mycosis. Extracutaneous sarcoidosis is rarely associated. Most likely, there is a tissue reaction to the lymphona.