[Non-small lung cancer, ECCO/ESMO congres 2017]. / Cancers bronchiques non à petite cellule : congrès de l'ECCO/ESMO 2017.

During the esmo congress that took place from 08 to 12 September 2017 in Madrid, non-small cell lung cancer (NSCLC) was the subject of various communications and posters. We selected the most innovative and most likely to change our daily practice These updates presented concerned both localized and metastatic lung cancers. For completely resected localized stages minimal monitoring by annual CT scan is recommended, in stage III after radio chemotherapy durvalumab treatment provides better progression-free survival (PFS). For metastatic stages, pembroluzumab immunotherapy plus platinum-based chemotherapy in first-line is superior to chemotherapy alone in terms of response rate, second-line treatment with nivolumab provides better overall survival (OS) at 3years, the duration of 1year is characterized by a PFS lower than a continuous treatment. In EGFR mutated NSCLCs, the best choice between 3rd and 1st generation EGFR antigen has generated a lot of debate after the interesting results in terms of progression-free survival (PFS) of osamertinib in 1st metastatic line as well as for NSCLC with ALK rearrangement, alectinib was superior to crizotinib in the first metastatic line even in the presence of brain metastases.

Patterns of practice in palliative radiotherapy in Africa - case revisited.

AIMS: To investigate patterns of practice in palliative radiotherapy in Africa. MATERIALS AND METHODS: Fifteen centres in Africa provided detailed information about radiotherapy in both metastatic and locally advanced disease via a questionnaire. Information included general information (institution status, equipment, staff, patient number), radiotherapy and other treatment characteristics in bone metastasis, brain metastasis, metastatic spinal cord compression, lung and liver metastasis, as well as locally advanced tumours. RESULTS: The number of patients annually seen/treated ranged from 285 to 5000. Breast, cervix, head and neck, gastrointestinal and prostate cancer were the top five cancers overall. Eight (53%) institutions were without linear accelerators, four (27%) had a single one, whereas one institution each had two, three and four linear accelerators. The number of cobalt machines ranged from 0 to 2 (median 1). Most centres still prefer to use fractionated radiotherapy regimens over single-fraction regimens in bone metastasis, although most centres are now using single-fraction radiotherapy in retreatments. Radiotherapy in brain metastasis and metastatic spinal cord compression mostly conform to worldwide standards. Lung and liver metastases are rarely irradiated, largely as a consequence of the lack of modern radiotherapy technology. Locally advanced disease in various tumour sites was mostly palliated, in agreement with current evidence-based practices. CONCLUSIONS: African countries still lack adequate staffing and equipment to adequately address their clinical burden, being palliative in most cases. Emphasis should also be made on more rationally using existing capacities by using more of the single-fraction radiotherapy regimens, especially in bone metastasis.