Metastatic desmoplastic small round cell tumor controlled by an anthracycline-based regimen: review of the role of chemotherapy.

Desmoplastic small round cell tumors (DSRCT) are rare and aggressive malignant neoplasms that usually occur in young males. They usually present intraabdominally with widespread peritoneal involvement at diagnosis and are sometimes associated with lymphadenopathies and liver metastases. Intraabdominal DSRCT is usually disseminated; no curative outcome has yet been achieved. We report a case of metastatic intraabdominal DSRCT controlled by an anthracycline-based regimen. A literature review of the treatment options, mainly chemotherapy, available for this unusual neoplasm, will be discussed. In patients with unresectable or metastatic disease, symptom control is most important because treatment modalities minimally impact survival. Palliative chemotherapy (mainly monotherapy) is preferable.

Treatment for metastatic nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a specific entity different from head and neck carcinoma. Incidence is higher in South-East Asia and North Africa. Prognosis, especially for locally advanced stages (IIB - IVB) and metastasis, remains poor: more than third of cases will present local and/or metastatic recurrence. Overall 5-year survival for all NPC stages ranges from 50% to 70%. The role of chemotherapy in metastasis is well established, and remains an important palliative treatment, although no randomized trial has been reported comparing the different chemotherapy regimens. As 1(st)-line treatment, platin-based regimens seems optimal; in 2(nd) line and after progression under platins, there is no consensus: monotherapy with drugs such as gemcitabine, capecitabine or taxanes has been the most widely tested, with acceptable results. Future trials should integrate targeted therapy, in the light of overexpression of EGFR1 and C-kit in NPC. The present study presents a review of the literature concerning the various studies of metastatic NPC.

[Psycho-social and religious impact of cancer diagnosis on Moroccan patients: experience from the National Oncology Center of Rabat]. / Impact psychosocial et religieux du diagnostic de cancer chez les patients marocains: expérience de l'Institut national d'oncologie de Rabat.

The impact cancer occurrence is variable according to the sociocultural issue, specific to each context and each area. In order to determine the psychosocial profile of Moroccan patients that have developed cancers, four studies were performed at the National institute of oncology (INO) in Rabat. These studies were prospective, included between 125 and 1,600 patients and were based on questionnaires developed by a medical oncologist, a psychologist and a sociologist. These studies were focused on the psychosocial characteristics of the Moroccan cancer occurrence on patients, the impact of cancer on the religious practice as well as the impact of cancer and its treatments on patients' sexuality. In this article, we will develop the particular characteristics of moroccan patients that were specific to their sociocultural context.

[Consequences of a comorbidity often neglected in oncology: malnutrition]. / Conséquences d'une comorbidité trop souvent négligée en cancérologie: la dénutrition.

Malnutrition is a common problem in patients with cancer, with a prevalence ranging between 30 and 80%, depending on the criteria used to determine malnutrition and patient characteristics. Malnutrition is a major cause of morbidity and mortality in cancer patients. It is associated with functional impairment, as well as poor outcome and quality of life. The impact on morbidity is persistent, with increased susceptibility to treatment-related adverse events, infection and postoperative complications. Significant weight loss is generally associated with higher mortality, possibly because it makes it impossible to administer the optimal therapeutic program in order to stabilize or cure the disease, in particular because of the patient's poor clinical condition or of increased treatment toxicity. In late stage patients, cachexia can be a direct cause of death. Studies have shown that direct or indirect complications of clinical malnutrition have economic implications; the number and length of hospital stays, as well as treatment and managements costs, are significantly increased in malnourished patients. Since the risk of hospital malnutrition can no longer be ignored, early nutritional assessment at the time of cancer diagnosis is mandatory in order to initiate timely nutritional therapy.