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The tribological properties of adding copper oxide (CuO) and molybdenum disulfide (MoS2) nanoparticles powder in both organic (castor oil) and mineral oil (moulding oil) were investigated. These properties include coefficient of friction and wear between two surfaces, CK50 steel alloy and 2024-T4 aluminum alloy. The Nano lubricants were prepared by dispersing CuO and MoS2 nanoparticle powders at variable weight fractions 0.3, 0.5, 0.7, 1.0 and 2.0% in each oil lubricant. The friction and wear tests were carried out using a pin on the disk test principle by the vertical universal friction testing machine (MMW-1A). The instability problem with the lubricant suspension was solved by adding different weight fractions of GUM ARABIC, which leads to 2% of it gives more stable suspensions. The best results from both friction and wear Tribo tests are observed in 1%W of adding both nanoparticles to both oil lubricants. The formation of Tribo film due to the adsorption and adherence of Nano additives on the surfaces was responsible in reducing the wear properties. Hybrid (1%Wt CuO + 1Wt% MoS2) nanoparticles that added to both oils indicates more decreasing in friction and wear compared to the base oil. The coefficient of friction for hybrid Nano-particulate lubricants reduced to 81.7% and 76.03%, while the wear rate reduced to 93.17% and 92.23% compared to castor oil and moulding oil respectively as a base oil. The study provides insights into how Nano-lubricant additives could contribute towards tribological enhancement and improved product quality.

Screening digital mammography: one year result for the Alpes-Maritimes region Purpose. After one year of experience with screening digital mammography, the results of this technique (n=9640) are compared to screen-film mammography (n=240 376) with double reading. Methods. Evaluation for each technique of the rate of call-back, positive results before and after work-up by the first reader and distribution based on the BI-RADS classification by the ACR, rate of complementary US, detected abnormalities (microcalcifications) and detected cancers. Results. The rate of positive mammograms was significantly higher for the digital technique (17.3% versus 15.1%) because of the first reader (16.3% versus 13.9%) whereas it was significantly lower after complementary work-up (3% versus 3.7%). The rate of BI-RADS 0 was significantly higher with digital imaging irrespective of patient age. The rate of US was higher for type 1 and 2 breasts at digital imaging (46% versus 36%, p Conclusion. The increased number of positive results at first reading and increased number of US for digital mammography may relate to a learning curve and difficulties in comparing with prior examinations. These results should continuously be monitored and compared to national averages.

La castration et le tamoxifene ont ete pendant des decennies les principaux traitements antihormonaux des patientes atteintes de cancer du sein en situation metastatique et adjuvante. Depuis la possibilite d'utiliser en clinique de nouveaux agents antihormonaux, la connaissance des mecanismes de resistance a ces traitements suscite de plus en plus d'interet. Dans cette revue breve, nous nous. attacherons a decrire les principaux mecanismes de resistance permettant d'expliquer les nouvelles strategies therapeutiques dans cette population de cancers du sein hormonodependants.

The aim of this study was to reexamine the prognostic role of tumor cell kinetics measured by S-phase fraction (SPF) and to establish its clinically relevant threshold values. SPF was determined by flow cytometry in a group of 920 consecutive breast cancer patients, all followed at our institute for 10 years (1988 to 1998). Mean age was 60.5 years (27–89 years). Median follow-up was 63 months (3–150 months). All patients had initial surgical treatment. SPF quartiles were: Q1=3.08%, median value = 5.98%, Q3=10.22%. A significant difference in overall specific survival was obtained between two populations divided by a cutoff at Q1 (p

Resume Les reactions cutanees reactivees referent a la reactivation de lesions cutanees par un agent cytotoxique apres radiotherapie externe survenant uniquement dans un territoire irradie. Le docetaxel est un membre de la famille des taxanes dont le principal mecanisme d’action consiste a interrompre la division cellulaire par blocage de la polymerisation des microtubules. Aussi bien dans les cancers mammaires que pulmonaires, les taxanes sont de plus en plus utilises et efficaces, en association a la radiotherapie. La plupart des reactions cutanees reactivees qui sont rapportees dans la litterature concernent le paclitaxel et autres drogues. Nous rapportons 2 cas de reactions cutanees reactivees par docetaxel survenues apres irradiation. Meme si les causes restent a determiner, des hypotheses peuvent etre etablies. La connaissance de cet effet secondaire et de son implication dans la therapeutique necessite un depistage precoce afin de ne pas compromettre le bon deroulement du traitement.

Objectives. To investigate tumor response rate and treatment toxicity of a modified combination chemotherapy consisting of bleomycin (B), methotrexate (M), and CCNU (C) for patients with locally advanced, squamous-cell carcinoma of the vulva (not amenable to resection by standard radical vulvectomy) or recurrent disease (after incomplete resection). Tumor resectability was reassessed in patients who had responded to chemotherapy. Methods. The regimen consisted of bleomycin 5 mg intramuscular (im) days 1-5, CCNU 40 mg per os (po) days 5-7, and methotrexate 15 mg po days 1 and 4 during the first week. During weeks 2-6 the patient was administered bleomycin 5 mg im days 1 and 4, and methotrexate 15 mg po on day 1 of the week. This 6-week cycle was repeated at 49-day intervals. Results. Twenty-five eligible patients with a median age of 66 years (range, 39-82 years) were entered in this phase II trial. Twelve patients had primary locally advanced disease, 13 patients had a locoregional recurrence, and all received up to three BMC cycles. Two complete and twelve partial responses were observed (response rate, 56%; 95% confidence limits, 35-76%). The BMC regimen was associated with major hematological side effects and mild signs of bleomycin-related pulmonary toxicity. At a median follow-up of 8 months, 3 patients were alive, 18 had died due to malignant disease, 2 had died due to toxicity, and 2 had died due to intercurrent disease and unknown cause. The median progression-free survival was 4.8 months and the median survival was 7.8 months. The 1-year survival was 32% (95% confidence limits, 13-51%). Conclusion. The present data confirm the therapeutic activity of the BMC regimen in locoregionally advanced or recurrent squamous-cell carcinoma of the vulva. Following neoadjuvant chemotherapy, the overall response rate was 56%. BMC is an outpatient treatment that may play a role in the palliative therapy of advanced or recurrent vulva cancer. (C) 2001 Academic Press.

One hundred and twenty-nine patients with dissiminated breast cancer were selected to study the clinical applicability of changes in CA 15-3, tissue polypeptide specific antigen (TPS) and carcinoembryonic antigen (CEA) during therapy and how these compare with responses as assessed by UICC criteria in a multicentre study. The alterations in tumour marker levels followed the course of disease but indicated changes in the disease state earlier than clinical assessment (UICC criteria). Patients were grouped according to whether they had progressive disease (PD in groups III and IV), stable disease (SD in group II) or partial remission/complete remission (PR/CR in group I) during a treatment period of 6 months. The number of patients with a 50% decrease of the marker level, and the time at which this reduction was reached, was analysed in patient groups I–III. TPS showed this 50% decrease more frequently (69%) and also earlier (1.1 months) than either CA 15-3 (46% and 2.5 months) or CEA (47% and 1.7 months). The number of patients for whom marker levels increased by 25% or more was analysed in patient groups III and IV versus groups I and II. Such rises were seen more often in patients with progressive disease (TPS 82%, CA 15-3 62% and CEA 61%) than in patients with a more favourable prognosis (TPS 43%, CA 15-3 22% and CEA 24%). The dynamics of changes in tumour marker levels were different during treatment in patients with SD, PR or CR. However, the markers showed similar behaviour in patients developing PD during the study period. TPS appeared to indicate outcome somewhat better than did either CA 15-3 or CEA. Combined determination of CA 15-3 and TPS during therapy for metastatic breast cancer is recommended.

PURPOSE To compare the efficacy and toxicity profiles of a combination of fluorouracil (5-FU) with recombinant human interferon alfa-2a (Roferon-A; Hoffman La-Roche AG, Basel, Switzerland) versus the combination of 5-FU with leucovorin (LV) in the treatment of advanced colorectal cancer. PATIENTS AND METHODS A total of 496 previously untreated colorectal cancer patients were randomized to receive either Roferon-A (9 MIU) subcutaneously three times per week, with 5-FU (750 mg/m2/d) by continuous intravenous (i.v.) infusion (CIV) on days 1 to 5, then, after a 9-day hiatus, as a weekly i.v. bolus at the same dose (IFN/5-FU); or LV (200 mg/m2/d) by i.v. infusion plus 5-FU (370 mg/m2/d) by i.v. bolus on days 1 to 5, repeated every 4 weeks (LV/5-FU). RESULTS There were no significant differences between IFN/5-FU and LV/5-FU in the overall response rate (21% v 18%), duration of response (7.3 v 6.2 months), or survival time (median, 11.0 v 11.3 months). Toxicity profiles differed; constitutional symptoms and myelosuppression were more frequent and more severe with IFN/5-FU, and gastrointestinal symptoms with LV/5-FU. More patients interrupted treatment for adverse events (AEs) with IFN/5-FU than with LV/5-FU. Five treatment-related deaths occurred with each regimen. CONCLUSION The combination IFN/5-FU produced response rates, response durations, and survival times similar to those with LV/5-FU. Biochemical modulation of 5-FU by either IFN or LV appears to result in equivalent efficacy; however, fewer patients were able to tolerate the specified IFN/5-FU combination used in this study.

The antiemetic efficacy and safety of granisetron (40 μg/kg), a selective and potent 5-hydroxytryptamine (serotonin) antagonist, was compared with that of metoclopramide (7 mg/kg) plus dexamethasone (12 mg) in patients receiving fractionated chemotherapy. Patients receiving cisplatin at doses of at least 15 mg/m2 or etoposide at least 120 mg/m2 or ifosfamide at least 1.2 g/m2 on each of 5 consecutive days were eligible. A total of 143 patients received granisetron and 141 received the comparator regimen. The 5-day complete response rate (no vomiting, no worse than mild nausea) for granisetron (46.8%) was equivalent to that for metoclopramide plus dexamethasone (43.9%). The overall 5-day response profile was superior for granisetron (P=0.013) because of fewer failures in this group. The overall incidence of adverse experiences was significantly lower in the granisetron group (60.8% versus 77.3%,P=0.003). Headache and constipation, more prevalent in the granisetron group, are recognized side-effects of serotonin antagonists. Extrapyramidal syndrome, not seen in any granisetron patients, occurred in 20.6% of comparator patients (P

Anthracyclines are among the most active drugs for the treatment of advanced breast cancer. Epirubicin has been found to be as effective as doxorubicin at equimolar doses but significantly better tolerated, especially in terms of alopecia, leucopenia, and cardiac toxicity. The role of anthracycline-containing regimens in adjuvant treatment of breast cancer has been studied by only a few clinical trial teams. In 1986, the French Adjuvant Study Group (FASG) began a randomised trial aimed to investigate the concept of dose intensity as well as the optimal duration of treatment in patients with early breast cancer. Between 1986 and 1990, 621 patients were included in the trial, of whom 595 were evaluable. Patients were randomised to 1 of 3 treatment groups: Group A (n = 207) received FEC 50 (fluorouracil 500 mg/m2, epirubicin 50 mg/m2 plus cyclophosphamide 500 mg/m2) every 21 days for 6 cycles; Group B (n = 193) received FEC 50 every 21 days for 3 cycles; Group C (n = 195) received FEC 75 (fluorouracil 500 mg/m2, epirubicin 75 mg/m2 plus cyclophosphamide 500 mg/m2) every 21 days for 3 cycles. Locoregional radiotherapy was administered after the third cycle of chemotherapy in all treatment arms. Clinical prognostic factors were similar between treatment groups. Approximately 62% of all patients had 1 to 3 positive lymph nodes; 50% of patients were hormone receptor positive and 73% were Scarff-Bloom Richardson (SBR) grade 2 to 3. Toxicity was evaluated in 595 patients (207, 193 and 195 patients in Groups A, B and C, respectively), who received a total of 2301 chemotherapy cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

38 adults with recurrent supratentorial malignant gliomas, including glioblastoma multiforme (21), anaplastic astrocytomas (9), probably transformed low-grade astrocytomas (6), pinealoblastoma (1) and non-metastatic tumour of unknown histology (1), were treated with fotemustine 100 mg/m2 intravenously every week for 3 consecutive weeks followed by a 5-week rest period. Maintenance treatment consisted of one infusion every 3 weeks. Patients were divided into three groups according to treatment effect. 10 objective responses (26%) with a median time without progression of 32.7 weeks, 18 stabilisations (47%) and 10 failures (26%) were observed. Pathological findings of the initial primary tumour and neurological functional status were unequally distributed in these groups. Haematological and liver toxicities were mild, delayed, transient and reversible. Thrombocytopenia and leukopenia were more frequent (30%) in patients treated with prior chemotherapy. Fotemustine is a well tolerated active drug in recurrent malignant gliomas with an original and short treatment schedule.

A randomized double-blind study with a 3-yr follow-up comparing the two arms “orchiectomy + Anandron ® (300 mg)” vs “orchiectomy + placebo” in 125 patients with stage D prostate cancer has confirmed the beneficial effects of the combined Anandron ® therapy on subjective parameters and on the best objective response (NPCP criteria), although these effects were not statistically significant, but failed to detect any improvement in time-to-disease progression or survival. Comparison with the results of other trials emphasizes the urgent need to establish suitable prognostic factors by further clinical research before evaluating the benefits of individual drugs.

L’indication standard d’un traitement neo–adjuvant repose sur le desir de realiser une chirurgie conservatrice chez une patiente dont la tumeur est trop grosse pour pouvoir esperer lui eviter un geste mutilant. De nombreux essais therapeutiques randomises ont demontre que cette approche provoquait en effet une diminution de la taille de la tumeur et augmentait par consequent le taux d’exerese partielle. Deux methodes therapeutiques neo–adjuvantes sont utilisees : la chimiotherapie et/ou l’hormonotherapie. Si la chimiotherapie neoadjuvante n’a ete concue que pour eviter les mammectomies totales, l’hormonotherapie neo–adjuvante a ete prescrite aussi a des patientes dont l’etat general etait trop precaire ou l’âge trop avance pour accepter ou tolerer un geste chirurgical. Les 1res hormonotherapies neo–adjuvantes ont ete constituees exclusivement par le tamoxifene. Actuellement, les inhibiteurs de l’aromate de 3e generation y prennent une place de plus en plus importante.

30 patients with advanced ovarian cancer, all platinum pretreated, were treated with an induction cycle of fotemustine. Maintenance therapy was given to 6 patients. No objective response was observed among the 21 evaluable patients. The main toxicities were gastrointestinal, with grade 3 nausea and vomiting reported in 40% of the patients, and haematological, with grade 4 leucopenia reported in 2 patients and grade 4 thrombocytopenia in 5 patients. Therefore, no role has been demonstrated in our cohort for the use of fotemustine, a nitrosourea, in pretreated ovarian cancer. (C) 2003 Elsevier Science Ltd. All rights reserved.

Between March and September 1988, 74 patients with progressive ovarian cancer after prior platinum-based therapy were treated with the luteinizing hormone-releasing hormone (LHRH) agonist Triptorelin (Decapeptyl(R)). Treatment consisted of i.m. injection of 3.75 mg of microencapsulated Triptorelin on days 1, 8 and 28 followed by 4-weekly injections until tumor progression. No objective responses were observed. Eleven out of 68 evaluable patients (16%) had stable disease. The median progression-free survival was 5 months in patients with disease stabilization and 2 months for all evaluable patients. The median survival for patients with disease stabilization was 17 months, whereas for all patients it was 4 months. The treatment was well tolerated; the only reported adverse events were incidental hot flushes. This study showed that the LHRH agonist Triptorelin has only modest efficacy in patients pretreated with platinum-containing chemotherapy. [(C) 2001 Lippincott Williams & Wilkins.].

TPS, CA 15-3 and CEA were determined in metastatic breast cancer patients during treatment. After six months of follow-up the patients were divided into four groups according to the UICC criteria for treatment response. Forty-six patients with a more favorable prognosis (complete remission, partial remission or stable disease) were followed for an extended period. In 30 of the 46 patients at least one marker had increased at the end of the six-month period by at least 25% (TPS in 54%, CA 15-3 in 20%, CEA in 20%). All these 30 patients subsequently developed progression. The prognostic sensitivity was 83%, 30% and 30%, respectively, for TPS, CA 15-3 and CEA. The combination of TPS and CA 15-3 showed a sensitivity of 96%. The median lead time was about 8 months for TPS and CA 15-3, but less than 50% of the patients showed a lead time for CA 15-3 as compared to TPS. We conclude that TPS and CA 15-3 determinations are helpful for the prediction of progression during the follow-up of breast cancer patients.

Patients with measurable or evaluable locally advanced or metastatic squamous cell carcinoma of the oesophagus were treated with cisplatin (CDDP), 100 mg/m2, combined with 5-fluorouracil (5-FU) at a dose of 1000 mg/m2 as a continuous infusion from days 1-5 (Arm A) or with CDDP alone (Arm B). Cycles were repeated every 3 weeks. 92 patients were randomised centrally, 88 were eligible. The response rate was 35% (95% CI (confidence interval), 20-54%) in Arm A and 19% (95% CI, 8-35%) in Arm B. One complete response was observed in each arm. The median duration of survival was 33 weeks and 28 weeks for Arm A and Arm B, respectively. Haematological and non-haematological toxicities were more frequent and more severe in Arm A. The most prominent toxicities were grade 4 aplasia and septicaemia (2), meningeal haemorrhage (1), cerebrovascular accident (3) and ischaemia of the lower limbs (1) all occurring in Arm A. Overall, seven treatment-related deaths (16%) were observed in Arm A, none in Arm B. The severe side-effects induced by the combination suggest that, currently, no standard chemotherapy can be recommended for patients with advanced squamous cell oesophageal cancer.

AIMS: To determine whether the presence of disseminated bone marrow tumour cells at diagnosis is a prognostic factor for breast cancer patients at high risk of recurrence or bone metastasis, and to assess their presence as a criterion for evaluation of the potential benefits of adjuvant chemotherapy. METHODS: Multiple bone marrow aspirates from 72 breast cancer patients free from metastasis were obtained during surgery at the time of diagnosis and were tested immunologically by alkaline phosphatase antialkaline phosphatase technique with a panel of three antiepithelial monoclonal antibodies (MoAb) KL1, EMA, and HMFG2. RESULTS: In nine of 72 patients, with each MoAb tested, numerous strongly positive cells always isolated were observed. However, it was demonstrated that these cells were non-specifically labelled and could be found in normal controls. CONCLUSIONS: There was no evidence of marrow tumour cells in 72 operable breast cancer patients. It is suggested that published results may be greatly overestimated and that non-specific labelling may be undetected. More specific MoAb should be found and a correlation with molecular biology should be performed if this criterion is to be considered as a prognostic factor.

ZD1694 ('Tomudex'), a novel, direct and specific thymidylate synthase (TS) inhibitor, was developed in a collaborative research programme between Zeneca Pharmaceuticals and the Institute of Cancer Research (UK) and entered clinical trials in 1991; phase II studies began in 1992, using 3.0 mg m-2 every 3 weeks as a short 15 min infusion. Forty-six patients entered a phase II study of ZD1694 in advanced breast cancer. A total of 74% of patients had received prior systemic therapy (either as adjuvant cytotoxic or hormonal therapy or hormone therapy for advanced disease); 39% had received prior adjuvant cytotoxic chemotherapy. All patients had measurable disease and 50% had liver metastases. In all 43 patients were evaluable for response. Of these patients 26% achieved complete (CR) or partial response (PR) (95% Cl 14-42%). A response rate of 44% was seen in liver metastases. Two patients achieved CR of 265 and 301 days' duration respectively, one in locoregional disease, and one in liver metastases. The most common grade 3/4 adverse events were nausea and vomiting (11%), diarrhoea (11%) and leucopenia (20%). Grade 3/4, self-limited and reversible increases in transaminases were seen in 22% of patients. ZD1694 has useful single agent activity in patients with hormone-refractory advanced breast cancer, comparable with that reported for other anti-metabolites, with acceptable tolerability.

Trilostane and aminoglutethimide, both given with a physiological replacement dose of hydrocortisone, were randomly allocated to 112 eligible patients with postmenopausal advanced breast cancer. Following treatment failure on either drug the patient continued with the other, if they were in a suitable clinical condition. Sixty-three patients initially received trilostane, of whom 33 subsequently received aminoglutethimide; 49 patients initially had aminoglutethimide and 14 of these then received trilostane. Both groups of patients were comparable in all respects. There was no difference in the response rate to either drug or in the average time to disease progression for the two drugs. Of the 47 patients who received both drugs, nine (19%) showed a response to both, indicating no cross-resistance. Side effects were seen to both drugs in approximately half the patients; these were mainly gastrointestinal symptoms with trilostane and rashes and drowsiness with aminoglutethimide. There was no evidence of cross-over patient susceptibility to side effects.

c-myc proto-oncogene amplification seems to have a prognostic value in breast cancer. In this study, quantitative analysis of c-myc amplification was carried out by differential polymerase chain reaction technique (d-PCR) using beta-globin as the reference gene. d-PCR assessment showed coampIification products of c-myc and beta-globin depend on variations in reaction factors such as the genomic DNA concentration, the relative concentrations of the various amplimers, the thermostable DNA polymerase concentration and the number of cycles. However, amplification of c-myc can be estimated quantitatively. In addition, results of individual sets of d-PCR can be expressed on a standard reference scale. A clinical study of 309 patients with breast cancer found c-myc amplification, respectively in 19% (45/236) of primary tumour tissues, 21% (4/19) of subsequent second primary cancers, 36% (4/11) of tumours of patients with bilateral lesions, 40% (8/20) of local recurrence tumours and 22% (5/23) of metastatic lesions. Amplification of c-myc was observed more frequently in histological grades 2-3 (p

e11556 Background: Metastatic breast cancer (MBC) is a heterogeneous disease with many treatment options, including single-agent or combination chemotherapy. We analyzed in a real-life setting the therapeutic decision for treating MBC with non-pegylated liposomal doxorubicin (Myocet, LED) or another chemotherapeutic agent (non-LED). Methods: A European, multicentre, prospective, 6-month cohort study, with a treatment group comparison at the time of inclusion (LED vs. non-LED), is currently recruiting across 8 countries adult women with confirmed MBC and scheduled first cycle of chemotherapy. LED and non-LED patients were matched on MBC chemotherapy line. Results: We analyzed 505 patients (360 LED, 145 non-LED) included from Jan-09 to Dec-10. 85% had a WHO performance status of 0-1 and the median age was 60 yrs. 22% were HER2-positive at initial diagnosis. The median number of metastatic sites per patient was 2, and main sites of metastases were bone (63%), liver (45%) and lung (39%). Comparison of 143 pat...

Objectif Le but de cette etude est d’identifier les facteurs influencant la participation des patients et des medecins lors de la premiere campagne de depistage organise du cancer olorectal dans les Alpes-Maritimes. Patients et Methodes Les 474 medecins generalistes de Nice en exercice ont ete repartis en 4 classes en fonction du nombre de tests Hemoccults® lus. Un tirage aleatoire de 14 medecins par classe a permis de constituer un echantillon representatif de 56 medecins generalistes. L’investigateur s’est rendu durant une journee dans chaque cabinet medical pour administrer les questionnaires aux patients de 50 a 74 ans presents dans la salle d’attente, tandis que chaque medecin remplissait lui-meme son questionnaire. Resultats Cinquante et un medecins soit 94,4 % de l’echantillon ont participe a l’enquete. 94 % d’entre eux declaraient participer au depistage organise. Beaucoup ressentaient des contraintes au depistage (82 %), et avaient des difficultes a recommander le test (60 %). Certains avaient peur de rassurer leurs patients a tort (45 %) ou trouvaient le test peu fiable au point de ne pas le recommander (29 %). Pour 39 % des medecins une consultation dediee a la prevention ameliorerait leur implication dans le depistage. Cote patients, 250 questionnaires ont ete distribues avec un taux d’acceptation de 96,8 %. Les femmes realisaient le test plus souvent que les hommes (26 vs 22 %). La non proposition du test par le medecin etait la raison principale de non participation. Cette non proposition du test etait plus frequente pour les patients celibataires (P L’analyse en miroir montrait que les medecins surestimaient les difficultes de realisation du test par les patients, et la gene a manipuler les selles. Discussion Une simplification administrative, des outils de rappel informatique, une consultation dediee a la prevention, et une meilleure information du public sont les moyens proposes pour augmenter la participation. Conclusion Les resultats de cette etude soulignent la confiance qu’ont les patients dans leur medecin generaliste, mais aussi les difficultes des medecins pour integrer le depistage dans la consultation pour un autre motif, surtout lorsque les patients ne sont pas demandeurs.

Objectif Decrire les modalites, le contenu et les techniques pedagogiques de la formation proposee aux medecins generalistes des Alpes-Maritimes avant le demarrage de la campagne de septembre 2005 a novembre 2006. Materiels et Methodes Le departement a ete decoupe en sept zones et les 1 190 medecins generalistes du departement ont ete invites successivement territoire par territoire, juste avant d’informer les patients sur la campagne, a participer a une journee (samedi) de formation sur le depistage du cancer colo-rectal. Le recrutement s’est appuye sur les associations locales de FMC, les medecins etant indemnises de meme que les formateurs. Cette journee se deroulait selon des methodes pedagogiques interactives en petits groupes. Le contenu etait reparti en 5 sequences comprenant le matin l’identification des representations des medecins sur depistage et cancer colo-rectal, le bilan des connaissances par la technique du Quizz, un atelier pratique de maniement de l’Hemoccult ® , et l’apres-midi des jeux de role sur la pratique du depistage puis un expose interactif du gastro-enterologue. Resultats Trente seminaires ont ete realises dans les sept zones du departement, permettant la formation de 455 generalistes soit 38,2 % de la cible. A l’issue de la formation 72 % des participants trouvaient la formation adaptee et 71 % se sentaient a l’aise pour proposer un depistage. Parmi ceux qui n’avaient pas participe a la formation, 705 medecins (59 %) ont ete visites par une deleguee a l’information d’APREMAS afin d’apporter les outils du depistage et delivrer les messages principaux ; 30 ont refuse la visite et 40 ont refuse de participer au depistage organise suite a la visite. Au total 1 120 MG (94 %) avaient recu une information ou une formation et disposaient du materiel. Discussion L’originalite de la formation dans notre departement repose sur sa duree d’une journee qui a permis d’utiliser des methodes pedagogiques interactives, favorisant une meilleure integration de la formation dans la pratique. L’integration des medecins generalistes au comite de pilotage de la formation, et leur presence comme formateurs ont favorise l’adhesion des participants et permis de repondre au plus pres aux questions de pratique. Conclusion La formation d’une journee au depistage du cancer colo rectal a permis d’aller au-dela de l’apprentissage du simple maniement du test, en proposant d’identifier les representations des medecins par rapport au depistage organise des cancers, ainsi que les freins et les moteurs au depistage organise.

Abstract #5010 Background: In 2005, a first EDIFICE survey was aimed to provide a better understanding of population s adherence to the screening tests available in France and results pertaining to breast cancer are reported (Int. J. Med. Sci. 2008, 5: 106-112). In 2008, EDIFICE survey is performed again to assess the evolution 3 years later. Taking into account that the Implementation of breast cancer screening has been generalized in France since 2003: All women aged between 50 and 74 years are systematically invited to perform a mammography every two years. Methods: This second nationwide observational survey was carried out from December 12, 2007 to January 07, 2008 among a representative samples of 1802 French people aged between 40 and 85 years and 600 general practitioners (GPs). Information collected included socio-demographic characteristics, attitude towards cancer screening and actual experience of cancer screening, as well as GPs practice regarding screening. The precision of the results is 4.3% for a 95% confidence interval. Results: In EDIFICE–1 and -2, 501 and 488 participating women aged between 50 and 74 years are assessed, respectively. In EDIFICE-2, there was a significant relationship (p Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5010.

In this study, patients with operable breast cancer T2 or T3, treated by mastectomy + axillary dissection and with invaded axillary nodes (N+), were randomized to receive either: 1) postoperative locoregional and pelvic radiotherapy (RX) and Poly(A).Poly(U) (AU), 60 mg IV once a week for 6 weeks, or 2) CMF (cyclophosphamide 100 mg/sqm P.O. on days 1-14, methotrexate 40 mg/sqm IV on day 1 and 8, fluorouracil 600 mg/sqm IV on day 1 and 8; monthly cycle, for 6 months. Between March 1982 and December 1985, 517 patients were enrolled, 257 of whom were treated by RX + AU and 260 with CMF. The main clinical, pathological and prognostic characteristics were equally distributed in the two groups. The present analysis was conducted after a mean follow-up of 69 months (S.D. = 13). There was no significant difference in overall survival (OS) between the two groups (test adjusted by center and menopausal status); the five-year OS rate was 74% in the RXAU group and 77% in the CMF group. Relapse-free survival (RFS) was significantly higher (p = 0.05) in the RXAU group compared to the MCF group; the five-year RFS rates were 57% and 46% in the two groups respectively. This short, well-tolerated combined RXAU treatment appears to be as efficient as CMF and might offer an alternative to chemo- or hormonotherapy, in case of contraindications to these treatments.

We measured squamous cell carcinoma antigen (SCC) in epidermoid carcinoma of the anal canal in 66 patients. Samples were taken at diagnosis, before treatment, and during follow-up; 353 samples were analyzed. The positive threshold was taken as 2 ng/ml. At diagnosis, the sensitivity of the marker was 44 percent and its specificity 92 percent. In our series, the pretherapeutic level of SCC does not correlate with T as in Papillons' Clinical Staging System, but it does correlate with nodal invasion (P less than 0.05). It is of no prognostic value at the time of diagnosis. During follow-up, at relapse the level of SCC is 20.3 +/- 43 ng/ml. This increase is significant (P less than 0.01): the sensitivity of the marker is 77 percent. In patients who have relapsed, development of the illness correlates with the level of SCC, which is of prognostic value (P less than 0.01). In conclusion, the level of SCC should be associated with the clinical follow-up of patients with epidermoid carcinoma of the anal canal.