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The article discusses initial treatment of cancer with intravenous chemotherapy. Topics discussed include impact of the treatment on patients' psychological and physical states and lifestyles, evaluation of the treatment through food analysis by patients, and importance of patient education program for the patients.

Glioblastoma is one of the most common types of primary brain tumor. In situations of local recurrence, physicians can suggest either specific palliative anticancer treatments (SPAT; surgery, chemotherapy, radiotherapy) or best supportive care (BSC). The objective of the present study was to identify clinical factors that may have influenced the continuation or cessation of SPAT during the final 3 months of life in patients with glioblastoma. In the present retrospective single-center study, all records of patients treated for glioblastoma, who succumbed to the disease between June 2006 and February 2014, were assessed. All selected patients were divided into two groups, according to treatments received during the last 3 months of life: The SPAT and BSC groups. A total of 148 patients were included: 81 patients in the SPAT group (group A) and 67 patients in the BSC group (group B). A performance status equal to 0 was observed for 17.3% of patients in group A vs. 6% in group B. Following progression, chemotherapy was administered in 39.5% of cases in group A vs. 20.9% of cases in group B (P=0.0149). The mean number of lines of chemotherapy administered in group A was equal to 1.44±0.77 as compared with 1.06±0.67 in group B (P=0.0017). SPAT are utilized frequently among patients approaching mortality due to a glioblastoma. Certain factors, including the utilization of novel chemotherapy after the first progression or number of lines of chemotherapy previously administered, may have influenced physicians' decisions whether to continue with the SPAT or not. [ABSTRACT FROM AUTHOR]

Background: The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. Methods: In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Results: Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Conclusion: Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Based on preclinical studies showing that IDH-mutant (IDHm) gliomas could be vulnerable to PARP inhibition we launched a multicenter phase 2 study to test the efficacy of olaparib monotherapy in this population., Methods: Adults with recurrent IDHm high-grade gliomas (HGGs) after radiotherapy and at least one line of alkylating chemotherapy were enrolled. The primary endpoint was a 6-month progression-free survival rate (PFS-6) according to response assessment in neuro-oncology criteria. Pre-defined threshold for study success was a PFS-6 of at least 50%., Results: Thirty-five patients with recurrent IDHm HGGs were enrolled, 77% at ≥ 2nd recurrence. Median time since diagnosis and radiotherapy were 7.5 years and 33 months, respectively. PFS-6 was 31.4% (95% CI [16.9; 49.3%]). Two patients (6%) had an objective response and 14 patients (40%) had a stable disease as their best response. Median PFS and median overall survival were 2.05 and 15.9 months, respectively. Oligodendrogliomas (1p/19q codeleted) had a higher PFS-6 (53.4% vs. 15.7%, P  = .05) than astrocytomas while an initial diagnosis of grade 4 astrocytoma tended to be associated with a lower PFS-6 compared to grade 2/3 gliomas (0% vs 31.4%, P  = .16). A grade 2 or 3 treatment-related adverse event was observed in 15 patients (43%) and 5 patients (14%), respectively. No patient definitively discontinued treatment due to side effects., Conclusions: Although it did not meet its primary endpoint, the present study shows that in this heavily pretreated population, olaparib monotherapy was well tolerated and resulted in some activity, supporting further PARP inhibitors evaluation in IDHm HGGs, especially in oligodendrogliomas., Competing Interests: I.E.: none. M.S.: none. O.C.: none. M.F.: research purposes from Servier company, benefits for interventions from Seagen and Novocure, and payment of congress fees from Gilead and Pfizer. R.R.: Advisory board (Daiichi Sankyo, Lilly), travel grants (Amgen, Astra Zeneca, Bayer HealthCare SAS, Daiichi Sankyo, Lilly, MSD France, Novartis Pharma SAS, Pfizer, Roche). S.C.: MSD (travel grant). E.T.: Gliocure, Leo Pharma (advisory board), Leo Pharma (research grant), Novocure, Servier (symposium. A.B-L.: none. A. D.: Servier, Novocure (advisory board), Servier (travel grants). D.M.: none. M.B.: none. F.G.: none. L.R.: none. D.M-B.: none. J.H.: Novocure (travel grants, advisory board). C.D.: none. F.D.: Servier, Novocure (advisory board, symposium)., (© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)

Competing Interests: B. Mery, G. Moriceau, R. Rivoirard et O. Collard déclarent n’avoir aucun lien d’intérêts.

Competing Interests: B. Mery, G. Moriceau, R. Rivoirard et O. Collard déclarent n’avoir aucun lien d’intérêts.

The ageing of French population imposes to radiotherapists the challenge to treat older patients and to adjust their treatment. Unthinkable 30 years ago, radiation therapy concerns nowadays patients aged more than 90 years old. Oncogeriatric scales have been improved those last years without necessarily making sure that the right treatment is given to the right patient: if oncogeriatric scales use influences the final therapeutic decision, it does not define new target volumes, new doses, or new fractionation protocols. Except for some organs, there is not, for the moment, any consensus concerning geriatric population adapted treatments. This makes any therapeutic decision difficult. The present review has for objective to realise a report of the studies about favorable and unfavorable effects of radiation therapy amongst aged (>70 years old) or very aged (>90years old) population., (Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Rare cancers represent about a quarter of all cancers diagnosed in Europe, and their incidence is increasing. Meanwhile, scientific advances provide techniques, which become more and more sophisticated in the domain of radiotherapy. Treatment options for radiotherapy rare cancers are increasing, but are not yet evaluated. The question of the appropriateness of treatment by modern radiotherapy techniques in rare cancers remains. There are a lot of cases reported in the literature for treating rare cancers by modern technology. These techniques are often used when anatomical and dosimetric constraints do not achieve optimal treatment by surgery or standard radiotherapy. In contrast, standard radiotherapy techniques also provide good results in terms of overall survival and tolerance. They are also less expensive and less complex in terms of dosimetry. The establishment of specialized centers in rare cancers seems essential to evaluate the appropriateness of the use of modern techniques in these cases. Currently, data from the literature does not provide an answer to this question., (Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

The number of nonagenarian people in the world is steadily growing. This phenomenon will increase in future years: in 2050, world population prospects estimate 71.16 million people aged 90 years or older. The two main causes of death among people aged 85 years or more in Europe in 2003 were cardiovascular and cerebrovascular diseases and cancers. However, the elderly are often excluded from clinical trials; they are underrepresented in clinical registries and especially nonagenarians. Care (medical, surgical, oncology) of these very elderly is currently insufficiently based on scientific recommendations. For the physician, the choice to treat or not to treat very elderly patients (for fear of side effects) is difficult. Oncology is particularly affected by this problem. Here we review these different fields of internal medicine management of nonagenarian patients with a special focus on oncology and on comprehensive geriatric assessment as a base for all care decision taking.

In France, there is an important interregional disparity concerning participation to cancer screening programs. The aim of this study was to assess oncologic screening practices in Loire, a French rural department, in women and in the elderly (over age 74 years). For this, two surveys were conducted. The first one was regarding screening for breast, cervical and colorectal cancer in women over age 18 years living in Loire. The second survey was regarding onco-geriatric screening through two questionnaires : one for the elderly and the other for general practitioner (GP) of the department, evaluating screening for breast, colorectal, prostate, cervical and lung cancer. One hundred sixty six women were included in the first investigation mean age of 47.6 years. Ninety three point six per cent were screening for breast cancer, 19% received Human Papilloma virus vaccine, 83.1% were screening by Papanicolau smear for cervical cancer and finally, 51.7% were screening for colorectal cancer, among the one entering screening program criteria. In the second survey, 44 patients and 28 GP were included. Thirty-eight point six per cent of patients over 74 years continue screening. Only 11.4% were reluctant to screening and in 80% because of anxiety du to the results. Among GP, 50 % continued screening on two major criteria : life expectancy and performans status. The present study shows heterogeneity of screening in this department both rural and working class and gives us a societo-medical photography.

Glioblastoma multiform is the most common and aggressive brain tumor with a worse prognostic. Ionizing radiation is a cornerstone in the treatment of glioblastome with chemo-radiation association being the actual standard. As a paradoxal effect, it has been suggested that radiotherapy could have a deleterious effect on local recurrence of cancer. In vivo studies have studied the effect of radiotherapy on biological modification and pathogenous effect of cancer cells. It seems that ionizing radiations with photon could activate oncogenic pathways in glioblastoma cell lines. We realized a review of the literature of photon-enhanced effect on invasion and migration of glioblastoma cells by radiotherapy.

In clinical practice and the literature, malignant melanoma usually appears in typical sites where melanocytes can be found: skin, eyes meninges and anal region. Malignant melanomas of the esophagus-gastrointestinal (EGI) tract are usually metastatic. Primary and diffuse EGI tract melanoma is rare and only a few descriptions of this presentation have been found in the literature. The prognosis of EGI tract melanoma is frightening because of late diagnosis and high malignancy potential. Treatment is based essentially on surgery. The objective of the present study is to specify the clinical and therapeutic aspects of primary digestive melanoma.