Search

Introduction: To determine the proportion and the reasons which lead to palliative treatment in patients initially a candidate for concomitant chemoradiotherapy (CCRT). Methods: A retrospective study including patients followed for locally advanced lung cancer newly diagnosed from April 1, 2016, to 12/31/2017 in the radiotherapy department of the National Oncology Institute who received palliative treatment. Results: We collected 52 patients out of a total of 225 stage III patients (23%) followed by lung cancer candidates for CCRT who had undergone palliative treatment. The mean age in our series was 61.23 years [22 - 81] with 86% male. The majority of patients (71%) had Performance Status (PS) ≤ 2. Histological confirmation was obtained by pathological examination in all our patients. It was an adenocarcinoma (ADK) in 54% of cases; squamous cell carcinoma in 46% of cases. The reasons for palliative treatment were mainly due to dosimetric constraints: large tumor volume 22/52 (42%); the tumor location close to the bone marrow in 15 of 52 (29%) patients; and general Performance Status impairment (29%) in 15 of 52 patients. Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients (71%), among whom 19 (51%) were stable after 2 months of chemotherapy, in palliative dose chest radiotherapy on the pulmonary parenchyma and/or mediastinum in 10 of 52 (19%) patients, and supportive care in 5 (10 %) patients. We observed 40/52 (77%) cases of stationary course, 04/52 (8%) cases of progress to metastases, and 08/52 (15%) deaths before radiotherapy. Conclusion: A large proportion of patients followed for locally advanced non-metastatic lung cancer are not eligible for curative treatment. The reasons for the palliative treatment of patients followed for lung cancer candidates for CCRT are variable but for a large proportion of patients due to the deterioration of their state of health during their diagnostic journey. Hence, there is the need to improve the early diagnosis and early management of patients with lung cancer to avoid delayed care.

Introduction: Chordoma is a rare bone tumor, which develops mainly from the sacrum, the base of the skull, or the spine. Surgery + radiotherapy (if necessary) is the standard treatment. Data on chordoma are scarce in this region, and thus, here we summarized 9 patients with this tumor whom we treated in this institute. Material: Nine chordoma patients were summarized, who were treated in National Institute of Oncology in Rabat between 2013 and 2018. We retrieved data from medical charts and analyzed the clinical characteristics of this tumor. Results: The average age was 49 years (range: 29 - 72), with male: female of 3:6. The manifestation-diagnosis time was 4 months (range: 2 - 14). Regarding the tumor location, lumbosacral spine; 5, the skull; 4. Mass was evident in 6. Signs of locoregional compressions (paraparesis or tetraparesis) were observed in 3. As for treatment, a partial tumor excision was performed in 8, with 3 patients undergoing a wide excision. Radiotherapy was done; 3 patients with a dose of 46 Gy, 3 patients with 66 Gy, 1 patient with 50 Gy, and 1 patient with a 16 Gy gamma radio-knife in a single session. 4 patients with a dose of 46 Gy, 2 patients with 60 Gy, and 1 patient with a 16 Gy gamma radio-knife in a single session. Of 9, 4 patients had good locoregional control whereas 5 patients had local recurrence. Conclusion: Chordoma is a predominantly local aggressive tumor with low metastatic potential. The surgical excision remains the main prognostic factor. Advances in radiotherapy may improve local control. These data are of use in management of this tumor in Rabat (Morocco).

Introduction: External-beam radiation therapy boost is a treatment option in cervical cancer when brachytherapy is not feasible. Though less effective than brachytherapy, some encouraging results have been reported from some institutions experiences. We conducted this study to assess outcomes of EBRT boost for our patients at National Institute of Oncology in Rabat. Patients and Methods: We collected data from patients treated for cervical cancer between January 2012 and December 2015. Patients, tumor and treatment characteristics were collected. Overall survival (OS), disease-free survival (DFS) and prognostic factors influencing DFS were assessed. Results: One hundred and thirty-three patients were enrolled. Median age was 52 years. Patient haemoglobin level ranged from 3.9 to 15.5 g/dl [mean: 11.2 g/dl]. Most tumors were classified stage III/IVA (63.2%) according to the FIGO classification. Regional lymph node metastases (pelvic and or para-aortic) were observed in 45.1%. Median total dose to tumor was 69.6 Gy (ranging from 66 to 70 Gy). Overall treatment time was protracted, with a median of 60 days. Most of patients received concurrent chemotherapy (94.7%) and the number of cycle ranged from 2 to 7 (median = 5). The follow-up median was 31.3 months, ranging from 6.2 to 96.8 months. At the first visit, most patients achieved complete response (80.5%). Five years OS and DFS were 47% and 44% respectively. In univariate and multivariate analysis, regional lymph nodes metastasis (presence or absence) and haemoglobin level (≤11 g/dl and >11 g/dl) were the two significant and independent prognostic factors influencing DFS (HR: 1.86; p = 0.01 for the former) (HR: 0.59; p = 0.03 for the latter). Conclusion: Our study showed that EBRT boost in conventional fractionation was an acceptable treatment option for cervical cancer unamenable to brachytherapy, especially in the two subgroups of patients that are those without pelvic and/or para-aortic lymph node metastasis and those with haemoglobin level above 11 g/dl.