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Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus that has never been identified in humans before. COVID-19 caused at the time of writing of this article, 2.5 million cases of infections in 193 countries with 165,000 deaths, including two-third in Europe. In this context, Oncology Departments of the affected countries had to adapt quickly their health system care and establish new organizations and priorities. Thus, numerous recommendations and therapeutic options have been reported to optimize therapy delivery to patients with chronic disease and cancer. Obviously, while these cancer care recommendations are immediately applicable in Europe, they may not be applicable in certain emerging and low- and middle-income countries (LMICs). In this review, we aimed to summarize these international guidelines in accordance with cancer types, making a synthesis for daily practice to protect patients, staff and tailor anti-cancer therapy delivery taking into account patients/tumour criteria and tools availability. Thus, we will discuss their applicability in the LMICs with different organizations, limited means and different constraints., Highlights • The first recommendations concerned mainly staff and patients with cancer protection. • More than half of the worldwide cancers are diagnosed in low- and middle-income countries (LMICs). • Organization in accordance with available means: main key for anti-cancer strategy in LMICs. • European recommendations applicability for coronavirus disease 2019 (COVID-19) pandemic is questioned in LMICs. • Amplification of pandemic effects on both COVID and cancer is to be feared in LMICs.

Objectif de l’etude Etude descriptive de la radiotherapie en conditions stereotaxiques des metastases cerebrales en termes de resultats oncologiques et en termes de toxicite, ainsi que l’analyse des facteurs determinants la reponse au traitement. Les metastases cerebrales representaient une evolution de 10 a 45 % des cancers, en fonction du site primitif. Le cancer et le poumon et le cancer du sein etaient les plus frequents. Historiquement, le traitement etait l’irradiation encephalique totale. L’avenement de la radiotherapie en conditions stereotaxiques a permis d’augmenter le taux de controle de la maladie, tout en diminuant la toxicite. Notre etude permet de depeindre les differents aspects cliniques et evolutifs de la radiotherapie en conditions stereotaxiques des metastases cerebrales. Materiel et methode Nous avons inclus tous les dossiers dans lesquels l’indication de la radiotherapie en conditions stereotaxiques a ete posee a la suite d’une reunion de concertation pluridisciplinaire. Nous avons collige dans notre etude l’ensemble des donnees epidemiologiques, cliniques et evolutives qui etaient l’âge, le sexe, les antecedents, le siege du cancer primitif, le nombre, le siege et la taille des metastases, l’utilisation ou non de l’irradiation encephalique totale, la dose et le fractionnement, et les donnees du suivi post-therapeutique, a savoir la reponse au traitement, le delai de reponse au traitement et la toxicite. Toutes les donnees ont ete inclues sur Excel et l’analyse statistique des donnees a ete faites par CPSS. Resultats Nous inclus 91 patients dans notre etude, le nombre total des metastases etait de 260, le sex-ratio etait de 0,9, l’âge moyen etait 60 ans, le siege le plus frequent etait le lobe temporal ou le frontal, la taille moyenne etait de 2 cm, le volume moyen etait de 5 cm3, il y avait entre une et trois metastases, le siege du cancer primitif etait majoritairement le sein et le poumon, 12 patients ont recu une radiotherapie panencephalique, la marge du volume tumoral macroscopique au volume cible previsionnel etait entre 0 a 2 mm. Le nombre de fractions pour une metastase dont la taille etait de moins de 3,5 cm etait de trois et il etait d’au moins cinq pour les metastases plus grandes ou multiples. Une IRM cerebrale a ete demandee 3 mois apres traitement, puis tous les 3 mois en cas de necessite neurologique. Le suivi median etait de 10 mois, 71 dossiers etaient evaluables. Cinquante et un patients etaient en situation de reponse, 90 % des patients ont eu une alopecie et aucun n’a ete atteint de radionecrose clinique. L’analyse statistique a releve comme facteur predictif de reponse au traitement la taille de la lesion et le volume total des metastases. Conclusion La radiotherapie en conditions stereotaxiques a permis d’assurer un controle local sur une longue periode des metastases cerebrales sans entrainer de toxicite invalidante. Elle devient des lors une alternative a la radiotherapie encephalique totale et la chirurgie. Il en demeure pas moins que plusieurs elements doivent etre developpes, tant sur la planification de traitement que pour le suivi des patients.

Liposarcoma of the larynx is an uncommon tumor. Only 27 cases have been described in literature. We report a new case occurring in a 50-year-old patient. The treatment consisted of a total laryngectomy with lymph node dissection followed by adjuvant irradiation. Prognosis for laryngeal liposarcoma is better than that of non laryngeal liposarcoma. This tumor is at high risk of local recurrence and seldom has metastatic potential.

Resume Cette etude est une analyse de l'apport de la polychimiotherapie d'induction dans les carcinomes du nasopharynx non metastatiques. Trois cures d'une polychimiotherapie (BEC modifie ou non BEC, BEC : bleomycine-epirubicine-cisplatine) ont ete realisees en preradiotherapie chez 90 patients. Le taux de reponse objective a ete de 57 %. La reponse a la chimiotherapie a ete meilleure chez les patients âges de 35 ans ou moins, porteurs d'un UCNT et dont le stade TNM n'etait pas T4 ou/et N3. Cependant, le protocole de chimiotherapie n'a pas influence la reponse. L'irradiation a permis de steriliser 51 patients dont 49 etaient en reponse satisfaisante apres chimiotherapie. La sterilisation par la radiotherapie a ete influencee par les memes facteurs que la chimiotherapie. La tolerance de ce protocole a ete jugee correcte. L'evolution a permis de noter sept recidives locoregionales, sept evolutions metastatiques et chez deux patients ces deux evenements etaient associes. La survie selon la methode de Kaplan et Meier a 36 mois a ete de 61 %. Elle a ete influencee par les memes facteurs que la reponse a la radiotherapie et a la chimiotherapie. Le facteur qui a semble le plus determinant a ete sans doute celui de la reponse a la chimiotherapie.

Liposarcoma of the larynx is an uncommon tumor. Only 27 cases have been described in literature. We report a new case occurring in a 50-year-old patient. The treatment consisted of a total laryngectomy with lymph node dissection followed by adjuvant irradiation. Prognosis for laryngeal liposarcoma is better than that of non laryngeal liposarcoma. This tumor is at high risk of local recurrence and seldom has metastatic potential.

The authors present results that were obtained by combining endoscopic resection and external beam radiation therapy in a population of 55 patients presenting with bladder cancer. They also explain the difficulties they encountered in the management of bladder cancer at the Ibn Rochd Cancer Center (Casablanca, Morocco).

A retrospective study of 337 cases of cervix cancers in women aged 35 years and under, treated between 1980-1990 at the Ibn Rochd Oncology Center in Casablanca, was analyzed in order to determine the main characteristics of this disease and the influence of age on prognosis. The incidence of these cases was stable throughout the 11 years study period with a mean of 7.4% of all cervix cancers. The rate of early sexual activity in age under 18 years was particularly high, with 80%, of which 45.4% before the puberty. The advanced cases were predominating (58.2%). Earlier cases were treated with combined radiotherapy and surgery and advanced cases with radiotherapy alone. Overall survival rate was 41% at 5 years. It was 45.2% for the 31-35 years of age group and 32% for women aged 30 years and less. The prognosis of these younger women was especially poor in tumoral volume more than 3 cm, in advanced cases, in undifferentiated carcinoma and in cases of lymph node involvement. The comparative analysis of all prognostic factors in function of the age had permitted to show that women aged 31-35 years old have been a good prognosis, concerning survival at 5 years, in regard to women less 30 years.

Leiomyosarcoma of the larynx is extremely rare, only 21 cases were reported in the literature. The authors report a personal case in a 26 years old patient treated by a total laryngectomy and analyse all cases of the literature. It comes in relative young man (42 years old) in regard to the others ORL localisations. There is not tobacco relation. The lymph node extension is rare however the distant metastasis are frequent specially in lung. The treatment is based on surgery, the neck lymphadenectomy is possible in patients with cervical lymph nodes. The Leiomyosarcoma is a resistant tumor to the irradiation and chemotherapy however the postoperative irradiation is justified. The prognosis of this tumor is reserved on account of local recurrences and distant metastasis.

This study is an analysis of the induction chemotherapy contribution in non metastatic nasopharyngeal carcinoma. Three chemotherapy cycles ("modified BEC" or not BEC, BEC: bleomycin-épirubicin-cisplatinum,) were delivered before irradiation in 90 patients. The rate of objective response was 57%. The chemotherapy response was better in patients no more than 35 year age, presenting with UCNT and not T4 or N3. Meanwhile, the chemotherapy protocol did not influence the response. The irradiation allowed the sterilization of 51 tumours and 49 of which were in satisfying response after chemotherapy. The sterilization by radiotherapy was influenced by the same factors as chemotherapy. The evolution showed 7 locoregional recurrences, 7 metastatic recurrences, and 2 patients presented with locoregional and metastatic recurrences. According to the Kaplan and Meier method, survival at 36 months was 61%. It was influenced by the same factors as chemotherapy and radiotherapy responses. The determining factor was indeed the chemotherapy response.

From 1980 to 1990, 50 children were treated for nasopharyngeal carcinoma in the Department of Oncology at the hospital Center Ibn Rochd in Casablanca. There were 34 boys and 16 girls with a median age of 12.3. UCNT were observed in 70% of cases. Fourty six percent were stage T3-T4 and 70% were N2-N3 disease. All children received irradiation therapy and 16 of them have had a neo-adjuvant chemotherapy. Thirty seven children were evaluable, the immediate response was complete in 26/37 cases. Recurrence of disease was noted for four children and metastatic for four others children. Two children have both recurrence and metastatic disease. The overall survival was 40.5% at 3 years. Disease free survival was 37.8% at 3 years.

A prospective investigation about the influence of the tabagism and its characters on the laryngeal cancer has been led in the department of oncology in the Hospital Center Ibnou Rochd in Casablanca from December 1990 to June 1991. The investigation concerned 58 new patients. We conclude from this investigation that the risk of cancer increases with the intensity of the tabagism (the precocious age at the beginning, long duration, high number of packets/years; black tobacco, deep inhalation of the smoke, absence of weanling). The risk increases with the association with an intense alcoholism. We don't find the professional exposition. These cancers related to tobacco have epidermoid predominance. Finally, the major interest of this study is to convince us about the ampleness of this flail and to lead us through an educative action for the preventive fight against tobacco because of the risk of laryngeal cancer.