Publications (2)0.42 Total impact
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Article: Métastases osseuses des cancers colorectaux: â propos de huit cas
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ABSTRACT: La constatation d’une fréquence anormalement élevée de métastases osseuses de cancers colorectaux au sein d’une même institution a poussée les auteurs â rapporter cette série de huit observations, afin de mettre le point sur ces atteintes réputées rares. Il s’agit d’une étude rétrospective observationnelle concernant une série de huit observations de métastases osseuses de cancers colorectaux, colligée au service d’oncologie médicale de l’hôpital militaire d’instruction Mohammed-V, pendant une durée de quatre ans entre 2004 et 2008. La prévalence des métastases osseuses dans notre série était de 9 %. Le délai moyen d’apparition des métastases osseuses était de 14 mois par rapport â la tumeur primitive et de 3,8 mois par rapport aux localisations viscérales. L’atteinte osseuse n’apparaissait jamais de façon isolée, accompagnant toujours les localisations secondaires viscérales (poumon: 87 %, foie: 75 %). Elles n’étaient symptomatiques que chez 38 % des malades et toutes de type ostéolytiques. La radiothérapie â visée antalgique a concerné 25 % de nos malades, aucun n’a subi une chirurgie osseuse et 50 % ont reçu les biphosphonates. Le changement récent du profil évolutif des cancers colorectaux métastatiques, grâce aux progrès des traitements systémiques, est en train de changer l’histoire naturelle de la maladie faisant apparaître â une fréquence croissante des sites métastatiques réputés exceptionnels. Ces nouvelles cibles métastatiques mériteraient un diagnostic précoce et une prise en charge codifiée. The finding of an abnormally high incidence of bone metastases of colorectal cancers within the same institution compelled the authors to perform this study in order to report on these violations, considered rare. This is a retrospective observational study on a series of eight observations of bone metastases of colorectal cancers being collected in the medical oncology department of Mohammed V military instruction hospital for a period of four years between 2004 and 2008. The prevalence of bone metastases in our series was 9%. The average time of onset of bone metastases was 14 months compared to the primary tumor, and 3.8 months compared to visceral locations. The osseous never appeared in isolation, always accompanying the secondary visceral locations (lung 87%, liver 75%) and they were symptomatic in 38% of all patients and of osteolytic type. Radiotherapy for pain treatment has affected 25% of our patients did not undergo surgery, bone and 50% received bisphosphonates. The recent change of profile rolling of metastatic colorectal cancer through advances in systemic therapy is enthusiasm to change the natural history of the disease showing an increasing incidence of metastatic sites deemed exceptional. These new targets metastatic warrant early diagnosis and management codified. Mots clésCancer colorectal–Métastase osseuse–Chimiothérapie–Radiothérapie–Biphosphonates KeywordsColorectal cancer–Bone metastasis–Chemotherapy–Radiotherapy–BisphosphonatesJournal africain du cancer / African Journal of Cancer 05/2012; 3(1):73-77. -
Article: [Cardiac safety of trastuzumab in adjuvant: a review across 53 observations].
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ABSTRACT: Trastuzumab has been a revolution in the treatment of breast cancer overexpressing HER. Its use as an adjuvant for a period of 1 year is currently an international standard. Its major toxicity is cardiac, where the systematic monitoring of the LVEF before and during treatment. To evaluate the cardiac safety for our patients, we conducted this retrospective case-control study. The average in LVEF before the start of trastuzumab was 62.5% (51-80), and at the end of treatment 60.55 (40-77), a decrease in absolute value by 2%. This difference is statistically significant with P<0.001. Eighty-three percent of our patients have completed treatment, of whom 26.4% with a provisional arrest because of a regressive fall in LVEF. A final arrest has been made in 17% cases due to either a nonregressive reduction in LVEF or the appearance of symptomatic heart failure found in two patients. Analysis of risk factors toxicity found in this group of patients with a cardiotoxicity persisting an average age and average number of treatments received anthracyclines higher than the rest of our sample, and diminished baseline LVEF. But all these differences were not statistically significants. During the period of monitoring of these patients, six (67%) had spontaneous recovery of their LFEV 5 months ± 2.01 after discontinuation of trastuzumab. For two cases of symptomatic heart failure, they had a clinical improvement under medical treatment in February but is still less than 40%. The cardiac safety in our study seems comparable with the literature data but located in the upper range of levels of toxicity. The lack of statistical power of our study does not exclude a greater cardiac toxicity of trastuzumab among Moroccan women and should prompt a more cautious use of this drug and the achievement of larger studies that could answer this question.Journal de Gynécologie Obstétrique et Biologie de la Reproduction 01/2011; 40(2):144-8. · 0.42 Impact Factor
