[Care organization in oncology].

Care organization in oncology. The health care organization for cancer patients has been built with the passing and current cancer plans, and the coordination of all the actions against cancer by the French national cancer institute. The authors describe the several phases of a patient pathway during and after cancer treatment, underline the importance of supporting good practice guidelines for health professionals, certification criteria and cancer authorization decrees for health care institutions, as well as coordination structures, and describe the specific organizations for children and elderly patients with cancer and for patients with rare cancers.

[Aging and cancer care in France: hospitalization requirement in 2012].

Introduction: French national cancer plans were rolled out oncogeriatric coordination units in France in particular to enable all elderly people with cancer in each region to benefit from a specific care management.

Methods: The national hospital discharge database was analyzed in order to analyze hospitalizations related to cancer care in ≥75 years patients for year 2012.

Results: A total of 358,721 patients with 1,492,935 hospitalizations were recorded, respectively with chemotherapy (32.

Aging and cancer - addressing a nation's challenge.

The incidence of cancer will increase dramatically among elderly people in the 21st century. The first French National Cancer Plan (2003-2006) with the French Ministry of Health supported the creation of 15 pilot coordination units in oncogeriatrics (UPCOG) in 13 out of the 27 French regions. The second French National Cancer Plan (2009-2013) continues to support oncogeriatrics.

Randomized phase II trial of gefitinib or gemcitabine or docetaxel chemotherapy in patients with advanced non-small-cell lung cancer and a performance status of 2 or 3 (IFCT-0301 study).

Background: To compare 3 treatment strategies in chemotherapy naive patients with advanced NSCLC and a PS 2-3.

Patients And Methods: Patients were assigned to gefitinib 250mg daily (n=43) or to gemcitabine (1250mg/m(2) d 1, 8 q 21d) (n=42) or docetaxel (75mg/m(2) d 1 q 21d) (n=42). Treatments were taken until progression or toxicity.

[Anemia and lung cancer].

Erythopoietin (EPO) treatment of anemia during cancer has dramatically improved the tolerance of chemotherapy and quality of life of patients at all stages of the disease. Several surveys have demonstrated a high prevalence and a high incidence of anemia in lung cancer patients. The guidelines updates concerning EPO treatment for these patients are described.

[Which truth for patients and their family].

Must the truth always be told to a cancer patient and/or his relatives? Taking a personal experience as the basis for discussion, the author examines this question in the context of Western cultural norms where death is taboo. The legal obligations to inform patients and the representation of cancer are discussed. Two key situations are considered: the delivery of a diagnosis of cancer and the announcement of a bad prognosis.

[What treatment for a patient of PS 2-3 with stage IV non-small cell lung cancer?].

Patients with poor performance status (PS) and advanced lung cancer have been underrepresented in clinical trials. As a consequence, the management of these patients in clinical practice is often empirical. Recent data indicate that patients with advanced non-small cell lung cancer (NSCLC) and a PS of 2 tend to benefit from first line chemotherapy with respect to symptom improvement and perhaps overall survival.

[Update of pemetrexed in thoracic oncology].

Efficacy of pemetrexed has been demonstrated in malignant pleural mesothelioma. This is based on the result of a phase III trial comparing cisplatin and pemetrexed to cisplatin alone, with a significant improvement of median survival in the doublet arm (11.4 versus 8.

[Lung cancer treatment in elderly patients].

The treatment of an elderly patient with a bronchial carcinoma is a daily challenge for the physician, because of the high incidence of lung carcinoma and a population getting older. The treatment has to be adapted, after geriatric assessment and evaluation of comorbidities, iatrogenic complications being more frequent and more severe in these patients. At the opposite, these patients are to often under-treated.

Baseline results of the Depiscan study: a French randomized pilot trial of lung cancer screening comparing low dose CT scan (LDCT) and chest X-ray (CXR).

Background: Lung cancer has the highest mortality-rate per cancer, with an overall 5-year survival <15%. Several non-randomized studies pointed out the high sensitivity of low dose computed tomography (LDCT) to detect early stage lung cancer. In France, Depiscan, a pilot RCT of LDCT versus chest X-ray (CXR), started on October 2002 to determine the feasibility of enrollment by general practitioners (GPs), investigations and diagnostic procedures by university hospital radiologists and multidisciplinary teams, data management by centralized clinical research assistants, and anticipate the future management of a large national trial.

Tumor lysis associated with sudden onset of syndrome of inappropriate antidiuretic hormone secretion.

Syndrome of inappropriate antidiuretic hormone secretion is frequent in small-cell lung carcinomas. We report on a case of syndrome of inappropriate antidiuretic hormone secretion after each of the first 2 cycles of chemotherapy for small-cell lung cancer. The association with chemotherapy-induced tumor lysis is proposed, particularly based on the course of antidiuretic hormone levels, and a review of the literature is presented.

[Pulmonary metastases from endometrial stromal sarcoma may benefit from hormone therapy].

Introduction: Low grade endometrial stromal sarcoma (ESS) often expresses oestrogen (ER) and progesterone (PR) receptors, even in metastatic disease. These receptors may also be hormone dependent.

Case Report: Two years after the institution of oestrogen replacement therapy (HRT) a woman of 56 presented with haemoptysis which led to the discovery of multiple pulmonary nodules.

[Complementary therapy in NSCLC. Supportive treatment in thoracic oncology. Management of chemotherapy induced anaemia and neutropenia, nausea and vomiting and bone metastases].

The aim of supportive treatment is to minimise the toxic effects of antineoplastic therapy. More useful new drugs are now available for the management of chemotherapy induced anaemia, neutropenia, and nausea and vomiting. One can include the treatment of bone metastases with biphosphonates.

[Gefitinib treatment for carcinomatous meningitis in non-small cell lung cancer].

Background: Carcinomatous meningitis is a major complication in Non Small Cell Lung Cancer (NSCLC). Despite treatment with radiotherapy alone or in combination with intrathecal and systemic chemotherapy, its prognosis remains poor.

Observation: We report a case of a female non-smoker with adenocarcinoma with bronchoalveolar features presenting with carcinomatous meningitis three years after the diagnosis of her primary tumour.

[Thrombosis and lung cancer].

Venous thromboembolism (TE) is a frequent occurrence in lung cancer patients and can be precipitated by venous stasis, the activation of clotting cascades by pro-coagulant tumour factors and by vascular injury due to chemotherapy and central venous catheters. Subcutaneous low molecular weight heparin (LMWH) has replaced intravenous unfractionated heparin in the treatment of acute TE. The use of long-term LMWH is recommended to prevent the recurrence of TE.

[Treatment of anemia and bone metastasis in metastatic non-small-cell lung cancer. A French survey].

Use of erythropoietin (EPO) for chemotherapy-induced anemia and biphosphonates (BP) for bone metastasis has increased steadily. However, there are no guidelines on their use in many situations such as non small cell lung carcinoma (NSCLC), which frequently alters quality of life markedly. Therefore, a multicentric survey was designed to assess the treatment of anemia and bone metastasis in chemotherapy-treated patients with non-small-cell lung carcinoma.

[The place of targeted treatments: receptor tyrosine kinase inhibitors].

Targeted biological treatments are aimed at correcting one or several abnormalities inherent to cancer cells by specifically affecting one or several identified abnormal cell mechanisms. Many signalisation pathways involve membrane receptors of the tyrosine kinase receptor family, notably the HER receptors (with, first-line, EGFR or epidermal growth factor receptor) and the VEGF receptors. These receptors can be blocked either by a monoclonal antibody directed against the ligand (i.