Lutte contre les cancers

Qualité de vie, soins de support

Mené sur 348 patientes atteintes d'un cancer du sein de stade I-II et ayant reçu une radiothérapie conservatrice, cet essai évalue l'effet à long terme (3 et 9 ans) d'une dose de rayonnement additionnel du lit tumoral ("boost") sur les résultats esthétiques

Long-term cosmetic changes after breast-conserving treatment of patients with stage I–II breast cancer and included in the EORTC ‘boost versus no boost’ trial
• Annals of Oncology, sous presse, 2012 (résumé)

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Mené sur 348 patientes atteintes d'un cancer du sein de stade I-II et ayant reçu une radiothérapie conservatrice, cet essai évalue l'effet à long terme (3 et 9 ans) d'une dose de rayonnement additionnel du lit tumoral ("boost") sur les résultats esthétiques

“Long-term cosmetic changes after breast-conserving treatment of patients with stage I–II breast cancer and included in the EORTC ‘boost versus no boost’ trial”

• Immink, J. M.;Putter, H.;Bartelink, H.;Cardoso, J. S.;Cardoso, M. J.;van der Hulst-Vijgen, M. H. V.;Noordijk, E. M.;Poortmans, P. M.;Rodenhuis, C. C.;Struikmans, H.

Background: In breast cancer treated with breast-conserving radiotherapy, the influence of the boost dose on cosmetic outcome after long-term follow-up is unknown.Patients and methods: We included 348 patients participating in the EORTC ‘boost versus no boost’ mega trial with a minimum follow-up of 6 years. Digitalised pictures were analysed using specific software, enabling quantification of seven relative asymmetry features associated with different aspects of fibrosis.Results: After 3 years, we noted a statistically significantly poorer outcome for the boost patients for six features compared with those of the no boost patients. Up to 9 years of follow-up, results continued to worsen in the same magnitude for the both patient groups. We noted the following determinants for poorer outcome: (i) boost treatment, (ii) larger excision volumes, (iii) younger age, (iv) tumours located in the central lower quadrants of the breast and (v) a boost dose administered with ...

Mots clés : Sein; Lutte contre les cancers (Qualité de vie, soins de support)

Menée sur 940 patients atteints d'un cancer du sein de stade 0-III et ayant reçu un traitement chirurgical conservateur entre 2005 et 2010, cette étude évalue, après 30 mois de suivi, la toxicité et les résultats esthétiques d'une radiothérapie conformationnelle tridimensionnelle en combinaison avec une irradiation additionnelle du lit tumoral ("boost")

Simultaneous Integrated Boost Irradiation After Breast-Conserving Surgery: Physician-Rated Toxicity and Cosmetic Outcome at 30 Months’ Follow-Up
• International journal of radiation oncology, biology, physics, sous presse, 2012 (résumé)

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Menée sur 940 patients atteints d'un cancer du sein de stade 0-III et ayant reçu un traitement chirurgical conservateur entre 2005 et 2010, cette étude évalue, après 30 mois de suivi, la toxicité et les résultats esthétiques d'une radiothérapie conformationnelle tridimensionnelle en combinaison avec une irradiation additionnelle du lit tumoral ("boost")

“Simultaneous Integrated Boost Irradiation After Breast-Conserving Surgery: Physician-Rated Toxicity and Cosmetic Outcome at 30 Months’ Follow-Up”

• Bantema-Joppe, Enja J.;Schilstra, Cornelis;de Bock, Geertruida H.;Dolsma, Wil V.;Busz, Dianne M.;Langendijk, Johannes A.;Maduro, John H.

To evaluate toxicity and cosmetic outcome (CO) in breast cancer survivors treated with three-dimensional conformal radiotherapy with a hypofractionated, simultaneous integrated boost (3D-CRT-SIB) and to identify risk factors for toxicity, with special focus on the impact of age. Included were 940 consecutive disease-free patients treated for breast cancer (Stage 0–III) with 3D-CRT-SIB, after breast-conserving surgery, from 2005 to 2010. Physician-rated toxicity (Common Terminology Criteria for Adverse Events version 3.0) and CO were prospectively assessed during yearly follow-up, up to 5 years after radiotherapy. Multivariate logistic regression analyses using a bootstrapping method were performed. At 3 years, toxicity scores of 436 patients were available. Grade ≥2 fibrosis in the boost area was observed in 8.5%, non-boost fibrosis in 49.4%, pain to the chest wall in 6.7%, and fair/poor CO in 39.7% of cases. Radiotherapy before chemotherapy was significantly associated with grade ...

Mots clés : Sein; Lutte contre les cancers (Qualité de vie, soins de support)

Cette étude américaine analyse la qualité de vie de patients atteints d'un cancer de la prostate en fonction de leur origine ethnique et de leurs préférences sexuelles

The effect of ethnicity and sexual preference on prostate-cancer-related quality of life
• Nature Reviews Urology, sous presse, 2012 (résumé)

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Cette étude américaine analyse la qualité de vie de patients atteints d'un cancer de la prostate en fonction de leur origine ethnique et de leurs préférences sexuelles

“The effect of ethnicity and sexual preference on prostate-cancer-related quality of life”

• Kleinmann, Nir;Zaorsky, Nicholas G.;Showalter, Timothy N.;Gomella, Leonard G.;Lallas, Costas D.;Trabulsi, Edouard J.

In general, patients with prostate cancer are able to maintain a relatively high quality of life (QOL), commonly reporting improvements in physical, emotional, and social functioning within 1 year of treatment. However, certain subpopulations of patients are susceptible to significant reductions in QOL during the course of their treatment. Data suggest that ethnic background and sexual preference both have significant effects on QOL for patients with prostate cancer. These parameters are often poorly documented and addressed by medical practitioners. Greater attention is needed to identify patients who are at increased risk of QOL reduction as a result of these factors.

Mots clés : Prostate; Lutte contre les cancers (Qualité de vie, soins de support)

A partir de données sur la qualité de vie rapportée par 100 patients atteints d'un cancer localisé de la prostate présentant un risque intermédiaire ou élevé de récidive, cet essai prospectif de phase II évalue l'évolution et la gravité des symptômes gastro-intestinaux et génito-urinaires au cours d'une radiothérapie

Patient-reported quality of life during radiation treatment for localized prostate cancer : results from a prospective phase II trial
• BJU International, sous presse, 2012 (résumé)

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A partir de données sur la qualité de vie rapportée par 100 patients atteints d'un cancer localisé de la prostate présentant un risque intermédiaire ou élevé de récidive, cet essai prospectif de phase II évalue l'évolution et la gravité des symptômes gastro-intestinaux et génito-urinaires au cours d'une radiothérapie

“Patient-reported quality of life during radiation treatment for localized prostate cancer : results from a prospective phase II trial”

• Chen, Ronald C.;Zhang, Yuanye;Chen, Ming-Hui;McMahon, Elizabeth;Loffredo, Marian;McPherson, Carol P.;Nguyen, Angela U.;Nguyen, Paul L.;D'Amico, Anthony V.

Study Type – Therapy (cohort)Level of Evidence 2aWhat's known on the subject? and What does the study add?Patient-reported quality of life (QoL) in prostate cancer is recognized as an important outcome, and has been shown in multiple studies to capture the incidence and timing of patient symptoms more accurately than physician-graded toxicity reports. Although the long-term QoL after completing radiation therapy (RT) has been previously studied, patient experience during RT is not well described in the literature.The present study collected patient-reported QoL during RT in a prospective phase II clinical trial. The study describes in detail the time course and severity of gastrointestinal and genitourinary symptoms during radiation, providing clinically useful information for patients and physicians considering RT during the treatment decision-making process. OBJECTIVE * •To evaluate data collected from a phase II trial to describe the time course and trajectory of ...

Mots clés : Prostate; Lutte contre les cancers (Qualité de vie, soins de support)

Observation

A partir des données d'un registre canadien portant sur 433 patients atteints d'un cancer du rein traité par néphrectomie radicale avec thrombectomie veineuse, cette étude évalue l'association entre le volume d'interventions chirurgicales, l'année de l'intervention, les caractéristiques tumorales et le taux de mortalité post-opératoire à 30 et 90 jours

Predictors of early mortality after radical nephrectomy with renal vein or inferior vena cava thrombectomy – a population-based study
• BJU International, sous presse, 2012 (résumé)

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A partir des données d'un registre canadien portant sur 433 patients atteints d'un cancer du rein traité par néphrectomie radicale avec thrombectomie veineuse, cette étude évalue l'association entre le volume d'interventions chirurgicales, l'année de l'intervention, les caractéristiques tumorales et le taux de mortalité post-opératoire à 30 et 90 jours

“Predictors of early mortality after radical nephrectomy with renal vein or inferior vena cava thrombectomy – a population-based study”

• Yap, Stanley A.;Horovitz, David;Alibhai, Shabbir M. H.;Abouassaly, Robert;Timilshina, Narhari;Finelli, Antonio

Study Type – Prognosis (cohort)Level of Evidence 2aWhat's known on the subject? and What does the study add?Surgical volume has been well established as a predictor of outcomes for several complex surgical procedures, yet few studies have evaluated this relationship with regards to radical nephrectomy with either renal vein or inferior vena cava thrombectomy. In addition, most published literature consists of single-institution series from centres of excellence.We performed a population-level analysis and identified surgeon volume as a significant predictor of short-term mortality for this procedure. Such findings have potential implications regarding future policy and regionalization of care. OBJECTIVE * •To study the short-term mortality associated with radical nephrectomy with renal vein or inferior vena cava thrombectomy and the variables associated with this adverse outcome. METHODS * •Using the Ontario Cancer Registry, we identified 433 patients in the province of ...

Mots clés : Rein; Lutte contre les cancers (Observation)

Menée en France, cette étude analyse l'évolution des disparités liées au niveau d'éducation dans la mortalité par cancer du poumon et par cancer des voies aérodigestives supérieures en France sur la période 1990 à 2007

Time trends in educational differences in lung and upper aero digestive tract cancer mortality in France between 1990 and 2007
• Cancer Epidemiology, sous presse, 2012 (résumé)

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Menée en France, cette étude analyse l'évolution des disparités liées au niveau d'éducation dans la mortalité par cancer du poumon et par cancer des voies aérodigestives supérieures en France sur la période 1990 à 2007

“Time trends in educational differences in lung and upper aero digestive tract cancer mortality in France between 1990 and 2007”

• Wagenaar, Kim P.;de Boer, Michiel R.;Luce, Danièle;Menvielle, Gwenn

Background: We investigated the magnitude of educational differences in lung and upper aero digestive tract (UADT) cancer mortality in France from 1990 to 2007. Methods: The analyses were based on census data from a representative sample of the French population. Educational level was used as the indicator for socioeconomic status. Educational differences in mortality from lung and UADT cancer were calculated among people aged 30–74 and by birth cohort. Two periods were compared: 1990–1998 and 1999–2007. Mortality rates, hazard ratios and relative indices of inequality (RII) were computed. Results: We found higher lung and UADT cancer mortality among those with less education. Inequalities in male UADT cancer mortality remained stable over time (RII1990–1998 = 0.21 (95% confidence interval 0.15–0.29); RII1999–2007 = 0.17 (0.11–0.26)) whereas inequalities in lung cancer mortality increased among the younger men (RII1990–1998 = 0.48 ...

Mots clés : Cancer (général); Lutte contre les cancers (Observation)

Menée auprès de 40 230 salariés du secteur de la construction, cette étude de cohorte suédoise évalue l'association entre le tabagisme et la survie des patients atteints de cancer

Tobacco use and cancer survival: A cohort study of 40,230 Swedish male construction workers with incident cancer
• International Journal of Cancer, sous presse, 2012 (résumé)

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Menée auprès de 40 230 salariés du secteur de la construction, cette étude de cohorte suédoise évalue l'association entre le tabagisme et la survie des patients atteints de cancer

“Tobacco use and cancer survival: A cohort study of 40,230 Swedish male construction workers with incident cancer”

• Nordenvall, Caroline;Nilsson, Per J.;Ye, Weimin;Andersson, Therese M. L.;Nyrén, Olof

On theoretical grounds, nicotine has been implicated as a modifier of cancer progression. We investigated possible associations of smoking or use of Scandinavian moist snuff (‘snus’) with survival after cancer among Swedish male construction workers. Snus use is associated with substantial exposure to nicotine but not to the combustion products in smoke. Among 336,381 workers with detailed information on tobacco use in 1971-1992 we observed 40,230 incident cancers. Complete follow-up through 2007 was accomplished through linkage to population and health registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) for death from any cause, cancer-specific death and death from other causes were derived from Cox proportional hazards regression models adjusted for age at diagnosis, body mass index at study entry and period of diagnosis. Never-users of any tobacco served as reference. Increased risks of cancer-specific death were observed both among exclusive smokers (HRall cancer ...

Mots clés : Cancer (général); Lutte contre les cancers (Observation)

Approches psycho-sociales

Menée sur une cohorte de 1 165 039 hommes en Suède, cette étude évalue différentes stratégies d'analyse de l'association entre troubles psychiatriques et risque de cancer

Psychiatric Disorder as a Risk Factor for Cancer: Different Analytic Strategies Produce Different Findings
• Epidemiology, sous presse, 2012 (résumé)

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Menée sur une cohorte de 1 165 039 hommes en Suède, cette étude évalue différentes stratégies d'analyse de l'association entre troubles psychiatriques et risque de cancer

“Psychiatric Disorder as a Risk Factor for Cancer: Different Analytic Strategies Produce Different Findings”

• Whitley, Elise;Batty, G. David;Mulheran, Paul A.;Gale, Catharine R.;Osborn, David P.;Tynelius, Per;Rasmussen, Finn

Background: Reported associations between psychiatric disorders and cancer incidence are inconsistent, with cancer rates in psychiatric patients that are variously higher than, similar to, or lower than the general population. Understanding these associations is complicated by difficulties in establishing the timing of onset of psychiatric disorders and cancer, and by the possibility of reverse causality. Some studies have dealt with this problem by excluding patients with cancers predating their psychiatric illness; others have not considered the issue. Methods: We examined associations between psychiatric hospitalization and cancer incidence in a cohort of 1,165,039 Swedish men, and we explored the impact of different analytic strategies on these associations using real and simulated data. Results: Relative to men without psychiatric hospitalization, we observed consistent increases in smoking-related cancers in those with psychiatric hospitalizations, regardless of analytic ...

Mots clés : Cancer (général); Lutte contre les cancers (Approches psycho-sociales)

Sensibilisation et communication

Cette étude américaine analyse les freins au dépistage du cancer colorectal chez la communauté hispanique vivant aux Etats-Unis et propose des outils éducatifs à domicile pour améliorer leurs connaissances relatives au dépistage et augmenter leur adhésion

Improving Knowledge and Screening for Colorectal Cancer Among Hispanics: Overcoming Barriers Through a PROMOTORA-Led Home-Based Educational Intervention
• Journal of Cancer Education, sous presse, 2012 (résumé)

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Cette étude américaine analyse les freins au dépistage du cancer colorectal chez la communauté hispanique vivant aux Etats-Unis et propose des outils éducatifs à domicile pour améliorer leurs connaissances relatives au dépistage et augmenter leur adhésion

“Improving Knowledge and Screening for Colorectal Cancer Among Hispanics: Overcoming Barriers Through a PROMOTORA-Led Home-Based Educational Intervention”

• Moralez, Ernesto;Rao, Satya;Livaudais, Jennifer;Thompson, Beti

In the U.S., nearly 67 % of Hispanics ages 50 and older report that they have never had a screening colonoscopy. Barriers to screening include cost, lack of health insurance, anticipation of pain, embarrassment, mistrust of medical/healthcare systems and institutions, a fatalistic belief system, as well as fear and lack of knowledge regarding cancer survival. These barriers are significantly more problematic among Hispanics who are poor and those who live in underserved rural and border communities. This study addressed barriers by using promotoras and a home-based educational intervention to improve knowledge of cancer and screening for colorectal cancer (CRC) among Hispanics in Yakima Valley, Washington. Study participants attended a promotora led home-based educational intervention consisting of home-health parties (HHPs) and completed baseline and follow-up surveys on general cancer knowledge and knowledge specific to CRC and related screening practices. Results suggest increase ...