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Nejmi M.,Institute National dOncologie | Wang X.S.,University of Houston | Mendoza T.R.,University of Houston | Gning I.,University of Houston | Cleeland C.S.,University of Houston
Journal of Pain and Symptom Management | Year: 2010

Context: Little is known about symptom burden-a concept encompassing both symptom severity and the degree of symptom interference with daily living-in patients with cancer in Morocco or other countries with Arabic-speaking populations. Objectives: The goal of this study was to psychometrically validate the Arabic version of the M. D. Anderson Symptom Inventory (MDASI-A), a tool for measuring multiple symptoms in patients with cancer, and to test its utility in a sample of patients with late-stage cancer in Morocco. Methods: The MDASI-A was developed by standard forward-backward translation of the English MDASI. We used nonidiomatic Arabic in the MDASI-A to enhance its possible usefulness for all Arabic-speaking patients with cancer. One hundred sixty-five Arabic-speaking patients with various cancer types were recruited from a city hospital in Rabat, Morocco. The MDASI-A was administered by interview, as only 5% of the patients had a high school education. Results: Psychometric analysis demonstrated acceptable internal consistency, with Cronbach alpha values of 0.85 for all 19 items, 0.78 for symptom severity items, and 0.79 for interference items; known-group validity was demonstrated by significant differences in mean symptom severity and interference between patients with good vs. poor performance status. All patients had moderate to severe pain and were taking pain medications. Additional severe symptoms included fatigue, lack of appetite, and disturbed sleep. Patients with gastrointestinal or gynecological cancer reported relatively more symptom severity than patients with breast or lung cancer. Poor performance status, male gender, and current infection were significant predictors of high symptom interference (R2 = 0.48, P < 0.05). Conclusion: The MDASI-A is a valid and reliable patient-reported outcome instrument that can be used to assess Moroccan Arabic-speaking cancer patients' multiple symptoms. Its utility for use in other Arab countries needs to be tested. © 2010 U.S. Cancer Pain Relief Committee Published by Elsevier Inc.

Ayrault S.,CEA Saclay Nuclear Research Center | Senhou A.,CEA Saclay Nuclear Research Center | Senhou A.,Institute National dOncologie | Moskura M.,CEA Saclay Nuclear Research Center | Gaudry A.,CEA Saclay Nuclear Research Center
Atmospheric Environment | Year: 2010

To evaluate today's trace element atmospheric concentrations in large urban areas, an atmospheric survey was carried out for 18 months, from March 2002 to September 2003, in Saclay, nearby Paris. The total suspended particulate matter (TSP) was collected continuously on quartz fibre filters. The TSP contents were determined for 36 elements (including Ag, Bi, Mo and Sb) using two analytical methods: Instrumental Neutron Activation Analysis (INAA) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The measured concentrations were in agreement within the uncertainties with the certified values for the polycarbonate reference material filter SRM-2783 (National Institute for Standard Technology NIST, USA). The measured concentrations were significantly lower than the recommended atmospheric concentrations. In 2003, the Pb atmospheric level at Saclay was 15ng/m3, compared to the 500ng/m3 guideline level and to the 200ng/m3 observed value in 1994. The typical urban background TSP values of 1-2, 0.2-1, 4-6, 10-30 and 3-5ng/m3 for As, Co, Cr, Cu and Sb, respectively, were inferred from this study and were compared with the literature data. The typical urban background TSP concentrations could not be realised for Cd, Pb and Zn, since these air concentrations are highly influenced by local features. The Zn concentrations and Zn/Pb ratio observed in Saclay represented a characteristic fingerprint of the exceptionally large extent of zinc-made roofs in Paris and its suburbs. The traffic-related origin of Ba, Cr, Cu, Pb and Sb was demonstrated, while the atmospheric source(s) of Ag was not identified. © 2010 Elsevier Ltd.

Afani L.,Institute Jules Bordet | Errihani H.,Institute National dOncologie | Benchafai I.,Service dORL | Lalami Y.,Institute Jules Bordet
Cancer/Radiotherapie | Year: 2016

Nasopharyngeal adenoid cystic carcinoma is a rare tumour. Compared with others nasopharyngeal tumours, it is characterised by slow evolution but it is locally aggressive and has a high tendency to recurrences. Due to the rarity of cases, no consensus exists about treatment approaches. We report the case of 45-year-old-man with a locally advanced adenoid cystic carcinoma. The patient received concurrent chemoradiation and had a good objective response. After one year, he developed a paucisymptomatic lung metastasis. The follow-up showed local recurrence after 3 years. One cycle of chemotherapy was given but poorly supported. Carbon ion radiotherapy was proposed. The aim of this work is to review the literature concerning this rare malignancy and discusses treatment approaches in initial situations and during recurrences. © 2016 Société française de radiothérapie oncologique (SFRO).

Rosenblatt E.,International Atomic Energy Agency | Abdel-Wahab M.,International Atomic Energy Agency | Abdel-Wahab M.,Cleveland Clinic | El-Gantiry M.,Cairo University | And 9 more authors.
Radiation Oncology | Year: 2014

Background: The purpose was to determine whether a brachytherapy boost improves outcomes in patients with advanced nasopharyngeal carcinoma treated with standard chemo-radiotherapy.Methods: Patients with nasopharyngeal carcinoma WHO grades I-III and TNM stages III or non-metastatic stage IV were eligible for this phase III study. Patients were randomized to either arm (A) induction chemotherapy, followed by external beam radiotherapy (EBRT) with concomitant cisplatin (n = 139) or arm (B), the same schedule plus a brachytherapy boost to the nasopharynx (n = 135). The EBRT doses given were 70 Gy to the primary tumour and positive lymph nodes and 46 Gy to the negative neck. The additional brachytherapy boost in arm (B) was given by either low dose-rate (LDR - 11 Gy) or high dose-rate (HDR - 3 fractions of 3.0 Gy) brachytherapy. The primary endpoint was 3-year overall survival (OS) and secondary endpoints were: local control, regional control, distant metastasis and grade 3-4 adverse events. Results: 274 patients were randomized between September 2004 and December 2008. The two arms were comparable with regard to age, gender, stage and grade. 273 patients completed treatment. Median follow-up was 29 months (0.2-67 months). The effect of treatment arm, country, age, gender, WHO pathology, stage (T3-4, N2-3 versus other) and chemotherapy on overall survival (OS), disease-free survival (DFS) and local recurrence-free survival (LRFS) was studied. Stage significantly affected OS (p = 0.024) and DFS (p = 0.018) while age significantly affected OS (p = 0.014). None of the other factors studied were significant. The 3-year LRFS was 60.5% and 54.4% in arms A and B respectively (p = 0.647). The 3-year regional control rate in the neck was 59.7% and 54.3% respectively (p = 0.7). Distant metastasis developed in 59.7% of patients in arm A and 55.4% in arm B (p = 0.377). Patients with T1/T2 N + had a 3 year LRFS of 51.8% in Arm A (62 patients) versus 57.9% in Arm B (67 patients) (p = 0.343). The grade 3-4 toxicity rate was 21.6% (30/139) and 24.4% (33/135) respectively (p = 0.687). Conclusions: The addition of a brachytherapy boost to external beam radiotherapy and chemotherapy did not improve outcome in loco-regionally advanced nasopharyngeal carcinoma. © 2014 Rosenblatt et al.; licensee BioMed Central Ltd.

Bensouda Y.,Institute National dOncologie | Kaikani W.,Institute National dOncologie | Ahbeddou N.,Institute National dOncologie | Rahhali R.,Institute National dOncologie | And 4 more authors.
European Annals of Otorhinolaryngology, Head and Neck Diseases | Year: 2011

Nasopharyngeal carcinoma (NPC) is a specific entity different from head and neck carcinoma. Incidence is higher in South-East Asia and North Africa. Prognosis, especially for locally advanced stages (IIB - IVB) and metastasis, remains poor: more than third of cases will present local and/or metastatic recurrence. Overall 5-year survival for all NPC stages ranges from 50% to 70%. The role of chemotherapy in metastasis is well established, and remains an important palliative treatment, although no randomized trial has been reported comparing the different chemotherapy regimens. As 1 st-line treatment, platin-based regimens seems optimal; in 2 nd line and after progression under platins, there is no consensus: monotherapy with drugs such as gemcitabine, capecitabine or taxanes has been the most widely tested, with acceptable results. Future trials should integrate targeted therapy, in the light of overexpression of EGFR1 and C-kit in NPC. The present study presents a review of the literature concerning the various studies of metastatic NPC. © 2010 Elsevier Masson SAS.

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