Menée sur 182 patients de type africain ou européen et présentant des douleurs associées à un cancer (âge supérieur à 18 ans), cette étude américaine met en évidence des inégalités dans l'accès à l'oxycodone, un analgésique pouvant éviter les risques associés à l'utilisation de la morphine

African Americans With Cancer Pain Are More Likely to Receive an Analgesic With Toxic Metabolite Despite Clinical Risks: A Mediation Analysis Study

Meghani, Salimah H. ; Kang, Youjeong ; Chittams, Jesse ; McMenamin, Erin ; Mao, Jun J. ; Fudin, Jeffrey

Purpose : Renal impairment is highly prevalent among patients with cancer, and many patients have undiagnosed chronic kidney disease (CKD) from underlying disease, treatment, or both. African American individuals have disproportionate risk factors (diabetes, hypertension) predisposing them to CKD. We investigated whether African American patients are more likely than white patients to receive morphine with 3- and 6-glucuronide metabolites, which are known to be neurotoxic and accumulate in CKD; [...]

Cet article fait le point sur la prise en charge thérapeutique des infections chez les patients atteints d'un cancer, en particulier dans le contexte d'une émergence de bactéries résistantes

Strategies for the empirical management of infection in cancer patients with emphasis on the emergence of resistant Gram-negative bacteria

Klastersky, Jean ; Georgala, Aspasia

Combinations of antibiotics (namely penicillins and aminoglycosides) have been advocated in the 70s for the empirical therapy of FN in cancer patients in order to take advantage of the possible synergism between these agents and to extend the potential antimicrobial spectrum of empirical therapy. Later, with the development of potent broad spectrum antibiotics, the need for combinations became less obvious as monotherapy with these new agents appeared as effective and less toxic than previously [...]

Cet article passe en revue les études récentes concernant l'utilisation de la radiothérapie palliative chez les patients atteints d'un cancer en phase terminale

Palliative radiotherapy at the end of life: A critical review

Jones, Joshua A. ; Lutz, Stephen T. ; Chow, Edward ; Johnstone, Peter A.

When delivered with palliative intent, radiotherapy can help to alleviate a multitude of symptoms related to advanced cancer. In general, time to symptom relief is measured in weeks to months after the completion of radiotherapy. Over the past several years, an increasing number of studies have explored rates of radiotherapy use in the final months of life and have found variable rates of radiotherapy use. The optimal rate is unclear, but would incorporate anticipated efficacy in patients whose [...]

Menée à partir de questionnaires auprès de 3 106 patients traités en ambulatoire pour un cancer du côlon-rectum, du sein, du poumon ou de la prostate et auprès de leur médecin clinicien, cette étude analyse les perceptions des médecins vis-à-vis de la prise en charge des symptômes neuropathiques associés aux traitements anticancéreux et de la qualité de vie des patients

Neuropathic symptoms, quality of life, and clinician perception of patient care in medical oncology outpatients with colorectal, breast, lung, and prostate cancer

Jones, Desiree ; Zhao, Fengmin ; Brell, Joanna ; Lewis, MarkA ; Loprinzi, CharlesL ; Weiss, Matthias ; Fisch, MichaelJ

Purpose : We investigated how treatment-induced neuropathic symptoms are associated with patients’ quality of life (QOL) and clinician-reported difficulty in caring for patients. Methods : Data were obtained from 3,106 outpatients with colorectal, breast, lung, or prostate cancer on numbness/tingling (N/T), neuropathic pain, and QOL. Clinicians reported the degree of difficulty in caring for patients’ physical and psychological symptoms. Results : For all patients, moderate to severe N/T was [...]

A partir d'une revue systématique de la littérature publiée jusqu'en février 2014 (22 études), cette méta-analyse évalue l'effet de la metformine sur la mortalité des patients diabétiques après le diagnostic d'un cancer

The effect of metformin on mortality following cancer among patients with diabetes

Lega, Iliana C ; Shah, Prakesh S. ; Margel, David ; Beyene, Joseph ; Rochon, Paula A. ; Lipscombe, Lorraine L.

Diabetes may be a risk factor for cancer and is associated with worse cancer outcomes. Metformin may reduce cancer risk, however its effect on mortality following cancer remains less clear. EMBASE and Medline were searched through February 10th, 2014 for studies with reporting an adjusted risk estimate for the effect of metformin therapy on mortality following cancer among diabetic patients. Random-effects models were used to obtain summary hazard ratios (HR) for the association between [...]

Menée en Ecosse, cette étude évalue, par rapport à la population générale, l'évolution du taux de cancer sur la période 1971-2006 chez les personnes nées ou vivant près d'installations nucléaires dans la région de Sellafield ou de Dounreay

Updated investigations of cancer excesses in individuals born or resident in the vicinity of Sellafield and Dounreay

Bunch, K. J. ; Vincent, T. J. ; Black, R. J. ; Pearce, M. S. ; McNally, R. J. Q. ; McKinney, P. A. ; Parker, L. ; Craft, A. W. ; Murphy, M. F. G.

Background : Earlier studies have shown raised risks of leukaemia and non-Hodgkin lymphoma in children, teenagers and young adults resident either at birth or diagnosis in Seascale. Some increases in cancer risk in these age groups have also been noted among those living around Dounreay. We aimed to update previous analyses relating to areas close to these nuclear installations by considering data from an additional 16 years of follow-up. Methods : Cross-sectional analyses compared cancer [...]

Menée sur 344 patients pédiatriques atteints d'une leucémie aiguë lymphoblastique à cellules B (LAL B), cette étude évalue la proportion de patients présentant une LAL B de type "BCR-ABL1 like", identifie les anomalies génétiques, puis évalue, du point de vue de la survie, la réponse à un protocole thérapeutique établi en fonction du niveau de maladie résiduelle minimale mesuré après le traitement d'induction

Outcomes of Children With BCR-ABL1–Like Acute Lymphoblastic Leukemia Treated With Risk-Directed Therapy Based on the Levels of Minimal Residual Disease

Roberts, Kathryn G. ; Pei, Deqing ; Campana, Dario ; Payne-Turner, Debbie ; Li, Yongjin ; Cheng, Cheng ; Sandlund, John T. ; Jeha, Sima ; Easton, John ; Becksfort, Jared ; Zhang, Jinghui ; Coustan-Smith, Elaine ; Raimondi, Susana C. ; Leung, Wing H. ; Relling, Mary V. ; Evans, William E. ; Downing, James R. ; Mullighan, Charles G. ; Pui, Ching-Hon

Purpose : BCR-ABL1–like acute lymphoblastic leukemia (ALL) is a recently identified B-cell ALL (B-ALL) subtype with poor outcome that exhibits a gene expression profile similar to BCR-ABL1-positive ALL but lacks the BCR-ABL1 fusion protein. We examined the outcome of children with BCR-ABL1–like ALL treated with risk-directed therapy based on minimal residual disease (MRD) levels during remission induction. Patients and Methods : Among 422 patients with B-ALL enrolled onto the Total Therapy XV [...]

Menée sur 31 patients ayant survécu à un lymphome hodgkinien (âge médian : 40 ans), cette étude évalue, à l'aide de l'angiographie coronarienne par tomodensitométrie, la prévalence de maladies coronariennes

Coronary artery disease detected by coronary computed tomography angiography in adult survivors of childhood Hodgkin lymphoma

Mulrooney, Daniel A. ; Nunnery, Sara E. ; Armstrong, Gregory T. ; Ness, Kirsten K. ; Srivastava, Deokumar ; Donovan, F. Daniel ; Kurt, Beth A. ; Metzger, Monika L. ; Krasin, Matthew J. ; Joshi, Vijaya ; Durand, Jean-Bernard ; Robison, Leslie L. ; Hudson, Melissa M. ; Flamm, Scott D.

BACKGROUND : Survivors of Hodgkin lymphoma (HL) have significant cardiovascular risk and require long-term surveillance. The current study assessed the prevalence of coronary artery disease (CAD) by coronary computed tomography angiography (CCTA) in adult survivors of childhood HL. METHODS : Thirty-one survivors of HL, 13 of whom (42%) were treated with radiotherapy (RT) only and 18 of whom (58%) were treated with multimodal therapy, underwent CCTA, echocardiography, electrocardiography (ECG), [...]

Menée à partir d'une revue systématique de la littérature publiée jusqu'en juillet 2013 (47 articles, 404 874 participants), cette méta-analyse évalue, en fonction du sexe, l'association entre le tabagisme et le risque de cancer du poumon

Gender susceptibility for cigarette smoking-attributable lung cancer: a systematic review and meta-analysis

Yu, Yunxian ; Liu, Hui ; Zheng, Shuangshuang ; Ding, Zheyuan ; Chen, Zexin ; Jin, Wen ; Wang, Lijuan ; Wang, Zhaopin ; Fei, Ying ; Zhang, Shanchun ; Ying, Kejing ; Zhang, Ruifeng

Objectives : As the primary cause of lung cancer, whether smoking confers the same risk of lung cancer for women as men is unclear. Therefore, we aimed to compare male and female susceptibility for cigarette smoking-attributable lung cancer. Methods : A systematic review and meta-analysis was conducted by searching articles published up to July 2013 in three online databases (MEDLINE, EMBASE, and Cochrane Database). All studies estimated the association of cigarette smoking with the risk of [...]

Menée à partir de questionnaires auprès de 182 patientes atteintes d'un cancer et ayant terminé leur traitement dans les 12 derniers mois, cette étude évalue leurs capacités à faire face aux conséquences associées aux traitements et à la maladie

Cancer survivors’ self-efficacy to self-manage in the year following primary treatment

Foster, C. ; Breckons, M. ; Cotterell, P. ; Barbosa, D. ; Calman, L. ; Corner, J. ; Fenlon, D. ; Foster, R. ; Grimmett, C. ; Richardson, A. ; Smith, P. W.

Purpose : Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment. Methods : This cross-sectional online survey included cancer survivors who had completed their treatment within the past 12 months. [...]

Mené sur 246 participants (âge moyen : 48 ans ; 196 femmes et 50 hommes), cet essai évalue l'efficacité d'un questionnaire, complété par les patients avant une consultation d'oncologie génétique et destiné à évaluer leurs problèmes psychosociaux, pour faciliter la communication entre le médecin et le patient, et réduire le niveau de détresse psychologique de ce dernier

Effect of Routine Assessment of Specific Psychosocial Problems on Personalized Communication, Counselors’ Awareness, and Distress Levels in Cancer Genetic Counseling Practice: A Randomized Controlled Trial

Eijzenga, Willem ; Aaronson, Neil K. ; Hahn, Daniela E.E. ; Sidharta, Grace N. ; van der Kolk, Lizet E. ; Velthuizen, Mary E. ; Ausems, Margreet G.E.M. ; Bleiker, Eveline M.A.

Purpose : This study evaluated the efficacy of a cancer genetics–specific questionnaire in facilitating communication about, awareness of, and management of psychosocial problems, as well as in lowering distress levels. Methods : Individuals referred to genetic counseling for cancer at two family cancer clinics in the Netherlands were randomly assigned to an intervention or a control group. All participants completed the psychosocial questionnaire before counseling. In the intervention group, [...]