Hôpital Clinique Claude-Bernard

Narrow-Band Imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect oesophageal squamous cell carcinoma (SCC) and appears more specific than Lugol chromoendoscopy in expert centres but its specificity in current practice is not known. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy to detect oesophageal SCC and high-grade dysplasia (HGD) in current practice (including tertiary care centres, local hospitals and private clinics).

Objective: To evaluate the efficacy and toxicity of pegylated liposomal doxorubicin (PLD; Caelyx®)-cyclophosphamide combination in older metastatic breast cancer patients. Methods: A multicenter phase II trial was conducted. Inclusion criteria were age 65–75 years, ECOG 0–1 and left ventricular ejection fraction ≧50%. First-line chemotherapy was given to metastatic breast cancer patients resistant to hormonal therapy. The treatment schedule was PLD 40 mg/m² and cyclophosphamide 500 mg/m² on day 1 every 4 weeks. Efficacy was the primary endpoint, while response duration and tolerance were the secondary endpoints. Results: Thirty-five patients (median age 71.3 years) were enrolled. No treatment-related death, no congestive heart failure or decrease in left ventricular ejection fraction and no febrile neutropenia were reported. Toxicity: grade 3 dyspnea was found in 1 patient, neutropenia in 11 patients (7 grade 3, 4 grade 4), grade 3 mucositis in 4 patients, grade 3 hand-foot syndrome in 1 patient and a generalized rash in 1 patient. An objective response (complete and partial response) was achieved in 10 (28.6%) patients and disease control in 24 (69%) with a progression-free survival of 8.8 months and a median overall survival of 20.3 months. Conclusion: The PLD-cyclophosphamide combination is moderately active and safe in elderly metastatic breast cancer patients, but cannot be recommended routinely due to myelotoxicity and mucositis hazards.

We used a loco-regional chemotherapy in some cases of rectal cancer: as a salvage method in presacral recurrences, in combination with radiotherapy boost and/or surgical excision of a residual mass as possible, in cases previously treated by primary radiotherapy and surgery at the time of the primary tumor; and sometimes, because of the results on the recurrences as a primary (Neo-Adjuvant) method before the classical strategy i.e. radiotherapy then surgery, in bulky rectal or anal tumors, and because of the proximity of the sphincter.