A. Elomrani

Female lung cancer in Marrakech

Background: To evaluate the epidemiological aspect of lung cancer in women in Marrakech city in Morocco. Methods: This is a retrospective study conducted between 2003 and 2009 in the Department of Oncology-Radiotherapy, University Hospital Mohamed VI Marrakech. Results: Twenty nine women with lung cancer were unrolled (9% of all lung cancer). The average age was 55.7 ± 12 years. Only twenty percent of our patients were smokers while 38% reported a greater or lesser exposure to passive smoking. Ninety percent of patients were housewives and 62% were from rural areas and all reported massive exposure to smoke from cooking fuels which was mainly charcoal. Squamous cell carcinoma represents 67% of cases. Tumors were diagnosed at advanced stages II/IV in 81% of cases. Eight patients received neo-adjuvant chemotherapy followed by radio-chemotherapy combination and palliative chemotherapy has been indicated in twelve patients. Nine patients received best supportive care. Average follow-up was of twelve months. Fourteen patients were lost to follow-up. Among fifteen evaluable patients, response was noted in seven patients, stabilization in four patients and progression in four patients. Conclusion: Female lung cancer is a relatively rare condition in Marrakech, Morocco. Although the role of smoking in the pathogenesis of lung cancer is clearly established; there are other risk factors including hormones that make women more susceptible to carcinogens of tobacco. Other geographical and environmental factors could be incriminated including domestic smoke exposure especially in our context.

Combination of Trastuzumab and Radiotherapy in the Adjuvant Treatment of Breast Cancer: A Single Center Experience and Focus on the Cardiac Safety

Background: The main toxicity of trastuzumab, is the alteration of cardiac function. The objective of this study is to examine the acute cardiotoxicity of the combination of Radiotherapy (RT) and trastuzumab in the adjuvant treatment of breast cancer. Materials and Methods: This is a retrospective study of 41 patients followed for localized breast cancer, treated by multimodal strategy combining chemotherapy, Radiotherapy and trastuzumab as adjuvant treatment in the medical oncology department at the Ibn Sina Military hospital of Marrakesh. Results: All patients underwent adjuvant RT on the wall, including 17 on the left side. The median value of the Left Ventricular Ejection Fraction (LVEF) before starting treatment was 64%. The median value of the absolute decrease of LVEF, after the end of RT, was of the order of 4%. All patients received treatment with trastuzumab, during irradiation at usual doses for twelve months. Trastuzumab was stopped temporarily in seven patients, because of the fall in LVEF of more than 10%. After a median followup of 13 months, one patient developed congestive heart failure, imposing the definitive cessation of trastuzumab. Conclusion: The association RT and trastuzumab, does not appear to increase the risk of acute cardiac toxicity, whatever the irradiated side.

Molecular Profile of Breast Cancer in Young Women in the Marrakech Region, Morocco: Experience of the Oncology Department CHU Mohamed VI Marrakech, Morocco

Breast cancer in young women is increasing. The objective of this work was to analyze the epidemiological, clinical, therapeutic and prognostic characteristics of breast cancer in young women under 40 years. Through a retrospective study spread over five years from 1 January 2008 to 31 December 2012 and held at the Radiation Oncology Service of the University Hospital Mohammed VI Marrakech, we identified 272 cases of breast cancer in patients aged 40 years and under. The frequency of breast cancer in young women under 40 years was 24.42%. The average age was 35.6 years. The pauciparity and nulliparity were predominant (60.6%). 8 % had a family history of breast cancer. The self-examination of a nodule was predominant (93%). Tumors classified T2 were the most frequent (45%), followed by T4 tumors (29%).17% were metastatic immediately with predominant hepatic localizations (37.6%). It was Invasive breast carcinoma no special type (NST) in 82.3% of cases, with the predominance of SBR grades II and III (96%). Hormone receptors were positive in 68% of cases and HER2 overexpressed in 29 % of cases. 218 patients underwent surgery, which was radical in 68% and conservative in 21%. 149 had a locoregional irradiation. 71% received adjuvant chemotherapy with the predominance of FAC60 protocol (35%). Hormonotherapy was prescribed in 78% of cases with positive hormone receptors and trastuzumab in 73.8 % of patients over expressing HER2. After a median follow-up of 8.1 months, 41.4 % had relapses. Overall survival at three years was 70%, and the relapse free survival was 62%. Our study joins the data in the literature advocating more advanced forms and worse prognosis of breast cancer in young patients.

Cancer du sein chez la femme âgée

Introduction : Le cancer du sein est une affection fréquente et grave, représente la 1ere cause de mortalité et de morbidité par cancer chez la femme dans toutes les tranches d’âge[1]. La quasi-totalité des études cliniques ont montré une augmentation linéaire de l’incidence de ce cancer avec l’âge. Ainsi et devant l’augmentation de l’espérance de vie de la femme Algérienne et l’amélioration de la qualité de vie des sujets âgés le cancer du sein chez la femme âgée devient un problème de santé publique. Objectif : L’objectif est de déterminer les caractéristiques épidémiologiques cliniques et immuno-histochimiques du cancer du sein chez femme âgée. Matériels et méthode: