Background: The goal of this study is to determine the efficacy and toxicity of a non-platinum based chemotherapy combination using irinotecan associated to bolus 5-FU as first line treatment in advanced gastric cancer. Materiel and methods: Retrospective analysis of a population of patients treated for metastatic and locally advanced gastric cancer with irinotecan and 5-FU as upfront chemotherapy. Results: Thirteen patients were enrolled. The median age was 56 years. Seven patients were males and six were of females. Ten patients had a metastatic disease and three patients had a locally advanced disease. Patients received a total number of 43 cycles of chemotherapy. Overall response rate was 38,4%, median time to progression (TTP) was 3 months, and median overall survival was 4 months. Three patients (23,1%) presented grade 3 /4 neutropenia complicated with an infectious episode with fever in two cases, three patients (23,1%) required blood transfusion for a grade 4 anemia, and one patient (7,6%) was hospitalized for a severe episode of diarrhea. Conclusion: Three weekly irinotecan and bolus 5-FU is an interesting combination as first line treatment of advanced gastric cancer; designed clinical trials are needed to confirm the activity of this combination.

Breast metastasis is fairly uncommon and prognosis is dismal. Breast metastasis might be the first symptom or may occur during the course of other malignancies dominantly arising from the contralateral breast. Leukemia, lung cancer and conjunctival melanoma may spread to the breast.

Le carcinosarcome du sein souvent appelé carcinome métaplasique du sein, est une tumeur maligne rare composée de deux lignées cellulaires distinctes, il est décrit comme un cancer du sein de type canalaire avec un composant de type sarcome. Il représente 0,08-0.2% de toutes les tumeurs malignes du sein. Il s'agit d'une étude rétrospective étalée sur un an, huit cas des carcinosarcomes mammaires ont été colligés à l'Institut national d'oncologie au Maroc durant l'année 2007. La médiane d’âge était de 49,5 ans, toutes les tumeurs étaient de haut grade, cliniquement 5 cas ont été classé t2 ou t3, et 3 cas classé sein localement avancé. Le traitement envisagé était basé sur une chirurgie mammaire suivie d'une radiothérapie et d'une chimiothérapie pour les cas adjuvants, l'envahissement ganglionnaire a été noté dans un cas, les récepteurs œstrogèniques sont négatifs, alors que les récepteurs progesteroniques sont positifs dans 4 cas, l'expression d'Her2 est absente dans tous les cas, le traitement des carcinosarcomes mammaires métastatiques était basé sur une chimiothérapie palliative. A 20 mois de médiane follow-up, la survie sans progression(SSP) pour le groupe entier est de 62,5%. Dans la limite de ce suivi, une rechute locorégionale a été détectée dans un cas, les deux patientes métastatiques sont décédées. Le carcinosarcome du sein est un sous-type rare du cancer du sein qui a un profil particulier et agressif, il a souvent un caractère triple négatif. Il est nécessaire de développer d'autres voies de recherche comme cibler le Récepteur HER1/EGFR.

e20624 Background: Cancer diagnosis and treatment of a parent has considerable impact on the lives of their children. The aim is to identify whether the diagnosis of parental cancer is associated with an increased risk of psychosocial difficulties amongst children and adolescents in Moroccan population. Methods: At the National Institute of Oncology in Rabat, from September to December 2009, 194 Children and adolescents whose parents were diagnosed with a cancer were interviewed. We used a questionnaire covering socio-epidemiological characteristics exploring the disease repercussions to their psychic. Results: There were 52% son and 48% daughters, aged between 10-15 years old (yo) in 26%, 15 - 20 yo in 44% and 20-22 yo in 30% of cases respectively. 67% were studying. Communication difficulties between parents with cancer and their children were observed in 100%. 20% of children were not aware of their parents' cancer. Only the children who were informed about their parents’ cancer were interviewed. All of them had traumatism, initial denial and anguish of loss of the parent. Guilt feelings were present in 90% of cases. 87% of them felt abandoned. The fear of having a stepfather or stepmother was observed in 41.2% of daughters and 12.8% of son, especially when the parent who had the cancer was the mother. Fear of inheriting cancer was seen in 80% of daughters whose mothers were suffering from breast cancer. The process of parentification was benign in 54% and destructive in 23% of cases. Enuresis was present in 30% of cases (20.6% in daughters 9.4% in son). Introversion was seen in 70% of cases. 30% of children noted a regression in their school abilities. Toxic habits appeared in 15% of cases. Conclusions: The result of this transversal study suggests that Moroccan children who have parents suffering from cancer, experiment an important distress. Unfortunately, the Moroccan parents do not use the services of psychological assistance. Thus, we should be vigilant to detect any potential psycho-pathologic disorders and to enable the family to live as normal as possible.

BACKGROUND:Multiple primary cancers have a low incidence particularly when cancers are synchronous. Few cases of synchronous head and neck cancer and breast carcinoma are reported in the literature.CASE PRESENTATION:We report here an exceptional case of a 47 years old Moroccan woman presenting two synchronous cancers, the first in the nasopharynx and the second in the breast. The patient was treated successfully with a combined strategy associating chemotherapy, radiation therapy, and surgery. She remains disease free after 27 months of follow up.CONCLUSIONS:Treatment strategy in the case of multiple primary cancers remains controversial because of the variety of presentations; initial aggressive treatment reports good results.

INTRODUCTION:The occurrence of multiple primary cancers is rare. Only a few cases and patient reviews of an association of triple malignancy have been reported.CASE PRESENTATION:We report here a case of a 78-year-old Moroccan woman presenting initially with a synchronous double malignancy, the first in her cervix and the second in her skin. Our patient was treated with radiation therapy for both tumors and remained in good control for 17 years, when she developed a metastatic disease from a neuroendocrine carcinoma of an unknown primary site.CONCLUSIONS:Although the association of multiple primary cancers can be considered a rare occurrence, improving survival in cancer patients has made this situation more frequent.

Bladder cancer is the fourth most common cancer for men and the eighth most common cancer for women. Transitional cell carcinoma is the most predominant histological type. Bladder cancer is highly chemosensitive. In metastatic setting the treatment is based on cisplatin chemotherapy regimens type MVAC, MVAC-HD or gemcitabine plus cisplatin. The standard treatment of muscle invasive operable bladder cancer (T2–T4) used widely was radical cystectomy with pelvic lymph nodes dissection; the anatomical extent of pelvic lymphadenectomy has not accurately been defined so far. However, in the last decade, the treatment of tumors was improved by the introduction of chemotherapy as part of the management of the disease. Neoadjuvant chemotherapy should be considered at first, as standard treatment of choice, before local treatment for patients with good performance status (0–1) and good renal function–glomerular filtration rate (GFR) >60 mL/min. For patients treated with primary surgery, adjuvant chemotherapy is a valuable option in the case of lymph nodes involvement. This brief review would provide the evidence of the role of neoadjuvant chemotherapy in the management of operable muscle invasive (T2–T4) bladder cancer.

Background Bevacizumab is a humanized monoclonal antibody that blocks vascular endothelial factor. It demonstrated an efficacy in many cancer types. The standard recommendation of administration is the 90-, 60-, and 30-min infusion sequence for all doses. We evaluated in this study the possibility of reducing infusion time to 10 min for bevacizumab given at 5 or 7.5 mg/kg in metastatic colorectal cancer (MCRC). Patients and Methods All patients who received bevacizumab for MCRC were analyzed. Patients were divided into two groups: Group A (bevacizumab was given in the 90-, 60-, and 30-min infusion sequence) and group B (bevacizumab was given over 10 min). Patients’ medical records were used to identify any hypersensitivity reactions (HSR) possibly related to bevacizumab. Results There were 38 patients in group A and 43 in group B. In group A, 459 doses of bevacizumab were given (286 doses at 5 mg/kg and 173 doses at 7.5 mg/kg). No HSR occurred in this group. In group B, 527 doses of bevacizumab were given (335 doses at 5 mg/kg and 192 doses at 7.5 mg/kg). Only two events of HSR grade 2 were reported in the 7.5 mg/kg infusions. Both of them were easily resolved with symptomatic treatment. Conclusions Bevacizumab 5 or 7.5 mg/kg in MCRC can be infused safely over 10 min.

Background: Breast cancer is the most common cancer affecting women in Morocco. Screening for early detection has led to reduction in mortality from the disease. It is known that female healthcare professionals have greater influence on women's positive perception of breast cancer and motivation to practice screening methods for early detection of the disease. This study aims to investigate knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among a cohort of female healthcare professionals in Morocco. Methods: A cross-sectional study was conducted using a self-administered questionnaire to assess the knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among 136 female doctors and nurses working in the university hospital of Rabat, Morocco. Stratified random sampling method was employed. Chi square test, analysis of variance and Mantel-Haenszel test were performed in data analysis using SPSS v19.0. Results: Female doctors were the only professional group that had satisfactory knowledge of risk factors while the nurses had an unsatisfactory knowledge with a mean score of 43%. A half of participants believed that that herbal therapy can cure breast cancer. 75% practice breast self-examination once a month and only 15% have ever had a mammogram. Age, profession and beliefs were not significantly associated with rate of BSE in this study; however this rate is influenced by knowledge of breast cancer risk factors. Conclusion: Results from this study suggest the need for continuing medical education programs aimed at improving knowledge of breast cancer among the nurses.