がん臨床試験ジャーナル

Family physicians can better care for their patients throughout and after cancer treatment if they are aware of the available breast cancer treatments. According to stage, histology, and biomarkers, this article summarises standard treatments. Treatment is not necessary for lobular cancer in situ. Without further lymph node exploration or systemic therapy, invasive ductal carcinoma in situ is treated with breast-conserving surgery and radiation therapy. Breast-conserving surgery and radiation therapy are typically used to treat breast cancer in stages I and II. Radiation therapy reduces mortality and recurrence after breast-conserving surgery. For the majority of breast cancers with clinically negative axillary lymph nodes, sentinel lymph node biopsy is an option because it does not cause the arm pain and swelling that come with axillary lymph node dissection. ERBB2 (formerly HER2 or HER2/neu) overexpression, lymph node involvement, hormone receptor status, patient age, and menopausal status all have a role in the adjuvant systemic therapy decision. Chemotherapy, endocrine therapy (for cancers that express hormone receptors), and trastuzumab are typically used as systemic treatments for node-positive breast cancer (for cancer overexpressing ERBB2). Breast cancer can be treated with chemotherapy regimens that contain anthracyclines and taxanes. For breast-conserving surgery, stage III breast cancer often needs induction chemotherapy to shrink the tumour. Even though it is stage III, inflammatory breast cancer is aggressive and necessitates mastectomy rather than breast-conserving surgery, axillary lymph node dissection, and chest wall radiation. It also requires induction chemotherapy. Women with recurrent or metastatic (stage IV) breast cancer have a dismal prognosis, and treatment options must weigh the advantages of increased life expectancy and less pain against the risks of the procedure.

The installation of brachytherapy applicator is a painful invasive procedure requiring anesthesia. In this study, we propose to compare intravenous anesthesia with spontaneous ventilation to an intrathecal analgesic protocol with local anesthetics and fentanyl. The main objective was to demonstrate the superiority of spinal analgesia in terms of per and postoperative analgesia during patient mobilization for CT scan. We performed a randomized clinical trial for women patients ASA 1 and 2 programmed for brachytherapy, and then we divided them into 2 groups. Group 1: Have benefited from intravenous anesthesia by propofol titration with fentanyl. Group 2: Benefited from spinal analgesia with bupivacaine 5 mg and fentanyl 25 mg. Then we collected demographic data, quality of anesthesia (Ramsay score for level of sedation, analgesia level by analogical visual scale score), hemodynamic and respiratory parameters, anesthetics events, duration of anesthetic acts, pain during mobilization. The period of our study was 6 months, from January to July 2019. A cohort of 99 patients (group 1=48, group 2=51). The results were similar for the preoperative demographic and medical data (age, Sex,comorbidities,the stage of the disease, chemotherapy and radiotherapy antecedent, surgery antecedent, preoperative pain, preoperative neurological examination). Anesthetic goals were achieved for 100% of the patients in first group and 98% in second group (n=50/51). They were 6 unwanted events in group 1 and 3 in group 2 (p=0.25), but no serious incident were reported, we didn’t achieve any conversion from spinal analgesia to general anesthesia and no drugs were added during the procedure. The induction time was 7.1 ± 2.2 min in group 1 and 12.1 ± 3.2 min in group 2 (p=0.045). The duration of awakening after anesthesia was 9.4 ± 5.8 min in group 1. The total duration of the procedure was 47.4 ± 8.7 min in group 1 versus 49.7 ± 8.4 min in group 2 (p=0.46). After the procedure the evaluation of the pain during mobilization at 5 minutes, 15 minutes and 30 minutes were respectively at 4/10-4/10-6/10 in group 1 and 0/10- 0/10-1/10 in group 2 (p=0.002).

Spindle cell sarcoma is a variant of Rhabdo Myo Sarcomas (RMS) which rarely presents in adulthood. Often, this entity has a predilection for head and neck. This pathology infrequently involves extra-abdominal pelvic areas. Herein, we present a case of spindle cell variant of spindle cell RMS of the lateral pelvic area and inguinal canal in a 50-year-old woman. This is the first case of its kind reported in the Englishlanguage literature. Negative margin radical resection is advised. For effective surgical planning, a biopsy-based preoperative diagnosis is essential. In the present case, a biopsy of the tumor's sluggish area resulted in an inaccurate pre-operative diagnosis. The abdominal wall and inguinal canal needed to be mesh-reconstructed after a wide resection.