Bulletin du cancer最新文献

Care quality assessment emerged in the late 1990s, leading to the integration of users into healthcare systems. To integrate patient perceptions, resources such as PROs (Patient Reported Outcomes), PROMs (Patient-Reported Outcome Measures), satisfaction and patient experts or partners have been developed. PREMs (Patient-Reported Experience Measures) have recently emerged, bringing a fresh perspective to improving quality and care pathways, but are still little-known. The aim of this study is to carry out a critical analysis of available publications on tools for evaluating the patient's experience of the care pathway for a chronic disease, with a focus on oncology, and to identify common themes. A literature search was carried out from June 2023 to March 2024. It focused on the concepts of quality of life, satisfaction and patient experience. Seventy-nine articles related to patient experience were identified, including 44 in oncology and 35 outside oncology. The measures analyzed include experience questions as well as satisfaction questions and/or PROMs measures. Nevertheless, they address concordant domains that are important to the patient. This study has shown a consistent development of PROMs and patient satisfaction. PROMs and patient experience are still new. Their use remains focused on targeted stages of care, and there is a lack of tools for assessing the patient's care pathway more globally.

Introduction: Treatment landscape in metastatic lung cancer has progressed quickly over the last decade, mainly due to immunotherapies and targeted therapies. This study aimed to describe change in epidemiological data of patients with metastatic lung cancer.

Methods: A cohort of patients identified between 2013 and 2021 with lung cancer and a marker of metastases (ICD-10 code or reimbursement for Bevacizumab or Pemetrexed) was built from the French claims database. A trend analysis of the rate of newly-diagnosed metastatic patients and the proportion of deaths over the study period was performed using Joinpoint® software.

Results: Between 2013 and 2021, 147,760 metastatic lung cancer patients were identified (men: 66.5%, median age: 66 years). A statistically significant decrease in the crude rate of newly-diagnosed metastatic patients was observed in men (-1.18% per year in average), whereas a statistically significant increase was described in women (+2.36% per year in average). A downward trend in the proportion of deaths was found for both gender (-4.37% and -5.07% per year on average, respectively).

Discussion: This study provides unpublished epidemiological data on metastatic lung cancer in France and confirms sex-differentiated trends in the rate of newly-diagnosed metastatic patients, already observed for all stages combined. A statistically significant decrease in the proportion of deaths among metastatic lung cancer patients is observed in both genders. These results underline the importance of ongoing investments in prevention and screening initiatives to reverse the incidence trends observed in women. Moreover, it highlights the criticality of therapeutic innovation in sustaining the increase in survival.

Sexual health is a central aspect of the well-being and quality of life of cancer patients. Through two separate surveys, one conducted among patients and the other among professionals, we assessed the needs and practices relating to sexual health in cancer care. The results showed that the importance attached to taking intimate and sexual life into account was fairly high, but that 44% of patients had discussed the subject with a professional, and the majority had done so on their own initiative. The types of support requested were a dedicated consultation (38%) and exchanges with other people with cancer (21%). More than half of the professionals did not discuss sexual health with their patients. The needs identified were specific training, time to exchange and share experiences with other professionals, and resources (documentation, reference websites). Professional training and appropriate tools seem necessary to meet patients' expectations.

Hairy cell proliferations represent very different entities. They include hairy cell leukemia in its classic form (HCL), a well-defined entity, but also the variant form of HCL (LT-V ou HCL-V), whose presentation is far from HCL and whose prognosis is poorer. Other hairy cell proliferations include splenic red pulp lymphoma (SDRPL) and splenic marginal zone lymphomas (SMZL) with circulating villous cells. In this article, we emphasize the novelties concerning the different recent biological aspects of HCL, including the unusual clinical presentations but also the importance for the diagnosis of the detection of the BRAF^V600E mutation, a molecular marker of the disease, and the presence of other non-canonical mutations that should be identified because of the contraindication to the use of BRAF inhibitors. Finally, the presence of a non-mutated profile of immunoglobulin heavy chains (IGHV), observed in 20% of cases, is associated with a poor prognosis. We also provide guidance in characterizing other hairy cell proliferations when examining the blood smear. The first-line treatment of HCL has recently changed and immunochemotherapy combining cladribine plus rituximab has become the gold standard. In relapsed or refractory forms, other treatments should be discussed in a multidisciplinary consultation meeting and combine BRAF inhibitors with anti-CD20 antibodies, BTK inhibitors or Bcl-2 inhibitors. The choices should be discussed according to the patient's profile but also their biological profile.

Introduction: The aim was to analyze the implementation of the Onco-Geriatrics model in a remote ultramarine territory: West-French Guiana. The population is socially precarious in terms of income, social coverage and administrative status, and most often speaks a non-French language and has a non-Western culture.

Methods: Narrative description of the implementation and retrospective study of anonymized data from the database of older patients managed for cancer between September 2014 and December 2020.

Results: A total of 574 new patients were managed. Of these, 107 were aged 70 and over; 78 (73 %) had a G8 test. Forty-two patients had a multidimensional geriatric assessment (MGA). More than half the patients had dependency criteria, malnutrition and a high number of severe comorbidities. Difficulties encountered were language, level of education, clinical context (in 18 patients), but also insufficient involvement of health professional and the consequences of health organization and gradual implementation.

Discussion: Implementation was impacted by the fact that quality criteria for implementation were not sufficient. Studies in high-middle-income countries in South America suggest that initial implementation of the MGA may be preferable, that frailty screening tests and the MGA procedure can be adapted to non-Western populations, and that the use of new technologies can improve the management of older patients in this context.

For the past decade, "long-term follow-up consultations" have been established for adults cured of pediatric cancer to ensure the prevention, early detection, and treatment of long-term effects. These consultations are now sometimes conducted in the form of teleconsultations, a practice that has seen significant growth following the COVID-19 crisis. The objective of this study was to evaluate the satisfaction, usefulness, and patient experience of teleconsultations conducted by an oncologist or hematologist as part of the long-term follow-up of adults cured of pediatric cancer. This is a descriptive multicenter study of a sample of adult patients cured of pediatric cancer who benefited from a long-term follow-up teleconsultation. After each teleconsultation, a satisfaction questionnaire was sent to the patient. Descriptive analyses were conducted for all variables, and bivariate analyses were performed between the variables of interest (satisfaction, trust, usefulness) and five covariates (gender, type of diagnosis, health status perception, education level, prior teleconsultation experience) using Fisher's exact test. Regarding the overall appreciation of their long-term follow-up teleconsultation experience, 73% of patients were very satisfied and 25% fairly satisfied. Notably, all of them were satisfied with the consultation time (88%), feeling that they were able to discuss the topics they wanted (83%). Consequently, 71% of patients expressed a desire to use teleconsultation in the future.

Children and adolescents who are being treated or have been treated for acute leukemia have a secondary immunodeficiency linked to chemotherapy, resulting in an increased risk of infections. Some of which can be prevented by vaccination but its effectiveness is not optimal during chemotherapy. Upon cessation of chemotherapy, the time required for immune reconstitution varies from three months to more than a year, depending on lymphocyte subpopulations, the patient's age, and the intensity of the treatment received. Although they may have regained their immune functions, studies show that most patients have lost part of their vaccine-induced protection post-chemotherapy and require booster doses of vaccines. Most practitioners agree on the importance of vaccinating or revaccinating these children, but practices are heterogeneous among pediatric hematologist-oncologists in France. Based on a practice study and a recent review of the literature, this work aims to propose new French recommendations for the vaccination strategy to be adopted for children and adolescents treated or recently treated for acute leukemia, excluding allogeneic transplant recipients, in 2024. These recommendations specifically include the vaccination protocols for human papillomavirus and meningococcal infections but do not address the COVID-19 vaccination, as its guidelines are subject to rapid changes.