Managing glioblastoma (GBM) is challenging even for the most experienced centers in high-income countries due to its infiltrative nature, its unique tumor and immune microenvironment, and the ...negative effect of the blood-brain barrier on the penetration of systemic therapies. In developing countries, the difficulties are even greater, mostly in relation to the lack of adequate medical infrastructure and resources. This paper highlights the disparities in GBM management between developed and developing countries. Throughout this retrospective study conducted at the Radiation Oncology Department of Mohammed VI University Hospital in Marrakech, Morocco, we investigated the management outcomes of 48 GBM patients diagnosed between 2016 and 2021. Results showed a male predominance (65%) and a mean age of 53 years. Gross total resection was achieved in 16% of the patients and subtotal resection in 80%. Adjuvant radiotherapy was pursued, with a prescribed dose of 60 Gray in 30 fractions of 2 Gray for most patients. Concurrent temozolomide was administered to 32 patients (66.6%) with favorable tolerance. However, disease progression occurred in all cases, with a median time to progression of five months and a median survival of eight months. In conclusion, a comprehensive awareness of our limitations empowers us to implement measures that secure impartial access to standard-of-care treatments for every patient in Morocco, ultimately elevating the effectiveness of therapeutic outcomes.
Gliomas are histologically defined as low-grade gliomas (LGG) and high-grade gliomas (HGG). The most common type of HGG is the glioblastoma (GBM). We aimed to determine the immunological ...characteristics of CD3 T-cells, Vδ1 T-cells, and microglia/macrophages infiltrating brain gliomas. We collected 24 formalin-fixed paraffin-embedded samples issued from 19 cases of GBM and 5 cases of LGG. An immunohistochemical analysis was performed using anti-CD3, anti-Vδ1, and anti-iba-1 antibodies. Labelling indexes (LI) of CD3 and Vδ1 were evaluated quantitatively, and other CD3, Vδ1, and iba-1 staining characteristics were evaluated qualitatively. The median age of patients was 49 years in GBM and 52 years in LGG. The sex ratio was 1.4 and GBM predominated in males (
p
= 0.05). In GBM, the medians of CD3-LI and Vδ1-LI were 30 and 3.5 respectively. CD3-LI inversely correlated with survival in GBM cases (
r
= − 0.543;
p
= 0.016). CD3 staining intensity correlated with CD3-LI (
p
< 0.0001) and with the survival in GBM cases (
p
= 0.003). Compared to LGG, the CD3-LI, the intensity of intra-tumoral Vδ1 staining, and the amount of iba-1 were higher in GBM (
p
= 0.042;
p
= 0.014; and
p
= 0.001 respectively). The iba-1 organization was more amoeboid in older patients and more branched in younger patients (
p
= 0.028) and tended to be more amoeboid in cases with high iba-1 amount (
p
= 0.09). Our results suggest that a high level of CD3-LI and a strong intra-tumoral infiltration of Vδ1 T-cells as well as a high involvement of TAM can be considered potential markers of poor prognosis of GBM. However, this requires further studies on more balanced GBM-LGG sample, including an expanded panel of biomarkers.
Background: This study aims to describe the knowledge, attitudes, and practices of cancer patients and their relatives regarding the COVID-19 pandemic in Morocco.Methods: A self-administered online ...questionnaire was administrated to 133 adults aged 19 to 70 years old, including 32 cancer patients and 101 people from the relatives of cancer patients.Results: The participants showed a very good level of knowledge (cancer patients (84.6%), relatives (82.7%)) and practice (cancer patients (96.0%), relatives (85%)) regarding covid-19. . A very large proportion of cancer patients (84.4%) were very worried about the virus, compared with only 52.5% of relatives. They were concerned about the potential risk of infection and felt personally exposed (93.8%) to serious complications from COVID-19. The knowledge, attitudes and practices score were significantly associated with age (p=0,018), sex (p=0.002), professional activity (p=0,036), medical insurance (p=0,009), place of residence (p= 0,017), presence or absence of cancer (p=0,000), and perception of the danger of catching COVID-19 (p=0,041).Conclusions: Although the level of knowledge and practices of cancer patients and relatives was very satisfying, disparities between the two groups were still to be noted. Cancer patients go out less and practice more, despite the impact of confinement on their health.
Purpose
The main objective of this study is to describe the association between the consumption of either traditional or modern dairy products or calcium intakes and the risk of colorectal cancer ...(CRC) in the adult Moroccan population.
Methods
A case–control study was conducted in five Moroccan hospital centers. The study was matched on sex, age (± 5 years) and center. Data were collected using validated food frequency questionnaire (FFQ) taking into account different types of Moroccan dairy products. Conditional logistic regression models were used to assess the association between dairy products consumption, calcium intakes and CRC risk subtypes. In all statistical tests, the significance level was set at 0.05.
Results
Among 1453 cases and 1453 matched controls, 50.7% were women and 49.3% were men. Milk OR
b
0.84, 95% CI 0.74–0.96 and yogurt OR
b
0.74, 95% CI 0.64–0.86 were inversely associated with CRC risk. Similar inverse associations were observed for traditional dairy products namely Lben OR
b
0.77, 95% CI 0.67–0.88, Raib OR
b
0.86, 95% CI 0.76–0.96 and Jben OR
b
0.77, 95% CI 0.67–0.88. The dairy calcium intake was inversely associated to CRC overall OR
b
0.83, 95% CI 0.74–0.93.
Conclusions
Our study supports previous international evidence and suggests that individuals who have a high intake of either modern or traditional dairy products are at lower risk for CRC. These findings should be further confirmed by longitudinal data and studies investigating potential pathways involved.
Les proliférations plasmocytaires malignes extra-médullaires isolées qu'on appelle plasmocytomes sont rares. Elles sont décrites habituellement au niveau de la tête et du cou (80% des cas) et ...exceptionnellement ailleurs. Nous rapportons l'observation d'un patient de 62 ans qui présente un plasmocytome solitaire pulmonaire mimant initialement un cancer bronchique primitif. Nous rapportons notre attitude thérapeutique et discutons à travers une revue de la littérature la rareté de ce cas clinique, les facteurs pronostiques ainsi que les modalités de prise charge de ces tumeurs.
Background. Lifestyle maintenance is a crucial condition before and after lung cancer disease. According to the previous research in the scientific databases, the effect of the interaction between ...socioeconomic and demographic factors on the lifestyle of lung cancer patients in Southern Morocco regions remains unexamined. Accordingly, this study was designed to examine the relationship between socioeconomic factors, demographic factors, and the lifestyle of lung cancer patients. Methods. A total of 133 patients with lung cancer were divided into 103 men and 30 women with a sex ratio of 3.43 and ages varying between 28 and 82 years, and they served as informants for the study and filled in a questionnaire to provide information on their sociodemographic background, various economic characteristics, and their lifestyle. These patients have also been submitted to an anthropometric examination following the standardized procedure recommended by the World Health Organization. The survey was conducted from July 2013 to March 2015 at the Oncology and Radiotherapy Department, at Mohammed VI Hospital Center in Marrakech, Morocco. Results. The preliminary results showed that the average age of patients was 59 ± 9 years. A proportion of 81% lived in the Marrakech-Safi region and 19% lived in four other southern regions. Among the patients, 6% were smokers, while 14% were nonsmokers and 80% were ex smokers. Following the discovery of the disease, 26% revealed that they had sleep disorders and 98% were reported to have a lack of appetite. Obesity, normal weight, and underweight were also taken as criteria to categorize the patients; thus, obese informants represented 23% of the total number, those having normal weight reached 67% and the patients having underweight represented 10%. Conclusion. Sociodemographic variables and various economic characteristics were shown to have a negative impact on the lifestyle of lung cancer patients.
Purpose
Studies of the etiology of inflammatory breast cancer (IBC), a rare but aggressive breast cancer, have been hampered by limited risk factor information. We extend previous studies by ...evaluating a broader range of risk factors.
Methods
Between 2009 and 2015, we conducted a case–control study of IBC at six centers in Egypt, Tunisia, and Morocco; enrolled were 267 IBC cases and for comparison 274 non-IBC cases and 275 controls, both matched on age and geographic area to the IBC cases. We administered questionnaires and collected anthropometric measurements for all study subjects. We used multiple imputation methods to account for missing values and calculated odds ratios (ORs) and 95% confidence intervals (CIs) using polytomous logistic regression comparing each of the two case groups to the controls, with statistical tests for the difference between the coefficients for the two case groups.
Results
After multivariable adjustment, a livebirth within the previous 2 years (OR 4.6; 95% CI 1.8 to 11.7) and diabetes (OR 1.8; 95% CI 1.1 to 3.0) were associated with increased risk of IBC, but not non-IBC (OR 0.9; 95% CI 0.3 to 2.5 and OR 0.9; 95% CI 0.5 to 1.6 for livebirth and diabetes, respectively). A family history of breast cancer, inflammatory-like breast problems, breast trauma, and low socioeconomic status were associated with increased risk of both tumor types.
Conclusions
We identified novel risk factors for IBC and non-IBC, some of which preferentially increased risk of IBC compared to non-IBC. Upon confirmation, these findings could help illuminate the etiology and aid in prevention of this aggressive cancer.
The antitumoral contribution of γδT cells depends on their activation and differentiation into effectors. This depends on different molecules and membrane receptors, which conditions their ...physiology. This study aimed to determine the phenotypic characteristics of γδT cells in glioblastoma (GBM) according to five layers of membrane receptors. Among ten GBM cases initially enrolled, five of them who had been confirmed by pathological examination and ten healthy controls underwent phenotyping of peripheral γδT cells by flow cytometry, using the following staining: αβTCR, γδTCR, CD3, CD4, CD8, CD16, CD25, CD27, CD28, CD45, CD45RA, CD56, NKG2D, CD272(BTLA), and CD279(PD‐1). Compared with the controls, the results showed no significant change in the number of γδT cells. However, there was a decrease of double‐negative (CD4−CD8−) Tγδ cells and an increase of naive γδT cells, a lack of CD25 expression, a decrease of the expression of CD279, and a remarkable, but not significant, increase in the expression of the CD27 and CD28 costimulation markers. Among the γδT cell subsets, the number of Vδ2 decreased in glioblastoma and showed no significant difference in the expression of CD16, CD56, and NKG2D. In contrast, the number of Vδ1 increased in glioblastoma with overexpression of CD16, CD56, and NKG2D. Our results showed that γδT cells are prone to adopt a pro‐inflammatory profile in the glioblastoma context, which suggests that they might be a potential tool to consider in T cell‐based immunotherapy in glioblastoma. However, this requires additional investigation on a larger sample size.
The retina is an uncommon site for metastases, in particular from solid tumors. Some authors have reported a recent increase in the incidence of metastases in infrequent sites, such as brain or bone, ...probably due to the expanded treatment options and the resulting improved survival. Choroidal metastasis is the most common type of intraocular malignancy. The most common primary sites associated with choroidal metastasis are breast cancer in women and lung cancer in men. Treatment options are limited, but they must be discussed and adapted to the patient profile.
We report a case of a 62-year-old Moroccan man with a history of monophthalmitis secondary to a war injury of 30 years' duration. He has been followed for 28 months for metastatic clear-cell renal carcinoma. The first-line treatment was effective for 24 months, before disease progression as retinal metastasis and accentuation of lung metastases. A second-line treatment with everolimus resulted in marked improvement of symptoms, complete recovery of visual function, and partial response in retinal localization.
Choroidal metastasis of renal cancer is a rare situation that must be actively sought in order to arrive at a suitable therapeutic approach.
Ewing sarcoma/primitive neuroectodermal tumor is a family of highly malignant proliferation of neuroectodermal origin, most often skeletal, adrenal localization is extremely rare. Only few cases have ...been reported in the literature. Classical management includes radical surgery with adjuvant chemotherapy or radiotherapy or both. This case report is the only one where recurrence was surgically removed, and it confirms the importance of adjuvant treatment, and the efficacy of neoadjuvant chemotherapy.
We report the case of a 23-year-old Moroccan woman presenting with flank pain. An abdominal computed tomography scan showed a large and enhancing left suprarenal mass. After radical nephrectomy, histologic examination revealed a small round cell proliferation. The diagnosis of Ewing sarcoma was confirmed by molecular analysis; time to final diagnosis was 5 months due to financial and coordination issues. Computed tomography (on an asymptomatic patient) revealed a locoregional recurrence, our patient received 12 cycles of the vincristine, doxorubicin and cyclophosphamide/ifosfamide and etoposide protocol used in an alternating schedule, with partial radiologic response (62%) and pathologic complete response, then underwent adjuvant radiotherapy of 45 Gy. The young women is still in remission after 36 months of follow-up.
Our patient had an early recurrence due to absence of adjuvant treatment, but did respond well to neoadjuvant chemotherapy with a pathologic complete response. Management of adrenal Ewing sarcoma could be extrapolated from skeletal one with good outcomes even in locoregional recurrence.
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