Health-related quality of life in advanced non-small cell lung cancer : a methodological appraisal based on a systematic literature review

Background: The majority of lung cancer patients are diagnosed with advanced non-small cell lung cancer (NSCLC), the bulk of which receive palliative systemic treatment with the goal to provide effective symptom palliation and safeguard health-related quality of life (HRQoL). Advanced NSCLC trials with HRQoL endpoints face methodological constraints limiting interpretability. Objectives: We provide a comprehensive overview of recent clinical trials evaluating the impact of systemic therapies on HRQoL in advanced NSCLC, focusing on the methodological quality, with the ultimate goal to improve interpretation, comparison and reporting of HRQoL data. Methods: A systematic literature review was performed. Prospective studies published over the last decade evaluating the impact of systemic treatments on HRQoL in advanced NSCLC were included. Methodological quality of HRQoL reporting was assessed with the CONSORT-PRO extension. Results: Hundred-twelve manuscripts describing 85 trials met all criteria. No formal conclusion can be drawn regarding the impact on HRQoL of different treatments. We report an important variety in methodological quality in terms of definitions of HRQoL, missing data points, lack of standardization of analyzing and presenting HRQoL and no standard follow-up time. The quality of HRQoL data reporting varies substantially between studies but improves over time. Conclusion: This review shows that in the heterogeneous landscape of trials addressing HRQoL in advanced stage NSCLC. Methodology reporting remains generally poor. Adequate reporting of HRQoL outcome data is equally important to support clinical decision-making as to correctly inform health policy regarding direct approval and reimbursement of the new drugs and combinations that will come online

EGFR mutation positive stage IV non small-cell lung cancer: treatment beyond progression

Non-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men en women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10-15% in Western countries, EGFR mutations are found. In this population, first-line treatment with the tyrosine kinase inhibitors (TKI) erlotinib, gefitinib or afatinib is recommended. The treatment beyond progression is less well-defined. In this paper we present 3 patients, EGFR mutation positive, with local progression after an initial treatment with TKI. These patients were treated with local radiotherapy. TKI was temporarily stopped and restarted after radiotherapy. We give an overview of the literature and discuss the different treatment options in case of progression after TKI: TKI continuation with or without chemotherapy, TKI continuation with local therapy, alternative dosing or switch to next-generation TKI or combination therapy. There are different options for treatment beyond progression in EGFR mutation positive metastatic NSCLC, but the optimal strategy is still to be defined. Further research on this topic is ongoing

Le Traitement différentiel en lexicographie diachronique : l'exemple de chansonnier

The lexicographical treatment of chansonnier features disparities of a diatopic type (Quebec meanings as against French meanings) and of a diachronic type. As regards geolinguistic variation, the sememes describe the definitions associated with the song activities of the two French-speaking communities. As regards history, a complex problem arises in so far as the medieval song collection was not termed chansonnier at the time, but rather by co-existing and varied lexicons (particularly albums de chanson). Moreover, the first reference acknowledged by the lexicographical tradition (1717) refers not to /recueil/ (collection) as expected but rather to /faiseur de chanson/ (song maker). Indeed the title in which this first definition appears la Clef des chansonniers is to be interpreted as a collection of then-popular tunes for singers, not as the key to song collections (/la clé des recueils de chanson/). This paper seeks to elucidate the semantic programme of the lexeme chansonnier in diachrony

Regards sur l’indiscipline :: ou quand la discipline reflète ce que nous sommes

Il n’existe pas une classe sans discipline. En effet, elle est la condition sine qua non pour que l’apprentissage ait lieu. L’enseignant est garant de cette discipline, mais que fait-il lorsque celle-ci est bafouée ? Surtout, quand estime-t-il qu’un élève fait preuve d’indiscipline ? Dans ce travail de recherche et par la méthode de collecte de données que sont les entretiens, je cherche à comprendre la définition que donnent les enseignants à l’indiscipline et je souhaite mettre en avant les arguments qui prouvent qu’un acte est indiscipline. Des pistes de résolutions pour faire face à ce manque de discipline en classe sont proposées. Un bref retour historique sur l’évolution de la discipline nous montre que l’homme ne peut pas constamment tout réinventer et se contente de mettre en pratique les méthodes qui ont fait leur preuve

France: National INIS Centre: New Directions and Main Achievements in an Evolving Context

International audienceA l’occasion de la célébration du 45ème anniversaire de la création de la Coopération Internationale INIS (International Nuclear Information System), l’Agence Internationale de l’Energie Atomique (AIEA) publie un numéro spécial de sa « Nuclear Information Newsletter » (https://www.iaea.org/inis/products-services/newsletter/INIS-Newsletter-2015-17/index.html). Ce numéro d’octobre 2015 est entièrement dédié aux témoignages des représentants des différents pays et organisations membres de la Coopération INIS ainsi que des personnels du Secrétariat INIS. La France, représentée par le SVI, y publie un article résumant l’évolution de l’activité de son Centre National INIS sur les vingt dernières années. L’accent est mis sur la production de notices et les actions de numérisation destinées à enrichir, non seulement la base de données INIS et sa collection unique de documents de littérature grise, mais aussi la Base des Thèses et HDR du CEA qui lui est étroitement liée. L’article présente également les actions de promotions menées par le SVI autour de ces deux bases de données à l’intérieur comme à l’extérieur du CEA. Enfin, l’utilisation en France de la Base INIS est illustrée par des statistiques de consultation collectées sur les dernières années et mettant en exergue le « coup de pouce » spectaculaire apporté depuis 2014 par les moteurs de recherche Google.com and Google Scholar qui indexent dorénavant la Base INIS