Abstract：
The quality of cancer care in the modern era is based on a precise diagnosis and personalized therapy according to patients and their disease based on validated guidelines with a high level of evidence. During cancer patients\' management, the objective is first to make an accurate diagnosis and then offer the best treatment, validated beforehand in a multidisciplinary board meeting, with the best benefit/risk ratio. In the context of many low- and middle-income countries, the limited available means do not allow an adequate offer, resulting in non-optimal patients\' care. In addition, in many low- and middle-income countries, priority can be given to other types of disease than cancer, which may considerably reduce allocation of specific resources to cancer care. Thus, the limited availability of systemic therapy, radiotherapy machines, brachytherapy and technological development may come up against another difficulty, that of geographical distribution of the means in the countries or a lack of expertise due to insufficient training programs. For all these reasons, the implementation of the guidelines established in Western countries could be impossible for many low- and middle-income countries which, moreover, have to face a completely different epidemiology of cancers compared to developed countries. In this work, we will discuss through a few examples of common cancers on both borders of the Mediterranean area, the applicability of the guidelines and the limits of their implementation for optimal cancer care.
摘要：
现代癌症护理的质量基于根据患者及其疾病的精确诊断和个性化治疗，基于具有高水平证据的经过验证的指南。在癌症患者管理期间，目标是首先做出准确的诊断，然后提供最佳的治疗方法，事先在多学科董事会会议上验证，最佳效益/风险比。在许多低收入和中等收入国家，有限的可用手段不允许提供足够的报价，导致非最佳患者护理。此外,在许多低收入和中等收入国家，可以优先考虑癌症以外的其他类型的疾病，这可能会大大减少癌症治疗的特定资源分配。因此，系统治疗的可用性有限，放射治疗机,近距离放射治疗和技术发展可能会遇到另一个困难，这是由于国家/地区的手段分布或由于培训计划不足而缺乏专业知识。由于所有这些原因,对于许多低收入和中等收入国家来说，实施西方国家制定的指导方针是不可能的，此外,与发达国家相比，必须面对完全不同的癌症流行病学。在这项工作中,我们将通过地中海地区两个边界的一些常见癌症的例子来讨论，指南的适用性及其对最佳癌症治疗的实施限制。
