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Biomedical subjects

C Bouffioux

Publications and source records attributed to C Bouffioux.

At least 19 recordsLinked to original sources
PubMed1992

Adjuvant chemotherapy of recurrent superficial transitional cell carcinoma: results of a European organization for research on treatment of cancer randomized trial comparing intravesical instillation of thiotepa, doxorubicin and cisplatin. The European Organization for Research on Treatment of Cancer Genitourinary Group.

A total of 356 patients with recurrent superficial transitional cell carcinoma of the bladder was entered in a randomized clinical trial to compare intravesical thiotepa, doxorubicin and cisplatin with respect to the recurrence rate and disease-free interval. After complete transurethral resection of all visible lesions, the drugs were administered weekly for 4 weeks and monthly for 11 months. The recurrence rates per year were 0.50 for thiotepa, 0.54 for doxorubicin and 0.58 for cisplatin. Of 266 patients (mean followup 41 months) 35 reported an increase in T category and 19 of them had distant metastases. No association between treatment and progression was noted. Thus, there is no difference among treatments with respect to efficacy. However, severe anaphylactic reactions were observed in the cisplatin arm and chemical cystitis was more frequently reported in patients who received doxorubicin.

Administration, Intravesical↗
PubMed1992

Original lithotomy positioning for transperineal extracorporeal shockwave lithotripsy for distal ureteric calculi with Tripter X1.

Extracorporeal shockwave lithotripsy (ESWL) has been initially designed for stones located in the kidney and the upper ureter. Our lithotripter is no exception. Its components (the table and the orientation of the semi-ellipsoid reflector) are adapted for the treatment of kidney or lumbar ureter stones. However, the elements forming the unit of treatment (the table, the C-arm and the Tripter) can be modified in such a way that focalization of stones of the lower ureter becomes possible through a perineal exposure. The aim is to avoid the pelvic bone shield while a good focalization of the stone is realized. From June 1989 to March 1991, 35 patients were treated for distal ureteric stones by ESWL in this original positioning.

Adolescent↗
PubMed1990

The staging of M+ disease.

Patients with newly diagnosed prostatic cancer should be investigated with regard to the presence or absence of distant metastases by: (1) Clinical history especially of weight loss, recent pain, or analgesics intake. (2) Physical examination, looking especially for hepatic enlargement, peripheral lymph nodes, local bone tenderness. (3) Performance status. (4) Hemoglobin, creatinine, PSA and/or PAP, alkaline phosphatases, liver tests, testosterone. (5) Bone scan with X-ray of doubtful hot spots. (6) Chest X-ray. (7) Ultrasound scans (liver, kidney, lymph nodes) or CT scan may be indicated if abnormal blood parameters or in specific situations. (8) Other investigations are only indicated in special circumstances. Follow-up should include: (1), (2), (3), (4) every 3 months. For patients in clinical trials, depending on the end point, bone scan should be repeated every 6 months or possibly depending on the prognostic group (good: every 12 months; bad: 3 to 6 months). For routine clinical management, it could be repeated only when markers (PAP, PSA, alkaline phosphatase) show significant (25-50%) increase and provided the result will influence treatment. Other investigations should only be repeated or performed if abnormal at the start of if clinical data require them.

Biomarkers, Tumor↗
PubMed1988

Intravesical chemoresection with 4'-epi-doxorubicin in patients with superficial bladder tumors.

The authors report the preliminary data concerning a multicentric study on ablative effects of 4'-epi-doxorubicin (EPR) on superficial bladder cancer. Forty-six patients affected by multiple transitional cell superficial bladder carcinoma were treated by transurethral resection of all but one tumor, left as a marker lesion. Subsequently, an intensive local treatment with EPR and 3-month control cystoscopies with biopsies were performed. In the 47% of cases the control cystoscopy and pathology assessed the complete disappearance of marker lesions without any new occurrence whereas it is interesting to observe that the breakdown of the complete remissions into primary (67%) versus recurrent (37%) and in intravesical unpretreated (55%) versus pretreated (31%) showed important differences. It may be concluded that EPR shows a real activity against transitional cell superficial bladder carcinoma.

Administration, Intravesical↗
PubMed1988

Total androgen blockade in advanced prostatic cancer. Critical review and personal experience.

The theoretical basis of 'total androgen blockade' in the treatment of advanced prostatic cancer is reviewed. The results of experimental and clinical data in the literature comparing medical or surgical castration alone versus castration plus peripheral antiandrogens are discussed. Most of these studies could not reproduce Labrie's results and do not establish the benefit of total androgen blockade. The author produces his own experience with LHRH analogs alone (Depot Zoladex; 30 patients) compared to orchidectomy plus antiandrogens (17 patients). After 2 years, there is no difference in the progression and death rates between the two groups. Moreover, the administration of an antiandrogen in 15 patients relapsing after first-line hormonal treatment (Zoladex or orchidectomy) produced an objective response in only 2 of them. 9 patients experienced a subjective response but the duration of response was very short (medium 3 months).

Androgen Antagonists↗
PubMed1988

[Which intravesical chemotherapy for what tumor of the bladder?].

The rationale for adjuvant chemoprophylaxis in superficial bladder cancer treated by transurethral resection is discussed. Many questions remain unsolved as far as chemoprophylaxis in concerned. The authors try to answer them through an analysis of the results of prospective and randomized studies undertaken by the EORTC genito-urinary group for 12 years. Advantages and disadvantages of the most common agents (Adriamycin, Epodyl, Mitomycin, Thiotepa, BCG) are analyzed; an attempt is done to define instillations regimens; indications and results of these adjuvant treatments are studied.

Administration, Intravesical↗
PubMed1988

The staging of M1 disease: the role of bone scan, Xray and other imaging techniques.

Patients with newly diagnosed prostatic cancer should be investigated with regard to the presence or absence of distant metastases by (1) Taking a history especially of weight loss and recent onset backache (2) Examining them, looking especially for hepatic enlargement or peripheral lymph nodes (3) Performance status (4) Hemoglobin, Bilirubin, Liver enzymes, Alkaline and Acid phosphatase (5) Chest Xray. (6) Bone scan with specific Xrays directed at hot spots. (7) Ultrasound scan of liver if liver function tests are abnormal. Ultrasound scan of lymph nodes and kidneys is optional. (8) Any other tests indicated in special circumstances. Follow-up, 3-monthly as a rule, should include (1) The presence of pain and analgesic requirements (2) Weight (3) Performance status (4) Hemoglobin, Alkaline phosphatase, Acid phosphatase (5) Chest Xray, three monthly if abnormal. Annually otherwise. (6) Bone scan with Xray of new hot spots, 6-monthly. If there is doubt about the presence of a new hot spot, repeat the bone scan and Xray at 3 months.

Bone Neoplasms↗
PubMed1987

Current status of intravesical chemotherapy trials in the EORTC Urological Group. An overview.

The EORTC Urological Group is one of the 31 clinical groups and working parties within the European Organization for Research and Treatment of Cancer (EORTC). Intravesical chemotherapy has been used as chemoresection or chemoprophylaxis. Chemoresection has mainly been utilized in phase II studies to demonstrate ablation of existing disease and to study the mechanism of drug action. These studies are usually performed by individual members to obtain relevant information for the preparation of randomized trials. One example is a phase II chemoresection study with 4'-epi-doxorubicin (EPR). The EORTC GU Group extended its phase II trials to study remission in patients with primary carcinoma in situ. A new concept introduced in the prospective, randomized phase III trials includes the evaluation of chemoresection of a marker lesion as a prognostic factor in long-term prophylactic treatment. Chemoprophylaxis in the phase III trials aims to study the disease-free period, the recurrence rate and the long-term survival. So far, a series of five phase III trials, totaling more than 2,000 patients, demonstrated the efficacy of chemoprophylaxis to reduce tumor recurrence rates. The variation in the results of the different trials are due more to the prognostic factors (characteristics of the tumors) than to the related efficacy of the chemoprophylactic drugs. The selection of currently employed drugs, Mitomycin C, Epirubicin and BCG, is based on reported results, lack of toxicity, and drug availability in Europe. The data collected will be of great importance to determine the optimal clinical management of superficial bladder cancer.

Administration, Intravesical↗
PubMed1986

A comparison of the effect of diethylstilbestrol with low dose estramustine phosphate in the treatment of advanced prostatic cancer: final analysis of a phase III trial of the European Organization for Research on Treatment of Cancer.

In a randomized phase III trial performed by the Urological Group of the European Organization for Research on Treatment of Cancer low dose estramustine phosphate (280 mg. twice daily for 8 weeks and 140 mg. twice daily thereafter) was compared to diethylstilbestrol (1 mg. 3 times daily) in patients with stages T3 to T4, M0 or M1 prostatic cancer. Of 248 patients entered 227 were evaluable for analysis: 115 received estramustine phosphate and 112 received diethylstilbestrol. The best response of the local tumor as assessed by palpation was seen in patients receiving diethylstilbestrol. There was no significant difference between treatments for response rate of metastases, interval to local progression, distant progression, over-all survival and death of carcinoma of the prostate. Duration of survival was correlated with the assessment of local response as determined by palpation. The response of distant lesions also was correlated closely with survival. Diethylstilbestrol (1 mg. 3 times daily) was associated with a significantly worse degree of cardiovascular toxicity than estramustine phosphate. This finding was especially obvious in patients who had no history of cardiovascular disease. Gastrointestinal toxicity occurred in 25 patients treated with estramustine phosphate, including 6 in whom cessation of treatment was necessary. Further studies are required to determine the optimum dose of diethylstilbestrol and estramustine phosphate, and to establish the best form of hormonal treatment for prostatic carcinoma.

Aged↗