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Biomedical subjects

Catherine Durdux

Publications and source records attributed to Catherine Durdux.

5 recordsLinked to original sources

Reduced-intensity conditioning regimen using low-dose total body irradiation before allogeneic transplant for hematologic malignancies: Experience from the European Group for Blood and Marrow Transplantation.

PURPOSE: The high rate of toxicity is the limitation of myeloblastive regimens before allogeneic transplantation. A reduced intensity regimen can allow engraftment of stem cells and subsequent transfer of immune cells for the induction of a graft-vs.-tumor reaction. METHODS AND MATERIALS: The data from 130 patients (80 males and 50 females) treated between 1998 and 2003 for various hematologic malignancies were analyzed. The median patient age was 50 years (range, 3-72 years). Allogeneic transplantation using peripheral blood or bone marrow, or both, was performed in 104 (82%), 22 (17%), and 4 (3%) patients, respectively, from HLA identical sibling donors (n = 93, 72%), matched unrelated donors (n = 23, 18%), mismatched related donors (4%), or mismatched unrelated donors (6%). Total body irradiation (TBI) at a dose of 2 Gy delivered in one fraction was given to 101 patients (78%), and a total dose of 4-6 Gy was given in 29 (22%) patients. The median dose rate was 14.3 cGy/min (range, 6-16.4). RESULTS: After a median follow-up period of 20 months (range, 1-62 months), engraftment was obtained in 122 patients (94%). Acute graft-vs.-host disease of Grade 2 or worse was observed in 37% of patients. Multivariate analysis showed three favorable independent factors for event-free survival: HLA identical sibling donor (p < 0.0001; relative risk [RR], 0.15), complete remission (p < 0.0001; RR, 3.08), and female donor to male patient (p = 0.006; RR 2.43). For relapse, the two favorable prognostic factors were complete remission (p < 0.0001, RR 0.11) and HLA identical sibling donor (p = 0.0007; RR 3.59). CONCLUSIONS: In this multicenter study, we confirmed high rates of engraftment and chimerism after the reduced intensity regimen. Our results are comparable to those previously reported. Radiation parameters seem to have no impact on outcome. However, the lack of a statistically significant difference in terms of dose rate may have been due, in part, to the small population size in the subgroup analysis.

Adolescent↗

[Chemoradiation in bladder cancer].

Bladder cancer is an urologic common tumor after prostate carcinoma. Radical treatment of localized invasive tumor is based on cystectomy. Surgical mutilation could be important when Bricker's urinary derivation is performed. Moreover, delated metastasis appeared frequently in spite of radical surgery. So, for selected patients, chemoradiotherapy is a valid alternative treatment to cystectomy. Cisplatin or derivatives were administered concurrently to radiation therapy up to 60-65 Gy. Patients underwent control cystoscopy at midtime of treatment in order to select responders from non responders. This review summarizes the main published series of radiochemotherapy in invasive bladder cancer. Results for local control, survivals, bladder preservation rates and toxicity are presented.

Antineoplastic Agents↗

[Bladder cancer: realities and perspectives].

Bladder cancer is an urologic common tumor after prostatic carcinoma. Treatment of bladder cancer requires an interdisdisciplinary approach, including urologist, medical oncologist and radiation oncologist. Treatment of superficial tumors is based on endovesical instillations and sometimes on radical cystectomy for pejorative recurrences. For invasive tumor, radical cystectomy is needed. At present, ileal reconstructions could be largely proposed, in men as in women, for better quality of life. For selected patients, chemoradiotherapy is a valid alternative treatment to radical cystectomy, with similar survival rates and conservation rates of functional bladder about 50-60 %. In spite of the efficacy of local treatment, almost one half of patients develop metastasis. Recently, new drugs like paclitaxel, gemcitabine or Herceptin are available to improve the management of metastatic disease.

Antineoplastic Combined Chemotherapy Protocols↗

The molecular detection of circulating tumor cells in bladder cancer using telomerase activity.

PURPOSE: The detection of circulating tumor cells and micrometastases may have important prognostic and therapeutic implications. We investigated telomerase activity as a molecular marker for detecting bladder carcinoma cells in blood. MATERIALS AND METHODS: Peripheral blood mononuclear cells were isolated from whole blood using Ficoll/Hypaque. Immuno-magnetic beads labeled with an epithelial specific antibody were used to harvest epithelial cells from peripheral blood mononuclear cells. Telomerase activity was detected in this select population using the telomerase-polymerase chain reaction-enzyme-linked immunosorbent assay test based on the telomerase repeat amplification protocol method. The clinical applicability of this technique was explored by evaluating 30 patients with muscle invasive or metastatic bladder carcinoma and 17 healthy volunteers. RESULTS: Telomerase expression was detected in 27 of the 30 patients (90%) with high grade, muscle invasive or metastatic bladder cancer but in none of the 17 healthy controls. CONCLUSIONS: This test is a minimally invasive and specific approach for detecting circulating epithelial cells in patients with bladder cancer. This method may have great value for monitoring cancer progression.

Aged↗

[Radio-chemotherapy combinations in non operable localized non small cell lung carcinoma: updates and perspectives].

Optimal treatment of non operable localized non small cell lung carcinoma (NSCLC) continues to evolve. Increasing overall survival must evolute through improving local tumoral control and eradication of probable occult metastasis. Historically, median survival varies between 7 and 10 months with a standard conventional fractionated radiotherapy (RT). Induction chemotherapy (CT) followed by RT has demonstrated its superiority over RT alone, modality which is widely utilised. Other studies revealed best results with decreasing metastatic relapses. Three independent meta-analysis confirmed benefit obtained with cisplatin based CT followed by RT that allowed to consider this association as a gold standard. Other authors demonstrated an improvement of local control and survival with concomitant RT-CT or hyperfractionated accelerated RT. Results of all of these new therapeutic modalities still poor. Implication of new CT drugs has conducted for an emergence of new studies finding to demonstrate more encouraging results. Randomized trials are conducted in this way.

Antineoplastic Agents↗