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F Maloisel

Publications and source records attributed to F Maloisel.

102 records · Page 6Linked to original sources
PubMed1990

Results of initial doxorubicin, 5-fluorouracil, and cyclophosphamide combination chemotherapy for inflammatory carcinoma of the breast.

Forty-three patients with nonmetastatic inflammatory breast carcinoma have been treated by initial doxorubicin, 5-fluorouracil, and cyclophosphamide (FAC) combination chemotherapy. After three chemotherapy cycles, responding patients underwent surgery. Chemotherapy was then completed for nine cycles of FAC followed by locoregional radiation therapy. All patients received tamoxifen 40 mg/day for 1 year from the time of diagnosis. Thirty-eight patients (88%) had a clinical response to chemotherapy and underwent surgery. On histologic examination 17 patients had a residual tumor mass less than 1 cm diameter or a complete tumor disappearance; lymph nodes dissection was negative in 15 patients. With a median follow-up of 48 months, the predicted 5-year disease-free survival (DFS) is 48% (median DFS, 46 months). Analysis of prognosis factors shows that age, menopausal status, and histologic grade have no predictive value. The DFS and overall survival were significantly improved by the presence of hormonal receptors and a low number of positive lymph nodes (less than 4) at surgery. The most significant prognosis factor was the residual tumor mass after initial chemotherapy with an 80% predicted 5-year DFS for the responding patients versus 30% for the no responding patients (P less than 0.001).

Adult↗
PubMed1990

Endoscopic photodynamic therapy with haematoporphyrin derivative in gastroenterology.

Endoscopic photodynamic therapy (PDT) with haematoporphyrin derivative was used in the primary treatment of 69 patients with inoperable gastrointestinal neoplasms. Patients were divided into three groups: 31 with oesophageal squamous cell carcinoma, 17 with adenocarcinoma of the stomach or lower third of the oesophagus and 21 with rectosigmoid adenocarcinoma. After infusion of 2.5-5.0 mg haematoporphyrin derivative per kilogram of body weight, lesions were irradiated using an argon dye laser (632 nm). During a follow-up period averaging 20 months (27.9 months for 35 surviving patients), complete local tumour destruction and negative histology were observed in 32 out of 69 cases. Flow-cytometric analysis of DNA content before and after PDT suggests that a clonal selection occurs in some cases of treatment failure. The results of this open pilot study suggest the potential efficacy of PDT as a curative treatment for selected cases of inoperable gastrointestinal cancers.

Adenocarcinoma↗
PubMed1990

The protection of hemopoietic mice progenitors by WR-2721 during photodynamic therapy.

Photodynamic therapy is a new concept for in vitro evaluation of bone marrow clearance in leukemia. This treatment eliminates 99.9999% of leukemic cells, but under the same conditions over 50% of normal bone marrow cells are damaged. WR-2721, a thiol compound, is reported to except a protective effect for bone marrow against radiation therapy. This study analyzed the protective effect of WR-2721 during photodynamic therapy with hematoporphyrin derivative. Mice hemopoietic cells were exposed to laser light after sensitization by hematoporphyrin, with or without WR-2721 at 3 dose levels (250, 500, 750 mg/kg). The efficacy of protection was evaluated by GM-CFU assay in collagen gel medium. Results showed significant protection at 25 and 50 j/cm2 (p less than 0.05), but at 75 j/cm2 irradiation only the 750 mg/kg dosage remained protective. The protective factor of WR-2721 is 1.65 (95% confidence interval: 1.38-1.99) WR-2721 is protective against photodynamic lesions but this protection is diminished by increased irradiation energy. The best results are obtained with a dose of 750 mg/kg though this appears to be toxic. Further studies are needed to evaluate the action of WR-2721 on leukemic cells before the use of WR-2721 in bone marrow clearance.

Amifostine↗
PubMed1990

[Trichosporon capitatum septicemia in immunosuppressed patients].

Disseminated Trichosporon capitatum infections are seldom reported. We observed 3 cases in leukemic patients within 4 months. All 3 patients were granulocytopenic. One of them was also treated with cyclosporine and methyl-prednisolone after an allogenic bone marrow transplant. The portal of entry was certainly the digestive tract as Tr. capitatum have been isolated in the stool before the septicemia. All 3 patients were previously treated with an azole antifungal compound. The part of this treatment in the emergence of Tr. capitatum in the digestive tract and in the occurrence of the septicemia must be considered. As Tr. capitatum are usually sensitive to the azole compounds the explanation may be a too low daily dosage for the treatment of severely immunocompromised hosts.

Adult↗
PubMed1989

[Results of cisplatin-based polychemotherapy and analysis of prognostic factors in ovarian cancer. Apropos of 106 cases].

One hundred and six patients with stage Ic to IV ovarian carcinoma were treated by a protocol consisting of optimal debulking surgery followed by 9 cycles of CHAP chemotherapy. Clinical response was confirmed by a second-look procedure. Sixty-nine patients (65%) responded with 54 histological complete remissions (50.8%). Nineteen patients did not receive any complementary treatment due to a negative reaction, or prolonged neutropenia. Seven patients received maintenance chemotherapy, 10 an abdominal radiotherapy, 22 intraperitoneal chemotherapy and 11 autologous bone marrow transplantation. The 5-year survival rate was 32.5% and disease-free survival rate was 39.7%. Prognostic-factor analysis showed that age, initial staging, residual disease and cytological grading were significant. The authors propose a classification based on the risk of relapse, and different therapeutic indications for improving response rate and patient survival.

Adult↗
PubMedDate not supplied

Etoposide, ifosfamide and methotrexate combination chemotherapy in patients with aggressive non-Hodgkin's lymphoma after failure of the LNH 84 regimen.

We assessed the efficacy of an etoposide, ifosfamide and methotrexate combination therapy (VIM) in 24 patients failing the LNH 84 protocol. Eight of these patients were refractory to the LNH 84 induction regimen, 10 were partial responders and the six remaining attained complete response after LNH 84 induction but relapsed during consolidation therapy or after completing the whole programme. Twenty-three patients were evaluable for response. The VIM regimen provided a 43 per cent complete response rate and an additional 17 per cent partial response rate. The complete response rate was particularly high (67 per cent) in the group of patients who were partial responders to LNH 84 induction treatment. Of the 10 complete responders, five relapsed after 4 to 42 months and five are still alive with no evidence of disease after 27 to 60 months. Overall VIM was well tolerated. Myelotoxicity was the most common side-effect. Infections with fever were observed in 8 per cent of the VIM courses. This study demonstrates that a complete response and a long survival can be obtained in patients after failure of a high-dose doxorubicin containing front-line treatment.

Adult↗
PubMedDate not supplied

[Hypothyroid hypertrophic myopathy following mantle irradiation for Hodgkin's disease. A case].

The authors report a case of hypothyroid hypertrophic myopathy consecutive to mantle irradiation for Hodgkin's disease. A rise in TSH level is frequent after mantle irradiation and it justifies prolonged monitoring of these patients' thyroid function, in view of the risk of patent hypothyroidism and perhaps cancer. The patient's age, the pre-irradiation lymphography and the chemotherapy associated with radiotherapy are all factors that influence the incidence of thyroid dysfunction, but there is no agreement concerning their relative importance. Hypertrophic myopathies due to hypothyroidism are rare, and their dramatic clinical presentation contrasts with an almost normal muscle histology. Alterations of energy metabolism and changes in the properties of myosin induced by hormonal deficiency account for the muscular weakness of these patients. On the other hand, the mechanism of muscle hypertrophy remains controverted, the most probable theory being and increase in the number of myotubes. Following irradiation, notably for Hodgkin's disease, the frequency of hypothyroidism requires a regular and systematic laboratory follow-up. Replacement therapy must be instituted if the basal TSH level increases, even if the T4 level is normal.

Adult↗
PubMedDate not supplied

Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.

To evaluate the results, prognostic factors and especially side-effects of the treatment for subdiaphragmatic Hodgkin's disease (SHD) a retrospective study was conducted in the Haematology Departments and in the Cancer Centres of Nancy and Strasbourg between 1976 and 1990; 55 patients corresponding to the IA to IIB SHD stages were analysed. The median age was 45 years. In accordance with Ann Arbor classification, we observed 12 CS IA (21.3%), 2 CS IB (3.5%), 14 CS IIA (25.4%) and 27 CS IIB (49.7%). Twenty-five patients (45.4%) underwent laparotomy with spleen involvement in 10 cases. Fifteen patients (27.3%) had exclusive radiotherapy, 10 by inverted-Y field with or without splenic field, 5 by limited field to inguinal and homolateral iliac nodes. Forty patients had prior chemotherapy, 18 by MOPP protocol, 18 by hybrid MOPP/ABVD protocol and 4 by other schemes. The total dose delivered ranged from 26 to 45 Gy. With a median follow-up of 8 years, the overall and disease specific survival rates are respectively 61% and 83% at 10 years. Nine patients relapsed (16.4%), 4 among the 15 (26.6%) treated by exclusive irradiation and 5 among the 40 (12.5%) treated by combined therapy. We observed 8.3%, 21.4% and 18.5% of relapses respectively among the clinical stages IA, IIA and IIB. Eleven patients (20%) developed a second cancer. Twenty-six long-term complications were noted, nine of which concerned the digestive system. The only significant prognostic factor is age, with 10-year specific survival rates of 96% and 66% respectively for patients younger and older than 50 years (p=0.0003). Our data confirm that the most appropriate treatment for stage IA is exclusive radiotherapy and combined therapy for all other cases. With the use of CT-scan and eventually lymphography, the laparotomy is reserved only for cases with an uncertain diagnosis. Tobacco use is also clearly a risk factor in our series for late vascular complications and second cancers.

Adolescent↗
PubMedDate not supplied

[Steinert's disease and conduction disorders. Apropos of a familial study].

The authors reported a new family case of Steinert with twelve years follow-up. The study of potentials in the bundle of his was performed in all patients, showed an intra- and infra-hisian blocks. This study showed a discrepancy between muscular and myocardial evolutive injury, a very important knowledge for follow-up. Conduction disturbances were found in two cases and pacemaker insertion was performed in one patient. The authors specified the indication of electrophysiological studies during the onset and pacemaker implantation in all patient with a typical or suggestive history of syncope.

Adult↗