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J Tredaniel

Publications and source records attributed to J Tredaniel.

18 recordsLinked to original sources
PubMed2005

Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC).

BACKGROUND: Taxotere (docetaxel) at the dose of 75 mg/m(2) every 3 weeks is a standard therapy for pretreated non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the safety profile of two schedules of docetaxel administration (every 3 weeks versus weekly) in patients with pretreated NSCLC. PATIENTS AND METHODS: From February 2000 to February 2001, 125 patients with locally advanced or metastatic NSCLC were randomised after failure of a previous platinum-based regimen to receive either docetaxel 75 mg/m(2) administered every 3 weeks (Dq3w) or docetaxel 40 mg/m(2) given weekly for 6 weeks followed by 2 weeks of rest (Dqw). Safety evaluations focused on grade 3-4 neutropenia, febrile neutropenia, nausea-vomiting and asthenia. RESULTS: Patients' characteristics were well balanced between arms. The most common National Cancer Institute Common Toxicity Criteria (NCI-CTC) grade 3-4 toxicity was neutropenia, which occurred in 48.4% of Dq3w patients versus 15.9% of Dqw patients (P=0.001). In addition, febrile neutropenia were observed in 6.5% of patients in Dq3w versus 0% in Dqw. Grade 3-4 asthenia was more frequent in Dqw. Other non-haematological toxicities were very rare. Regarding efficacy, there was a trend towards a better disease control rate in Dq3w: 32.2% versus 25.4% in Dqw. Median time to progression and survival were rather similar in both arms, respectively: 2.1 months (range 2-3.2) and 5.8 months (range 4.0-7.0) in Dq3w and 1.8 months (range 1.6-2.3) and 5.5 months (range 3.7-6.6) in Dqw. CONCLUSIONS: While both schedules had a favourable safety profile, a significant lower rate of severe neutropenia was observed in the weekly arm. Both regimens had similar efficacy. The weekly regimen could be considered as a good alternative for patients at risk of severe neutropenia.

Adult↗
PubMed1998

Predictive factors for late toxicity after endobronchial brachytherapy: a multivariate analysis.

PURPOSE: To determine the predictive factors associated with hemoptysis and radiation bronchitis after endobronchial brachytherapy by univariate and multivariate analyses METHODS AND MATERIALS: One hundred forty-nine patients underwent endobronchial brachytherapy and were divided into three therapeutic groups: group 1: patients treated with palliative intent (n=47); group 2: patients treated with curative intent (small endobronchial tumors without mediastinal or general dissemination: n=73); group 3: patients also receiving external irradiation (n=29). One hundred twelve patients had previously received external irradiation. Brachytherapy was delivered with a dose per fraction ranging from 4 to 7 Gy and a prescription point between 0.5 and 1.5 cm, usually 1 cm from the source center. Two to six fractions were delivered according to the therapeutic group and clinical situation. The influence of the following variables on the incidence of hemoptysis or radiation bronchitis was studied: age, sex, Karnofsky score, therapeutic group, histologic type, endoscopic tumor length, dose per fraction, total brachytherapy dose, total external beam irradiation dose, total dose (brachytherapy dose plus external irradiation dose), volumes of the 100% and 200% isodoses, and volumes of the 7 and 14 Gy isodoses. RESULTS: We observed 11 hemoptyses (7.4%), 10 were lethal. All but one occurred in patients with progressive disease. Two clinical factors were significantly associated with hemoptysis by univariate analysis: palliative group (p=0.009) and endobronchial tumor length (p=0.004). No technical factors seem to be implicated in the occurrence of hemoptysis. Only endobronchial tumor length remained in the multivariate model (p=0.02). Radiation bronchitis was observed in 13 cases (8.7%). By univariate analysis, a good Karnofsky score (p=0.02), curative treatment (p=0.02), and tumor location on trachea and main stem bronchus (p=0.002) were significantly associated with this complication. Two technical factors were also incriminated: the total dose (p=0.04) and the 100% isodose volume (p=0.02). By multivariate analysis, only the tumor location retained statistical significance (p=0.009). CONCLUSION: Hemoptysis is most likely due to disease progression, with the bleeding being facilitated by brachytherapy. Some rare cases could be a direct complication of brachytherapy itself, particularly when tumors are located in the upper lobes. In contrast, radiation bronchitis occurred more frequently in patients with controlled disease, and was significantly influenced by tumor location and technical factors (dose and volumes treated). Technical improvements should increase the therapeutic ratio.

Analysis of Variance↗
PubMed1993

Residual mediastinal mass in malignant lymphoma: value of magnetic resonance imaging and gallium scan.

Following treatment for mediastinal lymphoma, residual masses are defined as a mass greater than 2 cm observed on the CT scan in the absence of other evolutive signs of lymphoma. In this study, we examined 55 patients with residual mediastinal mass after optimal therapy, using gallium scan (37 cases) or magnetic resonance imaging (MRI, 44 cases). The group comprised 41 subjects with Hodgkin's disease and 14 with non Hodgkin's lymphoma, stages I and II (32 cases) and stages III and IV (23 cases); 35 subjects (64%) having bulky mediastinal involvement at diagnosis. A negative gallium scan or fibrotic signal on MRI was correlated with complete remission in 48 cases (87%). In seven of these 48 patients, MRI was not conclusive with a high signal of indeterminate tissue following radiotherapy, but four of the seven had fibrotic tissue on biopsy and none relapsed. Positive gallium scan was observed in six cases. In conclusion, we suggest performing a gallium scan at the end of induction chemotherapy and when it is negative, treatment may be continued without surgical biopsy or salvage therapy. MRI is of value when it shows fibrotic tissue but can be inconclusive.

Adolescent↗
PubMed1992

The significance of a residual mediastinal mass following treatment for aggressive non-Hodgkin's lymphomas.

The chest radiographs of 252 patients with aggressive non-Hodgkin's lymphoma, prospectively treated according to one of three protocols of combination chemotherapy, were reviewed to determine the incidence and prognostic significance of mediastinal abnormalities following treatment. Residual mediastinal masses were defined as any abnormality, greater than 2 cm in diameter, that had initially responded to chemotherapy and then remained stable in size for at least three months after its maximal response, together with the disappearance of all other clinical and biological signs of active lymphoma. At the end of treatment, 21 (8%) patients had some residual mediastinal abnormality. The predominant histological pattern was the diffuse large cell subtype (p less than 0.001). Disease free survival and overall survival for these patients were similar to those observed among patients in complete remission without a persisting radiological mass after treatment. We conclude that mediastinal residual masses after completion of treatment for aggressive lymphoma are frequent and do not indicate a poorer prognosis. Such patients can be observed clinically without any need for additional chemotherapy or radiotherapy.

Adult↗
PubMed1991

Cardiopulmonary toxicity after three courses of ABVD and mediastinal irradiation in favorable Hodgkin's disease.

The combination of chemotherapy and radiotherapy in Hodgkin's disease has been associated with iatrogenic effects. Forty adult patients were studied to evaluate the early toxicity following three courses of ABVD (cumulative dose of doxorubicin [Adriamycin] 150 mg/m2, and bleomycin 60 mg) and mediastinal irradiation at 40 Gy. Cardiopulmonary toxicity was assessed from six months to three years after completion of irradiation. Of the 40 patients, all of whom were in complete remission from Hodgkin's disease, 6 experienced dyspnea on exertion. In studies related to Cardiac toxicity, the left ventricular ejection fraction ranged from 50 to 77% (mean 63%); 8 patients had a minor pericardial effusion, 4 had valvular calcification, and 6 had minimal cardiac abnormalities. With regard to pulmonary toxicity, CT scan showed a small pleural effusion with pleural thickening in 19 patients and mediastinal or apical fibrosis in 15 patients. The total pulmonary capacity value was low (less than 80%), in 19 patients, and decreased carbon monoxide diffusion capacity (less than 70%) was found in 10 patients. We conclude that early cardiac toxicity was absent despite the use of Adriamycin and mediastinal irradiation. Pulmonary toxicity was present but minor, and it may decrease with the use of smaller fraction sizes for mantle field irradiation.

Adolescent↗
PubMed1991

[Detection of bronchial cancer. Realities and perspectives].

Primary bronchial cancer is responsible for at least 20,000 deaths per year in France. The treatment of cancer in the clinical phase remains disappointing. Numerous trials, which are reviewed here chronologically, have looked for a way to improve the prognosis by an earlier detection of this tumour. Unfortunately numerous methodological approaches have not been able to avoid the fact that the real value of such an early diagnosis is not always known. The only clear conclusion of these studies is that cytological examination of the expectorate does not lead to an improved survival in patients when compared to that which is obtained with the single radiographic film. However, taking account of the natural history of the disease, it is probably necessary to abandon the concept of an early diagnosis of a tumour which is already too late; it is towards a search for pre-cancerous lesions which are still reversible that the research effort should be turned.

Bias↗
PubMed1989

[Passive smoking and respiratory diseases. Current data].

Smoking is now unanimously recognised as a pathological factor and a major carcinogen. It is estimated that it is responsible for around 10% of the overall mortality in France or more than 50,000 deaths per year and in the United States for around 15% of the overall mortality or 300,000 deaths per year. There has been recent evidence that the risk linked to the inhalation of tobacco smoke does not appear only in active smokers, but also in all subjects who are involuntarily exposed to tobacco smoke. We have here planned a general review of the epidemiological studies which have looked for an association between passive exposure to tobacco and respiratory disease. In children, an increase in symptoms and respiratory infections has been observed, as well as a slowing down in pulmonary growth. In adults the effect of involuntary exposure to tobacco smoke seems above all to be carcinogenic. It is estimated that there is a 25% increase in the risk of bronchial cancer in a non smoker married to a smoker when compared to the risk observed in a non exposed non smoker. Thus the disastrous effect of smoking appears without any threshold.

Adult↗
PubMed1989

[Comparison of the antiemetic effectiveness of high-dose corticosteroids with synacthene in nausea induced by chemotherapy: results of a randomized study].

One hundred two patients submitted to intensive chemotherapy were included in a randomized study with cross over comparing for the second course two anti-emetics: tetracosactide (D1: 3 mg, D2 and D3: 2 mg/d) and methylprednisolone (D1: 240 mg, D2 and D3: 160 mg/d). Most patients presented with malignant lymphoma. All patients experienced nausea and emesis during first course of chemotherapy. Results were similar in both groups, respectively for tetracosactide and methylprednisolone: no nausea 37 versus 40%, less than 3 emesis 69% versus 73%. Secondary effects were observed in 5 and 8% of cases. Tetracosactide with a schedule of 7 mg for 3 days gives the same results than methylprednisolone 560 mg for 3 days in chemotherapy induced nausea and emesis prevention.

Adolescent↗
PubMed1988

[Isolated internal breast adenopathy. Late recurrence of breast cancer].

Invasion of the internal mammary lymph nodes is common in tumoral pathology of the breast, but an isolated internal mammary lymphadenopathy occurring long after treatment of the primary tumour is a rare event. The authors report one case and discuss the prognostic and therapeutic factors involved.

Adenocarcinoma↗
PubMed1985

[Acute suppurative myositis. 4 cases].

Four cases of acute pyomyositis are reported. They were diagnosed at an advanced stage, and the different complementary examinations were of uneven value. The responsible pathogen was Staphylococcus aureus in 3 cases and a strain of Streptococcus in 2 cases (one patient had both germs). Cure was obtained in 3 patients, including one who required amputation; the 4th patient died. In this disease only the finding of purulent fluid at surgery or by needle aspiration has a diagnostic value. Management consists of antibiotic therapy associated with surgical drainage.

Acute Disease↗
PubMedDate not supplied

Incidence of pleural mesothelioma in New Caledonia: a 10-year survey (1978-1987).

All cases of primary pleural cancers that were reported during a 10-y period (i.e., 1978-1987) in New Caledonia were recorded and compared with five cancer registers. There was an excess of primary pleural cancers in the area of New Caledonia, and it was particularly evident among the Melanesian ethnic group. Neither geographical nor occupational factors accounted for these results, but an environmental factor could not be excluded.

Adult↗