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Biomedical subjects

L Israël

Publications and source records attributed to L Israël.

At least 37 records · Page 2Linked to original sources
PubMed1989

Retinoid chemoprevention timing and dose intensity.

The concept of chemoprevention is generating increasing attention among oncologists. This article discusses the issue of dose of chemopreventive agents in relation to the stages of tumor development. Vitamin A-deficient animals have an increased susceptibility to cancer development, and epidemiologic studies have shown an inverse relationship between intake of food rich in vitamin A and/or beta-carotene and cancer risk. These data suggest that physiologic levels of these natural substances exert a protective effect against cancer development. In the presence of precursor lesions, however, this protective effect has been overwhelmed and pharmacologic doses of chemopreventive agents are required to induce regression or to arrest the progression of these lesions. Phase I pharmacologic and toxicologic studies, and Phase II dose-intensity investigation of chemopreventive agents in patients having precancerous lesions need to be carried out. Such studies would enable to select the least toxic effective chemopreventive dose for intervention trials in high-risk populations, which could then be undertaken based on evidence of activity.

Antineoplastic Agents↗
PubMed1988

Treatment of advanced epithelial ovarian cancer with a cis-dichloro-diammine platinum, cyclophosphamide, and bleomycin combination.

Twenty-five consecutive patients with previously untreated stage III (18) and IV (7) epithelial ovarian carcinoma underwent maximum surgical tumor reduction followed by cyclophosphamide, cisplatinum, and bleomycin chemotherapy, given 5 days every 3 weeks for a total of 6-8 courses. Patients were then submitted to second-look surgery, and complete responders to a 1-year additional chemotherapy with L phenylalanine mustard and hexamethylmelamine. The median survival is 23 months for the whole group, and 31+ months for 13 patients found in microscopically assessed complete remission (CR) at the time of second-look surgery. The possible significance of these results and of the addition of bleomycin to a well-known combination are discussed, together with the limitations of a phase II study.

Adult↗
PubMed1987

Problems of evaluation in gerontology--a short review.

Problems of health evaluation are summarized under three headings covering theoretical, technical, and practical aspects, in physical mental, and social fields. Methods used and instruments applied in gerontology are briefly commented. The heterogeneity of elderly populations is stressed considering group and individual features. Guidelines for comprehensive evaluation, in which psychological variables have an important role, are suggested for assessing the elderly.

Aged↗
PubMed1986

Two years of high-dose cyclophosphamide and 5-fluorouracil followed by surgery after 3 months for acute inflammatory breast carcinomas. A phase II study of 25 cases with a median follow-up of 35 months.

Twenty-five consecutive cases of inflammatory breast carcinoma were treated with high-dose cyclophosphamide and 5-fluorouracil in 5-day courses every 3 weeks for 2 years, with total mastectomy performed after the third course. The toxicity was high but acceptable in 24 of the patients, provided the doses were decreased. Tumor was found at surgery in all 24 patients, and the lymph nodes were involved in 19 of 24 cases. The median follow-up was 35 months (range, 16-76 months). Thirteen relapses were observed, three of which were exclusively locoregional. The median disease-free survival was 46 months. The expected median survival is greater than 6 years. Six patients were treated with radiotherapy for regional recurrences. The good results obtained with this severe form of the disease confirm: that chemotherapy is highly effective in primary tumors and that initial radiotherapy is not necessary in the management of this disease.

Acute Disease↗
PubMed1985

[Inhibition of DNA repair, major objective of anticancer chemotherapy. Apropos of 680 cases with continuous platin bleomycin combination].

Six hundred and eighty seven cases of cancers of various sites, essentially of squamous structure are presented. Their treatment consisted of a combination of cisplatinum, given 5 days in a row every 3 weeks and of continuously infused bleomycin, also 5 days every 3 weeks. Objective (greater than 50 p. 100) regressions were seen in 70 p. 100 of cases, a significantly greater proportion than obtained by other chemotherapies or by cisplatinum and bleomycin given for one day. This difference is attributed to the fact that bleomycin, a potent inhibitor of type II DNA polymerase, inhibits DNA repair. The authors evaluate the extent of DNA repair to be about 80 p. 100 of all the lesions created by platinum salts and consider DNA repair to be a major limitation of cytostatic therapy, often neglected in the design of chemotherapy protocols.

Adenocarcinoma↗
PubMed1985

[Vitamin A augmentation of the effects of chemotherapy in metastatic breast cancers after menopause. Randomized trial in 100 patients].

Vitamin A was administered to randomly allocated patients in a group of 100 patients with metastatic breast carcinoma treated by chemotherapy. The daily doses (given indefinitely) ranged from 350,000 to 500,000 IU according to body weight. A significant increase in the complete response rate was observed. When subgroups determined by menopausal status were considered, it was observed that serum retinol levels were only significantly increased in the post-menopausal group on high dose Vitamin A. Response rates, duration of response and projected survival were only significantly increased in this subgroup. The therapeutic and biological implications of these findings are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Thymus function in patients with resectable lung carcinoma.

A series of 43 patients (median age 57 years, range 39-73) underwent biopsy of the thymic area during resection for primary lung cancer (16 with negative nodes and 27 with positive nodes). In 22 cases in which study of lymphocyte subpopulations was possible T6 precursor thymocytes were found (mean 57%). T4 and T8 cells were present in proportions of 53% and 47%, respectively, equally distributed between T6 and T3 cells. A well-defined lobular structure was found in 11 cases and active thymic tissue with poorly defined lobules in 21 cases. There was no correlation of active thymus tissue either with age or with lymph node status. It is hypothesized that thymic tissue undergoes regeneration in response to tumor development, 50% of thymocytes being of the suppressor type in early tumors. Thymic structure in advanced cancer has not yet been studied.

Adult↗
PubMed1984

[Nonspecific chemotactic response of macrophages, lymph node status and prognosis in operable cancers of the lung and breast].

Using a technique developed in our department, we studied the macrophage chemotactic response "in vivo" to a non-specific stimulus in 125 patients with operable lung cancer and 56 patients with operable breast cancer. The response was compared to that of 45 normal controls and 54 patients with metastatic cancer. The results of the preoperative test were correlated with lymph node status determined postoperatively by pathologic examination and also with prognosis. The follow-up on these patients has now reached 60 months. The chemotaxis test has revealed subgroups with different prognoses among both the N+ and N- groups. Patients with N- status (both lung and breast) and a strong preoperative chemotactic response had a very high recurrence rate, above that of N+ patients. Among the N+ patients a subgroup with very limited lymph node involvement and a strong chemotactic response had a significantly better prognosis that the N group as a whole.

Breast Neoplasms↗
PubMed1983

[Methods of psychometric evaluation in geriatrics. Choice of an instrument and its reliability criteria].

As evaluation of patients functioning has become the key-stone of geriatric practice, the appropriated choice of a measuring instrument is of great importance. This article reviews rules and guidelines for a general approach to the orientation of this choice as well as the criteria of reliability of the chosen instrument. Starting from the principle that there is no universal instrument, but only instruments which are more or less adapted to the various requirements, the general characteristics which determine this choice are examined and discussed one by one. They concern the purpose, the study population, the rater, the applications and the variables, the type of instrument and the validation works. The various forms of validity, reliability and sensitivity are listed and defined. These criteria of reliability apply essentially to psychometric instruments with quantitative criteria of measurement, but not to clinical tests which have a qualitative evaluation and which are widely used in neurology. In geriatrics, particular attention should be paid to instruments with a high and demonstrated "face validity".

Aged↗
PubMed1982

[Advanced epithelial cancers of the ovary: results of 4 chemotherapy protocols (110 cases)].

Following surgery for epithelial carcinoma of the ovary, FIGO stages IIc, III and IV, 110 patients received chemotherapy in one of four treatment regimens (Melphalan; Cyclophosphamide-Methotrexate-Fluoro uracil; Cyclophosphamide-Cisplatinum; Cyclophosphamide-Cisplatinum-Fluoro-uracil). Melphalan alone was as effective as combination chemotherapy and less toxic. The study confirms that the survival duration is inversely correlated to the stage of the disease and to the amount of residual disease following surgery. It also confirms the role of the "second look" surgery in the evaluation of the response to chemotherapy, and in the overall management of the disease.

Adult↗