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Biomedical subjects

M Bolla

Publications and source records attributed to M Bolla.

At least 127 records · Page 7Linked to original sources
PubMed1992

Hyperfractionation versus conventional fractionation in oropharyngeal carcinoma: final analysis of a randomized trial of the EORTC cooperative group of radiotherapy.

EORTC protocol 22791 compared once daily fractionation (CF) of 70 Gy in 35-40 fractions in 7-8 weeks, to pure hyperfractionation (HF) of 80.5 Gy in 70 fractions in 7 weeks using 2 fractions of 1.15 Gy per day, in T2-T3 oropharyngeal carcinoma (excluding base of tongue), N0,N1 of less than 3 cm. From 1980 to 1987, 356 patients were entered. In the final analysis (June 1990), the local control was significantly higher (p = 0.02 log-rank) after HF compared with CF. At 5 years, 59% of patients are local disease-free in the HF arm compared to 40% in the CF arm. The superiority of HF was demonstrated in patients staged T3N0,T3N1 but not in T2. The Cox model confirmed that the treatment regimen was an independent significant prognostic factor for locoregional control (p = 0.007 log-rank). This improvement of locoregional control was responsible for a trend to an improved survival (p = 0.08 log-rank). There was no difference in late normal tissue damage between the two treatment modalities.

Carcinoma↗
PubMed1992

Combination of 5-FU cisplatinum and hypofractionated irradiation followed by split-course radiotherapy in 47 patients with unresectable non small cell lung cancer.

Forty-seven patients with unresectable non small cell lung carcinoma, 15 stage IIIA, 31 stage IIIB, 1 stage IV (cervical lymphadenopathy) were treated with a combination of three courses of chemotherapy and hypofractionated irradiation followed after 3 weeks by split course radiotherapy. Each course was repeated every 3 weeks with the following sequence: Cisplatinum (CDDP) (20 mg/m2) was given in a 20-min infusion, followed by a 2-h infusion of 5-fluorouracil (5-FU) (400 mg/m2) on days 1, 2, 5 and 6. Radiation with a dose of 3 Gy on the target volume was given on days 3 and 4--in one fraction for the former 27 patients, in 2 fractions of 1.5 Gy for the latter 20 patients with a 6-h interval--after a 2-h infusion of 5-FU (400 mg/m2). The results remain disappointing: the objective response rate was 53%, the median survival was 10 months for the series, and the one-year survival 47%. The median survival was 14 months for IIIA, 10 months for IIIB and IV. Regarding the therapeutic regimen there seems to be less morbidity with 2 fractions per day for which the median survival is nearly the same at 10 months (1 fraction/day) versus 12 months (2 fractions/day).

Aged↗
PubMed1992

Prognostic value of epidermal growth factor receptor in a series of 303 breast cancers.

125I-EGF (epidermal growth factor) binding assay was used in tumoral specimens concerning 303 clinical T1-T2, N0-N1 breast carcinoma diagnosed between May 1987 and October 1989. Binding assay for epidermal growth factor receptor (EGFR) was performed using single saturating concentration of 125I-EGF incubated with membrane preparations in the presence or absence of unlabelled EGF. A median value of 3 fmol EGF binding capacity per mg of membrane was obtained and then selected as the threshold value to define positive and negative EGFR tumour samples. According to this definition, 50.8% of the samples were EGFR positive. We noted an inverse relationship between the expression of EGFR and that of oestrogen receptor, and a decreased EGFR expression with tumour differentiation. With a rather short median follow-up (16 months), the multivariate analysis shows that progesterone receptor appears as the only powerful predictor of disease-free survival (P = 0.002), taking into account that 70% of the patients received an adjuvant medical treatment.

Adult↗
PubMed1992

[Malignant cervical epithelial adenopathy from unknown primary source. Apropos of a series of 54 cases].

Fifty four patients with cervical lymph node metastasis from an unknown primary tumor underwent treatment from 1969 to 1988. Fourty five underwent radical neck dissection. 69% had node capsular effraction and 36% perinodal vascular embolism. Thirty four patients underwent postoperative radiotherapy including rhinopharynx, cervical oesophagus and all the bilateral cervical nodes. The primary tumor appeared after treatment in 7 cases. Total survival rate is 36% 5 years after treatment. Vascular embolism aggravates the prognosis. Radiosurgical association allow effective control of loco-regional cancer but does not improve survival rate. Prognosis is aggravated by metastases arising (18%).

Adult↗
PubMed1990

Estimation of epidermal growth factor receptor in 177 breast cancers: correlation with prognostic factors.

Steroid receptors (ER, PR) and EGF-receptor were determined on 177 loco-regional primary breast cancers. Binding assay for EGF receptor was performed using a single saturating concentration of 125I-EGF incubated with membranes in the presence or absence of unlabeled EGF. With threshold values of 5 fmol/mg and 10 fmol/mg for EGF-R and steroid receptors respectively, we noted an inverse relationship between the expression of EGF-R, and ER and PR. EGF-R expression is decreased with tumor differentiation.

Breast Neoplasms↗
PubMed1990

[Cancers of the supraglottic larynx: results and therapeutic indications apropos of 124 cases].

The authors report their experience of the treatment of the supraglottic laryngeal carcinoma in a retrospective study of 124 patients primarily treated in the ENT department of Grenoble University hospital. Fourteen patients received only radiotherapy, the others 110 patients were treated by surgery: partial or reconstructive surgery in 47 cases, total surgery in 63 cases. The carcinological results demonstrate the good prognosis of the intra-laryngeal tumors. Their treatment allows a good loco-regional control (tumoral recurrences: 4%, regional recurrences: 2%). The main prognostic factor is the nodal involvement with capsular rupture which is responsible for the most locoregional and metastatic recurrences.

Adult↗
PubMed1990

[Primary and recovery transmaxillar buccopharyngectomy in buccopharyngeal cancers].

From january 1976 to december 1986, 78 patients were treated surgically for squamous cell carcinoma of the lateral buccopharyngeal junction without chemotherapy at first. 36 patients were treated by primary surgery with post-operative radiotherapy and 31 patients were treated by recovery surgery. Post-operative course was uncomplicated in 41% of cases (39% in primary surgery, 43% in recovery surgery); in 14% of cases serious local complications were observed (11% in primary surgery, 17% in recovery surgery). Carcinological failures appeared in 46% of cases in primary surgery and in 70% of cases in recovery surgery. Three years and five years actuarial survival rate were 45% and 39% respectively in recovery surgery. Prognostic factors are studied: resection quality, histological metastasis in lymph nodes. The authors emphasize on the best control of the big tumors in primary surgery and on the best results with small ulcerated infiltrant carcinoma.

Adult↗
PubMed1990

[Inflammatory carcinoma of the uterine cervix. Review of 9 cases].

Nine cases of inflammatory invasive carcinoma of the uterine cervix are reviewed. All appeared in women under less than fifty years old, quickly after normal PAP smears. They occupied the endocervix, which mean diameter was 5 cm and outcome was very poor with only one survivor: four patients were free of disease in the pelvis and relapsed outside, the others underwent a local regional failure in less than 2 years. Association of radiotherapy and surgery is mandatory for stage IB and IIA FIGO; radiotherapy modalities--brachytherapy, external irradiation followed by brachytherapy--must be chosen according to tumor volume, size of the cervix, anatomy of vagina. For other stages radiotherapy alone is recommended using hyperfractionated treatment; in the future such observation would be documented by cytofluorometry analysis and/or molecular biology approach.

Adult↗
PubMed1990

[Causes of failure in the curative treatment of cancer of the exocrine pancreas].

Causes of relapse are related to diagnostic delay, disagreement between early clinical diagnosis and post-surgical classification, poor performance status of patients, biological features, treatment modalities and particularly subclinical disease left after radical surgery. Gastro-intestinal specialists, radiologists, surgeons, pathologists, radiation and medical oncologists must come together to propose the best strategy: exactness of pre- and post-operative staging; surgical resection performed with minimal and acceptable morbidity after due consideration of all associated risk factors; accurate pathological examination with mention of tumoral diameter, capsular invasion, multicentricity, lymph nodes and venous involvement, pTNM classification; precise systematic external beam radiotherapy, which may be enhanced by 5-FU.

Neoplasm Staging↗
PubMed1990

[Association of 5-FU, CDDP and hypofractionated radiotherapy in recurrences of subtentorial astrocytomas and malignant gliomas in adults].

Twenty-seven patients who had a relapse of astrocytomas or supra-tentorial malignant gliomas, previously treated by radio-surgical combination or exclusive irradiation, underwent a combination of 3 courses of 5-FU, cis-platyl and hypofractionated irradiation. No objective response was observed, but there was a progression of the tumor in 33% of the cases, and no change in 67%. Overall median survival was 7 +/- 1.5 months. The 20 patients with grade III or IV astrocytomas had a lower median rate than the 7 patients with grade II astrocytomas or oligodendrogliomas: 6 +/- 1.8 months versus 18 +/- 3.2 (P = 0.16). Median survival was 14 +/- 2.7 months for neurological responders and 6 +/- 2.1 months for non-responders (P = 0.017).

Adult↗
PubMed1989

Sequential combination of 5-fluorouracil, cis-platinum and irradiation in unresectable non-small cell lung cancer.

Twenty patients with unresectable non-small cell lung carcinoma, 15 stage III and 5 stage IV (supraclavicular lymphadenopathy) were treated with a combination of three courses of chemotherapy and hypofractionated irradiation followed after 3 weeks by split-course radiotherapy. Each course was repeated every 3 weeks with the following sequence. Cis-platin (CDDP) (20 mg/m2) was given in a 20-min infusion, followed by a 2-h infusion of 5-fluorouracil (5-FU) (400 mg/m2) on days 1, 2, 5 and 6. Radiation with a dose of 3 Gy on the target volume was given on days 3 and 4, after a 2-h infusion of 5-FU (400 mg/m2). Split course of irradiation consisted of 16 Gy in 5 fractions repeated after 3 weeks interval. The objective response rate was 75%. Median follow-up was 24 months, the median survival was 14 months. The 1-year survival was 53% and the 2-year survival was 16%.

Actuarial Analysis↗
PubMed1988

Chemotherapy with low doses of radiation followed by definitive radiotherapy for advanced unresectable carcinoma of the head and neck.

Thirty-six patients with advanced unresectable carcinoma of the head and neck were treated with a combination of three courses of chemotherapy and low doses of radiation, followed after 3 weeks by definitive irradiation. Each course was repeated every 3 weeks with the following sequence. Cisplatin (20 mg/m2) was given in a 20-minute infusion, followed by a 2-hour infusion of 5-fluorouracil (400mg/m2), on days 1,2,5, and 6. Low doses of radiation were given on days 3 and 4, followed by a 2-hour infusion of 5-fluorouracil (400 mg/m2) with a dose of 3 Gy on the target volume. For definitive irradiation, a total dose of 60 Gy was delivered in 30 fractions within 6 weeks. The complete response rate reached 30%, and the partial response rate was 30%. With a median follow-up of 11 months, median overall survival was 10 months; median survival was 21 months for patients with complete response, 9 months for patients with partial response, and 6 months for those with no response (P=.02).

Adult↗
PubMed1987

[Prognostic value of estradiol and progesterone receptors in stage I and II breast cancer with an adjuvant treatment].

Forty-seven stage T1, 225 stage T2, treated from January 1977 to December 1982 were studied. The median followup is 31 months (18-92) and the median age 57.5 years (26-92). On the 247 axillary clearances performed, there were 53% N- and 47% N+. The dextran coal method was used for the receptors dosage with R 2858 as ligand for estradiol and R 5020 for progesterone: positivity threshold was set at 10 fmoles. The RE+/RP+ group represents 40%, the RE+/RP- group 30%, the RE-/RP- group 7%, the RE-/RP- group 23%. The radio-surgical combination was systematic, with or without conservative treatment, followed by an adjuvant chemotherapy (15%), an hormonotherapy (34%), a chemohormonoprophylaxy (23%), within a protocol balancing the systemic treatment according to the following poor prognosis factors: axillary clearance positivity, grade 3 SBR, cytological grade 3. The crude actuarial survival is 96 +/- 4% (RE+ RP+); 73 +/- 15% (RE+ RP-); 78 +/- 12% (RE- RP-) and the disease-free survival was 84 +/- 9% (RE+ RP+); 68 +/- 15% (RE+ RP-), 67 +/- 14% (RE- RP-) with a significant difference between RE+ RP+ and RE+ RP- (P less than 10(-3)) and RE+ RP+ and RE- RP- (P less than 10(-5)). The crude actuarial survival and the disease free survival are studied according to menopausal status, Scarff-Bloom grade, and N+/N- axillary status. For N- patients, there is no significant difference for the disease-free survival, 84 +/- 14% (RE+ RP+); 85 +/- 11% (RE+ RP-); 79 +/- 15% (RE- RP-), as there is no difference for the five year disease-free survival between N- RE+ RP+ patients (84 +/- 14%) and N+ RE+ RP+ patients (84 +/- 13%).

Adult↗