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Biomedical subjects

M Bolla

Publications and source records attributed to M Bolla.

At least 145 records · Page 8Linked to original sources
PubMed1986

Value of cytoprognostic classification in breast carcinomas.

Two hundred and four cases of breast carcinoma were classified according to cytological features, and these were related to prognosis. A disease free interval of seven years was 95% for patients with grade I, 70% for those with grade II, and 45% for those with grade III tumours. The risk of recurrence was also related to tumour size and the presence or absence of steroid receptors in the tumour. Cytological classification of breast carcinoma based on fine needle aspiration provides valuable information concerning the prognosis of patients, which is relevant to their clinical management.

Breast Neoplasms↗
PubMed1986

[Cancer of the prostate: therapeutic trials in 1985].

Phase III trials began since 1960 with the VACURG's studies and their results are sometimes difficult to interpret because of the variability of staging, classification, criteria of response, preliminary nature of some of them. Twenty three trials published between 1973 and 1984 are analyzed: 14 concerning advanced disease. 9 concerning loco-regional disease. For advanced disease, cyproterone acetate is not better than DES (3 mg), but a sufficient dose of Estracyt (10 mg/kg) seems to work better with less toxicity (Wisconsin trial). Among traditional hormonal manipulations, sub-capsular orchidectomy appeared to be better. The absence of results of ongoing trials with LHRH analogues, castration and anti-androgen combination do not allow an approach of their respective role. Chemotherapy has several efficacious compounds, CTM, 5FU, MTX, CDDP, ADM, which may be required after failure of hormonotherapy. Their association may take into account age and bone marrow reserves. For loco-regional disease NPCP protocols 900 and 1000 will focus indications of prostatectomy, cryosurgery, radiotherapy for stages B2, C, D1, as well as those of adjuvant treatment which will be probably modulated by prognostic factors such as stage, differentiation, lymph node status. For pelvic irradiation, the Standford trial make it easier to determine the target volume in correlation with lymph node status.

Antineoplastic Agents↗
PubMed1985

[Cancer of the prostate: results of radiotherapy. Multicenter study].

From 1975 to 1982, 597 patients with localized prostatic adenocarcinoma were treated using external beam irradiation in one of 6 cooperating centers. The mean patient age was 67 years. The 5 and 10 years actuarial survivals (including all causes of death) were 70% and 40% respectively. The adjusted survival rates become 86% at 5 years and 61% at 10 years when only death due to cancer is taken into consideration. Despite the fact that patients with stage A1 and A2 disease show different patterns of lymphatic spread, the actuarial and adjusted 8 years survivals were identical for both staging groups, in this study, 57% and 90%, respectively. It is significant that the majority of patients in both group A1 and in group A2 received irradiation to the pelvic lymph nodes as well as the prostate. Patients with stage B1 disease showed a 7 years actuarial survival of 53% and an 82% survival adjusted for death due to cancer only. Patients in both group B2 and group C, showed an identical 10 year actuarial survival rate of 49%. However, without CT scanning, it is difficult to differentiate between these 2 staging groups. Patients with stage C2 disease showed 10 years actuarial and adjusted survival rates of 20% and 40% respectively. The local recurrence rate after primary radiation therapy did not exceed 11% in any patient group. These data demonstrate, once again, that the dogma pertaining to the radioresistance of prostatic cancer is outdated.

Aged↗
PubMed1985

[Retrospective study of the treatment of piriform sinus cancers. Apropos of 97 cases].

Results of a retrospective analysis of case-reports of 97 patients treated for piriform sinus cancer showed a high frequency of large tumors and adenopathies providing an explanation for the very poor prognosis of these cancers. Therapy of choice for T1-T2 tumors is still radiotherapy. However, recently obtained results and data from the literature demonstrate the increased benefits of partial surgery with monoblock curettage followed by radiotherapy in cases with an ulcerous tumor, a mobile larynx and adenopathy of 3 cm or more. For T3-T4 cases the best treatment is by total pharyngolaryngectomy and postoperative radiotherapy.

Adult↗
PubMed1984

[Estradiol and progesterone receptors in loco-regional breast cancer. Clinical and prognostic correlations].

Estradiol (ER) and progesterone (PR) receptor assay was performed in breast cancer specimens from 133 women, 31 to 83 years of age. Mean ER levels increase significantly from one ten year age group to the next, ranging from 59.9 + 46.2 femtomoles/mg cytosolic protein in the 30-40 year group to 627 + 479 fmol/mg protein in the 89-90 year group. Mean ER values were found to be 50 + 20.4 fmol/mg protein in premenopausal patients and 176.8 + 55 after menopause. PR concentrations were similar in pre and post-menopausal patients (62.2 + 25.8 and 73.8 + 33.8 fmol/mg protein respectively. Receptor level was not correlated with T.N.M. clinical staging or lymph node involvement. Analysis of ER and PR levels according to histologic (Scarff and Bloom) grading showed a positive correlation between receptor concentration and cellular differentiation. Disease-free survival rate two years after initial therapy was significantly higher in ER positive cases (p = 0.01), although 79% of ER negative patients received adjuvant systemic therapy. In PR positive cases, this difference nearly disappears (p = 0.09), even though 70% of PR negative patients were submitted to adjuvant systemic therapy. Chemotherapy is therefore justified in RE negative patients who carry a poor prognosis.

Adult↗
PubMed1984

[Non-Hodgkin's malignant lymphoma with cervicofacial expression. Modulation of the radiotherapy-chemotherapy combination according to the cytological class].

An analysis was conducted in March 1983, after a mean follow up of 40 months, of cases of cervicofacial stages I and II non-Hodgkins malignant lymphoma in 3 children and 41 adults (mean age: 51 years, range: 6-90 years) treated between 1969 and March 1981. According to the Working Formulation malignancy was low in 4 cases, intermediate in 24 and high in 13; 3 cases could not ne classified retrospectively. Cytologic classification showed 13 of class 1 of low malignancy, 7 of class 2 of high malignancy with leukemic potential, and 16 of class 3 of high malignancy with a course leading to tumor formation. The cavum was involved in 10 cases, the tonsils in 9, the parotids in 1, the uvula in 1, isolated cervical adenopathies in 14, multiple unilateral adenopathies in 3 and bilateral cervical adenopathies in 5 cases. Therapy varied according to the series: in the first series (1969-1975) the 23 cases were treated by radiotherapy alone (40-55 Gy). In the second series (1976-1981) of 21 cases, chemotherapy was given as a function of the cytologic class: prophylactic chemotherapy for 6 months after radiation for classes 1 and 2, initial chemotherapy for 6 weeks, cerebral radiation and methotrexate intrathecally, and maintenance chemotherapy for 3 months in class 3. The failure rate for radiated zones was identical in the 2 series (less than 10%). Adjusted 5-year survival rate was 60% for series 1 against 70% for series 2 (p = 0.9), and adjusted remission rate was 43% against 64% (p = 0.8).

Adolescent↗
PubMed1982

[Conservative treatment of breast carcinoma with or without prophylactic chemotherapy. Preliminary results in 45 cases (author's transl)].

Between February 1969 and December 1979, 45 breast carcinomas T1 NO or T2 NO (greater than 3cm) were treated by tumorectomy and radiotherapy. Axillary dissection was performed in 22 cases. Twenty-one pre-menopausal patients were castrated either by oophrectomy (13 cas) or by pelvic irradiation (8 cases). From 1977 on, (10 cases) prophylactic chemotherapy using cyclophosphamide, 5 FU, methotrexate, vincristine, was administered for 4 to 6 months according to the number of poor prognostic factors. The five-year actuarial remission rate was 93% (84-100), the metastatic remission rate was 88% (72-100). Indications of prophylactic chemotherapy in forms with good prognostic factors are discussed.

Adult↗
PubMed1982

[Non-gonadic complications of chemoradiotherapy in Hodgkin's disease. A study of eighty-three patients (author's transl)].

Eighty-three patients with Hodgkin's disease were treated with a combination of chemotherapy and radiotherapy. 43 were included in protocol 1 (from january 1970 to january 1974) and 40 in protocol 2 (february 1974 to december 1977). In protocol 1, staging laparotomy was not systematically performed (20 cases). Treatment consisted of 2 intravenous injections in Vinblastine and total nodal irradiation. In protocol 2, laparotomy was systematic in patients over 50 (35 cases). Patients with stages 1 and II treated as mentioned above. Patients with stage III received two Mopp courses followed by total nodal irradiation. Patients older than 50 with stages I and II and poor prognosis factors received chemotherapy only. Laparotomy was associated with a 0% mortality rate and a 3,6% morbidity rate. No myelitis or pericarditis were observed. Herpes zoster occurred in 24% of the patients, pulmonary apex fibrosis in 6%, hypothyroiditis in 2,4%, and leucopenia in 3,6%. Two late infectious complications were fatal. No solid tumor was apparent. Acute leukemia and non-Hodgkin malignant lymphoma developed in two patients. Good tolerance, shortness of treatment, and remission rate, warrant the pursuit of protocol 2 in which systematic laparotomy for patients under 50 allows total nodal irradiation and therefore reduction of chemotherapy.

Adolescent↗
PubMed1982

The short effect of pelvic radiotherapy of gynecological cancers on humoral and cell mediated immunity.

An analysis of short effect of pelvic irradiation on cellular and humoral immunity was made in 24 patients treated by irradiation alone or a combination of surgery and irradiation for uterine carcinoma, at 2, 6, 12 months after loco-regional therapy. Twelve months later there is a decrease of T lymphocytes (P = 0.01), whereas the B lymphocytes count is normal; the percentage of T and B lymphocytes remains stable, but the lymphocyte response to PHA after 3 days is reduced (p = 0.03). A significant decrease of immunoglobulins G, A and M is observed.

Adult↗
PubMed1982

[Cytologic grade, a prognostic factor in breast cancer].

Fine needle aspirations of breast carcinomas, submitted to a hypochromic Papanicolaou staining procedure, provides useful prognostic data. Three grades of increasing severity were used as a classification. An homogeneous group of 189 patients submitted to similar therapeutic management has been analyzed: 15.3/1 000 patients/months of those classified in grade III, versus 5.2 in grade II and 2 in grade I have had a worsening outcome within 1 to 5 years. The correlation of the cytoprognostic classification with TNM classification and lymph node involvement is significant. Moreover grade III points at patients with high metastatic potential: 27 per cent of stage I, 18 per cent without lymph nodes involvement and 23 per cent with less than 3 lymph nodes involved will develop recurrence within 5 years. The absence of steroid receptors confirms the poor prognosis of grade III.

Biopsy, Needle↗