Biomedical subjects

M Gozy

Publications and source records attributed to M Gozy.

9 recordsLinked to original sources

PubMed1998

Hypertextual navigation operationalizing generic clinical practice guidelines for patient-specific therapeutic decisions.

Despite the proliferation of implemented clinical practice guidelines, there is still little evidence of physicians compliance to formal standards. The ONCODOC project proposes a framework for elaborating generic decision support guidelines in a document-based paradigm with a knowledge-based approach. It has been first applied to assist clinicians in the treatment of breast cancer patients. Therapeutic expertise has been encoded as a decision tree. The decision process is driven by the clinician who interactively browses a hypertext version of the decision tree. During the navigation, he incrementally assigns values to decision parameters on the basis of his free interpretation of his patient's condition and thus builds a clinical context leading to patient-specific therapeutic recommendations. These guidelines are distributed on a hospital intranet and are evaluated at the point of care in an oncology department.

Breast Neoplasms↗

PubMed1997

Salpêtrière Hospital experience with biochemotherapy in metastatic melanoma.

PURPOSE: This article investigates the safety and efficacy of a simple cisplatin-based biochemotherapy regimen, containing single-agent cisplatin plus recombinant interleukin-2 (rIL-2) and recombinant interferon-alpha (rIFN-alpha), in the treatment of metastatic melanoma. PATIENTS AND METHODS: Between December 1990 and April 1997, 129 patients were treated with cisplatin (100 mg/m2, day 0) plus continuous intravenous infusion rIL-2 (18 MIU/m2/day, days 3-6 and days 17-21) and subcutaneous rIFN-alpha (9 MIU three times per week) plus or minus tamoxifen (160 mg/day) on three different protocols. Tumor response, disease-free survival, and overall survival were evaluated for all evaluable patients (N = 127). RESULTS: The overall response rate was 49%, and 10% of patients achieved a complete response. Responses were observed at all sites of metastases. In one case, a patient with a large cutaneous inguinal mass experienced a dramatic regression of that lesion within 1 month. The median disease-free survival was 5 months, and median overall survival was 11 months. Patients who responded had a significant survival advantage over nonresponders, and patients who achieved a complete response had a significant survival advantage over patients with a partial response. Toxicities were manageable and reversible upon discontinuation of therapy. CONCLUSION: The response rates achieved with this simple biochemotherapy regimen are comparable to those for other cisplatin-based biochemotherapy regimens, which use more complex multiagent chemotherapy regimens. We found no added clinical benefit from the addition of tamoxifen to cisplatin.

Adolescent↗

PubMed1996

The clinical measurement of volumes using helical CT.

The object of this preliminary study is to evaluate the new techniques of measurement by helical CT which allow direct assessment of the volume of a lesion in clinical practice particularly by obtaining direct macroscopic anatomical correlation. Its primary application is anatomical, with measurement of the volumes of organs or anatomical structures, the clinical importance of which relates primarily to oncology. We present our initial results, including their applications and limits, before extending this study to a larger series so that it may be compared with other multicentre evaluations.

Feasibility Studies↗

PubMed1996

Cross resistance and collateral sensitivity between cytotoxic drugs and radiation in two human bladder cell lines.

The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium (MTT) test was employed as a means of studying the cross resistance and collateral sensitivities of two bladder cell lines able to grow in the presence of several antineoplastic drugs and/or despite the effects of radiotherapy. This cross resistance and collateral sensitivities were investigated in the context of two antineoplastic drugs (i.e. doxorubicin (an anthracycline) and vinorelbine (a Vinca alkaloid) and radiotherapy. The results show that cell lines able to grow in the presence of anticancer drugs develop a significant degree of resistance to antineoplastic compounds and may also develop resistance to radiotherapy. On the other hand, most cell lines treated first with radiotherapy develop a significant degree of resistance towards ionizing radiation and may also display increased sensitivity towards anticancer drugs. If these results obtained in vitro are clinically relevant, they may have important applications in the treatment of patients. Nevertheless, it will be necessary to validate the results on extensive series of chemo- and/or radioresistant cell lines exhibiting different mechanisms of resistance.

Antibiotics, Antineoplastic↗

PubMed1996

[Endometrial cancer: progress in the evaluation of locoregional extension by imaging techniques].

In the evaluation of loco regional extension, MRI and ultrasound provide highly valuable information, with respect to the invasion of deep myometrium, which determines prognosis, being highly similar for the two techniques. This gives ultrasound techniques a role of primary intention for reasons of public health economics. MRI, however, improves the work-up of other types of loco regional extension, and CT scan remains an indispensable tool for evaluating overall lymph node involvement and visceral extension.

Endometrial Neoplasms↗

PubMed1995

Survival of patients with radiation enteritis of the small and the large intestine.

We reviewed the clinical and survival data of 108 consecutive patients who presented with radiation enteritis between 1965 and 1981. One hundred and two (94%) had been irradiated for carcinoma of the cervix uteri. The median follow-up was of 11 years. The median time of occurrence of severe radiation-induced lesions (obstruction, perforation) after radiotherapy was of 18 months, against 10.5 months for mild symptoms (e.g., tenesmus) and 9 months for rectal bleeding (p < 0.001). Cox survival analysis taking into account the stage of the cancer and the age at diagnosis showed that rectal bleeding is a factor with a prognosis significantly poorer than the mild symptoms (p = 0.05), equivalent to that of the severe complications. We conclude that in the evaluation of patients who underwent radiotherapy for abdominal or pelvic tumours, rectal bleeding should be considered as a sign of serious radiation-induced complication.

Abdominal Neoplasms↗

PubMed1993

In vitro characterization of radiotherapy-induced morphonuclear modifications on chemosensitive as opposed to chemoresistant neoplastic cells.

PURPOSE: We describe by means of digital cell image analysis the influence of X-ray radiation on three in vitro cultured cell lines for which we set up chemosensitive and chemoresistant variants. METHODS AND MATERIALS: The three cell lines correspond to the MXT mouse mammary and the T24 and J82 neoplastic human bladder cells. The digital cell image analysis was carried out by computing morphometric (nuclear size), densitometric (proportion of cells in the G2 cell cycle phase), and textural features (chromatin pattern characteristics) on Feulgen-stained nuclei. RESULTS: The results show that such digital cell image analyses make it possible to monitor radiotherapy-induced effects on these morphonuclear characteristics accurately. X-ray radiotherapy induces a dose-dependent increase in the proportion of cells in the G2 phase of the cell cycle along with a decrease in the overall chromatin condensation level. These two concomitant phenomena lead to a marked radiotherapy-induced increase in nuclear size. We also observed that radiotherapy-induced effects at the morphonuclear level are not only highly specific to the cell type analyzed, that is MXT mouse mammary or J82 or T24 human bladder carcinoma cells, but also to the fact that the cells are either chemosensitive or chemoresistant. CONCLUSION: The digital cell image analyses of Feulgen-stained nuclei is helpful in monitoring the irradiation-induced morphonuclear modifications.

Animals↗

PubMed1992

Monitoring of radiotherapy-induced morphonuclear modifications in the MXT mouse mammary carcinoma by means of digital cell image analysis.

The present work deals with the characterization of the morphological changes induced by ionizing radiation on MXT mouse mammary cancer cell nuclei. The monitoring of the radiotherapy-induced morphonuclear modifications was carried out by means of digital cell image analysis, which made it possible to compute morphometric (nuclear area), densitometric (nuclear DNA content) and textural (chromatin pattern characteristics) parameters assessed on Feulgen-stained nuclei. The biological material was obtained from serial fine needle-aspirations performed on control tumors and 2Gy and 8Gy irradiated tumors. Digital cell image analyses were assessed at the 7th, 18th, and 28th days-post irradiation. We showed that radiotherapy induced specific morphonuclear modifications that appeared in a dose-dependent and time-dependent manner. The 2Gy and 8Gy radiotherapy doses led to an increase in the mean nuclear area value, this feature being observed at both the 1st and the 4th week post-irradiation. The resultant effect on the chromatin pattern characteristics corresponded to a decrease in overall condensation level as compared to the control cell nuclei. Finally, the mean nuclear DNA content increased at the 1st week post-irradiation, but decreased at the 4th week post-irradiation as compared to the MXT control tumor. Computerized cell image analysis, therefore, appears to be a useful tool in helping to monitor the radiotherapy-induced effects that occur in neoplastic cell nuclei and which can be observed by means of optical microscopy.

Animals↗

PubMedDate not supplied

[Patient-centered consultation of "good practice guidelines": OncoDoc, a decision support system for the management of breast cancer patients].

Beyond considerations of cost-effectiveness, clinical practice guidelines (CPG) can reduce practice variations and thus improve the quality of care. However, despite the proliferation of implemented CPG and their wide diffusion thanks to Internet-based technologies, physicians' compliance with formal standards is weak. Developed according to a document-based paradigm, OncoDoc proposes an original framework for implementing CPG. Domain knowledge has been encoded as a decision tree whose branches are both exclusive and exhaustive. This generic knowledge is operationalized at the point of care by the interactive building, through hypertextual navigation, of a patient-based clinical context leading to specific therapeutic recommendations. OncoDoc has first been applied to the management of breast cancer patients and demonstrated within a full-scale experimentation in a clinical setting a compliance of 80 per cent.

Breast Neoplasms↗