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Biomedical subjects

S Schraub

Publications and source records attributed to S Schraub.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Descriptive epidemiology of gynecologic and breast cancers].

The epidemiology of gynecological and breast cancers are better known in France as a result of the mortality data provided by INSERM and the mortality data obtained from the French Tumor Register. Breast cancers are the most common form of cancer in women, accounting for about 30 p. cent of tumors (excluding skin cancers) followed by cancers of the uterine cervix, uterine body and the ovary. The change in incidence shows a definite reduction in the number of uterine cancers over the past 10 years, whereas the incidence of breast cancers is rising by 1 to 2 p. cent per year. Mortality due to breast cancer has risen steadily in France since 1950, particularly in higher age groups. At birth, the risk of developing a breast cancers is 7 p. cent, i.e. one woman in 14 will develop a breast cancer. The figures for cancers of the uterus and ovary are much lower. Survival curves for various types of cancer confirm the steady decline in survival for breast cancers, whereas for cancers of the cervix, uterine body and ovary, mortality rates stabilize after 5 years. The risk of a secondary cancer remains very high for breast tumors, and half the cases of a secondary tumor involve a contralateral breast tumor. In general, there is an increased risk of a secondary cancer after a primary gynecological tumor.

Adult↗
PubMed1992

[Epidemiology of kidney cancers].

Renal carcinomas represent 2% of all tumors. More than 90% of these cancers occur in adults with the frequency in adult males being twice as high as that in adult females. The frequency of renal carcinomas is relatively high in France especially in males. Renal carcinomas mortality has been increasing in France over the last 40 years by more than 2% per year and suggests that tobacco is involved in this increase. Obesity, especially in women, and chronic renal failure are two other frequent associations found with renal carcinomas. The prognosis for this cancer is not clear-cut as the relative 5-year survival rate for all adult tumors ranges from 36 to 54%.

Adolescent↗
PubMed1991

Evaluation from population registry data of health care expenditure during the 6 months after cancer diagnosis.

It is currently estimated in France, that the cost of cancer has risen to $3.8 billion, with an annual growth of 5-10%. This represents approximately 6% of all health expenditure. The data from the Registry of Tumors in the Doubs region have enabled us to make an evaluation of health expenditure, reimbursed by the French Securite Sociale (S.S.), and its distribution in relation to different activities (diagnosis, type of treatment, follow-up, transport), according to cancer site. In 1984, the average cost per patient within the first 6 months of the illness was evaluated at $4,000. The results show major differences for the cancer sites, care facilities and budget items. Diagnosis assessment represents 27% of all expenditure, surgery 37%, radiotherapy, chemotherapy and transport, 11% each. All kinds of expenses are fully reimbursed by the French S.S. and transportation, which at the beginning used to avoid hospitalization, is now used as a comfort system and represents a high cost to the S.S. The different costs for the same illness between private, general public and university hospitals do not reflect a difference in care, but rather different systems of calculating and functioning. Till now there has not been any logical evaluation of care in the French health system.

Data Collection↗
PubMed1991

[Unproven treatments in cancerology].

A socio-ethnologic study of 21 patients localized or metastatic cancer with which consisted of 8-hour in-depth interview and family interviews determined 3 categories of cancer patients which used unproven methods. The first category (No 5) decided to use unproven methods immediately after classical treatment in order to improve the possibility of cure. These patients had already used unproven methods for benign illness. The second category (No 11) used unproven treatments a certain while after the completion of all classical treatment, to reduce the adverse effects of radiotherapy or chemotherapy and to prevent recurrences. The last category (No 5) used the unproven treatments before any classical treatment was treatment carried out, due to fear or lack of confidence in classical treatment. The frequency of unproven treatment among cancer patients is estimated at 52%. In most cases patients who were not representative of a specific socioeconomic level used classical treatment in parallel with unproven methods prescribed either by non medical (No 12) or medical doctors (No 9). Among these very few are permanent prescriptor and advice patient to take exclusively the unproven methods. A better information of patients and better relationships between patient and doctor can improve the chance of cure.

Acupuncture Therapy↗
PubMed1990

The predictive value of cell kinetic measurements in a European trial of accelerated fractionation in advanced head and neck tumors: an interim report.

The value of cell kinetic measurements in head and neck tumors in predicting which patients will benefit from accelerated fractionation radiotherapy regimens is being tested in a multicenter European trial (EORTC trial 22851). This paper reports on the first analysis of the correlation of kinetics with outcome in this trial. A proportion of patients in both the accelerated arm (72 Gy in 5 weeks, 1.6Gy per fraction, 45 fractions) and the conventional arm (70-72 Gy in 7-8 weeks, 1.8-2.0 Gy per fraction, 35-40 fractions) were given an i.v. injection of 100 mg/m2 IUdR (iododeoxyuridine) before treatment, and a tumor biopsy was taken several hours later. The potential doubling time of the tumor (Tpot) was obtained from a flow cytometric analysis of tumor cell nuclei using an anti-IUdR antibody. From a total of 260 patients entered in the trial, 53 have undergone kinetic analysis. Adequate IUdR labeling was seen in 47 patients (88.7%), from which the mean value for Tpot was found to be 4.5 +/- 2.5 days (+/- S.D.). Of the IUdR labeled patients, 30 have now been followed up for at least 1 year, 17 with conventional and 13 with accelerated radiotherapy. These patients were split into those with fast and those with slowly growing tumors, the dividing line being the median Tpot value of 4.6 days. After conventional 7-week radiotherapy, 2 of 6 patients with "fast" growing tumors obtained local control compared with 8 of 11 with "slow" growing tumors. A small difference in local control was seen been fast and slow tumors in the accelerated arm (5/9 vs. 3/4). These preliminary data support the hypothesis that patients with fast growing tumors do poorly with conventional radiotherapy and that pretreatment kinetic measurements can select patients at risk. The predictive power of the method must await the final analysis of trial results.

Cell Division↗
PubMed1989

Primary carcinoma of the gallbladder. Adjuvant postoperative external irradiation.

Seven patients received the same postoperative (Postop) external-beam irradiation (NRT) after apparent complete removal of gallbladder carcinoma between August 1983 to February 1988. A dosage of 4600 cGy were delivered on a first volume (average treated volume 0.87 liters) corresponding to this of potentially locoregional disease, completed by a boost dose of 900 cGy on the gallbladder bed. Moderate acute side effects were seen in five patients; regressive dyspepsia in three and mean weight loss of 1.5 kg in three. The minimum follow-up is 5 months and the maximum is 58 months. Five patients are alive with no evidence of disease (NED) after 5, 9, 11, 31, and 58 months, respectively. One died at 12 months with local recurrence, liver metastasis, and peritoneal implants. Another one died at 26 months of abdominal recurrence. With regard to the natural history of this tumor, the dismal results obtained by surgery alone, and our preliminary data, we advocate Postop adjuvant XRT as a safe treatment.

Aged↗
PubMed1989

Adenocarcinoma and wood.

The relation of adenocarcinoma of the facial sinuses and exposure to wood dust has been recognized for 20 years. As the tracheobronchial mucosa is similar to that lining the sinuses, a link between bronchial adenocarcinoma and wood dust exposure has been postulated. To test this hypothesis, a case-control study was conducted, based on all the histologically proven cases of adenocarcinoma of the lung reported to the tumor registry of the Doubs region of France from 1978 to 1985 and random population controls matched for age and residence. A questionnaire on occupational exposure and tobacco consumption was completed by 53 cases and 160 controls. Exposure to wood was similar for both groups, the crude relative risk (odds ratio) being 1.06; adjustment for tobacco consumption did not modify this value. Exposure to wood dust does not seem to be an occupational risk factor in the genesis of bronchial adenocarcinoma.

Adenocarcinoma↗
PubMed1988

Radiotherapy alone in carcinoma of the intact uterine cervix according to G. H. Fletcher guidelines: a French cooperative study of 1383 cases.

A French Cooperative study of 1383 cases with invasive carcinoma of the intact uterine cervix treated with radiation therapy alone, using the guidelines provided by G. H. Fletcher led to the following conclusions: The techniques of treatment were easily reproducible in 9 French centers, working in a prospective cooperative study; Results similar to those of the original study were achieved in Stages I and IIA (MDAH substaging) with a locoregional failure rate of 7%; In Stage IIB, the locoregional failure rate of 16% is also comparable in both studies; Locoregional failures in Stage III are slightly lower than those reported in Houston, probably reflecting differences in patient's prognostic factors in France and Texas; The 5-year survival rate obtained in advanced Stages (UICC FIGO staging) are among the highest in the literature (76% in Stage IIb, 62% in Stage IIIa and 50% in Stage IIIb); The rate of severe complications remains acceptable and decreased throughout the study thanks to a better use of computer dosimetry.

Female↗
PubMed1988

[Evaluation of health expenditures in the first 6 months after the diagnosis of cancer using a population register].

It is currently estimated in France, that the cost of cancer is rising to 25 billion francs, which represents approximately 6% of all health expenditure with an annual growth of 5-10%. The data from the Register of Tumors in the Doubs region have enabled us to make an evaluation of health expenditure, reimbursed by the social security system, and its distribution in relationship with the different posts (assessment, type of treatment, supervision, transport) according to the cancer site. The average cost per patient within the first 6 months of the illness has been evaluated at 26,000 F (1984). The results show major differences for the cancer sites, care facilities and posts which are budgeted for.

Cancer Care Facilities↗
PubMed1988

[Treatment of Peyronie's disease by a combination of radiotherapy and surgery. Apropos of 51 cases].

93 patients have been treated for Peyronie's disease. 51 patients with severe discomfort received less than 10 grays external radiotherapy. Six months later, 69% of the patients were satisfied. The remaining patients (31%) were operated by a contralateral plication technique. We obtained 65% good results with this technique. This protocol is indicated for patients with severe discomfort with marked deformity.

Adult↗
PubMed1987

Quality of life.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMed1987

A quantified approach to the analysis and prevention of urinary complications in radiotherapeutic treatment of cancer of the cervix.

This paper is the report of a dosimetric study of 79 urinary complications after radical radiation treatment (1975-1979) of 624 cervical uterine tumors. Treatment consisted of external irradiation (25 MeV linear accelerator) and intracavitary irradiation (Fletcher-Suit-Delclos applicator). Dosimetric-computerized studies were expressed as the maximum bladder dose on the trigone, as proposed by the I.C.R.U. Bladder doses were actually studied as a function of intracavitary irradiation and intracavitary + external irradiation. The results show a significant difference in patients with and without complications based on the dose reaching the bladder. The relative contribution of external therapy and intracavitary irradiation and their value can serve as one of the primary indicators for predicting complications. These values should be determined before placement of intracavitary sources. We found that the dose to the critical organs cannot be defined as a single number. These results argue in favor of adapting individual patient therapy based on rectal and bladder dosimetry and may be adjustable to all treatment modalities.

Brachytherapy↗
PubMed1987

[Long-term results of the treatment with physical agents exclusively in a series of cancers of the uterine cervix. Cooperative study of 1,383 cases].

The authors present a study of 1,383 cases of invasive carcinoma of the cervix treated exclusively by radiotherapy between 1970 and 1981. Combination external radiotherapy followed by intra-cavitary applications was carried out. The study was carried out in 9 different radiotherapy centres in France using the same protocol and the same recording systems. The therapeutic results which have been recorded at every stage are among the best obtained until now, with 90% success for stage I after 5 years, 80% success for stage II, 52% for stage III growths. Only 2.1% failures occurred in the cervico-vaginal region. Pelvic recurrences were 7% in stage I and IIA, 14% in stage IIB and 24% in stage III. These recurrence rates are lower than have generally been recorded. Complication rates are also low and became less as the study continued, thanks to better use of dose distribution in individual cases which took note of doses received by neighbouring organs. The prognostic value of lymphography was analysed.

Cesium Radioisotopes↗
PubMed1987

[Assessment of the quality of life].

Increases in survival rates obtained in the years with cancer patients are offset by the aggressivity of the treatments and especially by those based on antitumor drugs. So far, oncologists have addressed themselves to the notions of survival (with or without evolution of the disease), and of indicators of tumor regression and toxicity. The global notion of quality of life may be an additional parameter for weighing the impact of anticancer therapies. The assessment of the quality of life of a patient is complicated by the issue of objective versus subjective judgements. The patient's self-appreciation of his status is of primary importance, but quality of life is only a relative assessment of the patient linked to the different stages of therapy. The quest for a suitable analytical tool endowed with sufficient sensitivity and reproducibility has not yet ended. Some authors regard to psychological contact as the only satisfactory means in terms of fruitfulness, although it raises questions of quantitative estimations. Others, especially anglo-saxon authors, have compiled questionnaires to be filled out by the patients and rated them using general or itemized scores. Similar to this type of questionnaires is the technique of the linear analogs which consists in asking the patient to express an appraisal of his state by indicated a position between two extreme situations on a linear scale graded in centimeters. Some authors have prepared general questionnaires suitable to all types of cancer. Others, instead, have perfected tools specific to certain types of tumors. Finally, methods of global assessment have also been proposed, notably by Bernheim. Thus, questions arise such as the evaluation (doctor's versus patient's judgement), and that of finding a tool for assessing the physical autonomy and the well-being (in the wide sense) of the patient. In addition, such a tool should be applicable to a large number of cancer patients in order to achieve an objective evaluation of the proposed treatments. Here we report preliminary results of a study aimed at answering these different questions. Our study intended to compare: the assessment of the general condition versus the toxicity of the therapy as evaluated by the patient and the doctor; the appreciation of quality of life as determined by questionnaires and linear analogues filled out by the patients and psychological interviews. Finally, a compliance study could be made on the assessment of the quality of life in a randomized chemotherapeutic trial concerning patients with metastatic breast cancers.

Female↗